An improved method of supercharged transposed latissimus dorsi flap with the skin paddle for the management of a complicated lumbosacral defect

OBJECTIVE: Treatment of nonhealing wounds of lower back often poses a powerful challenge. We present one of the first report of treatment of a lumbosacral defect with a supercharged latissimus dorsi flap with the skin paddle. CASE REPORT: We report a case of a 59 yearold man with myeloma of the sacral spine who underwent radiotherapy and chemotherapy and subsequently, laminectomies and placement of hardware for ongoing paresis and spine instability. Then, he developed an open wound and osteomyelitis of the spine with culture positive tuberculous granulomas. After multiple surgical debridement, he presented to our service and was treated with a single stage debridement followed by the performance of a latissimus dorsi musculocutaneous flap based on paraspinal perforators and supercharged. RESULTS: This solution, allowed for augmentation of blood flow to the muscle with the inferior gluteal artery, provided coverage of the defect resistant to the pressure, and simplified post-operative management of the patient. CONCLUSIONS: Alternative treatment options, including free tissue transfer, posed difficulties in finding suitable recipient vessels near the defect, in inserting the flap so as to restore its original length without compromising blood flow, and in postoperative care of the patient. Treatment of a lumbosacral defect with a supercharged latissimus dorsi flap with the skin paddle may represent a milestone procedure for complicated lower spine wounds

Effects of pumping on entomopathogenic nematodes and temperature increase within a spray system

Exposure to hydrodynamic stresses and increased temperature during hydraulic agitation within a spray system could cause permanent damage to biological pesticides during spray application. Damage to a benchmark biopesticide, entomopathogenic nematodes (EPNs), was measured after a single passage through three different pump types (centrifugal, diaphragm, and roller) at operating pressures up to 828 kPa. No mechanical damage to the EPNs due to passage through the pumps was observed. Separate tests evaluated the effect of pump recirculation on temperature increase of water within a laboratory spray system (56.8-L spray tank) and a conventional-scale spray system (1136-L spray tank). A constant volume of water (45.4 L) was recirculated through each pump at 15.1 L/min within the laboratory spray system. After 2 h, the temperature increase for the centrifugal pump was 33.6 degrees C, and for the diaphragm and roller pumps was 8.5 degrees C and 11.2 degrees C, respectively. The centrifugal pump was also evaluated within the conventional spray system, under both a constant (757 L) and reducing volume scenario, resulting in an average temperature increase of 3.2 degrees C and 6.5 degrees C, respectively, during the 3-h test period. When comparing the number of recirculations for each test, the rate of temperature increase was the same for the conventional spray, system (for both the constant and reducing volume scenarios), while for the laboratory spray system the temperature increased at a greater rate, suggesting that the volume capacity of the spray tank is the primary factor influencing the temperature increase. Results from this study indicate that thermal influences during pump recirculation could be more detrimental to EPNs than mechanical stress. Results show that extensive recirculation of the tank mix can cause considerable increases in the liquid temperature. Diaphragm and roller pumps (low-capacity pumps) are better suited for use with biopesticides compared to the centrifugal pump, which was found to contribute significant heat to the spray system

Expectations and Experiences of Short-Term Study Abroad Leadership Teams

This paper explores the expectations and experiences of faculty, academic advisors, and graduate students leading a study abroad experience for first-year engineering students. In the current age of globalization, engineering students require a global understanding of engineering to be competent in the global workforce. In response, undergraduate engineering programs have created various programs to fill this student need. The research surrounding these initiatives focuses on the student experience but is limited when describing that of program leaders. This qualitative study draws from track leader journals that were completed during and shortly after the international program as well as semi-structured interviews in the following semester. The findings suggest that the majority of leaders expected their role to be that of an educator on the study abroad experience, but upon reflection, realized that their definition of what it means to be an educator expanded to encompass facilitation of learning. Many of the student learning instances leaders pointed to had to do with facilitating a learning environment rather than delivering content or answering technical questions. The roles described by leaders varied from troubleshooter to behavioral manager to informer. Leaders reflected that their roles developed as they met students where they were in their learning within the dynamic international context of the program. Overall, leaders saw their roles evolve over the course of the trip. The findings shed light on emergent power dynamics that leadership teams engage in outside of the formal learning environment and provide a unique insight into the types of learning program leaders can experience through leading study abroad programs. The multiple forms of data collection provide deeper insights into the experiences of the leaders while encouraging them to also reflect in real-time. This study has implications for the development of intentionally designed, condensed study-abroad experiences that draws from understanding the program leaders’ experience

(Il)Legitimisation of the role of the nation state: Understanding of and reactions to Internet censorship in Turkey

This study aims to explore Turkish citizen-consumers' understanding of and reactions to censorship of websites in Turkey by using in-depth interviews and online ethnography. In an environment where sites such as YouTube and others are increasingly being banned, the citizen-consumers' macro-level understanding is that such censorship is part of a wider ideological plan and their micro-level understanding is that their relationship with the wider global network is reduced, in the sense that they have trouble accessing full information on products, services and experiences. The study revealed that citizen-consumers engage in two types of resistance strategies against such domination by the state: using irony as passive resistance, and using the very same technology used by the state to resist its domination

An improved method of supercharged transposed latissimus dorsi flap with the skin paddle for the management of a complicated lumbosacral defect

OBJECTIVE: Treatment of non-healing wounds of lower back often poses a powerful challenge. We present one of the first report of treatment of a lumbosacral defect with a supercharged latissimus dorsi flap with the skin paddle. CASE REPORT: We report a case of a 59 year-old man with myeloma of the sacral spine who underwent radiotherapy and chemotherapy and subsequently, laminectomies and placement of hardware for ongoing paresis and spine instability. Then, he developed an open wound and osteomyelitis of the spine with culture positive tuberculous granulomas. After multiple surgical debridement, he presented to our service and was treated with a single stage debridement followed by the performance of a latissimus dorsi musculocutaneous flap based on paraspinal perforators and supercharged. RESULTS: This solution, allowed for augmentation of blood flow to the muscle with the inferior gluteal artery, provided coverage of the defect resistant to the pressure, and simplified post-operative management of the patient. CONCLUSIONS: Alternative treatment options, including free tissue transfer, posed difficulties in finding suitable recipient vessels near the defect, in inserting the flap so as to restore its original length without compromising blood flow, and in postoperative care of the patient. Treatment of a lumbosacral defect with a supercharged latissimus dorsi flap with the skin paddle may represent a milestone procedure for complicated lower spine wounds

Phi-values in protein folding kinetics have energetic and structural components

Phi-values are experimental measures of how the kinetics of protein folding is changed by single-site mutations. Phi-values measure energetic quantities, but are often interpreted in terms of the structures of the transition state ensemble. Here we describe a simple analytical model of the folding kinetics in terms of the formation of protein substructures. The model shows that Phi-values have both structural and energetic components. In addition, it provides a natural and general interpretation of "nonclassical" Phi-values (i.e., less than zero, or greater than one). The model reproduces the Phi-values for 20 single-residue mutations in the alpha-helix of the protein CI2, including several nonclassical Phi-values, in good agreement with experiments.Comment: 15 pages, 3 figures, 1 tabl

Conceptual design of a hydroelectric power plant for a rehabilitation project

This study presents the conceptual design of a hydroelectric power plant, as a part of a large scale rehabilitation project for an existing power plant in Antalya, Turkey. The aim of the rehabilitation project is to increase the power and efficiency of the plant and its scope includes CFD aided turbine design, model production and tests, the design, production and implementation of the turbine, generator and the SCADA system. This study is the first attempt, as a preliminary study, to handle the problem and perform a conceptual design of the hydroelectric power plant. The existing plant is modeled to estimate the head and flow rate characteristics at various sections of the system. The net head and flow rate of the turbine are estimated. Transient analyses of the system are also performed to evaluate water hammer characteristics. The results of the transient analyses provide the inputs for the design of by-pass pipeline and pressure relief valve. The estimated net head and flow rate from the simulations are used as inputs for the preliminary design. The dimensions of the spiral case, the diameter of the stay vanes and guide vanes, wicket gate heights, runner diameter and rotational speed, runaway characteristics and preliminary output power are determined. The best efficiency point and the design point of the turbine are also obtained as the net head versus the flow rate. These results provide an idea on the feasibility of the increase in power.Papers presented to the 12th International Conference on Heat Transfer, Fluid Mechanics and Thermodynamics, Costa de Sol, Spain on 11-13 July 2016

Epitaxial growth in dislocation-free strained alloy films: Morphological and compositional instabilities

The mechanisms of stability or instability in the strained alloy film growth are of intense current interest to both theorists and experimentalists. We consider dislocation-free, coherent, growing alloy films which could exhibit a morphological instability without nucleation. We investigate such strained films by developing a nonequilibrium, continuum model and by performing a linear stability analysis. The couplings of film-substrate misfit strain, compositional stress, deposition rate, and growth temperature determine the stability of film morphology as well as the surface spinodal decomposition. We consider some realistic factors of epitaxial growth, in particular the composition dependence of elastic moduli and the coupling between top surface and underlying bulk of the film. The interplay of these factors leads to new stability results. In addition to the stability diagrams both above and below the coherent spinodal temperature, we also calculate the kinetic critical thickness for the onset of instability as well as its scaling behavior with respect to misfit strain and deposition rate. We apply our results to some real growth systems and discuss the implications related to some recent experimental observations.Comment: 26 pages, 13 eps figure