3,306 research outputs found

    V-shaped Internal Nasal Vestibular Flap for Reconstruction of Iatrogenic Columellar Defect

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    Summary:. Columella is an important structure in the center of the face, and its structural integrity has an important functional, social, and psychological role. Columella reconstruction can be very challenging for surgeons and the ideal technique remains elusive. This article describes a reconstruction technique in a young woman with columella necrosis due to nasal continuous positive airway pressure treatment. The method of reconstruction described here, with a V-shaped internal nasal vestibular flap and a cartilage grafts from lateral crura, is simple and easily reproducible, providing an optimal aesthetic result and in addition the donor site does not create a secondary deformity by disrupting normal anatomy

    Combination of negative pressure wound therapy and systemic steroid therapy in postsurgical pyoderma gangrenosum after reduction mammoplasty; a case of proven efficacy and safety

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    Pyoderma gangrenosum (PG) is a rare non-infective inflammatory disease of unknown etiology characterized by cutaneous papulo-pustoles that rapidly evolve into painful ulcerative lesions. Postoperative PG (PPG) is a clinical variant of PG in which pathergic response occurs at surgical sites. It is important to include PG in the differential diagnosis of breast ulceration. An incorrect diagnosis and treatment can potentially worsen the patient state, causing disfigurement with extensive scarring, an unpleasant aesthetic result and produce consequent psychological trauma. We report a case of PPG after bilateral breast reduction mammoplasty treated with negative pressure wound therapy (NPWT) as local treatment for wound dehiscence in combination with systemic steroid therapy. This synergism led to a good aesthetic result. NPWT improved wound perfusion, it decreased the exudate, and promoted adherence of the mammary gland to the pectoral muscle. After 31 days deep sutures were placed to directly close the wound and the patient was discharged. PPG is a rare, devastating occurrence after surgery. Surgeons must know that PPG is an evenience that can occur in otherwise healthy patients and must be considered in the differential diagnosis in case of necrotic ulcers and apparent infection status. NPWT resulted to have benefits in the treatment of PPG, with a role in limiting the size of the defect, avoiding pathergic self-reaction and allowing a faster recovery with higher chances of achieving a better result

    Bringing Zoning into Focus: A Fine-Grained Analysis of Zonings Relationships to Housing Affordability, Income Distributions, and Segregation in Connecticut

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    For more than a century, local governments throughout the United States have used zoning to shape future growth. Through rules that regulate what sorts of housing can be built where, localities may either allow for new development or restrict construction to maintain the status quo. Using a first-of-its-kind database of zoning laws across an entire state, we provide evidence that strict zoning regulations limiting construction to single-family homes are associated with inadequate access to affordable housing and with the segregation of people by income, race, and ethnicity.We leverage the Connecticut Zoning Atlas, a unique dataset of zoning texts tied to geospatial files that allow for georeferenced comparisons between the zoning laws adopted by 180 localities. We overlay the geographies of zoning districts on spatially differentiated demographic and economic indicators at the neighborhood level. Analyzing and comparing this information allows us to provide a comprehensive view of the relationships between zoning laws, property values, and residents' demographic and economic characteristics.Our research focuses on a state with stark disparities in residential land uses: only 2 percent of Connecticut's land is zoned to allow the by-right construction of multifamily buildings with three or more units per parcel, while 91 percent of its land allows only the construction of single-family housing by right. Our analysis reveals that suburbs and towns have the most restrictive zoning rules by several measures, while the largest cities more readily permit multifamily construction. We show that the residents of neighborhoods with mostly single-family zoning, on average, have significantly higher household incomes and are much more likely to be white, much less likely to be Black or Hispanic, more likely to have a bachelor's degree, and much more likely to own their homes than residents of neighborhoods where zoning allows for multifamily building construction. These findings paint a picture of a state where localities' zoning either divides or reinforces the division of residents by income, race, ethnicity, and education levels. We also apply a segregation index to explore the associations between zoning rules and neighborhood- and locality-level segregation. After controlling for other characteristics, we find that higher concentrations of high-income and white residents are associated with lower number-of-unit zoning policies. We also find that higher concentrations of low-income, Black, Hispanic, and other residents of color are associated with zoning allowing the construction of two or more housing units per parcel and higher shares of renter-occupied housing.Together, these findings bring new insight into the relationship between zoning policy and residents' geographic distribution. Our results clearly point to the links between zoning laws, rental housing availability, and inequitable distributions of populations within and across jurisdictions. Policymakers considering how to improve access to opportunity while reducing income or racial segregation should evaluate the potential for altering local zoning codes to allow greater diversity of housing construction and tenure types in more places

    Iowa State University Fashion Show: Why do they Attend?

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    The popularity of the Peabody award-winning television show Project Runway has sparked public interest in and awareness of the fashion industry ( Project runway, 2009). Coupled with increasing enrollment in textiles and clothing programs (Arthur, O\u27Neal, Jordan, Kadolph, & Johnson, 2003) and sold out events, man colleges and universities have witnessed enhanced interest in student fashion shows

    Influence of Manufacturing Constraints on the Topology Optimization of an Automotive Dashboard

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    Topology Optimization (TO) methods optimize material layout to design light-weight and high-performance products. However, TO methods, applied for components or assembly with high complexity shape or for structures with copious number of parts respectively, do not usually take into account the manufacturability of the optimized geometries, then a heavy further work is required to engineer the product, risking to compromise the mass reduction achieved. Within an Industry 4.0 approach, we propose to evaluate manufacturing constraints since early stages of the conceptual design to perform a TO coherent with the manufacturing technology chosen. Several approaches of TO with different manufacturing constraints such as casting and extrusion are proposed and each solution is compared. The optimum conceptual design is determined in order to minimize the component weight while satisfying both the structural targets and the manufacturing constraints; a case study on a high-performance sport car dashboard is finally presented

    La pedagogía de contrato para la promoción de un uso adecuado de las TICS en el aula

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    La difusión masiva de la tecnología en las aulas escolares ha llevado a muchos teóricos a reflexionar sobre los beneficios o perjuicios de las tecnologías. También se preguntan sobre la estrategia que se debe utilizar para explotar el potencial tecnológico limitando al máximo los posibles peligros. El primer punto se resuelve no atribuyendo una connotación positiva o negativa a las tecnologías, sino estimando su valor a partir del uso que se vaya a hacer. En cambio, con respecto al segundo punto la idea es enfocar los medios de manera participativa, proporcionando claves para la reflexión; un enfoque media-educativo. La estrategia que aquí se analiza es la propuesta realizada por Philippe Meirieu, conocida con el nombre de pedagogía de contrato. Es una estrategia educativa que, poniendo el acento en la negociación y confrontación entre las partes, apoya al niño y al mismo tiempo le permite acceder progresivamente al mayor grado de autonomía.The massive spreading of technology in schools has led many theorists to reflect on the goodness or badness of technologies and on the strategy that we need to follow in order to exploit the technological potential and limit dangers as much as possible. The first goal is achieved by giving neither a positive nor a negative connotation to technologies, but on the contrary estimating their value according to the use of that. With regards to the second goal, the idea is to approach media in a participatory manner, providing keys to understanding and ideas for reflection; in fact, a media-educational approach. The strategy analysed here is the one proposed by Philippe Meirieu, known as pedagogy by contract: an educational strategy that, with the emphasis on negotiation and confrontation between the parties, supports the child and at the same time allows him to progressively access autonomy (Meirieu, 2002)

    Prevalence of Antibiotic Resistance in Enterococci: A 14 Year Survey

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