NECROTIZING FASCIITIS OF THE POSTERIOR CERVICAL COMPARTMENT: AN ATYPICAL CASE DUE TO STREPTOCOCCUS AGALACTIAE

Necrotizing fasciitis is a fulminant infection that affects the deep and superficial fascia while initially sparing the overlying skin and underlying muscle. The involvement of the cervicalcompartment is associated with a high morbidity and mortality rate. Immunocompromised patients are prone to this infection. We present a case of a 80 year-old diabetic womansuffering from streptococcal cervical NF (probably secondary to a arm injury) with an uncommon involvement of the posterior cervical compartment, highlighting the atypical responsible microorganism (Streptococcus Agalactiae), the role of imaging for early diagnosis and the timely surgical and medical treatment for a successful outcome.

Focus Harmonic Scalpel Compared to Conventional Haemostasis in Open Total Thyroidectomy: A Prospective Randomized Trial

The aim of this prospective randomized trial was to compare operative factors, postoperative outcomes and surgical complications of open total thyroidectomy when using the Harmonic Scalpel (HS) versus Conventional Haemostasis (CH). Methods. 100 consecutive patients underwent open total thyroidectomy were randomized into two groups: group CH (Conventional Haemostasis) and group HS (Harmonic Scalpel). We recorded the following: age, sex, pathology, thyroid volume, haemostatic technique, operative time, drainage volume, thyroid weight, postoperative pain, postoperative complications, and hospital stay. The results were analyzed using the Student's t test and χ2 test. Results. No significant difference was found between the two groups concerning mean thyroid weight and mean hospital stay. The mean operative time was significantly shorter in the HS group. The total drainage fluid volume was lower in HS group. Two (4%) transient recurrent laryngeal nerve palsies were observed in CH group and no one (0%) in the HS group. Postoperative transient hypocalcemia occurred more frequently in the CH group. HS group experienced significantly less postoperative pain at 24 and 48 hours. Conclusions. In patients undergoing thyroidectomy, HS is a reliable and safe tool. Comparing with CH techniques, its use reduces operative times, postoperative pain, drainage volume and transient hypocalcemia

The reliability of wind turbines

The residual scepticism surrounding the installation of wind turbines, is mainly due to the perceived lack of reliability and expense of these energy converters. Because of the commercial significance of reliability, few sources of such data are publicly available, with the result that knowledge of the true reliabihty of wind turbines is fragmentary and sometimes anecdotal, even among operators and professionals in the wind energy industry.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

The Effects of Graphing Calculator use on High-School Students\u27 Reasoning in Integral Calculus

This mixed-method study investigated the impact of graphing calculator use on high school calculus students\u27 reasoning skills through calculus problems when applying to concepts of the definite integral and its applications. The study provides an investigation of the effects on reasoning when graphing calculators are used, since it is proposed that, through reasoning, conceptual understanding can be achieved. Three research questions were used to guide the study: (1) Does the use of the graphing calculator improve high school calculus students\u27 reasoning ability in calculus problems applying the definite integral? (2) In what specific areas of reasoning does use of the graphing calculator seem to be most and least effective? and (3) To what extent can students who have used the graphing calculator demonstrate ability to solve problems using pencil and paper methods? The study included a quantitative, quasi-experimental component and a qualitative component. Results of the quantitative and qualitative analysis indicate that (1) graphing calculators had a positive impact upon students\u27 reasoning skills (2) graphing calculators were most effective in the areas of initiating a strategy and monitoring progress (3) students\u27 reasoning skills were most improved when graphing calculators were used together with the analytic approach during both instruction and testing and (4) students who used the graphing calculator performed equally as well in all elements of reasoning as those who used pencil and paper to solve problems

La pratica diaristica nei viaggi di commercio. L\u27America di Ubaldo Moriconi

No abstract availabl

State-owned and multinational enterprises partnership as an import substitution strategy: A narrative ARDL approach to the case of oil contracts in Argentina (1958–1962)

To avoid balance of payments crises, two Argentinian presidents tried to make deals (‘oil contracts’ ) with multinationals to transfer technology and know-how to YPF, which is a state-owned company in the oil sector. The aim was to substitute imports. The ‘oil nationalism’ doctrine opposed these agreements, arguing that multinational companies are a threat to the national security. In both cases, the story ended in a coup d’´etat, first in the period 1954/1955 (against President Juan Domingo Perón) and the second in 1962/1963 (against President Arturo Frondizi). Based on a demand-led growth model in small open economies, we show that the process of import substitution led by government agreements with multinational firms can result in an increase of national production. Using an original dataset, we corroborate this theoretical result by applying a narrative ARDL approach to the Argentinean experience (1958-1962), where a government policy to promote technological transfer, from multinational firms to YPF, to substitute imports was in place. We conclude that the oil contracts were successful

Thermo-Hydrodynamics in a Closed Loop Pulsating Heat Pipe

Pulsating heat pipes (PHPs) represent a promising solution for passive on-chip, two-phase cooling of micro-electronics, providing advantages such as a simple construction and operation in any gravitational orientation. Unfortunately, the unique coupling of thermodynamics, hydrodynamics and heat transfer responsible for their operation has so far eluded comprehensive description or accurate prediction. The complexity of the self-sustained two-phase flow in PHPs presents many challenges to the understanding on the physical phenomena taking place. It is important to evaluate the heat and mass transfer mechanisms occurring during their operation in order to better describe their performance as a function of the operating conditions. In the present study, a new facility at the Laboratory of Heat and Mass Transfer (LTCM) was built to allow the synchronized thermal and visual investigation of a Closed Loop Pulsating Heat Pipe (CLPHP). A single-turn channel CLPHP was investigated using R245fa as the working fluid. The tests were carried out at filling ratios from 10 to 90 % and heat inputs from 2 to 60 W, for vertical and inclined orientation. Flow visualization was attained via the transparent front side of the test section which provided full optical access to the flow inside of the CLPHP channels. A novel time-strip image processing technique was applied to the high speed videos to extract qualitative details of the flow regimes and quantitative flow data concerning the liquid/vapor interface dynamics. Local temperature oscillations were also measured and their frequency spectra further helped in characterizing the self-sustained two-phase flow. Thermal resistance measurements were used to qualitatively and quantitatively assess the effect of the flow dynamics on the system thermal performance, which are presented as operational maps. The dynamics governing the PHP operation during oscillating and circulating flows and their effects on the system thermal performance were investigated and insight gained. Four distinct flow regimes and their thermal and flow-dynamics characteristics were identified, suggesting the strong coupling between the two-phase flow pattern and the system thermal behavior. Thin film evaporation was observed to be the most dominant thermal mechanism while heat transfer into the oscillating liquid slug was of second importance, together with localized nucleate boiling. Moreover, the net forces acting on the system could be identified through the novel time-strip technique, revealing new details on the mechanisms producing self-sustained two-phase flow oscillation and circulation, and the two-phase flow pattern transition. The role of gravity for the operation of this single-turn CLPHP was also assessed

Ipofertilità nel cane maschio

openVET-55

Heat Pump Integration in Industrial Processes -II

This semester project follows a previous project at LENI-EPFL ad aims at finding the best optimization approach in terms of heat pump integration in industrial processes. The multi-objective optimization method chosen seeks the minimum of both operating and investment costs related to heat pump purchase

Experiences of learning about nursing care

Estudio cualitativo exploratorio descriptivo con el objetivo de conocer el proceso de aprendizaje del cuidado en relación a las vivencias de los alumnos del séptimo semestre de un curso de Enfermería en el interior del Rio Grande do Sul, en el periodo entre abril y junio de 2007. La colecta de datos fue realizada por la técnica del grupo focal y el análisis de las informaciones por el análisis temático de contenido que evidenció un tema y tres categorías: Reflexionando sobre la Formación. Visión de la Enfermería: el conocimiento de la profesión; El proceso de formación: el aprendizaje del cuidado y Expectativas con la finalización del curso. Los resultados apuntaron que temática del cuidado ha traspasado las vivencias de los alumnos, de manera implícita y explícita, pero, sin un basamento teórico y filosófico consistente.Estudo qualitativo, exploratório-descritivo, com o objetivo de conhecer o processo de aprendizagem do cuidado em relação às vivências dos alunos do sétimo semestre de um curso de Enfermagem no interior do Rio Grande do Sul, no período entre abril e junho de 2007. A coleta de dados foi realizada pela técnica do grupo focal, e a análise das informações, pela análise temática de conteúdo. A análise evidenciou um tema, Refletindo sobre a Formação, e três categorias: Visão da Enfermeira: o conhecimento da profissão; O processo de formação: a aprendizagem do cuidado; e Expectativas com a finalização do curso. Os resultados apontaram que a temática do cuidado permeou as vivências dos alunos, de maneira implícita e explícita, porém sem uma fundamentação teórica e filosófica consistente.The objective of this qualitative-exploratory was to learn about the process of developing knowledge in nursing care in term of the experiences of the students who attend the seventh semester of a Nursing Course located in the State of Rio Grande do Sul, Brazil, from April to June/2007. Data collection was performed using the focal group technique and the information was analyzed using the thematic content analysis, which revealed one theme with three categories: Reflecting upon nursing education: the nurse's view: the knowledge of the profession; the process of education: learning about nursing care; and Expectations regarding the end of the course. The results showed that the care theme permeated the students' experiences, both implicitly and explicitly, although without a consistent philosophical and theoretical background