Sample records for extradural pterional approach

  1. The extended pterional approach allows excellent results for removal of anterior cranial fossa meningiomas

    Directory of Open Access Journals (Sweden)

    Jose Carlos Lynch


    Full Text Available ABSTRACT Objective To describe a unique operative strategy, instead the classical pterional approach, and to analyses it safety and effectiveness for removal of anterior cranial fossa meningiomas. Method We identify 38 patients with tuberculum sellae and olphactory groove meningiomas operated between 1986 and 2013. Medical charts, operative reports, imaging studies and clinical follow-up evaluations were reviewed and analyzed retrospectively. The pterional craniotomy is extended toward the frontal bone providing access through the subfrontal route, besides the usual anterolateral view provided by the classical pterional approach. Results Surgical mortality occurred in one patient (2.6%. Gross total resection was achieved in 27 patients (86.8%. Median time of follow-up was 69.4 months. Conclusion The extended pterional approach allows excellent results. Total removal of meningiomas of the anterior cranial fossa was obtained in 86.8 % of patients, with low morbidity and mortality.

  2. Extradural transcavernous approach to cavernous sinus cavernous hemangiomas. (United States)

    Li, Mei-Hua; Zhao, Jian-Lan; Li, Yi-Yun; Zeng, Chun-Hui; Xu, Geng-Sheng; Hong, Tao


    Cavernous sinus cavernous hemangioma (CSCH) is a rare extra-axial vascular lesion and is difficult to be removed due to their location, propensity for profuse bleeding during surgery, and relationship to complex neurovascular structures. The purpose of this study is to report our experience of the removal of CSCHs through a completely extradural transcavernous approach. Twelve patients with CSCH, who were operated through a purely extradural approach, were retrospectively studied. Clinical symptoms and signs, radiographic characteristics, operative techniques and outcomes of these patients were analyzed. Headache and visual impairment were the most common clinical symptoms, followed by facial hypesthesia and ptosis. Radiographically, CSCHs have a characteristic pattern. On computed tomography (CT) scans, CSCHs are isodense or minimally hyperdense, with an intense homogenous contrast administration. Magnetic resonance image (MRI) scans revealed well-demarcated and hypo- to isointense lesions on T1-weighted images and characteristically, markedly hyperintense lesions on T2-weighted images. The T2-weighted images showed a marked homogeneous and an intense enhancement after contrast administration. All CSCHs were treated by a completely extradural transcavernous approach. Gross total excision was achieved in all 12 patients. Post-operative complication included transient cranial nerve dysfunction for 2-3 months in eight patients, and three patients developed a permanent VI nerve palsy. The follow-up period ranged from 4 to 117 months (mean 62 months), and no patient had experienced tumor recurrence. CSCHs are rare and challenging skull base tumors. The microsurgical resection, using an extradural transcavernous approach which allows complete tumor resection with an acceptable intraoperative and postoperative complications, should be considered as a favorable choice among all treatments. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. Keyhole Approach for Clipping Intracranial Aneurysm: Comparison of Supraorbital and Pterional Keyhole Approach. (United States)

    Lan, Qing; Zhang, Hengzhu; Zhu, Qing; Chen, Ailin; Chen, Yanming; Xu, Liang; Wang, Zhongyong; Yuan, Liqun; Liu, Shihai


    The aim of this research was to compare the functional outcome and safety between supraorbital keyhole approach (SKA) and pterional keyhole approach (PKA) for clipping intracranial aneurysms. This is a retrospective study involving 318 patients with a total of 365 aneurysms who underwent keyhole surgery, comprising 195 cases in SKA group and 123 cases in PKA group. The outcome measures include Glasgow Outcome Scale, complete clipping rate, adverse events incidence, operation view angle, working distance, and surgical incision condition. Of a total of 356 aneurysms that were clipped and 9 trapped, no significant difference was observed in Glasgow Outcome Scale score, adverse events incidence, or complete clipping rate between the SKA and PKA groups. The distance from skin incision to anterior clinoid process was 5.87 ± 0.24 cm in SKA and 5.12 ± 0.27 cm in PKA. The operation view angle (from midline to the operating channel in sagittal plane) was 30°-40° in the SKA group and 60°-68° in the PKA group. Our research demonstrates that both SKA and PKA are safe and effective for most anterior circulation aneurysms and parts of posterior circulation aneurysms. The SKA exposures aneurysm better on deep and sagittal directions and is more suitable for clipping aneurysms by the contralateral approach due to the short distance. The PKA has a good exposure on the neck of aneurysm with dorsal direction of parent artery and can be used to evacuate hematoma in the temporal lobe when clipping the aneurysm. Integrating multimodal 3-dimensional images could help neurosurgeon in selecting an appropriate and effective approach. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Endoscopic extradural subtemporal approach to lateral and central skull base: a cadaveric study. (United States)

    Komatsu, Fuminari; Komatsu, Mika; Di Ieva, Antonio; Tschabitscher, Manfred


    Endoscopy has provided a less invasive approach to skull base surgery, mainly through endonasal routes, but has been limited in its applications due to potential complications. The aims of this study were to evaluate the feasibility of the purely endoscopic extradural transcranial approach to lateral and central skull base through a subtemporal keyhole and to better understand potential distortions of the related anatomy via endoscopy. Ten fresh cadaver heads were studied with 4-mm 0° and 30° endoscopes to develop the surgical approach and to identify surgical landmarks. The endoscopic extradural subtemporal approach was divided into 3 sections after exposure of the extradural space in the middle cranial fossa: 1) exposure of the lateral wall of the cavernous sinus and the preauricular infratemporal fossa; 2) anterior petrosectomy and posterior cranial fossa exploration; and 3) unroofing of the tympanic cavity and exposure of the facial nerve. This keyhole endoscopic technique clearly visualized anatomical landmarks of the lateral and central skull base via an extradural subtemporal route. The endoscopic extradural subtemporal approach was feasible. This approach could display a wide range of lateral and central skull base structures with minimal invasiveness. The use of extradural space would be key to performing safe and effective endoscopic skull base surgery. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Endoscopic extradural supraorbital approach to the temporal pole and adjacent area: technical note. (United States)

    Komatsu, Fuminari; Imai, Masaaki; Shigematsu, Hideaki; Aoki, Rie; Oda, Shinri; Shimoda, Masami; Matsumae, Mitsunori


    The authors' initial experience with the endoscopic extradural supraorbital approach to the temporal pole and adjacent area is reported. Fully endoscopic surgery using the extradural space via a supraorbital keyhole was performed for tumors in or around the temporal pole, including temporal pole cavernous angioma, sphenoid ridge meningioma, and cavernous sinus pituitary adenoma, mainly using 4-mm, 0° and 30° endoscopes and single-shaft instruments. After making a supraorbital keyhole, a 4-mm, 30° endoscope was advanced into the extradural space of the anterior cranial fossa during lifting of the dura mater. Following identification of the sphenoid ridge, orbital roof, and anterior clinoid process, the bone lateral to the orbital roof was drilled off until the dura mater of the anterior aspect of the temporal lobe was exposed. The dura mater of the temporal lobe was incised and opened, exposing the temporal pole under a 4-mm, 0° endoscope. Tumors in or around the temporal pole were safely removed under a superb view through the extradural corridor. The endoscopic extradural supraorbital approach was technically feasible and safe. The anterior trajectory to the temporal pole using the extradural space under endoscopy provided excellent visibility, allowing minimally invasive surgery. Further surgical experience and development of specialized instruments would promote this approach as an alternative surgical option.

  6. Endoscopic supraorbital extradural approach to the cavernous sinus: a cadaver study. (United States)

    Komatsu, Fuminari; Komatsu, Mika; Inoue, Tooru; Tschabitscher, Manfred


    The cavernous sinus is a small complex structure located at the central base of the skull. Recent extensive use of endoscopy has provided less invasive approaches to the cavernous sinus via endonasal routes, although transcranial routes play an important role in the approach to the cavernous sinus. The aims of this study were to evaluate the feasibility of the purely endoscopic transcranial approach to the cavernous sinus through the supraorbital keyhole and to better understand the distorted anatomy of the cavernous sinus via endoscopy. Eight fresh cadavers were studied using 4-mm 0° and 30° endoscopes to develop a surgical approach and to identify surgical landmarks. The endoscopic supraorbital extradural approach was divided into 4 stages: entry into the extradural anterior cranial fossa, exposure of the middle cranial fossa and the periorbita, exposure of the superior cavernous sinus, and exposure of the lateral cavernous sinus. This approach provided superb views of the cavernous sinus structures, especially through the clinoidal (Dolenc) triangle. The lateral wall of the cavernous sinus, including the infratrochlear (Parkinson) triangle and anteromedial (Mullan) triangle, was also clearly demonstrated. An endoscopic supraorbital extradural approach offers excellent exposure of the superior and lateral walls of the cavernous sinus with minimal invasiveness via the transcranial route. This approach could be an alternative to the conventional transcranial approach.

  7. Microsurgical resection of a cavernous angioma that involves the optic pathway using a pterional approach: a case report and literature review. (United States)

    Sun, Xi-Yan; Yu, Feng


    Cavernous angiomas affecting the optic pathway are rare. This report describes the case of a 12-year-old girl who presented with a 10-month history of right-sided blurred vision caused by a cavernous angioma affecting the right side of the optic chiasm. The computed tomography (CT) scan demonstrated a hyperdense image with calcifications. T1-weighted magnetic resonance imaging (MRI) showed a sellar mass with uneven isointensities and hyperintensities, while T2-weighted showing a heterogeneous signal, which was initially misdiagnosed as a craniopharyngioma. The patient underwent complete resection of the mass using a pterional approach, which rapidly decompresses and protects the optic nerve function, rather than conservative treatment or cranial irradiation. Postoperative histopathology confirmed the diagnosis of a cavernous angioma.

  8. Anatomic study of the pterion in Nigerian dry human skulls | Ukoha ...

    African Journals Online (AJOL)

    The pterion was 4.02 ± 0.05 and 4.01 ± 0.03 cm above the midpoint of the zygomatic arch on the right and left sides, respectively. Conclusion: These findings are important for the surgeon as the pterion junction is a common extracranial landmark in neurosurgical and surgical approaches. Key words: Frontozygomatic suture ...

  9. Bilateral Symmetrical Parietal Extradural Hematoma

    African Journals Online (AJOL)

    careful planning, adequate exposure, judicious surgical approach, and time management for good results. Key words: Bilateral extradural ... However, having two operating neurosurgeons may not always be possible and performing bilateral ...

  10. Radical resection of a craniopharyngioma via the extradural anterior temporal approach with zygomatic arch osteotomy (United States)

    Ota, Nakao; Tanikawa, Rokuya; Miyama, Masataka; Miyazaki, Takanori; Kinoshita, Yu; Matsukawa, Hidetoshi; Yanagisawa, Takeshi; Sakakibara, Fumihiro; Saito, Norihiro; Miyata, Shiro; Noda, Kosumo; Tsuboi, Toshiyuki; Takeda, Rihei; Kamiyana, Hiroyasu; Tokuda, Sadahisa


    Background: Though the extradural anterior temporal approach (EDATA) with zygomatic osteotomy is useful, there are only few reports of this approach being used for craniopharyngioma resection. Herein, we report our surgical case series and the technical importance of EDATA for the radical removal of a craniopharyngioma. Methods: We report 7 cases of craniopharyngiomas treated surgically between April 1999 and October 2015. The surgical approaches, clinical presentation, pre and postoperative radiographic examination results, surgical outcomes, and morbidity were analyzed. Results: The mean follow-up period was 89.1 months. The surgical approach was EDATA with zygomatic osteotomy in 4, combined interhemispheric translamina terminalis approach (IHTLA) and trans-sylvian anterior temporal approach (ATA) in 2, and IHTLA in 1 patient. Complete tumor resection was achieved in all cases, without any recurrence during the follow-up period. Transient morbidities were oculomotor nerve palsy in 2, and meningitis and hydrocephalus in 1 patient. There was 1 case of permanent morbidity due to hydrocephalus that needed a ventriculoperitoneal shunt, and 1 case of blindness on the operative side. Visual acuity and visual field improved in 4 cases, showed no change in 2 cases, and deteriorated in 1 case. Though the pituitary stalk was preserved in 2 cases, all 7 cases needed total hormone replacement therapy. Conclusion: EDATA with zygomatic osteotomy ensures sufficient mobility of the internal carotid artery, and provides a good lateral and look up operative view. Hence, it can be used effectively for radical resection of craniopharyngiomas through the opticocarotid space and retrocarotid space. PMID:28194297

  11. Surgical Simulation of Extradural Anterior Clinoidectomy through the Trans-superior Orbital Fissure Approach Using a Dissectable Three-dimensional Skull Base Model with Artificial Cavernous Sinus. (United States)

    Mori, Kentaro; Yamamoto, Takuji; Nakao, Yasuaki; Esaki, Takanori


    Extradural anterior clinoidectomy via the trans-superior orbital fissure (SOF) approach can provide extensive exposure of the anterior clinoid process and safe drilling under direct view. This technique requires peeling of the dura propria of the temporal lobe from the lateral wall of the SOF. Therefore, cadaveric dissection is mandatory to acquire surgical technique. However, chances for cadaveric dissection are limited. We propose modification of our three-dimensional (3-D) skull base model made from surgically dissectable artificial bone with artificial cavernous sinus including multiple membranous layers and neurovascular structures to simulate extradural anterior clinoidectomy via the trans-SOF approach. The 3-D skull base model precisely reproduced the dura propria of the temporal lobe, periosteal bridge, and inner reticular layer in the cavernous sinus and SOF using silicone and varnish. The cranial nerves and blood vessels were made from rubber fibers and vinyl tube. Simulation of extradural anterior clinoidectomy via the trans-SOF approach could be performed on the model using a high-speed drill under the operating microscope. The steps of reconstruction of the skull base model and dissection promote clear understanding of the 3-D anatomy and techniques of extradural anterior clinoidectomy via the trans-SOF approach.

  12. The localization and morphology of pterion in adult West Anatolian skulls. (United States)

    Aksu, Funda; Akyer, Sahika Pınar; Kale, Ayşin; Geylan, Serdar; Gayretli, Ozcan


    The pterion is an important skull landmark because it is located where the frontal, the great wing of sphenoid, parietal, and squamous parts of the temporal bone junction. The objectives of this study were to determine the localization and the shape of pterion on skulls and to find out the distances between the pterion and some certain anatomic landmarks on neighboring structures. The study was performed on the skulls of 128 (256 sides) adult West Anatolian people. All of the morphometric measurements of the distances between the pterion and the anatomic landmarks were performed using a Vernier caliper with an accuracy of 0.1 mm. The pterion was classified into 4 types: the sphenoparietal, frontotemporal, stellate, or epipteric types. The incidences of types of pterion in the skulls were also found as the sphenoparietal type (85.2%), the epipteric type (8.2%), the stellate type (5.5%), and the frontotemporal type (1.1%). The mean (SD) distances from the center of the pterion to the zygomatic arch were measured as 40.02 (4.06) mm and 39.88 (4.01) mm; to the frontozygomatic suture, 31.80 (4.51) mm and 31.44 (4.73) mm; to the zygomatic angle, 41.54 (4.95) mm and 41.35 (5.14) mm; to the mastoid process, 82.48 (5.45) mm and 81.81 (5.50) mm; and to the external acoustic meatus, 53.29 (4.55) mm and 56.22 (4.60) mm, on the right and left sides, respectively. The mean (SD) distances between the foremost point of pterion and the anterior edge of the lateral wall of the orbit were 31.02 (5.78) mm and 32.31 (5.79) mm on the right and left sides, respectively. The localization and the shape of pterion are of importance because it is an anatomic landmark and should be of use in surgical approaches and interventions via the pterion.

  13. Quantitative and qualitative analysis of the working area obtained by endoscope and microscope in pterional and orbitozigomatic approach to the basilar artery bifurcation using computed tomography based frameless stereotaxy: A cadaver study. (United States)

    Filipce, Venko; Ammirati, Mario


    Basilar aneurisms are one of the most complex and challenging pathologies for neurosurgeons to treat. Endoscopy is a recently rediscovered neurosurgical technique that could lend itself well to overcome some of the vascular visualization challenges associated with this pathology. The purpose of this study was to quantify and compare the basilar artery (BA) bifurcation (tip of the basilar) working area afforded by the microscope and the endoscope using different approaches and image guidance. We performed a total of 9 dissections, including pterional (PT) and orbitozygomatic (OZ) approaches bilaterally in five whole, fresh cadaver heads. We used computed tomography based image guidance for intraoperative navigation as well as for quantitative measurements. We estimated the working area of the tip of the basilar, using both a rigid endoscope and an operating microscope. Operability was qualitatively assessed by the senior authors. In microscopic exposure, the OZ approach provided greater working area (160 ± 34.3 mm(2)) compared to the PT approach (129.8 ± 37.6 mm(2)) (P > 0.05). The working area in both PT and OZ approaches using 0° and 30° endoscopes was larger than the one available using the microscope alone (P approach, both 0° and 30° endoscopes provided a working area greater than a microscopic OZ approach (P approach (P > 0.05). Integration of endoscope and microscope in both PT and OZ approaches can provide significantly greater surgical exposure of the BA bifurcation compared to that afforded by the conventional approaches alone.

  14. Outcome of Traumatic Extradural Haematoma Managed Surgically ...

    African Journals Online (AJOL)

    One patient had associated cervical spine injury and developed respiratory failure and succumbed to it. Conclusions: Extradural haematoma is a neurosurgical emergency and timely intervention gives rewarding results. Early detection and aggressive approach is needed to manage these lesions. Keywords: Epidural ...

  15. Extradural lipomatosis presenting with paraplegia.

    Directory of Open Access Journals (Sweden)

    Deogaonkar M


    Full Text Available An unusual case with spinal extradural lipomatosis in a non-obese and otherwise healthy man is reported. The patient presented with a history of weakness of legs which progressed to paraplegia over a 40 day period.

  16. Piezosurgery in Modified Pterional Orbital Decompression Surgery in Graves Disease. (United States)

    Grauvogel, Juergen; Scheiwe, Christian; Masalha, Waseem; Jarc, Nadja; Grauvogel, Tanja; Beringer, Andreas


    Piezosurgery uses microvibrations to selectively cut bone, preserving the adjacent soft tissue. The present study evaluated the use of piezosurgery for bone removal in orbital decompression surgery in Graves disease via a modified pterional approach. A piezosurgical device (Piezosurgery medical) was used in 14 patients (20 orbits) with Graves disease who underwent orbital decompression surgery in additional to drills and rongeurs for bone removal of the lateral orbital wall and orbital roof. The practicability, benefits, and drawbacks of this technique in orbital decompression surgery were recorded. Piezosurgery was evaluated with respect to safety, preciseness of bone cutting, and preservation of the adjacent dura and periorbita. Preoperative and postoperative clinical outcome data were assessed. The orbital decompression surgery was successful in all 20 orbits, with good clinical outcomes and no postoperative complications. Piezosurgery proved to be a safe tool, allowing selective bone cutting with no damage to the surrounding soft tissue structures. However, there were disadvantages concerning the intraoperative handling in the narrow space and the efficiency of bone removal was limited in the orbital decompression surgery compared with drills. Piezosurgery proved to be a useful tool in bone removal for orbital decompression in Graves disease. It is safe and easy to perform, without any danger of damage to adjacent tissue because of its selective bone-cutting properties. Nonetheless, further development of the device is necessary to overcome the disadvantages in intraoperative handling and the reduced bone removal rate. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Anatomic study of the pterion in Nigerian dry human skulls

    African Journals Online (AJOL)


    Apr 14, 2012 ... The sphenoparietal type is where the greater wing of the sphenoid articulates with parietal bone to form letter. H,[5] the frontotemporal is the type where the squamous part of the temporal bone articulates with the frontal, the. Anatomic study of the pterion in Nigerian dry human skulls. U Ukoha, CK Oranusi, ...

  18. Thoracal spinal extradural arachnoid cyst

    Directory of Open Access Journals (Sweden)

    Olcay Eser


    Full Text Available Arachnoid cyst are fluid-filled that are located between the arachnoid and piamater or duplicationof arachnoid membrane. Extradural arachnoid cysts in the spine are rare and primary are congenital or acquired. These are occurring idiopathic, posttraumatic and post arachnoiditis. A 32 year-old male patient is became a clinic with urinary retention and gait disorders. Thoracic Magnetic Resonance Imaging showed a spinal extradurally cystic mass isointense with that cerebro-spinal fluid at T7-8 level. Patient underwent an operation. The diagnosis of arachnoid cyst was made based on histopathology exam. The case was reported due to very rare occurrence of this entity.

  19. Extradural spinal meningioma: Revisiting a rare entity

    Directory of Open Access Journals (Sweden)

    Guruprasad Bettaswamy


    Full Text Available Spinal meningiomas are mostly intradural in location although at times these are associated with some extradural extensions. Purely extradural spinal meningiomas (EDSMs are however, extremely rare and when present, may cause diagnostic dilemma preoperatively. Only seven cases of pure EDSM have been reported till date. In this paper, we describe two cases of EDSM affecting the cervical spine and present their clinical profiles, radiological findings, operative management, and follow-up data, along with a review of the literature.

  20. Traumatic Extradural Hematoma in Enugu, Nigeria

    African Journals Online (AJOL)

    Acute extradural (epidural) hematoma (EDH) is a neurosurgical emergency and timely surgical intervention for significant EDH is the accepted standard for treatment. Acute (EDH) occurs in approximately 1-3% of patients with head injuries and in 5 to. 15% of patients with severe head injuries.[1] It is rare before the age of 2 ...

  1. Secondary extradural spinal manifestation of esthesioneuroblastoma. (United States)

    Hong, Bujung; Hermann, Elvis J; Feuerhake, Friedrich; Krauss, Joachim K


    Secondary spinal manifestations of esthesioneuroblastoma are rare. A 67-year-old woman was presented with an extradural spinal manifestation at the vertebra Th7 within 8 weeks after resection of an esthesioneuroblastoma. Subtotal removal of the epidural tumour was achieved combined with dorsal transpedicular stabilization. Early screening for distant metastases may be considered in patients with esthesioneuroblastoma.

  2. Primary extradural meningioma arising from the calvarium

    Directory of Open Access Journals (Sweden)

    N Ravi


    Full Text Available Meningiomas are the most common intracranial tumours. Meningiomas arising at other locations are termed primary extradural meningiomas (EDM and are rare. Here we report a case of EDM arising from the calvarium – a primary calvarial meningioma (PCM.

  3. Non-traumatic spinal extradural haematoma: magnetic resonance findings

    Energy Technology Data Exchange (ETDEWEB)

    Law, E.M.; Smith, P.J.; Fitt, G.; Hennessy, O.F. [St. Vincent`s Hospital, Fitzroy, VIC (Australia). University of Melbourne, Department of Medical Imaging


    Non-traumatic extradural spinal haematoma is an uncommon condition that is usually associated with a poor outcome. It may present acutely with signs and symptoms of major neurological dysfunction secondary to cord compression, or subacutely over a number of days or weeks with fluctuating symptoms. The exact aetiology of this condition is incompletely understood, but it is believed that the blood is venous in origin, as distinct from the arterial origin of intracranial extradural haematomas. Causes of non-traumatic extradural spinal haematoma include anticoagulation, vasculitis such as systemic lupus erythematosus (SLE), and spinal arteriovenous malformations. Conditions that may mimic an acute spinal haematoma include extradural abscess and extradural metastatic infiltration. It is important to make a diagnosis of extradural compression because surgery may offer the best hope in restoring neurological function in these patients. Imaging modalities used for the investigation of extradural haematomas include myelography, CT myelography (CTM) and MRI with or without gadolinium enhancement. The MR appearances of acute extradural abscess and extradural tumour can mimic an extradural haematoma. In subacute haematoma, owing to the magnetic properties of blood degradation products, MR is more specific in diagnosing and ageing of the haematoma. Copyright (1999) Blackwell Science Pty Ltd 11 refs., 3 figs.

  4. Primary lumbar extradural hemangiosarcoma in a dog. (United States)

    Paek, Matthew; Glass, Eric; Kent, Marc; Clifford, Craig A; De Lahunta, Alexander


    A 9 yr old castrated male golden retriever weighing 36 kg was presented for evaluation of progressive left pelvic limb paresis and fecal and urinary incontinence. MRI demonstrated an extradural, ovoid mass compressing the lumbar spinal cord. Surgical excision of the mass was performed. Histologically, the mass was consistent with hemangiosarcoma with no involvement of the adjacent vertebrae. The dog underwent a doxorubicin-based chemotherapy protocol with the addition of oral cyclophosphamide. After completion of chemotherapy, the dog was evaluated q 4 mo for restaging. Clinicopathological evidence of primary tumor recurrence or metastatic disease was not detected for 15 mo after initial diagnosis and treatment. To the authors' knowledge, this is the first report of a primary extradural hemangiosarcoma in the lumbar vertebral column in a dog. The clinical presentation, diagnosis, treatment, and outcome are also discussed.

  5. Post-operative orofacial pain, temporomandibular dysfunction and trigeminal sensitivity after recent pterional craniotomy: preliminary study. (United States)

    Brazoloto, Thiago Medina; de Siqueira, Silvia Regina Dowgan Tesseroli; Rocha-Filho, Pedro Augusto Sampaio; Figueiredo, Eberval Gadelha; Teixeira, Manoel Jacobsen; de Siqueira, José Tadeu Tesseroli


    Surgical trauma at the temporalis muscle is a potential cause of post-craniotomy headache and temporomandibular disorders (TMD). The aim of this study was to evaluate the prevalence of pain, masticatory dysfunction and trigeminal somatosensory abnormalities in patients who acquired aneurysms following pterional craniotomy. Fifteen patients were evaluated before and after the surgical procedure by a trained dentist. The evaluation consisted of the (1) research diagnostic criteria for TMD, (2) a standardized orofacial pain questionnaire and (3) a systematic protocol for quantitative sensory testing (QST) for the trigeminal nerve. After pterional craniotomy, 80% of the subjects, 12 patients, developed orofacial pain triggered by mandibular function. The pain intensity was measured by using the visual analog scale (VAS), and the mean pain intensity was 3.7. The prevalence of masticatory dysfunction was 86.7%, and there was a significant reduction of the maximum mouth opening. The sensory evaluation showed tactile and thermal hypoesthesia in the area of pterional access in all patients. There was a high frequency of temporomandibular dysfunction, postoperative orofacial pain and trigeminal sensory abnormalities. These findings can help to understand several abnormalities that can contribute to postoperative headache or orofacial pain complaints after pterional surgeries.

  6. Factors Influencing the Outcomes in Extradural Haematoma Patients ...

    African Journals Online (AJOL)

    Background: Extradural hematomas are neurosurgical emergencies and are one of the most common causes of mortality and disability after traumatic brain injury. This study aimed at evaluating the current management and factors that influence outcome in patients treated for extradural hematoma in an African setting.

  7. Air in acute Extradural Hematoma: management and outcome analysis

    Directory of Open Access Journals (Sweden)

    Satyarthee Guru Dutta


    Full Text Available Extradural hematoma with air bubbles has been described in literature. However the significance of it needs special attention with respect to prognosis. We report five case of extradural hematoma with air bubble and its management along with pertinent literature is reviewed briefly.

  8. Extradural Myxopapillary Ependymoma arising in the lower lumbar ...

    African Journals Online (AJOL)

    Spinal extradural ependymoma is a rare tumor; we report an unusual case of extradural lumbar ependymoma and review the relevant literature. A 58 years old male presented with the history of low back pain of 4 months duration radiating to both the lower limbs (left more than the right), difficulty in gripping footwear and ...

  9. Meningoencephalocele of the temporal bone: pictorial essay on transmastoid extradural-intracranial repair. (United States)

    Manjila, Sunil; Wick, Cameron C; Cramer, John; Semaan, Maroun T; Bambakidis, Nicholas C; Selman, Warren R; Megerian, Cliff A


    A spontaneous meningoencephalocele of the temporal bone may present with effusion in the middle ear, a cerebrospinal fluid leak, hearing loss, or rarely otitic meningitis. Repair of spontaneous encephaloceles in the temporal bone has been performed using transmastoid and transcranial middle fossa approaches or a combination of the two with varied results. The authors present a technical paper on the transmastoid extradural intracranial approach for the management of temporal lobe encephaloceles. Case reports and cadaver dissections are used to provide a pictorial essay on the technique. Advantages and disadvantages compared with alternative surgical approaches are discussed. Traditional transmastoid approaches are less morbid compared with a transcranial repair as they avoid brain retraction. However, in the past, there has been a higher risk of graft failure and hearing loss due to downward graft migration and a potential need for ossicular disarticulation. For the appropriate lesion, the transmastoid extradural intracranial approach lesion offers a stable meningoencephalocele repair without the comorbidity of brain retraction. The authors describe a transmastoid extradural intracranial technique via case reports and cadaver dissections for the repair of spontaneous meningoencephalocele defects larger than 2 cm. This approach provides more support to the graft compared to the conventional transmastoid repair. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. MRI findings of intraspinal extradural paragonimiasis granuloma in a child. (United States)

    Qin, Yong; Cai, Jinhua


    Spinal paragonimiasis is a rare entity. We present a unique case of paragonimiasis involving the extradural space. MR imaging of the thoracic spine showed a bean-shaped extradural mass that extended through the left intervertebral foramen to paravertebral thickened pleura. This finding offers imaging evidence to support the theory that larvae of Paragonimus migrate through perivascular or perineural tissues into the extradural space. Another MRI finding was the hemorrhagic foci in the mass, which occurs frequently in the intracranial paragonimiasis and could also be a feature of the intraspinal paragonimiasis granuloma.

  11. Cisto extradural congênito Congenital extradural cyst: a case report

    Directory of Open Access Journals (Sweden)

    Nubor O. Facure


    Full Text Available Relato de um caso de cisto extradural congênito operado com sucesso. A importância do estudo radiológico da coluna vertebral é salientada. No caso relatado foi verificado, pelo exame radiológico contrastado, existir uma comunicação entre o cisto e o espaço subaracnóideo. Os autores chamam a atenção para a necessidade da intervenção cirúrgica em tempo hábil para prevenir lesão permanente da medula espinal.A case of congenital extradural cyst successfully operated is reported. The value of the radiographic examinations of vertebral colum is emphazised. Comunication betwen the cyst and subarachnoidal space was detected mielographically. Early diagnosis followed by prompt surgery may prevent permanent spinal cord damage.

  12. Unilateral proptosis and extradural hematoma in a child with scurvy

    Energy Technology Data Exchange (ETDEWEB)

    Verma, Sumit; Sivanandan, Sindhu; Seth, Rachna; Kabra, Shushil [All India Institute of Medical Sciences (AIIMS), Department of Pediatrics, New Delhi (India); Aneesh, Mangalasseril K.; Gupta, Vaibhav [All India Institute of Medical Sciences (AIIMS), Department of Radiodiagnosis, New Delhi (India)


    We report a 3-year-old boy with unilateral proptosis, painful swelling of the right thigh and aphasia. He had radiographic evidence of scurvy in the limbs and bilateral frontal extradural hematomas with a mass lesion in the left orbit on MRI. He was treated with vitamin C and on follow-up 8 weeks later had recovered with no evidence of the orbital mass on clinical or radiological study. Scurvy manifesting as proptosis and extradural hematoma is rare. (orig.)

  13. Thoracolumbar extradural arachnoid cysts: a study of 14 consecutive cases. (United States)

    Oh, Jae Keun; Lee, Dong Youp; Kim, Tae Yup; Yi, Seong; Ha, Yoon; Kim, Keung Nyun; Shin, Hyunchul; Kim, Dong Seok; Yoon, Do Heum


    To investigate characteristic clinical and radiological features of extradural arachnoid cysts (EDACs) in the thoracolumbar region, a retrospective review of medical records and imaging studies was performed. EDACs are well known but relatively rare lesions in the thoracolumbar spinal canal. The most common site is the lower thoracic spine, and it may cause neurological symptoms by compressing the spinal cord or nerve root. In this study, the pathogenesis, symptomatology, diagnostic approach, and surgical management of EDACs will be discussed. We studied 14 consecutive patients who were surgically treated for EDACs in the thoracolumbar region at our institute between March 2000 and January 2011. The history, clinical presentations, image findings, operative findings, and surgical outcomes of these patients were retrospectively analyzed. The mean follow-up period was 28 months (range: 6-72 months). Progressive motor weakness was the predominant symptom in all patients. Nine patients had radicular leg pain and back pain in the thoracolumbar area. On MRI, the cyst compressed the dural sac and spinal cord posteriorly typically with bilateral foraminal extensions. On radiological study, a communication point with the subarachnoid was hardly observed. The surgical treatment of EDACs included complete resection of the walls and closing the communicating point with the subarachnoid space. All patients showed excellent outcomes according to Odom's criteria without recurrence. One CSF leakage and one postoperative hematoma were noted. Thoracolumbar EDAC patients presented paraparesis and leg pain. Complete excision and closing the communicating point with the subarachnoid space were the choices of treatment, and the outcomes were favorable.

  14. Extradural Dermoid Cyst of Mastoid Bone: A Case Report

    Directory of Open Access Journals (Sweden)

    Hamad S. Al-Muhaimeed


    Full Text Available Dermoid cysts of the head and neck are rare congenital benign tumors. According to the literature they represent about seven percent of all dermoids and less than one percent of all intracranial neoplasms. Extradural dermoid cysts are very rare. We report a case of intracranial extradural dermoid cyst of mastoid bone. We believe that this is the second documented extradural dermoid cyst, the first case reported in the literature (Ammirati et al., 2007 was in close relation to the petrous apex but ours is in close relation to mastoid antrum. Hearing loss was the only clinical presentation in this case, while neurological symptoms were the main presenting symptoms in the first reported case. We present our management of this rare case with respect to the clinical, radiological, histopathological, and surgical aspects and conclude that dermoid tumors, though rare, need to be included in differential diagnosis of middle ear lesions.

  15. ESTUDIO MORFOLÓGICO DEL PTERION Y ASTERION EN CRÁNEOS ADULTOS MEXICANOS. Estudio morfológico del pterion y asterion en cráneos adultos mexicanos

    Directory of Open Access Journals (Sweden)

    Rodolfo Morales Ávalos


    Full Text Available Introducción. El pterion y asterion son puntos craneométricos de confluencia sutural observables en una vista lateral del cráneo, ambos representan puntos de referencia y/o acceso dentro del campo de la neurocirugía así como puntos de importancia dentro de la antropología física y medicina legal por sus diferencias morfológicas entre las diferentes poblaciones. Materiales y Métodos. Se examinaron ochenta y cinco cráneos secos de adultos mexicanos bilateralmente, se obtuvieron las distancias promedio entre el centro del pterion y el borde posterior de la sutura frontocigomática, borde superior del arco cigomático, base de la fosa mandibular, vértice de la apófisis mastoides y el centro del asterion. Resultados. Se identificaron cuatro tipos de pterion: esfenoparietal (90%, estellar (4.12%, epiptérico (3.53% y frontotemporal (2.35%. Se identificaron dos tipos de asterion: tipo 1 (7.06% y  tipo 2 (92.94%. Conclu-siones. Los resultados obtenidos en la morfología sutural de ambos puntos y los resultados de las mediciones son de importancia para el abordaje neuroquirúrgico del cráneo, patólogos forenses y antropólogos.  Introduction. Pterion and asterion are craniometrical landmarks of sutural confluence observable in a lateral view of the skull. Both represent points of reference and/or access in the field of neurosurgery, and are aspects of importance in disciplines such as physical anthropology and legal medicine for the morphological differences between the different populations. Materials and Methods. Examinations were conducted bilaterally in 85 (eighty five dry skulls from Mexican adults. The average distances were obtained from the center of the pterion to the following landmarks: posterior edge of the frontozygomatic suture, superior edge of the zygomatic arch, base of the mandibular fossa, vertex of the mastoid process and the center of the asterion. Results. Four types of pterion were identified: sphenoparietal (90

  16. Spontaneous resolution of a small extradural haematoma in a child.

    LENUS (Irish Health Repository)

    Sinha, A K


    We report the rapid spontaneous resolution of a small extradural haematoma (EDH) in a 19-month-old child. The haematoma was managed conservatively. The child went on to make a full recovery. The authors discuss the significance of this surprising clinical finding.

  17. Factors Influencing the Outcomes in Extradural Haematoma Patients

    African Journals Online (AJOL)

    neurosurgical emergencies and are one of the most common causes of mortality and disability after traumatic brain injury. This study aimed at evaluating the current management and factors that influence outcome in patients treated for extradural hematoma in an African setting. Methods: A total of 224 consecutive patients ...

  18. Compresión medular dorsal extradural por condroma

    Directory of Open Access Journals (Sweden)

    B. B. Srota


    Full Text Available For the first time in Argentine bibliography a chondroma of the vertebra with extradural dorsal medular compression, is described. The clinical characteristics of the onset by intermitent medular claudication of Dejerine and the painless evolution until surgical intervention, are stressed. The bibliography is put up to date and the radiographics signs and the pathologic anatomy of the chondromas, are studied.

  19. Patient Profile and Outcomes of Traumatic Extradural Haematomas ...

    African Journals Online (AJOL)

    Methods: A prospective cross sectional descriptive study of patients diagnosed with extradural haematoma by CT scan conducted at the Nakuru level five hospital between 1st January 2015 and 30th November 2015. Descriptive patient demographic data, clinical presentation data, investigations, surgical treatments offered, ...

  20. MRI in primary intraspinal extradural hydatid disease: case report

    Energy Technology Data Exchange (ETDEWEB)

    Berk, C. [Department of Neurosurgery, Ankara University Faculty of Medicine, Avicenna Medical Centre, Ankara (Turkey); Ciftci, E. [Camlik Sitesi, Ankara (Turkey); Erdogan, A. [Department of Radiology, Ankara University Faculty of Medicine, Avicenna Medical Centre, Ankara (Turkey)


    A rare case of pathologically proven primary intraspinal extradural hydatid disease of the thoracic region with spinal cord compression is reported. The diagnosis was established preoperatively on the basis of the MRI findings. The patient underwent surgery and recovered completely. (orig.) With 2 figs., 12 refs.

  1. Minimally Invasive Resection of an Extradural Far Lateral Lumbar Schwannoma with Zygapophyseal Joint Sparing: Surgical Nuances and Literature Review

    Directory of Open Access Journals (Sweden)

    Vítor M. Gonçalves


    Full Text Available Introduction. Spinal schwannomas are benign nerve sheath tumors. Completely extradural schwannomas of the lumbar spine are extremely rare lesions, accounting for only 0,7–4,2% of all spinal NSTs. Standard open approaches have been used to treat these tumors, requiring extensive muscle dissection, laminectomy, radical foraminotomy, and facetectomy. In this paper the authors present the case of a minimally invasive resection of a completely extradural schwannoma. Operative technique literature review is presented. Material & Methods. A 50-year-old woman presented with progressive complains of chronic right leg pain and paresthesia. The magnetic resonance imaging revealed a giant well-encapsulated dumbbell-shaped extradural lesion at the L3-L4 level. The patient underwent a minimally invasive gross total resection of the tumor using a tubular expandable retractor system. Results. The patient had complete resolution of radiculopathy in the immediate postoperative period and she was discharged home, neurologically intact, on the second postoperative day. Postoperative MRI demonstrated no evidence of residual tumor. At latest follow-up (18 months the patient remains asymptomatic. Conclusion. Although challenging, this minimally invasive procedure is safe and effective, being an appropriate alternative, with many potential advantages, to the open approach.

  2. Minimally invasive resection of extradural dumbbell tumors of thoracic spine: surgical techniques and literature review. (United States)

    Li, Chunbo; Ye, Yun; Gu, Yutong; Dong, Jian


    Dumbbell-shaped thoracic tumors represent a distinct type of tumor and involve in both the spinal canal and the posterior thoracic cavity. Successful treatment for the tumors depends on gross total resection (GTR) via an open laminectomy and facetectomy or transthoracic transpleural approach. In this case series, we report our experiments with minimally invasive method for the removal of extradural dumbbell thoracic tumor and present related literature review. We retrospectively reviewed two patients with dumbbell-shaped thoracic tumors who underwent minimally invasive resection and unilateral transforaminal thoracic intervertebral fusion (TTIF) through unilateral paraspinal muscle approachwith a spotlight expandable tubular retractor. Clinical data, tumor characteristics, and outcomes were analyzed. Two patients underwent successful minimally invasive treatment of their spinal neoplasms. There were no procedure-related complications. The efficacy in terms of neurological recovery, pain improvement and operative variables (length of incision, operative duration, blood loss, and hospital stay) was better when compared with prior published studies. Postoperative CT image demonstrated complete resection of dumbbell tumor in the patients. The solid fusion was obtained after 3 months follow-up and there was no failure of internal fixation. If the medial border of intracanal component of extradural dumbbell tumor is near the midline of canal and the pedicles of adjacent vertebrae to tumor are intact, minimally invasive resection of tumor through unilateral paraspinal muscle approach combined with unilateral TTIF is good choice.

  3. Tumoral calcinosis presenting as an extradural mass: MR findings and pathological correlation

    Energy Technology Data Exchange (ETDEWEB)

    Iglesias, A.; Arias, M.; Brasa, J. [Unidad de Resonancia Magnetica (MEDTEC), Hospital Xeral-Cies, 36204 Vigo (Spain); Gonzalez, A. [Servicio de Anatomia Patologica, Hospital Xeral-Cies, 36204 Vigo (Spain); Conde, C. [Servicio de Neurocirugia, Hospital Xeral-Cies, 36204 Vigo (Spain)


    Two cases of idiopathic tumoral calcinosis presenting as an extradural mass are reported. There are few reports in the literature of this pathological process presenting as extradural masses, so both cases represent very unusual locations for tumoral calcinosis. Magnetic resonance imaging features and pathological correlation of these two cases are presented. Tumoral calcinosis might be considered as a rare but possible cause of extradural mass. (orig.)

  4. Acute promyelocytic leukemia presenting as an extradural mass


    Henrique Bittencourt; Antonio Lucio Teixeira Junior; Ana Beatriz Firmato Glória; Ana Flávia Leonardi Tiburcio Ribeiro; Evandro Maranhão Fagundes


    Acute promyelocytic leukemia is potentially a highly curable type of leukemia that usually presents with pancytopenia, coagulopathies and bleeding. We describe a case of an unusual presentation of acute promyelocytic leukemia. A 53 year-old male was admitted complaining of pain and weakness in his legs. He presented at examination a spastic paraparesis with a sensitive level at the eighth thoracic medullar (T8) segment. Magnetic resonance imaging showed a posterolateral extradural mass from T...

  5. Acute promyelocytic leukemia presenting as an extradural mass

    Directory of Open Access Journals (Sweden)

    Henrique Bittencourt


    Full Text Available Acute promyelocytic leukemia is potentially a highly curable type of leukemia that usually presents with pancytopenia, coagulopathies and bleeding. We describe a case of an unusual presentation of acute promyelocytic leukemia. A 53 year-old male was admitted complaining of pain and weakness in his legs. He presented at examination a spastic paraparesis with a sensitive level at the eighth thoracic medullar (T8 segment. Magnetic resonance imaging showed a posterolateral extradural mass from T6 through T8 segments with medullar compression. A complete blood count showed anemia, thrombocytopenia and the presence of promyelocytes and blasts. Marrow examination was compatible with the diagnosis of acute promyelocytic leukemia by cytogenetics and polymerase chain reaction for the PML-RARα gene. He was treated with all-trans-retinoic acid therapy plus daunorubicin and presented an all-trans-retinoic acid syndrome. Despite hematological remission, the patient presented neurologic deterioration and had to be treated with radiotherapy (total dose 3000 cGy of the extradural lesion. The patient evolved with severe sepsis and died without any recovery from his neurologic deficit. Extramedullary infiltration is a very rare complication in acute promyelocytic leukemia. Most cases are related to relapse after initial treatment with all-trans-retinoic acid. The skin and the central nervous system are the most frequently involved sites. This is possibly the first case reported of this condition in which the patient had a symptomatic extradural mass.

  6. Effect of extradural morphine on somatosensory evoked potentials to dermatomal stimulation

    DEFF Research Database (Denmark)

    Lund, C; Selmar, P; Hansen, O B


    The effect of the extradural (L2-3) administration of morphine 6 mg on early (less than 0.5 s) somatosensory evoked cortical potentials (SEP) to electrical stimulation of the L1- and S1-dermatomes was examined in eight patients. Extradural morphine did not influence SEP amplitude. SEP latency did...

  7. Imaging of extradural spinal lesions; Bildgebung extraduraler Raumforderungen

    Energy Technology Data Exchange (ETDEWEB)

    Ahlhelm, F.; Schulte-Altedorneburg, G.; Naumann, N.; Reith, W. (Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar); Nabhan, A. (Universitaetsklinikum des Saarlandes, Homburg/Saar, Klinik fuer Allgemeine und Spezielle Neurochirurgie)


    There is a wide variety of spinal extradural tumors. In addition to real neoplasms, degenerative diseases, congenital abnormalities and inflammatory disorders can be causes of extradural masses. Due to the bony boundary of the spinal canal, both benign as well as malignant masses can cause progressive neurological deficits including paraplegia. Most of the spinal tumors are benign (hemangioma of the vertebral body, degenerative diseases). In younger patients congenital abnormalities and primary tumors of the spine have to be considered, whereas in adults the list of differential diagnoses should include secondary malignancies such as metastases and lymphomas as well as metabolic disorders such as osteoporotic vertebral compression fracture and Paget's disease. Cross-sectional imaging techniques such as magnetic resonance imaging (MRI) and computed tomography (CT) of the spine often help to make a specific diagnosis of extradural spinal lesions and represent important tools for tumor staging and preoperative evaluation. (orig.) Das Spektrum der spinalen extraduralen Tumoren ist sehr gross. Neben echten Neoplasien koennen auch degenerative Veraenderungen und Anlagestoerungen sowie entzuendliche Veraenderungen Ursachen einer extraduralen Raumforderung sein. Aufgrund der knoechernen Begrenzung des Spinalkanals koennen neben Malignomen auch benigne Tumoren und degenerative spinale Veraenderungen zu progredienten neurologischen Ausfallsymptomen (einschliesslich Querschnittsymptomatik) fuehren. Die ueberwiegende Mehrzahl der extraduralen Raumforderungen der Wirbelsaeule ist benigne (Haemangiom des Wirbelkoerpers, degenerative Erkrankungen). Bei jungen Patienten sind Anlagestoerungen und primaere Wirbelsaeulentumoren zu beruecksichtigen, wogegen beim Erwachsenen an sekundaere Malignome, wie Metastasen und Lymphome sowie eine metabolische Erkrankung, wie die osteoporotische Wirbelkoerpersinterungsfraktur oder der Morbus Paget, differenzialdiagnostisch gedacht werden

  8. Extradural chondroma presenting as lumbar mass with compressive neuropathy

    Directory of Open Access Journals (Sweden)

    Jonathan Pace


    Full Text Available The identification of a soft tissue chondroma within the spine represents a rarity and is typically not included within the differential diagnosis for patients with sensory complaints of the leg. The authors describe 46-year-old female presenting with 3-week history of decreased sensation and paresthesias of the left leg. Magnetic resonance imaging of the lumbar spine demonstrated an L3 extradural soft tissue mass. She underwent an uncomplicated excision through an L3 laminectomy and exhibited complete resolution of symptoms. Pathologic examination revealed benign cartilaginous tissue; however, the authors recommend long-term follow-up for such lesions as the potential for malignant transformation is unknown.

  9. Cisto aracnóideo extradural do canal espinal Arachnoideal extradural cyst of the spinal canal. A case report

    Directory of Open Access Journals (Sweden)

    Nelson Pires Ferreira


    Full Text Available É relatado o caso de um paciente que apresentava paraparesia sensitivo-motora evolutiva, datando de um ano. As radiográficas da coluna vertebral e mielografia permitiram o diagnóstico de cisto de aracnóide extradural do canal espinal de localização torácica, que foi confirmado pelo ato cirúrgico. Os autores revisam a literatura assinalando 76 casos já publicados. São comentadas a incidência do processo patológico nos diversos grupos etários, sua localização ao longo do canal raqueano, a evolução do quadro clínico, a etiología e a fisiopatologia do crescimento do cisto, o diagnóstico, a terapêutica e o prognóstico.The case of a pacient with thoracic arachnoideal cyst is reported. There was a neurological picture of a spinal cord compression in thoracic level with analgesia and anesthesia in T12 and L1 at left. Radiographs showed compression of the pedicles with widening of interpedicular spaces of the eight to twelfth thoracic vertebrae. The myelogram and the laminectomy confirmed the hypothesis of aracnoideal cyst. This case of extradural cyst of the spinal canal is added to the 76 previously described in the literature. The incidence, etiology, phisiopathology, clinical-picture, diagnosis, surgical treatment and prognosis are discussed.

  10. Dumbbell trigeminal schwannoma in a child: complete removal by a one-stage pterional surgical approach.

    NARCIS (Netherlands)

    Verstappen, C.C.P.; Beems, T.; Erasmus, C.E.; Lindert, E.J. van


    OBJECTIVE: The objective was to describe a rare case of a trigeminal schwannoma in a child and the surgical procedure performed for therapy. PATIENT AND METHODS: A 6-year-old girl presented with tiredness, dysarthric speech and cerebellar symptoms. Imaging studies revealed a unilateral

  11. Cisto aracnóideo extradural do canal espinal

    Directory of Open Access Journals (Sweden)

    Nelson Pires Ferreira


    Full Text Available É relatado o caso de um paciente que apresentava paraparesia sensitivo-motora evolutiva, datando de um ano. As radiográficas da coluna vertebral e mielografia permitiram o diagnóstico de cisto de aracnóide extradural do canal espinal de localização torácica, que foi confirmado pelo ato cirúrgico. Os autores revisam a literatura assinalando 76 casos já publicados. São comentadas a incidência do processo patológico nos diversos grupos etários, sua localização ao longo do canal raqueano, a evolução do quadro clínico, a etiología e a fisiopatologia do crescimento do cisto, o diagnóstico, a terapêutica e o prognóstico.

  12. Thoracolumbar extradural arachnoid cyst--three surgical case reports. (United States)

    Tomii, Masato; Mizuno, Junichi; Takeda, Masaaki; Matsushima, Tadao; Itoh, Yasunobu; Numazawa, Shinichi; Matsuoka, Hidenori; Watanabe, Kazuo


    Three cases of symptomatic extradural arachnoid cyst were treated by surgery. Total excision of the cyst followed by tight closure of the fistula by suture was achieved in all 3 cases. Surgery improved the neurological deficits but urinary incontinence persisted in all three patients. Obliteration of the fistula is considered to be important at surgery from the etiological perspective of the cyst. There are many surgical options, but surgical removal of the cyst and obliteration of the communication usually leads to prompt improvement in neurological deficits. Instability, malalignment, and worsening scoliosis are well-recognized postoperative complications of excessive laminotomy, but the exposure should be wide enough to cover the cyst completely at the operation. Wide exposure of the entire cyst is preferable to avoid missing the fistula and to identify any adhesions or fistula between the cyst and the dura. Identification of the fistula location based on preoperative imaging studies is also important.

  13. Surgical Treatment of Benign Fibrous Histiocytoma as a Form of Intraspinal Extradural Tumor at Lumbar Spine


    Kim, Soo-Beom; Jang, Jee-Soo; Lee, Sang-Ho


    A benign fibrous histiocytoma (BFH) is one of the fibrohistiocytic groups of soft-tissue tumors for which spinal involvement is extremely rare. To the best of our knowledge, most spine-originating BFHs are bone tumors. We report the first case of BFH occurring in the intraspinal extradural space on the lumbar spine. A 66-year-old female presented with severe claudication symptom. The preoperative magnetic resonance images showed a huge intraspinal, extradural, thecal-sac-compressing soft-tiss...

  14. Analgesia extradural posoperatoria en pacientes con lumbotomías

    Directory of Open Access Journals (Sweden)

    Jorge Enrique Trujillo Salgado


    Full Text Available Se estudiaron los efectos analgésicos de los siguientes fármacos por vía extradural: epinefrina 0,1 mg, clonidina 0,15 mg, fentanyl 0,15 mg, morfina 2 mg y morfina 2 mg más clonidina 0,15 mg, todos añadidos a la bupivacaína 0,5, 20 mL (100. Un total de 145 pacientes fueron estudiados en forma prospectiva. El análisis estadístico se practicó mediante análisis de varianza y se compararon los tiempos de analgesia máxima y las reacciones indeseables. La clonidina superó al fentanyl en este objetivo, pero su inclusión a la mezcla bupivacaína/morfina sólo incrementó la incidencia de efectos indeseables. En este estudio resultó mejor la asociación de bupivacaína 0,5 % y morfina 2 mgThe analgesic effects of the following drugs by extradural route were studied: epinephrine 0.1 mg, clonidine 0.15 mg, fentanyl 0.15 mg, morphine 2 mg, and morphine 2 mg plus clonidine 0.15 mg, all of them added to bupivacaine 0.5 20 mL (100. A total number of 145 patients were studied in a prospective way. The statistical analysis was applied by the analysis of variance and the times of maximal analgesia and undesirable reactions were compared. Clonidine was to be better than fentanyl for this objective, but its inclusion to the mixture of bupivacaine/morphine only increased the incidence of adverse effects. It is concluded that the best combination was bupivacaine 0.5 % and morphine 2 mg

  15. Ventral extradural spinal meningeal cyst causing cord compression: neurosurgical treatment Cisto meníngeo extradural ventral do canal espinhal causando compressão medular: tratamento neurocirúrgico

    Directory of Open Access Journals (Sweden)

    Daniel Monte-Serrat Prevedello


    Full Text Available Spinal extradural meningeal cysts are typically formed by a thin fibrotic membranous capsule, macroscopically similar that of an arachnoid membrane, filled by cerebro spinal fluid and related to a nerve root or to the posterior midline. Ventral location is extremely rare and when it occurs they usually cause spinal cord herniation through the ventral dural gap. A 61 year-old man who began with a two years long history of insidious tetraparesis, spasticity and hyperreflexia in lower extremities, and flaccid atrophy of upper limbs, without sensory manifestations, is presented. Investigation through magnetic resonance imaging demonstrated an extensive spinal ventral extradural cystic collection from C6 to T11. The lesion was approached through a laminectomy and a cyst-peritoneal shunt was introduced. The cyst reduced in size significantly and the patient is asymptomatic over a 48 months follow-up. This is the first reported case of a spontaneous ventral extradural spinal meningeal cyst causing cord compression. Cyst-peritoneal shunt was effective in the treatment of the case and it should be considered in cases in which complete resection of the cyst is made more difficult or risky by the need of more aggressive surgical maneuvers.Cistos meníngeos extradurais espinhais são formados tipicamente por estreita cápsula membranosa fibrótica, macroscopicamente semelhante a uma membrana de aracnóide, repleta de líquor e relacionada com uma raiz nervosa ou com a linha média posterior. Eles são extremamente raros em posição anterior e, quando ocorrem, habitualmente causam herniação da medula espinhal pela falha dural ventral. O caso de um homem de 61 anos de idade que iniciou com tetraparesia, espasticidade e hiperreflexia em membros inferiores, e flacidez com hipotrofia nos membros superiores, sem manifestação sensitiva, é apresentado. A investigação com ressonância magnética demonstrou extensa coleção cística extradural ventral

  16. [Spinal extradural arachnoid cyst: A case report and review of literature]. (United States)

    Quillo-Olvera, Javier; Quillo-Reséndiz, Javier; Gutiérrez-Partida, Carlos-Francisco; Rodríguez-García, Manuel

    Arachnoid cysts of spine are a very rare occurrence. The aetiology still remains unclear, but the most accepted explanation is the existence of areas of weakness in the spinal dura. Symptoms depend on the location in the spine. Magnetic resonance imaging is used for its diagnosis. Management depends of clinical presentation, and the surgery is reserved for patients with neurological impairment. A case is described of 67 year-old male with myelopathy and radiculopathy symptoms, both diagnosed simultaneously. The magnetic resonance imaging was used to diagnose a thoracolumbar extradural arachnoid cyst from T12-L2 and lumbar spinal canal stenosis. The patient was treated with a puncture procedure to empty the cyst and decompress the neural elements. There was a clinical improvement of myelopathy syndrome after puncture procedure. One month later, the patient underwent a minimally invasive surgical approach to decompress the neural elements in lumbar spine, achieving improvement of the radiculopathy syndrome and neurogenic claudication in both legs. There is currently no standard minimally invasive approach to surgically treat these cysts, but if the patient has mild symptoms, clinical observation is recommended. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  17. Surgical treatment of lumbar extradural chondroma in a dog - case reportTratamento cirúrgico de condroma extradural lombar em cão - relato de caso

    Directory of Open Access Journals (Sweden)

    Paulo Vinícius Tertuliano Marinho


    Full Text Available Neoplasms originating in the spinal canal are uncommon in small animal veterinary clinic, but when present can cause significant neurological signs. Anatomically, these neoplasms can be classified as extradural, intradural-extramedullary and medullary. Extradural neoplasms are located outside the dura mater, but they can cause compression of the spinal cord. The chondromas are benign neoplasms characterized by the formation of cartilage and is rarely located in the spinal canal in both human and veterinary medicine. We describe a case of lumbar extradural chondroma in a dog that surgical decompression and removal of the mass allowed the resolution of clinical signs of paralysis with return of function of the hind limbs of the patient. As neoplasias com origem no canal medular são infrequentes na clínica veterinária de pequenos animais, porém quando presentes podem causar sinais neurológicos importantes. Anatomicamente estas neoplasias podem ser classificadas em extradural, intradural-extramedular e medular. As neoplasias extradurais estão localizadas fora da dura-máter, porém podem causar compressão da medula. Os condromas são neoplasias benignas, caracterizadas pela formação de tecido cartilaginoso sendo rara a sua localização no canal medular tanto em medicina humana como na medicina veterinária. O objetivo deste trabalho é descrever um caso de condroma extradural lombar em cão em que a descompressão cirúrgica e retirada da massa permitiu a resolução dos sinais clínicos de paralisia com retorno da função dos membros pélvicos do paciente.

  18. Lumbosacral intraspinal extradural ganglion cyst in a cat

    Directory of Open Access Journals (Sweden)

    Francesca de Strobel


    Full Text Available Case summary A 16-year-old neutered female domestic shorthair cat was referred for chronic history of reluctance to jump, stiffness of the tail and lower back pain. Mild pelvic limb ataxia, reduced perianal reflex and lumbosacral discomfort were present on neurological examination. On magnetic resonance imaging, a well-defined rounded structure of 3 mm in diameter was identified on the right dorsal aspect of the epidural space at L7–S1, causing displacement of the cauda equina. The lesion was hyperintense to spinal cord parenchyma on T2-weighted images and hypointense on T1-weighted images, consistent with a fluid-filled structure. A Lumbosacral dorsal laminectomy was performed. A clear fluid-containing structure was identified between the right L7 nerve root and the cauda equina. Following surgical excision, histopathology confirmed the cystic nature of the lesion and revealed thick disorganised sheaths of fibrocollagenous tissue and flattened mesenchymal cells lining the luminal part of the cyst wall. A diagnosis of intraspinal ganglion cyst was made. The cat recovered uneventfully. Seven months after surgery euthanasia was performed for unrelated reasons; no neurological deficits were present. Relevance and novel information This is the first reported case of intraspinal ganglion cyst in a cat. Intraspinal extradural cysts should be considered among other differential diagnoses for cats with lumbosacral myelopathy/radiculopathy.

  19. Influence of timing on the effect of continuous extradural analgesia with bupivacaine and morphine after major abdominal surgery

    DEFF Research Database (Denmark)

    Dahl, J B; Hansen, B L; Hjortsø, N C


    We have studied the effect of continuous extradural analgesia with bupivacaine and morphine, initiated before or after colonic surgery, in a double-blind, randomized study. Thirty-two patients were allocated randomly to receive an identical extradural block initiated 40 min before surgical incision...

  20. Extradural resection of the anterior clinoid process: How I do it. (United States)

    Troude, L; Bernard, F; Bauchet, G; De La Rosa Morilla, S; Roche, P H


    The anterior clinoid process shares a close relationship with the optic canal, the internal carotid artery, the superior orbital fissure and the cavernous sinus. These structures may be involved in diseases whose surgical exposure requires prior clinoid process resection. Based on operative cases we describe the different steps of this surgical technique and illustrate our surgical procedure with a video. Dividing the orbito-temporal periosteal fold is a key-step in order to optimize the elevation of the periosteal dural layer at the level of the superior orbital fissure to expose the contours of the anterior clinoid process. The clinoid tip is removed after "debulking" the bony content inside the anterior clinoid process in order to leave only a thin shell of bony contour. The bony shell is then detached from the dura, twisted and pulled out. The indications and limitations of the technique are presented. The extradural approach of the anterior clinoid process totally provides a full resection of the anterior clinoid process and safety for the paraclinoid space structures. Meticulous stepwise bony resection and optimized dura opening contribute to reduce the risk inherent to this technique. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  1. Partial lateral corpectomy associated with pediculectomy to treat extradural chondroma in a dog: technique description

    Directory of Open Access Journals (Sweden)

    P.V.T. Marinho


    Full Text Available This study aimed to describe in detail the surgical technique of partial lateral corpectomy (PLC associated with pediculectomy to treat an in vitro extradural chondroma. A 12-year old female Cocker Spaniel was seen in the hospital with proprioceptive ataxia of hind limbs associated with extradural compression between the 1st and 2nd lumbar vertebrae. The owner opted for euthanasia since the patient's condition changed due to simultaneous illnesses that culminated in a poor prognosis. The patient's body was formally ceded to perform experimental spinal decompression. The technique was effective to completely remove the epidural mass with minimal manipulation of the spinal cord.

  2. Results of radiotherapy for metastatic extradural tumors of the spine

    Energy Technology Data Exchange (ETDEWEB)

    Akagi, Yukio; Hirokawa, Yutaka; Kashiwado, Kouzo (Hiroshima Univ. (Japan). School of Medicine) (and others)


    From April 1984 through March 1989, 30 patients were treated with radiation therapy for metastatic extradural tumors of the spine associated with spinal cord compression. This is a retrospective analysis of therapeutic results in the 30 patients followed up for two months or more. The total dose was 25.0-52.5 Gy with an average dose of 42.5 Gy. The intervals between the occurrence of paralysis symptoms to the beginning of radiation therapy varied widely from 5 days to 70 days with an average of 38.2 days; it took a long time in spite of emergency candidates for radiation therapy. Therapeutic results were classified as extremely improved (++) when transverse paralysis was completely resolved, as improved (+) when subjective or objective paralysis symptoms were improved, and as unchanged (-). Five patients were evaluated as (++), 8 as (+), and unchanged (-); the effective rate was 43% (13/30). According to primary cancer, (++) was seen in one patient each with cancer of the liver, lung, prostate, and nasopharynx, and one patient with cancer of unknown origin. In addition, (+) was seen in two each with lung and breast cancer, and in single patients with lung cancer, malignant lymphoma, prostatic cancer, and multiple myeloma. The effective rate was lower as prolonging the time after the occurrence of paralysis symptoms. The effective rate was not significantly related to the severity of paralysis; 39% for complete paralysis (7/18) vs 50% for incomplete paralysis (6/12). It is important to determine the method and candidates of palliative radiation therapy to maintain the quality of life in terminal cancer. (N.K.).

  3. Unpredictability of regression of analgesia during the continuous postoperative extradural infusion of bupivacaine

    DEFF Research Database (Denmark)

    Mogensen, T; Hjortsø, N C; Bigler, D


    Twenty-four otherwise healthy patients scheduled for elective major abdominal surgery received general anaesthesia plus lumbar extradural analgesia. A loading dose of 0.5% plain bupivacaine was given to produce sensory analgesia (pin prick) from T4 to S5 and followed by a continuous infusion of 0...

  4. Direct spinal effect of intrathecal and extradural midazolam on visceral noxious stimulation in rabbits

    DEFF Research Database (Denmark)

    Crawford, M E; Jensen, F M; Toftdahl, D B


    was demonstrated using transcutaneous electrical stimulation in the areas of the neck and the lower back. The effect of intrathecal midazolam 62.5 microrgrams kg-1 was restricted to the lumbar region, demonstrating a selective action on the spinal cord. Thus extradural and intrathecal midazolam produced a dose......-dependent effect on the reflex response to visceral distension in rabbits. This effect is caused by a direct spinal action on benzodiazepine receptors in the spinal cord.......We measured alterations in a noxious visceromotor reflex in rabbits subjected to intestinal distension, after i.m., extradural or intrathecal injection of midazolam or saline. Spinal catheters were inserted and tunnelled surgically and the animals allowed to recover for 2 weeks. A balloon catheter...

  5. Gradient-echo MR imaging of the cervical spine: evaluation of extradural disease. (United States)

    VanDyke, C; Ross, J S; Tkach, J; Masaryk, T J; Modic, M T


    A prospective study was undertaken on 204 consecutive patients comparing low flip angle gradient-echo and T1-weighted spin-echo techniques in the MR evaluation of cervical extradural disease. Four patient groups were studied with varying gradient-echo TEs (6 or 13 msec) and flip angles (10 degrees or 60 degrees). Images were evaluated independently for contrast behavior and anatomy, then directly compared for conspicuity of lesions. The FLASH sequences (especially with a 10 degrees flip angle) produced better conspicuity of disease in half the imaging time. T1-weighted spin-echo sequences were more sensitive to marrow changes and intradural disease. The short TE sequence (6 msec) did not produce any diagnostic advantage over the longer TE sequence (13 msec). A fast and sensitive MR examination for cervical extradural disease combines a sagittal T1-weighted spin-echo acquisition with sagittal and axial FLASH 10 degrees sequences.

  6. Emergency radiation treatment for paraplegia caused by extradural leukemic invasion; Report of 2 cases

    Energy Technology Data Exchange (ETDEWEB)

    Murakami, Masao; Kuroda, Yasumasa; Sano, Akira (Tenri Hospital, Nara (Japan)) (and others)


    We present 2 cases of emergency radiation therapy for paraplegia caused by extradural leukemic invasion. Tumor regression was noted at 12 Gy, and complete disappearance at 20 Gy. MRI proved useful in early detection and in the follow-up. They were doing well for 14 months after irradiation. Irradiation should be the treatment of first choice for these tumors, and the detail such as radiation field, total dosage should be determined in consideration of other therapeutic measures. (author).

  7. Bilateral cortical atrophy after severe brain trauma and extradural homatoma Atrofia cortical bilateral após traumatismo cranioencefálico grave e hematoma extradural

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Louzada


    Full Text Available We report the case of a severe head injured 43-year old male patient with a large extradural hematoma, Glasgow Coma Scale 3 and dilated fixed pupils. Patient was promptly submitted to surgical evacuation of the lesion, but remained in persistent vegetative state in the post-operative time. Head computed tomography scans performed before surgery, and at early and late post-operative periods comparatively revealed extreme bilateral cortical atrophy. Late consequences of severe head trauma drastically affect the prognosis of patients, being its prevention, and neuroprotection against secondary injury still a therapeutical challenge for neurosurgeons.Relatamos o caso de um paciente de 43 anos, com traumatismo cranioencefálico grave, com grande hematoma extradural, Escala de Coma de Glasgow 3 e pupilas fixas e dilatadas. O paciente foi prontamente submetido à evacuação cirúrgica da lesão mas permaneceu em estado vegetativo persistente no período pós-operatório. As TC de crânio realizadas antes da cirurgia e nos períodos pós-operatórios precoce e tardio revelaram comparativamente extrema atrofia cerebral bilateral. As conseqüências tardias do traumatismo craniano grave afetam drasticamente o prognóstico dos pacientes, sendo sua prevenção, e a neuroproteção contra a injúria secundária ainda um desafio terapêutico para os neurocirurgiões.

  8. Resection of large invasive pituitary adenomas with individualized approach under neuronavigator guidance:a report of 17 cases

    Directory of Open Access Journals (Sweden)

    Jing-min CHENG


    Full Text Available Objective To explore the operative method and therapeutic efficacy of surgical resection of large invasive pituitary adenomas with individualized approach under neuronavigator guidance.Methods Seventeen patients(10 males and 7 females,aged from 22 to 78 years with a mean of 39.2±9.2 years suffering from large invasive pituitary adenoma of higher than Hardy IV grade hospitalized from 2004 to 2009 were involved in the present study.All procedures were performed with the assistance of neuronavigator via individualized pterion approach,subfrontal extradural approach,trans-sphenoidal approach,or combined approach.The dispersedly invasive pituitary adenomas were resected under the guidance of neuronavigator by fully utilizing the natural anatomical cleavages.All the patients received follow-up CT scanning 3 days after operation,MRI scanning 1 to 3 months after operation,and clinical follow-up ranged from 6 to 72 months.The resection extent and outcome were assessed by imaging examination and clinical results.Results Total tumor removal was achieved in 15 cases,subtotal removal in 1 case,and extensive partial removal in 1 case.The visual impairment and headache were ameliorated in most cases,but in 1 patient they were worsened.Transient diabetes insipidus occurred in 8 cases,electrolyte disturbances were observed in 2 cases,leakage of cerebrospinal fluid appeared in 2 cases,hyposmia in 2 cases,visual impairment aggravated in 1 case,oculomotor nerve and abducens nerve paralysis on the operative side in 1 case,epidural hematoma in occipital and parietal regions in 1 case.No patient died during the follow-up period.Conclusions Individualized surgical approach designed according to the growth direction of tumor under neuronavigator guidance is helpful for the operators to identify the vessels and nerves in the operative field distinctly during the operation,thus the total removal rate is improved,safely of the operation to remove large invasive pituitary


    Directory of Open Access Journals (Sweden)



    Full Text Available Introduction. Extradural anesthesia is a successfull procedure in many operations.This is also a suitable and elective anesthetic procedure in many operations have particular hemodynamic conditions. Hence the onset time on this of anesthesia is slow and the degree of sensory and motor block is relatively variable in many cases, this procedure is not accepted by anesthesiologists and surgeons. So, inspite of its priority in many cases, it is less used. Thegoal of this study is to achieve a practical and effective solution to shorten the onset of analgesia and increasing analgesic duration which studies adding ketamin to bupivacain in extradural anesthesia. Methods. This study is a double blinded randomized clinical trial. Forty adult patients in class 1 and 2 of ASA who have been candidate for elective lower limb or lower abdominal surgery in Al-zahra and Kashani medical center in 1998 were selected. Without receiving any premedications, all of the patients received 500 CC ringer lactated solution before onset of anesthesia and they were divided into 2 groups. Group 1 received 20 cc of 0.5 percent bupivacain+0.5cc of 0.9 percent normal saline. Group 2 (interventional received 20 cc of 0.5 percent bupivacain + 0.5 cc of Ketamin (25mg. The onset of sensory block and the duration of sensory and motor block were measured and compared in both groups. Results. The onset of sensory block in interventional group was shorter than in controlled group. The duration of sensory block in interventional group was longer than in controlled group. The duration of the motor block was longer in controlled group than interventional group (P < 0.05. Discussion. Adding ketamin to bupivacain results in earlier onset and longer duration of analgesia in extradural anesthesia. This effect may be due to the inhibitory effect of the ketamin on posterior nerve root activity in spinal cord which can be an effective mechanism of ketamin in making analgesia.

  10. Spinal extradural inclusion dermoid cyst mimicking pseudomeningocele, appearing after 17 years of meningomyelocele repair (United States)

    Yerramneni, Vamsi Krishna; Patibandla, M. R.; Venkateswararao, K.; Mudumba, VS


    Dermoid cysts are congenital cystic tumors arising from embryonic rests and commonest site is in the thoracic region of the spinal canal. The authors reported a case of dermoid cyst in a 17-year-old boy appearing after lumbar meningomyelocele repair at 2 months of age. The boy presented with 6 months history of gradually progressive globular swelling at the site of previous scar and weakness of the left foot. Preoperatively small extradurally protruding placode was seen attached to the swelling. The swelling was completely excised. At 1 year follow-up patient had improvement in foot weakness with magnetic resonance imaging showing no residual or recurrent lesion. PMID:24082940

  11. Lameness caused by an extradural lumbosacral foraminal synovial cyst in three German Shepherd Dogs. (United States)

    Schmökel, Hugo; Rapp, Martin


    Three German Shepherd Dogs that were presented for investigation of chronic unilateral hindlimb lameness and pain in the lumbosacral region were diagnosed with an intraspinal, extradural synovial cyst and reactive fibrosis protruding into the foramen of the lumbosacral articulation using magnetic resonance imaging and histology. This extradural mass compressed the nerve root in the foramen and the cauda equina. During a dorsal laminectomy and unilateral partial foraminotomy, the cyst and the fibrotic tissue were removed with the aid of a 2.4 mm 30° arthroscope for visualization of the foramen. The fibrotic tissue surrounding the cysts was in all cases confluent with the annulus of the intervertebral disc. The histological examination confirmed the diagnosis of a synovial cyst in all three cases by finding inflamed synovial membrane in the samples from the wall of the cyst as well as reactive fibrosis and cartilaginous metaplasia in the surrounding tissue. The three patients improved after the surgery and were pain free during the follow-up evaluations.

  12. Radiculopathy in the setting of lumbar nerve root compression due to an extradural intraforaminal lipoma: a report of 3 cases. (United States)

    Loriaux, Daniel B; Adogwa, Owoicho; Gottfried, Oren N


    A true adult spinal lipoma is an exceedingly rare cause of lumbar compression neuropathy. Only 5 cases of true extradural intraforaminal lipomas have been documented in the medical literature. The diagnostic criteria and treatment guidelines for this specific lipoma have yet to be established. This report features 3 histologically confirmed cases of extradural intraforaminal spinal lipomas that recently presented to the authors' practice. In addition, the literature was surveyed to include the 5 previously reported cases of true adult extradural intraforaminal spinal lipomas. The consistency in presentation, response to surgical intervention, and postoperative recovery in these 8 cases supports surgical intervention at the time of diagnosis. The authors' findings support elevated clinical suspicion, efficient diagnosis based on MRI, and early surgical intervention for this rare pathological entity. All cases presented in this report were symptomatic and occurred in the absence of other significant pathologies such as general spinal epidural lipomatosis, intradural lesions, tethering, or severe degenerative stenosis or herniated discs. The clinical, neuroradiological, and histological findings characteristic of a true adult extradural intraforaminal lipoma are emphasized to differentiate this lesion from the more common etiologies for lumbar compression neuropathy. Heightened awareness and clinical suspicion for the focal, foraminal spinal lipoma as a cause of radiculopathy symptoms will enable more efficient diagnosis and treatment.

  13. Quantitative electroencephalographic analysis of the biphasic concentration-effect relationship of propofol in surgical patients during extradural analgesia

    NARCIS (Netherlands)

    Kuizenga, K; Kalkman, CJ; Hennis, PJ

    We studied effects on the EEG of propofol infused at a rate of 0.5 mg kg(-1) min(-1) for 10 min in 10 healthy male surgical patients under extradural analgesia. The EEG amplitude in six frequency bands was related to arterial blood propofol concentrations and responsiveness to verbal commands. The

  14. Sensitivity, specificity and predictive value of the sensation of warmth as a method of detecting inadvertent subarachnoid injection of local anaesthetic when performing extradural blocks. (United States)

    Kalso, E; Aromaa, U; Tammisto, T


    In order to test if the rate of onset of sensation of warmth in the legs after the injection of 0.5% bupivacaine might discriminate between subarachnoid and extradural injection, 150 urological patients were allocated randomly to receive either spinal anaesthesia with isobaric (IS) or hyperbaric (HS) 0.5% bupivacaine, or extradural anaesthesia with isobaric 0.5% bupivacaine. The volume of the local anaesthetic for spinal anaesthesia and for the extradural test dose was 3-4 ml. The patients were asked to report at once if they had a sensation of warmth in the legs during or after injection of local anaesthetic. The mean time to the sensation of warmth was significantly shorter in the spinal groups (80 (SEM 10) s in IS and 76 (8.0) s in HS) than in the extradural group (558 (38) s). However, six patients in the IS and two in the HS group had no sensation of warmth.

  15. Magnetic resonance imaging of malignant extradural tumors with acute spinal cord compression

    Energy Technology Data Exchange (ETDEWEB)

    Lien, H.H.; Blomlie, V.; Heimdal, K. (Norwegian Radium Hospital, Oslo (Norway). Dept. of Diagnostic Radiology Norwegian Radium Hospital, Oslo (Norway). Dept. of Medical Oncology Norwegian Radium Hospital, Oslo (Norway). Dept. of Radiotherapy)


    Thirty-six cancer patients with extradural spinal metastatic disease and acute symptoms of spinal cord compression underwent magnetic resonance (MR) imaging at 1.5 T. Cord involvement was found in all 36, 7 of whom had lesions at 2 different sites. Vertebral metastases in addition to those corresponding to the cord compressions were detected in 27 patients, and 18 of these had widespread deposits. MR displayed the extent of the tumors in the craniocaudal and lateral directions. The ability to identify multiple sites of cord and vertebral involvement and to delineate tumor accurately makes MR the examination of choice in cancer patients with suspected spinal cord compression. It obviates the need for myelography and postmyelography CT in this group of patients. (orig.).

  16. Symptomatic Thoracic Nerve Root Herniation into an Extradural Arachnoid Cyst: Case Report and Review of the Literature. (United States)

    Shanbhag, Nagesh C; Duyff, Ruurd F; Groen, Rob J M


    Spinal extradural arachnoid cysts (SEACs) are relatively rare and usually asymptomatic. They preferentially are situated in the thoracic extradural space and almost always dorsal. SEACs may present with back pain and/or cord compression symptoms. Needle aspiration, needle fenestration, or open surgical resection/fenestration have been reported as treatment modalities. We present a 35-year-old woman who complained of radiating pain from the right lower thoracic region of her back toward the right inguinal region, which was aggravated upon defecation and straining. Magnetic resonance imaging (MRI) revealed an extradural cyst located laterally at T11-T12 level on the right, with a nerve root herniation. During a T11-T12 hemilaminectomy, on resection of the cyst wall, a nerve root was noted to be herniating into the cyst cavity through a dural defect. The nerve root was released and repositioned intradurally, followed by direct suture of the dural tear. Histologic findings of the cyst wall confirmed an arachnoid cyst. Postoperative course was uneventful without complications. Postoperative MRI confirmed a complete resection of the cyst. Five years after surgery, the patient is asymptomatic with complete recovery. Thoracic SEACs can present with radiating pain due to a transdural herniation of a thoracic nerve root into the cyst, potentially due to a mechanism of intermittent pressure gradients between the intradural and extradural spaces. MRI can prove beneficial in visualizing the nerve prolapsing into the cyst. Open resection of the cyst wall, reduction of the nerve root herniation, and subsequent direct closure of the dural tear led to complete recovery. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Extradural developmental dural root sleeve cyst presenting as a lumbar paraspinal mass with renal compression in an infant. (United States)

    Srinivas, Balaji; Joseph, Vivek; Chacko, Geeta; Rajshekhar, Vedantam


    Spinal extradural cysts do not normally present as a visible paraspinal mass or cause compression of the abdominal organs. The authors describe the case of a 9-month-old boy with multiple spinal extradural cysts. The largest of these cysts was along the right L-2 nerve root with significant extraspinal extension resulting in a visible slow-growing swelling in the right paraspinal region and radiological evidence of compression of the right kidney with hydronephrosis. Another large cyst along the left T-12 root caused radiologically evident compression of the left kidney but to a lesser degree. The patient also had monoparesis of the left lower limb and phenotypic features of Noonan syndrome. The authors performed marsupialization of the cysts, as well as repair of the fistula between the subarachnoid space and the cyst on the right side along the L-2 root and on the left side along the T-12 root. At 1-year follow-up, there was no paraspinal mass and the lower limbs exhibited normal power. Magnetic resonance imaging confirmed marked reduction in the size of the cysts and relief of the renal compression. To the authors' knowledge, their patient is the youngest reported in literature to have a spinal extradural cyst and also the first with the cyst presenting as a paraspinal mass.

  18. Neck transfixion for sacral extradural spinal meningeal cysts without spinal nerve root fibers. (United States)

    Sun, Jian-Jun; Wang, Zhen-Yu; Liu, Bin; Li, Zhen-Dong; Wu, Hai-Bo; Yen, Ru-Yu; Zheng, Mei; Teo, Mario; Liu, Isabelle Yisha


    This prospective study analyzes clinical characteristics and outcomes of sacral extradural spinal meningeal cysts (SESMC) without spinal nerve root fibers (SNRF) undergoing neck transfixion. Using the relationship between the cysts and SNRF, SESMCs were divided into two types: cysts with SNRF known as Tarlov cysts and cysts without. If the SESMCs were identified as those without SNRFs, the neck of the cyst was transfixed, ligated and the remaining cyst wall removed distal to the clip. The improved Japanese Orthopedic Association (IJOA) scoring system was used to evaluate preoperative and postoperative neurological functions of the patients. Twenty-seven patients were included in this study. The average age was 42.7 ± 11.93 years. The mean preoperative IJOA score was 17.5 ± 2.47, and postoperative IJOA score was 19.1 ± 1.41. The difference between preoperative and postoperative IJOA scores was statistically significant (t = -3.75, P = 0.001), with a significant improvement in neurological function after surgery. Among the improvements in neurological function, the most significant was bowel/bladder function (z = -2.33, P = 0.02). Most patients experienced significant improvement in their neurological function after surgery. The most significant area of neurological improvement was bowel/bladder dysfunction, however, preoperative stool or urine incontinence did not recover completely.

  19. Reconstruction of nerve root sheaths for sacral extradural spinal meningeal cysts with spinal nerve root fibers. (United States)

    Sun, Jianjun; Wang, Zhenyu; Li, Zhendong; Wu, Haibo; Yen, Ruyu; Zheng, Mei; Chang, Qing; Liu, Isabelle Yisha


    This study analyzed the clinical characteristics and outcomes of sacral extradural spinal meningeal cysts with spinal nerve root fibers treated by reconstruction of the nerve root sheaths. The relationships between the cysts and spinal nerve root fibers were examined microscopically, the cysts were partially excised, and the defects were oversewn to reconstruct the nerve root sheaths. The Improved Japanese Orthopedic Association (IJOA) scoring system was used to evaluate preoperative and postoperative neurological function. Thirty-eight patients were included in this study, with a mean age of 41.4 ± 15.57 years. The mean IJOA score was 18.8 ± 1.32 preoperatively and 19.6 ± 0.65 postoperatively, which was a significant difference (t=-3.77, P=0.001). These results indicate a significant improvement in neurological function after surgery. The most significant improvement in neurological function was sensation (z=-2.86, P=0.004), followed by bowel/bladder function (z=-2.31, P=0.02).

  20. Case Report: Intraneural Intracanalicular Ganglion Cyst of the Hypoglossal Nerve Treated by Extradural Transcondylar Approach. (United States)

    Bilgin-Freiert, Arzu; Fugleholm, Kåre; Poulsgaard, Lars


    We report a case of an intraneural ganglion cyst of the hypoglossal canal. The patient presented with unilateral hypoglossal nerve palsy, and magnetic resonance imaging showed a small lesion in the hypoglossal canal with no contrast enhancement and high signal on T2-weighted imaging. The lesion was assumed to be a cystic schwannoma of the hypoglossal nerve. Stereotactic irradiation was considered, but in accordance with the patient's wishes, surgical exploration was performed. This revealed that, rather than a schwannoma, the patient had an intraneural ganglion cyst, retrospectively contraindicating irradiation as an option. This case illustrates a very rare location of an intraneural ganglion cyst in the hypoglossal nerve. To our knowledge there are no previous reports of an intraneural ganglion cyst confined to the hypoglossal canal.

  1. Extramedullary Cavernous Hemangioma with Intradural and Extradural Growth and Clinical Symptoms of Brown-Séquard Syndrome: Case Report and Review of the Literature. (United States)

    Baldvinsdóttir, Bryndís; Erlingsdóttir, Gígja; Kjartansson, Ólafur; Ólafsson, Ingvar Hákon


    Primary spinal tumors are rare. Symptoms depend on the size and location of the tumor. A patient presented with a rare clinical finding, Brown-Séquard syndrome. The symptoms were caused by an extramedullary tumor compressing on the thoracic spinal cord. Pathologic examination showed cavernous hemangioma with growth both intradurally and extradurally. This is an extremely rare finding; to our knowledge, only 1 case report has been published before in which a spinal cavernous hemangioma had intradural and extradural growth. The clinical symptoms of Brown-Séquard syndrome have not been described before in the findings of spinal cavernous hemangiomas. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Hematoma extradural do vértex: relato de caso Epidural hematoma at the vertex: case report

    Directory of Open Access Journals (Sweden)

    Luiz Fernando Haikel Jr.


    Full Text Available Relatamos caso incomum de um paciente de 37 anos com hematoma extradural traumático do vértex com sintomas de hipertensão intracraniana. O diagnóstico foi feito através da tomografia do crânio em cortes coronais e o paciente foi submetido a craniotomia com drenagem do hematoma.We report the unusual case of a 37 years old man with an epidural traumatic hematoma at the vertex with intracranial hypertension symptoms. The diagnostic was achieved with coronal cranial tomographic scans and a craniotomy was performed for hematoma removal.

  3. Spinal extradural angiolipomas: 7 new cases and review of the literature. (United States)

    Carrasco Moro, R; Gutiérrez Cierco, J A; Martínez San Millán, J S; Pian, H; Martínez Rodrigo, M A


    We present our experience with the diagnosis and treatment of spinal angiolipomas (SAL). We used our database of surgical patients to gather epidemiological, clinical, diagnostic, treatment, and follow-up data from confirmed cases of SAL. Patients' functional status was evaluated using the modified Japanese Orthopaedic Association (mJOA) score for thoracic myelopathy. We included 7 patients with ages ranging between 42 and 63 years; 4 were women. Lesions in all patients were located in the thoracic epidural space; in 2 cases, lesions extended outside the spinal canal. The most frequent form of presentation was pain combined with progressive myelopathy; patients scored 5 to 9 points on the mJOA scale. Radiological findings varied; this variability clearly depended on the proportion of tumour components (cellular variant in one case, predominantly angiomatous in another, and myxoid in yet another case). Four cases displayed radiological signs of bone involvement. Surgery resulted in excellent mJOA scores except in one case (mJOA score of 10); no recurrences were detected during follow-up (periods ranging from 1 to 5 years). Extradural SAL can present with highly variable radiological and clinical features. Surgery must be tailored to each individual situation according to tumour extension; in some cases, it may include spinal reconstruction. Surgery results in excellent outcomes regardless of preoperative functional status and it is associated with low recurrence rates, even in case of incomplete resection. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Dysfunction of the temporalis muscle after pterional craniotomy for intracranial aneurysms: comparative, prospective and randomized study of one flap versus two flaps dieresis Disfunção do músculo temporal após craniotomia pterional para tratamento de aneurismas intracranianos: estudo comparativo, prospectivo e aleatório da diérese em camada única versus camada dupla

    Directory of Open Access Journals (Sweden)



    Full Text Available Patients with intracranial aneurysm(s of the carotid artery territory, treated with pterional craniotomy, were prospectively and randomly addressed to one layer flap (n=36 or myocutaneous (MC versus two layers' dieresis (n=32 or interfascial (IF. The study protocol included the patient's sex, age, area of craniotomy, time of flap dieresis and synthesis, time of bone dieresis and synthesis, the intracranial time, including dura mater dieresis and synthesis and time of flap retraction. Before and after surgery, the patients were evaluated with examination specially oriented to V and VII cranial nerves, bi-temporal diameter measurement, the symmetry of the temporal region, tempora-mandibularis joint (TMJ movements and cranial CT scan. The evaluations of the TMJ dysfunctions were postoperative pain, movement limitations at mastication, occlusion, mouth aperture and lateral movements of the jaw. The statistical analysis showed that the incidence of pain at TMJ and moderate and severe temporalis muscle atrophy was observed, comparing MC and IF, and there were significant differences among these ones, being greater in IF group. We concluded that both techniques permit equivalent access to the studied intracranial aneurysm(s, and the atrophy of temporalis muscle, pain and movement limitations of the temporomandibularis joint were prevalent, worse and more long-lasting in two-layers flap dieresis than in one-layer flap dieresis.Pacientes com aneurisma(s intracraniano(s foram tratados pela via pterional e de modo prospectivo e aleatório submetidos às variantes técnicas, miocutânea (MC(n=36 ou em retalho único e interfascial (IF (n=32 ou em retalho duplo. No protocolo foram anotados o sexo, idade, área da craniotomia, período de diérese e síntese do retalho, período de diérese e síntese óssea, o período do procedimento intracraniano, incluindo o tempo de diérese e síntese da dura-máter e o período de retração do retalho. Os pacientes

  5. Aggressive or conservative management in extradural hematomas in children – a challenging neurosurgical choice

    Directory of Open Access Journals (Sweden)

    Tascu A.


    Full Text Available epidural hematomas (EDH in children appear as a consequence of head trauma. Although emergency surgical intervention was the classical neurosurgical treatment for EDH, lately there has been observed a tendency to replace operation by conservative management, whenever the neurological status and imaging appearance allows it. The aim of this article is to present our experience in treating EDH in children 0-3 years old and to establish a management protocol for EDH in infants, by evaluating the clinical and neuroimaging status, of both surgically and conservatively treated patients, from hospital admission to discharge. Retrospective study includes 52 patients diagnosed with an extradural hematoma, admitted in the First Neurosurgery Department of the Clinical Hospital ‘Bagdasar-Arseni’ in Bucharest, from January 2004 to December 2013. The patients were identified by diagnosis from the clinic’s database; clinical and imaging data was extracted from the patient’s individual records and crosschecked with the operating protocols. Cerebral CT scan was the preferred imaging investigation for diagnosis. Our study includes 52 patients (26 boys and 26 girls, with a mean age of 14.5 months (range 6 weeks - 3 years old. 25 patients were surgically treated, while the other 27 received symptomatic medication and were monitored clinically and by imaging exams. The most frequent clinical manifestations were intracranial hypertension (21 patients and psychomotor agitation (19 patients. The traumatic mechanisms were: accidental falling (38 patients, blunt head trauma (3 patients, road accident (2 patients, unspecified (8 patients other causes (1 patient. Based on the Glasgow Coma Scale classification of TBI, 39 patients suffered a mild TBI, 7 a moderate TBI and 6 patients suffered a severe TBI. Most of the patients had a good recovery; there was a total of two deaths. The most common location for the EDHs was parietal (20 patients and temporal-parietal (11

  6. Langerhans’ cell histiocytosis involving posterior elements of the dorsal spine: An unusual cause of extradural spinal mass in an adult (United States)

    Tyagi, Devendra K.; Balasubramaniam, Srikant; Savant, Hemant V.


    Langerhans cell histiocytosis (LCH) is a clonal proliferation of Langerhans cells occurring as an isolated lesion or as part of a systemic proliferation. It is commoner in children younger than 10 years of age with sparing of the posterior elements in more than 95% of cases. We describe a case of LCH in an adult female presenting with paraplegia. MRI revealed a well-defined extradural contrast enhancing mass at D2-D4 vertebral level involving the posterior elements of spine. D2-5 laminectomy with excision of lesion was performed which lead to marked improvement of patients neurological status. Histopathology was suggestive of eosinophilic granuloma. We describe the case, discuss its uniqueness and review the literature on this rare tumor presentation. PMID:23125497

  7. Langerhans' cell histiocytosis involving posterior elements of the dorsal spine: An unusual cause of extradural spinal mass in an adult. (United States)

    Tyagi, Devendra K; Balasubramaniam, Srikant; Savant, Hemant V


    Langerhans cell histiocytosis (LCH) is a clonal proliferation of Langerhans cells occurring as an isolated lesion or as part of a systemic proliferation. It is commoner in children younger than 10 years of age with sparing of the posterior elements in more than 95% of cases. We describe a case of LCH in an adult female presenting with paraplegia. MRI revealed a well-defined extradural contrast enhancing mass at D2-D4 vertebral level involving the posterior elements of spine. D2-5 laminectomy with excision of lesion was performed which lead to marked improvement of patients neurological status. Histopathology was suggestive of eosinophilic granuloma. We describe the case, discuss its uniqueness and review the literature on this rare tumor presentation.

  8. Langerhans′ cell histiocytosis involving posterior elements of the dorsal spine: An unusual cause of extradural spinal mass in an adult

    Directory of Open Access Journals (Sweden)

    Devendra K Tyagi


    Full Text Available Langerhans cell histiocytosis (LCH is a clonal proliferation of Langerhans cells occurring as an isolated lesion or as part of a systemic proliferation. It is commoner in children younger than 10 years of age with sparing of the posterior elements in more than 95% of cases. We describe a case of LCH in an adult female presenting with paraplegia. MRI revealed a well-defined extradural contrast enhancing mass at D2-D4 vertebral level involving the posterior elements of spine. D2-5 laminectomy with excision of lesion was performed which lead to marked improvement of patients neurological status. Histopathology was suggestive of eosinophilic granuloma. We describe the case, discuss its uniqueness and review the literature on this rare tumor presentation.

  9. Olfactory Groove Meningiomas: Comparison of Extent of Frontal Lobe Changes After Lateral and Bifrontal Approaches. (United States)

    Nanda, Anil; Maiti, Tanmoy K; Bir, Shyamal C; Konar, Subhas K; Guthikonda, Bharat


    Olfactory groove meningiomas often are behaviorally silent. Numerous surgical approaches have been described in the literature for the successful removal of these meningiomas. Lateral (pterional/frontolateral) and anterior (bifrontal/fronto-orbito-basal) approaches with their various modifications remain the 2 major corridors in resecting them. In this study, we discuss our experience in microsurgical treatment of these tumors at our institution and assess the extent of frontal lobe damage after the resection of tumor. We reviewed the medical records of patients who underwent surgical excision of olfactory groove meningiomas from 1990 to 2014. To measure the extent of frontal lobe damage via lateral and anterior approaches, we measured the volume of porencephalic cave in the postoperative magnetic resonance imaging by using Brainlab software. The ratio of volume of porencephalic cave to tumor was measured between 2 sides and 2 approaches. Fifty-seven patients with olfactory groove meningiomas, who underwent 62 microsurgical resection procedures in 1990-2014 were included in the study (74% were more than 5 cm at presentation). Pterional and bifrontal craniotomies were the most commonly used approaches. At follow-up, the volume of porencephalic cave after lateral approach was significantly less in the side contralateral to craniotomy irrespective of tumor size. The difference between ratio of volume of porencephalic cave and initial tumor was significantly less after lateral approaches, when compared to anterior approaches. Lateral approaches (pterional/frontolateral) resulted in less frontal lobe change and better olfactory preservation in comparison to anterior approaches in present series. Published by Elsevier Inc.

  10. Cranio-orbital approach for complex aneurysmal surgery.

    LENUS (Irish Health Repository)

    Kelleher, M O


    Certain aneurysms of the anterior circulation continue to offer a technical challenge for safe exposure and clipping. The purpose of this paper was to describe the cranio-orbital approach for surgical clipping of complex aneurysms and to evaluate prospectively the associated complications of this approach. Prospective audit of all patients undergoing cranio-orbital approach for aneurysm surgery from 1997 to 2004 by the senior author. Twenty-five patients, eight male and 17 female, median age of 52 years, range 28-73. All patients had a standard pterional approach supplemented by an orbital osteotomy. In the 7-year period 367 patients underwent treatment for their aneurysms (169 clipped and 198 coiled). Of the 169 patients who were operated on, 29 had a skull base approach, of which 25 were cranio-orbital. The aneurysm location was as follows: 16 middle cerebral artery (MCA), three carotid bifurcation, four anterior communicating artery (ACOMM), one ophthalmic and one basilar. There were no approach-related complications. The cranio-orbital craniotomy can be a useful adjunct in the surgical treatment of giant or complex aneurysms. It offers the following advantages over a standard pterional approach: reduces operative distance; allows easy splitting of the sylvian fissure; and provides a wide arc of exposure with multiple working corridors.

  11. Análise epidemiológica de 210 casos de hematoma extradural traumático tratados cirurgicamente

    Directory of Open Access Journals (Sweden)

    João Luiz Vitorino Araujo

    Full Text Available OBJETIVO: Analisar aspectos da epidemiologia, apresentação clínica e radiológica de pacientes com hematoma extradural traumático (HED submetidos a procedimento neurocirúrgico. MÉTODOS: Foi realizada a revisão de prontuários de 210 pacientes admitidos no Serviço de Emergência com HED diagnosticados através de tomografia computadorizada, tratados cirurgicamente no período de agosto de 1998 a janeiro de 2008. Foram analisados: idade, sexo, apresentação clínica e radiológica, mecanismo de trauma e status neurológico no momento da alta hospitalar. RESULTADOS: Em 49,2% o mecanismo de trauma foi queda; 89,2% dos pacientes eram do gênero masculino; 49,7% dos casos tinham Escala de Coma de Glasgow (ECG entre 13-15; 61% dos pacientes tinham idade entre 20-49 anos; A localização do HED em 26,5% e 19,6% dos casos foi têmporo-parietal e temporal, respectivamente; 32,8% tinham lesões intracranianas associadas, sendo a fratura craniana evidenciada em cerca de 45% dos casos; 76,2% dos pacientes tratados cirurgicamente tiveram alta com déficit mínimo ou ausência de déficit neurológico. CONCLUSÃO: Observamos que o HED, na população de estudo, apresenta-se mais frequentemente no gênero masculino, na quarta década de vida, mais relacionado às quedas. Na admissão, observamos uma ECG entre 13 e 15, sendo pertinente mencionar o envolvimento da região têmporo-parietal na maioria dos casos. Acreditamos que o conhecimento da epidemiologia do hematoma extradural traumático pode auxiliar na elaboração de medidas de saúde pública, visando à prevenção e identificação precoce desta doença em determinada população.

  12. Comparative outcomes of the two types of sacral extradural spinal meningeal cysts using different operation methods: a prospective clinical study.

    Directory of Open Access Journals (Sweden)

    Jian-Jun Sun

    Full Text Available This prospective study compares different clinical characteristics and outcomes of patients with two types of sacral extradural spinal meningeal cysts (SESMC undergoing different means of surgical excision. Using the relationship between the cysts and spinal nerve roots fibers (SNRF as seen under microscope, SESMCs were divided into two types: cysts with SNRF known as Tarlov cysts and cysts without. The surgical methods were tailored to the different types of SESMCs. The improved Japanese Orthopedic Association (IJOA scoring system was used to evaluate preoperative and postoperative neurological function of the patients. Preoperative IJOA scores were 18.5 ± 1.73, and postoperative IJOA scores were 19.6 ± 0.78. The difference between preoperative and postoperative IJOA scores was statistically significant (t = -4.52, p = 0.0001, with a significant improvement in neurological function after surgery. Among the improvements in neurological functions, the most significant was sensation (z=-2.74, p=0.006, followed by bowel/bladder function (z=-2.50, p=0.01. There was a statistically significant association between the types of SESMC and the number (F=12.57, p=0.001 and maximum diameter (F=8.08, p=0.006 of the cysts. SESMC with SNRF are often multiple and small, while cysts without SNRF tend to be solitary and large. We advocate early surgical intervention for symptomatic SESMCs in view of significant clinical improvement postoperatively.

  13. Intradural spine surgery may not carry an increased risk of shunt revision compared with extradural spine surgery in pediatric patients with myelomeningocele. (United States)

    Kuhn, Elizabeth N; Hopson, Betsy; Conklin, Michael J; Blount, Jeffrey P


    OBJECTIVE Patients with myelomeningocele are often affected by scoliosis and tethered cord syndrome, and frequently require spine surgery. Intradural spine surgeries may carry an inherently higher risk of inducing shunt malfunction due to entry into the subarachnoid space. In this study, the authors sought to compare rates of shunt malfunction after intradural and extradural spine surgeries among pediatric patients with myelomeningocele. METHODS The authors reviewed records of the National Spina Bifida Program Registry for Children's Hospital of Alabama. The Exago reporting function was used to identify patients who had received at least one of the following procedures: shunt revision, tethered cord release (TCR), or spinal fusion for deformity. The registry records were reviewed for all identified patients to determine if a shunt revision was performed within the 1st year after TCR or spinal fusion. RESULTS Final analyses included 117 patients, of whom 39 underwent spinal fusion and 78 underwent TCR. Among patients who underwent spinal fusion, shunt revision was performed within 30 days in 2 patients (5.1%), within 60 days in 2 (5.1%), within 90 days in 4 (10.3%), and within 1 year in 5 (12.8%). Among patients who underwent TCR, shunt revision was performed within 30 days in 7 patients (9.0%), within 60 days in 10 (12.8%), within 90 days in 11 (14.1%), and within 1 year in 17 (21.8%). Using the log-rank test, there was no significant difference in Kaplan-Meier curves between intradural and extradural groups (p = 0.59). CONCLUSIONS In a review of single-institution registry data, the authors found no statistically significant difference in the risk of shunt malfunction after intradural and extradural spine surgeries.

  14. A 2011 Updated Systematic Review and Clinical Practice Guideline for the Management of Malignant Extradural Spinal Cord Compression

    Energy Technology Data Exchange (ETDEWEB)

    Loblaw, D. Andrew, E-mail: [Department of Radiation Oncology, Sunnybrook Health Science Centre, University of Toronto, Toronto (Canada); Mitera, Gunita [Department of Radiation Oncology, Sunnybrook Health Science Centre, University of Toronto, Toronto (Canada); Ford, Michael [Division of Orthopedic Surgery, Sunnybrook Health Science Centre, University of Toronto, Toronto (Canada); Laperriere, Normand J. [Department of Radiation Oncology, Princess Margaret Hospital/University Health Network, University of Toronto, Toronto (Canada)


    Purpose: To update the 2005 Cancer Care Ontario practice guidelines for the diagnosis and treatment of adult patients with a suspected or confirmed diagnosis of extradural malignant spinal cord compression (MESCC). Methods: A review and analysis of data published from January 2004 to May 2011. The systematic literature review included published randomized control trials (RCTs), systematic reviews, meta-analyses, and prospective/retrospective studies. Results: An RCT of radiation therapy (RT) with or without decompressive surgery showed improvements in pain, ambulatory ability, urinary continence, duration of continence, functional status, and overall survival. Two RCTs of RT (30 Gy in eight fractions vs. 16 Gy in two fractions; 16 Gy in two fractions vs. 8 Gy in one fraction) in patients with a poor prognosis showed no difference in ambulation, duration of ambulation, bladder function, pain response, in-field failure, and overall survival. Retrospective multicenter studies reported that protracted RT schedules in nonsurgical patients with a good prognosis improved local control but had no effect on functional or survival outcomes. Conclusions: If not medically contraindicated, steroids are recommended for any patient with neurologic deficits suspected or confirmed to have MESCC. Surgery should be considered for patients with a good prognosis who are medically and surgically operable. RT should be given to nonsurgical patients. For those with a poor prognosis, a single fraction of 8 Gy should be given; for those with a good prognosis, 30 Gy in 10 fractions could be considered. Patients should be followed up clinically and/or radiographically to determine whether a local relapse develops. Salvage therapies should be introduced before significant neurologic deficits occur.

  15. Hemophilia and child abuse as possible causes of epidural hematoma: case report Hemofilia e abuso infantil como possíveis causas de hematoma extradural: relato de caso

    Directory of Open Access Journals (Sweden)

    Fernando Campos Gomes Pinto


    Full Text Available INTRODUCTION: Head trauma is an important consequence of child abuse. Specific pathophysiological mechanisms in child abuse are responsible for the ''whiplash shaken-baby syndrome'', which would favour the occurrence of intracranial hemorrhages. CASE REPORT: We report the case of a child who developed epidural hematoma following minor-intensity head trauma. Initial diagnosis of child abuse was made, but subsequent investigation led to the diagnosis of hemophilia A. CONCLUSION: Even though epidural hematoma is not closely associated with child abuse, this aethiology must always be considered when the reported trauma mechanism is out of proportion to the magnitude of the encountered lesions.INTRODUÇÃO: Traumatismo crânio-encefálico é importante conseqüência de abuso infantil. Mecanismos fisiopatológicos específicos do abuso infantil são responsáveis pela ''whiplash shaken-baby syndrome'', o que favoreceria o aparecimento de hemorragias intracranianas. RELATO DE CASO: Relatamos o caso de uma criança que desenvolveu hematoma extradural após trauma de pequena intensidade. Foi feito diagnóstico inicial de abuso infantil, mas investigações subseqüentes levaram ao diagnóstico de hemofilia A. CONCLUSÃO: Embora o hematoma extradural não esteja intimamente relacionado com abuso infantil, esta etiologia deve ser sempre considerada quando o mecanismo de trauma relatado estiver fora de proporção com as lesões encontradas.

  16. Extradural Spinal Arachnoid Cysts

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap


    Full Text Available A 14-year-old boy with multiple spinal arachnoid cysts and paraplegia, and 37 similar cases in the literature are reviewed by neurosurgeons and radiologist at Univ of Sao Paulo, Brazil.

  17. Transjugular tubercle-preaccessory approach for ventrocaudally located PICA aneurysm. (United States)

    Horiuchi, Tetsuyoshi; Nagm, Alhusain; Hasegawa, Takatoshi; Hongo, Kazuhiro


    Posterior inferior cerebellar artery (PICA) aneurysms are often located in the ventral craniocervical junction. Such deep-seated aneurysms are usually treated with coil embolization. However, recurred and/or very small PICA aneurysms are hardly treated with an endovascular approach. We present a modification of the transcondylar fossa approach with intradural and extradural removal of the jugular tubercle. An adequate preaccessory surgical corridor was created with this novel technique. The ventocaudal PICA aneurysm was clipped through the outside of the spinal accessory nerve without surgical manipulation of other lower cranial nerves. This approach is worthwhile to avoid dysphagia.

  18. Clinical analysis of transcranial orbitotomy approach on cranio-orbital tumors. (United States)

    Jian, Tianming; Sun, Fengyuan; Tang, Dongrun; Wang, Song; Wu, Tong; Zhao, Liang


    The aims of this study were to investigate 21 cases of transcranial orbitotomy for cranio-orbital tumors and evaluate the clinical value of the surgical approach. A retrospective study was done on 21 patients with cranio-orbital tumors. According to the tumors' location, shape, boundary, and invasion on the images, coronal scalp flap approach, subfrontal approach, or pterion approach for transcranial orbitotomy was performed. The surgical route was coronal scalp flap approach in 7 cases (including 3 cases combined with lateral orbitotomy), subfrontal approach in 6 cases, or pterion approach in 8 cases (including 1 case combined with evisceration of orbit). Tumors were en bloc resection in 4 cases, block resection or curettage in 13 cases, and incomplete resection in 4 cases. Postoperatively, the mean reduction in exophthalmos was 4 mm; maximum reduction was 11 mm. Ocular movement restriction was made better in 10 of 14 patients, whereas there was no change in 4 of 14 patients. Ophthalmoplegia occurred in 2 cases, complete ptosis occurred in 3 cases, and mydriasis occurred in 3 cases. No vision loss or cerebrospinal fluid leak was observed. Fourteen patients were followed up, including 2 patients with metastatic carcinoma who died dead because of systemic metastasis; 2 patients had a recurrence (schwannoglioma and meningioma). No recurrence was found in the other 10 patients. Cranio-orbital tumors can be removed effectively through transcranial orbitotomy, whereas operative approach is convenient to the surgical procedure and can offer better exposure. Being familiar with the tumors' location, adhesion, and invasion, coupled with the skilled surgical techniques, would improve the results and reduce serious complications.

  19. Bilateral Symmetrical Parietal Extradural Hematoma

    African Journals Online (AJOL)

    left parietal trephine craniotomy was performed (to decompress dominant cerebral hemisphere and no fracture) and without disturbing the blood clot, left trephine craniotomy was performed and both hematomas were exposed. Hematomas were evacuated left followed by right and the bleeding from meningeal arteries was.

  20. Low-profile 1-piece bifrontal craniotomy for anterior skull base approach and reconstruction. (United States)

    Ozlen, Fatma; Abuzayed, Bashar; Dashti, Reza; Isler, Cihan; Tanriover, Necmettin; Sanus, Galip Zihni


    The anterior skull base is a location of many pathologic lesions. These pathologic lesions are treated by bifrontal craniotomy and anterior skull base approach, either primarily or combined with facial osteotomies. To obtain wide exposure, low-profile craniotomies are preferred. In this article, we attempt to describe our own technique of frontal craniotomy for anterior skull base approach. In this technique, the frontal bone, frontal sinus, and the superior supraorbital bar are elevated in en bloc fashion. Bicoronal skin incision is followed by dissection and retraction of the skin flap in the epigaleal plan. The pericranial galeal flap is dissected separately in subperiosteal fashion until the superior orbital rim. After dissection and retraction of the tip of the temporal muscles, bilateral pterional key burr holes and 1 or 2 parasagittal burr holes are opened. The sagittal burr hole(s) is placed in the point where the upper horizontal surface of the frontal bone slopes vertically downward the forehead. With the craniotome rotating tip (Midas F2/8TA23, Medtronic Inc, Ft Worth, TX), bone cut is made between the pterional key burr holes, passing through the superior orbital bar and the anterior wall of the frontal sinus. To minimize the brain retraction, the operating microscope is placed beside the head, and exposure from the lateral view angle is obtained. Reconstruction of the defect is performed by using pericranial galeal flap and/or Cortoss (Orthovita, Malvern, PA). With this approach, wide exposure of the anterior skull base pathologic lesions was achieved with minimal brain retraction. In the postoperative period, patients tolerated this approach well with favorable functional and cosmetic outcomes. No infections or adverse effects related to this technique or Cortoss were observed. Anterior skull base pathologic lesions can be widely exposed by low-profile bicoronal craniotomy and anterior skull base approach with minimal brain retraction. This wide

  1. Subtemporal approach to basilar tip aneurysm with division of posterior communicating artery: Technical note

    Directory of Open Access Journals (Sweden)

    Shunsuke Kakino


    Full Text Available Shunsuke Kakino, Kuniaki Ogasawara, Yoshitaka Kubo, Hideaki Nishimoto, Akira OgawaDepartment of Neurosurgery, Iwate Medical University School of Medicine, Morioka, Iwate, JapanAbstract: The subtemporal approach with division of the posterior communicating artery (PcomA is described for treating aneurysms of the basilar tip. When the ipsilateral posterior cerebral artery (PCA interferes with visibility and manipulation around the aneurysm neck and the artery is tethered by the PcomA and not mobilized, the PcomA can be divided near the junction with the PCA. The procedure permits PCA mobilization and exposes the neck of the aneurysm. We applied this procedure to a patient with a ruptured aneurysm of the basilar tip. The postoperative course was uneventful except for transient left oculomotor nerve palsy. Postoperative cerebral angiography and magnetic resonance imaging confirmed the respective disappearance of the aneurysm and no new ischemic lesions. The subtemporal approach allows safer and easier division of the PcomA near the junction to the PCA compared with the pterional approach, and the present procedure is more suitable for the subtemporal approach.Keywords: basilar tip aneurysm, subtemporal approach, posterior communicating artery

  2. [Clinical analysis of lateral supraorbital microsurgical approach for ruptured anterior circulation aneurysm]. (United States)

    Meng, Q H; Xu, J J; Wei, S C; Yu, R; Jiang, J; Wang, J; Qu, C C


    Objective: To explore the safety and efficiency of lateral supraorbital (LSO) approach for the ruptured anterior circulation aneurysm. Methods: The clinical data of 23 patients with grade Ⅰ-Ⅲ ruptured anterior circulation aneurysm via LSO at the Second Hospital of Shandong University from February 2016 to December 2016 were retrospectively analyzed. The clinical data included their clinical manifestations, radiological finding, microsurgical techniques and follow-up results. Results: All patients were diagnosed as anterior circulation aneurysm by preoperative CT angiography (CTA) or Digital Subtraction Angiography (DSA). They all accepted aneurysm clipping via LSO. The operations carried out smoothly, with no operation related complications. They were followed up for 2 to 12 months, and the Glasgow outcome scales (GOS) were 5 in 18 patients (78.3%), 4 in 2 patients (8.7%), 3 in 2 patients (8.7%), and 1 in 1 patient (4.3%). Conclusion: LSO could provide adequate exposure for the anterior circulation aneurysm, so the clipping could be carried out safely and effectively. LSO is a simple and minimally invasive surgical approach, and when it is used by the skilled master of pterion approach, its advantage could be fully played.

  3. Transfrontoethmoidal approach to medial intraconal lesions. (United States)

    Jittapiromsak, Pakrit; Deshmukh, Pushpa; Nakaji, Peter; Spetzler, Robert F; Preul, Mark C


    Object The standard superior craniotomy approach through the orbital roof is obstructed by numerous muscles, nerves, and vessels. Accessing the medial intraconal space also involves considerable brain retraction. The authors present a modified approach through the frontal sinus that overcomes these limitations. Methods Seven fixed silicone-injected cadaveric specimens were dissected bilaterally. In addition to the superior orbital wall, the ethmoidal sinuses and medial orbital wall were removed. The anatomical relationships between the major neurovascular complexes in the medial intraconal space and the optic nerve were observed. Results Intraconally, working space was created both in a "superior window" between the superior oblique and levator palpebrae muscle and in a "medial window" between the superior oblique and medial rectus muscle. The superior window mainly created an ipsilateral trajectory to the deep target. The medial window, which created a contralateral trajectory, provided a more inferior view of the medial intraconal space. Removal of the medial orbital wall further widened the exposure obtained from the superior window. The combination of these working windows makes the medial surface of the optic nerve available for exploration from multiple angles. Most of the major neurovascular complexes of the posterior orbit can be retracted safely without impinging on the optic nerve. Conclusions This novel extradural transfrontoethmoidal approach affords a direct view to the medial posterior orbit without major conflicts with intraconal neurovascular structures and requires minimal brain manipulation. The approach appears to offer advantages for medially located intraconal lesions.

  4. A comparative study of extradural anesthesia using 0.75% ropivacaine, 0.75% ropivacaine with fentanyl, and 0.75% ropivacaine with buprenorphine for cesarean section from a rural teaching hospital in India

    Directory of Open Access Journals (Sweden)

    Grace Maria George


    Full Text Available Context: The study was to compare the analgesic efficacy of three different epidural solutions - ropivacaine, ropivacaine fentanyl mixture, and ropivacaine buprenorphine mixture - for cesarean section. Materials and Methods: This was a prospective, randomized, controlled, double blind study carried out in primi parturients undergoing elective cesarean section with singleton fetus. A total of 102 parturients in the age group of 20-35 years, American Society of Anesthesiologists (ASA I or II scheduled for elective cesarean under continuous epidural anesthesia were divided into three groups using a computer-generated random number list. The test dose (3 ml 2% lignocaine with 15 μg adrenaline and 0.75% ropivacaine 12 ml were given to all parturients. In addition, normal saline 1 ml, fentanyl 50 μg, and buprenorphine 300 μg were given to Group I, II, and III respectively. Sensory block, motor block, analgesia, maternal effects, fetal outcome, and surgeons′ and parturients′ satisfaction were evaluated. Results: Onset of sensory block was faster in the fentanyl and buprenorphine groups compared to ropivacaine group (9.94 ± 0.48, 10.72 ± 0.26 versus 14.59 ± 0.34. Duration of sensory block was prolonged in buprenorphine group as compared to fentanyl and ropivacaine groups (120.41 ± 4.31 versus (95.68 ± 3.28, 98.28 ± 3.42. Duration of analgesia was prolonged in buprenorphine group compared to fentanyl and ropivacaine groups (516.38 ± 29.14 versus 327.06 ± 12.41, 285.78 ± 10.10. It proved to be safe for mother and fetus. The surgeon and the parturients were satisfied with the mode of anesthesia. Conclusion: Ropivacaine 0.75%, ropivacaine 0.75% with fentanyl 50 mg, or buprenorphine 300 mg provided safe anesthesia when given extradurally for cesarean section. Addition of both fentanyl and buprenorphine to ropivacaine hastened the onset of sensory block, while addition of buprenorphine provided prolonged excellent postoperative analgesia.

  5. Contralateral Approach to Middle Cerebral Artery Aneurysms: An Anatomical-Clinical Analysis to Improve Patient Selection. (United States)

    Meybodi, Ali Tayebi; Lawton, Michael T; Rubio, Roberto Rodriguez; Yousef, Sonia; Benet, Arnau


    A contralateral approach to aneurysm clipping in cases of bilateral middle cerebral artery (MCA) aneurysms reduces surgical time and cost. However, there is a lack of evidence for objective patient selection. In this study, we assessed the change in surgical freedom along the contralateral MCA to provide objective evidence for patient selection. Sixteen cadaveric specimens were studied. Through a pterional approach, the surgical freedom was calculated moving distally along the contralateral MCA in 5-mm increments. In addition, in a series of 19 MCA aneurysms clipped contralaterally by the senior author, the average length of the MCA from its origin to the aneurysm neck was measured on angiography. In these patients treated via a contralateral approach, the average length of the MCA segment from its origin to the aneurysm neck was 12.4 mm. Starting at the MCA origin, surgical freedom decreased significantly between all adjacent target points except at 5-10 mm from the MCA origin. After the proximal 5 mm, there is no significant decrease in surgical maneuverability within the proximal 10 mm of MCA when approached contralaterally. When compared to the average length of the MCA from its origin to the aneurysm neck in the clinical series, it can be concluded that the first 10 mm (average, 12.4 mm) of the contralateral MCA may be considered a surgical comfort zone for a contralateral approach. This criterion may be useful for patient selection for a contralateral approach in cases of multiple bilateral intracranial aneurysms. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Complicações neurológicas por osteomas dos seios paranasais: A propósito de um caso de pneumatocele extradural por osteoma do seio frontal

    Directory of Open Access Journals (Sweden)

    R. Melaragno Filho


    Full Text Available Os autores relatam o caso de um homem de 38 anos de idade que apresentava uma hemiparesia direita nítida, sem afasia, datando de cerca de um mês. O déficit motor no dimídio direito se iniciara com violenta cefaléia, rebelde ao uso de analgésicos, mas que, pouco a pouco, cedeu completamente. O exame clínico não revelou qualquer causa capaz de explicar a hemiparesia. Liqüido cefaiorraquidiano e exame oftalmoscòpico inteiramente normais. As radiografias simples do crânio mostravam opacificação de consistência compacta no seio frontal e imagem aérea, volumosa, ocupando a maior parte do hemicrânio esquerdo. Os cortes planigráficos sagitais revelaram erosão da parede posterior e do assoalho do seio frontal, sem continuidade com a coleção de ar. Durante a operação foi verificada integridade da dura mater. Dias após a intervenção, a motricidade voluntária do hemicorpo direito já havia melhorado consideravelmente e, um mês após, o exame neurológico foi totalmente negativo. Tratava-se de osteoma ebùrneo. Após estudar os aspectos otorrinolaringológicos dos osteomas dos seios frontais, os autores consideram as suas eventuais complicações. Assim, se o tumor crescer para o lado, poderá invadir a órbita, causando exoftalmo, proptose e diplopia; expandindo-se para trás, poderá erosar a parede posterior do seio frontal, ocasionando pneumatocele extradural, como ocorreu no caso registrado neste trabalho; sucessivamente, poderá também perfurar a dura mater (pneumatocele subdural, invadir o tecido cerebral (pneumatocele intracerebral e mesmo se comunicar com o ventrículo lateral (pneumatocele ventricular. Essas coleções aéreas intracranianas (pneumocéfalos são eventualidades excepcionais em doença também rara. De fato, até 1941, haviam sido registrados 321 casos de osteomas, dos quais apenas 8 se complicaram de pneumocéfalo: 2 extradurais, 4 intracerebrais e 2 ventriculares. Por outro lado, essas complica

  7. Delayed Diagnosis of Acute Extradural Haematoma

    African Journals Online (AJOL)

    normally to light. Fundoscopy showed bilateral papilledema. Power and sensations were normal in all limbs. A skull X-ray showed a linear fracture of the frontal bone. Computed tomography (CT) scan of the brain ... The classical history of deterioration in level of consciousness after a lucid interval occurs in about 50% of ...

  8. PICTORIAL INTERLUDE Primary extradural meningioma arising ...

    African Journals Online (AJOL)

    enhancement.[1-5] The most common MRI appearance is a hypo-intense. T1 and hyperintense T2 bone lesion, which shows intense homogenous contrast enhancement following IV gadolinium administration.[1-5] The dura underlying the tumour might show contrast enhancement; this is thought to be due to either dural ...

  9. Craniocervical junction diseases treatment with a minimally invasive approach

    Directory of Open Access Journals (Sweden)

    Roberto Carlos Díaz


    Full Text Available Objective: To introduce a new minimally invasive surgical approach to anterior and lateral craniocervical junction diseases, preserving the midline posterior cervical spine stabilizing elements and reducing the inherent morbidity risk associated with traditional approaches. Methods: We describe a novel surgical technique in four cases of extra-medullary anterolateral compressive lesions located in the occipito-cervical junction, including infections and intra- and/or extradural tumor lesions. We used a paramedian trasmuscular approach through an anatomical muscle corridor using a micro MaXcess(r surgical expandable retractor, with the purpose of reducing morbidity and preserving the posterior muscle and ligamentous tension band. Results: This type of surgical approach provides adequate visualization and microsurgical resection of lesions and reduces muscle manipulation and devascularisation, preserving the tension of the ligament complex. There was minimal blood loss and a decrease in postoperative pain, with rapid start of rehabilitation and shorter hospitalization times. There were no intraoperative complications, and all patients recovered from their pre-operative symptoms. Conclusions: This novel surgical technique is feasible and adequate for the occipito-atlanto-axial complex, with better results than traditional procedures.

  10. The Middle Fossa Approach for the Removal of a Trochlear Schwannoma

    Directory of Open Access Journals (Sweden)

    Andrew B. Boucher


    Full Text Available Objectives. Schwannomas originating from the trochlear nerve are extremely rare; only 30 cases have been reported in the literature. Many operative approaches have been utilized for lesion resection, but the advantages of the anterior transpetrosal approach are numerous and include excellent exposure, minimal extradural retraction of the temporal lobe, and minimal cerebrospinal fluid leaks. We report the second case of a trochlear schwannoma resected via the anterior transpetrosal approach. Setting. A 64-year-old male presented with 3-month history of diplopia and headaches. On physical examination, he was found to have a right fourth nerve palsy. Brain magnetic resonance imaging revealed a mass within the right ambient cistern compressing the adjacent midbrain. A right-sided anterior transpetrosal approach was used—which confirmed that the trochlear nerve entered the mass—to achieve gross total resection. Pathological examination confirmed diagnosis of schwannoma. The patient was discharged on postoperative day 3. He experienced a persistent fourth nerve palsy postoperatively with an otherwise normal neurological examination. Follow-up imaging confirmed complete removal of the tumor. Conclusion. The anterior transpetrosal approach is an excellent approach for removal of trochlear schwannomas involving the cisternal course of the trochlear nerve. It affords complete visualization of this anatomical region while introducing minimal morbidity.

  11. Posterior Laminoplastic Laminotomy Combined with a Paraspinal Transmuscular Approach for Removing a Lumbar Dumbbell-shaped Schwannoma: A Technical Note. (United States)

    Ngerageza, Japhet Gideon; Ito, Kiyoshi; Aoyama, Tatsuro; Murata, Takahiro; Horiuchi, Tetsuyoshi; Hongo, Kazuhiro


    The surgical strategies and methods used to treat dumbbell-shaped tumors located in the lumbar-foraminal region are controversial. Although a total facetectomy and combined intra- and extraspinal canal approach provide a wide operative field, facet fusion is required, which can be rather invasive. Here, we report a successful removal of a lumbar dumbbell-shaped schwannoma using a combined laminoplastic laminotomy with Wiltse's paraspinal surgical approach. This was performed under an operating microscope without a complete facetectomy, fusion, and posterior fixation. Briefly, we treated two patients with lumbar foraminal tumors, both dumbbell-shaped schwannomas located in the intra- and extradural portion. After a laminoplastic laminotomy, the intradural tumor was removed. The tumor located at the extracanalicular site was removed after drilling the pars interarticularis of the lamina, which was performed to enlarge the intervertebral foramen via Wiltse's paraspinal surgical approach. During surgery, facetectomy with posterior fixation was not needed to remove the intraforaminal component. There was no lumbar instability or complication after surgery. Our results suggest that a combined posterior laminoplastic laminotomy and Wiltse's paraspinal surgical approach is useful and less invasive for treating patients with lumbar foraminal tumors.

  12. Prechiasmatic transection of the optic nerve in optic nerve glioma: technical description and surgical outcome. (United States)

    Borghei-Razavi, Hamid; Shibao, Shunsuke; Schick, Uta


    Optic pathway glioma (OPG) encompasses a spectrum of findings ranging from lesions confined to the optic nerve only, lesions affecting the optic chiasm and hypothalamus, and lesions with diffuse involvement of a large part of the optic pathway and neighboring structures. The majority of pediatric low-grade astrocytomas in the optic/chiasmatic region are typical pilocytic astrocytoma. The rest of them (10 %) may be other gliomas such as fibrillary pilomyxoid astrocytoma (grade 2 WHO). The postsurgical local recurrence rate of 55 to 76 % has been reported in some histological subtypes such as pilomyxoid astrocytoma (grade 2). Performing a prechiasmatic transection might offer a new surgical option to avoid further tumor growth toward the chiasm in the optic nerve glioma with predominantly orbital manifestations. In this retrospective study, four patients (three children, two without neurofibromatosis type 1 (NF1), and one with NF1 and one adult without NF1) with optic nerve glioma without involvement of the chiasm but blindness, disfiguring proptosis, and pain of the affected eye were included. The surgical approach was performed as a combined approach from pterional extradural and intradural. Without any exceptions, vision of the contralateral eye could be preserved and did not show any deterioration after surgery or during the follow-up time between 17 and 106 months. Furthermore, in all patients, gross total tumor resection could be achieved. During follow-up observation in all patients, no further tumor progress or recurrences could be observed. None of the patients were treated postoperatively by radiotherapy or chemotherapy. Prechiasmatic transection of the optic nerve in optic nerve glioma without affecting the chiasm might offer a surgical treatment option to control tumor growth and to preserve vision of the contralateral eye.

  13. Trans-zygomatic middle cranial fossa approach to access lesions around the cavernous sinus and anterior parahippocampus: a minimally invasive skull base approach. (United States)

    Melamed, Itay; Tubbs, R Shane; Payner, Troy D; Cohen-Gadol, Aaron A


    Exposure of the cavernous sinus or anterior parahippocampus often involves a wide exposure of the temporal lobe and mobilization of the temporalis muscle associated with temporal lobe retraction. The authors present a cadaveric study to illustrate the feasibility, advantages and landmarks necessary to perform a trans-zygomatic middle fossa approach to lesions around the cavernous sinus and anterior parahippocampus. The authors performed bilateral trans-zygomatic middle fossae exposures to reach the cavernous sinus and parahippocampus in five cadavers (10 sides). We assessed the morbidity associated with this procedure and compared the indications, advantages, and disadvantages of this method versus more extensive skull base approaches. A vertical linear incision along the middle portion of the zygomatic arch was extended one finger breadth inferior to the inferior edge of the zygomatic arch. Careful dissection inferior to the arch allowed preservation of facial nerve branches. A zygomatic osteotomy was followed via a linear incision through the temporalis muscle and exposure of the middle cranial fossa floor. A craniotomy along the inferolateral temporal bone and middle fossa floor allowed extradural dissection along the middle fossa floor and exposure of the cavernous sinus including all three divisions of the trigeminal nerve. Intradural inspection demonstrated adequate exposure of the parahippocampus. Exposure of the latter required minimal or no retraction of the temporal lobe. The trans-zygomatic middle fossa approach is a simplified skull base exposure using a linear incision, which may avoid the invasivity of more extensive skull base approaches while providing an adequate corridor for resection of cavernous sinus and parahippocampus lesions. The advantages of this approach include its efficiency, ease, minimalism, preservation of the temporalis muscle, and minimal retraction of the temporal lobe.

  14. A Symptomatic Spinal Extradural Arachnoid Cyst with Lumbar Disc Herniation

    Directory of Open Access Journals (Sweden)

    Yoshinori Kadono


    Full Text Available Spinal epidural arachnoid cyst (EAC is a rare, usually asymptomatic condition of unknown origin, which typically involves the lower thoracic spine. We report a case of posttraumatic symptomatic EAC with lumbar disc herniation. A 22-year-old man experienced back pain and sciatica after a traffic accident. Neurological examination revealed a right L5 radiculopathy. Magnetic resonance imaging demonstrated a cystic lesion at the L3 to L5 level and an L4-5 disc herniation; computed tomography myelography showed that the right L5 root was sandwiched between the cyst and the herniation. A dural defect was identified during surgery. The cyst was excised completely and the defect was repaired. A herniation was excised beside the dural sac. Histology showed that the cyst wall consisted of collagen and meningothelial cells. Postoperatively the symptoms resolved. Lumbar spinal EACs are rare; such cysts may arise from a congenital dural crack and grow gradually. The 6 cases of symptomatic lumbar EAC reported in the literature were not associated with disc herniation or trauma. In this case, the comorbid disc herniation was involved in symptom progression. Although many EACs are asymptomatic, comorbid spinal disorders such as disc herniation or trauma can result in symptom progression.

  15. Hematoma extradural da fossa posterior: relato de sete casos

    Directory of Open Access Journals (Sweden)

    Mauro A. Oliveira


    Full Text Available Hematomas da fossa posterior são complicação incomum de traumatismo cra-nioencefálico. Quase invariavelmente eles ocorrem após traumatismo da região occipital e estão associados com fraturas de crânio. O diagnóstico e tratamento dessa patologia tem sido grandemente favorecido pela tomografia computadorizada. Na presente série, a maioria dos pacientes teve evolução aguda, indicando o risco potencial de um tratamento conservador. Nossos resultados (29% de mortalidade são similares àqueles previamente relatados para outras séries dessas lesões.

  16. Spinal extradural metastasis: review of current treatment options.

    NARCIS (Netherlands)

    Bartels, R.H.M.A.; Linden, Y.M. van der; Graaf, W.T.A. van der


    Bone metastases, especially to the spine, are frequently encountered during the course of a malignancy. Due to a worldwide increase of cancer incidence and to a longer life expectancy of patients with cancer, a rise in incidence of bone metastases is observed. A brief historical overview is the base

  17. Esthesioneuroblastoma located in the thoracic extradural space: Case report

    Directory of Open Access Journals (Sweden)

    Mehmet Hüseyin Akgul, MD


    Conclusion: It has been known that the metastasis of the ENB to the spinal cord is an uncommon event, and it occurs often years after initial diagnosis. MRI scan is helpful for making the diagnosis, and surgery is the treatment of choice for obtaining diagnostic tissue and debulking the tumor. Radiotherapy is also a mainstay of postoperative treatment.

  18. Traumatic Fracture of Thin Pedicles Secondary to Extradural ...

    African Journals Online (AJOL)

    Our objective is to report a technical case report, illustrating a traumatic spinal injury with multiple pedicle fractures, secondary to atrophic lumbar pedicles as well as the diagnostic workup and surgical management of this problem. Posterior lumbar decompression, resection of the meningeal cyst, ligation of the cyst ostium, ...

  19. Traumatic Fracture of Thin Pedicles Secondary to Extradural ...

    African Journals Online (AJOL)

    the surrounding structures, hyperintense signal to the. CSF on T2, partial enhancement with contrast, and possible signal void on the fast spin echo sequence ... cyst. To better define the point of communication, a diluted Omnipaque (GE Healthcare) was injected into the cyst in order to obtain an intraoperative myelogram.

  20. The rectus capitis lateralis and the condylar triangle: important landmarks in posterior and lateral approaches to the jugular foramen. (United States)

    Cohen, Michael A; Evins, Alexander I; Lapadula, Gennaro; Arko, Leopold; Stieg, Philip E; Bernardo, Antonio


    OBJECTIVE The rectus capitis lateralis (RCL) is a small posterior cervical muscle that originates from the transverse process of C-1 and inserts onto the jugular process of the occipital bone. The authors describe the RCL and its anatomical relationships, and discuss its utility as a surgical landmark for safe exposure of the jugular foramen in extended or combined skull base approaches. In addition, the condylar triangle is defined as a landmark for localizing the vertebral artery (VA) and occipital condyle. METHODS Four cadaveric heads (8 sides) were used to perform far-lateral, extended far-lateral, combined transmastoid infralabyrinthine transcervical, and combined far-lateral transmastoid infralabyrinthine transcervical approaches to the jugular foramen. On each side, the RCL was dissected, and its musculoskeletal, vascular, and neural relationships were examined. RESULTS The RCL lies directly posterior to the internal jugular vein-only separated by the carotid sheath and in some cases cranial nerve (CN) XI. The occipital artery travels between the RCL and the posterior belly of the digastric muscle, and the VA passes medially to the RCL as it exits the C-1 foramen transversarium and courses posteriorly toward its dural entrance. CNs IX-XI exit the jugular foramen directly anterior to the RCL. To provide a landmark for identification of the occipital condyle and the extradural VA without exposure of the suboccipital triangle, the authors propose and define a condylar triangle that is formed by the RCL anteriorly, the superior oblique posteriorly, and the occipital bone superiorly. CONCLUSIONS The RCL is an important surgical landmark that allows for early identification of the critical neurovascular structures when approaching the jugular foramen, especially in the presence of anatomically displacing tumors. The condylar triangle is a novel and useful landmark for identifying the terminal segment of the hypoglossal canal as well as the superior aspect of the

  1. Reshaping the zygomatic complex: A "small step" in frontotemporal craniotomy and a "big leap" in exposure. (United States)

    Mishra, Shashwat; Srivastava, Arun K; Kumar, Hitesh; Sharma, Bhawani S


    Pterional or fronto-temporal craniotomy, developed by Prof. M. G. Yasargil, is among the most familiar skull base surgery techniques. The cranio-orbito zygomatic (COZ) approach evolved to address the significant limitations of the pterional exposure in excising some parasellar lesions. Although extremely versatile, the COZ technique involves extensive dissection of the cranio-facial soft tissue and reconstruction towards the end of the procedure. The zygomatic reshaping is a minor modification of the pterional approach, which enhances the exposure possible through the classical approach and often circumvents the need for an orbito-zygomatic osteotomy. To demonstrate the technique of reshaping of the zygomatic complex for an optimum surgical exposure and cosmetic results. Between April 2013 and December 2014, 8 patients with various middle and anterior skull base lesions were operated using this technique. These patients form the clinical material for this study. The clinical details, radiological images and follow-up data of these patients were collected for this clinical series. No mortality or significant morbidity were noted in this series. The post-operative cosmetic results were also acceptable. A quick and easy modification of the classical pterional approach through zygomatic reshaping has the potential to provide a significantly enhanced surgical exposure for parasellar lesions. Using this approach, it might be possible to avoid an extensive orbito-zygomatic osteotomy in suitable lesions.

  2. Surgical excision of hypothalamic hamartoma in a twenty months old boy with precocious puberty

    Directory of Open Access Journals (Sweden)

    Rajesh K Ghanta


    Full Text Available A twenty months old boy presented to our department with true precocious puberty due to hypothalamic hamartoma. Total surgical excision of pedunculated hypothalamic hamartoma was done successfully by the pterional trans-sylvian approach as he could not afford medical management. Patient had uneventful post-operative course with normalization of serum testosterone levels and regression of secondary sexual characters.

  3. Abordaje subcraneal discusión y revisión histórica de la técnica quirúrgica Anterior subcranial approach: Discussion and historical review of the surgical technique

    Directory of Open Access Journals (Sweden)

    I. Zubillaga Rodríguez


    Full Text Available Introducción. La cirugía de la base craneal es en la actualidad una realidad que se ha ido consolidando en las últimas décadas. El vertiginoso avance tecnológico desarrollado ha actuado como motor en la evolución de las técnicas quirúrgicas que abordan dicha región anatómica. Su impulso definitivo se ha cimentado en el concepto básico de equipo multidisciplinario. Material y métodos. Se describe el abordaje subcraneal como alternativa a los tradicionales abordajes a la base craneal anterior. Discusión y revisión histórica de los distintos pasos claves en la realización del mismo. Discusión. La elección del abordaje más adecuado a la base craneal en cada caso es esencial para la obtención de resultados quirúrgicos globales satisfactorios. Inicialmente dependerá de la localización anatómica exacta de la lesión dentro de la base craneal y de su extensión tridimensional, así como de la naturaleza de la misma. El abordaje subcraneal representa un paso importante en el desarrollo de las técnicas quirúrgicas de la base craneal. Conclusiones. El abordaje subcraneal permite una amplia y óptima exposición de todos los planos de la fosa craneal anterior, desde el techo etmoidal anterior hasta el clivus-planum esfenoidale incluyendo los techos orbitarios. Este objetivo se logra sin retracción de los lóbulos frontales evitando de esta manera la morbimortalidad asociada que dicha maniobra conlleva. Favorece el manejo precoz preciso de patología oncológica con afectación intra-extradural y el tratamiento de fracturas tras impactos de alta energía con afectación de la fosa craneal anterior.Introduction. Skull base surgery is now a reality that has become consolidated over the last decades. The dizzyingly rapid technological advances that have taken place have served as a motor for the development of surgical techniques to approach this anatomic region. The foundation for the definitive push forward of this technique was

  4. Perspective of the frontolateral craniotomies Perspectivas das craniotomias frontolaterais

    Directory of Open Access Journals (Sweden)

    Eberval Gadelha Figueiredo


    Full Text Available The pterional craniotomy is one of the most frequently surgical approaches used in neurosurgery and currently it has become a mainsteam. It allows excellent microsurgical exposure of anterior and posterior regions of the arterial circle of Willis, supra and paraselar regions, the superior orbital fissure of sphenoid bone, cavernous sinus, orbit, temporal lobe, midbrain and the frontal lobe. Like others techniques, the pterional craniotomy presented disadvantages related to dissection of the temporal muscle. From the first fronto lateral craniotomy described by Dandy to expose the optic chiasm and the pituitary we pass through the Yasargil's classical description of craniotomy centered in fronto-temporal sylvian fissure until reaching the recent"minipterional craniotomy", modifications of the pterional craniotomy were proposed to reduce the extra cranial tissue trauma and reduce the area of craniotomy without affecting the exposure of surgical targets, thus improving their aesthetic and functional results. An historical analysis of the frontolateral approaches has demonstrated that they have evolved from larger craniotomies to smaller ones, however only the minipterional craniotomy is able to offer similar surgical exposure.A craniotomia pterional é um dos acessos cirúrgicos mais freqüentemente utilizados. Esta técnica permite excelente exposição microcirúrgica das regiões anterior e posterior do polígono de Willis, regiões supra-selar, fissura orbital superior do osso esfenóide, seio cavernoso, órbita, lobo temporal, mesencéfalo e lobo frontal. Como outras técnicas, a craniotomia pterional tem desvantagens relacionadas à manipulação do músculo temporal. Desde a primeira craniotomia fronto lateral descrita por Dandy para expor o quiasma óptico e a hipófise, passando pela descrição clássica de Yasrgil para craniotomia centrada na fissura silviana, até chegar em craniotomias recentes como a"minipterional", modificações da

  5. The "no-drill" technique of anterior clinoidectomy: a cranial base approach to the paraclinoid and parasellar region. (United States)

    Chang, Dongwoo John


    A high-speed power-drilling technique of anterior clinoidectomy has been advocated in all publications on paraclinoid region surgery. The entire shaft of the power drill is exposed in the operative field; thus, all neurovascular structures in proximity to any portion of the full length of the rotating drill bit are at risk for direct mechanical and/or thermal injury. Ultrasonic bone removal has recently been developed to mitigate the potential complications of the traditional power-drilling technique of anterior clinoidectomy. However, ultrasound-related cranial neuropathies are recognized complications of its use, as well as the increased cost of device acquisition and maintenance. A retrospective review of a cerebrovascular/cranial base fellowship-trained neurosurgeon's 45 consecutive cases of anterior clinoidectomy using the "no-drill" technique is presented. Clinical indications have been primarily small to giant aneurysms of the proximal internal carotid artery; however, in addition to ophthalmic segment aneurysms, selected internal carotid artery-posterior communicating artery aneurysms and internal carotid artery bifurcation aneurysms, and other large/giant/complex anterior circulation aneurysms, this surgical series of "no-drill" anterior clinoidectomy includes tuberculum sellae meningiomas, clinoidal meningiomas, cavernous sinus lesions, pituitary macroadenomas with significant suprasellar extension, other perichiasmal lesions (sarcoid), and fibrous dysplasia. A bony opening is made in the mid-to posterior orbital roof after the initial pterional craniotomy. Periorbita is dissected off the bone from inside the orbital compartment. Subsequent piecemeal resection of the medial sphenoid wing, anterior clinoid process, optic canal roof, and optic strut is performed with bone rongeurs of various sizes via the bony window made in the orbital roof. No power drilling was used in this surgical series of anterior clinoidectomies. Optimal microsurgical exposure was

  6. Capability approach

    DEFF Research Database (Denmark)

    Jensen, Niels Rosendal; Kjeldsen, Christian Christrup

    Lærebogen er den første samlede danske præsentation af den af Amartya Sen og Martha Nussbaum udviklede Capability Approach. Bogen indeholder en præsentation og diskussion af Sen og Nussbaums teoretiske platform. I bogen indgår eksempler fra såvel uddannelse/uddannelsespolitik, pædagogik og omsorg....

  7. Pedagogical approaches

    DEFF Research Database (Denmark)

    Lund Larsen, Lea

    in formal settings, but in most teaching settings, the teachers act alone and develop their pedagogical approaches/- teaching strategies with no synchronous sparring from a colleague. Adult learners have particular needs and characteristics that their teachers must be able to address (cf. Knowles......This paper is a part of an on-going qualitative empirical research project: “Teachers of adults as learners. A study on teachers’ experiences in practice”. Data is collected at a Danish Adult Education Centre. The aim of the study is to understand teachers’ learning experiences. The research...... questions are: How (much) and what do teachers learn from experience? And how do teachers of adults develop their pedagogical approach? I examine the field of adult learners from the teachers’ perspective. Firstly, I identify some of the commonly described characteristics of adults as learners...

  8. synthetic approaches

    African Journals Online (AJOL)

    Dr Mdachi

    Avances en Quimica 8: 145-151. Chen J, Zhou L, Tan CK and Yeung Y-Y. 2012 An Enantioselective Approach toward 3,4-Dihydroisocoumarin through the Bromocyclization of Styrene-type. Carboxylic Acids. J. Org. Chem.77: 999-. 1009. Chen P-Y, Wang Y-F, Chen L-Y, Wang G-. L and Wang E-C 2013 Reaction of o-.

  9. Atlanto-axial approach for cervical myelography in a Thoroughbred horse with complete fusion of the atlanto-occipital bones (United States)

    Aleman, Monica; Dimock, Abigail N.; Wisner, Erik R.; Prutton, Jamie W.; Madigan, John E.


    A 2-year-old Thoroughbred gelding with clinical signs localized to the first 6 spinal cord segments (C1 to C6) had complete fusion of the atlanto-occipital bones which precluded performing a routine myelogram. An ultrasound-assisted myelogram at the intervertebral space between the atlas and axis was successfully done and identified a marked extradural compressive myelopathy at the level of the atlas and axis, and axis and third cervical vertebrae. PMID:25392550

  10. Total resection of a solitary fibrous tumor of the sellar diaphragm: A case report




    The present study reports the case of a patient with a vision impairment in the right eye. Head computed tomography revealed a round, hyperdense mass in the sellar and suprasellar regions. Pituitary gland magnetic resonance imaging (MRI) revealed isointensity on T1- and T2-weighted imaging. Tumor-enhanced scanning showed heterogeneous contrast enhancement. The initial diagnosis was that of meningioma or pituitary tumor. A total tumor resection was performed using a right pterional approach un...

  11. Myelopathy and sciatica induced by an extradural S1 root haemangioblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Hermier, M.; Cotton, F.; Froment, J.C. [Department of Radiology, Hopital Neurologique et Neurochirurgical, Lyon (France); Saint-Pierre, G.; Jouvet, A. [Department of Neuropathology, Hopital Neurologique et Neurochirurgical, Lyon (France); Ongolo-Zogo, P. [Department of Radiology, Hopital Neurologique et Neurochirurgical, Lyon (France); Department of Radiology, Hopital Central, Yaounde (Cameroon); Fischer, G. [Department of Neurosurgery, Hopital Neurologique et Neurochirurgical, Lyon (France)


    Haemangioblastomas are vascular tumours which mainly involve the central nervous system and retina, often in the setting of von Hippel-Lindau disease. Haemangioblastomas occurring outside the central nervous system are uncommon. Wherever it is, recognising this tumour prior to surgery is desirable, as preoperative embolisation may be considered. We report the clinical, imaging and pathological features of a sporadic sacral root haemangioblastoma in a 58-year-old man with chronic sciatica and myelopathy. The diagnosis was questioned preoperatively because an enlarged sacral foramen, seen to be filled by a highly vascular, enhancing mass and dilated vessels. Myelopathy was attributed to the presumed high venous pressure resulting from increased flow in veins draining the vascular tumour. Microneurosurgical excision was performed after endovascular embolisation and led to persistent clinical improvement. (orig.)

  12. Dural permeability to narcotics: in vitro determination and application to extradural administration. (United States)

    Moore, R A; Bullingham, R E; McQuay, H J; Hand, C W; Aspel, J B; Allen, M C; Thomas, D


    The permeability of cranial and lumbar dura to various substances including a number of narcotic analgesics was measured in vitro. Preliminary data On human postmortem material is reported. Permeability had a linear relation to the inverse of the square root of molecular weight. This is the expected relationship for a diffusion process dependent upon molecular weight. The differential mass selectivity coefficients for lumbar and cranial dura were calculated; they were similar at 0.8 and 0.9. This was greater than for diffusion in simple liquids, but much less than that for biological lipid membranes. This suggests that the low rates of diffusion are a property of the thickness of the dura rather than any inherent impermeability. A simple model for the dural transfer of drugs is described, and applied to narcotics. Its purposes were to suggest: the factors involved in the dural transfer of drugs; the physicochemical properties of drugs relevant to their dural transfer; worthwhile measurements in future studies. The model indicates that drug molecular weight and rate of absorption are important determinants of the efficiency of dural transfer. Low molecular weight and slow absorption produce high dural transfers. When applied to narcotics, these factors could produce a difference of up to an order of magnitude in the amount transferred directly across the dura.

  13. Extradural spinal cord lesion in a dog: first case study of canine neurological histoplasmosis in Italy. (United States)

    Reginato, A; Giannuzzi, P; Ricciardi, M; De Simone, A; Sanguinetti, M; Porcellato, I; Mandara, M T


    A 7-year-old intact male mixed dog was presented with a history of acute and progressive paraparesis. Abnormal clinical signs consisted of non-ambulatory paraparesis, hind limbs hypertonia and severe thoracolumbar pain. Magnetic resonance imaging demonstrated an isointense in T1 and T2 WI epidural lesion, with good contrast enhancement, extending from T-10 to T-13. Laminectomy was carried out to remove the epidural mass. Histological examination revealed a pyogranulomatous lesion characterized by numerous macrophages containing yeast-like Grocott and PAS-positive bodies. Immunohistochemistry and PCR performed on formalin-fixed paraffin-embedded tissue confirmed Histoplasma capsulatum as the causative agent. H. capsulatum has a worldwide distribution in temperate and subtropical climates but its presence as an autochthonous fungus in Europe is now recognized. To the authors' knowledge this is the first report of canine histoplasmosis in Italy with lesion confined to the central nervous system. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Microsurgical Clipping of an Unruptured Carotid Cave Aneurysm: 3-Dimensional Operative Video. (United States)

    Tabani, Halima; Yousef, Sonia; Burkhardt, Jan-Karl; Gandhi, Sirin; Benet, Arnau; Lawton, Michael T


    Most aneurysms originating from the clinoidal segment of the internal carotid artery (ICA) are nowadays managed conservatively, treated endovascularly with coiling (with or without stenting) or flow diverters. However, microsurgical clip occlusion remains an alternative. This video demonstrates clip occlusion of an unruptured right carotid cave aneurysm measuring 7 mm in a 39-year-old woman. The patient opted for surgery because of concerns about prolonged antiplatelet use associated with endovascular therapy. After patient consent, a standard pterional craniotomy was performed followed by extradural anterior clinoidectomy. After dural opening and sylvian fissure split, a clinoidal flap was opened to enter the extradural space around the clinoidal segment. The dural ring was dissected circumferentially, freeing the medial wall of the ICA down to the sellar region and mobilizing the ICA out of its canal of the clinoidal segment. With the aneurysm neck in view, the aneurysm was clipped with a 45° angled fenestrated clip over the ICA. Indocyanine green angiography confirmed no further filling of the aneurysm and patency of the ICA. Complete aneurysm occlusion was confirmed with postoperative angiography, and the patient had no neurologic deficits (Video 1). This case demonstrates the importance of anterior clinoidectomy and thorough distal dural ring dissection for effective clipping of carotid cave aneurysms. Control of venous bleeding from the cavernous sinus with fibrin glue injection simplifies the dissection, which should minimize manipulation of the optic nerve. Knowledge of this anatomy and proficiency with these techniques is important in an era of declining open aneurysm cases. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Antisense RNA Approach

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Antisense RNA Approach. Antisense RNA approach is already well documented and well established in therapeutic research. Our system can also be subjected to such an approach. Which gene to target? Our objective would be to target the leader RNA as is thought ...

  16. Evaluating six soft approaches

    Directory of Open Access Journals (Sweden)

    Lene Sørensen


    Full Text Available The paper introduces and evaluates six soft approaches used in strategy development and planning. We take a planner’s perspective on discussing the concepts of strategy development and planning. This means that we see strategy development and planning as learning processes based on Ackoff’s interactive planning principles to be supported by soft approaches in carrying out the principles in action. These six soft approaches are suitable for supporting various steps of the strategy development and planning process. These are the SWOT analysis, the Future Workshop, the Scenario methodology, Strategic Option Development and Analysis, Strategic Choice Approach and Soft Systems Methodology. Evaluations of each methodology are carried out using a conceptual framework in which the organisation, the result, the process and the technology of the specific approach are taken into consideration. Using such a conceptual framework for evaluations of soft approaches increases the understanding of them, their transparency, and their usability in practice.

  17. Alternative Auditing Approaches

    Energy Technology Data Exchange (ETDEWEB)

    Kandt, Alicen J [National Renewable Energy Laboratory (NREL), Golden, CO (United States)


    This presentation for the 2017 Energy Exchange in Tampa, Florida, offers information about advanced auditing technologies and techniques including alternative auditing approaches and considerations and caveats.

  18. Revitalizing the setting approach

    DEFF Research Database (Denmark)

    Bloch, Paul; Toft, Ulla; Reinbach, Helene Christine


    impact of supersetting initiatives. The supersetting approach is an ecological approach, which places the individual in a social, environmental and cultural context, and calls for a holistic perspective to change potentials and developmental processes with a starting point in the circumstances of people...... approach is based on ecological and whole-systems thinking, and stipulates important principles and values of integration, participation, empowerment, context and knowledge-based development....... in local community settings and on the strengths of social interaction and local ownership as drivers of change processes. Interventions based on a supersetting approach are first and foremost characterised by being integrated, but also participatory, empowering, context-sensitive and knowledge...

  19. The TLC Approach. (United States)

    Welker, William A.


    Notes how the author has developed the Teaching and Learning Cues (TLC) approach, an offspring of textbook organizational patterns instruction that stresses the significance of certain words and phrases in reading. Concludes that with the TLC approach, students learn to appreciate the important role cue words and phrases play in understanding…

  20. Flipped Classroom Approach (United States)

    Ozdamli, Fezile; Asiksoy, Gulsum


    Flipped classroom is an active, student-centered approach that was formed to increase the quality of period within class. Generally this approach whose applications are done mostly in Physical Sciences, also attracts the attention of educators and researchers in different disciplines recently. Flipped classroom learning which wide-spreads rapidly…

  1. Approach behavior as information. (United States)

    van Uijen, Sophie L; van den Hout, Marcel A; Engelhard, Iris M


    Anxious individuals infer danger from information about physiological responses, anxiety responses, and safety behaviors. This study investigated whether anxious individuals also infer safety from approach behavior. 325 students rated the danger they perceived in general and spider-relevant scenarios in which information about objective safety versus objective danger, and approach behavior versus no approach behavior, was varied. A high and low spider fearful group was created with a median split on spider fear. Participants with a high fear of spiders, compared to participants with low spider fear, rated spider scenarios with approach behavior as safer than spider scenarios without approach behavior. This effect was similar for objectively dangerous and safe spider scenarios. No behavior as information effects were found for general scenarios. The data were collected in a non-clinical student sample. Spider fearful individuals infer safety from approach behavior in spider-relevant scenarios. For spider fearful individuals, approach behavior may add to the beneficial effects of exposure therapy. Future research is needed to investigate whether patients with anxiety disorders also show a tendency to infer safety from approach behavior. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Approaches to understand culture

    DEFF Research Database (Denmark)

    Rasmussen, Lauge Baungaard; Rauner, Felix


    Different approaches to understand the concept ofculture are presented and evaluated. The author'sconcept of culture is defined. Different aspectsof the concept are discussed.......Different approaches to understand the concept ofculture are presented and evaluated. The author'sconcept of culture is defined. Different aspectsof the concept are discussed....

  3. Stuttering-Psycholinguistic Approach (United States)

    Hategan, Carolina Bodea; Anca, Maria; Prihoi, Lacramioara


    This research promotes psycholinguistic paradigm, it focusing in delimitating several specific particularities in stuttering pathology. Structural approach, on language sides proves both the recurrent aspects found within specialized national and international literature and the psycholinguistic approaches dependence on the features of the…

  4. Evaluating six soft approaches

    DEFF Research Database (Denmark)

    Sørensen, Lene Tolstrup; Vidal, Rene Victor Valqui


    's interactive planning principles to be supported by soft approaches in carrying out the principles in action. These six soft approaches are suitable forsupporting various steps of the strategy development and planning process. These are the SWOT analysis, the Future Workshop, the Scenario methodology...

  5. Evaluating six soft approaches

    DEFF Research Database (Denmark)

    Sørensen, Lene; Vidal, Rene Victor Valqui


    ’s interactive planning principles to be supported by soft approaches in carrying out the principles in action. These six soft approaches are suitable for supporting various steps of the strategy development and planning process. These are the SWOT analysis, the Future Workshop, the Scenario methodology...

  6. Evaluating Six Soft Approaches

    DEFF Research Database (Denmark)

    Sørensen, Lene Tolstrup; Valqui Vidal, René Victor


    's interactive planning principles to be supported by soft approaches in carrying out the principles in action. These six soft approaches are suitable forsupporting various steps of the strategy development and planning process. These are the SWOT analysis, the Future Workshop, the Scenario methodology...

  7. Articulating Design Approaches?

    DEFF Research Database (Denmark)

    Kensing, Finn; Bødker, Keld; Simonsen, Jesper

    We are working on an approach for designing CSCW systems since we advocate the importance of generalizing from own work practice as designers and from studies of designers working under industrial conditions. We use the term approach as something in between commodified methods and isolated techni...

  8. Life Span Developmental Approach

    Directory of Open Access Journals (Sweden)

    Ali Eryilmaz


    Full Text Available The Life Span Developmental Approach examines development of individuals which occurs from birth to death. Life span developmental approach is a multi-disciplinary approach related with disciplines like psychology, psychiatry, sociology, anthropology and geriatrics that indicates the fact that development is not completed in adulthood, it continues during the life course. Development is a complex process that consists of dying and death. This approach carefully investigates the development of individuals with respect to developmental stages. This developmental approach suggests that scientific disciplines should not explain developmental facts only with age changes. Along with aging, cognitive, biological, and socioemotional development throughout life should also be considered to provide a reasonable and acceptable context, guideposts, and reasonable expectations for the person. There are three important subjects whom life span developmental approach deals with. These are nature vs nurture, continuity vs discontinuity, and change vs stability. Researchers using life span developmental approach gather and produce knowledge on these three most important domains of individual development with their unique scientific methodology.

  9. Flipped Classroom Approach

    Directory of Open Access Journals (Sweden)

    Fezile Ozdamli


    Full Text Available Flipped classroom is an active, student-centered approach that was formed to increase the quality of period within class. Generally this approach whose applications are done mostly in Physical Sciences, also attracts the attention of educators and researchers in different disciplines recently. Flipped classroom learning which wide-spreads rapidly in the world, is not well recognized in our country. That is why the aim of study is to attract attention to its potential in education field and provide to make it recognize more by educators and researchers. With this aim, in the study what flipped classroom approach is, flipped classroom technology models, its advantages and limitations were explained.

  10. The sustainable livelihoods approach

    DEFF Research Database (Denmark)

    Oelofse, Myles; Jensen, Henning Høgh


    The rapid development of organic agriculture on a global scale has led to an increased inclusion of producers in developing and transitional countries in the organic food chain. In order to enhance the theoretical frame for the analysis and understanding of the impact that inclusion in the organic...... food chain has on producers and their families, an analysis was conducted of the use of the Sustainable Livelihoods Approach (SLA). The SLA provides a holistic and integrative approach which researchers can use as the overriding frame for their research. The application of the approach is recommended...

  11. Otoplasty: A graduated approach. (United States)

    Foda, H M


    Numerous otoplastic techniques have been described for the correction of protruding ears. Technique selection in otoplasty should be done only after careful analysis of the abnormal anatomy responsible for the protruding ear deformity. A graduated surgical approach is presented which is designed to address all contributing factors to the presenting auricular deformity. The approach starts with the more conservative cartilage-sparing suturing techniques, then proceeds to incorporate other more aggressive cartilage weakening maneuvers. Applying this approach resulted in better long-term results with less postoperative lateralization than that encountered on using the cartilage-sparing techniques alone.

  12. Approach behavior as information

    NARCIS (Netherlands)

    van Uijen, Sophie L.; van den Hout, Marcel A.; Engelhard, Iris M.


    Background and objectives Anxious individuals infer danger from information about physiological responses, anxiety responses, and safety behaviors. This study investigated whether anxious individuals also infer safety from approach behavior. Methods 325 students rated the danger they perceived in

  13. The transformativity approach

    DEFF Research Database (Denmark)

    Holm, Isak Winkel; Lauta, Kristian Cedervall


    an identifiable and promising approach for future disaster research. We suggest naming it the transformativity approach. Whereas the vulnerability approach explores the social causation of disasters, the transformativity approach reverses the direction of the gaze and investigates the social transformation...... brought about by disasters. Put simply, the concept of vulnerability is about the upstream causes of disaster and the concept of transformativity about the downstream effects. By discussing three recent contributions (by the historian Greg Bankoff, the legal sociologist Michelle Dauber......During the last five to ten years, a considerable body of research has begun to explore how disasters, real and imagined, trigger social transformations. Even if the contributions to this this research stems from a multitude of academic disciplines, we argue in the article, they constitute...

  14. The case study approach (United States)


    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

  15. Alternate approach slab reinforcement. (United States)


    The upper mat of reinforcing steel, in exposed concrete bridge approach slabs, is prone to corrosion damage. Chlorides applied to the highways : for winter maintenance can penetrate this concrete layer. Eventually chlorides reach the steel and begin ...

  16. Climate Change Adaptation Approaches (United States)


    US Army Corps of Engineers BUILDING STRONG® Climate Change Adaptation Approaches Presented at the E2S2 Symposium May 11th, 2011 New Orleans, LA...COVERED 00-00-2011 to 00-00-2011 4. TITLE AND SUBTITLE Climate Change Adaptation Approaches 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM...10/09).  One of the four priorities is to maintain readiness in the face of climate change .  Addressing Climate Change Risk and Vulnerability: a

  17. Sustainable fashion: New approaches


    Niinimäki, Kirsi


    This publication is intended to be used as a source of inspiration for designers and companies, and all stakeholders whose interest lies in the area of sustainable fashion. While the strategies for sustainability are complex and approaches are many, this publication presents only a few ways to approach sustainable fashion. I hope the publication offers inspiration on how to make positive change in current practices and how to effect new mindsets, creating transformative fashion. Theoretica...

  18. Multidisciplinary Approach to Obesity


    Berna Bulut Çakmak; Aslýhan DÖNMEZ


    Obesity is a world wide public health problem which increases morbidity and mortality. A multidiciplinary approach is increasingly becoming important for treatment of obesity. Pharmacological agents, sergery, and cognitive behavioral terapy (CBT) are the recommended treatment approaches. In this review, these treatment modalities are reviewed. In CBT of obesity, the dysfunctional thoughts and behaviors which prevent the person for losing weight or doing exercise opr which cause gaining back t...

  19. A supervised approach


    Khoramshahi, Ehsan; Hietaoja, Juha; Valros, Anna; Yun, Jinhyeon; Pastell, Matti


    This paper proposes a supervised classification approach for the real-time pattern recognition of sows in an animal supervision system (asup). Our approach offers the possibility of the foreground subtraction in an asup’s image processing module where there is lack of statistical information regarding the background. A set of 7 farrowing sessions of sows, during day and night, have been captured (approximately 7 days/sow), which is used for this study. The frames of these recordings have been...

  20. Flipped Classroom Approach


    Fezile Ozdamli; Gulsum Asiksoy


    Flipped classroom is an active, student-centered approach that was formed to increase the quality of period within class. Generally this approach whose applications are done mostly in Physical Sciences, also attracts the attention of educators and researchers in different disciplines recently. Flipped classroom learning which wide-spreads rapidly in the world, is not well recognized in our country. That is why the aim of study is to attract attention to its potential in education field and pr...

  1. Theoretical Approaches to Coping

    Directory of Open Access Journals (Sweden)

    Sofia Zyga


    Full Text Available Introduction: Dealing with stress requires conscious effort, it cannot be perceived as equal to individual's spontaneous reactions. The intentional management of stress must not be confused withdefense mechanisms. Coping differs from adjustment in that the latter is more general, has a broader meaning and includes diverse ways of facing a difficulty.Aim: An exploration of the definition of the term "coping", the function of the coping process as well as its differentiation from other similar meanings through a literature review.Methodology: Three theoretical approaches of coping are introduced; the psychoanalytic approach; approaching by characteristics; and the Lazarus and Folkman interactive model.Results: The strategic methods of the coping approaches are described and the article ends with a review of the approaches including the functioning of the stress-coping process , the classificationtypes of coping strategies in stress-inducing situations and with a criticism of coping approaches.Conclusions: The comparison of coping in different situations is difficult, if not impossible. The coping process is a slow process, so an individual may select one method of coping under one set ofcircumstances and a different strategy at some other time. Such selection of strategies takes place as the situation changes.

  2. Approaching a Postcolonial Arctic

    DEFF Research Database (Denmark)

    Jensen, Lars


    This article explores different postcolonially configured approaches to the Arctic. It begins by considering the Arctic as a region, an entity, and how the customary political science informed approaches are delimited by their focus on understanding the Arctic as a region at the service of the co......-colonial presences in the Arctic before moving on to consider artworks about the Arctic that arguably through their transgressive forms pushes at the boundaries of geopolitical, geohistorical and geoaesthetic approaches.......This article explores different postcolonially configured approaches to the Arctic. It begins by considering the Arctic as a region, an entity, and how the customary political science informed approaches are delimited by their focus on understanding the Arctic as a region at the service...... of the contemporary neoliberal order. It moves on to explore how different parts of the Arctic are inscribed in a number of sub-Arctic nation-state binds, focusing mainly on Canada and Denmark. The article argues that the postcolonial can be understood as a prism or a methodology that asks pivotal questions to all...

  3. New Approaches to Robotics (United States)

    Brooks, Rodney A.


    In order to build autonomous robots that can carry out useful work in unstructured environments new approaches have been developed to building intelligent systems. The relationship to traditional academic robotics and traditional artificial intelligence is examined. In the new approaches a tight coupling of sensing to action produces architectures for intelligence that are networks of simple computational elements which are quite broad, but not very deep. Recent work within this approach has demonstrated the use of representations, expectations, plans, goals, and learning, but without resorting to the traditional uses of central, abstractly manipulable or symbolic representations. Perception within these systems is often an active process, and the dynamics of the interactions with the world are extremely important. The question of how to evaluate and compare the new to traditional work still provokes vigorous discussion.

  4. Approaches to Methadone Treatment

    DEFF Research Database (Denmark)

    Järvinen, Margaretha


    The paper analyses methadone treatment in Copenhagen – as it is described by methadone users and staff at different outpatient centres. The starting point is a theoretical model distinguishing between two different approaches to methadone treatment: ‘palliative’ and ‘curative’. Included...... in the model are three dimensions (1) treatment goals at the methadone centres (abstinence vs. stabilisation) (2) treatment focus (focus on addiction vs. focus on the consequences of addiction) and (3) conceptualisation of methadone (methadone as similar to or different from heroin). The paper shows...... that there is a discrepancy between the attitudes of the staff and those of the users. While the staff favour an almost clear-cut palliative approach to methadone treatment, defining curative goals as both unrealistic and as belonging to the past, the users prefer an approach that does not exclude the goal of abstinence...

  5. Personal Approaches to Career Planning. (United States)

    DeMont, Billie; DeMont, Roger


    Identifies four approaches to career planning based on situational leadership theory: the network approach, self-help approach, engineering approach, and mentor approach. Guidelines for the selection of a planning method based on the nature of the work environment and personal preference are discussed. (JAC)

  6. Technical approach document

    Energy Technology Data Exchange (ETDEWEB)


    The Uranium Mill Tailings Radiation Control Act (UMTRCA) of 1978, Public Law 95-604 (PL95-604), grants the Secretary of Energy the authority and responsibility to perform such actions as are necessary to minimize radiation health hazards and other environmental hazards caused by inactive uranium mill sites. This Technical Approach Document (TAD) describes the general technical approaches and design criteria adopted by the US Department of Energy (DOE) in order to implement remedial action plans (RAPS) and final designs that comply with EPA standards. It does not address the technical approaches necessary for aquifer restoration at processing sites; a guidance document, currently in preparation, will describe aquifer restoration concerns and technical protocols. This document is a second revision to the original document issued in May 1986; the revision has been made in response to changes to the groundwater standards of 40 CFR 192, Subparts A--C, proposed by EPA as draft standards. New sections were added to define the design approaches and designs necessary to comply with the groundwater standards. These new sections are in addition to changes made throughout the document to reflect current procedures, especially in cover design, water resources protection, and alternate site selection; only minor revisions were made to some of the sections. Sections 3.0 is a new section defining the approach taken in the design of disposal cells; Section 4.0 has been revised to include design of vegetated covers; Section 8.0 discusses design approaches necessary for compliance with the groundwater standards; and Section 9.0 is a new section dealing with nonradiological hazardous constituents. 203 refs., 18 figs., 26 tabs.

  7. Logotherapeutic approach to depression


    Vidović, Boris


    In this paper we will deal with depression, i.e. depression dis- order, and the possibility that the logo-therapy of Viktor E. Frankl offers in understudying and processing the treatment of this dis- order. According to some indicators, depression is one of the most widespread diseases of our time and deserves to be discussed about considering the logo-therapeutic approach. The specificity of this approach is to understand the human being as a psycho-somatic- spiritual being. Starting from th...

  8. Hematoma extradural estudo radiológico comparativo entre pacientes em coma e não comatosos

    Directory of Open Access Journals (Sweden)

    Luis Renato Mello


    Full Text Available Considerando o estado neurológico imediatamente antes da operação como a variável miais fidedigna para antecipação do prognóstico dos hematomas extradurais, os autores realizaram estudo radiológico comparativo de 129 pacientes operados por esta patologia. Desta amostra, 78 casos se encontravam em coma (Grupo I e 51 eram não comatosos (Grupo II. No grupo I, os 30 casos investigados pré-operatoriamente com tomografia tiveram 23,3% de mortalidade e 50% de bons resultados; dos 31 casos submetidos a angiografia, 48,3% faleceram e 38,7% tiveram bons resultados; 17 casos foram operados pela radiografia simples de crânio e exame neurológico, com 47% de mortalidade e 35,2% de bons resultados. A presença de fratura de crânio e a densidade tomográfica do hematoma não interferiram nos resultados. A presença de lesão associada intracraniana aumentou a mortalidade e diminuiu a quantidade de bons resultados tanto no Grupo I quanto no Grupo II. A localização frontal do hematoma foi associada a elevada mortalidade (52,6% no grupo comatoso, por estarem todos os pacientes entre 3 a 5 pontos na Escala de Glasgow e seis deles por apresentarem lesões associadas intracranianas únicas ou múltiplas.

  9. Vol. 29, No 1 47 Mots-clés: hématome extra-dural ...

    African Journals Online (AJOL)


    Cependant nous avons été confrontés à des difficultés diagnostiques et thérapeutiques : Les difficultés diagnostiques sont liées à l'inaccessibilité du scanner de par son coût et sa disponibilité, ce qui explique en partie le retard de prise en charge noté dans notre série. Les difficultés thérapeutiques sont liées à la précarité ...

  10. Financial Management: An Organic Approach (United States)

    Laux, Judy


    Although textbooks present corporate finance using a topical approach, good financial management requires an organic approach that integrates the various assignments financial managers confront every day. Breaking the tasks into meaningful subcategories, the current article offers one approach.

  11. Thematic curriculum approach

    Directory of Open Access Journals (Sweden)

    Šefer Jasmina P.


    Full Text Available Thematic curriculum combines disciplines and media. The process is problem-oriented and the scenario most often follows the logic of exploring or storytelling. Those two approaches to teaching are appropriate because they fit into interdisciplinary and creative open-ended problem solving through play, as insisted upon by thematic curriculum. The matrix, where seven types of abilities intersect with five types of problems according to their degree of openness, defines well the outcomes of teaching. However, it did not prove to be suitable for planning the majority of activities in thematic curriculum, for it follows with difficulty the process of exploring or storytelling i.e. it disrupts the subject matter coherence of thematic curriculum. Therefore, it is suggested that matrix should be used for disciplinary curriculum planning but for that of thematic curriculum only in exclusive cases. The matrix should be used primarily as a framework for evaluating the distribution of various types of abilities and problem situations in teaching. The logic of diverse approaches to teaching reflects itself in the manner of planning and organizing the teaching process. Conceptual, visual-graphic, structural and other aids employed during educational process planning should suit the nature of the approach chosen. On the basis of qualitative investigations of educational process, in the present paper considerations are given to various approaches to teaching development of various drafts for the planning of teaching, and recognition of the logic of storytelling and exploring in thematic curriculum.

  12. Ethical Approaches to Compliance (United States)

    Buzo, Carina


    This article explores the role that higher education has in ethical compliance to Title IX and the Clery Act. The discussion includes a curious look at common practices as potential future approaches to consent and sexual assault education. Articles and research are included to ground understanding in the current context, while examples from a…

  13. The Capability Approach

    NARCIS (Netherlands)

    I.A.M. Robeyns (Ingrid)


    textabstract In its most general description, the capability approach is a flexible and multi-purpose normative framework, rather than a precise theory of well-being, freedom or justice. At its core are two normative claims: first, the claim that the freedom to achieve well-being is of primary

  14. Orion Emergency Mask Approach (United States)

    Tuan, George C.; Graf, John C.


    Emergency mask approach on Orion poses a challenge to the traditional Shuttle or Station approaches. Currently, in the case of a fire or toxic spill event, the crew utilizes open loop oxygen masks that provide the crew with oxygen to breath, but also dumps the exhaled oxygen into the cabin. For Orion, with a small cabin volume, the extra oxygen will exceed the flammability limit within a short period of time, unless a nitrogen purge is also provided. Another approach to a fire or toxic spill event is the use of a filtering emergency masks. These masks utilize some form of chemical beds to scrub the air clean of toxic providing the crew safe breathing air for a period without elevating the oxygen level in the cabin. Using the masks and a form of smoke-eater filter, it may be possible to clean the cabin completely or to a level for safe transition to a space suit to perform a cabin purge. Issues with filters in the past have been the reaction time, breakthroughs, and high breathing resistance. Development in a new form of chemical filters has shown promise to make the filtering approach feasible.

  15. Approach to Absolute Zero

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 2; Issue 10. Approach to Absolute Zero Below 10 milli-Kelvin. R Srinivasan. Series Article Volume 2 Issue 10 October 1997 pp 8-16. Fulltext. Click here to view fulltext PDF. Permanent link: ...

  16. Approach To Absolute Zero

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 1; Issue 12. Approach to Absolute Zero Liquefaction of Gases. R Srinivasan. Series Article Volume 1 Issue 12 December 1996 pp 6-16. Fulltext. Click here to view fulltext PDF. Permanent link: ...


    African Journals Online (AJOL)


    scopic or external spheno-eth- moidectomy. Complications of ABRS. Orbital complications are the most common complication of sinusitis. The Chandler classification gives a clinical approach to orbital inflamma- tion: • inflammatory oedema (lid oedema). • orbital cellulitis (diffuse oedema). • subperiosteal abscess (displace-.

  18. Approaches to Machine Learning. (United States)

    Langley, Pat; Carbonell, Jaime G.


    Reviews approaches to machine learning (development of techniques to automate acquisition of new information, skills, and ways of organizing existing information) in symbolic domains. Four categorical tasks addressed in machine learning literature are examined: learning from examples, learning search heuristics, learning by observation, and…

  19. Approaches to Contrastive Linguistics. (United States)

    Akhmanova, Olga; And Others

    Linguistics as a science has been concerned with comparison ever since its inception, the number and variety of approaches increasing steadily in the course of its development. Interest in linguistic comparison extends into the field of foreign language teaching. Linguists have attempted to solve the problem of methodology in contrastive…

  20. Approaches to acceptable risk

    Energy Technology Data Exchange (ETDEWEB)

    Whipple, C.


    Several alternative approaches to address the question {open_quotes}How safe is safe enough?{close_quotes} are reviewed and an attempt is made to apply the reasoning behind these approaches to the issue of acceptability of radiation exposures received in space. The approaches to the issue of the acceptability of technological risk described here are primarily analytical, and are drawn from examples in the management of environmental health risks. These include risk-based approaches, in which specific quantitative risk targets determine the acceptability of an activity, and cost-benefit and decision analysis, which generally focus on the estimation and evaluation of risks, benefits and costs, in a framework that balances these factors against each other. These analytical methods tend by their quantitative nature to emphasize the magnitude of risks, costs and alternatives, and to downplay other factors, especially those that are not easily expressed in quantitative terms, that affect acceptance or rejection of risk. Such other factors include the issues of risk perceptions and how and by whom risk decisions are made.

  1. External approach to rhinoplasty. (United States)

    Goodman, Wilfred S; Charbonneau, Paul A


    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.

  2. Comparing Information Access Approaches. (United States)

    Chalmers, Matthew


    Presents a broad view of information access, drawing from philosophy and semiology in constructing a framework for comparative discussion that is used to examine the information representations that underlie four approaches to information access--information retrieval, workflow, collaborative filtering, and the path model. Contains 32 references.…

  3. Synopsis of emergent approaches (United States)

    Malcolm North; Brandon Collins; John Keane; Jonathan W. Long; Carl Skinner; Bill. Zielinski


    This synopsis presents three integrated themes that emerged from synthesizing information about biological resources. These themes become particularly important when managing forests to promote resilience at large landscape scales and long timeframes. This synopsis summarizes ideas in the longer chapter 1.2, “Integrative Approaches: Promoting Socioecological Resilience...

  4. Implementation of Communicative Approach (United States)

    Jabeen, Shazi Shah


    In the contemporary age of high professional requirements such as excellent communicative skills, the need for successful learning of communicative skills of English language suggests communicative ability to be the goal of language teaching. In other words, to teach English language using communicative approach becomes essential. Studies to…

  5. Islamic approach in counseling. (United States)

    Hanin Hamjah, Salasiah; Mat Akhir, Noor Shakirah


    A religious approach is one of the matters emphasized in counseling today. Many researchers find that there is a need to apply the religious element in counseling because religion is important in a client's life. The purpose of this research is to identify aspects of the Islamic approach applied in counseling clients by counselors at Pusat Kaunseling Majlis Agama Islam Negeri Sembilan (PKMAINS). In addition, this research also analyses the Islamic approach applied in counseling at PKMAINS with reference to al-Quran and al-Sunnah. This is a qualitative research in the form of case study at PKMAINS. The main method used in this research is interview. The research instrument used is interview protocol. The respondents in this study include 9 counselors who serve in one of the counseling centers in Malaysia. This study also uses questionnaire as an additional instrument, distributed to 36 clients who receive counseling service at the center. The findings of the study show that the Islamic approach applied in counseling at PKMAINS may be categorized into three main aspects: aqidah (faith), ibadah (worship/ultimate devotion and love for God) and akhlaq (moral conduct). Findings also show that the counseling in these aspects is in line with Islamic teachings as contained in al-Quran and al-Sunnah.

  6. Ecosystem approach in education (United States)

    Nabiullin, Iskander


    Environmental education is a base for sustainable development. Therefore, in our school we pay great attention to environmental education. Environmental education in our school is based on ecosystem approach. What is an ecosystem approach? Ecosystem is a fundamental concept of ecology. Living organisms and their non-living environments interact with each other as a system, and the biosphere planet functions as a global ecosystem. Therefore, it is necessary for children to understand relationships in ecosystems, and we have to develop systems thinking in our students. Ecosystem approach and systems thinking should help us to solve global environmental problems. How do we implement the ecosystem approach? Students must understand that our biosphere functions as a single ecosystem and even small changes can lead to environmental disasters. Even the disappearance of one plant or animal species can lead to irreversible consequences. So in the classroom we learn the importance of each living organism for the nature. We pay special attention to endangered species, which are listed in the Red Data List. Kids are doing projects about these organisms, make videos, print brochures and newspapers. Fieldwork also plays an important role for ecosystem approach. Every summer, we go out for expeditions to study species of plants and animals listed in the Red Data List of Tatarstan. In class, students often write essays on behalf of any endangered species of plants or animals, this also helps them to understand the importance of each living organism in nature. Each spring we organise a festival of environmental projects among students. Groups of 4-5 students work on a solution of environmental problems, such as water, air or soil pollution, waste recycling, the loss of biodiversity, etc. Participants shoot a clip about their project, print brochures. Furthermore, some of the students participate in national and international scientific Olympiads with their projects. In addition to

  7. Domain Approach: An Alternative Approach in Moral Education (United States)

    Vengadasalam, Chander; Mamat, Wan Hasmah Wan; Mail, Fauziah; Sudramanian, Munimah


    This paper discusses the use of the domain approach in moral education in an upper secondary school in Malaysia. Moral Education needs a creative and an innovative approach. Therefore, a few forms of approaches are used in the teaching-learning of Moral Education. This research describes the use of domain approach which comprises the moral domain…

  8. Transaction based approach (United States)

    Hunka, Frantisek; Matula, Jiri


    Transaction based approach is utilized in some methodologies in business process modeling. Essential parts of these transactions are human beings. The notion of agent or actor role is usually used for them. The paper on a particular example describes possibilities of Design Engineering Methodology for Organizations (DEMO) and Resource-Event-Agent (REA) methodology. Whereas the DEMO methodology can be regarded as a generic methodology having its foundation in the theory of Enterprise Ontology the REA methodology is regarded as the domain specific methodology and has its origin in accountancy systems. The results of these approaches is that the DEMO methodology captures everything that happens in the reality with a good empirical evidence whereas the REA methodology captures only changes connected with economic events. Economic events represent either change of the property rights to economic resource or consumption or production of economic resources. This results from the essence of economic events and their connection to economic resources.

  9. The Knowledge Governance Approach

    DEFF Research Database (Denmark)

    Foss, Nicolai J.

    An attempt is made to characterize a `knowledge governance approach' as a distinctive, emerging field that cuts across the fields of knowledge management, organisation studies, strategy and human resource management. Knowledge governance is taken up with how the deployment of administrative...... apparatus influences knowledge processes, such as sharing, retaining and creating knowledge. It insists on clear behavioural foundations, adopts an economizing perspective and examines efficient alignment between knowledge transactions with diverse characteristics and governance structures and mechanisms...... with diverse capabilities of handling these transactions. Various open research issues that a knowledge governance approach may illuminate are sketched. Although knowledge governance draws clear inspiration from organizational economics and `rational' organization theory, it recognizes that knowledge...

  10. Multidisciplinary Approach to Obesity

    Directory of Open Access Journals (Sweden)

    Berna Bulut Çakmak


    Full Text Available Obesity is a world wide public health problem which increases morbidity and mortality. A multidiciplinary approach is increasingly becoming important for treatment of obesity. Pharmacological agents, sergery, and cognitive behavioral terapy (CBT are the recommended treatment approaches. In this review, these treatment modalities are reviewed. In CBT of obesity, the dysfunctional thoughts and behaviors which prevent the person for losing weight or doing exercise opr which cause gaining back the lost weight are identified, and specific techniques to change these thoughts and behaviors are thought. It may be used as an individiual therapy, but it may also be more effective when used as a group psychotherapy. In this article, the CBT techniques used in obesity treatment are summarized. [JCBPR 2014; 3(3.000: 142-149

  11. Rail transport systems approach

    CERN Document Server


    This book shows how the systems approach is employed by scientists in various countries to solve specific problems concerning railway transport. In particular, the book describes the experiences of scientists from Romania, Germany, the Czech Republic, the UK, Russia, Ukraine, Lithuania and Poland. For many of these countries there is a problem with the historical differences between the railways. In particular, there are railways with different rail gauges, with different signaling and communication systems, with different energy supplies and, finally, with different political systems, which are reflected in the different approaches to the management of railway economies. The book’s content is divided into two main parts, the first of which provides a systematic analysis of individual means of providing and maintaining rail transport. In turn, the second part addresses infrastructure and management development, with particular attention to security issues. Though primarily written for professionals involved...

  12. A Personal Approach

    Directory of Open Access Journals (Sweden)

    Kellyn Weir


    Full Text Available This study explored the process of taking a personal approach to my son’s problems with computer games. As a psychology student, I should have been in a good position to explore the paradoxical emotions and this situation of conflict. Yet I was also aware that relating closely to the people we are studying has long been a taboo even in qualitative research. I nevertheless adopted a collaborative methodology in which I balanced a dual role of parent and researcher. Taking a personal approach, allowing intimate, reciprocal negotiation, I was not only able to put this taboo to the rare empirical test but also achieved an insight that would otherwise have not been available to me. By engaging in dialogue and encouraging the ability to object, a first-person plural (We, position was achieved in which an understanding of this situation developed and has transferred to our everyday lives.

  13. Dimensional Approach in Psychiatry

    Directory of Open Access Journals (Sweden)

    Osman Ozdemir


    Full Text Available In psychiatry there is a traditional categorical conception stating that several disorders like schizophrenia and bipolar disorder have distinct etiologies. On the other hand, dimensional approach claims that these entities are actually the same disorder reflecting different clinical aspects of same mental disorder in the course of time. ICD and DSM classifications are based on separate categories of different mental disorders. Howewer, it is quite difficult to consider a mental disorder as a discrete entity that has absolute boundaries from other disorders. There are patients manifesting symptoms of two or more categories but do not fulfill all diagnostic criteria for any mental disorder. Dimensional approach handles the psychopathology as a continuing process and establish the patients to the different ongoing points. According to this view, in fact, multiple diagnosis reflect dimensions of the same disease.

  14. Phase Field Approach (United States)

    Koyama, Toshiyuki

    The term phase field has recently become known across many fields of materials science. The meaning of phase field is the spatial and temporal order parameter field defined in a continuum-diffused interface model. By using the phase field order parameters, many types of complex microstructure changes observed in materials science are described effectively. This methodology has been referred to as the phase field method, phase field simulation, phase field modeling, phase field approach, etc. In this chapter, the basic concept and theoretical background for the phase field approach is explained in Sects. 21.1 and 21.2. The overview of recent applications of the phase field method is demonstrated in Sects. 21.3 to 21.6.

  15. Microscopic approach to polaritons

    DEFF Research Database (Denmark)

    Skettrup, Torben


    The interaction between excitons and light has been investigated in detail. The perturbational approach turns out to be invalid. However, an exact solution can be obtained directly from the Schrödinger equation for a fixed light field. This solution corresponds to a nonlinear optical response...... contrary to experimental experience. In order to remove this absurdity the semiclassical approach must be abandoned and the electromagnetic field quantized. A simple microscopic polariton model is then derived. From this the wave function for the interacting exciton-photon complex is obtained...... of light of the crystal. The introduction of damping smears out the excitonic spectra. The wave function of the polariton, however, turns out to be very independent of damping up to large damping values. Finally, this simplified microscopic polariton model is compared with the exact solutions obtained...

  16. Thermodynamics an engineering approach

    CERN Document Server

    Cengel, Yunus A


    Thermodynamics, An Engineering Approach, eighth edition, covers the basic principles of thermodynamics while presenting a wealth of real-world engineering examples so students get a feel for how thermodynamics is applied in engineering practice. This text helps students develop an intuitive understanding by emphasizing the physics and physical arguments. Cengel and Boles explore the various facets of thermodynamics through careful explanations of concepts and use of numerous practical examples and figures, having students develop necessary skills to bridge the gap between knowledge and the confidence to properly apply their knowledge. McGraw-Hill is proud to offer Connect with the eighth edition of Cengel/Boles, Thermodynamics, An Engineering Approach. This innovative and powerful new system helps your students learn more efficiently and gives you the ability to assign homework problems simply and easily. Problems are graded automatically, and the results are recorded immediately. Track individual stude...

  17. An Approach to Cosmeceuticals. (United States)

    Milam, Emily C; Rieder, Evan A


    The cosmeceutical industry is a multi-billion dollar, consumer-driven market. Products promise highly desirable anti-aging benefits, but are not subject to regulation. We present an introduction to cosmeceuticals for the general and cosmetic dermatologist, including definitions and explanations of key terms, an approach to the evidence base, a dissection of chamomile and green tea, two paradigmatic cosmeceutical products, and a window into the underlying psychology of this vast marketplace.

  18. Laparoscopic approach to hysterectomy


    Nazik, Hakan


    Modern laparoscopic surgery is widely used throughout the world as it offers greater advantages than open procedures. The laparoscopic approach to hysterectomy has evolved over the last 20 years. Hysterectomies are performed abdominally, vaginally, laparoscopically or, more recently, with robotic assistance. Indications for a total laparoscopic hysterectomy are similar to those for total abdominal hysterectomy, and most commonly include uterine leiomyomata, pelvic organ prolapse, and a...

  19. Breakfast: a multidisciplinary approach


    Affinita, Antonio; Catalani, Loredana; Cecchetto, Giovanna; De Lorenzo, Gianfranco; Dilillo, Dario; Donegani, Giorgio; Fransos, Lucia; Lucidi, Fabio; Mameli, Chiara; Manna, Elisa; Marconi, Paolo; Mele, Giuseppe; Minestroni, Laura; Montanari, Massimo; Morcellini, Mario


    Background The role of breakfast as an essential part of an healthy diet has been only recently promoted even if breakfast practices were known since the Middle Age. The growing scientific evidences on this topic are extremely sector-based nevertheless breakfast could be regarded from different point of views and from different expertises. This approach, that take into account history, sociology, anthropology, medicine, psychology and pedagogy, is useful to better understand the value of this...

  20. [Approaches to radial shaft]. (United States)

    Bartoníček, J; Naňka, O; Tuček, M


    In the clinical practice, radial shaft may be exposed via two approaches, namely the posterolateral Thompson and volar (anterior) Henry approaches. A feared complication of both of them is the injury to the deep branch of the radial nerve. No consensus has been reached, yet, as to which of the two approaches is more beneficial for the proximal half of radius. According to our anatomical studies and clinical experience, Thompson approach is safe only in fractures of the middle and distal thirds of the radial shaft, but highly risky in fractures of its proximal third. Henry approach may be used in any fracture of the radial shaft and provides a safe exposure of the entire lateral and anterior surfaces of the radius.The Henry approach has three phases. In the first phase, incision is made along the line connecting the biceps brachii tendon and the styloid process of radius. Care must be taken not to damage the lateral cutaneous nerve of forearm.In the second phase, fascia is incised and the brachioradialis identified by the typical transition from the muscle belly to tendon and the shape of the tendon. On the lateral side, the brachioradialis lines the space with the radial artery and veins and the superficial branch of the radial nerve running at its bottom. On the medial side, the space is defined by the pronator teres in the proximal part and the flexor carpi radialis in the distal part. The superficial branch of the radial nerve is retracted together with the brachioradialis laterally, and the radial artery medially.In the third phase, the attachment of the pronator teres is identified by its typical tendon in the middle of convexity of the lateral surface of the radial shaft. The proximal half of the radius must be exposed very carefully in order not to damage the deep branch of the radial nerve. Dissection starts at the insertion of the pronator teres and proceeds proximally along its lateral border in interval between this muscle and insertion of the supinator

  1. Peritonitis: laparoscopic approach

    Directory of Open Access Journals (Sweden)

    Agresta Ferdinando


    Full Text Available Abstract Background Laparoscopy has became as the preferred surgical approach to a number of different diseases because it allows a correct diagnosis and treatment at the same time. In abdominal emergencies, both components of treatment – exploration to identify the causative pathology and performance of an appropriate operation – can often be accomplished via laparoscopy. There is still a debate of peritonitis as a contraindication to this kind of approach. Aim of the present work is to illustrate retrospectively the results of a case-control experience of laparoscopic vs. open surgery for abdominal peritonitis emergencies carried out at our institution. Methods From January 1992 and January 2002 a total of 935 patients (mean age 42.3 ± 17.2 years underwent emergent and/or urgent surgery. Among them, 602 (64.3% were operated on laparoscopically (of whom 112 -18.7% – with peritonitis, according to the presence of a surgical team trained in laparoscopy. Patients with a history of malignancy, more than two previous major abdominal surgeries or massive bowel distension were not treated Laparoscopically. Peritonitis was not considered contraindication to Laparoscopy. Results The conversion rate was 23.2% in patients with peritonitis and was mainly due to the presence of dense intra-abdominal adhesions. Major complications ranged as high as 5.3% with a postoperative mortality of 1.7%. A definitive diagnosis was accomplished in 85.7% (96 pat. of cases, and 90.6% (87 of these patients were treated successfully by Laparoscopy. Conclusion Even if limited by its retrospective feature, the present experience let us to consider the Laparoscopic approach to abdominal peritonitis emergencies a safe and effective as conventional surgery, with a higher diagnostic yield and allows for lesser trauma and a more rapid postoperative recovery. Such features make Laparoscopy a challenging alternative to open surgery in the management algorithm for abdominal

  2. New Encrypted Steganography Approach

    Directory of Open Access Journals (Sweden)

    Saba Mohammed Husain‎


    Full Text Available The proposed research Provides an approach for hiding an encrypted text in side a digital image. Where the text is encrypted in a complex manner used method of PlayFair to encrypt clear text and to increase security put lettering ciphertext on the geometric shape clockwise and then we write the ciphertext output in the form of lines, taken new ciphertext and converted to Ascii code and then to binary and hidden text in bits least importance in the picture. The results were good by PNSR scale

  3. Experimental approaches and applications

    CERN Document Server

    Crasemann, Bernd


    Atomic Inner-Shell Processes, Volume II: Experimental Approaches and Applications focuses on the physics of atomic inner shells, with emphasis on experimental aspects including the use of radioactive atoms for studies of atomic transition probabilities. Surveys of modern techniques of electron and photon spectrometry are also presented, and selected practical applications of inner-shell processes are outlined. Comprised of six chapters, this volume begins with an overview of the general principles underlying the experimental techniques that make use of radioactive isotopes for inner-sh


    Directory of Open Access Journals (Sweden)

    Ledyaeva Ol'ga Mikhaylovna


    Full Text Available Several approaches that underlie urban politics are discussed in the paper. They include neo-liberalism, political economy discourse, elitist/pluralist debates, and postmodernism. The neoliberal approach focuses on the limited role of the state and individual responsibility. The legal framework protects both the rights and responsibilities of individuals and regulates the operation of the market. It is the market that fosters individual choices and provides goods and services by virtue of the processes which are flexible, efficient and transparent. The political economy approaches (regulation theory, public choice theory, neo-Marxism explain urban politics via the analysis of national and international economic processes and changes in contemporary capitalism. Changes in national and international economies determine what solutions are possible. The discourse has been influenced by the debate on globalization of capital and labour markets. Modern elitism and neopluralism are represented by theories of "growth machines" and "urban regimes". The former focuses on bargaining alliances between political and business leaders in order to manage the urban system and to promote its growth. The latter develops neopluralist explanations of power within local communities with an emphasis on the fragmented nature of the government where local authorities lack comprehensive governing powers. Postmodernism views the city as the site of the crisis of late capitalism which leads to segregation of neighbourhoods onto prosperous areas and ghettoes. In contrast to the modern city, the postmodern city is not defined by its industrial base; rather, it is determined by its consumerist environment of malls and museums, characterized by revivalist architecture. At the same time, the suburban shopping mall and a motorway network make nonsense of the idea of the city as a unique and well-defined space. These and other approaches encompass a wide spectrum of possibilities

  5. Topology optimization approaches

    DEFF Research Database (Denmark)

    Sigmund, Ole; Maute, Kurt


    Topology optimization has undergone a tremendous development since its introduction in the seminal paper by Bendsøe and Kikuchi in 1988. By now, the concept is developing in many different directions, including “density”, “level set”, “topological derivative”, “phase field”, “evolutionary” and se......” and several others. The paper gives an overview, comparison and critical review of the different approaches, their strengths, weaknesses, similarities and dissimilarities and suggests guidelines for future research....

  6. The collaboratory approach

    Energy Technology Data Exchange (ETDEWEB)

    Peskin, A.M.


    A {open_quotes}collaboratory{close_quotes} has been defined as a center without walls, in which researchers can perform their work without regard to geographical location. To an increasing degree, engineering design and development is also taking the form of far-flung collaborations among divisions of a plant, subcontractors, university consultants and customers. It has long been recognized that quality engineering education presents the student with an environment that duplicates as much as possible that which the graduate will encounter in industry. To that end, it is important that engineering schools begin to introduce the collaboratory approach in its preparation, and even use it in delivery of subject matter to students.

  7. Towards a Tectonic Approach

    DEFF Research Database (Denmark)

    Hvejsel, Marie Frier; Kirkegaard, Poul Henning; Mortensen, Sophie Bondgaard


    through this transformation is inevitably a tectonic question. By analyzing three historical examples, Adolf Loos’ Villa Moller, Le Corbusier’s Unité d’Habitation, and Frank Lloyd Wright’s Johnson Wax Administration Building, chosen for their tectonic ability to exploit the technical ‘principle’ defining...... the building envelope as an aesthetic ‘gesture’, this paper discusses the architectural challenges related to energy renovation in a Danish context and tectonic design method as an approach to these challenges in everyday practice....

  8. Approaches for Stereo Matching

    Directory of Open Access Journals (Sweden)

    Takouhi Ozanian


    Full Text Available This review focuses on the last decade's development of the computational stereopsis for recovering three-dimensional information. The main components of the stereo analysis are exposed: image acquisition and camera modeling, feature selection, feature matching and disparity interpretation. A brief survey is given of the well known feature selection approaches and the estimation parameters for this selection are mentioned. The difficulties in identifying correspondent locations in the two images are explained. Methods as to how effectively to constrain the search for correct solution of the correspondence problem are discussed, as are strategies for the whole matching process. Reasons for the occurrence of matching errors are considered. Some recently proposed approaches, employing new ideas in the modeling of stereo matching in terms of energy minimization, are described. Acknowledging the importance of computation time for real-time applications, special attention is paid to parallelism as a way to achieve the required level of performance. The development of trinocular stereo analysis as an alternative to the conventional binocular one, is described. Finally a classification based on the test images for verification of the stereo matching algorithms, is supplied.

  9. Predictive ecology: systems approaches. (United States)

    Evans, Matthew R; Norris, Ken J; Benton, Tim G


    The world is experiencing significant, largely anthropogenically induced, environmental change. This will impact on the biological world and we need to be able to forecast its effects. In order to produce such forecasts, ecology needs to become more predictive--to develop the ability to understand how ecological systems will behave in future, changed, conditions. Further development of process-based models is required to allow such predictions to be made. Critical to the development of such models will be achieving a balance between the brute-force approach that naively attempts to include everything, and over simplification that throws out important heterogeneities at various levels. Central to this will be the recognition that individuals are the elementary particles of all ecological systems. As such it will be necessary to understand the effect of evolution on ecological systems, particularly when exposed to environmental change. However, insights from evolutionary biology will help the development of models even when data may be sparse. Process-based models are more common, and are used for forecasting, in other disciplines, e.g. climatology and molecular systems biology. Tools and techniques developed in these endeavours can be appropriated into ecological modelling, but it will also be necessary to develop the science of ecoinformatics along with approaches specific to ecological problems. The impetus for this effort should come from the demand coming from society to understand the effects of environmental change on the world and what might be performed to mitigate or adapt to them.

  10. Breakfast: a multidisciplinary approach (United States)


    Background The role of breakfast as an essential part of an healthy diet has been only recently promoted even if breakfast practices were known since the Middle Age. The growing scientific evidences on this topic are extremely sector-based nevertheless breakfast could be regarded from different point of views and from different expertises. This approach, that take into account history, sociology, anthropology, medicine, psychology and pedagogy, is useful to better understand the value of this meal in our culture. The aim of this paper was to analyse breakfast-related issues based on a multidisciplinary approach with input by specialists from different fields of learning. Discussion Breakfast is now recommended as part of a diet because it is associated with healthier macro- and micronutrient intakes, body mass index and lifestyle. Moreover recent studies showed that breakfast improves cognitive function, intuitive perception and academic performance. Research demonstrates the importance of providing breakfast not only to children but in adults and elderly too. Although the important role breakfast plays in maintaining the health, epidemiological data from industrialised countries reveal that many individuals either eat a nutritionally unhealthy breakfast or skip it completely. Summary The historical, bio-psychological and educational value of breakfast in our culture is extremely important and should be recognized and stressed by the scientific community. Efforts should be done to promote this practice for the individual health and well-being. PMID:23842429

  11. Modular Approach to Spintronics. (United States)

    Camsari, Kerem Yunus; Ganguly, Samiran; Datta, Supriyo


    There has been enormous progress in the last two decades, effectively combining spintronics and magnetics into a powerful force that is shaping the field of memory devices. New materials and phenomena continue to be discovered at an impressive rate, providing an ever-increasing set of building blocks that could be exploited in designing transistor-like functional devices of the future. The objective of this paper is to provide a quantitative foundation for this building block approach, so that new discoveries can be integrated into functional device concepts, quickly analyzed and critically evaluated. Through careful benchmarking against available theory and experiment we establish a set of elemental modules representing diverse materials and phenomena. These elemental modules can be integrated seamlessly to model composite devices involving both spintronic and nanomagnetic phenomena. We envision the library of modules to evolve both by incorporating new modules and by improving existing modules as the field progresses. The primary contribution of this paper is to establish the ground rules or protocols for a modular approach that can build a lasting bridge between materials scientists and circuit designers in the field of spintronics and nanomagnetics.

  12. Comorbidity: a multidimensional approach. (United States)

    Capobianco, Enrico; Lio', Pietro


    Comorbidity represents an extremely complex domain of research. An individual entity, the patient, is the center of gravity of a system characterized by multiple, complex, and interrelated conditions, disorders, or diseases. Such complexity is influenced by uncertainty that is difficult to decipher and is proportional to the number of associated morbidities. Computational scientists usually provide meta-analysis studies aimed at integrating various types of evidence, but in our opinion they may help reformulate comorbidity by emphasizing, in particular, two aspects: (i) a systems approach, which allows for an ensemble view of comorbidity, and offers a model representation generalizable to multimorbidity; and (ii) a dynamic network inference approach, which is indicated for the analysis of links among morbidities and evaluation of risk. Notably, the main question remains whether such instruments suggest a shift of paradigm providing prospective impact on medical practice. We have identified in the simultaneous consideration of multiple dimensions linked to comorbidity complexity the rationale for such translation. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Engineering approaches to immunotherapy. (United States)

    Swartz, Melody A; Hirosue, Sachiko; Hubbell, Jeffrey A


    As the science of immunology grows increasingly mechanistic, motivation for developing quantitative, design-based engineering approaches has also evolved, both for therapeutic interventions and for elucidating immunological pathways in human disease. This has seeded the nascent field of "immunoengineering," which seeks to apply engineering analyses and design approaches to problems in translational immunology. For example, cell engineers are creating ways to tailor and use immune cells as living therapeutics; protein engineers are devising new methods of rapid antibody discovery; biomaterials scientists are guiding vaccine delivery and immune-cell activation with novel constructs; and systems immunologists are deciphering the evolution and maintenance of T and B cell receptor repertoires, which could help guide vaccine design. The field is multidisciplinary and collaborative, with engineers and immunologists working together to better understand and treat disease. We discuss the scientific progress in this young, yet rapidly evolving research area, which has yielded numerous start-up companies that are betting on impact in clinical and commercial translation in the near future.

  14. Breakfast: a multidisciplinary approach. (United States)

    Affinita, Antonio; Catalani, Loredana; Cecchetto, Giovanna; De Lorenzo, Gianfranco; Dilillo, Dario; Donegani, Giorgio; Fransos, Lucia; Lucidi, Fabio; Mameli, Chiara; Manna, Elisa; Marconi, Paolo; Mele, Giuseppe; Minestroni, Laura; Montanari, Massimo; Morcellini, Mario; Rovera, Giuseppe; Rotilio, Giuseppe; Sachet, Marco; Zuccotti, Gian Vincenzo


    The role of breakfast as an essential part of an healthy diet has been only recently promoted even if breakfast practices were known since the Middle Age. The growing scientific evidences on this topic are extremely sector-based nevertheless breakfast could be regarded from different point of views and from different expertises. This approach, that take into account history, sociology, anthropology, medicine, psychology and pedagogy, is useful to better understand the value of this meal in our culture. The aim of this paper was to analyse breakfast-related issues based on a multidisciplinary approach with input by specialists from different fields of learning. Breakfast is now recommended as part of a diet because it is associated with healthier macro- and micronutrient intakes, body mass index and lifestyle. Moreover recent studies showed that breakfast improves cognitive function, intuitive perception and academic performance. Research demonstrates the importance of providing breakfast not only to children but in adults and elderly too. Although the important role breakfast plays in maintaining the health, epidemiological data from industrialised countries reveal that many individuals either eat a nutritionally unhealthy breakfast or skip it completely. The historical, bio-psychological and educational value of breakfast in our culture is extremely important and should be recognized and stressed by the scientific community. Efforts should be done to promote this practice for the individual health and well-being.

  15. Management practice: phenomenological approach

    Directory of Open Access Journals (Sweden)

    Myriam Siqueira da Cunha


    Full Text Available This work has the aim of understanding the lived experiences by managers in relation to organizational changes in an enterprise in the food area, located in the State of Rio Grande do Sul, Brazil. The role of managers has been constantly evaluated and their capacity of continuous learning and also the ability of transforming the learning in good organizational results is reacquired every instant. In this work, my intention is to show, using an interpretative analysis, real and practical situations, from lived experiences. The methodological way followed was the hermeneutic phenomenological approach, trying to give a global and a contextual treatment to the theme. The results achieved offer subsides for a new look over the management practice and point out the importance of the study of what is lived, as an inspiration source for the strategic decisions in the enterprises.

  16. Slurry pipeline design approach

    Energy Technology Data Exchange (ETDEWEB)

    Betinol, Roy; Navarro R, Luis [Brass Chile S.A., Santiago (Chile)


    Compared to other engineering technologies, the design of a commercial long distance Slurry Pipeline design is a relatively new engineering concept which gained more recognition in the mid 1960 's. Slurry pipeline was first introduced to reduce cost in transporting coal to power generating units. Since then this technology has caught-up worldwide to transport other minerals such as limestone, copper, zinc and iron. In South America, the use of pipeline is commonly practiced in the transport of Copper (Chile, Peru and Argentina), Iron (Chile and Brazil), Zinc (Peru) and Bauxite (Brazil). As more mining operations expand and new mine facilities are opened, the design of the long distance slurry pipeline will continuously present a commercially viable option. The intent of this paper is to present the design process and discuss any new techniques and approach used today to ensure a better, safer and economical slurry pipeline. (author)

  17. Towards a Dual Approach

    DEFF Research Database (Denmark)

    Holli, Anne Maria; Harder, Mette Marie Stæhr


    countries acknowledged as forerunners in gender equality, which also have ‘fairly strong’ parliamentary standing committees. The results show that both committees on gender equality can be regarded as ‘feminist’ in character and both interact with relevant civil society organisations. Their impact......Drawing on insights from state feminism and legislative studies on parliamentary committees, this article develops a dual approach for the comparative analysis of committees on gender equality. Empirically, it compares the standing committees on gender equality in Denmark and Finland, two Nordic...... as measured by legislative outputs and oversight differs, however, in line with differing committee system characteristics: the Finnish committee has more impact on legislative outputs while the Danish committee has more impact on overseeing government....

  18. Globalization - Different approaches

    Directory of Open Access Journals (Sweden)

    Viorica Puscaciu


    Full Text Available In this paper we investigate the different approaches of the globalization phenomenon. Despite the geographical distancesm, the link between people are ever more strong on different ways and plans: from technology between political, economical, cultural world events, and many other aspects. So, the link between globalization and democracy, and its impact on the most important social and economic matters. We also surprise the impact of the internet revolution and its corolar e-commerce, and its consequences, sometimes unpredictible ones. Another annalysed problem is that of the governments trying, and sometimes succeeding to controll the money, products, peole and their ideas that freely move inside the national frontiers, thus going to slower or to stop the progress. Nevertheless, this global interraction between people also create phenomena of insecurity on different ways: terrorism, traffic of arms, drugs, economical aggresions causing the environment, and other inconvenient facts and situations.

  19. Bioengineering a conceptual approach

    CERN Document Server

    Pavlovic, Mirjana


    This book explores critical principles and new concepts in bioengineering, integrating the biological, physical and chemical laws and principles that provide a foundation for the field. Both biological and engineering perspectives are included, with key topics such as the physical-chemical properties of cells, tissues and organs; principles of molecules; composition and interplay in physiological scenarios; and the complex physiological functions of heart, neuronal cells, muscle cells and tissues. Chapters evaluate the emerging fields of nanotechnology, drug delivery concepts, biomaterials, and regenerative therapy. The leading individuals and events are introduced along with their critical research. Bioengineering: A Conceptual Approach is a valuable resource for professionals or researchers interested in understanding the central elements of bioengineering. Advanced-level students in biomedical engineering and computer science will also find this book valuable as a secondary textbook or reference.

  20. Integration a functional approach

    CERN Document Server

    Bichteler, Klaus


    This book covers Lebesgue integration and its generalizations from Daniell's point of view, modified by the use of seminorms. Integrating functions rather than measuring sets is posited as the main purpose of measure theory. From this point of view Lebesgue's integral can be had as a rather straightforward, even simplistic, extension of Riemann's integral; and its aims, definitions, and procedures can be motivated at an elementary level. The notion of measurability, for example, is suggested by Littlewood's observations rather than being conveyed authoritatively through definitions of (sigma)-algebras and good-cut-conditions, the latter of which are hard to justify and thus appear mysterious, even nettlesome, to the beginner. The approach taken provides the additional benefit of cutting the labor in half. The use of seminorms, ubiquitous in modern analysis, speeds things up even further. The book is intended for the reader who has some experience with proofs, a beginning graduate student for example. It might...

  1. Life History Approach

    DEFF Research Database (Denmark)

    Olesen, Henning Salling


    of the social and the psychic, both in the interpretation procedure and in some main theoretical understandings of language, body and mind. My article will present the reflections on the use of life history based methodology in learning and education research as a kind of learning story of research work.......The article presents a development of biographical research in education and learning research, in which psycho-societal interpretations play a key role. The horizon of the approach is the lifelong subjective engagement in intended as well as unintended learning, in formal education as well...... as in everyday life. Life histories represent lived lives past, present and anticipated future. As such they are interpretations of individuals’ experiences of the way in which societal dynamics take place in the individual body and mind, either by the individual him/herself or by another biographer. The Life...

  2. Cognitive approaches to emotions. (United States)

    Oatley, Keith; Johnson-Laird, P N


    Cognitive approaches offer clear links between how emotions are thought about in everyday life and how they are investigated psychologically. Cognitive researchers have focused on how emotions are caused when events or other people affect concerns and on how emotions influence processes such as reasoning, memory, and attention. Three representative cognitive theories of emotion continue to develop productively: the action-readiness theory, the core-affect theory, and the communicative theory. Some principles are common to them and divergences can be resolved by future research. Recent explanations have included how emotions structure social relationships, how they function in psychological illnesses, and how they are central to music and fiction. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Laparoscopic approach to hysterectomy

    Directory of Open Access Journals (Sweden)

    Hakan Nazik


    Full Text Available Modern laparoscopic surgery is widely used throughout the world as it offers greater advantages than open procedures. The laparoscopic approach to hysterectomy has evolved over the last 20 years. Hysterectomies are performed abdominally, vaginally, laparoscopically or, more recently, with robotic assistance. Indications for a total laparoscopic hysterectomy are similar to those for total abdominal hysterectomy, and most commonly include uterine leiomyomata, pelvic organ prolapse, and abnormal uterine bleeding. When hysterectomy is going to be performed, the surgeon should decide which method is safer and more cost-effective. This paper aims to make a review of the indications, techniques and advantages of laparoscopic hysterectomy as well as the criteria to be used for appropriate patient selection.

  4. The Tripod Approach

    DEFF Research Database (Denmark)

    Bang, Anne Louise


    -and-break decision for a company. However textile design research has shown that experience of emotional value is closely connected to fabric perception, and much literature suggests that textiles are experienced by a combination of sensory evaluation and memory associations. This paper introduces the Tripod......The term ‘next to my skin’ is frequently used as a way to describe the close bonds between human beings and textiles. It is also widely accepted within the broad field of textile professionals that textile attributes related to emotional value – for example hand, look and drape – can be a make...... Approach as a framework that can support designing the stimuli, which can lead to personal experiences of emotional value in relation to applied textiles. It can be used to access the relevant level of entry in the textile design process focusing on appropriate design parameters, and support designing...

  5. Investigational approaches for mesothelioma

    Directory of Open Access Journals (Sweden)

    Veerle F Surmont


    Full Text Available MPM is a rare, aggressive tumour with a poor prognosis. In view of the poor survival benefit from first-line chemotherapy and the lack of subsequent effective treatment options, there is a strong need for the development of more effective treatment approaches for patients with MPM. This review will provide a comprehensive state of the art of new investigational approaches for mesothelioma. In an introductory section, the aetiology, epidemiology, natural history and standard of care treatment for MPM will be discussed. This review provide an update of the major clinical trials that impact mesothelioma treatment, discuss the impact of novel therapeutics and provide perspective on where the clinical research in mesothelioma is moving.The evidence was collected by a systematic analysis of the literature (2000–2011 using the databases Medline (National Library of Medicine, USA, Embase (Elsevier, Netherlands, Cochrane Library (Great Britain, National Guideline Clearinghouse (USA, HTA Database (International Network of Agencies for Health Technology Assessment – INAHTA, NIH database (USA, International Pleural Mesothelioma Program – WHOLIS (WHO Database , with the following keywords and filters: mesothelioma, guidelines, treatment, surgery, chemotherapy, radiotherapy, review, investigational, drugsCurrently different targeted therapies and biologicals are under investigation for MPM. It is important that the molecular biologic research should first focus on mesothelioma-specific pathways and biomarkers in order to have more effective treatment options for this disease. The use of array technology will be certainly an implicit gain in the identification of new potential prognostic or biomarkers or important pathways in the MPM pathogenesis. Probably a central mesothelioma virtual tissue bank may contribute to the ultimate goal to identify druggable targets and to develop personalized treatment for the MPM patients.

  6. Standard Approaches to the Acetabulum Part 2: Ilioinguinal Approach. (United States)

    Gänsslen, A; Grechenig, S T; Nerlich, M; Müller, M; Grechenig, W


    The ilioinguinal approach is one of the standard approaches in the treatment of displaced acetabular fractures used during the last decades (9). The meta-analysis of Giannoudis et al. showed that 21.9% of acetabular fractures were historically treated using this approach (3). One of the disadvantages of this study was, that studies focussing especially on posterior wall stabilization and studies dealing with more complex fracture types treated by extended approaches were integrated. Thus, these fracture types were overrepresented. Re-analysis excluding these data lead to an increase of the rate of anterior approaches to 25.9%. More recent data (years 2005-2007) from the German multicenter study showed that presently in almost 45% of the cases the single ilioinguinal approach was used and only 38% of patients were stabilized via the KocherLangenbeck approach (11). Historically, the Smith-Peterson approach (15, 17) and the iliofemoral approach were used to treat acetabular fractures. In the 60ies, based on the work by Letournel and Judet, the ilioinguinal approach was developed for acetabular fracture fixation (9). It is an extrapelvic approach resulting in an indirect reconstruction concept of the acetabulum without direct visualization of the articular acetabulum. The ilioinguinal approach was the standard anterior approach during the last 30-40 years. An important advantage is the reduced soft tissue detachment of periarticular muscles with only a small risk of developing heterotopic bone formation. The aim of the second part of "Standard approaches to the acetabulum" is to report on the special topics indication, positioning, exposure, incision, dissection, the anatomical basis of osteosynthesis and present results using ilioinguinal approach.

  7. Anatomical considerations in the treatment of intracranial aneurysms. (United States)

    Almeida, Joao P; Reghin Neto, Matheus; Chaddad Neto, Feres; DE Oliveira, Evandro


    Comprehensive understanding of the vascular anatomy, including anatomic variations, anatomy of the perforators, and areas of irrigation for each specific vascular trunk is relevant for the treatment of intracranial aneurysms. Understanding the microanatomy of the cerebral vessels helps surgeons to select the most appropriate microsurgical approach for each case. Anterior circulation aneurysms may be originated from the internal carotid artery and its branches, anterior cerebral artery, middle cerebral artery and anterior communicating artery. Although presenting different surgical nuances, we favor the use of the pterional approach for most anterior circulation aneurysms. In some instances, extensions of the pterional approach improve the surgical exposure and may be selected. In its turn, posterior fossa aneurysms remain a challenge to the neurosurgeon. The exquisite eloquence and complexity of posterior fossa contents require a through knowledge of microsurgical anatomy of this region. Such anatomic background guides the surgeon to the most appropriate approach, which may vary dependind on the size, position of the aneuryms and its relatonship to the surrounding structures.

  8. Structural Sustainability - Heuristic Approach (United States)

    Rostański, Krzysztof


    Nowadays, we are faced with a challenge of having to join building structures with elements of nature, which seems to be the paradigm of modern planning and design. The questions arise, however, with reference to the following categories: the leading idea, the relation between elements of nature and buildings, the features of a structure combining such elements and, finally, our perception of this structure. If we consider both the overwhelming globalization and our attempts to preserve local values, the only reasonable solution is to develop naturalistic greenery. It can add its uniqueness to any building and to any developed area. Our holistic model, presented in this paper, contains the above mentioned categories within the scope of naturalism. The model is divided into principles, actions related, and possible effects to be obtained. It provides a useful tool for determining the ways and priorities of our design. Although it is not possible to consider all possible actions and solutions in order to support sustainability in any particular design, we can choose, however, a proper mode for our design according to the local conditions by turning to the heuristic method, which helps to choose priorities and targets. Our approach is an attempt to follow the ways of nature as in the natural environment it is optimal solutions that appear and survive, idealism being the domain of mankind only. We try to describe various natural processes in a manner comprehensible to us, which is always a generalization. Such definitions, however, called artificial by naturalists, are presented as art or the current state of knowledge by artists and engineers. Reality, in fact, is always more complicated than its definitions. The heuristic method demonstrates the way how to optimize our design. It requires that all possible information about the local environment should be gathered, as the more is known, the fewer mistakes are made. Following the unquestionable principles, we can

  9. Halitosis: the multidisciplinary approach. (United States)

    Bollen, Curd M L; Beikler, Thomas


    Halitosis, bad breath or oral malodour are all synonyms for the same pathology. Halitosis has a large social and economic impact. For the majority of patients suffering from bad breath, it causes embarrassment and affects their social communication and life. Moreover,halitosis can be indicative of underlying diseases. Only a limited number of scientific publications were presented in this field until 1995. Ever since, a large amount of research is published, often with lack of evidence. In general, intraoral conditions, like insufficient dental hygiene, periodontitis or tongue coating are considered to be the most important cause (85%) for halitosis. Therefore, dentists and periodontologists are the first-line professionals to be confronted with this problem. They should be well aware of the origin, the detection and especially of the treatment of this pathology. In addition, ear-nose-throat-associated (10%) or gastrointestinal/endocrinological (5%) disorders may contribute to the problem. In the case of halitophobia, psychiatrical or psychological problems may be present. Bad breath needs a multidisciplinary team approach: dentists, periodontologists, specialists in family medicine, ear-nose-throat surgeons, internal medicine and psychiatry need to be updated in this field, which still is surrounded by a large taboo.Multidisciplinary bad breath clinics offer the best environment to examine and treat this pathology that affects around 25% of the whole population. This article describes the origin, detection and treatment of halitosis, regarded from the different etiological origins.

  10. Combinatorial approach to modularity. (United States)

    Radicchi, Filippo; Lancichinetti, Andrea; Ramasco, José J


    Communities are clusters of nodes with a higher than average density of internal connections. Their detection is of great relevance to better understand the structure and hierarchies present in a network. Modularity has become a standard tool in the area of community detection, providing at the same time a way to evaluate partitions and, by maximizing it, a method to find communities. In this work, we study the modularity from a combinatorial point of view. Our analysis (as the modularity definition) relies on the use of the configurational model, a technique that given a graph produces a series of randomized copies keeping the degree sequence invariant. We develop an approach that enumerates the null model partitions and can be used to calculate the probability distribution function of the modularity. Our theory allows for a deep inquiry of several interesting features characterizing modularity such as its resolution limit and the statistics of the partitions that maximize it. Additionally, the study of the probability of extremes of the modularity in the random graph partitions opens the way for a definition of the statistical significance of network partitions.

  11. Approaching Moisture Recycling Governance (United States)

    Keys, Patrick; Wang-Erlandsson, Lan; Gordon, Line; Galaz, Victor; Ebbesson, Jonas


    The spatial and temporal dynamics of water resources are a continuous challenge for effective and sustainable national and international governance. Despite the surface watershed being the typical unit of water management, recent advances in hydrology have revealed 'atmospheric watersheds' - otherwise known as precipitationsheds. Also, recent research has demonstrated that water flowing within a precipitationshed may be modified by land-use change in one location, while the effect of this modification could be felt in a different province, nation, or continent. Notwithstanding these insights, the major legal and institutional implications of modifying moisture recycling have remained unexplored. In this presentation, we examine potential approaches to moisture recycling governance. We first identify a set of international study regions, and then develop a typology of moisture recycling relationships within these regions ranging from bilateral moisture exchange to more complex networks. This enables us to classify different types of legal and institutional governance principles. Likewise, we relate the moisture recycling types to existing land and water governance frameworks and management practices. The complexity of moisture recycling means institutional fit will be difficult to generalize for all moisture recycling relationships, but our typology allows the identification of characteristics that make effective governance of these normally ignored water flows more tenable.

  12. Exploring the integrated approach. (United States)


    The integration of family planning with maternal and child health and nutrition has been implemented in India, but integration with developmental activities like community development involves the linking up of several different disciplines. Current trends of the integrated approach to family planning in the ESCAP countries are discussed by administrators from Bangkok, Manilla, Bangalore, Islamabad, and Trivandrum, India. IPPF experience in the nongovernmental sector found that to succeed, projects must be clearly described, realistic, and capable of evaluation. Development programs can be integrated with family planning programs as well as family planning/population education programs can be integrated with development projects. Possible areas of integration are income-generating skills/services; training programs; nutrition and health (home extension services); environmental sanitation and personal hygiene; water supply, tube wells; water management, conservation; and, utilization of agricultural by-products. The message of family planning can be effectively communciated through community organizations. In the Philippines, services which could be transferred to the field were transferred to volunteers in the barangays (neighborhoods) who worked on other projects, e.g. cooperatives, nutrition. All forum participants agreed that integration is a very good concept, but practising it is a complex reality.


    Directory of Open Access Journals (Sweden)

    Simona-Roxana ULMAN


    Full Text Available Both concepts, integrity and public integrity, are always asked qualities in the social and economic environment, but they are never well defined. In this context, finding precise definitions and offering an ample explanation of the concepts are desired and useful for both economic theoretical and practical levels and become the aim of the present paper. Without a good understanding of a concept, no one is capable to attain it. In this context, it is impossible to ask for a public sector of integrity if both public actors and the citizens do not know what it really means. Therefore, the public actors first have to understand what integrity really supposes, and, then, to be capable to respect its principles. Taking into consideration the effects of public integrity or, on its opposite, of the divergence from it, especially represented by the phenomenon of corruption, on the economy at the macro, but also, on the micro level, public integrity in itself becomes a real economic problem that is aimed to be extensively analyzed through our interdisciplinary approach.

  14. Approaches to refractory epilepsy

    Directory of Open Access Journals (Sweden)

    Jerome Engel


    Full Text Available Epilepsy is one of the most common serious neurological conditions, and 30 to 40% of people with epilepsy have seizures that are not controlled by medication. Patients are considered to have refractory epilepsy if disabling seizures continue despite appropriate trials of two antiseizure drugs, either alone or in combination. At this point, patients should be referred to multidisciplinary epilepsy centers that perform specialized diagnostic testing to first determine whether they are, in fact, pharmacoresistant, and then, if so, offer alternative treatments. Apparent pharmacoresistance can result from a variety of situations, including noncompliance, seizures that are not epileptic, misdiagnosis of the seizure type or epilepsy syndrome, inappropriate use of medication, and lifestyle issues. For patients who are pharmacoresistant, surgical treatment offers the best opportunity for complete freedom from seizures. Surgically remediable epilepsy syndromes have been identified, but patients with more complicated epilepsy can also benefit from surgical treatment and require more specialized evaluation, including intracranial EEG monitoring. For patients who are not surgical candidates, or who are unwilling to consider surgery, a variety of other alternative treatments can be considered, including peripheral or central neurostimulation, ketogenic diet, and complementary and alternative approaches. When such alternative treatments are not appropriate or effective, quality of life can still be greatly improved by the psychological and social support services offered by multidisciplinary epilepsy centers. A major obstacle remains the fact that only a small proportion of patients with refractory epilepsy are referred for expert evaluation and treatment.

  15. Approaches to adenomyomectomy

    Directory of Open Access Journals (Sweden)

    Serene Thain


    Full Text Available Adenomyosis is a common gynecological condition that affects women, causing menstrual disturbances, pain, and subfertility. Adenomyomectomy as an alternative to hysterectomy has been widely performed in those who have not completed childbearing or those refusing a hysterectomy for a variety of reasons. Whichever the surgical route, the challenges of adenomyomectomy include possible misdiagnosis, defining the extent of resection, technical difficulties, dealing with the associated complications, and managing the risks of uterine rupture during a subsequent pregnancy. The principles of surgery mimic those of myomectomy, but the evolution of adenomyomectomy has been relatively unexciting with a general paucity of published data to date. Laparoscopic techniques have proven feasible generally, avoiding the risks of open surgery while conferring the benefits of microsurgery. Limitations in tactile feedback and access constraints have been the main drawbacks via this route. Meticulous stitching and repair is still of paramount importance in these operations. Preoperative gonadotropin-releasing hormone agonists have proven effective in shrinking the disease and reducing blood loss during surgery, whereas the postoperative use has resulted in a dramatic reduction in symptoms. Uterine artery ligation techniques have also been shown to be useful adjuncts, although we still need to be mindful of the potential effects in those desiring fertility. Furthermore, there is still no foolproof way in predicting those at risk of uterine rupture after adenomyomectomy. Hence, a nonprescriptive approach in managing adenomyomas is advised, where proper patient selection and counseling are important.

  16. Combinatorial approach to modularity (United States)

    Radicchi, Filippo; Lancichinetti, Andrea; Ramasco, José J.


    Communities are clusters of nodes with a higher than average density of internal connections. Their detection is of great relevance to better understand the structure and hierarchies present in a network. Modularity has become a standard tool in the area of community detection, providing at the same time a way to evaluate partitions and, by maximizing it, a method to find communities. In this work, we study the modularity from a combinatorial point of view. Our analysis (as the modularity definition) relies on the use of the configurational model, a technique that given a graph produces a series of randomized copies keeping the degree sequence invariant. We develop an approach that enumerates the null model partitions and can be used to calculate the probability distribution function of the modularity. Our theory allows for a deep inquiry of several interesting features characterizing modularity such as its resolution limit and the statistics of the partitions that maximize it. Additionally, the study of the probability of extremes of the modularity in the random graph partitions opens the way for a definition of the statistical significance of network partitions.

  17. Exploring Mouse Protein Function via Multiple Approaches

    National Research Council Canada - National Science Library

    Huang, Guohua; Chu, Chen; Huang, Tao; Kong, Xiangyin; Zhang, Yunhua; Zhang, Ning; Cai, Yu-Dong


    .... In this study, we presented a novel approach to predict mouse protein functions. The approach was a sequential combination of a similarity-based approach, an interaction-based approach and a pseudo amino acid composition-based approach...

  18. Intermodal service - system approach

    Directory of Open Access Journals (Sweden)

    Mirosław Antonowicz


    Full Text Available   Introduction: Transportation services may be described in systemic categories. Intermodal freight transport is a practical expression of the system approach to transport. Development of the intermodal transport system has brought about the need for the comprehensive grasp of transportation processes. Intermodal transport operators manage the whole transportation service organization process. Hence, a question arises whether the service offered by an intermodal transport operator may be interpreted as a complex system service. Systemness of contemporary products and services consists in that their value for clients is predefined by their place in the whole system of products and/or services as well as by the network of their users. The network language, occurring in this paper, is connected with the development of the notion of network, one of the inspiring ideas in organization and management science of the recent years. Methods: Literature on the intermodal freight transport issue has been analysed by the present author for the purposes of this paper, with a view to the developing idea of marketing of system products. Within the adopted interpretative paradigm, qualitative / quantitative research was used. Case study is used, among others, to interpret a particular situation, in a way that the subsequent description appears as the research result and may be recognized as valuable contribution to the existent knowledge. The aim of the paper is to highlight, following the research results, the necessity to treat the service offered by intermodal transport operators in system categories. Such systemic interpretation points both to the multitude of components of the service and to the arising opportunity for comprehensive solution of the clients' needs and expectations. Results: The outcomes reveal that the service offered by an intermodal transport operator may be recognized as the complex systemic intermodal service. They contribute to the

  19. Diagnostic approach to diplopia. (United States)

    Dinkin, Marc


    This article offers a pragmatic roadmap to the practicing neurologist on how to approach the patient with double vision. Strategies of history taking and examination techniques are reviewed, followed by a broad overview of the causes of diplopia organized by neuroanatomic localization. Diplopia may be the first symptom of serious vision or life-threatening neurologic disease, and its correct localization and diagnosis are therefore essential. The systems responsible for ocular movement and alignment in the vertical and horizontal plane include complex supranuclear circuitry, brainstem nuclei, cranial nerves III, IV, and VI, and their respective neuromuscular junctions and target muscles. Disruption at any point within this system or within the vestibular afferents that govern eye movement in response to head movements may therefore produce diplopia, leading to a broad differential diagnosis for the patient with diplopia. With a careful history and examination, the neurologist should be able to observe the patterns of diplopia that reveal the site of dysfunction, thus generating a shorter localization-specific list of possible etiologies. Examination of ocular motility including smooth pursuit and saccadic function, followed, if necessary, by testing designed to uncover misalignments of the eyes, including cover and Maddox rod testing, are primary components of the efferent neurologic examination. Further testing designed to detect myasthenia (eg, lid testing and fatigable upgaze) and orbital disease (eg, measuring proptosis, testing for resistance to retropulsion) may be necessary. Recent advances in the diagnosis of diplopia include the observation that vertical diplopia from skew deviation is more likely to improve with supine positioning than that caused by trochlear nerve palsies. Advances in the field of ocular myasthenia include the observation of decreased conversion to the generalized form with treatment with either steroids or thymectomy, although these

  20. The narrative approach to personalisation (United States)

    Conlan, Owen; Staikopoulos, Athanasios; Hampson, Cormac; Lawless, Séamus; O'keeffe, Ian


    This article describes the narrative approach to personalisation. This novel approach to the generation of personalised adaptive hypermedia experiences employs runtime reconciliation between a personalisation strategy and a number of contextual models (e.g. user and domain). The approach also advocates the late binding of suitable content and services to the generated personalised pathway resulting in an interactive composition that comprises services as well as content. This article provides a detailed definition of the narrative approach to personalisation and showcases the approach through the examination of two use-cases: the personalised digital educational games developed by the ELEKTRA and 80Days projects; and the personalised learning activities realised as part of the AMAS project. These use-cases highlight the general applicability of the narrative approach and how it has been applied to create a diverse range of real-world systems.

  1. New Approaches to Final Cooling

    Energy Technology Data Exchange (ETDEWEB)

    Neuffer, David [Fermilab


    A high-energy muon collider scenario require a “final cooling” system that reduces transverse emittances by a factor of ~10 while allowing longitudinal emittance increase. The baseline approach has low-energy transverse cooling within high-field solenoids, with strong longitudinal heating. This approach and its recent simulation are discussed. Alternative approaches which more explicitly include emittance exchange are also presented. Round-to-flat beam transform, transverse slicing, and longitudinal bunch coalescence are possible components of the alternative approach. A more explicit understanding of solenoidal cooling beam dynamics is introduced.

  2. Simplified Approach to Inspection Planning

    DEFF Research Database (Denmark)

    Bloch, Allan; Sørensen, John Dalsgaard; Faber, Michael Havbro


    structural details and thereby develop pre-made inspection plans in tables which depend on relative cost of inspections, repairs and failures. Due to the simplicity of the format of the developed inspection plans the proposed approach has a high potential in code making for the design and maintenance......A simplified and practically applicable approach for risk based inspection planning of fatigue sensitive structural details is presented. The basic idea behind the approach is that the fatigue sensitive details are categorized according to their stress intensity factors and their design fatigue...... of steel structures. The validity of the proposed approach is illustrated through a study regarding inspection planning of offshore structures....

  3. Microbial Burden Approach : New Monitoring Approach for Measuring Microbial Burden (United States)

    Venkateswaran, Kasthuri; Vaishampayan, Parag; Barmatz, Martin


    Advantages of new approach for differentiating live cells/ spores from dead cells/spores. Four examples of Salmonella outbreaks leading to costly destruction of dairy products. List of possible collaboration activities between JPL and other industries (for future discussion). Limitations of traditional microbial monitoring approaches. Introduction to new approach for rapid measurement of viable (live) bacterial cells/spores and its areas of application. Detailed example for determining live spores using new approach (similar procedure for determining live cells). JPL has developed a patented approach for measuring amount of live and dead cells/spores. This novel "molecular" method takes less than 5 to 7 hrs. compared to the seven days required using conventional techniques. Conventional "molecular" techniques can not discriminate live cells/spores among dead cells/spores. The JPL-developed novel method eliminates false positive results obtained from conventional "molecular" techniques that lead to unnecessary delay in the processing and to unnecessary destruction of food products.


    African Journals Online (AJOL)

    DREAM OR POSSIBILITY? Jo-Anne Ferreira. Research indicates that few teachers are currently using a democratic approach to teaching in environmental education even though much of the environmental education literature supports and encourages such an approach. Various explanations are offered for this situation ...

  5. Extending cosmology: the metric approach


    Mendoza, S.


    Comment: 2012, Extending Cosmology: The Metric Approach, Open Questions in Cosmology; Review article for an Intech "Open questions in cosmology" book chapter (19 pages, 3 figures). Available from:

  6. Current approaches to norms research (United States)

    John L. Heywood


    The dialogue session was a continuation of a debate about norms and the application of normative standards to wilderness management that has taken place throughout the 1990s at national meetings and in the research literature. Researchers who have made significant contributions to the normative approach to wilderness recreation management presented three approaches to...

  7. Workplace English: Approach and Analysis. (United States)

    Prince, David


    Describes two approaches to teaching vocational English as a second language: (1) describing work activities in terms of processes and procedures and (2) describing work activities in terms of specific human behaviors. Suggests a goal analysis as an initial step before deciding which approach to take in any training project. (SED)

  8. An approach to the future (United States)

    Peter C. Bishop


    This paper describes the rudiments of an approach to the future that we should teach and practice in our personal and professional lives. It begins with a consideration of change. The future is about change. If there were no change, we would have no reason to pay attention to the future. The paper concludes with an approach to long-term forecasting that takes...

  9. Adolescent Suicide: An Ecological Approach. (United States)

    Ayyash-Abdo, Huda


    Proposes an ecological approach to enhance our understanding of how personal, interpersonal, and sociocultural factors contribute to the increased risk for suicide among adolescents. The ecological approach allows exploration of how adolescent suicide is determined by multiple factors related to the adolescent's personal history or ontogenic…

  10. Alcoholism: A Family System Approach (United States)

    Foley, Vincent D.


    One approach to the problem of alcohol is to see it less as that of an individual's and more as the result of the interaction of a given family system. A structural approach is suggested in which the family system is examined and rearranged into a new and functioning system. (Author/NG)

  11. Library Administration: A Humanistic Approach. (United States)

    Hood, Lillian


    Discusses the tasks of library administration in relation to autocratic, participatory, and contingency approaches to management problems. The psychological and organizational side-effects of the three management styles are considered and a humanistic combination of approaches is suggested. A bibliography is included. (JL)

  12. Systems Approach to Environmental Pollution. (United States)

    Chacko, George K., Ed.

    The objective of a two-day Symposium on Systems Approach to Environmental Pollution of the Operations Research Society of America at the 137th Annual Meeting of the American Association for the Advancement of Science, December 27-28, 1970 in Chicago, Illinois, was not to raise the litany of a systems approach as the answer to all environmental…


    Directory of Open Access Journals (Sweden)

    S. V. Bibikov


    Full Text Available The paper deals with detection algorithm for rail vibroacoustic waves caused by approaching train on the background of increased noise. The urgency of algorithm development for train detection in view of increased rail noise, when railway lines are close to roads or road intersections is justified. The algorithm is based on the method of weak signals detection in a noisy environment. The information statistics ultimate expression is adjusted. We present the results of algorithm research and testing of the train approach alarm device that implements the proposed algorithm. The algorithm is prepared for upgrading the train approach alarm device “Signalizator-P".

  14. Probabilistic approach to pattern selection (United States)

    Yukalov, V. I.


    The problem of pattern selection arises when the evolution equations have many solutions, whereas observed patterns constitute a much more restricted set. An approach is advanced for treating the problem of pattern selection by defining the probability distribution of patterns. Then the most probable pattern naturally corresponds to the largest probability weight. This approach provides the ordering principle for the multiplicity of solutions explaining why some of them are more preferable than others. The approach is applied to solving the problem of turbulent photon filamentation in resonant media.

  15. A Biosemiotic Approach to Health

    DEFF Research Database (Denmark)

    Hoffmeyer, Jesper


    By replacing the traditional chemical approach to the understanding of body function by a sign-theoretic or semiotic approach, biosemiotics enters a no-man’s-land between biological and social domains of human life. The aim is not to subsume the social under the biological or vice versa; both...... approaches are invaluable. The aim is to find a common platform that serves in treating human persons as undivided wholes. Since semiosis (viz. the meaningful interpretation of cues, signals, events or states) is vital to communication at both levels, the resulting sign-process is a viable choice...... as the basis for an integrated theory of health....

  16. Vanpooling: the three major approaches

    Energy Technology Data Exchange (ETDEWEB)

    Sears, P.M.


    The manual provides technical assistance to existing or prospective vanpool sponsors. It is designed to help them promote vanpooling in its three major approaches: employer sponsored, third party sponsored, and driver owned and operated. The first chapter is an overview of vanpooling and a second chapter, on vanpool marketing, is addressed to ridesharing coordinators and others whose responsibilities include the promotion of vanpooling. Some fact sheets on the three approaches provide convenient summaries of the needs and opportunities of each approach and suggest solutions to practical problems likely to be encountered in starting new vanpool programs.

  17. Approaches to Scandinavian Crime Fiction

    DEFF Research Database (Denmark)

    Agger, Gunhild


    The working paper discusses some of the major approaches to Scandinavian crime fiction in the light of the dominant features of crime culture, e.g. the broad exposure of crime fiction via different platforms and media. In this connection, the concept of mediatization is considered as well...... as the approach of genre typology and the concept of evil – seemingly disparate concepts and approaches, but all related to the complex processes in the borderlands between crime fiction and society. Using examples from Scandinavian crime fiction, I discuss whether the growing proximity to international genres......, ways of production and standards increasingly removes Scandinavian crime fiction from its original attractions or not....

  18. Approaches for assessing sustainable remediation

    DEFF Research Database (Denmark)

    Søndergaard, Gitte Lemming; Binning, Philip John; Bjerg, Poul Løgstrup

    remediation strategies for a contaminated site. Most approaches use multi-criteria assessment methods (MCA) to structure a decision support process. Different combinations of environmental, social and economic criteria are employed, and are assessed either in qualitative or quantitative forms with various...... tools such as life cycle assessment and cost benefit analysis. Stakeholder involvement, which is a key component of sustainable remediation, is conducted in various ways. Some approaches involve stakeholders directly in the evaluation or weighting of criteria, whereas other approaches only indirectly...

  19. Approaches to Teaching Organizational Communication. (United States)

    Applebaum, Ronald L.


    Discusses fundamental problems in selecting an approach to organizational communications; the purpose of an organizational communication course; the structure and content of organizational communication coursework; and teaching strategies used in the basic course in organizational communication. (RS)

  20. Nonlinear Approaches in Engineering Applications

    CERN Document Server

    Jazar, Reza


    Nonlinear Approaches in Engineering Applications focuses on nonlinear phenomena that are common in the engineering field. The nonlinear approaches described in this book provide a sound theoretical base and practical tools to design and analyze engineering systems with high efficiency and accuracy and with less energy and downtime. Presented here are nonlinear approaches in areas such as dynamic systems, optimal control and approaches in nonlinear dynamics and acoustics. Coverage encompasses a wide range of applications and fields including mathematical modeling and nonlinear behavior as applied to microresonators, nanotechnologies, nonlinear behavior in soil erosion,nonlinear population dynamics, and optimization in reducing vibration and noise as well as vibration in triple-walled carbon nanotubes. This book also: Provides a complete introduction to nonlinear behavior of systems and the advantages of nonlinearity as a tool for solving engineering problems Includes applications and examples drawn from the el...

  1. Approach to lower back pain

    African Journals Online (AJOL)

    the number of work days lost. LBP, by ... and psychologically taxing work are also risk factors. ... that in a primary care setting the majority of patents have nonspecific .... multidisciplinary team approach, employing pharmacological and non.

  2. Radiological Approach to Forefoot Pain

    Directory of Open Access Journals (Sweden)

    Sai Chung Ho


    Full Text Available Forefoot pain is a common clinical complaint in orthopaedic practice. In this article, we discuss the anatomy of the forefoot, clinical and radiological approaches to forefoot pain, and common painful forefoot disorders and their associated radiological features.

  3. Treatment Approaches for Drug Addiction (United States)

    ... Trends Nationwide Trends Prevention and Treatment Lessons from Prevention Research Substance Abuse in the Military Treatment Approaches for Drug Addiction Get this Publication Español PDF (773KB) Cite this ...

  4. Fibromyalgia and Complementary Health Approaches (United States)

    ... R S T U V W X Y Z Fibromyalgia: In Depth Share: On This Page What’s the ... about the effectiveness of complementary health approaches for fibromyalgia? Although some studies of tai chi , yoga , mindfulness ...

  5. Humane Education: A Curriculum Approach. (United States)

    Pearce, Robert W.


    Describes a curriculum-based approach to humane education and addresses the role of humane education in the school curriculum as well as the relationship's of education to other facets of animal welfare work. (Author/DS)

  6. Paraspinal approach for thoracolumbar fracture

    Directory of Open Access Journals (Sweden)

    JIANG Rui


    Full Text Available 【Abstract】Objective: To explore the advantages and indications of the paraspinal approach by anatomical study and clinical application. Methods: The anatomical data and clinical practice of 27 cases were analyzed to explore the accurate approach between the paraspinal muscles and the structure of ambient tissues, as well as the results of clinical application of paraspinal approach. The operation time, blood loss, incision length, radiographic result (Cobb angle, height of anterior edge of the vertebrae were compared with those in 24 cases treated by traditional approach. Results: Complete exposure of the facets could be easily performed by identifying natural cleavage plane between the multifidus and longissimus muscles. The natural muscular cleavage was (1.47±0.23 cm lateral to the midline for females, and (1.64±0.35 cm for males at T12 level. The distance was (3.3±0.6 cm lateral to the midline for females, and (3.7±1.0 cm for males at L4 level. In paraspinal approach group, the operation time was (76.2±15.7 min, blood loss was (91.6±16.9 ml and incision length was (7.6±0.8 cm. In traditional approach group, the operation time was (121.4±19.6 min, blood loss was (218.7±32.3 ml and incision length was (17.4±2.1 cm. To compare paraspinal approach with traditional approach, the operation time, blood loss and incision length had statistical difference (P<0.05 and the radiographic result (Cobb angle, height of anterior edge of the vertebrae had no statistical difference (P>0.05. Conclusions: When the paraspinal approach is performed through natural cleavage plane between the multifidus and longissimus muscles, there are no wide muscular disinsertions, leaving the supraspinous and interspinous ligaments intact. The distance of natural cleavage to the midline is different at T12 and L4 planes. By this approach, the facet joints can be explored easily and completely, and a clear surgical field will be available for the placement of

  7. An approach to chaotic synchronization


    Hramov, Alexander E.; Koronovskii, Alexey A.


    This paper deals with the chaotic oscillator synchronization. A new approach to the synchronization of chaotic oscillators has been proposed. This approach is based on the analysis of different time scales in the time series generated by the coupled chaotic oscillators. It has been shown that complete synchronization, phase synchronization, lag synchronization and generalized synchronization are the particular cases of the synchronized behavior called as "time-scale synchronization". The quan...

  8. Bounding approaches to system identification

    CERN Document Server

    Norton, John; Piet-Lahanier, Hélène; Walter, Éric


    In response to the growing interest in bounding error approaches, the editors of this volume offer the first collection of papers to describe advances in techniques and applications of bounding of the parameters, or state variables, of uncertain dynamical systems. Contributors explore the application of the bounding approach as an alternative to the probabilistic analysis of such systems, relating its importance to robust control-system design.

  9. Approaches toward learning in physiotherapy

    Directory of Open Access Journals (Sweden)

    L. Keiller


    Full Text Available The aim of this study was to investigate the approaches toward learning of undergraduate Physiotherapy students in a PBl module to enhance facilitation of learning at the Stellenbosch University, Division of Physiotherapy in South Africa. This quantitative, descriptive study utilized the revised Two-factor Study Process Questionnaire (r-SPQ-2f to evaluate the study cohorts’ approaches toward learning in the module. results of the data instruments were analysed statistically and discussed in a descriptive manner. There were a statistically significant greater number of students who adopted a deep approach toward learning at the commencement of the academic year. Students showed a trend toward an increase in their intrinsic interest in the learning material as the module progressed. Students in the Applied Physiotherapy module (ATP started to shift their focus from a surface learning approach to a deep learning approach. further research is needed to determine the long-term changes in approach toward learning and the possible determinants of these changes. This can be done in conjunction with the implementation of quality assurance mechanisms for learning material and earlier preparation of students for the change in the learning environment.

  10. Approach

    Directory of Open Access Journals (Sweden)

    Guido Pinto Aguirre


    Full Text Available El propósito de este documento es investigar y re-estimar los efectos de los patrones de lactancia, salud y estado nutricional de la mujer y consumo de energía sobre la duración del retorno de la fertilidad de postparto (es decir, retorno de la menstruación de postparto utilizando toda la información relevante en el estudio longitudinal del Instituto de Nutrición de Centroamérica y Panamá y un procedimiento de estimación más adecuado (modelos de riesgo. Los datos utilizados provienen del Estudio Longitudinal llevado a cabo en Guatemala entre 1967 y 1979. En este artículo se utiliza un modelo de riesgo con varios estados que reconoce diferentes caminos y estados en el proceso del retorno de la fertilidad de postparto. El modelo descansa en la existencia de cinco estados (lactancia total, lactancia parcial, destete, mortalidad infantil y menstruación. También incluye de manera explícita nutrición maternal y consumo de energía de la mujer como elementos estratégicos del modelo. El estudio encontró que los efectos de los patrones de lactancia, nutrición de la madre y patrones de trabajo de la mujer (consumo de energía sobre la fertilidad en las áreas rurales de Guatemala son fuertes y significativos. La contribución de este artículo es mostrar que la aplicación de los modelos de riesgo con múltiples estados proporciona estimados que son consistentes con hipótesis que relacionan patrones de lactancia, estado nutricional maternal y estresores maternales externos a procesos que aceleran (desaceleran el retorno de ciclos menstruales normales.

  11. A systems approach to obesity. (United States)

    Lee, Bruce Y; Bartsch, Sarah M; Mui, Yeeli; Haidari, Leila A; Spiker, Marie L; Gittelsohn, Joel


    Obesity has become a truly global epidemic, affecting all age groups, all populations, and countries of all income levels. To date, existing policies and interventions have not reversed these trends, suggesting that innovative approaches are needed to transform obesity prevention and control. There are a number of indications that the obesity epidemic is a systems problem, as opposed to a simple problem with a linear cause-and-effect relationship. What may be needed to successfully address obesity is an approach that considers the entire system when making any important decision, observation, or change. A systems approach to obesity prevention and control has many benefits, including the potential to further understand indirect effects or to test policies virtually before implementing them in the real world. Discussed here are 5 key efforts to implement a systems approach for obesity prevention: 1) utilize more global approaches; 2) bring new experts from disciplines that do not traditionally work with obesity to share experiences and ideas with obesity experts; 3) utilize systems methods, such as systems mapping and modeling; 4) modify and combine traditional approaches to achieve a stronger systems orientation; and 5) bridge existing gaps between research, education, policy, and action. This article also provides an example of how a systems approach has been used to convene a multidisciplinary team and conduct systems mapping and modeling as part of an obesity prevention program in Baltimore, Maryland. © The Author(s) 2016. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail:

  12. Percutaneous puncture of spinal cysts in the diagnosis and therapy of syringomyelia and cystic tumors

    Energy Technology Data Exchange (ETDEWEB)

    Dietemann, J.L.; Babin, E.; Wackenheim, A.; Maitrot, D.; Bonneville, J.F.


    The experience with percutaneous puncture of intraspinal cystic lesions is reported in cases: an extradural cyst demonstrated with air, a spinal cord tumor with lipiodol and two cases of syringomyelia with metrizamide. Percutaneous puncture of cystic lesions makes possible an accurate delineation of the lesion and a histological approach through biochemical and cytological analysis of the aspirated cystic fluid, while aspiration of the fluid of cystic tumors decompresses the spinal cord and thus plays a therapeutic role.

  13. Laparoscopic approach in gastrointestinal emergencies. (United States)

    Jimenez Rodriguez, Rosa M; Segura-Sampedro, Juan José; Flores-Cortés, Mercedes; López-Bernal, Francisco; Martín, Cristobalina; Diaz, Verónica Pino; Ciuro, Felipe Pareja; Ruiz, Javier Padillo


    This review focuses on the laparoscopic approach to gastrointestinal emergencies and its more recent indications. Laparoscopic surgery has a specific place in elective procedures, but that does not apply in emergency situations. In specific emergencies, there is a huge range of indications and different techniques to apply, and not all of them are equally settle. We consider that the most controversial points in minimally invasive procedures are indications in emergency situations due to technical difficulties. Some pathologies, such as oesophageal emergencies, obstruction due to colon cancer, abdominal hernias or incarcerated postsurgical hernias, are nearly always resolved by conventional surgery, that is, an open approach due to limited intraabdominal cavity space or due to the vulnerability of the bowel. These technical problems have been solved in many diseases, such as for perforated peptic ulcer or acute appendectomy for which a laparoscopic approach has become a well-known and globally supported procedure. On the other hand, endoscopic procedures have acquired further indications, relegating surgical solutions to a second place; this happens in cholangitis or pancreatic abscess drainage. This endoluminal approach avoids the need for laparoscopic development in these diseases. Nevertheless, new instruments and new technologies could extend the laparoscopic approach to a broader array of potentials procedures. There remains, however, a long way to go.

  14. an alternative approach to t reservations for hand ative approach

    African Journals Online (AJOL)


    ETF CENTRE OF EXCELLENCE IN COMM. N. E-m. ABSTRACT. This work presents an alternative approach to the c network for handover call requests. Prioritizing so as to guarantee seamless connection. Successful h the later is directly dependent on call continuit reservations to be made was determined using the G.

  15. Approaches to Teaching Early Reading: Whole Language or Phonic Approach?

    Directory of Open Access Journals (Sweden)

    Didi Sukyadi


    Full Text Available Abstract: The impacts of the great debate on early reading instruc­tion, which was started in the late 1960 and early 1970s, remain until today. In our education system, curriculum change also brings about the change of teaching ideology. For teachers, the result sometimes is more threatening than encouraging because they cannot anticipate the quick and inevitable change. They become disempowered and deprived, and that innovation is often difficult to implement. This study aimed to explore the orientation of student teachers and expe­rienced teachers towards reading instruction, namely phonic, skills, and whole language approach. This involved 30 primary student teachers of an Institute of Education in London and 30 experienced teachers teaching at Year 1 and 2 London inner city primary schools. Each of the respondents was sent a questionnaire, and asked to answer an open ended question concerning the best approach of teaching reading. The results revealed that in general there was no difference in teaching reading orientation between student teachers and experienced teachers. Both of them tend to believe that there was no single best method. The competing approaches are seen as comple­mentary. Any approach chosen should take into account child devel­opment, the nature of reading and environmental support. The impli­cations of these findings for teacher empowerment are discussed.

  16. New approaches to antibiotic discovery. (United States)

    Kealey, C; Creaven, C A; Murphy, C D; Brady, C B


    New antibiotics are urgently required by human medicine as pathogens emerge with developed resistance to almost all antibiotic classes. Pioneering approaches, methodologies and technologies have facilitated a new era in antimicrobial discovery. Innovative culturing techniques such as iChip and co-culturing methods which use 'helper' strains to produce bioactive molecules have had notable success. Exploiting antibiotic resistance to identify antibacterial producers performed in tandem with diagnostic PCR based identification approaches has identified novel candidates. Employing powerful metagenomic mining and metabolomic tools has identified the antibiotic'ome, highlighting new antibiotics from underexplored environments and silent gene clusters enabling researchers to mine for scaffolds with both a novel mechanism of action and also few clinically established resistance determinants. Modern biotechnological approaches are delivering but will require support from government initiatives together with changes in regulation to pave the way for valuable, efficacious, highly targeted, pathogen specific antimicrobial therapies.

  17. Solid mechanics a variational approach

    CERN Document Server

    Dym, Clive L


    Solid Mechanics: A Variational Approach, Augmented Edition presents a lucid and thoroughly developed approach to solid mechanics for students engaged in the study of elastic structures not seen in other texts currently on the market. This work offers a clear and carefully prepared exposition of variational techniques as they are applied to solid mechanics. Unlike other books in this field, Dym and Shames treat all the necessary theory needed for the study of solid mechanics and include extensive applications. Of particular note is the variational approach used in developing consistent structural theories and in obtaining exact and approximate solutions for many problems.  Based on both semester and year-long courses taught to undergraduate seniors and graduate students, this text is geared for programs in aeronautical, civil, and mechanical engineering, and in engineering science. The authors’ objective is two-fold: first, to introduce the student to the theory of structures (one- and two-dimensional) as ...

  18. Toward predicate approaches to modality

    CERN Document Server

    Stern, Johannes


    In this volume, the author investigates and argues for, a particular answer to the question: What is the right way to logically analyze modalities from natural language within formal languages? The answer is: by formalizing modal expressions in terms of predicates. But, as in the case of truth, the most intuitive modal principles lead to paradox once the modal notions are conceived as predicates. The book discusses the philosophical interpretation of these modal paradoxes and argues that any satisfactory approach to modality will have to face the paradoxes independently of the grammatical category of the modal notion. By systematizing modal principles with respect to their joint consistency and inconsistency, Stern provides an overview of the options and limitations of the predicate approach to modality that may serve as a useful starting point for future work on predicate approaches to modality. Stern also develops a general strategy for constructing philosophically attractive theories of modal notions conce...

  19. City evacuations an interdisciplinary approach

    CERN Document Server

    Binner, Jane; Branicki, Layla; Galla, Tobias; Jones, Nick; King, James; Kolokitha, Magdalini; Smyrnakis, Michalis


    Evacuating a city is a complex problem that involves issues of governance, preparedness education, warning, information sharing, population dynamics, resilience and recovery. As natural and anthropogenic threats to cities grow, it is an increasingly pressing problem for policy makers and practitioners.   The book is the result of a unique interdisciplinary collaboration between researchers in the physical and social sciences to consider how an interdisciplinary approach can help plan for large scale evacuations.  It draws on perspectives from physics, mathematics, organisation theory, economics, sociology and education.  Importantly it goes beyond disciplinary boundaries and considers how interdisciplinary methods are necessary to approach a complex problem involving human actors and increasingly complex communications and transportation infrastructures.   Using real world case studies and modelling the book considers new approaches to evacuation dynamics.  It addresses questions of complexity, not only ...

  20. Market-based approaches to tree valuation (United States)

    Geoffrey H. Donovan; David T. Butry


    A recent four-part series in Arborist News outlined different appraisal processes used to value urban trees. The final article in the series described the three generally accepted approaches to tree valuation: the sales comparison approach, the cost approach, and the income capitalization approach. The author, D. Logan Nelson, noted that the sales comparison approach...

  1. Elementary calculus an infinitesimal approach

    CERN Document Server

    Keisler, H Jerome


    This first-year calculus book is centered around the use of infinitesimals, an approach largely neglected until recently for reasons of mathematical rigor. It exposes students to the intuition that originally led to the calculus, simplifying their grasp of the central concepts of derivatives and integrals. The author also teaches the traditional approach, giving students the benefits of both methods.Chapters 1 through 4 employ infinitesimals to quickly develop the basic concepts of derivatives, continuity, and integrals. Chapter 5 introduces the traditional limit concept, using approximation p

  2. Real analysis a constructive approach

    CERN Document Server

    Bridger, Mark


    A unique approach to analysis that lets you apply mathematics across a range of subjects This innovative text sets forth a thoroughly rigorous modern account of the theoretical underpinnings of calculus: continuity, differentiability, and convergence. Using a constructive approach, every proof of every result is direct and ultimately computationally verifiable. In particular, existence is never established by showing that the assumption of non-existence leads to a contradiction. The ultimate consequence of this method is that it makes sense-not just to math majors but also to students from a

  3. A Psycho-Societal Approach

    DEFF Research Database (Denmark)

    Mellon, Karsten

    This is a project about Danish vocational bachelor students admitted on the basis of an Individual Competency Assessment (VPL/IKV) in light of a Psycho-Societal Approach. The core idea of this paper is to present a PhD project which aims to contribute findings regarding students enrolled in a Dan......This is a project about Danish vocational bachelor students admitted on the basis of an Individual Competency Assessment (VPL/IKV) in light of a Psycho-Societal Approach. The core idea of this paper is to present a PhD project which aims to contribute findings regarding students enrolled...

  4. A practical approach to TQI. (United States)

    Perras, S T; Mattern, M


    Total quality improvement (TQI) is a refreshing new approach to leadership that can be applied to a dialysis setting. The team approach to prospective data analysis is used for problem solution and reevaluation. Adapting theory to daily practical application can be successfully done using time, energy, and full senior management commitment. Staff education and involvement are essential to successful program implementation. Evaluation tools are easily adapted to analyze common dialysis problems. The initial time invested in education and data collection can be great but results in a streamlined process.

  5. New Approaches to Reliability Assessment

    DEFF Research Database (Denmark)

    Ma, Ke; Wang, Huai; Blaabjerg, Frede


    of energy. New approaches for reliability assessment are being taken in the design phase of power electronics systems based on the physics-of-failure in components. In this approach, many new methods, such as multidisciplinary simulation tools, strength testing of components, translation of mission profiles......, and statistical analysis, are involved to enable better prediction and design of reliability for products. This article gives an overview of the new design flow in the reliability engineering of power electronics from the system-level point of view and discusses some of the emerging needs for the technology...

  6. Systems biology approach to bioremediation

    Energy Technology Data Exchange (ETDEWEB)

    Chakraborty, Romy; Wu, Cindy H.; Hazen, Terry C.


    Bioremediation has historically been approached as a ‘black box’ in terms of our fundamental understanding. Thus it succeeds and fails, seldom without a complete understanding of why. Systems biology is an integrated research approach to study complex biological systems, by investigating interactions and networks at the molecular, cellular, community, and ecosystem level. The knowledge of these interactions within individual components is fundamental to understanding the dynamics of the ecosystem under investigation. Finally, understanding and modeling functional microbial community structure and stress responses in environments at all levels have tremendous implications for our fundamental understanding of hydrobiogeochemical processes and the potential for making bioremediation breakthroughs and illuminating the ‘black box’.

  7. Approaching Bose-Einstein Condensation (United States)

    Ferrari, Loris


    Bose-Einstein condensation (BEC) is discussed at the level of an advanced course of statistical thermodynamics, clarifying some formal and physical aspects that are usually not covered by the standard pedagogical literature. The non-conventional approach adopted starts by showing that the continuum limit, in certain cases, cancels out the crucial…


    African Journals Online (AJOL)

    approach. Various explanations are offered for this situation although all agree that the principles, goals and processes of democratic pedagogy are often antithetical to the processes of contemporary schooling. Based on a case study of an attempt at democratic pedagogy in an Australian primary school, this paper explores.

  9. Indecisiveness: A Dynamic, Integrative Approach. (United States)

    Johnson, Douglas Paul


    Responds to case of Sondra presented in Career Development Quarterly (September 1990). Suggests that her inability to decide on a career may be rooted in long-term personality style, poor ego strength, noisome family dynamics, and/or developmental delay. Recommends an integrative approach incorporating both personal and career counseling. (PVV)




  11. On psychoanalytic approaches to autism. (United States)

    Hobson, R P


    An analysis of the strengths and limitations of psychoanalytic approaches to autism serves to highlight the need for a theoretical scheme adequate to encompass social as well as cognitive development in autistic individuals. It is proposed that such a scheme will entail an account of normal development in which children's "object relations" feature prominently.

  12. Ethnic Studies: Issues and Approaches. (United States)

    Yang, Philip Q.

    This book offers a comprehensive definition of the field of ethnic studies, covering both major issues in the field and its theoretical and methodological approaches. It traces the origins and evolution of the discipline in the United States and maps its domain. Some of the current issues addressed include affirmative action, illegal/legal…

  13. Using Natural Approach Teaching Techniques. (United States)

    Whitman, Charles


    Describes a beginning foreign language class applying the principles of Stephen Krashen's "Natural Approach" and James Asher's "Total Physical Response" method. Initially students carry out the instructor's commands in the form of actions rather than being required to speak. In later stages role play and simple discussions are…

  14. Eschenmoser Approach to Vitamin B

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 19; Issue 7. Eschenmoser Approach to Vitamin B12 by A/D Strategy: An Unexpected Journey. G Wayne Craig. General Article Volume 19 Issue 7 July 2014 pp 624-640. Fulltext. Click here to view fulltext PDF. Permanent link:

  15. An analogical approach to grammaticalization

    NARCIS (Netherlands)

    Fischer, O.; Stathi, K.; Gehweiler, E.; König, E.


    Two well-known approaches to language change illustrate a fundamental difference between functional and formal linguistics as to what are considered important mechanisms in change. In Grammaticalization, emphasis is on the semantic-pragmatic factors guiding change, while Generative Theory

  16. Petrov classification: An elementary approach

    Energy Technology Data Exchange (ETDEWEB)

    Kalotas, T.M.; Eliezer, C.J.


    We reduce the length of the usual algebraic classification scheme of the Weyl tensor by avoiding the step centered around its reduction to canonical form. Instead the different algebraic types are established more economically via the elementary approach of constructing explicit examples.

  17. Therapeutic approaches to genetic disorders

    African Journals Online (AJOL)


    hemophilia and many storage disor- ders), cell-tissue-organ transplantation. (e.g for many disorders like tyrosinemia and polycystic kidney disease), surgical intervention for genetically-determined congenital malformations and late de- veloping surgically correctable com- plications and gene therapy approaches.

  18. Appreciating Music: An Active Approach (United States)

    Levin, Andrew R.; Pargas, Roy P.


    A particularly innovative use of laptops is to enhance the music appreciation experience. Group listening and discussion, in combination with a new Web-based application, lead to deeper understanding of classical music. ["Appreciating Music: An Active Approach" was written with Joshua Austin.

  19. Japanese approaches to development communication


    Wilkins, Karin Gwinn


    Development communication literature neglects attention to Japanese approaches to development practice as a prominent donor institution. Based on a series of interviews and document reviews, this analysis characterizes how Japanese development projects use communication technologies to address a variety of development goals. Moreover, this research explores how this development discourse constructs social problems, beneficiaries, and appropriate solutions. Japan's development communication ap...

  20. Interdisciplinary approaches in career studies

    NARCIS (Netherlands)

    Khapova, S.N.; Arthur, M.B.


    This is the opening article in a Human Relations special issue on 'Interdisciplinary approaches to contemporary career studies'. After introducing a story of an 'exceptional - but real' career, we argue for an urgent shift toward greater interdisciplinary inquiry. We reflect on the story to describe

  1. Novel approaches to epilepsy treatment

    DEFF Research Database (Denmark)

    Sørensen, Andreas T; Kokaia, Merab


    The aim of epilepsy treatment is to achieve complete seizure freedom. Nonetheless, numerous side effects and seizure resistance to antiepileptic drugs (AEDs) affecting about 30-40% of all patients are main unmet needs in today's epileptology. For this reason, novel approaches to treat epilepsy ar...

  2. International Approaches to Clinical Costing

    DEFF Research Database (Denmark)

    Chapman, Christopher; Kern, Anja; Laguecir, Aziza

    This report has been commissioned by both HFMA and Monitor and the work has been led by Imperial College Business School’s Health Management Group. The report compares current approaches to costing, primarily across Europe. The findings reveal wide-ranging practices and uses for costing data...

  3. Theoretical Approaches to Political Communication. (United States)

    Chesebro, James W.

    Political communication appears to be emerging as a theoretical and methodological academic area of research within both speech-communication and political science. Five complimentary approaches to political science (Machiavellian, iconic, ritualistic, confirmational, and dramatistic) may be viewed as a series of variations which emphasize the…

  4. Integrative approaches: promoting socioecological resilience (United States)

    J.W. Long; Carl Skinner; M. North; C.T. Hunsaker; L. Quinn-Davidson


    This chapter begins by discussing current challenges for ecosystem management that emerged from multiple chapters of the full synthesis. It then considers integrative approaches to promote resilience, including general strategies that recognize the integrated nature of socioecological systems, the importance of promoting disturbance regimes upon which these systems...

  5. Corpus Approaches to Language Ideology (United States)

    Vessey, Rachelle


    This paper outlines how corpus linguistics--and more specifically the corpus-assisted discourse studies approach--can add useful dimensions to studies of language ideology. First, it is argued that the identification of words of high, low, and statistically significant frequency can help in the identification and exploration of language ideologies…

  6. Integrated reclamation: Approaching ecological function? (United States)

    Ann L. Hild; Nancy L. Shaw; Ginger B. Paige; Mary I. Williams


    Attempts to reclaim arid and semiarid lands have traditionally targeted plant species composition. Much research attention has been directed to seeding rates, species mixes and timing of seeding. However, in order to attain functioning systems, attention to structure and process must compliment existing efforts. We ask how to use a systems approach to enhance...

  7. a systemic functional linguistic approach

    African Journals Online (AJOL)

    Analysing social identity in casual Zambian/English conversation: a systemic functional linguistic approach. ... Through an analysis of sentence-level grammatical patterns, and of speakers' mood choices in particular, the study shows how interactants construct identities ('self' and 'other') and social roles, as well as role ...

  8. Eight Approaches to Language Teaching. (United States)

    Doggett, Gina

    Important features of eight second language teaching methods--grammar-translation, direct, audiolingual, the Silent Way, Suggestopedia, community language learning, Total Physical Response, and the communicative approach--are summarized . A chart outlines characteristics of these aspects of the methods: goals, teacher and student roles, the…

  9. Mathematical Analysis, A Straightforward Approach

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 4; Issue 4. Mathematical Analysis, A Straightforward Approach. K Rama Murthy. Book Review Volume 4 Issue 4 April 1999 pp 96-96. Fulltext. Click here to view fulltext PDF. Permanent link: ...


    African Journals Online (AJOL)


    constitutes a distinctive 'lens' on world affairs.9 The question can be raised as to how, and if, theoretical approaches in IR can contribute to an improved understanding of the role and functions of militaries. There are concrete or specific theories, such as Realism, but not even realist theories guarantee a clear and accurate.

  11. Geometrical approach to fluid models

    NARCIS (Netherlands)

    Kuvshinov, B. N.; Schep, T. J.


    Differential geometry based upon the Cartan calculus of differential forms is applied to investigate invariant properties of equations that describe the motion of continuous media. The main feature of this approach is that physical quantities are treated as geometrical objects. The geometrical

  12. Institutional Planning: A Systems Approach. (United States)

    Adamson, Willie D.

    This four-chapter report explores the possible contributions of a systems approach to institutional planning. After introductory comments, Chapter I reviews the management theory of Henry Fayol, which emphasizes management tasks, such as planning, organizing, commanding, coordinating, and controlling, which are "universal" regardless of the level…

  13. Therapeutic approaches to genetic disorders

    African Journals Online (AJOL)


    Although prevention is the ideal goal for genetic disorders, various types of therapeutic management are available. Such management approaches depend on the nature of the defect, how well it is understood at the genetic and bio- chemical levels and the practical feasibility of correction. In some conditions.

  14. Novel Approaches to Surfactant Administration


    Gupta, Samir; Donn, Steven M.


    Surfactant replacement therapy has been the mainstay of treatment for preterm infants with respiratory distress syndrome for more than twenty years. For the most part, surfactant is administered intratracheally, followed by mechanical ventilation. In recent years, the growing interest in noninvasive ventilation has led to novel approaches of administration. This paper will review these techniques and the associated clinical evidence.

  15. Planning approaches for rurban areas

    DEFF Research Database (Denmark)

    Busck, Anne Gravsholt; Hidding, Marjan; Kristensen, Søren Bech Pilgaard


    encroachment, and how resilient green landscapes are ensured. The results reveal significant differences in approaches, reflecting variations in the public involvement in rurban areas development, the role of different administrative levels and the use of zonation. Variation in the use of zonation encapsulates...

  16. Oncoplastic Approaches to Breast Conservation

    Directory of Open Access Journals (Sweden)

    Dennis R. Holmes


    Full Text Available When a woman is diagnosed with breast cancer many aspects of her physical, emotional, and sexual wholeness are threatened. The quickly expanding field of oncoplastic breast surgery aims to enhance the physician commitment to restore the patient's image and self-assurance. By combining a multidisciplinary approach to diagnosis and treatment with oncoplastic surgery, successful results in the eyes of the patient and physician are significantly more likely to occur. As a way to aid oncoplastic teams in determining which approach is most suitable for their patient's tumor size, tumor location, body habitus, and desired cosmetic outcome we present a review of several oncoplastic surgical approaches. For resections located anywhere in the breast, the radial ellipse segmentectomy incision and circumareolar approach for segmental resection are discussed. For resections in the upper or central breast, crescent mastopexy, the batwing incision, the hemibatwing incision, donut mastopexy, B-flap resection, and the central quadrantectomy are reviewed. For lesions of the lower breast, the triangle incision, inframammary incision, and reduction mastopexy are discussed. Surgeons who are interested in adding oncoplastic breast conserving therapies to their skill sets are encouraged to implement these surgical techniques where applicable and to seek out breast fellowships or enhanced training when appropriate.

  17. Multidisciplinary Approaches in Evolutionary Linguistics (United States)

    Gong, Tao; Shuai, Lan; Wu, Yicheng


    Studying language evolution has become resurgent in modern scientific research. In this revival field, approaches from a number of disciplines other than linguistics, including (paleo)anthropology and archaeology, animal behaviors, genetics, neuroscience, computer simulation, and psychological experimentation, have been adopted, and a wide scope…

  18. A Psychoanalytic Approach to Fieldwork (United States)

    Ramvi, Ellen


    This article focuses on what both psychoanalysis and anthropology have in common: the emphasis on the researcher's own experience. An ethnographic fieldwork will be used to illustrate how a psychoanalytical approach unfolds the material when studying conditions for learning from experience among teachers in two Norwegian junior high schools, and…

  19. Minimalist approach to perceptual interactions. (United States)

    Lenay, Charles; Stewart, John


    WORK AIMED AT STUDYING SOCIAL COGNITION IN AN INTERACTIONIST PERSPECTIVE OFTEN ENCOUNTERS SUBSTANTIAL THEORETICAL AND METHODOLOGICAL DIFFICULTIES: identifying the significant behavioral variables; recording them without disturbing the interaction; and distinguishing between: (a) the necessary and sufficient contributions of each individual partner for a collective dynamics to emerge; (b) features which derive from this collective dynamics and escape from the control of the individual partners; and (c) the phenomena arising from this collective dynamics which are subsequently appropriated and used by the partners. We propose a minimalist experimental paradigm as a basis for this conceptual discussion: by reducing the sensory inputs to a strict minimum, we force a spatial and temporal deployment of the perceptual activities, which makes it possible to obtain a complete recording and control of the dynamics of interaction. After presenting the principles of this minimalist approach to perception, we describe a series of experiments on two major questions in social cognition: recognizing the presence of another intentional subject; and phenomena of imitation. In both cases, we propose explanatory schema which render an interactionist approach to social cognition clear and explicit. Starting from our earlier work on perceptual crossing we present a new experiment on the mechanisms of reciprocal recognition of the perceptual intentionality of the other subject: the emergent collective dynamics of the perceptual crossing can be appropriated by each subject. We then present an experimental study of opaque imitation (when the subjects cannot see what they themselves are doing). This study makes it possible to characterize what a properly interactionist approach to imitation might be. In conclusion, we draw on these results, to show how an interactionist approach can contribute to a fully social approach to social cognition.

  20. Technology approaches to currency security (United States)

    Murphy, John C.; Dubbel, Daniel C.; Benson, Richard C.


    The continued development of reprographic technology and computer graphics (notably color laser copiers, scanners and color laser printers) has increased the tools available to both professional and casual counterfeiters. The result is an increase in the counterfeit risk to the U.S. dollar and other currencies. To counter these threats improved methods of currency authentication are needed both for use by the general public and by national currency authorities. The growing number of cash transfer machines has increased the importance of machine readable security features. This paper describes some technology based approaches to currency security based on special materials. It also proposes a metaphor for currency authentication which attempts to provide a framework for unifying approaches based on secure features and those based on codes.

  1. Novel approaches in herbal cosmetics. (United States)

    Chanchal, Deep; Swarnlata, Saraf


    Nutracosmetics are an emerging class of health and beauty aid products that combine the benefits of nutracosmetical ingredients with the elegance, skin feel, and delivery systems of cosmetics. Herbs and spices have been used in maintaining and enhancing human beauty because herbs have many beneficial properties, such as sunscreen, antiaging, moisturizing, antioxidant, anticellulite, and antimicrobial effects. As compared with synthetic cosmetic products, herbal products are mild, biodegradable, and have low toxicity profile. To enhance these properties, research is being done in the development of newer approaches, which could improve both the aesthetic appeal and performance of a cosmetic product. In this respect, the approaches studied and discussed include liposomes, phytosomes, transferosomes, nanoemulsions, nanoparticles, microemulsions, nanocrystals, and cubosomes.

  2. Nanorobotics current approaches and techniques

    CERN Document Server

    Ferreira, Antoine


    Nanorobot devices now perform a wide variety of tasks at the nanoscale in a wide variety of fields including but not limited to fields such as manufacturing, medicine, supply chain, biology, and outer space. Nanorobotics: Current Approaches and Techniques is a comprehensive overview of this interdisciplinary field with a wide ranging discussion that includes nano-manipulation and industrial nanorobotics, nanorobotics in biology and medicine, nanorobotic sensing, navigation and swarm behavior, and protein and DNA-based nanorobotics. Also included is the latest on topics such as bio-nano-actuators and propulsion and navigation of nanorobotic systems using magnetic fields. Nanorobotics: Current Approaches and Techniques is an ideal book for scientists, researchers, and engineers actively involved in applied and robotic research and development.

  3. Variational approach in transport theory

    Energy Technology Data Exchange (ETDEWEB)

    Panta Pazos, R. [Nucler Engineering Department, UFRGS, Porto-Alegre (Brazil); Tullio de Vilhena, M. [Institute of Mathematics, UFRGS, Porto-Alegre (Brazil)


    In this work we present a variational approach to some methods to solve transport problems of neutral particles. We consider a convex domain X (for example the geometry of a slab, or a convex set in the plane, or a convex bounded set in the space) and we use discrete ordinates quadrature to get a system of differential equations derived from the neutron transport equation. The boundary conditions are vacuum for a subset of the boundary, and of specular reflection for the complementary subset of the boundary. Recently some different approximation methods have been presented to solve these transport problems. We introduce in this work the adjoint equations and the conjugate functions obtained by means of the variational approach. First we consider the general formulation, and then some numerical methods such as spherical harmonics and spectral collocation method. (authors)

  4. 'Academic literacies approaches to genre'?

    Directory of Open Access Journals (Sweden)

    Brian Street

    Full Text Available I provide an overview of approaches to writing referred to as 'academic literacies' building on broader traditions, such as New Literacy Studies, and I draw out the relevance of such traditions for the ways in which lecturers provide support to their students with regard to the writing requirements of the University. I offer three case studies of the application of academic literacies approaches to programmes concerned with supporting student writing, in the UK and the USA. I briefly conclude by asking how far these accounts and this work can be seen to bring together many of the themes raised at SIGET conferences - including academic literacies and its relation to genre theories - and express the hope that it opens up trajectories for future research and collaboration of the kind they were founded to develop.


    Directory of Open Access Journals (Sweden)

    Alina Petronela NEGREA


    Full Text Available The economic literature and the political discourse typically look at international competitiveness mainly by the means of export market shares. However, globalisation, production fragmentation and the growing importance of global value chains (GVCs increasingly challenge traditional approaches of export competitiveness and call for a more accurate and disaggregated level of analysis. Due to the growing fragmentation of production, a country exports now include a significant amount of imports of intermediate goods which are part of the export value. In this case, a simple analysis of the evolution of exports can distort the international competitive position of a country. The article suggests a new approach based on the value-added content of international trade measured by means of global value chain analysis.

  6. Malaysia implements the integrated approach. (United States)


    Malaysia has implemented an integrated approach in providing family planning services to eligible couples. In 1964 the government of Malaysia adopted a national family planning program, and implementation began in the urban areas and extended into the rural areas. Other agencies are involved in providing family planning services and information including the Federation of Family Planning Associations, the Ministry of Health, the National Family Planning Board, and the Federal Land Development Authority. The number of women practicing contraception has increased from 20,726 in 1967 to 533,646 by 1976. and other methods, 3.9%, respectively. There has been an increase in the percentage of acceptors between ages 15-29 from 56% in 1968 to 71.3% in 1975. The 2nd Malaysian national plan will use a multidisciplinary approach to the problem.

  7. Approaching work and learning indirectly


    Macintyre, Ronald; Thomson, Joan


    This paper approaches work and learning indirectly. It is part of a mixed method longitudinal study that looks at the articulation from Higher National (HN) to part time Higher Education (HE). Since 2003 the Open University in Scotland (OU) has been collecting quantitative and qualitative data on students who have HN qualifications. This paper looks at the experiences of those students and the central place of work in those journeys. \\ud \\ud The paper beings with a statistical overview. HN St...

  8. Intensional Approaches for Symbolic Methods


    Kushnarenko, Olga; Pinchinat, Sophie


    We present a behavioral model for discrete event systems based on an intentional formalism, as a possible approach within the broader trend towards rich symbolic representations in verification. We define Intensional Labeled Transition Systems with associated combinators of parallel composition and event hiding, and we propose symbolic bisimulation to handle strong bisimulation intentionally. Further on, we explain how the methodology has been developed for the synchronous language Signal, vi...


    Directory of Open Access Journals (Sweden)

    L. S. Namazova-Baranova


    Full Text Available This article covers one of the most discussed issues of clinical immunology — the role of dendritic cells in acquired immunity. Modern conception of dendritic cells participating in antigen handling procedure and its presentation, interaction with other immune cells made it possible to change approach towards immunomodulating therapy dramatically and to develop a new class of immunostimulants, that influence simultaneously cell and humoral immunity both in loci of antigen intervention on the mucosal level and systemically.

  10. Architecture Approach in System Development

    Directory of Open Access Journals (Sweden)

    Ladislav Burita


    Full Text Available The purpose of this paper is to describe a practical solution of architecture approach in system development. The software application is the system which optimizes the transport service. The first part of the paper defines the enterprise architecture, its parts and frameworks. Next is explained the NATO Architecture Framework (NAF, a tool for command and control systems development in military environment. The NAF is used for architecture design of the system for optimization of the transport service.

  11. Teaching urbanism: the Delft approach


    Nijhuis, S.; Stolk, E.H.; Hoekstra, M.J.


    The Department of Urbanism at the Faculty of Architecture and Built Environment at the Delft University of Technology has a long tradition in educating generations of internationally oriented designers, planners and researchers in urbanism. Here the domain of urbanism is defined as an interdisciplinary approach that engages in real-world sociocultural, ecological and technological issues affecting urban landscapes, from the perspective of spatial planning and design. Specifically, it combines...

  12. An automatic image recognition approach

    Directory of Open Access Journals (Sweden)

    Tudor Barbu


    Full Text Available Our paper focuses on the graphical analysis domain. We propose an automatic image recognition technique. This approach consists of two main pattern recognition steps. First, it performs an image feature extraction operation on an input image set, using statistical dispersion features. Then, an unsupervised classification process is performed on the previously obtained graphical feature vectors. An automatic region-growing based clustering procedure is proposed and utilized in the classification stage.

  13. Algebraic Approach to Algorithmic Logic


    Bancerek Grzegorz


    We introduce algorithmic logic - an algebraic approach according to [25]. It is done in three stages: propositional calculus, quantifier calculus with equality, and finally proper algorithmic logic. For each stage appropriate signature and theory are defined. Propositional calculus and quantifier calculus with equality are explored according to [24]. A language is introduced with language signature including free variables, substitution, and equality. Algorithmic logic requires a bialgebra st...

  14. An approach to risk assessment

    DEFF Research Database (Denmark)

    Simonsen, L.; Lund, S. P.; Hass, Ulla


    A strategy for delineating risk factors from use of neurotoxic chemicals was applied to the Danish working environment. An analysis using this strategy disclosed the need for internationally adopted criteria for neurotoxicity, and consequently a working group was established by the Nordic Council...... in the nineties. Different approaches to risk assessment are discussed, the quality of the databases available for hazard assessment are evaluated, and the needs for further research are identified. (C) 1996 Intox Press, Inc....

  15. Postprandial hyperglycemia. II. Pharmacological approaches


    Scheen, André; Letiexhe, Michel; Geronooz, I.; Paquot, Nicolas; Jandrain, Bernard


    Besides dietary approaches, various pharmacological means have been recently developed in order to better control postprandial hyperglycaemia. This objective may be obtained: 1) by slowing down the intestinal absorption of carbohydrates; 2) by insuring a better insulin priming soon after the meal; and 3) by inhibiting post-prandial glucagon secretion or action. Some hormones (amylin, glucagon-like peptide-1) can slow gastric emptying while alpha-glucosidase inhibitors (acarbose, miglitol) ret...

  16. The Entrepreneurial Approach in Marketing


    Florin Foltean


    The marketing - entrepreneurship interface at corporate level has generated many debates and studies in the last two decades, both in marketing and entrepreneurship fields. Certain elements of marketing orientation and approach may be used in the development of entrepreneurial processes, while entrepreneurial orientation and behavior enhance the marketing performance of a company which operates in a dynamic environment. This paper presents the concept of entrepreneurial marketing, a proposed ...

  17. Complications of the laparoscopic approach. (United States)

    Hill, D J


    Most laparoscopic complications occur as a result of creating and maintaining a pneumoperitoneum and the blind insertion of the first trocar. Thus, it is the complications of the laparoscopic approach rather than the complications of the laparoscopic technique for a specific condition which should be considered. The hazards and the incidences, causes, prevention and management of these complications are discussed using the experience of the author and reported data.

  18. Review og pattern matching approaches

    DEFF Research Database (Denmark)

    Manfaat, D.; Duffy, Alex; Lee, B. S.


    This paper presents a review of pattern matching techniques. The application areas for pattern matching are extensive, ranging from CAD systems to chemical analysis and from manufacturing to image processing. Published techniques and methods are classified and assessed within the context of three...... key issues: pattern classes, similiarity types and mathing methods. It has been shown that the techniques and approaches are as diverse and varied as the applications....

  19. Recommended approach to sofware development (United States)

    Mcgarry, F. E.; Page, J.; Eslinger, S.; Church, V.; Merwarth, P.


    A set of guideline for an organized, disciplined approach to software development, based on data collected and studied for 46 flight dynamics software development projects. Methods and practices for each phase of a software development life cycle that starts with requirements analysis and ends with acceptance testing are described; maintenance and operation is not addressed. For each defined life cycle phase, guidelines for the development process and its management, and the products produced and their reviews are presented.



    Ruxandra-Irina POPESCU; Razvan-Andrei CORBOs


    In recent years urban management conceptual evolutions are more and more connected to the chances in public administration practice, in particular to ways of raising efficiency and effectiveness. The interest shared by a great number of stakeholders regarding urban development, the increasing role of environment issues and the need for a broad vision for managing cities, are all premises required for a strategic approach to urban management performance. The paper presents some relevant issues...

  1. Biotechnological approaches to rose breeding


    Marchant, Robert


    The production of new rose cultivars by sexual crossing is problematic and time consuming due to sexual incompatibility. the failure of seeds to genninate. and to a limited gene pool. Biotechnology provides an obvious alternative for the creation of genetic novelty in rose. This thesis focuses on the development of novel approaches, based on embryo rescue, pollen cryopreservation, protoplast and transformation technologies. A reproducible embryo rescue technique was developed in which embr...

  2. Sociocultural epidemiology: an essential approach.

    Directory of Open Access Journals (Sweden)

    Paul Hersch-Martínez


    Full Text Available The necessity of an inclusive epidemiological approach, capable to attend the diverse dimensions involved in health damage as a reflective phenomenon of society is analyzed. The range of perspectives involved requires an inclusive methodological scope and applicative channels, in order to deal with sanitary realities systematically related to culture and social organization. Some constitutive elements of sociocultural epidemiology are underlined, shaping an operative proposal that can enhance the relationship between disciplines and sectors regarding specific outstanding public health problems.

  3. System Approach in RIPRAN Method

    Directory of Open Access Journals (Sweden)

    Branislav Lacko


    Full Text Available The article describes reasons, principles for design, structure and using of RIPRAN method (Risk Project Analysis for risk project analysis. The RIPRAN method is used to identify, quantify risks, and design proposals that reduce risk in the project to increase the likelihood of successful completion of the project. The method uses a system and process approach to risk analysis and respects international ISO standards that recommend how to perform a high‑quality risk analysis of the project. The method has been incorporated into the national standard of the Czech Republic among the recommended knowledge for certified project managers. The third version of the method is available. The method is included in teaching at many universities in the Czech Republic, trained by a number of training firms and used by firms to analyse the risks of corporate projects or by various risk analysis institutions for projects funded by the EU structural funds. The aim of the article is to inform about the RIPRAN method. At the same time, the paper points out that the method describes the procedure for risk analysis of the project and presents the benefits of RIPRAN application. The description of a system approach application when designing the RIPRAN method serves as an example of a system approach to risk engineering.

  4. Opening: Toward an Integrated Approach

    Directory of Open Access Journals (Sweden)

    Cheryl Geisler


    Full Text Available The rise of digital humanities has led many writing researchers to consider using digital tools to analyze rhetorical patterns in text. Yet taking a digital approach to the analysis of texts is a complex task. We are faced with a variety of techniques and tools, all of which require significant investment to learn and use. How can we best understand the costs and benefits of adopting a particular approach? Are they simply alternatives or can they be integrated? The three sets of authors in this special section attempt to address these questions by using alternative methodologies to analyze a common set of documents. The following opening piece serves as an introduction to the project. In it, we place their research in the context of taxonomy of approaches to text analysis, and review prior attempts at integration. Following the articles, a closing piece examines the prospects for integration. In it, we provide a brief review of the results of the analyses followed by an examination of their commonalities and variations. Finally, we conclude with the considerations that should be taken into account in choosing a method for textual analysis, as well as a discussion of the potential for an integration of methods.

  5. An abstract approach to music.

    Energy Technology Data Exchange (ETDEWEB)

    Kaper, H. G.; Tipei, S.


    In this article we have outlined a formal framework for an abstract approach to music and music composition. The model is formulated in terms of objects that have attributes, obey relationships, and are subject to certain well-defined operations. The motivation for this approach uses traditional terms and concepts of music theory, but the approach itself is formal and uses the language of mathematics. The universal object is an audio wave; partials, sounds, and compositions are special objects, which are placed in a hierarchical order based on time scales. The objects have both static and dynamic attributes. When we realize a composition, we assign values to each of its attributes: a (scalar) value to a static attribute, an envelope and a size to a dynamic attribute. A composition is then a trajectory in the space of aural events, and the complex audio wave is its formal representation. Sounds are fibers in the space of aural events, from which the composer weaves the trajectory of a composition. Each sound object in turn is made up of partials, which are the elementary building blocks of any music composition. The partials evolve on the fastest time scale in the hierarchy of partials, sounds, and compositions. The ideas outlined in this article are being implemented in a digital instrument for additive sound synthesis and in software for music composition. A demonstration of some preliminary results has been submitted by the authors for presentation at the conference.

  6. A possibilistic approach to clustering (United States)

    Krishnapuram, Raghu; Keller, James M.


    Fuzzy clustering has been shown to be advantageous over crisp (or traditional) clustering methods in that total commitment of a vector to a given class is not required at each image pattern recognition iteration. Recently fuzzy clustering methods have shown spectacular ability to detect not only hypervolume clusters, but also clusters which are actually 'thin shells', i.e., curves and surfaces. Most analytic fuzzy clustering approaches are derived from the 'Fuzzy C-Means' (FCM) algorithm. The FCM uses the probabilistic constraint that the memberships of a data point across classes sum to one. This constraint was used to generate the membership update equations for an iterative algorithm. Recently, we cast the clustering problem into the framework of possibility theory using an approach in which the resulting partition of the data can be interpreted as a possibilistic partition, and the membership values may be interpreted as degrees of possibility of the points belonging to the classes. We show the ability of this approach to detect linear and quartic curves in the presence of considerable noise.

  7. Security Management – Systems Approach

    Directory of Open Access Journals (Sweden)

    Milan Kný


    Full Text Available The aim of the contribution is the use of the systems approach to treat security management as a practical field and new scientific discipline. The philosophy of systems approach to the solution of problems generally is an adequate methodological basis even for the theory of management. The path to the real optimization of security situation leads only through the holistic and solid solution. Applications of systems analysis and synthesis back up the fact, that systems approach and systems thinking should not absent in security objects. The truthfulness of the claim, that security management is a well-established discipline, depends on ongoing discussion that represents useful process of development of new scientific discipline. At the same time the rationality of science and systematism works as a counterbalance to irrational fear of the whole society, too. Which questions of security remain open in relation to „our interests“? Current problems of Europe should be solved systematically. It is necessary to define the space of interest (territorially the border of the EU or the Schengen area, to implement the system to the object with respect to the borders of the space, to specify the structure and subjects of decision making and implementation.

  8. Combined Approach for Solving the Electromagnetic Induction ...

    African Journals Online (AJOL)


    approaches to the reconstruction problem: the pixel-based approach and the parameter-based approach. This paper describes how both approaches may be combined for a more systematic reconstruction. Keywords: Electromagnetic induction, inverse problem, image reconstruction. *For correspondences and reprints ...

  9. Fuzzy multiple linear regression: A computational approach (United States)

    Juang, C. H.; Huang, X. H.; Fleming, J. W.


    This paper presents a new computational approach for performing fuzzy regression. In contrast to Bardossy's approach, the new approach, while dealing with fuzzy variables, closely follows the conventional regression technique. In this approach, treatment of fuzzy input is more 'computational' than 'symbolic.' The following sections first outline the formulation of the new approach, then deal with the implementation and computational scheme, and this is followed by examples to illustrate the new procedure.

  10. Commercial dissemination approaches for solar home systems

    Energy Technology Data Exchange (ETDEWEB)

    Terrado, E.


    The author discusses the issue of providing solar home systems to primarily rural areas from the perspective of how to commercialize the process. He considers two different approaches, one an open market approach and the other an exclusive market approach. He describes examples of the exclusive market approach which are in process in Argentina and Brazil. Coming from a banking background, the business aspects are discussed in detail. He points out the strengths and weaknesses of both approaches toward developing such systems.

  11. Computational approaches for drug discovery. (United States)

    Hung, Che-Lun; Chen, Chi-Chun


    Cellular proteins are the mediators of multiple organism functions being involved in physiological mechanisms and disease. By discovering lead compounds that affect the function of target proteins, the target diseases or physiological mechanisms can be modulated. Based on knowledge of the ligand-receptor interaction, the chemical structures of leads can be modified to improve efficacy, selectivity and reduce side effects. One rational drug design technology, which enables drug discovery based on knowledge of target structures, functional properties and mechanisms, is computer-aided drug design (CADD). The application of CADD can be cost-effective using experiments to compare predicted and actual drug activity, the results from which can used iteratively to improve compound properties. The two major CADD-based approaches are structure-based drug design, where protein structures are required, and ligand-based drug design, where ligand and ligand activities can be used to design compounds interacting with the protein structure. Approaches in structure-based drug design include docking, de novo design, fragment-based drug discovery and structure-based pharmacophore modeling. Approaches in ligand-based drug design include quantitative structure-affinity relationship and pharmacophore modeling based on ligand properties. Based on whether the structure of the receptor and its interaction with the ligand are known, different design strategies can be seed. After lead compounds are generated, the rule of five can be used to assess whether these have drug-like properties. Several quality validation methods, such as cost function analysis, Fisher's cross-validation analysis and goodness of hit test, can be used to estimate the metrics of different drug design strategies. To further improve CADD performance, multi-computers and graphics processing units may be applied to reduce costs. © 2014 Wiley Periodicals, Inc.

  12. [Causal analysis approaches in epidemiology]. (United States)

    Dumas, O; Siroux, V; Le Moual, N; Varraso, R


    Epidemiological research is mostly based on observational studies. Whether such studies can provide evidence of causation remains discussed. Several causal analysis methods have been developed in epidemiology. This paper aims at presenting an overview of these methods: graphical models, path analysis and its extensions, and models based on the counterfactual approach, with a special emphasis on marginal structural models. Graphical approaches have been developed to allow synthetic representations of supposed causal relationships in a given problem. They serve as qualitative support in the study of causal relationships. The sufficient-component cause model has been developed to deal with the issue of multicausality raised by the emergence of chronic multifactorial diseases. Directed acyclic graphs are mostly used as a visual tool to identify possible confounding sources in a study. Structural equations models, the main extension of path analysis, combine a system of equations and a path diagram, representing a set of possible causal relationships. They allow quantifying direct and indirect effects in a general model in which several relationships can be tested simultaneously. Dynamic path analysis further takes into account the role of time. The counterfactual approach defines causality by comparing the observed event and the counterfactual event (the event that would have been observed if, contrary to the fact, the subject had received a different exposure than the one he actually received). This theoretical approach has shown limits of traditional methods to address some causality questions. In particular, in longitudinal studies, when there is time-varying confounding, classical methods (regressions) may be biased. Marginal structural models have been developed to address this issue. In conclusion, "causal models", though they were developed partly independently, are based on equivalent logical foundations. A crucial step in the application of these models is the

  13. Approach to Mars Field Geology (United States)

    Muehlberger, William; Rice, James W.; Parker, Timothy; Lipps, Jere H.; Hoffman, Paul; Burchfiel, Clark; Brasier, Martin


    The goals of field study on Mars are nothing less than to understand the processes and history of the planet at whatever level of detail is necessary. A manned mission gives us an unprecedented opportunity to use the immense power of the human mind to comprehend Mars in extraordinary detail. To take advantage of this opportunity, it is important to examine how we should approach the field study of Mars. In this effort, we are guided by over 200 years of field exploration experience on Earth as well as six manned missions exploring the Moon.

  14. Location theory a unified approach

    CERN Document Server

    Nickel, Stefan


    Although modern location theory is now more than 90 years old, the focus of researchers in this area has been mainly problem oriented. However, a common theory, which keeps the essential characteristics of classical location models, is still missing.This monograph addresses this issue. A flexible location problem called the Ordered Median Problem (OMP) is introduced. For all three main subareas of location theory (continuous, network and discrete location) structural properties of the OMP are presented and solution approaches provided. Numerous illustrations and examples help the reader to bec

  15. Nanothermodynamics: a subdivision potential approach

    Directory of Open Access Journals (Sweden)

    R. Moussavi


    Full Text Available  Classical thermodynamic laws and relations have been developed for macroscopic systems that satisfy the thermodynamic limit. These relations are challenged as the system size decreases to the scale of nano-systems, in which thermodynamic properties are overshadowed by system size, and the usual classical concepts of extensivity and intensivity are no longer valid. The challenges to the classical thermodynamics in relation to small systems are demonstrated, and via the approach introduced by Hill, the concept of sub-division potential is clarified in details. The fundamental thermodynamic relations are obtained using a rational-based method.

  16. The calculus a genetic approach

    CERN Document Server

    Toeplitz, Otto


    When first published posthumously in 1963, this book presented a radically different approach to the teaching of calculus.  In sharp contrast to the methods of his time, Otto Toeplitz did not teach calculus as a static system of techniques and facts to be memorized. Instead, he drew on his knowledge of the history of mathematics and presented calculus as an organic evolution of ideas beginning with the discoveries of Greek scholars, such as Archimedes, Pythagoras, and Euclid, and developing through the centuries in the work of Kepler, Galileo, Fermat, Newton, and Leibniz. Through this unique a

  17. Microfluidic Approach to Cell Microencapsulation. (United States)

    Sharma, Varna; Hunckler, Michael; Ramasubramanian, Melur K; Opara, Emmanuel C; Katuri, Kalyan C


    Bioartificial pancreas made of insulin-secreting islets cells holds great promise in the treatment of individuals with Type-1 diabetes. Successful islet cell microencapsulation in biopolymers is a key step for providing immunoisolation of transplanted islet cells. Because of the variability in the size and shape of pancreatic islets, one of the main obstacles in their microencapsulation is the inability to consistently control shape, size, and microstructure of the encapsulating biopolymer capsule. In this chapter, we provide a detailed description of a microfluidic approach to islet cell encapsulation in alginate that might address the microencapsulation challenges.

  18. Gene Therapy Approaches to Hemoglobinopathies. (United States)

    Ferrari, Giuliana; Cavazzana, Marina; Mavilio, Fulvio


    Gene therapy for hemoglobinopathies is currently based on transplantation of autologous hematopoietic stem cells genetically modified with a lentiviral vector expressing a globin gene under the control of globin transcriptional regulatory elements. Preclinical and early clinical studies showed the safety and potential efficacy of this therapeutic approach as well as the hurdles still limiting its general application. In addition, for both beta-thalassemia and sickle cell disease, an altered bone marrow microenvironment reduces the efficiency of stem cell harvesting as well as engraftment. These hurdles need be addressed for gene therapy for hemoglobinopathies to become a clinical reality. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Hemorrhagic shock: The "physiology approach"

    Directory of Open Access Journals (Sweden)

    Fabrizio Giuseppe Bonanno


    Full Text Available A shift of approach from ′clinics trying to fit physiology′ to the one of ′physiology to clinics′, with interpretation of the clinical phenomena from their physiological bases to the tip of the clinical iceberg, and a management exclusively based on modulation of physiology, is finally surging as the safest and most efficacious philosophy in hemorrhagic shock. ATLS® classification and recommendations on hemorrhagic shock are not helpful because antiphysiological and potentially misleading. Hemorrhagic shock needs to be reclassified in the direction of usefulness and timing of intervention: in particular its assessment and management need to be tailored to physiology.

  20. Cognitive reasoning a formal approach

    CERN Document Server

    Anshakov, Oleg M


    Dealing with uncertainty, moving from ignorance to knowledge, is the focus of cognitive processes. Understanding these processes and modelling, designing, and building artificial cognitive systems have long been challenging research problems. This book describes the theory and methodology of a new, scientifically well-founded general approach, and its realization in the form of intelligent systems applicable in disciplines ranging from social sciences, such as cognitive science and sociology, through natural sciences, such as life sciences and chemistry, to applied sciences, such as medicine,

  1. Two Approaches to Entrepreneurship Education

    DEFF Research Database (Denmark)

    Moberg, Kåre


    and focuses on fostering non-cognitive entrepreneurial skills. Furthermore, the role of supportive teaching styles and action-based teaching methods in entrepreneurship education at this level of education is investigated. The analysis is based on data from two surveys including 801 randomly selected Danish...... an alternative way to assess educational dimensions (content and teaching methods) separately.......The objective of this paper is to analyse the influence of two different approaches to entrepreneurship education at the lower secondary level of education. The influence of education for entrepreneurship and education through entrepreneurship on pupils' level of school engagement...

  2. Educational approaches for discouraging plagiarism. (United States)

    Fischer, Beth A; Zigmond, Michael J


    Suggested approaches to reduce the occurrence of plagiarism in academia, particularly among trainees. These include (1) educating individuals as to the definition of plagiarism and its consequences through written guidelines, active discussions, and practice in identifying proper and improper citation practices; (2) distributing checklists that break the writing task into more manageable steps, (3) requiring the submission of an outline and then a first draft prior to the deadline for a paper; (4) making assignments relevant to individual interests; and (5) providing trainees with access to software programs that detect plagiarism. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. Algebraic Approach to Algorithmic Logic

    Directory of Open Access Journals (Sweden)

    Bancerek Grzegorz


    Full Text Available We introduce algorithmic logic - an algebraic approach according to [25]. It is done in three stages: propositional calculus, quantifier calculus with equality, and finally proper algorithmic logic. For each stage appropriate signature and theory are defined. Propositional calculus and quantifier calculus with equality are explored according to [24]. A language is introduced with language signature including free variables, substitution, and equality. Algorithmic logic requires a bialgebra structure which is an extension of language signature and program algebra. While-if algebra of generator set and algebraic signature is bialgebra with appropriate properties and is used as basic type of algebraic logic.

  4. Unified approach to dense matter

    Energy Technology Data Exchange (ETDEWEB)

    Park, Byung-Yoon [CSSM, University of Adelaide, Adelaide 5005 (Australia); Lee, Hee-Jung [Departament de Fisica Teorica and Institut de Fisica Corpuscular Universitat de Valencia and Consejo Superior de Investigaciones Cientificas, E-46100 Burjassot (Valencia) (Spain); Vento, Vicente [Departament de Fisica Teorica and Institut de Fisica Corpuscular Universitat de Valencia and Consejo Superior de Investigaciones Cientificas, E-46100 Burjassot (Valencia) (Spain); Kim, Joon-Il [Department of Physics, Seoul National University, Seoul 151-742 (Korea, Republic of); Min, Dong-Pil [Department of Physics, Seoul National University, Seoul 151-742 (Korea, Republic of); Rho, Mannque [Department of Physics, Hanyang University, Seoul 133-791, Korea, and Service de Physique Theorique, CE Saclay, 91191 Gif-sur-Yvette (France)


    We apply the Skyrme model to dense hadronic matter, which provides a unified approach to high density, valid in the large N {sub c} limit. In our picture, dense hadronic matter is described by the classical soliton configuration with minimum energy for the given baryon number density. By incorporating the meson fluctuations on such ground state we obtain an effective Lagrangian for meson dynamics in a dense medium. Our starting point has been the Skyrme model defined in terms of pions, thereafter we have extended and improved the model by incorporating other degrees of freedom such as dilaton, kaons and vector mesons.

  5. Real Analysis A Historical Approach

    CERN Document Server

    Stahl, Saul


    A provocative look at the tools and history of real analysis This new edition of Real Analysis: A Historical Approach continues to serve as an interesting read for students of analysis. Combining historical coverage with a superb introductory treatment, this book helps readers easily make the transition from concrete to abstract ideas. The book begins with an exciting sampling of classic and famous problems first posed by some of the greatest mathematicians of all time. Archimedes, Fermat, Newton, and Euler are each summoned in turn, illuminating the utility of infinite, power, and trigonome

  6. A geometric approach to complexity. (United States)

    Ay, Nihat; Olbrich, Eckehard; Bertschinger, Nils; Jost, Jürgen


    We develop a geometric approach to complexity based on the principle that complexity requires interactions at different scales of description. Complex systems are more than the sum of their parts of any size and not just more than the sum of their elements. Using information geometry, we therefore analyze the decomposition of a system in terms of an interaction hierarchy. In mathematical terms, we present a theory of complexity measures for finite random fields using the geometric framework of hierarchies of exponential families. Within our framework, previously proposed complexity measures find their natural place and gain a new interpretation.

  7. 'Lean' approach gives greater efficiency. (United States)

    Call, Roger


    Adapting the 'Lean' methodologies used for many years by many manufacturers on the production line - such as in the automotive industry - and deploying them in healthcare 'spaces' can, Roger Call, an architect at Herman Miller Healthcare in the US, argues, 'easily remedy many of the inefficiencies' found within a healthcare facility. In an article that first appeared in the September 2013 issue of The Australian Hospital Engineer, he explains how 'Lean' approaches such as the 'Toyota production system', and 'Six Sigma', can be harnessed to good effect in the healthcare sphere.

  8. HEDR modeling approach: Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Shipler, D.B.; Napier, B.A.


    This report is a revision of the previous Hanford Environmental Dose Reconstruction (HEDR) Project modeling approach report. This revised report describes the methods used in performing scoping studies and estimating final radiation doses to real and representative individuals who lived in the vicinity of the Hanford Site. The scoping studies and dose estimates pertain to various environmental pathways during various periods of time. The original report discussed the concepts under consideration in 1991. The methods for estimating dose have been refined as understanding of existing data, the scope of pathways, and the magnitudes of dose estimates were evaluated through scoping studies.

  9. Computer Networks A Systems Approach

    CERN Document Server

    Peterson, Larry L


    This best-selling and classic book teaches you the key principles of computer networks with examples drawn from the real world of network and protocol design. Using the Internet as the primary example, the authors explain various protocols and networking technologies. Their systems-oriented approach encourages you to think about how individual network components fit into a larger, complex system of interactions. Whatever your perspective, whether it be that of an application developer, network administrator, or a designer of network equipment or protocols, you will come away with a "big pictur

  10. Computational approaches to energy materials

    CERN Document Server

    Catlow, Richard; Walsh, Aron


    The development of materials for clean and efficient energy generation and storage is one of the most rapidly developing, multi-disciplinary areas of contemporary science, driven primarily by concerns over global warming, diminishing fossil-fuel reserves, the need for energy security, and increasing consumer demand for portable electronics. Computational methods are now an integral and indispensable part of the materials characterisation and development process.   Computational Approaches to Energy Materials presents a detailed survey of current computational techniques for the

  11. Chemoselective approaches to glycoprotein assembly

    Energy Technology Data Exchange (ETDEWEB)

    Hang, Howard C.; Bertozzi, Carolyn R.


    Oligosaccharides on proteins and lipids play central roles in human health and disease. The molecular analysis of glycoconjugate function has benefited tremendously from new methods for their chemical synthesis, which provides homogeneous material not attainable from biosynthetic systems. Still, glycoconjugate synthesis requires the manipulation of multiple stereocenters and protecting groups and remains the domain of a few expert laboratories around the world. This account summarizes chemoselective approaches for assembling homogeneous glycoconjugates that attempt to reduce the barriers to their synthesis. The objective of these methods is to make glycoconjugate synthesis accessible to a broader community, thereby accelerating progress in glycobiology.

  12. Operational gaming an international approach

    CERN Document Server

    Ståhl, Ingolf


    Operational Gaming: An International Approach focuses on various research on this method of systems analysis. The text points out the value of this method in decision making, planning, and in the implementation of policies. The book presents a survey that highlights the connection of experimental gaming, game theory, and operational gaming. The value of gaming as a balancing method in assessing multifaceted computer models, most notably about their assumptions on human behavior, is noted. The book also offers an overview of gaming in other countries, such as Bulgaria, Soviet Union, and Japan,

  13. Enamel microabrasion: a new approach. (United States)

    Croll, T P; Helpin, M L


    Enamel microabrasion is a proven method of removing superficial intrinsic enamel discoloration defects. The method is safe, easily performed, and causes no discomfort for the patient. A new commercially available microabrasion system has been introduced by Ultradent Products Inc. In addition, a new tooth isolation material is available, along with a visible light-activated in-office hydrogen peroxide solution. This article describes these new products and documents tooth-color correction for two young patients using this new tooth-color correction approach.

  14. Experimental design a chemometric approach

    CERN Document Server

    Deming, SN


    Now available in a paperback edition is a book which has been described as `` exceptionally lucid, easy-to-read presentation... would be an excellent addition to the collection of every analytical chemist. I recommend it with great enthusiasm.'' (Analytical Chemistry). Unlike most current textbooks, it approaches experimental design from the point of view of the experimenter, rather than that of the statistician. As the reviewer in `Analytical Chemistry' went on to say: ``Deming and Morgan should be given high praise for bringing the principles of experimental design to the level of the p

  15. Predictability of processed electroencephalography effects on the basis of pharmacokinetic-pharmacodynamic modeling during repeated propofol infusions in patients with extradural analgesia

    NARCIS (Netherlands)

    Kuizenga, K; Proost, JH; Wierda, JM; Kalkman, CJ

    Background: Pharmacokinetic-pharmacodynamic (PKPD) modeling can be used to characterize the concentration-effect relation of drags. If the concentration-effect relation of a hypnotic drug is stable over time, an effect parameter derived from the processed electroencephalographic signal may be used

  16. Low back pain as the presenting sign in a patient with primary extradural melanoma of the thoracic spine - A metastatic disease 17 Years after complete surgical resection

    Directory of Open Access Journals (Sweden)

    Katalinic Darko


    Full Text Available Abstract Primary spinal melanomas are extremely rare lesions. In 1906, Hirschberg reported the first primary spinal melanoma, and since then only 40 new cases have been reported. A 47-year-old man was admitted suffering from low back pain, fatigue and loss of body weight persisting for three months. He had a 17-year-old history of an operated primary spinal melanoma from T7-T9, which had remained stable for these 17 years. Routine laboratory findings and clinical symptoms aroused suspicion of a metastatic disease. Multislice computed tomography and magnetic resonance imaging revealed stage-IV melanoma with thoracic, abdominal and skeletal metastases without the recurrence of the primary process. Transiliac crest core bone biopsy confirmed the diagnosis of metastatic melanoma. It is important to know that in all cases of back ore skeletal pain and unexplained weight loss, malignancy must always be considered in the differential diagnosis, especially in the subjects with a positive medical history. Patients who have back, skeletal, or joint pain that is unresponsive to a few weeks of conservative treatment or have known risk factors with or without serious etiology, are candidates for imaging studies. The present case demonstrates that complete surgical resection alone may result in a favourable outcome, but regular medical follow-up for an extended period, with the purpose of an early detection of a metastatic disease, is highly recommended.

  17. Comparison of the effects of extradural clonidine with those of morphine on postoperative pain, stress responses, cardiopulmonary function and motor and sensory block

    DEFF Research Database (Denmark)

    Lund, Claus; Qvitzau, S; Greulich, A


    made for 6 h after each patient's first request for analgesia. Clonidine provided greater pain relief than morphine only for the first 2 h of observation (P less than 0.001). Plasma cortisol concentrations decreased to a greater extent (P less than 0.05) with morphine, while plasma glucose...... concentration increased by a similar extent in both groups. After clonidine, mean arterial pressure decreased from 100 (SEM 3) mm Hg to 70 (3) mm Hg (P less than 0.05), but there was no change after morphine. There were no significant changes in heart rate, pulmonary function (FEV1), motor function or sensory...


    Directory of Open Access Journals (Sweden)

    Anak Agung Sagung Shanti Sari Dewi


    Full Text Available The history has noted that the emergence of various approcahes towards foreign language learning is to search for the most effective and efficient way in teaching foreign languages that should match the development and change in the world. Before the Communicative Language Approach was widely known and considered by many as the best approach in foreign language teaching, there have also been other approaches around, which emerged in accordance with the development of particular period. Those approaches are Grammar Translation Approach, Dirext Method, Reading Approach, Audio Lingual Aproach dan Cognitive Approach. At the present times, with the advance of technology, language teaching seems to adapt itslef to that development. CALL approach as one of the computer-based approaches to foreign language teaching is considered to be effective to achieve success in foreign language learning.

  19. Approach/avoidance in dreams. (United States)

    Malcolm-Smith, Susan; Koopowitz, Sheri; Pantelis, Eleni; Solms, Mark


    The influential threat simulation theory (TST) asserts that dreaming yields adaptive advantage by providing a virtual environment in which threat-avoidance may be safely rehearsed. We have previously found the incidence of biologically threatening dreams to be around 20%, with successful threat avoidance occurring in approximately one-fifth of such dreams. TST asserts that threat avoidance is over-represented relative to other possible dream contents. To begin assessing this issue, we contrasted the incidence of 'avoidance' dreams with that of their opposite: 'approach' dreams. Because TST states that the threat-avoidance function is only fully activated in ecologically valid (biologically threatening) contexts, we also performed this contrast for populations living in both high- and low-threat environments. We find that 'approach' dreams are significantly more prevalent across both contexts. We suggest these results are more consistent with the view that dreaming is generated by reward-seeking systems than by fear-conditioning systems, although reward-seeking is clearly not the only factor determining the content of dreams. Copyright © 2011 Elsevier Inc. All rights reserved.

  20. Interdisciplinary Approach in Engineering Education

    Directory of Open Access Journals (Sweden)

    Anda Zeidmane


    Full Text Available The analysis of the scientific literature available on the types of general competences and their classification caused the authors to conclude that it is necessary to implement interdisciplinary approach in engineering education to develop competences necessary for engineers to make them competitive in the labour market. The attention should be paid to a professional foreign language, computer literacy and educational psychology recommendations. To improve professional foreign language skills, CLIL (Content and Language Integrated Learning method should be integrated in the study process of engineering education. In order to develop information literacy competence, it is important to create a single e-study environment. The academic staff, developing study subjects for engineering programmes, should focus on the study content and study methods. As regards the content, the compromise should be sought between fundamental acquisition of the knowledge of the subject matter, the know-how of the application of this knowledge as well as the use of brand new software in the calculations. The paper presents the examples of the application of the interdisciplinary approach in the universities, where the authors of the paper are affiliated: the LUA (Latvia University of Agriculture and the RTU (Riga Technical University, respectively.

  1. Modeling Approaches in Planetary Seismology (United States)

    Weber, Renee; Knapmeyer, Martin; Panning, Mark; Schmerr, Nick


    Of the many geophysical means that can be used to probe a planet's interior, seismology remains the most direct. Given that the seismic data gathered on the Moon over 40 years ago revolutionized our understanding of the Moon and are still being used today to produce new insight into the state of the lunar interior, it is no wonder that many future missions, both real and conceptual, plan to take seismometers to other planets. To best facilitate the return of high-quality data from these instruments, as well as to further our understanding of the dynamic processes that modify a planet's interior, various modeling approaches are used to quantify parameters such as the amount and distribution of seismicity, tidal deformation, and seismic structure on and of the terrestrial planets. In addition, recent advances in wavefield modeling have permitted a renewed look at seismic energy transmission and the effects of attenuation and scattering, as well as the presence and effect of a core, on recorded seismograms. In this chapter, we will review these approaches.

  2. Snow metamorphism: A fractal approach (United States)

    Carbone, Anna; Chiaia, Bernardino M.; Frigo, Barbara; Türk, Christian


    Snow is a porous disordered medium consisting of air and three water phases: ice, vapor, and liquid. The ice phase consists of an assemblage of grains, ice matrix, initially arranged over a random load bearing skeleton. The quantitative relationship between density and morphological characteristics of different snow microstructures is still an open issue. In this work, a three-dimensional fractal description of density corresponding to different snow microstructure is put forward. First, snow density is simulated in terms of a generalized Menger sponge model. Then, a fully three-dimensional compact stochastic fractal model is adopted. The latter approach yields a quantitative map of the randomness of the snow texture, which is described as a three-dimensional fractional Brownian field with the Hurst exponent H varying as continuous parameters. The Hurst exponent is found to be strongly dependent on snow morphology and density. The approach might be applied to all those cases where the morphological evolution of snow cover or ice sheets should be conveniently described at a quantitative level.

  3. Neural Approaches to Machine Consciousness (United States)

    Aleksander, Igor; Eng., F. R.


    `Machine Consciousness', which some years ago might have been suppressed as an inappropriate pursuit, has come out of the closet and is now a legitimate area of research concern. This paper briefly surveys the last few years of worldwide research in this area which divides into rule-based and neural approaches and then reviews the work of the author's laboratory during the last ten years. The paper develops a fresh perspective on this work: it is argued that neural approaches, in this case, digital neural systems, can address phenomenological consciousness. Important clarifications of phenomenology and virtuality which enter this modelling are explained in the early parts of the paper. In neural models, phenomenology is a form of depictive inner representation that has five specific axiomatic features: a sense of self-presence in an external world; a sense of imagination of past experience and fiction; a sense of attention; a capacity for planning; a sense of emotion-based volition that influences planning. It is shown that these five features have separate but integrated support in dynamic neural systems.

  4. Improving immunization approaches to cholera. (United States)

    Saha, Amit; Rosewell, Alexander; Hayen, Andrew; MacIntyre, C Raina; Qadri, Firdausi


    Cholera's impact is greatest in resource-limited countries. In the last decade several large epidemics have led to a global push to improve and implement the tools for cholera prevention and control. Areas covered: PubMed, Google Scholar and the WHO website were searched to review the literature and summarize the current status of cholera vaccines to make recommendations on improving immunization approaches to cholera. Oral cholera vaccines (OCVs) have demonstrated their effectiveness in endemic, outbreak response and emergency settings, highlighting their potential for wider adoption. While two doses of the currently available OCVs are recommended by manufacturers, a single dose would be easier to implement. Encouragingly, recent studies have shown that cold chain requirements may no longer be essential. The establishment of the global OCV stockpile in 2013 has been a major advance in cholera preparedness. New killed and live-attenuated vaccines are being actively explored as candidate vaccines for endemic settings and/or as a traveller's vaccine. The recent advances in cholera vaccination approaches should be considered in the global cholera control strategy. Expert commentary: The development of affordable cholera vaccines is a major success to improve cholera control. New vaccines and country specific interventions will further reduce the burden of this disease globally.

  5. Robotic approaches to prolapse surgery. (United States)

    Rosenblum, Nirit


    Pelvic reconstructive surgeons in the fields of urology, gynecology and urogynecology have continually adapted new techniques in pelvic organ prolapse (POP) repair in order to improve both anatomic and subjective outcomes. In the last 5 years, robotic surgery has gained a strong foothold in urologic oncology, gynecologic oncology, cardiothoracic surgery and now in female pelvic medicine. Robotic surgery has made its way into the armamentarium of POP treatment and has allowed pelvic surgeons to adapt the 'gold standard' technique of abdominal sacrocolpopexy to a minimally invasive approach with improved intraoperative morbidity and decreased convalescence. This review article aims to discuss the techniques of robotic prolapse repair as well as morbidity, cost and clinical outcomes. The adaptation of minimally invasive approaches to the treatment of POP initially began with laparoscopy, something only those surgeons with extensive and advanced laparoscopic skills are able to accomplish. Access to robotic technology makes conversion from open or laparoscopic to robotic surgery much more feasible for most pelvic floor surgeons. There are currently no published randomized, controlled trials comparing robotic with open or laparoscopic sacrocolpopexy, however, there are several publications reporting both retrospective and prospective series of women undergoing robotic-assisted sacrocolpopexy. Robotic-assisted pelvic floor surgery has become an important component of the pelvic surgeon's armamentarium in the treatment of symptomatic POP. Those pelvic surgeons without significant expertise in laparoscopy required for sacral dissection and intracorporeal suturing can readily learn the necessary techniques required for robotic surgery.

  6. Approaching Bose-Einstein condensation

    Energy Technology Data Exchange (ETDEWEB)

    Ferrari, Loris, E-mail: [Department of Physics of the University, Viale B. Pichat, 6/2, 40127, Bologna (Italy)


    Bose-Einstein condensation (BEC) is discussed at the level of an advanced course of statistical thermodynamics, clarifying some formal and physical aspects that are usually not covered by the standard pedagogical literature. The non-conventional approach adopted starts by showing that the continuum limit, in certain cases, cancels out the crucial role of the bosonic ground level. If so, a correct treatment of the problem, including the ground level population N{sub 0} by construction, leads to BEC in a straightforward way. For a density of states of the form G({epsilon}){approx}{epsilon}{sup {gamma}}, the chemical potential {mu} is explicitly calculated as a function of the temperature T and of the number N of bosons, for various significant values of the positive exponent {gamma}. In the thermodynamic limit, in which the boson number N diverges and BEC is a sharp process, the chemical potential {mu} is a singular function of T at the critical temperature T{sub B}, determined by an appropriate critical exponent. The condensate population N{sub 0} is studied analytically and numerically as a function of the temperature, for various values of N and for different {gamma}. This provides an accurate description of the way BEC approaches the character of a sharp phase transition. Some aspects of the real experiments on BEC, involving a finite number of bosons, are also illustrated.

  7. Shore approach of Camarupim pipeline

    Energy Technology Data Exchange (ETDEWEB)

    Bernardi, Tiaraju P.; Oliveira Neto, Vasco A. de; Siqueira, Jakson [Petroleo Brasileiro S.A. (PETROBRAS), Rio de Janeiro, RJ (Brazil)


    Camarupim Field is located in the northern portion of Espirito Santo Basin and was discovered from the drilling of the well 1-ESS-164 in 2006. It is a gas field which start of the production is in mid of 2009. The production unit will be a FPSO (Floating Production, Storage and Offloading) and the gas will flow through a pipeline with diameter ranging from 12 inches and 24 inches with approximately 60 km long, from the FPSO Cidade de Sao Mateus to UTGC (Unit for Treatment of Gas Cacimbas-Linhares-ES). The FPSO will have processing capacity of 10MMm3/day of gas. Due to the approach of the pipeline in the continental portion, located in an environmental protection area and place of spawning of sea turtles, the connection between the stretch of sea and land pipeline running through a shore approach, known and proven technique of horizontal directional drilling about 950m in length. This paper will be shown the assumptions adopted, the technique employed, the challenges faced by the team and the lessons learned to build the directional hole. (author)

  8. Approach to Rectal Cancer Surgery

    Directory of Open Access Journals (Sweden)

    Terence C. Chua


    Full Text Available Rectal cancer is a distinct subset of colorectal cancer where specialized disease-specific management of the primary tumor is required. There have been significant developments in rectal cancer surgery at all stages of disease in particular the introduction of local excision strategies for preinvasive and early cancers, standardized total mesorectal excision for resectable cancers incorporating preoperative short- or long-course chemoradiation to the multimodality sequencing of treatment. Laparoscopic surgery is also increasingly being adopted as the standard rectal cancer surgery approach following expertise of colorectal surgeons in minimally invasive surgery gained from laparoscopic colon resections. In locally advanced and metastatic disease, combining chemoradiation with radical surgery may achieve total eradication of disease and disease control in the pelvis. Evidence for resection of metastases to the liver and lung have been extensively reported in the literature. The role of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal metastases is showing promise in achieving locoregional control of peritoneal dissemination. This paper summarizes the recent developments in approaches to rectal cancer surgery at all these time points of the disease natural history.

  9. A new approach to magic

    Directory of Open Access Journals (Sweden)

    Čvorović Jelena


    Full Text Available This paper uses the example of traditional practices of magic to suggest ways to incorporate cultural behaviors within the evolutionary paradigm. The first suggestion is to restrict hypotheses to only identifiable variables. This means avoiding the temptation of following the nonevolutionary social sciences in the practice of basing explanations on unverifiable guesses about what beliefs (or memes in evolutionary jargon may or may not inhabit people's brains. In contrast with previous explanations that magical practices result from beliefs and memes whose primarily purpose is to reduce anxiety, we propose that magic is a form of communication that promotes cooperation and often avoids anti-social behavior. This effect of increased cooperation could explain why traditional forms of magic have probably existed and had significant positive consequences for the participants. To be effective as a means of communication, magical rituals must specify both the content of the message and the receiver of the message. Although the content of the communicative message differs with different types of magic, all magical acts serve a purpose to influence the behavior of the party involved and that is the most significant identifiable effect of such behavior. An advantage of this approach over many previous explanations of magic is that because it focuses on identifiable phenomena, the definitions and explanations used in this approach can be falsified.

  10. The ethnoprimatological approach in primatology. (United States)

    Fuentes, Agustin; Hockings, Kimberley J


    Recent and long-term sympatries between humans and nonhuman primates (hereafter primates) are central to the behavioral ecology, conservation, and evolutionary trajectories of numerous primate species. Ethnoprimatology emphasizes that interconnections between humans and primates should be viewed as more than just disruptions of a "natural" state, and instead anthropogenic contexts must be considered as potential drivers for specific primate behavioral patterns. Rather than focusing solely on the behavior and ecology of the primate species at hand, as in traditional primatology, or on the symbolic meanings and uses of primates, as in socio-cultural anthropology, ethnoprimatology attempts to merge these perspectives into a more integrative approach. As human pressures on environments continue to increase and primate habitats become smaller and more fragmented, the need for a primatology that considers the impact of human attitudes and behavior on all aspects of primate lives and survival is imperative. In this special issue, we present both data-driven examples and more general discussions that describe how ethnoprimatological approaches can be both a contribution to the core theory and practice of primatology and a powerful tool in our goal of conservation action. 2010 Wiley-Liss, Inc.

  11. Systematic approach to thermal leptogenesis

    Energy Technology Data Exchange (ETDEWEB)

    Frossard, T.; Kartavtsev, A. [Max-Planck-Institut fuer Kernphysik, Heidelberg (Germany); Garny, M. [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Hohenegger, A. [Ecole Polytechnique Federale de Lausanne, LPPC, BSP (Switzerland); Mitrouskas, D. [Muenchen Univ. (Germany)


    In this work we study thermal leptogenesis using non-equilibrium quantum field theory. Starting from fundamental equations for correlators of the quantum fields we describe the steps necessary to obtain quantum kinetic equations for quasiparticles. These can easily be compared to conventional results and overcome conceptional problems inherent in the canonical approach. Beyond CP-violating decays we include also those scattering processes which are tightly related to the decays in a consistent approximation of fourth order in the Yukawa couplings. It is demonstrated explicitly how the S-matrix elements for the scattering processes in the conventional approach are related to two- and three-loop contributions to the effective action. We derive effective decay and scattering amplitudes taking medium corrections and thermal masses into account. In this context we also investigate CP-violating Higgs decay within the same formalism. From the kinetic equations we derive rate equations for the lepton asymmetry improved in that they include quantum-statistical effects and medium corrections to the quasiparticle properties.

  12. Current approach to liver traumas. (United States)

    Kaptanoglu, Levent; Kurt, Necmi; Sikar, Hasan Ediz


    Liver injuries remain major obstacle for successful treatment, due to size and location of the liver. Requirement for surgery should be determined by clinical factors, most notably hemodynamical state. In this present study we tried to declare our approach to liver traumas. We also tried to emphasize the importance of conservative treatment, since surgeries for liver traumas carry high mortality rates. Patients admitted to the Department of Emergency Surgery at Kartal Research and Education Hospital, due to liver trauma were retrospectively analyzed between 2003 and 2013. Patient demographics, hepatic panel, APTT (activated partial thromboplastin time), PT (prothrombin time), INR (international normalized ratio), fibrinogen, biochemistry panel were recorded. Hemodynamic instability was the most prominent factor for surgery decision, in the lead of current Advanced Trauma Life Support (ATLS) protocols. Operation records and imaging modalities revealed liver injuries according to the Organ Injury Scale of the American Association for the Surgery of Trauma. 300 patients admitted to emergency department were included in our study (187 males and 113 females). Mean age was 47 years (range, 12-87). The overall mortality rate was 13% (40 out of 300). Major factor responsible for mortality rates and outcome was stability of cases on admission. 188 (% 63) patients were counted as stable, whereas 112 (% 37) cases were found unstable (blood pressure ≤ 90, after massive resuscitation). 192 patients were observed conservatively, whereas 108 cases received abdominal surgery. High levels of AST, ALT, LDH, INR, creatinine and low levels of fibrinogen and low platelet counts on admission were found to be associated with mortality and these cases also had Grade 4 and 5 injuries. Hemodynamic instability on admission and the type and grade of injury played major role in mortality rates). Packing was performed in 35 patients, with Grade 4 and 5 injuries. Mortality rate was %13 (40

  13. Hydrogeological challenges through gender approaches (United States)

    Di Lorenzo, Maria Rosaria; Saltari, Davide; Di Giacomo, Tullia Valeria


    Women and Men play a different role in the society, tied from the differences (physical, biological, somatic, etc…) typical of each one. In the last decades, more gender approach has been introduced in a number of fields including the hydrogeological risk. Experiences, needs and potential of each one, women and men, covers both the risk reduction before the occurrence of extreme events (vulnerability assessment and prediction of the expected risk), then in the next emergency and intervention in follow-up actions to the overcoming of the event for the return to everyday life. The response of the extreme hydrological events are also subordinated from gender participation and it is closely related from other aspects, as natural disasters (flood events), gender inequalities and urban floodings. These aspects are also scheduled by the different approaches: a woman focuses different primary and social aspects than a man. How women can help organizations offering new 'policies' and government is the main aspect to be considered and how a gender approach can mitigate disasters to hydrological risk. It depends on some factors: gender inequalities (gender perception and sensibility), importance of natural disasters and urban floodings. Gender inequalities can match both in the natural disasters and urban floodings in a relevant way. ICT solutions can also give a helpful framework to accelerate and focus the quicker condition to get the better approach and solution. Gender has a particular significant, explanatory variable in disaster research. Many studies, show how women have higher mortality and morbidity rates than men during natural disasters, especially in lower income countries. In the aftermath disasters, at the same time, specific responsibilities on women are imposed from the gendered division of labour. Furthermore gender differences are sometimes attributed to traditional women's roles, discrimination, lower physical strength, nutritional deficiencies, etc. as

  14. Computer architecture a quantitative approach

    CERN Document Server

    Hennessy, John L


    Computer Architecture: A Quantitative Approach, Sixth Edition has been considered essential reading by instructors, students and practitioners of computer design for over 20 years. The sixth edition of this classic textbook is fully revised with the latest developments in processor and system architecture. It now features examples from the RISC-V (RISC Five) instruction set architecture, a modern RISC instruction set developed and designed to be a free and openly adoptable standard. It also includes a new chapter on domain-specific architectures and an updated chapter on warehouse-scale computing that features the first public information on Google's newest WSC. True to its original mission of demystifying computer architecture, this edition continues the longstanding tradition of focusing on areas where the most exciting computing innovation is happening, while always keeping an emphasis on good engineering design.

  15. Therapeutic approaches for celiac disease (United States)

    Plugis, Nicholas M.; Khosla, Chaitan


    Celiac disease is a common, lifelong autoimmune disorder for which dietary control is the only accepted form of therapy. A strict gluten-free diet is burdensome to patients and can be limited in efficacy, indicating there is an unmet need for novel therapeutic approaches to supplement or supplant dietary therapy. Many molecular events required for disease pathogenesis have been recently characterized and inspire most current and emerging drug-discovery efforts. Genome-wide association studies (GWAS) confirm the importance of human leukocyte antigen genes in our pathogenic model and identify a number of new risk loci in this complex disease. Here, we review the status of both emerging and potential therapeutic strategies in the context of disease pathophysiology. We conclude with a discussion of how genes identified during GWAS and follow-up studies that enhance susceptibility may offer insight into developing novel therapies. PMID:26060114

  16. Waste Characterization: Approaches and Methods

    DEFF Research Database (Denmark)

    Lagerkvist, A.; Ecke, H.; Christensen, Thomas Højlund


    Characterization of solid waste is usually a difficult task because of the heterogeneity of the waste and its spatial as well as temporal variations. This makes waste characterization costly if good and reliable data with reasonable uncertainty is to be obtained. Therefore, a waste characterization...... is often narrowly defined to meet specific needs for information. This may however limit the general usefulness of the information gained, for example, if the specific purpose limited the characterization to a subset of variables. In general, data available in the solid waste area are limited and often...... with limited representation. This chapter describes common approaches and methods in waste characterization including common terms, sampling, characterization methods and data evaluation. The focus is on the characterization of waste as it is generated or collected, while specific issues on characterization...

  17. A Dialogic Approach to Pragmatics

    Directory of Open Access Journals (Sweden)

    Иштван Кечкеш


    Full Text Available This paper focuses on how the limits of pragmatics - as long as it is restricted to the analysis of one utterance at a time - are overcome by including the hearer not only as interpreter who tries to understand the speaker’s utterance but as an interlocutor who tries to come to an understanding with the speaker. The goal of the paper is not to describe and analyze the dialogue approach rather explain what inner developments in the pragmatics paradigm have made it necessary to move in a dialogic direction, specifically emphasizing the importance of evaluating speaker meaning from the perspective of the speaker rather than from the perspective of the hearer and the double role of the interlocutor (speaker-hearer.

  18. A programming approach to computability

    CERN Document Server

    Kfoury, A J; Arbib, Michael A


    Computability theory is at the heart of theoretical computer science. Yet, ironically, many of its basic results were discovered by mathematical logicians prior to the development of the first stored-program computer. As a result, many texts on computability theory strike today's computer science students as far removed from their concerns. To remedy this, we base our approach to computability on the language of while-programs, a lean subset of PASCAL, and postpone consideration of such classic models as Turing machines, string-rewriting systems, and p. -recursive functions till the final chapter. Moreover, we balance the presentation of un solvability results such as the unsolvability of the Halting Problem with a presentation of the positive results of modern programming methodology, including the use of proof rules, and the denotational semantics of programs. Computer science seeks to provide a scientific basis for the study of information processing, the solution of problems by algorithms, and the design ...

  19. Special relativity a heuristic approach

    CERN Document Server

    Hassani, Sadri


    Special Relativity: A Heuristic Approach provides a qualitative exposition of relativity theory on the basis of the constancy of the speed of light. Using Einstein's signal velocity as the defining idea for the notion of simultaneity and the fact that the speed of light is independent of the motion of its source, chapters delve into a qualitative exposition of the relativity of time and length, discuss the time dilation formula using the standard light clock, explore the Minkowski four-dimensional space-time distance based on how the time dilation formula is derived, and define the components of the two-dimensional space-time velocity, amongst other topics. Provides a heuristic derivation of the Minkowski distance formula Uses relativistic photography to see Lorentz transformation and vector algebra manipulation in action Includes worked examples to elucidate and complement the topic being discussed Written in a very accessible style

  20. Tuberous breast: a new approach. (United States)

    Ribeiro, L; Canzi, W; Buss, A; Accorsi, A


    The authors make a historical summary of the pathologic condition of tuberous breast and describe a new procedure for its correction. The method involves a periareolar approach, dividing the breast in two portions to disrupt the constricting ring, and making an inferiorly based flap or pedicle, as described and used by the senior author since 1969, with publication in 1973. The main goal is to correct the deformity at a one-stage operation, resulting in a periareolar scar only, without the use of alloplastic elements such as prostheses, mesh, or tissue expanders. The authors emphasize that Brazilian patients prefer having small breasts rather than large ones, even though the procedure allows the implantation of pre- or retromuscular implants through the periareolar incision.

  1. Endoscopic approach to subepithelial lesions. (United States)

    Menon, Laila; Buscaglia, Jonathan M


    Endoscopy and endoscopic ultrasound (EUS) play a critical role in the detection and management of subepithelial lesions of the gastrointestinal tract. The most common subepithelial lesions detected by endoscopists are gastrointestinal stromal tumors (GISTs), leiomyomas, lipomas, granular cell tumors (GCTs), pancreatic rests and carcinoid tumors. These lesions can be classified based on unique histochemical staining and the gastrointestinal layer of origin. While the majority of the lesions are considered benign, some tumors such as GISTs and carcinoids have a strong propensity for malignant transformation. Therefore, appropriate endoscopic versus surgical management based on size and location is crucial in the prevention of malignant transformation and metastasis. In this review, we provide a systematic approach to the diagnosis, management and treatment of commonly encountered subepithelial lesions.

  2. Branding approach and valuation models

    Directory of Open Access Journals (Sweden)

    Mamula Tatjana


    Full Text Available Much of the skill of marketing and branding nowadays is concerned with building equity for products whose characteristics, pricing, distribution and availability are really quite close to each other. Brands allow the consumer to shop with confidence. The real power of successful brands is that they meet the expectations of those that buy them or, to put it another way, they represent a promise kept. As such they are a contract between a seller and a buyer: if the seller keeps to its side of the bargain, the buyer will be satisfied; if not, the buyer will in future look elsewhere. Understanding consumer perceptions and associations is an important first step to understanding brand preferences and choices. In this paper, we discuss different models to measure value of brand according to couple of well known approaches according to request by companies. We rely upon several empirical examples.

  3. Dietary approaches to prevent hypertension. (United States)

    Bazzano, Lydia A; Green, Torrance; Harrison, Teresa N; Reynolds, Kristi


    Elevated blood pressure arises from a combination of environmental and genetic factors and the interactions of these factors. A substantial body of evidence from animal studies, epidemiologic studies, meta-analyses, and randomized controlled trials has demonstrated that certain dietary patterns and individual dietary elements play a prominent role in the development of hypertension. Changes in diet can lower blood pressure, prevent the development of hypertension, and reduce the risk of hypertension-related complications. Dietary strategies for the prevention of hypertension include reducing sodium intake, limiting alcohol consumption, increasing potassium intake, and adopting an overall dietary pattern such as the DASH (Dietary Approaches to Stop Hypertension) diet or a Mediterranean diet. In order to reduce the burden of blood pressure-related complications, efforts that focus on environmental and individual behavioral changes that encourage and promote healthier food choices are warranted.

  4. Pharmacotherapy of Schizophrenia: Ploypharmacy Approaches

    Directory of Open Access Journals (Sweden)

    Fatemeh Rahiminejad


    Full Text Available "nSchizophrenia is a debilitating illness, rating as one of the leading causes of lost years of quality of life. The illness imposes a disproportionate burden on patients and their families, healthcare systems and society. Pharmacological management is the cornerstone of treatment of schizophrenia, and antipsychotics, both first generation of antipsychotics and second generation of antipsychotics, are efficacious in reducing levels of psychopathology in acute episodes of schizophrenia. Clearly a need for innovative treatment strategies in schizophrenia that will ensure increased effectiveness against negative symptoms and cognitive dysfunction dysfunction. Therefore, in majority of cases polypharmacy is one of the effective approaches. This review focused on polypharmacy in the treatment of schizophrenia and in particular negative symptoms.

  5. [Identity and aging: psychosocial approaches]. (United States)

    Danko, Marianna; Arnaud, Christiane; Gély-Nargeot, Marie-Christine


    This review is devoted to the notion of identity with regard to the process of aging from various approaches in social sciences. Continuity or transformation of identity is challenged in advanced age according to the place reserved in the society for the elderly subjects and their social age groups. Study methods are discussed in relation with the theoretical models, and their relevance to address aging people singularity and influence of environment. Changes of identity among elderly subjects appear to proceed in two ways. In the first one, called "rebirth", they establish a new self. In the second way, termed "turning point", better strategy for coping the aging effects is obtained by revealing untapped dimensions of the Self.

  6. Laboratory approaches to infectious diarrhea. (United States)

    Turgeon, D K; Fritsche, T R


    Future applications of advanced molecular diagnostics in clinical laboratories will enhance significantly capabilities to diagnose bacterial, parasitic, and viral agents in the early course of disease through enhanced assay sensitivities and specificities and improved turnaround times, theoretically leading to more timely and directed therapeutic intervention. Until such time, clinicians must continue to rely on clinical judgment and the diverse battery of traditional culture techniques, direct examination (including light microscopy and electron microscopy), and immunoassays that are available. Cost considerations and the ever-increasing array of infectious agents responsible for infectious gastroenteritis will continue to drive the development of practice guidelines to assist practitioners with reasoned and reasonable approaches to management of diarrheal illnesses.

  7. Kinetic approach to relativistic dissipation (United States)

    Gabbana, A.; Mendoza, M.; Succi, S.; Tripiccione, R.


    Despite a long record of intense effort, the basic mechanisms by which dissipation emerges from the microscopic dynamics of a relativistic fluid still elude complete understanding. In particular, several details must still be finalized in the pathway from kinetic theory to hydrodynamics mainly in the derivation of the values of the transport coefficients. In this paper, we approach the problem by matching data from lattice-kinetic simulations with analytical predictions. Our numerical results provide neat evidence in favor of the Chapman-Enskog [The Mathematical Theory of Non-Uniform Gases, 3rd ed. (Cambridge University Press, Cambridge, U.K., 1970)] procedure as suggested by recent theoretical analyses along with qualitative hints at the basic reasons why the Chapman-Enskog expansion might be better suited than Grad's method [Commun. Pure Appl. Math. 2, 331 (1949), 10.1002/cpa.3160020403] to capture the emergence of dissipative effects in relativistic fluids.

  8. Approaches to translational plant science

    DEFF Research Database (Denmark)

    Dresbøll, Dorte Bodin; Christensen, Brian; Thorup-Kristensen, Kristian


    Translational science deals with the dilemma between basic research and the practical application of scientific results. In translational plant science, focus is on the relationship between agricultural crop production and basic science in various research fields, but primarily in the basic plant...... science. Scientific and technological developments have allowed great progress in our understanding of plant genetics and molecular physiology, with potentials for improving agricultural production. However, this development has led to a separation of the laboratory-based research from the crop production...... is lessened. In our opinion, implementation of translational plant science is a necessity in order to solve the agricultural challenges of producing food and materials in the future. We suggest an approach to translational plant science forcing scientists to think beyond their own area and to consider higher...

  9. Novel therapeutic approaches in chondrosarcoma. (United States)

    Polychronidou, Genovefa; Karavasilis, Vasilios; Pollack, Seth M; Huang, Paul H; Lee, Alex; Jones, Robin L


    Chondrosarcoma is a malignant tumor of bones, characterized by the production of cartilage matrix. Due to lack of effective treatment for advanced disease, the clinical management of chondrosarcomas is exceptionally challenging. Current research focuses on elucidating the molecular events underlying the pathogenesis of this rare bone malignancy, with the goal of developing new molecularly targeted therapies. Signaling pathways suggested to have a role in chondrosarcoma include Hedgehog, Src, PI3k-Akt-mTOR and angiogenesis. Mutations in IDH1/2, present in more than 50% of primary conventional chondrosarcomas, make the development of IDH inhibitors a promising treatment option. The present review discusses the preclinical and early clinical data on novel targeted therapeutic approaches in chondrosarcoma.

  10. Raman spectroscopy an intensity approach

    CERN Document Server

    Guozhen, Wu


    This book summarizes the highlights of our work on the bond polarizability approach to the intensity analysis. The topics covered include surface enhanced Raman scattering, Raman excited virtual states and Raman optical activity (ROA). The first chapter briefly introduces the Raman effect in a succinct but clear way. Chapter 2 deals with the normal mode analysis. This is a basic tool for our work. Chapter 3 introduces our proposed algorithm for the Raman intensity analysis. Chapter 4 heavily introduces the physical picture of Raman virtual states. Chapter 5 offers details so that the readers can have a comprehensive idea of Raman virtual states. Chapter 6 demonstrates how this bond polarizability algorithm is extended to ROA intensity analysis. Chapters 7 and 8 offer details on ROA, showing many findings on ROA mechanism that were not known or neglected before. Chapter 9 introduces our proposed classical treatment on ROA which, as combined with the results from the bond polarizability analysis, leads to a com...

  11. How to approach chronic anemia. (United States)

    Koury, Mark J; Rhodes, Melissa


    We present herein an approach to diagnosing the cause of chronic anemia based on a patient's history and complete blood cell count (CBC). Four patterns that are encountered frequently in CBCs associated with chronic anemias are considered: (1) anemia with abnormal platelet and/or leukocyte counts, (2) anemia with increased reticulocyte counts, (3) life-long history of chronic anemia, and (4) anemia with inappropriately low reticulocytes. The pathophysiologic bases for some chronic anemias with low reticulocyte production are reviewed in terms of the bone marrow (BM) events that reduce normal rates of erythropoiesis. These events include: apoptosis of erythroid progenitor and precursor cells by intrinsic and extrinsic factors, development of macrocytosis when erythroblast DNA replication is impaired, and development of microcytosis due to heme-regulated eIF2α kinase inhibition of protein synthesis in iron-deficient or thalassemic erythroblasts.

  12. Mindful approach to University education. (United States)

    Broggi, Fiorenza; Bomba, Monica; Rimondini, Michela; Mutti, Maura; Pasta, Sara; Ricci, Chiara; Tagliabue, Luca; Valsecchi, Silvia; Monaco, Elide; Neri, Francesca; Oggiano, Silvia; Nacinovich, Renata


    A mindful approach to education and training could improve students' reflective capacities and have positive effects on clinical practice because it facilitates a helping relationship. The main aims of this study were to investigate whether participation in a mindful-based University training was associated with increases in mindfulness skills as measured by the 5-Facet M Questionnaire, and to present the Italian validation of the questionnaire. Sixty-seven students from the course Neuro and Psychomotor Therapy were enrolled. They filled in the self-administered 5-Facet M Questionnaire before and 1 month after a mindfulness-based training, focused on role-playing and followed by a feedback group discussion. The Italian version of the 5-Facet M Questionnaire had good psychometric properties. The pre- and post-training analysis showed a significant increase in the subscale 'Observing'. Findings suggest that role-playing and feedback group sessions are valid tools to improve students' mindfulness skills.

  13. Elliptic curves a computational approach

    CERN Document Server

    Schmitt, Susanne; Pethö, Attila


    The basics of the theory of elliptic curves should be known to everybody, be he (or she) a mathematician or a computer scientist. Especially everybody concerned with cryptography should know the elements of this theory. The purpose of the present textbook is to give an elementary introduction to elliptic curves. Since this branch of number theory is particularly accessible to computer-assisted calculations, the authors make use of it by approaching the theory under a computational point of view. Specifically, the computer-algebra package SIMATH can be applied on several occasions. However, the book can be read also by those not interested in any computations. Of course, the theory of elliptic curves is very comprehensive and becomes correspondingly sophisticated. That is why the authors made a choice of the topics treated. Topics covered include the determination of torsion groups, computations regarding the Mordell-Weil group, height calculations, S-integral points. The contents is kept as elementary as poss...

  14. Possible State Approaches to Cryptocurrencies

    Directory of Open Access Journals (Sweden)

    Jan Lansky


    Full Text Available Cryptocurrencies are a type of digital currencies that are relying on cryptographic proofs for confirmation of transactions. Cryptocurrencies usually achieve a unique combination of three features: ensuring limited anonymity, independence from central authority and double spending attack protection. No other group of currencies, including fiat currencies, has this combination of features. We will define cryptocurrency ownership and account anonymity. We will define cryptocurrency ownership and account anonymity. We will introduce a classification of the types of approaches to regulation of cryptocurrencies by various individual countries. We will present the risks that the use of cryptocurrencies involves and the possibilities of prevention of those risks. We will present the possible use of cryptocurrencies for the benefit of the state. The conclusion addresses the implications of adoption of a cryptocurrency as a national currency.

  15. Queueing networks a fundamental approach

    CERN Document Server

    Dijk, Nico


    This handbook aims to highlight fundamental, methodological and computational aspects of networks of queues to provide insights and to unify results that can be applied in a more general manner.  The handbook is organized into five parts: Part 1 considers exact analytical results such as of product form type. Topics include characterization of product forms by physical balance concepts and simple traffic flow equations, classes of service and queue disciplines that allow a product form, a unified description of product forms for discrete time queueing networks, insights for insensitivity, and aggregation and decomposition results that allow subnetworks to be aggregated into single nodes to reduce computational burden. Part 2 looks at monotonicity and comparison results such as for computational simplification by either of two approaches: stochastic monotonicity and ordering results based on the ordering of the proces generators, and comparison results and explicit error bounds based on an underlying Markov r...

  16. Bruxism and Current Treatment Approaches

    Directory of Open Access Journals (Sweden)

    Selin Eren


    Full Text Available Among the mastication system disorders bruxism is a parafunctional behavior that comes from psychophysiological origin. Epidemiologic studies have reported great variability of bruxism prevalence. The factors that could cause bruxism is highly controversial. There are different opinions on this issue. The etiologic factors of bruxism include stress, malnutrition, allergic and endocrinologic diseases, central nervous system disorders, genetic factors, medicines, malocclusion, and wrong dental treatment. The aim of treatment of bruxism is to prevent damage that may occur on teeth and in the temporomandibular joint and to eliminate pain. Dental treatment, physical therapy, pharmacological treatment and behavioral and cognitive therapy can be considered for this purpose of treatment. This review summarizes the etiologic factors, epidemiology, diagnosis, and current treatment approaches of patient with bruxism. [Archives Medical Review Journal 2016; 25(2.000: 241-258

  17. Managerial Leadership - A Theoretical Approach

    Directory of Open Access Journals (Sweden)

    Felicia Cornelia MACARIE


    Full Text Available The paper endeavors to offer an overview of the major theories on leadership and the way in which it influences the management of contemporary organizations. Numerous scholars highlight that there are numerous overlaps between the concepts of management and leadership. This is the reason why the first section of the paper focuses on providing an extensive overview of the literature regarding the meaning of the two aforementioned concepts. The second section addresses more in depth the concept of leadership and managerial leadership and focuses on the ideal profile of the leader. The last section of the paper critically discusses various types of leadership and more specifically modern approaches to the concept and practices of leadership.

  18. Molecular approaches for bacterial azoreductases

    Directory of Open Access Journals (Sweden)

    Montira Leelakriangsak


    Full Text Available Azo dyes are the dominant types of synthetic dyes, widely used in textiles, foods, leather, printing, tattooing, cosmetics, and pharmaceutical industries. Many microorganisms are able to decolorize azo dyes, and there is increasing interest in biological waste treatment methods. Bacterial azoreductases can cleave azo linkages (-N=N- in azo dyes, forming aromatic amines. This review mainly focuses on employing molecular approaches, including gene manipulation and recombinant strains, to study bacterial azoreductases. The construction of the recombinant protein by cloning and the overexpression of azoreductase is described. The mechanisms and function of bacterial azoreductases can be studied by other molecular techniques discussed in this review, such as RT-PCR, southern blot analysis, western blot analysis, zymography, and muta-genesis in order to understand bacterial azoreductase properties, function and application. In addition, understanding the regulation of azoreductase gene expression will lead to the systematic use of gene manipulation in bacterial strains for new strategies in future waste remediation technologies.

  19. Four Approaches to Project Evaluation

    DEFF Research Database (Denmark)

    Laursen, Markus; Svejvig, Per; Rode, Anna Le Gerstrøm

    There are many theoretical and practical reasons for evaluating projects – including explorative arguments focusing on expanding descriptive knowledge on project work as well as normative arguments focusing on improving prescriptive models of project performance. Despite the need for project...... management methodologies that work and combat project failure, and research methods that can assess effective project management and methodologies, as well as empirical research on the actuality of projects as practice, evaluation research on projects including project management and methodologies is scarce....... Each of the framework’s four approaches provides a distinct evaluation that sheds light on some issues while leaving others unattended. Following these lines, the paper calls for more multi-faceted project evaluations. Introducing a framework that can help analyze existing evaluations and structure...

  20. Spinal trauma. An imaging approach

    Energy Technology Data Exchange (ETDEWEB)

    Cassar-Pullicino, V.N. [The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire (United Kingdom). Dept. of Radiology; Imhof, H. [University and General Hospital Vienna (Austria). Dept. of Radiodiagnostics


    The diagnosis of trauma to the spine - where the slightest oversight may have catastrophic results - requires a thorough grasp of the spectrum of resultant pathology as well as the imaging modalities used in making an accurate diagnosis. In Spinal Trauma, the internationally renowned team of experts provides a comprehensive, cutting-edge exposition of the current vital role of imaging in the diagnosis and treatment of injuries to the axial skeleton. Beginning with a valuable clinical perspective of spinal trauma, the book offers the reader a unique overview of the biomechanics underlying the pathology of cervical trauma. Acute trauma topics include: - Optimization of imaging modalities - Malalignment - signs and significance - Vertebral fractures - detection and implications - Classification of thoraco-lumbar fractures - rationale and relevance - Neurovascular injury. Distilling decades of clinical and teaching expertise, the contributors further discuss the current role of imaging in special focus topics, which include: - The pediatric spine - Sports injuries - The rigid spine - Trauma in the elderly - Vertebral collapse, benign and malignant - Spinal trauma therapy - Vertebral fractures and osteoporosis - Neuropathic spine. All throughout the book, the focus is on understanding the injury, and its implications and complications, through 'an imaging approach'. Lavishly illustrated with hundreds of superb MR images and CT scans, and clear full-color drawings, the authors conclude with a look into the future, defining clinical trends and research directions. Spinal Trauma - with its broad scope, practical imaging approach, and current focus - is designed to enhance confidence and accuracy, making it essential reading for clinicians and radiologists at all levels. (orig.)

  1. Design approaches to experimental mediation. (United States)

    Pirlott, Angela G; MacKinnon, David P


    Identifying causal mechanisms has become a cornerstone of experimental social psychology, and editors in top social psychology journals champion the use of mediation methods, particularly innovative ones when possible (e.g. Halberstadt, 2010, Smith, 2012). Commonly, studies in experimental social psychology randomly assign participants to levels of the independent variable and measure the mediating and dependent variables, and the mediator is assumed to causally affect the dependent variable. However, participants are not randomly assigned to levels of the mediating variable(s), i.e., the relationship between the mediating and dependent variables is correlational. Although researchers likely know that correlational studies pose a risk of confounding, this problem seems forgotten when thinking about experimental designs randomly assigning participants to levels of the independent variable and measuring the mediator (i.e., "measurement-of-mediation" designs). Experimentally manipulating the mediator provides an approach to solving these problems, yet these methods contain their own set of challenges (e.g., Bullock, Green, & Ha, 2010). We describe types of experimental manipulations targeting the mediator (manipulations demonstrating a causal effect of the mediator on the dependent variable and manipulations targeting the strength of the causal effect of the mediator) and types of experimental designs (double randomization, concurrent double randomization, and parallel), provide published examples of the designs, and discuss the strengths and challenges of each design. Therefore, the goals of this paper include providing a practical guide to manipulation-of-mediator designs in light of their challenges and encouraging researchers to use more rigorous approaches to mediation because manipulation-of-mediator designs strengthen the ability to infer causality of the mediating variable on the dependent variable.

  2. EFQM approach and the Dutch Quality Award

    NARCIS (Netherlands)

    Nabitz, U. W.; Klazinga, N. S.


    Different approaches to improve quality are used in organizations delivering health care. Donabedian introduced structure, process and outcome, from which other approaches like self-assessment, accreditation, visitation, International Standards Organisation (ISO) and European Foundation for Quality

  3. Writing approaches of student teachers of English

    National Research Council Canada - National Science Library

    Karabınar, Selma


    .... "The approaches to writing framework" (Biggs, 1988; Lavelle, 1993) presents a different perspective based on the notion that strategies used by the writers are determined by deep or surface level approaches...

  4. Scientific Overview /Regional Analyses and Approaches (United States)

    A workshop, Tools for Assessing Stream Dissolved Minerals, will introduce approaches and EPA tools for regional and site specific development of water quality criteria based on observations from Arkansas streams. In this presentation regional approaches and tools are described. ...

  5. Multidisciplinary approach for evaluation of neurocutaneous ...

    African Journals Online (AJOL)

    Multidisciplinary approach for evaluation of neurocutaneous disorders in children in Sohag University Hospital, Upper Egypt. ... rhabdomyoma. Conclusion: Neurocutaneous disorders had multiple clinical presentations and required a team work approach including various specialties in their evaluation and management.

  6. A Stochastic Approach to Stereo Vision

    National Research Council Canada - National Science Library

    Barnard, Stephen T


    A stochastic optimization approach to stereo matching is presented. Unlike conventional correlation matching and feature matching, the approach provides a dense array of disparities, eliminating the need for interpolation...

  7. A systems approach to traditional oriental medicine

    DEFF Research Database (Denmark)

    Kim, Hyun Uk; Ryu, Jae Yong; Lee, Jong Ok


    Analyzing structural similarities between compounds derived from traditional oriental medicine and human metabolites is a systems-based approach that can help identify mechanisms of action and suggest approaches to reduce toxicity.......Analyzing structural similarities between compounds derived from traditional oriental medicine and human metabolites is a systems-based approach that can help identify mechanisms of action and suggest approaches to reduce toxicity....

  8. Systems approach to reduce errors in surgery

    NARCIS (Netherlands)

    Dankelman, J.; Grimbergen, C. A.


    Reducing the number of medical errors significantly is the challenge for the coming decade. In medicine and in surgery, in particular, errors are traditionally treated as being committed by individuals. To reduce human errors, two approaches can be used: the person approach and the systems approach.

  9. Nonlinear approaches in engineering applications 2

    CERN Document Server

    Jazar, Reza N


    Provides updated principles and applications of the nonlinear approaches in solving engineering and physics problems Demonstrates how nonlinear approaches may open avenues to better, safer, cheaper systems with less energy consumption Has a strong emphasis on the application, physical meaning, and methodologies of nonlinear approaches in different engineering and science problems

  10. Risk communication: a mental models approach

    National Research Council Canada - National Science Library

    Morgan, M. Granger (Millett Granger)


    ... information about risks. The procedure uses approaches from risk and decision analysis to identify the most relevant information; it also uses approaches from psychology and communication theory to ensure that its message is understood. This book is written in nontechnical terms, designed to make the approach feasible for anyone willing to try it. It is illustrat...

  11. Anterior approach v. posterior approach - ultrasound-guided shoulder arthrogram injection

    Directory of Open Access Journals (Sweden)

    Merle Neethling-du Toit


    Full Text Available Anterior approach ultrasound guided arthrogram injections are a quick reliable way of injecting contrast prior to MRI scan. We did a retrospective study on patients, previously injected and scanned at our clinic, to compare the more manifested posterior approach with the anterior approach. The success rate for successful intra-articular injections for the anterior approach far outweighs the posterior approach. Also the anterior approach is more tolerable for patients as the injections are much quicker and seemingly less painful. In our knowledge it is thus far better to perform anterior approach shoulder arthrogram injections than posterior approach injections

  12. Two approaches to physics tutoring (United States)

    Solomaniuck, Tania

    One in two first-year students at science or biomedical faculties fail in basic subjects such as mathematics, chemistry or physics. Course-specific tutoring is one of the available means for improving their performance. In the present research, two tutoring models are developed. Both incorporate independent learning, but from different perspectives and priorities. A pragmatic tutoring approach. The first part of the thesis describes the search process for an optimal course-specific tutoring strategy for a standard first-year physics course in life sciences curricula. After a number of empirical research rounds, a pragmatic compromise emerged as the most suitable form of tutoring. The approach is characterised by: (1) priority to questions from students; (2) a high degree of interactivity with the tutor and among students; (3) due consideration to the number of questions to be dealt with and the depth in which they should be discussed. Most students participating in the tutoring sessions expressed their satisfaction and performed sufficiently well in their exams. However, there was still a problem: the students' insight into the course material was restricted to first-order processing of the syllabus. While this would be satisfactory in non-scientific study programmes, it is deemed insufficient in programmes where deeper insight is required in order that students be able to deal adequately with new conceptual questions or problems. In-depth tutoring. In science programmes, the core objective is for students to acquire in-depth knowledge. Therefore, science educators are designing and studying teaching methods that are geared not only to the acquisition of in-depth knowledge as such, but also to the motivation of students to take a more in-depth approach to learning. Some of the crucial notions in their research are: the extent to which the course content ties in with students' prior knowledge, problem-setting strategies and concept-context linking. 'In

  13. Molecular approaches in experimental neuroimaging

    Energy Technology Data Exchange (ETDEWEB)

    Tavitian, B. [CEA Saclay, 91 - Gif sur Yvette (France)


    We quantified and compared six parameters (resolution, depth, sensitivity, portability, quantification and cost) of four molecular imaging techniques (MRI, optics, ultrasound and TEP), with the three types of electromagnetic radiation used in vivo (Frequencies (10{sup 6} to 10{sup 22} Hz), Photonic Energy (10{sup -4} to 10{sup 9} eV) and Wavelengths (10{sup -2} to 10{sup -15} m)). This form of molecular imaging demands the most sensitive technique available (Pl. 26-2 to 26-4). Four examples of experimental in vivo approaches on small animals are shown: molecular passage through the blood-brain barrier (endothelial cells, astrocytes and occludin, pharmacokinetics, studied with PET) (Pl. 2-5 to 2-11); imaging of receptors and ligands, especially peripheral benzodiazepine receptors (PBR) by PET and MRI in the rat (Pl. 2-12 to Pl. 2-15); neuro-pathology of neuro-degenerative and inflammatory diseases and stroke by PET and MRI in the rat (Pl. 2-16 to 2-17); and the study of responses to stimulation explored with in vivo imaging of calcium signals and their variations by photonic analysis, as on the scale of mitochondrial calcium (Pl.2-18 to Pl.2-22). (author)

  14. Emerging approaches in predictive toxicology. (United States)

    Zhang, Luoping; McHale, Cliona M; Greene, Nigel; Snyder, Ronald D; Rich, Ivan N; Aardema, Marilyn J; Roy, Shambhu; Pfuhler, Stefan; Venkatactahalam, Sundaresan


    Predictive toxicology plays an important role in the assessment of toxicity of chemicals and the drug development process. While there are several well-established in vitro and in vivo assays that are suitable for predictive toxicology, recent advances in high-throughput analytical technologies and model systems are expected to have a major impact on the field of predictive toxicology. This commentary provides an overview of the state of the current science and a brief discussion on future perspectives for the field of predictive toxicology for human toxicity. Computational models for predictive toxicology, needs for further refinement and obstacles to expand computational models to include additional classes of chemical compounds are highlighted. Functional and comparative genomics approaches in predictive toxicology are discussed with an emphasis on successful utilization of recently developed model systems for high-throughput analysis. The advantages of three-dimensional model systems and stem cells and their use in predictive toxicology testing are also described. © 2014 Wiley Periodicals, Inc.

  15. Diagnostic approach to peripheral neuropathy

    Directory of Open Access Journals (Sweden)

    Misra Usha


    Full Text Available Peripheral neuropathy refers to disorders of the peripheral nervous system. They have numerous causes and diverse presentations; hence, a systematic and logical approach is needed for cost-effective diagnosis, especially of treatable neuropathies. A detailed history of symptoms, family and occupational history should be obtained. General and systemic examinations provide valuable clues. Neurological examinations investigating sensory, motor and autonomic signs help to define the topography and nature of neuropathy. Large fiber neuropathy manifests with the loss of joint position and vibration sense and sensory ataxia, whereas small fiber neuropathy manifests with the impairment of pain, temperature and autonomic functions. Electrodiagnostic (EDx tests include sensory, motor nerve conduction, F response, H reflex and needle electromyography (EMG. EDx helps in documenting the extent of sensory motor deficits, categorizing demyelinating (prolonged terminal latency, slowing of nerve conduction velocity, dispersion and conduction block and axonal (marginal slowing of nerve conduction and small compound muscle or sensory action potential and dennervation on EMG. Uniform demyelinating features are suggestive of hereditary demyelination, whereas difference between nerves and segments of the same nerve favor acquired demyelination. Finally, neuropathy is classified into mononeuropathy commonly due to entrapment or trauma; mononeuropathy multiplex commonly due to leprosy and vasculitis; and polyneuropathy due to systemic, metabolic or toxic etiology. Laboratory investigations are carried out as indicated and specialized tests such as biochemical, immunological, genetic studies, cerebrospinal fluid (CSF examination and nerve biopsy are carried out in selected patients. Approximately 20% patients with neuropathy remain undiagnosed but the prognosis is not bad in them.

  16. A practical approach to fibromyalgia. (United States)

    Brecher, L S; Cymet, T C


    The term fibromyalgia refers to a collection of symptoms with no clear physiologic cause, but the symptoms together constitute a clearly recognizable and distinct pathologic entity. The diagnosis is made through the examiner's clinical observations. The differential diagnosis must include other somatic syndromes as well as disease entities, including hepatitis, hypothyroidism, diabetes mellitus, electrolyte imbalance, multiple sclerosis, and cancer. Diagnostic criteria serve as guidelines for diagnosis, not as absolute requirements. Treatment of fibromyalgia, which is an ongoing process, remains individualized, relying on a good physician-patient relationship. It is goal-oriented, directed at helping patients get restorative sleep, alleviating the somatic pains, keeping patients productive, and regulating schedules. It can be achieved through a goal-oriented agreement between patient and provider. Because fibromyalgia is chronic and may affect all areas of an individual's functioning, the physician needs to also evaluate the social support systems of patients with fibromyalgia. The approach to treatment should integrate patient education as well as non-pharmacologic and pharmacologic modalities. To keep patients well educated and involved in their healthcare, physicians should provide patients with adequate sources for reliable information.

  17. Comprehensive approach to diabetic nephropathy

    Directory of Open Access Journals (Sweden)

    Bancha Satirapoj


    Full Text Available Diabetic nephropathy (DN is a leading cause of mortality and morbidity in patients with diabetes. This complication reflects a complex pathophysiology, whereby various genetic and environmental factors determine susceptibility and progression to end-stage renal disease. DN should be considered in patients with type 1 diabetes for at least 10 years who have microalbuminuria and diabetic retinopathy, as well as in patients with type 1 or type 2 diabetes with macroalbuminuria in whom other causes for proteinuria are absent. DN may also present as a falling estimated glomerular filtration rate with albuminuria as a minor presenting feature, especially in patients taking renin–angiotensin–aldosterone system inhibitors (RAASi. The pathological characteristic features of disease are three major lesions: diffuse mesangial expansion, diffuse thickened glomerular basement membrane, and hyalinosis of arterioles. Functionally, however, the pathophysiology is reflected in dysfunction of the mesangium, the glomerular capillary wall, the tubulointerstitium, and the vasculature. For all diabetic patients, a comprehensive approach to management including glycemic and hypertensive control with RAASi combined with lipid control, dietary salt restriction, lowering of protein intake, increased physical activity, weight reduction, and smoking cessation can reduce the rate of progression of nephropathy and minimize the risk for cardiovascular events. This review focuses on the latest published data dealing with the mechanisms, diagnosis, and current treatment of DN.

  18. Ancient Climatic Architectural Design Approach

    Directory of Open Access Journals (Sweden)

    Nasibeh Faghih


    Full Text Available Ancient climatic architecture had found out a series of appropriate responses for the best compatibility with the critical climate condition for instance, designing ‘earth sheltered houses’ and ‘courtyard houses’. They could provide human climatic comfort without excessive usage of fossil fuel resources. Owing to the normal thermal conditions in the ground depth, earth sheltered houses can be slightly affected by thermal fluctuations due to being within the earth. In depth further than 6.1 meters, temperature alternation is minute during the year, equaling to average annual temperature of outside. More to the point, courtyard buildings as another traditional design approach, have prepared controlled climatic space based on creating the maximum shade in the summer and maximum solar heat absorption in the winter. The courtyard houses served the multiple functions of lighting to the rooms, acting as a heat absorber in the summer and a radiator in the winter, as well as providing an open space inside for community activities. It must be noted that they divided into summer and winter zones located in south and north of the central courtyard where residents were replaced into them according to changing the seasons. Therefore, Ancient climatic buildings provided better human thermal comfort in comparison with the use contemporary buildings of recent years, except with the air conditioning

  19. Newer approaches to malaria control. (United States)

    Damodaran, Se; Pradhan, Prita; Pradhan, Suresh Chandra


    Malaria is the third leading cause of death due to infectious diseases affecting around 243 million people, causing 863,000 deaths each year, and is a major public health problem. Most of the malarial deaths occur in children below 5 years and is a major contributor of under-five mortality. As a result of environmental and climatic changes, there is a change in vector population and distribution, leading to resurgence of malaria at numerous foci. Resistance to antimalarials is a major challenge to malaria control and there are new drug developments, new approaches to treatment strategies, combination therapy to overcome resistance and progress in vaccine development. Now, artemisinin-based combination therapy is the first-line therapy as the malarial parasite has developed resistance to other antimalarials. Reports of artemisinin resistance are appearing and identification of new drug targets gains utmost importance. As there is a shift from malaria control to malaria eradication, more research is focused on malaria vaccine development. A malaria vaccine, RTS,S, is in phase III of development and may become the first successful one. Due to resistance to insecticides and lack of environmental sanitation, the conventional methods of vector control are turning out to be futile. To overcome this, novel strategies like sterile insect technique and transgenic mosquitoes are pursued for effective vector control. As a result of the global organizations stepping up their efforts with continued research, eradication of malaria can turn out to be a reality.

  20. Buried penis: classification surgical approach. (United States)

    Hadidi, Ahmed T


    The purpose of this study was to describe morphological classification of congenital buried penis (BP) and present a versatile surgical approach for correction. Sixty-one patients referred with BP were classified into 3 grades according to morphological findings: Grade 1-29 patients with Longer Inner Prepuce (LIP) only, Grade II-20 patients who presented with LIP associated with indrawn penis that required division of the fundiform and suspensory ligaments, and Grade III-12 patients who had in addition to the above, excess supra-pubic fat. A ventral midline penile incision extending from the tip of prepuce down to the penoscrotal junction was used in all patients. The operation was tailored according to the BP Grade. All patients underwent circumcision. Mean follow up was 3 years (range 1 to 10). All 61 patients had an abnormally long inner prepuce (LIP). Forty-seven patients had a short penile shaft. Early improvement was noted in all cases. Satisfactory results were achieved in all 29 patients in grade I and in 27 patients in grades II and III. Five children (Grades II and III) required further surgery (9%). Congenital buried penis is a spectrum characterized by LIP and may include in addition; short penile shaft, abnormal attachment of fundiform, and suspensory ligaments and excess supra-pubic fat. Congenital Mega Prepuce (CMP) is a variant of Grade I BP, with LIP characterized by intermittent ballooning of the genital area. Copyright © 2014 Elsevier Inc. All rights reserved.


    Directory of Open Access Journals (Sweden)

    Šemsudin Plojović


    Full Text Available Information technology is very important part in training process. Training process is always in innovation and assembling faze, especially at those that want to compete on international level. In that surrounding training process, as the trainers also, must be transformed. Great deal of information must be reliable for headquarter for optimal training process. Informational approach on training process, subject of this research, represent informational technologies and information systems with all aspects an possibilities of applications in sport. Information technology, information system and its application in sport in last decade is developed very fast in last decade. Computer is used, not only for data process, but also for making decisions. That is the key moment changing the basics of information system, especially the role of information system in training process. To define key words connected for information systems in sport we will start from characteristics of information, exchanging in this relations: man to man, machine to machine, man to machine, and opposite, machine to man. According to this we need to make the difference between data and information. In this research we talk about concrete application of information technology and information system as the backup of training process. Behind practical application of IT in sport, that is the main issue of this work, stands the marvelous results of athletes from AK Novi Pazar. Azra Eminovic, Edin Zukovic, Muamer Hasanovic, Emir Koca and Senadin Plojovic, they’ve achieved great results with information back up of training process.

  2. Common approach to common interests

    Energy Technology Data Exchange (ETDEWEB)



    In referring to issues confronting the energy field in this region and options to be exercised in the future, I would like to mention the fundamental condition of the utmost importance. That can be summed up as follows: any subject in energy area can never be solved by one country alone, given the geographical and geopolitical characteristics intrinsically possessed by energy. So, a regional approach is needed and it is especially necessary for the main players in the region to jointly address problems common to them. Though it may be a matter to be pursued in the distant future, I am personally dreaming a 'Common Energy Market for Northeast Asia,' in which member countries' interests are adjusted so that the market can be integrated and the region can become a most economically efficient market, thus formulating an effective power to encounter the outside. It should be noted that Europe needed forty years to integrate its market as the unified common market. It is necessary for us to follow a number of steps over the period to eventually materialize our common market concept, too. Now is the time for us to take a first step to lay the foundation for our descendants to enjoy prosperity from such a common market.

  3. [Clinical approach to imported eosinophilia]. (United States)

    Cañas García-Otero, Elías; Praena-Segovia, Julia; Ruiz-Pérez de Pipaón, Maite; Bosh-Guerra, Xerach; Sánchez-Agüera, Magdalena; Álvarez-Martínez, Daniel; Cisneros-Herreros, José Miguel


    Eosinophilia is a common finding in international travelers and immigrants, being an helmintic infection its main etiology. The positive predictive value of eosinophilia for an helmintosis is low in travellers. Eosinophilia may be an incidental finding, or symptomatic, and it represents a clinical challenge due to the low sensitivity and specificity of direct and indirect parasitological diagnostic tests, respectively. It requires a structured approach based on geographical areas, environmental exposures and behavioral risks, and associated symptoms. The initial assessment should include a comprehensive and tailored anamnesis and physical examination, basic laboratory tests, a complete parasitological examination of stool samples and a Strongyloides stercoralis serology, supplemented with other explorations guided by epidemiological and clinical suspicion. Empiric treatment with albendazole and/or ivermectin (plus praziquantel if risk of schistosomiasis) is an option for unidentified persistent eosinophilia after study, and in persons in whom a proper assessment or follow-up can not be assured. In patients at risk for estrongiloidosis who are candidates for immunosuppressive therapies, it is indicated a prior screening and treatment to prevent a future hyperinfestation syndrome. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  4. Current Approach to Child Rights

    Directory of Open Access Journals (Sweden)

    Huseyin Dag


    Full Text Available Rights of children, legally or morally all over the world that children are born with; education, health, life, shelter; physical, psychological or sexual exploitation protection of such rights is universal concept used to describethemall. Rights of children is an issue that should be addressed in the concept of human rights. Today, there are many parts of the world that human rights violations, child-size and grew broader, more difficult to intervene in a way that is situated. The idea that children than in adults of different physical, physiological, behavioral and psychological characteristics that continuous growth and improve dawareness that the establishment of thecare of children a society where the problem is and scientific approach everyone with this responsibility should be installed is shaped in Geneva Declaration of Childrens Rights. Today, the international document related to childrens rights is the United Nations Convention on the Rights of the Child adoptedand approved by 193 countries. Child policy in Turkey where 25 million children live is an issue that should be seriously considered. Thus, childrens rights, children working in coordination with the contract on the basis of a policy should be implemented fully. [Cukurova Med J 2015; 40(1.000: 1-5

  5. Biomimetic approach to dental implants. (United States)

    Kim, Tae-Il; Jang, Jun-Hyeog; Kim, Hae-Won; Knowles, Jonathan C; Ku, Young


    Titanium, as an implant material, is regarded to be durable and biocompatible, which allows functional replacement of missing teeth. Successful dental implantation depends on an osseointegration phenomenon, a direct structural and functional binding reaction between bone and implant. It is well known that physicochemical characteristics of the dental implant surface, such as roughness, topography, chemistry, and electrical charge affect the biological reactions occurring at the interface of tissue and implant. Therefore, considerable efforts have been made to modify the surface of titanium implants which are based on mechanical, physical and chemical treatments. Recently, biological molecules were introduced onto the surface of implants to stimulate osteogenic cells in the early stage of implantation and consequently accelerate bone formation around implant and subsequent rapid implant stabilization. A range of extracellular matrix components, designed peptides, and growth factors have been proposed as the biological moiety. In this review, we address several issues related to the biology of dental implants and discuss biomimetic modification of the implant surface as a novel approach to obtain successful osseointegration.

  6. Nonstationary Approaches to Hydrologic Design (United States)

    Vogel, Richard; Hecht, Jory; Read, Laura


    We introduce a generalized framework for evaluating the risk, reliability and return period of hydrologic events in a nonstationary world. A heteroscedastic regression model is introduced as an elegant and general framework for modeling trends in the mean and/or variance of hydrologic records using ordinary least squares regression methods. A regression approach to modeling trends has numerous advantages over other methods including: (1) ease of application, (2) considers linear or nonlinear trends, (3) graphical display of trends, (4) analytical estimate of the power of the trend test and prediction intervals associated with trend extrapolation. Traditional statements of risk, reliability and return periods which assume that the annual probability of a flood event remains constant throughout the project horizon are revised to include the impacts of trends in the mean and/or variance of hydrologic records. Our analyses reveal that in a nonstationary world, meaningful expressions of the likelihood of future hydrologic events are unlikely to result from knowledge of return periods whereas knowledge of system reliability over future planning horizons can effectively communicate the likelihood of future hydrologic events of interest.

  7. The wonder approach to learning

    Directory of Open Access Journals (Sweden)

    Catherine eL'Ecuyer


    Full Text Available Wonder, innate in the child, is an inner desire to learn that awaits reality in order to be awakened. Wonder is at the origin of reality-based consciousness, thus of learning. The scope of wonder, which occurs at a metaphysical level, is greater than that of curiosity. Unfortunate misinterpretations of neuroscience have led to false brain-based ideas in the field of education, all of these based on the scientifically wrong assumption that children’s learning depends on an enriched environment. These beliefs have re-enforced the Behaviorist Approach to education and to parenting and have contributed to deadening our children’s sense of wonder. We suggest wonder as the center of all motivation and action in the child. Wonder is what makes life genuinely personal. Beauty is what triggers wonder. Wonder attunes to beauty through sensitivity and is unfolded by attachment. When wonder, beauty, sensitivity and secure attachment are present, learning is meaningful.On the contrary, when there is no volitional dimension involved (no wonder, no end or meaning (no beauty and no trusting predisposition (secure attachment, the rigid and limiting mechanical process of so-called learning through mere repetition become a deadening and alienating routine. This could be described as training, not as learning, because it does not contemplate the human being as a whole.

  8. New approaches to nuclear power

    KAUST Repository

    Dewan, Leslie


    The world needs a cheap, carbon-free alternative to fossil fuels to feed its growing electricity demand. Nuclear power can be a good solution to the problem, but is hindered by issues of safety, waste, proliferation, and cost. But what if we could try a new approach to nuclear power, one that solves these problems? In this lecture, the CEO of Transatomic Power will talk about how their company is advancing the design of a compact molten salt reactor to support the future of carbon-free energy production. Can the designs of new reactor push the boundaries of nuclear technology to allow for a safe, clean, and affordable answer to humanityメs energy needs? Nuclear power involves capturing the energy produced in nuclear fission reactions, which emerges as heat. This heat is most frequently used to boil water into steam, which then drives a turbine to produce electricity in a nuclear power plant. Worldwide, there is a renaissance of new nuclear technology development -- a new generation of young engineers are racing to develop more advanced nuclear reactors for a better form of power generation. Transatomic Power, specifically, is advancing the design of an easily contained and controlled, atmospheric pressure, high power density molten salt reactor that can be built at low cost. The road to commercialization is long, and poses many challenges, but the benefits are enormous. These new reactors push the boundaries of technology to allow for better, safer ways to power the world.

  9. Understanding Progress: A Heterodox Approach

    Directory of Open Access Journals (Sweden)

    Blanca Lemus


    Full Text Available This paper examines the possibility of understanding and measuring well-being as a result of “progress” on the basis of today’s dominant epistemological framework. Market criteria distort social values by allowing purchasing power to define priorities, likening luxury goods to basic needs; in the process they reinforce patterns of discrimination against disadvantaged social groups and women, introducing fatal distortions into the analysis. Similarly, because there are no appropriate mechanisms to price natural resources adequately, the market overlooks the consequences of the abuse of natural resources, degrading the quality of life, individually and collectively, or—in the framework of Latin American indigenous groups—foreclosing the possibility of “living well”. We critique the common vision of the official development discourse that places its faith on technological innovations to resolve these problems. The analysis points to the need for new models of social and environmental governance to promote progress, approaches like those suggested in the paper that are inconsistent with public policies currently in place. At present, the social groups forging institutions to assure their own well-being and ecological balance are involved in local processes, often in opposition to the proposals of the political leaders in their countries.

  10. Approaches towards endogenous pancreatic regeneration. (United States)

    Banerjee, Meenal; Kanitkar, Meghana; Bhonde, Ramesh R


    The phenomenon of pancreatic regeneration in mammals has been well documented. It has been shown that pancreatic tissue is able to regenerate in several species of mammal after surgical insult. This tissue is also known to have the potential to maintain or increase its beta-cell mass in response to metabolic demands during pregnancy and obesity. Since deficiency in beta-cell mass is the hallmark of most forms of diabetes, it is worthwhile understanding pancreatic regeneration in the context of this disease. With this view in mind, this article aims to discuss the potential use in clinical strategies of knowledge that we obtained from studies carried out in animal models of diabetes. Approaches to achieve this goal involve the use of biomolecules, adult stem cells and gene therapy. Various molecules, such as glucagon-like peptide-1, beta-cellulin, nicotinamide, gastrin, epidermal growth factor-1 and thyroid hormone, play major roles in the initiation of endogenous islet regeneration in diabetes. The most accepted hypothesis is that these molecules stimulate islet precursor cells to undergo neogenesis or to induce replication of existing beta-cells, emphasizing the importance of pancreas-resident stem/progenitor cells in islet regeneration. Moreover, the potential of adult stem cell population from bone marrow, umbilical cord blood, liver, spleen, or amniotic membrane, is also discussed with regard to their potential to induce pancreatic regeneration.

  11. Immunological approaches to fertility regulation. (United States)

    Stevens, V C


    Strong evidence that specific immunogenic components of the reproductive system exist that are not represented in other body systems has led to efforts to develop an acceptable vaccine for fertility regulation. The aim is to create a vaccine administered infrequently by trained technicians outside the clinical environment. For safety and practical reasons, an approach using active immunization with a vaccine is preferred to passive immunization with antibodies. In current research with sperm antigens, a lactate dehydrogenase isoenzyme (LDH-X), an enzyme normally present on the sperm surface, reduced fertility in mice and rabbits. However, significant embryo mortality occurred. Other sperm antigens have been tested and rejected. Most of the research on ovum antigens is directed toward the zona pellucida, and work is in progress to isolate experimental quantities of specific zona pellucida antigens. Antibodies to human zona are reported to react with pig zona and vice versa, providing a model system. Antibodies to whole-placenta homogenates reportedly disrupt pregnancy in several laboratory animal species, and 2 placenta-specific proteins are potential antigens since antibodies to them do not react with any other tissue so far tested. Of 3 protein hormones isolated from placental tissue, 2 are potential antigens. The possible hazards of antifertility vaccines can be divided into 2 categories: problems related to immunization and problems caused by antibodies produced.

  12. Approaches to teaching primary level mathematics

    Directory of Open Access Journals (Sweden)

    Caroline Long


    Full Text Available In this article we explore approaches to curriculum in the primary school in order to map and manage the omissions implicit in the current unfolding of the Curriculum and Assessment Policy Statement for mathematics. The focus of school-based research has been on curriculum coverage and cognitive depth. To address the challenges of teaching mathematics from the perspective of the learner, we ask whether the learners engage with the subject in such a way that they build foundations for more advanced mathematics. We firstly discuss three approaches that inform the teaching of mathematics in the primary school and which may be taken singly or in conjunction into organising the curriculum: the topics approach, the process approach, and the conceptual fields approach. Each of the approaches is described and evaluated by presenting both their advantages and disadvantages. We then expand on the conceptual fields approach by means of an illustrative example. The planning of an instructional design integrates both a topics and a process approach into a conceptual fields approach. To address conceptual depth within this approach, we draw on five dimensions required for understanding a mathematical concept. In conclusion, we reflect on an approach to curriculum development that draws on the integrated theory of conceptual fields to support teachers and learners in the quest for improved teaching and learning.

  13. Operationalizing the integrated landscape approach in practice

    Directory of Open Access Journals (Sweden)

    Olivia E. Freeman


    the process of taking a landscape approach. Drawing on a review of the literature, we identify and discuss three different kinds of landscape approaches: using the landscape scale, a sectoral landscape approach, and an integrated landscape approach. Focusing on an integrated landscape approach, we examine five concepts to help characterize landscape approaches: multifunctionality, transdisciplinarity, participation, complexity, and sustainability. For each term, a continuum of application exists. To help improve and move the integrated landscape approach more toward operationalization, more focus needs to be placed on the process of taking the approach. Although the process can be implemented in a range of ways, in a more integrated approach it will require explicitly defined objectives as well as a clear understanding of what is meant by multifunctionality and sustainability. It will also require collaborative participation, transdisciplinarity/cross-sectoral approaches, managing for adaptive capacity, and applying an iterative process to address the inherent complexity within the system. Although these concepts are not new, we present continuums on which they can exist, allowing for clarification and distinctions to be made regarding what it means to take a landscape approach.

  14. Logical and epistemological approach to critical thinking

    Directory of Open Access Journals (Sweden)

    Pešić Jelena


    Full Text Available Two main approaches in the conceptualization of critical thinking, logical and epistemological, are presented and analyzed in this paper. The review of logical approach begins with defining its general framework (relationship between critical thinking and informal logic and afterwards we analyze abilities and skills which are seen as basic constituents of critical thinking. In the review of epistemological approach we analyze four conceptions that present the main directions in criticizing logical approach, and also in developing the broader perspective on critical thinking that includes specific view of knowledge and its development, noncognitive dispositions and the role of subject based knowledge. At the end, we discuss the relationship between logical and epistemological approach. We claim and justify that they should be understood as complementary approaches, and we consider specific contribution of each approach to comprehensive definition of critical thinking. .

  15. Standard Approaches to the Acetabulum Part 1: Kocher-Langenbeck Approach. (United States)

    Gänsslen, A; Grechenig, S; Nerlich, M; Müller, M


    Historically, standard approaches for surgical treatment of displaced acetabular fractures were the KocherLangenbeck approach, the ilioinguinal approach and the extended iliofemoral approach (12). Presently, several modifications of these approaches are accepted alternatives, especially anterior modifications based on the intrapelvic approach described by Hirvensalo (8). Single access approaches allowing visualization of one acetabular column are the posterior Kocher-Langenbeck approach and the anterior ilioinguinal approach (12) and the use of a single approach is favoured (9, 24). For more complex situations, in the 80s and 90s extended approaches (extended iliofemoral approach according to Letournel (12), its modification to Reinert (19) (Baltimore approach), and the Triradiate approach according to Mears (14)) were introduced. These approaches are presently rarely choosen due to the extensive soft tissue dissection and higher complication rates (28). Alternatively, the combination of an anterior and posterior standard approach was recommended (7, 21, 22) having the disadvantage of longer operating time and blood loss and showed no superior results compared to a single approach. The meta-analysis by Giannoudis et al. stated that 48,7% of patients were treated using the Kocher-Langenbeck approach, followed by 21,9% ilioinguinal approaches and 12,4% extended approaches (6). More recent data from the years 2005-2007, showed that anterior approaches are now predominantly used according to a higher number of acetabular fractures with anterior column involvement. Overall, more than 40% of all patients with acetabular fractures are still approached via the Kocher-Langenbeck approach (18). Therefore, the Kocher-Langenbeck approach is still a "working horse" in approaching displaced acetabular fractures. The Kocher-Langenbeck approach consists of two parts. In 1874 von Langenbeck described a longitudinal incision starting from above the greater sciatic notch to the

  16. Approaches to adolescent pregnancy prevention. (United States)

    Haffner, D; Casey, S


    The US has one of the highest teenage pregnancy rates in the industrialized world, over 1,000,000 a year. This can add to social problems including poverty, unemployment, family breakup, juvenile crime, school dropouts, and child abuse. In several studies various approaches have been developed and it is concluded that teens must not only be given the knowledge to avoid teen pregnancies, but the motivation to do so. Sex education is an important part of pregnancy prevention, but few programs go beyond the facts of reproduction and less than 14% of them are 40 hours long. Studies have shown mixed results as to the effect of education on teen pregnancy. There are many programs that have been developed by different communities, including computer programs and youth service agencies. Religious groups also play an important part in sex education and they have some distinct advantages in affecting teens' sexual values and activities. Education programs for teen's parents appear to be very important since studies show when sexuality is discussed at home, the teens begin activity later and use birth control more. Clinics have had difficulty recruiting and retaining teen patients and devote special attention to establishing a rapport with them. The school-based clinic is becoming increasingly popular and can provide birth control counseling, contraceptives, family planning clinic referral, examinations, pregnancy testing, and prenatal care. There success is due to confidentiality, convenience, and comprehensive service. However, since nearly all efforts on teen pregnancy prevention are directed at girls, 1/2 of those involved in teen pregnancies--males--are not participating in programs. This must change for longterm success of these programs and also the involvement of the community and media.

  17. Systemic Approach to Architectural Performance

    Directory of Open Access Journals (Sweden)

    Marie Davidova


    Full Text Available First-hand experiences in several design projects that were based on media richness and collaboration are described in this article. Although complex design processes are merely considered as socio-technical systems, they are deeply involved with natural systems. My collaborative research in the field of performance-oriented design combines digital and physical conceptual sketches, simulations and prototyping. GIGA-mapping - is applied to organise the data. The design process uses the most suitable tools, for the subtasks at hand, and the use of media is mixed according to particular requirements. These tools include digital and physical GIGA-mapping, parametric computer aided design (CAD, digital simulation of analyses, as well as sampling and 1:1 prototyping. Also discussed in this article are the methodologies used in several design projects to strategize these tools and the developments and trends in the tools employed.  The paper argues that the digital tools tend to produce similar results through given pre-sets that often do not correspond to real needs. Thus, there is a significant need for mixed methods including prototyping in the creative design process. Media mixing and cooperation across disciplines is unavoidable in the holistic approach to contemporary design. This includes the consideration of diverse biotic and abiotic agents. I argue that physical and digital GIGA-mapping is a crucial tool to use in coping with this complexity. Furthermore, I propose the integration of physical and digital outputs in one GIGA-map and the participation and co-design of biotic and abiotic agents into one rich design research space, which is resulting in an ever-evolving research-design process-result time-based design.

  18. Schwinger's Approach to Einstein's Gravity (United States)

    Milton, Kim


    Albert Einstein was one of Julian Schwinger's heroes, and Schwinger was greatly honored when he received the first Einstein Prize (together with Kurt Godel) for his work on quantum electrodynamics. Schwinger contributed greatly to the development of a quantum version of gravitational theory, and his work led directly to the important work of (his students) Arnowitt, Deser, and DeWitt on the subject. Later in the 1960's and 1970's Schwinger developed a new formulation of quantum field theory, which he dubbed Source Theory, in an attempt to get closer contact to phenomena. In this formulation, he revisited gravity, and in books and papers showed how Einstein's theory of General Relativity emerged naturally from one physical assumption: that the carrier of the gravitational force is a massless, helicity-2 particle, the graviton. (There has been a minor dispute whether gravitational theory can be considered as the massless limit of a massive spin-2 theory; Schwinger believed that was the case, while Van Dam and Veltman concluded the opposite.) In the process, he showed how all of the tests of General Relativity could be explained simply, without using the full machinery of the theory and without the extraneous concept of curved space, including such effects as geodetic precession and the Lense-Thirring effect. (These effects have now been verified by the Gravity Probe B experiment.) This did not mean that he did not accept Einstein's equations, and in his book and full article on the subject, he showed how those emerge essentially uniquely from the assumption of the graviton. So to speak of Schwinger versus Einstein is misleading, although it is true that Schwinger saw no necessity to talk of curved spacetime. In this talk I will lay out Schwinger's approach, and the connection to Einstein's theory.

  19. An intelligent approach to nanotechnology (United States)

    Demming, Anna


    Control counts for little without a guiding principle. Whether manipulating atoms with a scanning probe or controlling carrier concentration in thin film deposition, intelligent intervention is required to steer the process from aimless precision towards a finely optimized design. In this issue G M Sacha and P Varona describe how artificial intelligence approaches can help towards modelling and simulating nanosystems, increasing our grasp of the nuances of these systems and how to optimize them for specific applications [1]. More than a labour-saving technique their review also suggests how genetic algorithms and artificial neural networks can supersede existing capabilities to tackle some of the challenges in moving a range of nanotechnologies forward. Research has made giant strides in determining not just what system parameters enhance performance but how. Nanoparticle synthesis is a typical example, where the field has shifted from simple synthesis and observation to unearthing insights as to dominating factors that can be identified and enlisted to control the morphological and chemical properties of synthesized products. One example is the neat study on reaction media viscosity for silver nanocrystal synthesis, where Park, Im and Park in Korea demonstrated a level of size control that had previously proved hard to achieve [2]. Silver nanoparticles have many potential applications including catalysis [3], sensing [4] and surface enhanced Raman scattering [5]. In their study, Park and colleagues obtain size-controlled 30 nm silver nanocrystals in a viscosity controlled medium of 1,5-pentanediol and demonstrate their use as sacrificial cores for the fabrication of a low-refractive filler. Another nanomaterial that has barely seen an ebb in research activity over the past two decades is ZnO, with a legion of reports detailing how to produce ZnO in different nanoscale forms from rods [6], belts [7] and flowers [8] to highly ordered arrays of vertically aligned

  20. [Official approach to sexual abuse]. (United States)

    Oberloskamp, H


    , psychotherapeutic treatment instead of, or combined with penal sentence sanctions) and correct inadequate acts (competence of Family Court and Guardianship Court, counterproductive data protection). In conclusion, it must be said that many details concerning the official approach to sexual abuse could be improved. However, the main problem lies in the fact that the State does not really attempt to create a systematic solution to sexual abuse. The ad hoc reaction in Germany has led to an uncoordinated set of rules and practices without a common sense of purpose.

  1. A Tandem Learning Approach to Task Evaluation


    Stewart, Timothy; スチュワート, ティモシー


    This paper describes an approach to task evaluation that emerged out of the process of course development. The multi-layered approach to task evaluation described synthesizes student and teacher evaluations of tasks written in journals with more traditional course evaluation data in a reflective process of course development. Ultimately, the approach opens up dynamic insights into the appropriateness of tasks by incorporating the views of both students and teachers.The paper concludes by illu...


    Directory of Open Access Journals (Sweden)

    Vladimir V. Kureychik


    Full Text Available The article discusses several approaches to training, namely the virtual. Concrete examples of virtual learning systems were described, we disclosed their features, advantages and disadvantages. A new suggested approach integrates the features of existing systems, and opens new horizons and opportunities to obtain certain skills and abilities. Introduction of a new approach to the educational process will improve the quality and effectiveness of learning. 

  3. Solution Focused Approach and Usage of Nursing




    "Problem talk creates problems; solution talk creates solutions " Steve de Shazer In recent years, concern for solution-oriented approach has increased in nursing practice. In this review it is aimed to give information about nursing application of solution-oriented approach whose efficacy has been proved with many studies. In addition, solution-oriented approach is what how it turned out, the answer to the question of principle, and that is what the management strategy and what the n...

  4. An approximate analytical approach to resampling averages

    DEFF Research Database (Denmark)

    Malzahn, Dorthe; Opper, M.


    Using a novel reformulation, we develop a framework to compute approximate resampling data averages analytically. The method avoids multiple retraining of statistical models on the samples. Our approach uses a combination of the replica "trick" of statistical physics and the TAP approach...... for approximate Bayesian inference. We demonstrate our approach on regression with Gaussian processes. A comparison with averages obtained by Monte-Carlo sampling shows that our method achieves good accuracy....

  5. [Therapeutic approaches in court-ordered therapy]. (United States)

    Floris, Emmanuelle; De Jésus, Arnaud; Cano, Jean-Philippe; Raymondaud, Séverine; Rouveyrol, Éric; Bouchard, Jean-Pierre

    As is the case with other contexts of mental health treatments, the therapeutic approaches to court-ordered therapy are varied. They are based on the principle of their clinical indication and must be delivered by therapists trained in the specific area. The classic therapeutic approaches are used: medication, psychoanalysis and psychoanalytically inspired therapies, cognitive behavioural therapies, group therapies and body-oriented approach. Copyright © 2017. Published by Elsevier Masson SAS.



    Prima Angkupi


    Limitations of law in cyberporn law enforcement demands the need for non-penal approach as pre-ventive effort to eliminate causes of Cyberporn crimes. This approach includes crime prevention which aims to prevent a crime from being recurred. This approach can be implemented through situ-ational control by active involvement of cultural roles in community. However, it cannot be separat-ed from observing human life variations including childhood, youth, family, school, gender, peer group which ...

  7. Art approaches and techniques in surrealism


    Novak, Anita


    In my thesis I have chosen theme of surrealism. The emphasis is on representation of surrealistic visual techniques and developement. At researching of those visual techniques, I represented main artists who were their inventors. In my thesis, I also explained historical overview of surrealistic movement, it's art techniques and approaches. One of the first most important art approaches was automatism and with that approach flourished set of new visual methods, techniques and mind games,...

  8. Mental Effort and Safety in Curved Approaches


    Entzinger, Jorg Onno; Uemura, Tsuneharu; Suzuki, Shinji


    Curved approach procedures are implemented around the world. Although typically flown by the autopilot, human pilots need the situational awareness and skills to take over control in rare-event cases to ensure flight safety. We try to understand the pilot’s cognitive models and differences in required (mental) effort between conventional straight-in approaches and curved approaches. We developed various methods to visualize pilots’ control efforts during manual flight, show their capabilities...

  9. Information Security Awareness: An Innovation Approach


    Corona, Carlos Orozco


    Scholars and security practitioners seem to converge in the understanding that Information Security is in great part a problem about people; hence the need for a more holistic approach in order to understand human behaviour in the Information Security field which requires a multidisciplinary approach. Recent events such as the “Interdisciplinary Workshop on Security and Human Behaviour” hosted in Boston, Massachusetts in June 2008, are considering this approach and they have conveyed a multi...

  10. A Hybrid Approach to Clinical Question Answering (United States)


    participation in TREC, we submitted a single run using a hybrid Natural Language Processing ( NLP )-driven approach to accomplish the given task. Evaluation re...for the CDS track uses a variety of NLP - based techniques to address the clinical questions provided. We present a description of our approach, and...discuss our experimental setup, results and eval- uation in the subsequent sections. 2 Description of Our Approach Our hybrid NLP -driven method presents a

  11. Investment Portfolio Evaluation by the Fuzzy Approach

    Directory of Open Access Journals (Sweden)

    Lambovska Maya


    Full Text Available This paper presents a new fuzzy approach for the evaluation of investment portfolio, where the approach is viewed by the authors as a sub-phase of the management process of these portfolios. The approach defines the mutual and delayed effects among the significant variables of the investment portfolio. The evaluation of the effects is described as fuzzy trapezoidal numbers and they are aggregated by mathematical operations with incidence matrices and fuzzy functions “experton”.

  12. Comparison of Bayesian and frequentist approaches


    Ageyeva, Anna


    The thesis deals with Bayesian approach to statistics and its comparison to frequentist approach. The main aim of the thesis is to compare frequentist and Bayesian approaches to statistics by analyzing statistical inferences, examining the question of subjectivity and objectivity in statistics. Another goal of the thesis is to draw attention to the importance and necessity to teach Bayesian statistics at our University more profound. The thesis includes three chapters. The first chapter prese...

  13. Epidural hematoma (United States)

    ... belts). Follow safety precautions at work and in sports and recreation. For example, do not dive into water if the water depth is unknown or if rocks may be present. Alternative Names Extradural hematoma; Extradural hemorrhage; Epidural hemorrhage; EDH ...

  14. Fuzzy Approach to Statistical Control Charts

    Directory of Open Access Journals (Sweden)

    Shahryar Sorooshian


    Full Text Available After investigating the advantages and disadvantages of current methods of statistical process control, it becomes important to overcome the disadvantages and then use the advantages to improve a method for monitoring a process with categorical observations. An approach which considers uncertainty and vagueness is tried for this study; and for this purpose, fuzzy set theory is inevitable to use. So, a new approach based on fuzzy set theory is introduced in this research for monitoring attribute quality characteristics. This approach is then compared with the current related approach to see the difference in performance.

  15. Multiperipheral and polyperipheral approaches to pionization

    CERN Document Server

    Bishari, M; Nussinov, S


    Introduction of Regge trajectories in addition to the pomeron, which appears in Mueller's approach to pionization, is shown to predict a small dip. The analysis is motivated by a multiperipheral approach. The question whether this approach may lead to an understanding of the peak in the pionic distribution or the asymmetry effect is discussed. A new (polyperipheral) approach based on the exchange of several chains is introduced in order to account for the observed effects. It leads naturally to Mandelstam cuts and is compared with a partonic picture. (16 refs).

  16. Transseptal dorsal approaches to the wrist. (United States)

    Zemirline, Ahmed; Hoël, Gérard; Naïto, Kiyohito; Uguen, Arnaud; Liverneaux, Philippe; Le Nen, Dominique


    The dorsal approach to the wrist is the exposure of choice for most of the surgical procedures on the radiocarpal and intercarpal joints. Contrary to the volar approach, it encounters neither the main arteries nor the motor nerve branch. However, the dorsal approach goes necessarily through the extensor retinaculum. We describe two transseptal dorsal approaches that pass through the extensor retinaculum in the thickness of a septum between two compartments. A virtual space was developed beneath the infratendinous retinaculum (which is a deep layer covering the floor of the extensor compartments) to expose the periosteum, the ligaments and the joint capsule without opening the extensor compartments. Twenty cadaveric wrists have been dissected to study the feasibility of the two transseptal approaches. Ten wrists were exposed through a 3-4 transseptal approach, passing through the extensor retinaculum in the thickness of the septum between the third and fourth compartments. Ten wrists were exposed through a 4-5 transseptal approach, passing through the extensor retinaculum in the thickness of the septum between the fourth and fifth compartments. The extent of violations of extensor compartments and joint capsule, and the exposed anatomical structures were noted. At the end of each dissection, the whole extensor system was outrightly removed for histological study. The feasibility of the transseptal approaches was demonstrated for all the dissected wrists. The dissection plane beneath the infratendinous retinaculum was macroscopically and microscopically highlighted. The transseptal approaches provide a good exposure to the dorsal side of the wrist joint, without opening the extensor tendon compartments.

  17. Bioequivalence approach for whole effluent toxicity testing

    Energy Technology Data Exchange (ETDEWEB)

    Shukla, R.; Wang, Q.; Fulk, F.; Deng, C.; Denton, D.


    Increased use of whole effluent toxicity (WET) tests in the regulatory arena has brought increased concern over the statistical analysis of WET test data and the determination of toxicity. One concern is the issue of statistical power. A number of WET tests may pass the current hypothesis test approach because they lack statistical power to detect relevant toxic effects because of large within-test variability. Additionally, a number of WET tests may fail the current approach because they possess excessive statistical power, as a result of small within-test variability, and detect small differences that may not be biologically relevant. The strengths and limitations of both the traditional hypothesis test approach and the bioequivalence approach for use in the National Pollutant Discharge Elimination System program were evaluated. Data from 5,213 single-concentration, short-term chronic WET tests with Ceriodaphnia dubia provided the database for analysis. Comparison of results between the current approach and the bioequivalence approach indicates that the current approach to WET testing is generally sound but that adopting the proposed bioequivalence approach resolves concerns of statistical power. Specifically, within this data set, applying the bioequivalence approach resulted in failure for tests with relatively large test variability and a pass for tests with relatively small within-test variability.

  18. Percutaneous approaches to mitral valve disease

    National Research Council Canada - National Science Library

    Fassa, A-A; Himbert, D; Brochet, E; Bouleti, C; Vahanian, A


    Percutaneous approaches to mitral valve disease consist in modifications of existing surgical techniques, aiming to replicate the favourable outcomes of surgery, with less procedure-related risk, due...

  19. Global energy modeling - A biophysical approach

    Energy Technology Data Exchange (ETDEWEB)

    Dale, Michael


    This paper contrasts the standard economic approach to energy modelling with energy models using a biophysical approach. Neither of these approaches includes changing energy-returns-on-investment (EROI) due to declining resource quality or the capital intensive nature of renewable energy sources. Both of these factors will become increasingly important in the future. An extension to the biophysical approach is outlined which encompasses a dynamic EROI function that explicitly incorporates technological learning. The model is used to explore several scenarios of long-term future energy supply especially concerning the global transition to renewable energy sources in the quest for a sustainable energy system.

  20. Probabilistic approach to earthquake prediction.

    Directory of Open Access Journals (Sweden)

    G. D'Addezio


    Full Text Available The evaluation of any earthquake forecast hypothesis requires the application of rigorous statistical methods. It implies a univocal definition of the model characterising the concerned anomaly or precursor, so as it can be objectively recognised in any circumstance and by any observer.A valid forecast hypothesis is expected to maximise successes and minimise false alarms. The probability gain associated to a precursor is also a popular way to estimate the quality of the predictions based on such precursor. Some scientists make use of a statistical approach based on the computation of the likelihood of an observed realisation of seismic events, and on the comparison of the likelihood obtained under different hypotheses. This method can be extended to algorithms that allow the computation of the density distribution of the conditional probability of earthquake occurrence in space, time and magnitude. Whatever method is chosen for building up a new hypothesis, the final assessment of its validity should be carried out by a test on a new and independent set of observations. The implementation of this test could, however, be problematic for seismicity characterised by long-term recurrence intervals. Even using the historical record, that may span time windows extremely variable between a few centuries to a few millennia, we have a low probability to catch more than one or two events on the same fault. Extending the record of earthquakes of the past back in time up to several millennia, paleoseismology represents a great opportunity to study how earthquakes recur through time and thus provide innovative contributions to time-dependent seismic hazard assessment. Sets of paleoseimologically dated earthquakes have been established for some faults in the Mediterranean area: the Irpinia fault in Southern Italy, the Fucino fault in Central Italy, the El Asnam fault in Algeria and the Skinos fault in Central Greece. By using the age of the

  1. Democratic approaches to environmental education: Dream or ...

    African Journals Online (AJOL)

    Research indicates that few teachers are currently using a democratic approach to teaching in environmental education even though much of the environmental education literature supports and encourages such an approach. Various explanations are offered for this situation although all agree that the principles, goals and ...

  2. Book Review: Organizations: A Systems Approach

    DEFF Research Database (Denmark)

    Schoeneborn, Dennis


    Review of: Stefan Kühl: Organizations. A Systems Approach (trans. P. Schmitz). Farnham: Gower Publishing, 2013. 195 pp. £14.99. ISBN 9781472413413.......Review of: Stefan Kühl: Organizations. A Systems Approach (trans. P. Schmitz). Farnham: Gower Publishing, 2013. 195 pp. £14.99. ISBN 9781472413413....

  3. Student center approach in maths and sc

    African Journals Online (AJOL)


    implementation of student- centered approach across subjects, schools and grade levels? Objective of the study. Generally, this study attempted to assess ... literatures on student centered approach and related articles with similar topics were assessed in order to set framework for the study. These are Yore (2001); Saleh.

  4. Promotion of Agricultural Innovation Systems Approach: Policy ...

    African Journals Online (AJOL)

    delivery for maize production in Morogoro and Dodoma Regions of Tanzania using Agricultural. Innovation Systems (AIS) Approach. Maize productivity in Tanzania is low in spite of its importance to the country's food security and economic well-being of farmers. New approaches to extension and advisory service delivery ...

  5. Organizational design approaches in management consulting

    NARCIS (Netherlands)

    Visscher, Klaasjan; Visscher-Voerman, Irene


    Purpose: The purpose of this paper is to map the variety in organizational design approaches, to clarify their differences, and to find out what constitutes good designing in practice. - Design/methodology/approach: A series of in-depth interviews with experienced, high-reputation consultants is

  6. A POMDP approach to Affective Dialogue Modeling

    NARCIS (Netherlands)

    Bui Huu Trung, B.H.T.; Poel, Mannes; Nijholt, Antinus; Zwiers, Jakob; Keller, E.; Marinaro, M.; Bratanic, M.


    We propose a novel approach to developing a dialogue model that is able to take into account some aspects of the user's affective state and to act appropriately. Our dialogue model uses a Partially Observable Markov Decision Process approach with observations composed of the observed user's

  7. An instrumental approach to deception in bargaining

    NARCIS (Netherlands)

    Koning, Lukas Frederik


    Deception is often described as a form of unethical behavior, yet it is frequently used in bargaining. This raises the question why people use deception in bargaining. In this dissertation an instrumental approach to deception is presented to help answer this question. In an instrumental approach,

  8. Reconsidering Graduate Employability: The "Graduate Identity" Approach. (United States)

    Holmes, Len


    Elaborates a cogent alternative to the skills agenda as an approach to graduate employability--the graduate identity approach. Using a conceptual and theoretical examination of the key notion of performance, presents the twin concepts of practices and identity as significant for understanding human behavior. Offers suggestions for curriculum…

  9. Trialing a contextual approach to academic honesty. (United States)

    Coffey, Sue; Anyinam, Charles


    Concerns about academic honesty in higher education are widespread. To address this issue, faculty took part in a 3-year trial of a highly successful approach to academic honesty. Guiding this approach were an appreciation of student context, faculty orientation to student engagement, and available antiplagiarism technology.

  10. A Ricoeurian Approach to Rhetorical Criticism. (United States)

    Warnick, Barbara


    Proposes an approach to rhetorical criticism that features the relationship between a message and a culturally distanced interpreter or critic. Applies Paul Ricoeur's critical approach to an interpretation of the Gettysburg Address to illustrate how hermeneutics reveals the underlying meaning and cultural significance of enduring texts. (NKA)

  11. Comparison between Fisherian and Bayesian approach to ...

    African Journals Online (AJOL)

    ... the Bayesian approach assigns an observed unit to a group with the greatest posterior probability. Fisher's linear discriminant analysis though is the most widely used method of classification because of its simplicity and optimality properties is normally used for two group cases. However, Bayesian approach is found to ...

  12. Machine Learning Approaches for Music Information Retrieval


    Li, Tao; Ogihara, Mitsunori; Shao, Bo; DingdingWang,


    We discussed the following machine learning approaches used in music information retrieval: (1) multi-class classification methods for music genre categorization; (2) multi-label classification methods for emotion detection; (3) clustering methods for music style identification; and (4) semi-supervised learning methods for music recommendation. Experimental results are also presented to evaluate the approaches.

  13. Toward an Integrated Psychological Approach - Phase II

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

    Trauma, Development and Peacebuilding : Toward an Integrated Psychological Approach - Phase II. Over the past decade, the peace, conflict and development community has begun to question the value of medicalized approaches such as post-traumatic stress disorder (PTSD) in dealing with aftermath of political violence ...

  14. Combined Approach for Solving the Electromagnetic Induction ...

    African Journals Online (AJOL)

    Inverse electromagnetic induction is an imaging technique for reconstructing the conductivity and permeability distributions in a region of interest from measurements of impedance made at its boundary. In general, there are two approaches to the reconstruction problem: the pixel-based approach and the parameter-based ...

  15. A Balanced Approach to Early Childhood Education. (United States)

    Lodish, Richard


    Based on 30 years' experience, the author advocates a balanced approach that accommodates extremes in four important areas: curriculum, teaching, structure, and classroom management. Using a whole-language approach to reading should not mean that phonics, spelling, or punctuation skills can't be taught. Authoritarian and open classroom structures…

  16. Theoretical Approaches to the College Environment (United States)

    Baird, Leonard L.


    There is a need for theories of how college environments operate. Criteria for theories are proposed, with emphasis on the production of testable theoretical predictions. Three approaches appear unusually promising: role theory, organizational psychology, and social ecological analysis. The advantages of using such theoretical approaches are…

  17. An Ethnographic Descriptive Approach to Video Microanalysis

    DEFF Research Database (Denmark)

    Holck, Ulla


    In the ethnographically informed approach to observational research one studies everyday settings, and seeks to understand actions and meanings in their social context (Silverman 1993; Wolcott 1990). This approach is a strong tool for investigating interactions of a more or less implicit character...

  18. Evaluation and Opportunities in Overtraining Approaches (United States)

    Roose, Jolanda; de Vries, Wouter R.; Schmikli, Sandor L.; Backx, Frank J. G.; van Doornen, Lorenz J. P.


    Overtraining (OT) as a sports phenomenon can be caused by stressors on various levels (physical, emotional, psychological, and social) and evokes responses on these levels. This study evaluated research and new opportunities in the field of OT by introducing an integrated multidisciplinary approach, based on the single and multistressors approach.…

  19. Neuroevolutional Approach to Cerebral Palsy and Speech. (United States)

    Mysak, Edward D.

    Intended for cerebral palsy specialists, the book emphasizes the contribution that a neuroevolutional approach to therapy can make to habilitation goals of the child with cerebral palsy and applies the basic principles of the Bobath approach to therapy. The first section discusses cerebral palsy as a reflection of disturbed neuro-ontogenisis and…

  20. Competence: Conceptual Approach and Practice in France (United States)

    Le Deist, Francoise


    Purpose: The purpose of this article is to analyse the conceptual approaches to competence and practice in competence management in France. Design/methodology/approach: Extensive literature review, discussion with academic experts in the French competence network of AGRH and interviews concerning developments following the 2003 national agreement…