Family Therapy Approach to Incapacitating Migraine.

ERIC Educational Resources Information Center

Rosenstock, Harvey A.; And Others

1979-01-01

The case of a nine-year-old boy suffering from psycosomatic migraine headaches is discussed. The main article presents the case study and discusses the family systems approach which was successfully used in therapy. The following discussion deals with the psychosomatic personality. (HMV)

Transdisciplinary Case Studies as a Means of Sustainability Learning: Historical Framework and Theory

ERIC Educational Resources Information Center

Scholz, Roland W.; Lang, Daniel J.; Wiek, Arnim; Walter, Alexander I.; Stauffacher, Michael

2006-01-01

Purpose: This paper aims at presenting the theoretical concepts of the transdisciplinary case study approach (TCS), which is a research and teaching approach developed and elaborated at the Swiss Federal Institute of Technology (ETH), as a means of transition support. Design/methodology/approach: The paper reveals the historical roots of case…

A Transdisciplinary Approach to Training: Preliminary Research Findings Based on a Case Analysis

ERIC Educational Resources Information Center

Bimpitsos, Christos; Petridou, Eugenia

2012-01-01

Purpose: The purpose of this paper is to discuss the benefits, barriers and challenges of the transdisciplinary approach to training, and to present findings of a case analysis. Design/methodology/approach: The paper is based on the research findings of an experimental training program for Greek local government managers co-funded by the European…

Robotic assisted laparoscopic repair of a symptomatic ureterosciatic hernia.

PubMed

Regelman, Mikhail; Raman, Jay D

2016-04-01

Ureterosciatic hernias (USH) are a rare entity and to date there have been limited case reports detailing their presentation, diagnosis, and management. Until recently, repair of ureterosciatic hernias has been performed via open, endoscopic, or purely laparoscopic approaches. We present the second known published case of a robotic approach to the USH repair with detailed outline of the surgical technique accompanied by video recording from the operative procedure.

An Approach to Using Toxicogenomic Data in US EPA Human ...

EPA Pesticide Factsheets

EPA announced the availability of the final report, An Approach to Using Toxicogenomic Data in U.S. EPA Human Health Risk Assessments: A Dibutyl Phthalate Case Study. This report outlines an approach to evaluate genomic data for use in risk assessment and a case study to illustrate the approach. The dibutyl phthalate (DBP) case study example focuses on male reproductive developmental effects and the qualitative application of genomic data because of the available data on DBP. The case study presented in this report is a separate activity from any of the ongoing IRIS human health assessments for the phthalates. The National Center for Environmental Assessment (NCEA) prepared this document for the purpose of describing and illustrating an approach for using toxicogenomic data in risk assessment.

Teaching ethics in the clinic. The theory and practice of moral case deliberation.

PubMed

Molewijk, A C; Abma, T; Stolper, M; Widdershoven, G

2008-02-01

A traditional approach to teaching medical ethics aims to provide knowledge about ethics. This is in line with an epistemological view on ethics in which moral expertise is assumed to be located in theoretical knowledge and not in the moral experience of healthcare professionals. The aim of this paper is to present an alternative, contextual approach to teaching ethics, which is grounded in a pragmatic-hermeneutical and dialogical ethics. This approach is called moral case deliberation. Within moral case deliberation, healthcare professionals bring in their actual moral questions during a structured dialogue. The ethicist facilitates the learning process by using various conversation methods in order to find answers to the case and to develop moral competencies. The case deliberations are not unique events, but are a structural part of the professional training on the work floor within healthcare institutions. This article presents the underlying theory on (teaching) ethics and illustrates this approach with an example of a moral case deliberation project in a Dutch psychiatric hospital. The project was evaluated using the method of responsive evaluation. This method provided us with rich information about the implementation process and effects the research process itself also lent support to the process of implementation.

Treatment of Children's Fears: A Strategic Utilization Approach.

ERIC Educational Resources Information Center

Protinsky, Howard

1985-01-01

Describes briefly Milton Erickson's strategic utilization approach to therapy. Discusses the usefulness of this approach in treating children's fears. Presents two case histories in which the approach successfully eliminated the fear of the child. (BH)

Avascular Necrosis of Acetabulum: The Hidden Culprit of Resistant Deep Wound Infection and Failed Fixation of Fracture Acetabulum - A Case Report.

PubMed

K, Kandhari V; M, Desai M; S, Bava S; N, Wade R

2015-01-01

Chances of avascular necrosis of acetabulum are rare as it enjoys a rich blood supply. But cases of post - traumatic avascular necrosis of acetabulum following fracture of posterior column have been well documented. Importance of identifying and suspecting the avascular necrosis of acetabulum is essential in cases of failed fixation of fracture acetabulum, previously operated using extensile approach to acetabulum; either extended anterior ilio - femoral or tri - radiate approach. Such patients usually present with repeated deep bone infection or with early failure of fixation with aseptic loosening and migration of its components. We present a similar case. 40 years female presented with inadequately managed transverse fracture of left acetabulum done by anterior extended ilio-inguinal approach. The fixation failed. She presented 6 months later with painful hip. Cemented total hip replacement was performed with reconstruction of acetabulum by posterior column plating. Six months postoperatively patient presented with dislodgement of cup, pelvic discontinuity and sinus in the thigh. Two stage revision surgery was planned. First implant, removal; debridement and antibiotic spacer surgery was performed. At second stage of revision total hip replacement, patient had Paprosky grade IIIb defect in acetabulum. Spacer was removed through the posterior approach. Anterior approach was taken for anterior plating. Intra-operatively external iliac pulsations were found to be absent so procedure was abandoned after expert opinion. Postoperatively digital subtraction angiography demonstrated a chronic block in the external iliac artery and corona mortis was the only patent vascular channel providing vascular to the left lower limb. Thus, peripheral limb was stealing blood supply from the acetabulum to maintain perfusion. Patient was ultimately left with pelvic discontinuity, excision arthroplasty and pseudoarthrosis of the left hip. Avascular necrosis of acetabulum is a rare entity & often not recognized. One should be suspicious about diagnosis of avascular necrosis of acetabulum in select cases of failed acetabular fixation, previously operated via extensile anterior ilio - inguinal approach. Angiographic evaluation is essential in revision cases of failed acetabular fixation. Corona mortis (crown or circle of death) can sometimes act as a savior of limb.

Extended endoscopic transsphenoidal approach infrachiasmatic corridor.

PubMed

Ceylan, Savas; Anik, Ihsan; Koc, Kenan; Cabuk, Burak

2015-01-01

An extended endoscopic transsphenoidal approach is required for skull base lesions extending to the suprasellar area. Inferior approach using the infrachiasmatic corridor allows access to the lesions through the tumor growth that is favorable for the extended transsphenoidal approaches. Infrachiasmatic corridor is a safer route for the inferior approaches that is made up by basal arachnoid membrane and Liliequist's membrane with its leaves (diencephalic and mesencephalic leaf). This area extends from the optic canal and tuberculum sella to the corpus mamillare. We performed extended endoscopic approach using the infrachiasmatic corridor in 52 cases, including tuberculum sella meningiomas (n:23), craniopharyngiomas (n:16), suprasellar Rathke's cleft cyst (n:6), pituitary adenoma (n:2), fibrous dysplasia (n:1), infundibular granulosa cell tumor (n:2), and epidermoid tumor (n:2). Total resection was achieved in 17 of 23 (74%) with tuberculum sellae meningioma using infrachiasmatic approach. Twenty patients presented with visual disorders and 14 of them improved. There were two postoperative cerebrospinal fluid (CSF) leakages and one transient diabetes insipidus and one permanent diabetes insipidus. Sixteen patients were operated on by the infrachiasmatic approach for craniopharyngiomas. Improvement was reached in seven of eight patients presented with visual disorders. Complete tumor resection was performed in 10 of 16 cases and cyst aspiration in 4 cases, and there were remnants in two cases. Postoperative CSF leakage was seen in two patients. Infrachiasmatic corridor provides an easier and safer inferior route for the removal of middle midline skull base lesions in selected cases.

Role of Echocardiograghy in Treating a Case of Double Chamber Right Ventricle with Delayed Presentation.

PubMed

Barik, Ramachandra

2017-01-01

The clinical diagnosis of double chamber right ventricle (DCRV) is not straightforward. Clinical history, clinical examination, 12-lead electrocardiogram, chest X-ray, and Echocardiography (echo) contribute to morphological diagnosis. Cardiac catheterization is essential for hemodynamic evaluation. A thorough presurgical workup helps the cardiac surgeon to choose the appropriate surgical approach and timing of surgery in an individual case. We present a case of a DCRV who presented to us in the fifth decade of life. Echo confirmed the morphological diagnosis and cardiac catheterization complemented the exact pull back gradient across the obstruction in the right ventricle. This patient was suggested muscle bundle resection and ventricular septal defect closure using right atrial approach.

Sharing the Diagnostic Process in the Clinical Teaching Environment: A Case Study

ERIC Educational Resources Information Center

Cuello-Garcia; Carlos

2005-01-01

Revealing or visualizing the thinking involved in making clinical decisions is a challenge. A case study is presented with a visual implement for sharing the diagnostic process. This technique adapts the Bayesian approach to the case presentation. Pretest probabilities and likelihood ratios are gathered to obtain post-test probabilities of every…

A Case-Based Curriculum for Introductory Geology

ERIC Educational Resources Information Center

Goldsmith, David W.

2011-01-01

For the past 5 years I have been teaching my introductory geology class using a case-based method that promotes student engagement and inquiry. This article presents an explanation of how a case-based curriculum differs from a more traditional approach to the material. It also presents a statistical analysis of several years' worth of student…

How to improve the teaching of clinical reasoning: a narrative review and a proposal.

PubMed

Schmidt, Henk G; Mamede, Sílvia

2015-10-01

The development of clinical reasoning (CR) in students has traditionally been left to clinical rotations, which, however, often offer limited practice and suboptimal supervision. Medical schools begin to address these limitations by organising pre-clinical CR courses. The purpose of this paper is to review the variety of approaches employed in the teaching of CR and to present a proposal to improve these practices. We conducted a narrative review of the literature on teaching CR. To that end, we searched PubMed and Web of Science for papers published until June 2014. Additional publications were identified in the references cited in the initial papers. We used theoretical considerations to characterise approaches and noted empirical findings, when available. Of the 48 reviewed papers, only 24 reported empirical findings. The approaches to teaching CR were shown to vary on two dimensions. The first pertains to the way the case information is presented. The case is either unfolded to students gradually - the 'serial-cue' approach - or is presented in a 'whole-case' format. The second dimension concerns the purpose of the exercise: is its aim to help students acquire or apply knowledge, or is its purpose to teach students a way of thinking? The most prevalent approach is the serial-cue approach, perhaps because it tries to directly simulate the diagnostic activities of doctors. Evidence supporting its effectiveness is, however, lacking. There is some empirical evidence that whole-case, knowledge-oriented approaches contribute to the improvement of students' CR. However, thinking process-oriented approaches were shown to be largely ineffective. Based on research on how expertise develops in medicine, we argue that students in different phases of their training may benefit from different approaches to the teaching of CR. © 2015 John Wiley & Sons Ltd.

Approaches to Assessment in CLIL Classrooms: Two Case Studies

ERIC Educational Resources Information Center

O'Dwyer, Fergus; de Boer, Mark

2015-01-01

This article presents two case studies that show how learner involvement and collaboration in assessment are valid pedagogic tools to encourage learner reflection and engagement, particularly where a very traditional approach to language learning is the norm. The authors, who teach in universities in Japan, discuss different but related approaches…

Enhancing Leadership in Colleges and Universities: A Case Approach

ERIC Educational Resources Information Center

Sandeen, Arthur

2011-01-01

In view of the serious challenges facing college and university administrators, it is encouraging to note the increased interest in improving leadership knowledge and skills. This book presents an additional option to college and university administrators in their efforts to enhance their leadership skills. The case study approach to improving…

Case Studies of Water Utility Climate Change Vulnerability Assessment [External Review Draft Report

EPA Science Inventory

This report presents a series of case studies describing the approaches taken by four water utilities in the United States to assess their vulnerability to climate change. The report is not intended to be a comprehensive listing of assessment approaches or utilities conducting v...

An approach for integrating toxicogenomic data in risk assessment: The dibutyl phthalate case study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Euling, Susan Y., E-mail: euling.susan@epa.gov; Thompson, Chad M.; Chiu, Weihsueh A.

An approach for evaluating and integrating genomic data in chemical risk assessment was developed based on the lessons learned from performing a case study for the chemical dibutyl phthalate. A case study prototype approach was first developed in accordance with EPA guidance and recommendations of the scientific community. Dibutyl phthalate (DBP) was selected for the case study exercise. The scoping phase of the dibutyl phthalate case study was conducted by considering the available DBP genomic data, taken together with the entire data set, for whether they could inform various risk assessment aspects, such as toxicodynamics, toxicokinetics, and dose–response. A descriptionmore » of weighing the available dibutyl phthalate data set for utility in risk assessment provides an example for considering genomic data for future chemical assessments. As a result of conducting the scoping process, two questions—Do the DBP toxicogenomic data inform 1) the mechanisms or modes of action?, and 2) the interspecies differences in toxicodynamics?—were selected to focus the case study exercise. Principles of the general approach include considering the genomics data in conjunction with all other data to determine their ability to inform the various qualitative and/or quantitative aspects of risk assessment, and evaluating the relationship between the available genomic and toxicity outcome data with respect to study comparability and phenotypic anchoring. Based on experience from the DBP case study, recommendations and a general approach for integrating genomic data in chemical assessment were developed to advance the broader effort to utilize 21st century data in risk assessment. - Highlights: • Performed DBP case study for integrating genomic data in risk assessment • Present approach for considering genomic data in chemical risk assessment • Present recommendations for use of genomic data in chemical risk assessment.« less

Lingual Thyroid Carcinoma: A Case Report and Review of Surgical Approaches in the Literature.

PubMed

Stokes, William; Interval, Eric; Patel, Rusha

2018-07-01

Lingual thyroid cancer is a rare entity with a paucity of literature guiding methods of surgical treatment. Its location presents anatomic challenges with access and excision. We present a case of T4aN1b classical variant papillary thyroid carcinoma of the lingual thyroid that was removed without pharyngeal entry. We also present a review of the literature of this rare entity and propose a treatment algorithm to provide safe and oncologic outcomes. Our review of the literature found 28 case reports of lingual thyroid carcinoma that met search criteria. The trans-cervical/trans-hyoid approach was the most frequently used and provides safe oncologic outcomes. This was followed by the transoral approach and then lateral pharyngotomy. Complications reported across the series include 1 case of pharyngocutaneous fistula associated with mandibulotomy and postoperative respiratory distress requiring reintubation or emergent tracheostomy in 2 patients. The location of lingual thyroid carcinoma can be variable, and surgical management requires knowledge of adjacent involved structures to decrease the risk of dysphagia and airway compromise. In particular, for cases where there is extensive loss to swallowing mechanisms, laryngeal suspension can allow the patient to resume a normal diet after treatment.

Developing Emotion-Based Case Formulations: A Research-Informed Method.

PubMed

Pascual-Leone, Antonio; Kramer, Ueli

2017-01-01

New research-informed methods for case conceptualization that cut across traditional therapy approaches are increasingly popular. This paper presents a trans-theoretical approach to case formulation based on the research observations of emotion. The sequential model of emotional processing (Pascual-Leone & Greenberg, 2007) is a process research model that provides concrete markers for therapists to observe the emerging emotional development of their clients. We illustrate how this model can be used by clinicians to track change and provides a 'clinical map,' by which therapist may orient themselves in-session and plan treatment interventions. Emotional processing offers as a trans-theoretical framework for therapists who wish to conduct emotion-based case formulations. First, we present criteria for why this research model translates well into practice. Second, two contrasting case studies are presented to demonstrate the method. The model bridges research with practice by using client emotion as an axis of integration. Key Practitioner Message Process research on emotion can offer a template for therapists to make case formulations while using a range of treatment approaches. The sequential model of emotional processing provides a 'process map' of concrete markers for therapists to (1) observe the emerging emotional development of their clients, and (2) help therapists develop a treatment plan. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Treating powerless minorities through an ecosystem approach.

PubMed

Chung, W S; Pardeck, J T

1997-01-01

An ecological approach to social work practice for a minority based on an ecosystem-oriented assessment-intervention model is presented. Strengths and limitations of the ecological perspective for practice are emphasized (in the context of power dynamics). A case study is presented.

Metropolitan Forensic Anthropology Team (MFAT) studies in identification: 1. Race and sex assessment by discriminant function analysis of the postcranial skeleton.

PubMed

Taylor, J V; DiBennardo, R; Linares, G H; Goldman, A D; DeForest, P R

1984-07-01

A case study is presented to demonstrate the utility of the team approach to the identification of human remains, and to illustrate a methodological innovation developed by MFAT. Case 1 represents the first of several planned case studies, each designed to present new methodological solutions to standard problems in identification. The present case describes a test, by application, of race and sex assessment of the postcranial skeleton by discriminant function analysis.

Web Tools for Distributed Clinical Case Conferencing

PubMed Central

Lober, WB; Li, H; Trigg, LJ; Stewart, BK; Chou, D

2001-01-01

We have developed an information system to support distributed clinical case conferences held via video conferencing. The system has been designed by studying physicians of several specialties presenting hematology-oncology patients at Tumor Board. However, the principles of clinical case presentation are similar across many medical specialties, and we believe our approach has general applicability for presenting image and other clinical information, and organizing it for subsequent re-use in teaching files.

Exposure of the sciatic nerve in the gluteal region without sectioning the gluteus maximus: Analysis of a series of 18 cases

PubMed Central

Socolovsky, Mariano; Masi, Gilda Di

2012-01-01

Background: Dissecting through the gluteus maximus muscle by splitting its fibers, instead of complete sectioning of the muscle, is faster, involves less damage to tissues, and diminishes recovery time. The objective of the current paper is to present a clinical series of sciatic nerve lesions where the nerve was sufficiently exposed via the transgluteal approach. Methods: We retrospectively selected 18 traumatic sciatic nerve lesions within the buttock, operated upon from January 2005 to December 2009, with a minimum follow-up of 2 years. In all patients, a transgluteal approach was employed to explore and reconstruct the nerve. Results: Ten males and eight females, with a mean age of 39.7 years, were studied. The etiology of the nerve lesion was previous hip surgery (n = 7), stab wound (n = 4), gunshot wound (n = 3), injection (n = 3), and hip dislocation (n = 1). In 15 (83.3%) cases, a motor deficit was present; in 12 (66.6%) cases neuropathic pain and in 12 (66.6%) cases sensory alterations were present. In all cases, the transgluteal approach was adequate to expose the injury and treat it by neurolysis alone (10 cases), neurolysis and neurorrhaphy (4 cases), and reconstruction with grafts (4 cases; three of these paired with neurolysis). The mean pre- and postoperative grades for the tibial nerve (LSUHSC scale) were 1.6 and 3.6, respectively; meanwhile, for the peroneal division, preoperative grade was 1.2 and postoperative grade was 2.4. Conclusions: The transgluteal approach adequately exposes sciatic nerve injuries of traumatic origin in the buttock and allows for adequate nerve reconstruction without sectioning the gluteus maximus muscle. PMID:22439106

Role of Echocardiograghy in Treating a Case of Double Chamber Right Ventricle with Delayed Presentation

PubMed Central

Barik, Ramachandra

2017-01-01

The clinical diagnosis of double chamber right ventricle (DCRV) is not straightforward. Clinical history, clinical examination, 12-lead electrocardiogram, chest X-ray, and Echocardiography (echo) contribute to morphological diagnosis. Cardiac catheterization is essential for hemodynamic evaluation. A thorough presurgical workup helps the cardiac surgeon to choose the appropriate surgical approach and timing of surgery in an individual case. We present a case of a DCRV who presented to us in the fifth decade of life. Echo confirmed the morphological diagnosis and cardiac catheterization complemented the exact pull back gradient across the obstruction in the right ventricle. This patient was suggested muscle bundle resection and ventricular septal defect closure using right atrial approach. PMID:28465983

Case management considerations of progressive dementia in a home setting.

PubMed

Pierce, Mary Ellen

2010-01-01

Nursing theory, research, and best practice guidelines contribute substantially to the field of dementia care. Interventional plans are challenged most by those dementias considered progressive and deteriorative in nature, requiring ongoing reassessment and modification of care practices as the clinical course changes. The purpose of this article is to provide guidelines for case managers in the development of effective, individualized care plans for clients with progressive dementia residing in a home setting. The application of these guidelines is illustrated through the presentation of an actual case. The practice setting is a private home in the Pacific Northwest. Geriatric case management is provided by an RN case manager. Progressive dementia presents challenges to home care. Professional case management using comprehensive, holistic assessment, collaborative approaches, and best practice fundamentals serve to create an effective, individualized plan of care. The increasing geriatric population presents great opportunities for case managers in strategic management for creating successful home care models in clients with progressive dementia. Use of nursing diagnoses, dementia research, and collaborative approaches with families and other medical providers creates a viable alternative for clients with progressive dementia.

Developing Mathematics Teacher Knowledge: The Paradidactic Infrastructure of "Open Lesson" in Japan

ERIC Educational Resources Information Center

Miyakawa, Takeshi; Winslow, Carl

2013-01-01

In this paper, we first present a theoretical approach to study mathematics teacher knowledge and the conditions for developing it, which is firmly rooted in a systemic approach to didactic phenomena at large, namely the anthropological theory of the didactic. Then, a case of open lesson is presented and analysed, using this theoretical approach,…

The Interns Play: A Mimetic Approach to Introducing and Working with Countertransference in Professional Training

ERIC Educational Resources Information Center

DiMino, John L.

2009-01-01

An approach is presented that introduces the concept of countertransference to predoctoral interns and externs in a unique way during their professional training. This approach goes beyond a didactic presentation of the concept and even beyond discussion of case material in supervision. Through an experiential role-play process called Mimesis,…

Best practices in intercultural health: five case studies in Latin America.

PubMed

Mignone, Javier; Bartlett, Judith; O'Neil, John; Orchard, Treena

2007-09-05

The practice of integrating western and traditional indigenous medicine is fast becoming an accepted and more widely used approach in health care systems throughout the world. However, debates about intercultural health approaches have raised significant concerns. This paper reports findings of five case studies on intercultural health in Chile, Colombia, Ecuador, Guatemala, and Suriname. It presents summary information on each case study, comparatively analyzes the initiatives following four main analytical themes, and examines the case studies against a series of the best practice criteria.

An Explorative Learning Approach to Teaching Clinical Anatomy Using Student Generated Content

ERIC Educational Resources Information Center

Philip, Christo T.; Unruh, Kenneth P.; Lachman, Nirusha; Pawlina, Wojciech

2008-01-01

Translating basic sciences into a clinical framework has been approached through the implementation of various teaching techniques aimed at using a patient case scenario to facilitate learning. These techniques present students with a specific patient case and lead the students to discuss physiological processes through analysis of provided data…

And the Survey Says: The Case for Community Engagement

ERIC Educational Resources Information Center

Johnson, Paul A.

2009-01-01

Often superintendents and boards of education employ an expert-based, school-centered, "decide and defend" decision making approach when dealing with critical school district issues. In the case presented here, involving what to do with an historic school building, it is an approach that did not yield the result the superintendent or board of…

Continuum approach to the BF vacuum: The U(1) case

NASA Astrophysics Data System (ADS)

Drobiński, Patryk; Lewandowski, Jerzy

2017-12-01

A quantum representation of holonomies and exponentiated fluxes of a U(1) gauge theory that contains the Pullin-Dittrich-Geiller (DG) vacuum is presented and discussed. Our quantization is performed manifestly in a continuum theory, without any discretization. The discreteness emerges on the quantum level as a property of the spectrum of the quantum holonomy operators. The new type of a cylindrical consistency present in the DG approach now follows easily and naturally. A generalization to the non-Abelian case seems possible.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lundstrom, Blake; Chakraborty, Sudipta; Lauss, Georg

This paper presents a concise description of state-of-the-art real-time simulation-based testing methods and demonstrates how they can be used independently and/or in combination as an integrated development and validation approach for smart grid DERs and systems. A three-part case study demonstrating the application of this integrated approach at the different stages of development and validation of a system-integrated smart photovoltaic (PV) inverter is also presented. Laboratory testing results and perspectives from two international research laboratories are included in the case study.

Enhanced ergonomics approaches for product design: a user experience ecosystem perspective and case studies.

PubMed

Xu, Wei

2014-01-01

This paper first discusses the major inefficiencies faced in current human factors and ergonomics (HFE) approaches: (1) delivering an optimal end-to-end user experience (UX) to users of a solution across its solution lifecycle stages; (2) strategically influencing the product business and technology capability roadmaps from a UX perspective and (3) proactively identifying new market opportunities and influencing the platform architecture capabilities on which the UX of end products relies. In response to these challenges, three case studies are presented to demonstrate how enhanced ergonomics design approaches have effectively addressed the challenges faced in current HFE approaches. Then, the enhanced ergonomics design approaches are conceptualised by a user-experience ecosystem (UXE) framework, from a UX ecosystem perspective. Finally, evidence supporting the UXE, the advantage and the formalised process for executing UXE and methodological considerations are discussed. Practitioner Summary: This paper presents enhanced ergonomics approaches to product design via three case studies to effectively address current HFE challenges by leveraging a systematic end-to-end UX approach, UX roadmaps and emerging UX associated with prioritised user needs and usages. Thus, HFE professionals can be more strategic, creative and influential.

Standing up to the black cloud: case example of narrative therapy in the motor vehicle sector.

PubMed

Gibson, Michelle

2015-01-01

Using a case study, this article presents narrative therapy as an effective psychotherapy practice for work with victims of motor vehicle accidents. By troubling the standard cognitive behavioral approaches as deficit focused, narrative therapy is outlined as an approach that is focused on the skills and values present in the client's life; it is an approach that allows the client to take authorship over his or her concerns and enact change. This article is meant to be an example of narrative therapy's usefulness and open space for conversation about rehabilitation therapies that focus less on structure and more on strength.

Laryngopyocele: report of a rare case and systematic review.

PubMed

Al-Yahya, Syarifah N; Baki, Marina Mat; Saad, Sakina Mohd; Azman, Mawaddah; Mohamad, Abdullah Sani

2016-01-01

A systematic review on laryngopyoceles across Ovid, PubMed, and Google Scholar database was conducted. A total of 61 papers published between 1952 and 2015 were found. Of these, 23 cases written in English, which described the number of cases, surgical approaches, resort to tracheostomy, complications, and outcomes, were shortlisted. Four cases of laryngopyoceles were managed endoscopically using a cold instrument, microdebrider, or laser. Eighteen cases were operated via an external approach, and 1 case applied both approaches. One of 4 endoscopic and 10 of 18 external approaches involved tracheostomy. The present study aimed to report a case of large mixed laryngopyocele that was successfully drained and marsupialized endoscopically using suction diathermy without requiring tracheostomy. Management using suction diathermy for excision and marsupialization of a laryngopyocele has never been reported and can be recommended as a feasible method due to its widespread availability. In the presence of a large laryngopyocele impeding the airway, tracheostomy may be averted in a controlled setting. None specified.

Methodology or method? A critical review of qualitative case study reports.

PubMed

Hyett, Nerida; Kenny, Amanda; Dickson-Swift, Virginia

2014-01-01

Despite on-going debate about credibility, and reported limitations in comparison to other approaches, case study is an increasingly popular approach among qualitative researchers. We critically analysed the methodological descriptions of published case studies. Three high-impact qualitative methods journals were searched to locate case studies published in the past 5 years; 34 were selected for analysis. Articles were categorized as health and health services (n=12), social sciences and anthropology (n=7), or methods (n=15) case studies. The articles were reviewed using an adapted version of established criteria to determine whether adequate methodological justification was present, and if study aims, methods, and reported findings were consistent with a qualitative case study approach. Findings were grouped into five themes outlining key methodological issues: case study methodology or method, case of something particular and case selection, contextually bound case study, researcher and case interactions and triangulation, and study design inconsistent with methodology reported. Improved reporting of case studies by qualitative researchers will advance the methodology for the benefit of researchers and practitioners.

Appendicular Mucocele: Possibilities and Limits of Laparoscopy. Brief Series and Review of the Literature.

PubMed

Tărcoveanu, E; Vasilescu, A; Hee, R Van; Moldovanu, R; Ursulescu, C; Ciobanu, D; Bradea, C

2015-01-01

Appendicular mucocele, a cystic dilatation of the appendix, is a rare disease, but unfortunately about 1/10 of cases evolves into pseudomyxoma peritonei. We performed a prospective study between 1 January 2010 to 31 December 2014 in order to track the incidence, symptoms, and circumstances of diagnosis, treatment and evolution of these rare tumors. A total of seven patients underwent curative surgery for a mucocele of the appendix: one woman and six men with an average age of 59.71 years. Clinical signs, present in two cases, were uncharacteristic. Ultrasound performed in all cases, could guide diagnosis in 5 cases. CT performed in 5 cases diagnosed only two cases. All cases were operated on: the open approach was used in four cases and a minimally invasive in three cases. We performed two right colectomies, an open appendectomy associated to anterior resection of the rectum, two laparoscopic appendectomies and two appendectomies and cecum resection with stapler, one by open approach and one by a minimally invasive approach. Intraoperative spillage of mucinous tumor did not occur in any case. The mean hospital stay was 5.7 days. Postoperative complications were present in 1 case (14.2%): wound infection. The average follow-up period was 40.28 months. (Range 6 to 48 months). No tumor recurrence or readmission, such as pseudomyxoma peritonei, has occurred. Appendicular mucocele is a rare entity; it can be found incidentally and it can mimic acute appendicitis, appendicular plastron or cecum tumor. Once diagnosed, surgical treatment is required for fear of perforation, tumor evolution and the emergence of the rule of complications. Laparoscopic approach in selected cases can be used, accompanied by safety measures to avoid iatrogenic perforation and peritoneal and parietal seeding. Celsius.

A treatment-oriented typology of self-identified hypersexuality referrals.

PubMed

Cantor, James M; Klein, Carolin; Lykins, Amy; Rullo, Jordan E; Thaler, Lea; Walling, Bobbi R

2013-07-01

Men and women have been seeking professional assistance to help control hypersexual urges and behaviors since the nineteenth century. Despite that the literature emphasizes that cases of hypersexuality are highly diverse with regard to clinical presentation and comorbid features, the major models for understanding and treating hypersexuality employ a "one size fits all" approach. That is, rather than identify which problematic behaviors might respond best to which interventions, existing approaches presume or assert without evidence that all cases of hypersexuality (however termed or defined) represent the same underlying problem and merit the same approach to intervention. The present article instead provides a typology of hypersexuality referrals that links individual clinical profiles or symptom clusters to individual treatment suggestions. Case vignettes are provided to illustrate the most common profiles of hypersexuality referral that presented to a large, hospital-based sexual behaviors clinic, including: (1) Paraphilic Hypersexuality, (2) Avoidant Masturbation, (3) Chronic Adultery, (4) Sexual Guilt, (5) the Designated Patient, and (6) better accounted for as a symptom of another condition.

Primary aneurysmal bone cyst of coronoid process

PubMed Central

Goyal, Amit; Tyagi, Isha; Syal, Rajan; Agrawal, Tanu; Jain, Manoj

2006-01-01

Background Aneurysmal bone cysts are relatively uncommon in the facial skeleton. These usually affect the mandible but origin from the coronoid process is even rarer. To the best of our knowledge, this is the first reported case of a coronoid process aneurysmal bone cyst presenting as temporal fossa swelling. Case presentation A 17 year old boy presented with a progressively increasing swelling in the left temporal region developed over the previous 8 months. An expansile lytic cystic lesion originating from the coronoid process of the left mandible and extending into the infratemporal and temporal fossa regions was found on CT scan. It was removed by a superior approach to the infratemporal fossa. Conclusion Aneurysmal bone cyst of the coronoid process can attain enormous dimensions until the temporal region is also involved. A superior approach to the infratemporal fossa is a reasonable approach for such cases, providing wide exposure and access to all parts of the lesion and ensuring better control and complete excision. PMID:16533409

Neurosurgical management of anterior meningo-encephaloceles about 60 cases

PubMed Central

Rifi, Loubna; Barkat, Amina; El Khamlichi, Abdeslam; Boulaadas, Malek; El Ouahabi, Abdessamad

2015-01-01

Anterior meningo-encephaloceles (AME) are congenital malformations characterized by herniation of brain tissue and meninges through a defect in the cranium, in frontal, orbital, nasal and ethmoidal regions. The management of this complex congenital malformation is controversial according to whether use, an intracranial, extra-cranial or combined approach. This is the first largest series published in Africa, in which we present our experience in the operative management of AME; we share our recommendation in technical consideration for surgical approach with review of the literature. All patients beneficed of neuro-radiological investigations including Plan X rays, Spiral Three dimensional CT scan and MRI. Ophthalmologic and maxillo-facial evaluations were done in all the cases. MEA are surgically approached in various ways, mainly on the basis of its location and type, by cranio-facial approach in one-step, or in two stages by intracranial approach followed by facial approach, only by cranial approach or facial approach. The surgical results were evaluated in the follow up on the basis of disappearance of cranio-facial tumefaction with correction of hypertelorism. 60 children with AME were treated in our department between January 1992 and December 2012. The mean age at time of surgery was 14 months (20 days to 18 years) with slight men predominance (28 females/32 males). Cranio-facial team operated 21 patients, 16 were operated in two stages by intracranial approach followed by facial approach, 20 cases beneficed the neurosurgical approach and three only the facial approach Some post operative complications were observed: 2 cases of post operative hydrocephalus underwent shunt; CSF fistulas in three cases cured by spinal drainage, one death due to per operative hypothermia, 3 cases of recurrence how needed second surgery. After mean follow up for 80 months (1 year to 19 years) theses techniques permitted a good cosmetics results in 42 cases, average cosmetics results in 8 cases, poor results in 5 cases and worse cosmetics results in 4 cases, The AME are rare conditions we used the multiples approach first intracranial approach followed by facial approach, but after 1998 we used one-step correction by combined approach, only cranial approach when needed or facial correction. PMID:26448810

Charting Collective Knowledge: Supporting Self-Regulated Learning in the Workplace

ERIC Educational Resources Information Center

Littlejohn, Allison; Milligan, Colin; Margaryan, Anoush

2012-01-01

Purpose: This study aims to outline an approach to improving the effectiveness of work-based learning through knowledge creation and enhancing self-regulated learning. The paper presents a case example of a novel approach to learning through knowledge creation in the workplace. This case example is based on empirical data collected through a study…

A robust approach to using of the redundant information in the temperature calibration

NASA Astrophysics Data System (ADS)

Strnad, R.; Kňazovická, L.; Šindelář, M.; Kukal, J.

2013-09-01

In the calibration laboratories are used standard procedures for calculating of the calibration model coefficients based on well described standards (EN 60751, ITS-90, EN 60584, etc.). In practice, sensors are mostly calibrated in more points and redundant information is used as a validation of the model. This paper will present the influence of including all measured points with respect to their uncertainties to the measured models using standard weighted least square methods. A special case with regards of the different level of the uncertainty of the measured points in case of the robust approach will be discussed. This will go to the different minimization criteria and different uncertainty propagation methodology. This approach also will eliminate of the influence of the outline measurements in the calibration. In practical part will be three cases of this approach presented, namely industrial calibration according to the standard EN 60751, SPRT according to the ITS-90 and thermocouple according to the standard EN 60584.

Case Series in Cognitive Neuropsychology: Promise, Perils and Proper Perspective

PubMed Central

Rapp, Brenda

2012-01-01

Schwartz & Dell (2010) advocated for a major role for case series investigations in cognitive neuropsychology. They defined the key features of this approach and presented a number of arguments and examples illustrating the benefits of case series studies and their contribution to computational cognitive neuropsychology. In the Special Issue on “Case Series in Cognitive Neuropsychology” there are six commentaries on Schwartz and Dell (2010) as well as a response to the six commentaries by Dell and Schwartz. In this paper, I provide a brief summary of the key points made in Schwartz and Dell (2010) and I review the promise and perils of case series design as revealed by the six commentaries. I conclude by placing the set of papers within a broader perspective, providing some clarification of the historical record on case series and single case approaches, raising some cautionary notes for case series studies and situating both case series and single case approaches within the larger context of theory development in the cognitive sciences. PMID:22746685

Universal Quantification in a Constraint-Based Planner

NASA Technical Reports Server (NTRS)

Golden, Keith; Frank, Jeremy; Clancy, Daniel (Technical Monitor)

2002-01-01

Constraints and universal quantification are both useful in planning, but handling universally quantified constraints presents some novel challenges. We present a general approach to proving the validity of universally quantified constraints. The approach essentially consists of checking that the constraint is not violated for all members of the universe. We show that this approach can sometimes be applied even when variable domains are infinite, and we present some useful special cases where this can be done efficiently.

Best practices in intercultural health: five case studies in Latin America

PubMed Central

Mignone, Javier; Bartlett, Judith; O'Neil, John; Orchard, Treena

2007-01-01

The practice of integrating western and traditional indigenous medicine is fast becoming an accepted and more widely used approach in health care systems throughout the world. However, debates about intercultural health approaches have raised significant concerns. This paper reports findings of five case studies on intercultural health in Chile, Colombia, Ecuador, Guatemala, and Suriname. It presents summary information on each case study, comparatively analyzes the initiatives following four main analytical themes, and examines the case studies against a series of the best practice criteria. PMID:17803820

Designed for Learning: A Case Study in Rethinking Teaching and Learning for a Large First Year Class

ERIC Educational Resources Information Center

Goldacre, Lisa; Bolt, Susan; Lambiris, Michael

2013-01-01

This paper presents a case study in which the principles of scholarship were applied to designing an approach to learning suitable for large classes. While this case study describes an Australian first year Business Law unit, the findings presented in this paper would be relevant to a wide range of teachers faced with large enrollments in first…

Utilization of the Safe Surgical Dislocation Approach of the Hip to Retrieve a Bullet from the Femoral Head

PubMed Central

Delaney, Ruth; Albright, Maurice; Rebello, Gleeson

2011-01-01

Retained intra-articular missiles from low-velocity handguns can lead to mechanical arthritis, synovitis, and lead toxicity. Various surgical approaches have been described to extract such foreign bodies from the hip joint. We present the case of a 17-year-old male in which the surgical dislocation approach was utilized to retrieve a bullet from the femoral head with a good short-term outcome. This case represents a rare application of the surgical hip dislocation approach for an unusual trauma. PMID:23198205

Resolving Relationship Problems in Communication Disorders Treatment: A Systems Approach.

ERIC Educational Resources Information Center

Stone, Judith R.

1992-01-01

Systems concepts from general systems theory and family therapy literature are presented as analytical tools to help professionals understand and change interactions with their clients having communication disorders. Two case examples that illustrate relationship problems are presented, and approaches taken to their resolution are described.…

Sudden suffocation with cancer of unknown primary: a case report and review of diagnostic approach.

PubMed

Tehrani, Omid S; Ahmad, Omar; Vypritskaya, Ekaterina; Chen, Emily; Hasan, Saba

2012-10-01

A case of a 31-year-old woman with sudden respiratory distress is presented. Preliminary evaluations and imaging studies did not reveal the underlying cause. Workup during hospital stay showed advanced metastatic cancer of unknown primary origin. This is an unusual presentation of cancer of an unknown primary involving the thyroid with sudden suffocation. It suggests that malignancies involving the thyroid gland should be considered in patients with abrupt onset of respiratory distress. Also, this case shows the application of fine needle aspiration in diffuse thyroid enlargements mimicking thyroiditis without nodules. Diagnostic approach to cancer of unknown primary origin (CUP) is reviewed in further detail.

Key practices for implementing geospatial technologies for a planning and environment linkages (PEL) approach

DOT National Transportation Integrated Search

2008-07-01

This report presents three case studies that illustrate how geographic information systems (GIS) have been used to implement the Federal Highway Administrations (FHWA) Planning and Environment Linkages (PEL) approach. The PEL approach provides inf...

The combined endonasal and transoral approach for the management of skull base and nasopharyngeal pathology: a case series.

PubMed

Sreenath, Satyan B; Rawal, Rounak B; Zanation, Adam M

2014-01-01

The posterior skull base and the nasopharynx have historically represented technically difficult regions to approach surgically given their central anatomical locations. Through continued improvements in endoscopic instrumentation and technology, the expanded endonasal approach (EEA) has introduced a new array of surgical options in the management of pathology involving these anatomically complex areas. Similarly, the transoral robotic surgical (TORS) approach was introduced as a minimally invasive surgical option to approach tongue base, nasopharyngeal, parapharyngeal, and laryngeal lesions. Although both the EEA and the TORS approach have been extensively described as viable surgical options in managing nasopharyngeal and centrally located head and neck pathology, both endonasal and transoral techniques have inherent limitations. Given these limitations, several institutions have published feasibility studies with the combined EEA and TORS approaches for a variety of skull base and nasopharyngeal pathologies. In this article, the authors present their clinical experience with the combined endonasal and transoral approach through a case series presentation, and discuss advantages and limitations of this approach for surgical management of the middle and posterior skull base and nasopharynx. In addition, a presentation is included of a unique, simultaneous endonasal and transoral dissection of the nasopharynx through an innovative intraoperative setup.

Combined Interhemispheric and Transsylvian Approach for Resection of Craniopharyngioma.

PubMed

Inoue, Tomohiro; Ono, Hideaki; Tamura, Akira; Saito, Isamu

2018-04-01

We present a 37-year-old male case of cystic suprasellar huge craniopharyngioma, who presented with significant memory disturbance due to obstructive hydrocephalus. Combined interhemispheric and pterional approach was chosen to resect huge suprasellar tumor. Interhemispheric trans-lamina terminalis approach was quite effective to resect third ventricular tumor, while pterional approach was useful to dissect tumor out of basilar perforators and stalk. The link to the video can be found at: https://youtu.be/BoYIPa96kdo .

A Patient Presenting with Cardiac Tamponade and the Challenges of Finding Its Cause: A Cardiac Angiosarcoma.

PubMed

Habibi, Roshanak; Faramarzi, Negar; Altamirano, Alvaro J; Dadkhah, Shahriar

2018-01-01

Primary malignancies of the heart are so rare that most of the available data come from case reports or large single-center-based studies, with the overall incidence of 0.02% in the United States. Diagnosis in case of an isolated pericardial effusion as presentation is challenging, and determining that an angiosarcoma is even more challenging. Here, we presented a rare case of pericardial angiosarcoma which presented to us with tamponade. The patient eventually was diagnosed through pericardiectomy. A multimodality approach was attempted to treat the cancer. The clinical details of such a unique disease entity inspired us to present it as a case report.

Chondrosarcoma of the nasal septum: A case report.

PubMed

Kainuma, Kazuyuki; Netsu, Kiminori; Asamura, Kenji; Hayashi, Keiko; Takumi, Yutaka; Ota, Hiroyoshi; Usami, Shin-ichi

2009-10-01

Chondrosarcoma make up only 10-20% of malignant primary bone tumors, with 5-10% located in the head and neck (Downey TJ, Clark SK, Moore DW. Chondrosarcoma of the nasal septum. Otolaryngol Head Neck Surg 2001;125:98-100), and nasal septal chondrosarcoma is extremely rare. Surgical excision is the only curative treatment and radiation and chemotherapy have a limited role for palliation. We used a navigation system in endoscopic surgery without complications for a case of chondrosarcoma of the nasal septum by means of a midfacial degloving approach at primary operation and an external incision approach at salvage operation for local recurrence. To our knowledge, this is the first report of the use of such a system for this surgical approach along with a salvage operation. We discuss the clinical presentation, diagnosis, and treatment of this case as well as present a review of the literature.

Angiomyolipoma of the Liver: A Rare Benign Tumor Treated with a Laparoscopic Approach for the First Time.

PubMed Central

DAMASKOS, CHRISTOS; GARMPIS, NIKOLAOS; ANNA, GARMPI; NONNI, AFRODITI; SAKELLARIOU, STRATIGOULA; MARGONIS, GEORGIOS-ANTONIOS; SPARTALIS, ELEFTHERIOS; SCHIZAS, DIMITRIOS; ANDREATOS, NIKOLAOS; MAGKOUTI, ELENI; GRIVAS, ALEXANDROS; KONTZOGLOU, KONSTANTINOS; ANTONIOU, A. EFSTATHIOS

2017-01-01

Background/Aim: Epithelioid angiomyolipoma of the liver is a rare benign mesenchymal tumor that usually presents in adult female patients. It most frequently occurs in the kidney, with the liver being the second most common site of involvement. Angiomyolipoma belongs to a family of tumors arising from perivascular epithelioid cells but in rare cases may also have cystic features. We report our experience via the first case of hepatic angiomyolipoma treated by laparoscopic approach. Patients and Methods: We present the case of a 50-year old female patient complaining of abdominal pain. Abdominal ultrasound (US) and Magnetic Resonance Imaging (MRI) revealed a 5x3cm mass located in the left liver lobe. The tumor was resected with a laparoscopic approach. Microscopic examination of the tumor revealed hepatic angiomyolipoma. Results: Twenty-seven months postoperatively, the patient remains fit and healthy. Conclusion: Angiomyolipoma can be removed by laparoscopy. PMID:29102941

A "Great Roads" Approach to Teaching Modern World History and Latin American Regional Survey Courses: A Veracruz to Mexico City Case Study.

ERIC Educational Resources Information Center

Brown, James Seay, Jr.; Sullivan-Gonzalez, Douglass

2002-01-01

Outlines an innovative way of teaching "World History Since 1500" at Samford University (Birmingham, Alabama) called the "great roads" approach, centered upon important roads in a country's history. Presents the "Veracruz to Mexico City corridor" case study used to teach a Latin American modern history course. (CMK)

Bridging the Research to Practice Gap: A Case Study Approach to Understanding EIBI Supports and Barriers in Swedish Preschools

ERIC Educational Resources Information Center

Roll-Pettersson, Lise; Olsson, Ingrid; Ala'i-Rosales, Shahla

2016-01-01

The present study examined proximal and distal barriers and supports within the Swedish service system that may affect implementation of early and intensive behavioral intervention (EIBI) for children with autism. A case study approach with roots in ethnography was chosen to explore this issue. Two preschools exemplifying "high quality…

Computation of transonic separated wing flows using an Euler/Navier-Stokes zonal approach

NASA Technical Reports Server (NTRS)

Kaynak, Uenver; Holst, Terry L.; Cantwell, Brian J.

1986-01-01

A computer program called Transonic Navier Stokes (TNS) has been developed which solves the Euler/Navier-Stokes equations around wings using a zonal grid approach. In the present zonal scheme, the physical domain of interest is divided into several subdomains called zones and the governing equations are solved interactively. The advantages of the Zonal Grid approach are as follows: (1) the grid for any subdomain can be generated easily; (2) grids can be, in a sense, adapted to the solution; (3) different equation sets can be used in different zones; and, (4) this approach allows for a convenient data base organization scheme. Using this code, separated flows on a NACA 0012 section wing and on the NASA Ames WING C have been computed. First, the effects of turbulence and artificial dissipation models incorporated into the code are assessed by comparing the TNS results with other CFD codes and experiments. Then a series of flow cases is described where data are available. The computed results, including cases with shock-induced separation, are in good agreement with experimental data. Finally, some futuristic cases are presented to demonstrate the abilities of the code for massively separated cases which do not have experimental data.

Methodology or method? A critical review of qualitative case study reports

PubMed Central

Hyett, Nerida; Kenny, Amanda; Dickson-Swift, Virginia

2014-01-01

Despite on-going debate about credibility, and reported limitations in comparison to other approaches, case study is an increasingly popular approach among qualitative researchers. We critically analysed the methodological descriptions of published case studies. Three high-impact qualitative methods journals were searched to locate case studies published in the past 5 years; 34 were selected for analysis. Articles were categorized as health and health services (n=12), social sciences and anthropology (n=7), or methods (n=15) case studies. The articles were reviewed using an adapted version of established criteria to determine whether adequate methodological justification was present, and if study aims, methods, and reported findings were consistent with a qualitative case study approach. Findings were grouped into five themes outlining key methodological issues: case study methodology or method, case of something particular and case selection, contextually bound case study, researcher and case interactions and triangulation, and study design inconsistent with methodology reported. Improved reporting of case studies by qualitative researchers will advance the methodology for the benefit of researchers and practitioners. PMID:24809980

SU-F-E-15: Initial Experience Implementing a Case Method Teaching Approach to Radiation Oncology Physics Residents, Graduate Students and Doctorate of Medical Physics Students

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gutierrez, A

Purpose: Case Method Teaching approach is a teaching tool used commonly in business school to challenge students with real-world situations—i.e. cases. The students are placed in the role of the decision maker and have to provide a solution based on the multitude of information provided. Specifically, students must develop an ability to quickly make sense of a complex problem, provide a solution incorporating all of the objectives (at time conflicting) and constraints, and communicate that solution in a succinct, professional and effective manner. The validity of the solution is highly dependent on the auxiliary information provided in the case andmore » the basic didactic knowledge of the student. A Case Method Teaching approach was developed and implemented into an on-going course focused on AAPM Task Group reports at UTHSCSA. Methods: A current course at UTHSCSA reviews and discusses 15 AAPM Task Group reports per semester. The course is structured into three topic modules: Imaging QA, Stereotactic Radiotherapy, and Special Patient Measurements—i.e. pacemakers, fetal dose. After a topic module is complete, the students are divided into groups (2–3 people) and are asked to review a case study related to the module topic. Students then provide a solution presented in an executive summary and class presentation. Results: Case studies were created to address each module topic. Through team work and whole-class discussion, a collaborative learning environment was established. Students additionally learned concepts such vendor relations, financial negotiations, capital project management, and competitive strategy. Conclusion: Case Method Teaching approach is an effective teaching tool to further enhance the learning experience of radiation oncology physics students by presenting them with though-provoking dilemmas that require students to distinguish pertinent from peripheral information, formulate strategies and recommendations for action, and confront obstacles to implementation.« less

Spontaneous Intrahepatic Portal Venous Shunt: Presentation and Endovascular Treatment.

PubMed

Sheth, Nakul; Sabbah, Nathanael; Contractor, Sohail

2016-07-01

Spontaneous intrahepatic portal venous shunts are rare with only few case reports published. Treatments using various endovascular techniques have been described, although no single technique has been shown to be preferred. We present a patient who was referred for treatment of a spontaneous portal venous shunt and describe our treatment approach and present a review on previously reported cases. © The Author(s) 2016.

Is There Life on Mars?

ERIC Educational Resources Information Center

Allen, Bruce C.; Herreid, Clyde Freeman

1998-01-01

Presents a conflict scenario for a case study on whether there is evidence of past life on Mars. Includes details about the use of this case study in developing an interdisciplinary approach to scientific ethics. (DDR)

Combining Campbell Standards and the Realist Evaluation Approach: The Best of Two Worlds?

ERIC Educational Resources Information Center

van der Knaap, Leontien M.; Leeuw, Frans L.; Bogaerts, Stefan; Nijssen, Laura T. J.

2008-01-01

This article presents an approach to systematic reviews that combines the Campbell Collaboration Crime and Justice standards and the realist notion of contexts-mechanisms-outcomes (CMO) configurations. Both approaches have their advantages and drawbacks, and the authors will make a case for combining both approaches to profit from their advantages…

Rectangular Relief Diffraction Gratings for Coherent Lidar Beam Scanning

NASA Technical Reports Server (NTRS)

Cole, H. J.; Chambers, D. M.; Dixit, S. N.; Britten, J. A.; Shore, B. W.; Kavaya, M. J.

1999-01-01

The application of specialized rectangular relief transmission gratings to coherent lidar beam scanning is presented. Two types of surface relief transmission grating approaches are studied with an eye toward potential insertion of a constant thickness, diffractive scanner where refractive wedges now exist. The first diffractive approach uses vertically oriented relief structure in the surface of an optical flat; illumination of the diffractive scanner is off-normal in nature. The second grating design case describes rectangular relief structure slanted at a prescribed angle with respect to the surface. In this case, illumination is normal to the diffractive scanner. In both cases, performance predictions for 2.0 micron, circularly polarized light at beam deflection angles of 30 or 45 degrees are presented.

Multiple Myeloma and Epidural Spinal Cord Compression : Case Presentation and a Spine Surgeon's Perspective

PubMed Central

Ha, Kee-Yong; Kim, Hyun-Woo

2013-01-01

Multiple myeloma, a multicentric hematological malignancy, is the most common primary tumor of the spine. As epidural myeloma causing spinal cord compression is a rare condition, its therapeutic approach and clinical results have been reported to be diverse, and no clear guidelines for therapeutic decision have been established. Three patients presented with progressive paraplegia and sensory disturbance. Image and serological studies revealed multiple myeloma and spinal cord compression caused by epidural myeloma. Emergency radiotherapy and steroid therapy were performed in all three cases. However, their clinical courses and results were distinctly different. Following review of our cases and the related literature, we suggest a systematic therapeutic approach for these patients to achieve better clinical results. PMID:24175035

Teaching Business French through Case Studies: Presentation of a Marketing Case.

ERIC Educational Resources Information Center

Federico, Salvatore; Moore, Catherine

The use of case studies as a means for teaching business French is discussed. The approach is advocated because of the realism of case studies, which are based on actual occurrences. Characteristics of a good case are noted: it tells a story, focuses on interest-arousing issues, is set in the past 10 years, permits empathy with the main…

Endoscopic Evacuation of Basal Ganglia Hemorrhage via Keyhole Approach Using an Adjustable Cannula in Comparison with Craniotomy

PubMed Central

Zhang, Heng-Zhu; Li, Yu-Ping; Yan, Zheng-cun; Wang, Xing-dong; She, Lei; Wang, Xiao-dong; Dong, Lun

2014-01-01

Neuroendoscopic (NE) surgery as a minimal invasive treatment for basal ganglia hemorrhage is a promising approach. The present study aims to evaluate the efficacy and safety of NE approach using an adjustable cannula to treat basal ganglia hemorrhage. In this study, we analysed the clinical and radiographic outcomes between NE group (21 cases) and craniotomy group (30 cases). The results indicated that NE surgery might be an effective and safe approach for basal ganglia haemorrhage, and it is also suggested that NE approach may improve good functional recovery. However, NE approach only suits the selected patient, and the usefulness of NE approach needs further randomized controlled trials (RCTs) to evaluate. PMID:24949476

Results of transnasal transostial sphenoidotomy in 79 cases of chronic sphenoid sinusitis.

PubMed

Massoubre, J; Saroul, N; Vokwely, J-E; Lietin, B; Mom, T; Gilain, L

2016-09-01

This study was designed to retrospectively review the postoperative results of transnasal transostial sphenoidotomy in 79 patients with isolated chronic sphenoid sinusitis operated between 1995 and 2013 and evaluate the recurrence rate due to postoperative closure of the sphenoidotomy. Seventy-nine patients, 44 women and 35 men (M:F sex ratio: 0.79) aged 10 to 84 years (mean age: 48), were included. The most common presenting symptom was headache in 61% of cases. Visual disturbances were present in three cases. The diagnostic work-up comprised nasal endoscopy, computed tomography (CT) and magnetic resonance imaging (MRI) of the sinuses. The surgical indication was based on failure of antibiotic therapy and/or the nature and severity of sphenoid sinusitis. All patients were operated by endoscopic transnasal transostial sphenoidotomy. Samples were taken for histological, bacteriological and mycological examination. No intraoperative or immediate postoperative complications were observed. Nature of the lesion: forty-seven patients (59.5%) presented nonspecific inflammatory lesions with negative bacterial or fungal culture and inflammatory mucosal changes, 19 patients (24%) had fungal sinusitis presenting as a fungus ball and 13 patients (16.4%) had documented bacterial sinusitis. Mean postoperative follow-up was 7.4 months (range: 6-48). No recurrence of the sinusitis or symptoms was observed in 71 cases (89.8%). Recurrence: eight cases (10.2%) of postoperative closure of the sphenoidotomy were observed, requiring one (6 cases) or several (2 cases) reoperations with a mean of 16.4 months after the initial procedure. Symptoms of recurrence consisted of varying degrees of headache, with similar symptoms to those of the first episode in 7 cases, and retro-orbital headache in 1 case. Reoperation was performed via a transnasal transostial approach in 6 cases and a transethmoidal approach in 2 cases. The transnasal transostial surgical approach is a safe and effective procedure for the treatment of isolated sphenoid sinusitis. However, the recurrence rate due to postoperative closure of the sphenoidotomy observed in our series raises the question of postoperative maintenance of a patent and functional sphenoidotomy. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

A multimedia case based approach to the study of office ergonomics.

PubMed

August-Dalfen, Sharon; Snider, Laurie

2003-01-01

Multimedia technology has the capacity to provide students with an interactive approach to problem based learning and to bridge the gap between theoretical knowledge and clinical practice. The present paper describes the design and development of the program ErgoROM, a CD which presents a case study to assist occupational therapy students in their studies of office ergonomics. A pilot study showed that overall, 91% of respondents rated the ErgoROM as either "Excellent" or "Very Good". Additionally they reported that ErgoROM had a positive impact on active learning and critical thinking.

Supracervical hysterectomy - the vaginal route.

PubMed

Wilczyński, Miłosz; Cieślak, Jarosław; Malinowski, Andrzej

2014-06-01

Removal of the cervix during hysterectomy is not mandatory. There has been no irrefutable evidence so far that total hysterectomy is more beneficial to patients in terms of pelvic organ function. The procedure that leaves the cervix intact is called a subtotal hysterectomy. Traditional approaches to this surgery include laparoscopic and abdominal routes. Vaginal total hysterectomy has been proven to present many advantages over the other approaches. Therefore, it seems that this route should also be applied in the case of subtotal hysterectomy. We present 9 cases of patients who underwent subtotal hysterectomy performed through the vagina for benign gynecological diseases.

Recovering Process from Child Sexual Abuse During Adulthood from an Integrative Approach to Solution-Focused Therapy: A Case Study.

PubMed

Gonzalez, Carolina

2017-10-01

In recent times, strengths-based recovery approaches that focus on the present and build strategies that look toward the future have become popular. However, some cases require the consideration of experiences from previous stages of the clients' development. This single-case study explores the psychotherapeutic process of a middle-aged woman who presented with a history of child sexual abuse (incest) and a long-term adult diagnosis of depression that was treated in public health services. This psychotherapy involved an integrative approach to solution-focused therapy; specifically, the approach proposed by Yvonne Dolan to work with adult survivors of sexual abuse, in conjunction with techniques and strategies from the transtheoretical model. Measures incorporating therapeutic working alliance and outcomes were administered over sessions. Results showed positive outcomes from this therapeutic intervention, which remained at 3-month and 12-month follow-ups. Implications for practitioners' specialist practice in health services are discussed, given the complexity of comorbid mental health conditions with a history of child sexual abuse.

Many roads may lead to Rome: Selected features of quality control within environmental assessment systems in the US, NL, CA, and UK

DOE Office of Scientific and Technical Information (OSTI.GOV)

Günther, Markus, E-mail: markus.guenther@tu-berlin.de; Geißler, Gesa; Köppel, Johann

As there is no one-and-only concept on how to precisely define and establish quality control (QC) or quality assurance (QA) in the making of environmental assessments (EA), this paper presents selected features of international approaches that address quality in EA systems in the USA, the Netherlands, Canada, and the United Kingdom. Based on explanative case studies, we highlight the embedding of specific quality control features within the EA systems, the objectives and processes, and relevant transparency challenges. Such features of QC/QA approaches can be considered in cases where substantial quality control and assurance efforts are still missing. Yet further researchmore » needs to be conducted on the efficacy of these approaches, which remains beyond the scope of this study. - Highlights: • We present four tools for quality control and assurance from different EA systems. • Approaches vary in institutional setting, objectives, procedures, and transparency. • Highlighted features might provide guidance in cases where QC/QA is still lacking.« less

Development and application of computational aerothermodynamics flowfield computer codes

NASA Technical Reports Server (NTRS)

Venkatapathy, Ethiraj

1993-01-01

Computations are presented for one-dimensional, strong shock waves that are typical of those that form in front of a reentering spacecraft. The fluid mechanics and thermochemistry are modeled using two different approaches. The first employs traditional continuum techniques in solving the Navier-Stokes equations. The second-approach employs a particle simulation technique (the direct simulation Monte Carlo method, DSMC). The thermochemical models employed in these two techniques are quite different. The present investigation presents an evaluation of thermochemical models for nitrogen under hypersonic flow conditions. Four separate cases are considered. The cases are governed, respectively, by the following: vibrational relaxation; weak dissociation; strong dissociation; and weak ionization. In near-continuum, hypersonic flow, the nonequilibrium thermochemical models employed in continuum and particle simulations produce nearly identical solutions. Further, the two approaches are evaluated successfully against available experimental data for weakly and strongly dissociating flows.

Containing Pedagogical Complexity through the Assignment of Photography: Two Case Presentations

ERIC Educational Resources Information Center

Garrett, H. James; Matthews, Sara

2014-01-01

This article investigates the use of photography as a narrative approach to learning in the context of postsecondary education. Two cases are presented: a social studies methods course in a teacher education program in the South of the United States; and a senior undergraduate seminar on global violence at a university in southern Ontario, Canada.…

Integrated Project Management: A Case Study in Integrating Cost, Schedule, Technical, and Risk Areas

NASA Technical Reports Server (NTRS)

Smith, Greg

2004-01-01

This viewgraph presentation describes a case study as a model for integrated project management. The ISS Program Office (ISSPO) developed replacement fluid filtration cartridges in house for the International Space Station (ISS). The presentation includes a step-by-step procedure and organizational charts for how the fluid filtration problem was approached.

Student Enrichment in Mathematics: A Case Study with First Year University Students

ERIC Educational Resources Information Center

Wiggins, Harry; Harding, Ansie; Engelbrecht, Johann

2017-01-01

This paper presents an enrichment case study to showcase a possible avenue for attending to the needs of academically strong mathematics students. We report on a group of university students who were presented with the opportunity of exploring a specific first year mathematics topic deeper, using an inquiry-based learning approach as part of an…

A time-and-motion approach to micro-costing of high-throughput genomic assays

PubMed Central

Costa, S.; Regier, D.A.; Meissner, B.; Cromwell, I.; Ben-Neriah, S.; Chavez, E.; Hung, S.; Steidl, C.; Scott, D.W.; Marra, M.A.; Peacock, S.J.; Connors, J.M.

2016-01-01

Background Genomic technologies are increasingly used to guide clinical decision-making in cancer control. Economic evidence about the cost-effectiveness of genomic technologies is limited, in part because of a lack of published comprehensive cost estimates. In the present micro-costing study, we used a time-and-motion approach to derive cost estimates for 3 genomic assays and processes—digital gene expression profiling (gep), fluorescence in situ hybridization (fish), and targeted capture sequencing, including bioinformatics analysis—in the context of lymphoma patient management. Methods The setting for the study was the Department of Lymphoid Cancer Research laboratory at the BC Cancer Agency in Vancouver, British Columbia. Mean per-case hands-on time and resource measurements were determined from a series of direct observations of each assay. Per-case cost estimates were calculated using a bottom-up costing approach, with labour, capital and equipment, supplies and reagents, and overhead costs included. Results The most labour-intensive assay was found to be fish at 258.2 minutes per case, followed by targeted capture sequencing (124.1 minutes per case) and digital gep (14.9 minutes per case). Based on a historical case throughput of 180 cases annually, the mean per-case cost (2014 Canadian dollars) was estimated to be $1,029.16 for targeted capture sequencing and bioinformatics analysis, $596.60 for fish, and $898.35 for digital gep with an 807-gene code set. Conclusions With the growing emphasis on personalized approaches to cancer management, the need for economic evaluations of high-throughput genomic assays is increasing. Through economic modelling and budget-impact analyses, the cost estimates presented here can be used to inform priority-setting decisions about the implementation of such assays in clinical practice. PMID:27803594

Collaborative Action Research in the Context of Developmental Work Research: A Methodological Approach for Science Teachers' Professional Development

ERIC Educational Resources Information Center

Piliouras, Panagiotis; Lathouris, Dimitris; Plakitsi, Katerina; Stylianou, Liana

2015-01-01

The paper refers to the theoretical establishment and brief presentation of collaborative action research with the characteristics of "developmental work research" as an effective methodological approach so that science teachers develop themselves professionally. A specific case study is presented, in which we aimed to transform the…

Evaluating a Tacit Knowledge Sharing Initiative: A Case Study

ERIC Educational Resources Information Center

Gubbins, Claire; Corrigan, Siobhan; Garavan, Thomas N.; O'Connor, Christy; Leahy, Damien; Long, David; Murphy, Eamonn

2012-01-01

Purpose: This paper aims to present a case study illustrating the issues involved in the tacit knowledge conversion process and to determine whether such conversion delivers value to the organisation in terms of business value and return on investment (ROI). Design/methodology/approach: A single-case multiple baseline participants experimental…

Retroperitoneal extraadrenal paraganglioma report of two cases.

PubMed

Becheanu, G; Laky, D

1997-01-01

Two cases with retroperitoneal tumours affecting young women who cannot undergo surgery were investigated by biopsy and needle sampling. One of these cases presented a mainly alveolar histologic pattern and was easily diagnosed by immunohistochemical means, as well as a chromaffin paraganglioma. We discussed different diagnoses and approaches in the literature.

Data Use and Inquiry in Research-Practice Partnerships: Four Case Examples

ERIC Educational Resources Information Center

Biag, Manuelito; Gerstein, Amy; Fehrer, Kendra; Sanchez, Monika; Sipes, Laurel

2016-01-01

The four case examples presented in this brief are drawn from the Gardner Center's substantial experience conducting rigorous research in research-practice partnerships. The first case describes a partnership approach that enhances a school district's capacity to use integrated longitudinal data to tackle persistent problems of practice and…

Tools of the Mind: A Case Study of Implementing the Vygotskian Approach in American Early Childhood and Primary Classrooms. Innodata Monographs 7.

ERIC Educational Resources Information Center

Bodrova, Elena; Leong, Deborah J.

This monograph, one in a series describing innovative educational practice, presents a case study of the Tools of the Mind project. This project, the result of collaboration between Russian and American education researchers, used the Vygotskian approach to create a series of tools or strategies for teachers to use in supporting the development of…

Estimating time-varying exposure-outcome associations using case-control data: logistic and case-cohort analyses.

PubMed

Keogh, Ruth H; Mangtani, Punam; Rodrigues, Laura; Nguipdop Djomo, Patrick

2016-01-05

Traditional analyses of standard case-control studies using logistic regression do not allow estimation of time-varying associations between exposures and the outcome. We present two approaches which allow this. The motivation is a study of vaccine efficacy as a function of time since vaccination. Our first approach is to estimate time-varying exposure-outcome associations by fitting a series of logistic regressions within successive time periods, reusing controls across periods. Our second approach treats the case-control sample as a case-cohort study, with the controls forming the subcohort. In the case-cohort analysis, controls contribute information at all times they are at risk. Extensions allow left truncation, frequency matching and, using the case-cohort analysis, time-varying exposures. Simulations are used to investigate the methods. The simulation results show that both methods give correct estimates of time-varying effects of exposures using standard case-control data. Using the logistic approach there are efficiency gains by reusing controls over time and care should be taken over the definition of controls within time periods. However, using the case-cohort analysis there is no ambiguity over the definition of controls. The performance of the two analyses is very similar when controls are used most efficiently under the logistic approach. Using our methods, case-control studies can be used to estimate time-varying exposure-outcome associations where they may not previously have been considered. The case-cohort analysis has several advantages, including that it allows estimation of time-varying associations as a continuous function of time, while the logistic regression approach is restricted to assuming a step function form for the time-varying association.

A conservative approach for restoring anterior guidance: a case report.

PubMed

Pontons-Melo, Juan Carlos; Pizzatto, Eduardo; Furuse, Adilson Yoshio; Mondelli, José

2012-06-01

One of the most common dental problems in today's clinics is tooth wear, specifically when related to bruxism. In such cases, the esthetics of anterior teeth may be compromised when excessive wear to the incisal surfaces occurs. Anterior tooth wear resulting from parafunctional bruxism can be conservatively treated with the use of direct resin composite restorations. This restorative approach has the advantages of presenting good predictability, load resistance, acceptable longevity, preservation of healthy dental tissues, and lower cost when compared with indirect restorations. The use of resin composites to solve esthetic problems, however, requires skill and practice. Thus, the present article demonstrates a conservative approach for restoring the esthetics and function of worn anterior teeth with the aid of direct resin composite restorations and selective occlusal adjustment. A conservative approach to restore anterior teeth with excessive wear is possible with direct resin composites. © 2011 Wiley Periodicals, Inc.

Environmental release of living modified organisms: current approaches and case studies.

PubMed

Thomas, E; Nickson, Ph D

2005-01-01

Agricultural biotechnology is being rapidly adopted as evidenced by the acreage of genetically modified (GM) crops planted and tonnes of product (grain and fiber) harvested. Concurrent with this technological progress, is a growing concern that the worlds biological diversity is coming under increasing threat from human activities. As such, ecological risk assessment approaches are being developed for GM crop plants as international agreements regulating the transboundary movements of these products are being implemented. This paper reviews the ecological risk assessment approach that has been used to date to approve GM crops to date. The process has been case-by-case, using a comparative, science-based approach balancing the potential risks and benefits of the new technology versus those present with the currently accepted practices. The approach used to evaluate and approve these products is consistent with the conditions and requirements outlined in the Cartagena Protocol.

Hepatic fascioliasis presenting with bile duct obstruction: a case report

PubMed Central

Lefryekh, Rachid; Bensaad, Ahmed; Bensardi, Fatimazahra; Elhattabi, Khalid; Bouali, Mounir; Daif, Bessam; Fadil, Abdelaziz; Jaouhari, Zakaria; Hicham, Tazi; Hamdani, Aziz; Abdalaoui, Maha Soussi

2017-01-01

Fascioliasis is a zoonotic infection caused by a liver trematode: fasciola hepatica; which commonly affects cattle and sheep, humans are accidental hosts. Several cases have been reported in the literature worldwide with a large geographical distribution. We present a case of bile duct obstruction due to a hepatic fascioliasis, successfully treated with both a combined surgical and medical approaches. A high index of suspicion should be kept in mind for all cases of obstructive jaundice, especially in areas in which human fascioliasis infection is repeatedly reported. PMID:29158867

Hepatic fascioliasis presenting with bile duct obstruction: a case report.

PubMed

Lefryekh, Rachid; Bensaad, Ahmed; Bensardi, Fatimazahra; Elhattabi, Khalid; Bouali, Mounir; Daif, Bessam; Fadil, Abdelaziz; Jaouhari, Zakaria; Hicham, Tazi; Hamdani, Aziz; Abdalaoui, Maha Soussi

2017-01-01

Fascioliasis is a zoonotic infection caused by a liver trematode: fasciola hepatica; which commonly affects cattle and sheep, humans are accidental hosts. Several cases have been reported in the literature worldwide with a large geographical distribution. We present a case of bile duct obstruction due to a hepatic fascioliasis, successfully treated with both a combined surgical and medical approaches. A high index of suspicion should be kept in mind for all cases of obstructive jaundice, especially in areas in which human fascioliasis infection is repeatedly reported.

Adult-onset Rasmussen encephalitis associated with focal cortical dysplasia.

PubMed

Hohenbichler, Katharina; Lelotte, Julie; Lhommel, Renaud; Tahry, Riëm El; Vrielynck, Pascal; Santos, Susana Ferrao

2017-12-01

Rasmussen encephalitis is a rare, devastating condition, typically presenting in childhood. Cases of adult-onset Rasmussen have also been described, but the clinical picture is less defined, rendering final diagnosis difficult. We present a case of adult-onset Rasmussen encephalitis with dual pathology, associated with focal cortical dysplasia and encephalitis. We interpreted the Rasmussen encephalitis to be caused by severe and continuous epileptic activity due to focal cortical dysplasia. The best therapeutic approach for such cases remains unclear.

Brain Stem Cavernous Malformations: Operative Nuances of a Less-Invasive Resection Technique.

PubMed

Singh, Harminder; Elarjani, Turki; da Silva, Harley Brito; Shetty, Rakshith; Kim, Louis; Sekhar, Laligam N

2017-12-08

Different operative techniques are reported for the resection of brainstem cavernous malformations (BSCMs). The senior author has previously reported on a less-invasive technique of entering the brain stem with piecemeal removal of BSCMs, especially the deep-seated ones. To present a larger series of these lesions, emphasizing the approach to the brain stem via case selection. We discuss the nuances of the less-invasive operative technique through case illustrations and intraoperative videos. A retrospective review of 46 consecutive cases of BSCMs, with their clinical and radiographic data, was performed. Nine cases were selected to illustrate 7 different operative approaches, and discuss surgical nuances of the less-invasive technique unique to each. Postoperative morbidity, defined as an increase in modified Rankin Scale, was observed in 5 patients (10.9%). A residual BSCM was present in 2 patients (4.3%); both underwent reoperation to remove the remainder. At follow-up of 31.1 ± 27.8 mo, 3 patients experienced recurrence (6.5%). Overall, 65% of our patients improved, 20% stayed the same, and 11% worsened postsurgery. Two patients died, yielding a mortality of 4.3%. Using the less-invasive resection technique for piecemeal BSCM removal, in appropriately selected patients, has yielded comparable to improved patient outcomes over existing large series. In our experience, lateral, anterolateral, and posterolateral approaches are favorable over direct midline (dorsal or ventral) approaches. A thorough understanding of brain-stem safe-entry zones, in conjunction with appropriate approach selection, is key to a good outcome in challenging cases. Copyright © 2017 by the Congress of Neurological Surgeons

Simple approach in understanding interzeolite transformations using ring building units

NASA Astrophysics Data System (ADS)

Suhendar, D.; Buchari; Mukti, R. R.; Ismunandar

2018-04-01

Recently, there are two general approaches used in understanding interzeolite transformations, thermodynamically represented by framework density (FD) and kinetically by structural building units. Two types of structural building units are composite building units (CBU’s) and secondary building units (SBU’s). This study aims to examine the approaches by using interzeolite transformation data available in literature and propose a possible alternative approach. From a number of cases of zeolite transformation, the FD and CBU approach are not suitable for use. The FD approach fails in cases involving zeolite parents that have moderate or high FD’s, while CBU approach fails because of CBU’s unavailability in parent zeolites compared with CBU’s in their transformation products. The SBU approach is most likely to fit because SBU’s are units that have basic form of ring structures and closer to the state and shape of oligomeric fragments present in zeolite synthesis or dissolution cases. Thus, a new approach can be considered in understanding the interzeolite transformation, namely the ring building unit (RBU) approach. The advantage of RBU approach is RBU’s can be easily derived from all framework types, but in SBU approach there are several types of frameworks that cannot be expressed in SBU forms.

Management of major vascular injury during pedicle screw instrumentation of thoracolumbar spine.

PubMed

Mirza, Aleem K; Alvi, Mohammed Ali; Naylor, Ryan M; Kerezoudis, Panagiotis; Krauss, William E; Clarke, Michelle J; Shepherd, Daniel L; Nassr, Ahmad; DeMartino, Randall R; Bydon, Mohamad

2017-12-01

Vascular injury is a rare complication of spinal instrumentation. Presentation can vary from immediate hemorrhage to pseudoaneurysm formation. In the literature, surgical approach to repair has varied based on anatomy, acuity of diagnosis, infection, and available technology. In this manuscript, we aim to describe our institutional experience with vascular injuries in thoraco-lumbar spine surgery. We report our institutional experience of three cases of vascular injury secondary to pedicle screw misplacement and their management, as well as a review of the literature. The first case had a history of previous instrumentation and presented with back pain and fever. The patient was taken for instrumentation exploration via a posterior approach. Aortic violation was discovered at T6 intraoperatively during instrumentation removal and the patient underwent emergent endovascular repair. The second case presented with chronic back pain after multiple prior posterior fusions and CT angiogram showing screw perforation on the aorta at T10. The patient underwent elective endovascular repair with synchronous removal of the instrumentation. The third case presented with radicular leg pain 6 months after L4-S1 posterior lumbar interbody fusion, with CT scan demonstrating the left S1 screw abutting the L5 nerve root and common iliac vein. The patient underwent elective instrumentation revision with intraoperative venography. Major vascular injury is a known complication of spinal surgery, especially if it involves instrumentation with pedicle screws. Treatment approach has evolved with the advancement of endovascular technology; however, open surgery remains an option when anatomy or infection is prohibitive. In the elective setting, preoperative planning with attention to surgical approach, positioning, and contingencies, should occur in a multidisciplinary fashion. Repair with an aortic stent-graft cuff may minimize unnecessary coverage of the descending thoracic aorta and intercostal arteries. Copyright © 2017 Elsevier B.V. All rights reserved.

CNES reliability approach for the qualification of MEMS for space

NASA Astrophysics Data System (ADS)

Pressecq, Francis; Lafontan, Xavier; Perez, Guy; Fortea, Jean-Pierre

2001-10-01

This paper describes the reliability approach performs at CNES to evaluate MEMS for space application. After an introduction and a detailed state of the art on the space requirements and on the use of MEMS for space, different approaches for taking into account MEMS in the qualification phases are presented. CNES proposes improvement to theses approaches in term of failure mechanisms identification. Our approach is based on a design and test phase deeply linked with a technology study. This workflow is illustrated with an example: the case of a variable capacitance processed with MUMPS process is presented.

Angiomyolipoma of the Liver: A Rare Benign Tumor Treated with a Laparoscopic Approach for the First Time.

PubMed

Damaskos, Christos; Garmpis, Nikolaos; Garmpi, Anna; Nonni, Afroditi; Sakellariou, Stratigoula; Margonis, Georgios-Antonios; Spartalis, Eleftherios; Schizas, Dimitrios; Andreatos, Nikolaos; Magkouti, Eleni; Grivas, Alexandros; Kontzoglou, Konstantinos; Weiss, Matthew J; Antoniou, Efstathios A

2017-01-01

Epithelioid angiomyolipoma of the liver is a rare benign mesenchymal tumor that usually presents in adult female patients. It most frequently occurs in the kidney, with the liver being the second most common site of involvement. Angiomyolipoma belongs to a family of tumors arising from perivascular epithelioid cells, but in rare cases may also have cystic features. We report our experience via the first case of hepatic angiomyolipoma treated by laparoscopic approach. We present the case of a 50-year-old female patient complaining of abdominal pain. Abdominal ultrasound (US) and Magnetic Resonance Imaging (MRI) revealed a 5 × 3 cm mass located in the left liver lobe. The tumor was resected with a laparoscopic approach. Microscopic examination of the tumor revealed hepatic angiomyolipoma. Twenty-seven months postoperatively, the patient remains fit and healthy. Angiomyolipoma can be removed by laparoscopy. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

A biopsychosocial approach to liver transplant evaluation in two patients with Wilson's disease.

PubMed

Boeka, Abbe G; Solomon, Andrea C; Lokken, Kristine; McGuire, Brendan M; Bynon, J Steve

2011-05-01

Wilson's disease (WD) is characterized by hepatic, neurological, and/or psychiatric disturbances. In some cases, liver transplantation is indicated. Because psychologists and other health care workers play an increasing role in the evaluation of individuals presenting for transplant, an understanding of the heterogeneous phenotype of WD is important for mental health professionals working in medical settings. This article reviews two cases of patients with WD (one probable, one confirmed) presenting for liver transplantation and a biopsychosocial assessment approach is demonstrated. Patients are presented in terms of medical, psychiatric, and psychosocial history, neuropsychological examination results, and the subsequent indications for liver transplantation. Both patients exhibited neurocognitive and psychiatric symptoms. One patient was determined to be a marginally suitable candidate for transplantation, whereas the other was considered at high risk for negative outcome post-transplant. This article demonstrates the importance of considering phenotypic presentation, neurocognitive function, psychiatric status, and psychosocial circumstances in assessing transplant readiness in patients with WD. A comprehensive and integrative biopsychosocial assessment approach is appropriate for evaluating patients with WD presenting for liver transplantation. © 2011 Taylor & Francis

Arts-based and creative approaches to dementia care.

PubMed

McGreevy, Jessica

2016-02-01

This article presents a review of arts-based and creative approaches to dementia care as an alternative to antipsychotic medications. While use of antipsychotics may be appropriate for some people, the literature highlights the success of creative approaches and the benefits of their lack of negative side effects associated with antipsychotics. The focus is the use of biographical approaches, music, dance and movement to improve wellbeing, enhance social networks, support inclusive practice and enable participation. Staff must be trained to use these approaches. A case study is presented to demonstrate how creative approaches can be implemented in practice and the outcomes that can be expected when used appropriately.

Contaminant source and release history identification in groundwater: A multi-step approach

NASA Astrophysics Data System (ADS)

Gzyl, G.; Zanini, A.; Frączek, R.; Kura, K.

2014-02-01

The paper presents a new multi-step approach aiming at source identification and release history estimation. The new approach consists of three steps: performing integral pumping tests, identifying sources, and recovering the release history by means of a geostatistical approach. The present paper shows the results obtained from the application of the approach within a complex case study in Poland in which several areal sources were identified. The investigated site is situated in the vicinity of a former chemical plant in southern Poland in the city of Jaworzno in the valley of the Wąwolnica River; the plant has been in operation since the First World War producing various chemicals. From an environmental point of view the most relevant activity was the production of pesticides, especially lindane. The application of the multi-step approach enabled a significant increase in the knowledge of contamination at the site. Some suspected contamination sources have been proven to have minor effect on the overall contamination. Other suspected sources have been proven to have key significance. Some areas not taken into consideration previously have now been identified as key sources. The method also enabled estimation of the magnitude of the sources and, a list of the priority reclamation actions will be drawn as a result. The multi-step approach has proven to be effective and may be applied to other complicated contamination cases. Moreover, the paper shows the capability of the geostatistical approach to manage a complex real case study.

Assessment and Management of Proximal and Incomplete Symptomatic Obstruction of the Lacrimal Drainage System

PubMed Central

Kashkouli, Mohsen Bahmani; Pakdel, Farzad; Kiavash, Victoria

2012-01-01

Epiphora is a common complaint of patients who present to an Ophthalmology Clinic. In many cases, epiphora is due to an obstruction in the lacrimal drainage system. However, a subgroup of symptomatic patients with epiphora has a patent lacrimal drainage system. Such cases are usually termed ‘functional obstruction’ and / or ‘stenosis of the lacrimal drainage system’. Various etiologies and diagnostic and therapeutic approaches have been described in literature, which implies the lack of a standardized approach. This article will review the evolving diagnostic and therapeutic approaches in literature, and in the end, propose a paradigm in approaching this group of patients. PMID:22346116

Safety assessment in plant layout design using indexing approach: implementing inherent safety perspective. Part 2-Domino Hazard Index and case study.

PubMed

Tugnoli, Alessandro; Khan, Faisal; Amyotte, Paul; Cozzani, Valerio

2008-12-15

The design of layout plans requires adequate assessment tools for the quantification of safety performance. The general focus of the present work is to introduce an inherent safety perspective at different points of the layout design process. In particular, index approaches for safety assessment and decision-making in the early stages of layout design are developed and discussed in this two-part contribution. Part 1 (accompanying paper) of the current work presents an integrated index approach for safety assessment of early plant layout. In the present paper (Part 2), an index for evaluation of the hazard related to the potential of domino effects is developed. The index considers the actual consequences of possible escalation scenarios and scores or ranks the subsequent accident propagation potential. The effects of inherent and passive protection measures are also assessed. The result is a rapid quantification of domino hazard potential that can provide substantial support for choices in the early stages of layout design. Additionally, a case study concerning selection among various layout options is presented and analyzed. The case study demonstrates the use and applicability of the indices developed in both parts of the current work and highlights the value of introducing inherent safety features early in layout design.

Research in the Rehabilitation Unit Presents Challenges to Nurse Researchers.

PubMed

Rose, Mary Ann; Neil, Janice A; Castles, Ricky; Pokorny, Marie; Watkins, Frank; Hand, Mark

Gathering data from patients on a rehabilitation unit poses challenges for nurse researchers. A case study is presented that describes ways the researchers attempted to meet these challenges while conducting their study. The case study presents the approaches that the investigators took to undertake the study and then described the ways in which these approaches could have been improved. Their successes and failures are described. Suggestions are made for future investigators. Clinical nursing research is required to develop an evidence base for practice in the rehabilitation unit. An analysis of the challenges and possible methods of overcoming these challenges is useful to both future investigators and nurses in practice to insure that studies can be carried out effectively.

Ethics education for clinician–researchers in genetics: The combined approach

PubMed Central

Zawati, Ma'n; Cohen, Eliza; Parry, David; Avard, Denise; Syncox, David

2014-01-01

Advancements in genomic technology and genetic research have uncovered new and unforeseen ethical and legal issues that must now be faced by clinician–researchers. However, lack of adequate ethical training places clinician–researchers in a position where they might be unable to effectively assess and resolve the issues presented to them. The literature demonstrates that ethics education is relevant and engaging where it is targeted to the level and context of the learners, and it includes real-world based cases approached in innovative ways. In order to test the feasibility of a combined approach to ethics education, a conference was held in 2012 to raise awareness and familiarize participants with the ethical and legal issues surrounding medical technology in genetics and then to have them apply this to reality-based case studies. The conference included participants from a variety of backgrounds and was divided into three sections: (i) informative presentations by experts in the field; (ii) mock REB deliberations; and (iii) a second mock-REB, conducted by a panel of experts. Feedback from participants was positive and indicated that they felt the learning objectives had been met and that the material was presented in a clear and organized fashion. Although only an example of the combined approach in a particular setting, the success of this conference suggests that combining small group learning, practical cases, role-play and interdisciplinary learning provides a positive experience and is an effective approach to ethics education. PMID:26937344

Introducing Case-Based Peer-Assisted Learning in a Professional Course

ERIC Educational Resources Information Center

Hodgson, Yvonne; Brack, Charlotte; Benson, Robyn

2014-01-01

This paper describes students' experience of participating in a case-based peer-assisted learning (PAL) program in order to examine whether the approach is pedagogically effective and likely to contribute to students' professional development. It presents the findings of a study which examined the integration of PAL and case-based learning (CBL)…

The Plan for Donations or "Don'tations": The Case of the Alumni-Funded Entrepreneurship Center

ERIC Educational Resources Information Center

Olsen, Mona Anita Kristiansen

2012-01-01

This case was developed for use in a course on entrepreneurial education that focuses on leadership. Background from Blue Stone University, including information on its mission, organizational structure, metrics, entrepreneurial programs, and stakeholders, is presented. This case explores how a school within a university approached the creation of…

Description of congenital hand anomalies: a personal view.

PubMed

Tonkin, M A

2006-10-01

A series of four congenital hand cases exhibiting central clefting are presented. The cases are morphologically similar and exhibit characteristics of both symbrachydactyly and central longitudinal deficiency. The cases demonstrate difficulties in classification by either the IFSSH classification system or the JSSH modification of it. An alternative descriptive approach to classification is suggested.

Use of Case Studies for Stimulating Thinking and Learning.

ERIC Educational Resources Information Center

Zeakes, Samuel J.

Noting that a case-study approach can stimulate student thinking and learning, this paper describes how students in a writing-intensive course on parasitology wrote brief medical case studies of parasites already studied for other students to read, evaluate, and identify the parasite. The paper presents a brief description of the course, an…

Analyzing self-controlled case series data when case confirmation rates are estimated from an internal validation sample.

PubMed

Xu, Stanley; Clarke, Christina L; Newcomer, Sophia R; Daley, Matthew F; Glanz, Jason M

2018-05-16

Vaccine safety studies are often electronic health record (EHR)-based observational studies. These studies often face significant methodological challenges, including confounding and misclassification of adverse event. Vaccine safety researchers use self-controlled case series (SCCS) study design to handle confounding effect and employ medical chart review to ascertain cases that are identified using EHR data. However, for common adverse events, limited resources often make it impossible to adjudicate all adverse events observed in electronic data. In this paper, we considered four approaches for analyzing SCCS data with confirmation rates estimated from an internal validation sample: (1) observed cases, (2) confirmed cases only, (3) known confirmation rate, and (4) multiple imputation (MI). We conducted a simulation study to evaluate these four approaches using type I error rates, percent bias, and empirical power. Our simulation results suggest that when misclassification of adverse events is present, approaches such as observed cases, confirmed case only, and known confirmation rate may inflate the type I error, yield biased point estimates, and affect statistical power. The multiple imputation approach considers the uncertainty of estimated confirmation rates from an internal validation sample, yields a proper type I error rate, largely unbiased point estimate, proper variance estimate, and statistical power. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

A Non-Blaming Chance and Action Approach to Therapy with Sexually Explicit Media Overuse: A Case Study

ERIC Educational Resources Information Center

Wernik, Uri

2012-01-01

In this clinical presentation a non-blaming, non-judgmental approach to overuse of sexually explicit media (SEM) is introduced. This approach normalizes the problem and sees it in the context of evolution and market forces. It is claimed that such an approach contributes to change and strengthens the therapeutic alliance. A new technique utilizing…

A Framework for Six Sigma Project Selection in Higher Educational Institutions, Using a Weighted Scorecard Approach

ERIC Educational Resources Information Center

Holmes, Monica C.; Jenicke, Lawrence O.; Hempel, Jessica L.

2015-01-01

Purpose: This paper discusses the importance of the Six Sigma selection process, describes a Six Sigma project in a higher educational institution and presents a weighted scorecard approach for project selection. Design/Methodology/Approach: A case study of the Six Sigma approach being used to improve student support at a university computer help…

[Neurosurgical planning using osirix software].

PubMed

Jaimovich, Sebastián Gastón; Guevara, Martin; Pampin, Sergio; Jaimovich, Roberto; Gardella, Javier Luis

2014-01-01

Anatomical individuality is key to reduce surgical trauma and obtain a better outcome. Nowadays, the advances in neuroimaging has allowed us to analyze this anatomical individuality and to plan the surgery. With this objective, we present our experience with the OsiriX software. We present three different applications as example of forty procedures performed. Case 1: Patient with a premotor cortex convexity parasagittal meningioma; Case 2: Patient with a nonfunctioning pituitary macroadenoma operated on 2 years ago in another institution, achieving a partial resection by a transsphenoidal approach; Case 3: Patient with bilateral middle cerebellar peduncles lesions. OsiriX Software was used for surgical planning. Volumetric CT and MRI images were fused and 3D reconstruction images obtained, to analyze anatomical relationships, measure distances, coordinates and trajectories, among other features. OsiriX software is a useful, open-source and free software tool that provides the surgeon with valuable information. It allows to study individual patient's anatomy and plan a surgical approach in a fast, simple, inexpensive and safety way. In Case 1 the software let us analyze the relationship of the tumor with the surrounding structures in order to minimize the approach's morbidity. In Case 2, to understand the unique anatomic characteristics of an already operated patient giving us important information regarding pathways and need for extra bone removal, achieving a complete tumor resection by an endoscopic transnasal approach. In Case 3, allowed us to obtain the stereotactic coordinates and trajectory for a not visualizable CT scan lesion. When expensive neuronavigation systems are not available, OsiriX is an alternative for neurosurgical planning, with the aim of reducing trauma and surgical morbidity.

Three-dimensional boundary layers approaching separation

NASA Technical Reports Server (NTRS)

Williams, J. C., III

1976-01-01

The theory of semi-similar solutions of the laminar boundary layer equations is applied to several flows in which the boundary layer approaches a three-dimensional separation line. The solutions obtained are used to deduce the nature of three-dimensional separation. It is shown that in these cases separation is of the "ordinary" type. A solution is also presented for a case in which a vortex is embedded within the three-dimensional boundary layer.

Case study to illustrate an approach for detecting contamination and impurities in pesticide formulations.

PubMed

Karasali, Helen; Kasiotis, Konstantinos M; Machera, Kyriaki; Ambrus, Arpad

2014-11-26

Counterfeit pesticides threaten public health, food trade, and the environment. The present work draws attention to the importance of regular monitoring of impurities in formulated pesticide products. General screening revealed the presence of carbaryl as a contaminant in a copper oxychloride formulated product. In this paper, as a case study, a liquid chromatographic diode array-mass spectrometric method developed for general screening of pesticide products and quantitative determination of carbaryl together with its validation is presented. The proposed testing strategy is considered suitable for use as a general approach for testing organic contaminants and impurities in solid pesticide formulations.

Caudal Duplication Syndrome: the Vital Role of a Multidisciplinary Approach and Staged Correction

PubMed Central

Samuk, Inbal; Levitt, Marc; Dlugy, Elena; Kravarusic, Dragan; Ben-Meir, David; Rajz, Gustavo; Konen, Osnat; Freud, Enrique

2015-01-01

Caudal duplication syndrome is a rare entity that describes the association between congenital anomalies involving caudal structures and may have a wide spectrum of clinical manifestations. A full-term male presented with combination of anomalies including anorectal malformation, duplication of the colon and lower urinary tract, split of the lower spine, and lipomyelomeningocele with tethering of the cord. We report this exceptional case of caudal duplication syndrome with special emphasis on surgical strategy and approach combining all disciplines involved. The purpose of this report is to present the pathology, assessment, and management strategy of this complex case. PMID:28018799

Infiltration of MHD liquid into a deformable porous material

NASA Astrophysics Data System (ADS)

Naseem, Anum; Mahmood, Asif; Siddique, J. I.; Zhao, Lifeng

2018-03-01

We analyze the capillary rise dynamics for magnetohydrodynamics (MHD) fluid flow through deformable porous material in the presence of gravity effects. The modeling is performed using mixture theory approach and mathematical manipulation yields a nonlinear free boundary problem. Due to the capillary rise action, the pressure gradient in the liquid generates a stress gradient that results in the deformation of porous substrate. The capillary rise process for MHD fluid slows down as compared to Newtonian fluid case. Numerical solutions are obtained using a method of lines approach. The graphical results are presented for important physical parameters, and comparison is presented with Newtonian fluid case.

A New Learning Approach: Flipped Classroom and Its Impacts

ERIC Educational Resources Information Center

Yildirim, Gürkan

2017-01-01

The aim of this study is to present opinions of undergraduate students towards Flipped Classroom (FC) practices and to determine their different aspects then traditional learning approaches. The case study approach is preferred to conduct the study. In this context, 34 volunteered students were included in the study group by purposive sampling…

Wittgenstein's Contextualist Approach to Judging "Sound" Teaching: Escaping Enthrallment in Criteria-Based Assessments

ERIC Educational Resources Information Center

Stickney, Jeff Alan

2009-01-01

Comparing the early, analytic attempt to define "sound" teaching with the current use of criteria-based rating schemes, Jeff Stickney turns to Wittgenstein's holistic, contextualist approach to judging teaching against its complex "background" within our "form of life." To exemplify this approach, Stickney presents cases of classroom practice…

Implementing a Flipped Classroom Approach in a University Numerical Methods Mathematics Course

ERIC Educational Resources Information Center

Johnston, Barbara M.

2017-01-01

This paper describes and analyses the implementation of a "flipped classroom" approach, in an undergraduate mathematics course on numerical methods. The approach replaced all the lecture contents by instructor-made videos and was implemented in the consecutive years 2014 and 2015. The sequential case study presented here begins with an…

MODFLOW/MT3DMS-based simulation of variable-density ground water flow and transport

USGS Publications Warehouse

Langevin, C.D.; Guo, W.

2006-01-01

This paper presents an approach for coupling MODFLOW and MT3DMS for the simulation of variable-density ground water flow. MODFLOW routines were modified to solve a variable-density form of the ground water flow equation in which the density terms are calculated using an equation of state and the simulated MT3DMS solute concentrations. Changes to the MODFLOW and MT3DMS input files were kept to a minimum, and thus existing data files and data files created with most pre- and postprocessors can be used directly with the SEAWAT code. The approach was tested by simulating the Henry problem and two of the saltpool laboratory experiments (low- and high-density cases). For the Henry problem, the simulated results compared well with the steady-state semianalytic solution and also the transient isochlor movement as simulated by a finite-element model. For the saltpool problem, the simulated breakthrough curves compared better with the laboratory measurements for the low-density case than for the high-density case but showed good agreement with the measured salinity isosurfaces for both cases. Results from the test cases presented here indicate that the MODFLOW/MT3DMS approach provides accurate solutions for problems involving variable-density ground water flow and solute transport. ?? 2006 National Ground Water Association.

Health level seven interoperability strategy: big data, incrementally structured.

PubMed

Dolin, R H; Rogers, B; Jaffe, C

2015-01-01

Describe how the HL7 Clinical Document Architecture (CDA), a foundational standard in US Meaningful Use, contributes to a "big data, incrementally structured" interoperability strategy, whereby data structured incrementally gets large amounts of data flowing faster. We present cases showing how this approach is leveraged for big data analysis. To support the assertion that semi-structured narrative in CDA format can be a useful adjunct in an overall big data analytic approach, we present two case studies. The first assesses an organization's ability to generate clinical quality reports using coded data alone vs. coded data supplemented by CDA narrative. The second leverages CDA to construct a network model for referral management, from which additional observations can be gleaned. The first case shows that coded data supplemented by CDA narrative resulted in significant variances in calculated performance scores. In the second case, we found that the constructed network model enables the identification of differences in patient characteristics among different referral work flows. The CDA approach goes after data indirectly, by focusing first on the flow of narrative, which is then incrementally structured. A quantitative assessment of whether this approach will lead to a greater flow of data and ultimately a greater flow of structured data vs. other approaches is planned as a future exercise. Along with growing adoption of CDA, we are now seeing the big data community explore the standard, particularly given its potential to supply analytic en- gines with volumes of data previously not possible.

Mergers and Anti-trust Issues in Recent CAB Cases

NASA Technical Reports Server (NTRS)

Andrews, A. M.

1972-01-01

The airline industry is surveyed-particularly domestic trunklines-in relation to collective approaches to industry concerns. These actions are classified by the apparent degree of anti-trust issue present. Recent route merger cases are considered from the CAB staff viewpoint.

Middle infratemporal fossa less invasive approach for radical resection of parapharyngeal tumors: surgical microanatomy and clinical application.

PubMed

Nonaka, Yoichi; Fukushima, Takanori; Watanabe, Kentaro; Sakai, Jun; Friedman, Allan H; Zomorodi, Ali R

2016-01-01

Surgery of the infratemporal fossa (ITF) and parapharyngeal area presents a formidable challenge to the surgeon due to its anatomical complexity and limited access. Conventional surgical approaches to these regions were often too invasive and necessitate sacrifice of normal function and anatomy. To describe a less invasive transcranial extradural approach to ITF parapharyngeal lesions and to determine its advantages, 17 patients with ITF parapharyngeal neoplasms who underwent tumor resection via this approach were enrolled in the study. All lesions located in the ITF precarotid parapharyngeal space were resected through a small operative corridor between the trigeminal nerve third branch (V3) and the temporomandibular joint (TMJ). Surgical outcomes and postoperative complications were evaluated. Pathological diagnosis included schwannoma in eight cases, paraganglioma in two cases, gangliocytoma in two cases, carcinosarcoma in one case, giant cell tumor in one case, pleomorphic adenoma in one case, chondroblastoma in one case, and juvenile angiofibroma in one case. Gross total resection was achieved in 12 cases, near-total and subtotal resection were in 3 and 2 cases, respectively. The most common postoperative complication was dysphagia. Surgical exposure can be customized from minimal (drilling of retrotrigeminal area) to maximal (full skeletonization of V3, removal of all structures lying lateral to the petrous segment of internal carotid artery) according to tumor size and location. Since the space between the V3 and TMJ is the main corridor of this approach, the key maneuver is the anterior translocation of V3 to obtain an acceptable surgical field.

The Development of the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders: A Case Study

PubMed Central

Boisseau, Christina L.; Farchione, Todd J.; Fairholme, Christopher P.; Ellard, Kristen K.; Barlow, David H.

2013-01-01

A detailed description of treatment utilizing the Unified Protocol (UP), a transdiagnostic emotion-focused cognitive-behavioral treatment, is presented using a clinical case example treated during the most current phase of an ongoing randomized controlled trial of the UP. The implementation of the UP in its current, modular version is illustrated. A working case conceptualization is presented from the perspective of the UP drawing from theory and research that underlies current transdiagnostic approaches to treatment and consistent with recent dimensional classification proposals (Brown & Barlow, in press). Treatment is illustrated module-by-module describing how the principles of the UP were applied in the presented case. PMID:23997572

A Health Systems Approach to Integrated Community Case Management of Childhood Illness: Methods and Tools

PubMed Central

McGorman, Laura; Marsh, David R.; Guenther, Tanya; Gilroy, Kate; Barat, Lawrence M.; Hammamy, Diaa; Wansi, Emmanuel; Peterson, Stefan; Hamer, Davidson H.; George, Asha

2012-01-01

Integrated community case management (iCCM) of childhood illness is an increasingly popular strategy to expand life-saving health services to underserved communities. However, community health approaches vary widely across countries and do not always distribute resources evenly across local health systems. We present a harmonized framework, developed through interagency consultation and review, which supports the design of CCM by using a systems approach. To verify that the framework produces results, we also suggest a list of complementary indicators, including nine global metrics, and a menu of 39 country-specific measures. When used by program managers and evaluators, we propose that the framework and indicators can facilitate the design, implementation, and evaluation of community case management. PMID:23136280

A stochastic approach for automatic generation of urban drainage systems.

PubMed

Möderl, M; Butler, D; Rauch, W

2009-01-01

Typically, performance evaluation of new developed methodologies is based on one or more case studies. The investigation of multiple real world case studies is tedious and time consuming. Moreover extrapolating conclusions from individual investigations to a general basis is arguable and sometimes even wrong. In this article a stochastic approach is presented to evaluate new developed methodologies on a broader basis. For the approach the Matlab-tool "Case Study Generator" is developed which generates a variety of different virtual urban drainage systems automatically using boundary conditions e.g. length of urban drainage system, slope of catchment surface, etc. as input. The layout of the sewer system is based on an adapted Galton-Watson branching process. The sub catchments are allocated considering a digital terrain model. Sewer system components are designed according to standard values. In total, 10,000 different virtual case studies of urban drainage system are generated and simulated. Consequently, simulation results are evaluated using a performance indicator for surface flooding. Comparison between results of the virtual and two real world case studies indicates the promise of the method. The novelty of the approach is that it is possible to get more general conclusions in contrast to traditional evaluations with few case studies.

A Hamiltonian approach to the planar optimization of mid-course corrections

NASA Astrophysics Data System (ADS)

Iorfida, E.; Palmer, P. L.; Roberts, M.

2016-04-01

Lawden's primer vector theory gives a set of necessary conditions that characterize the optimality of a transfer orbit, defined accordingly to the possibility of adding mid-course corrections. In this paper a novel approach is proposed where, through a polar coordinates transformation, the primer vector components decouple. Furthermore, the case when transfer, departure and arrival orbits are coplanar is analyzed using a Hamiltonian approach. This procedure leads to approximate analytic solutions for the in-plane components of the primer vector. Moreover, the solution for the circular transfer case is proven to be the Hill's solution. The novel procedure reduces the mathematical and computational complexity of the original case study. It is shown that the primer vector is independent of the semi-major axis of the transfer orbit. The case with a fixed transfer trajectory and variable initial and final thrust impulses is studied. The acquired related optimality maps are presented and analyzed and they express the likelihood of a set of trajectories to be optimal. Furthermore, it is presented which kind of requirements have to be fulfilled by a set of departure and arrival orbits to have the same profile of primer vector.

Complete treatment with partial cystectomy in giant xanthogranulomatous cystitis case imitating bladder tumor.

PubMed

Balasar, Mehmet; Sönmez, Mehmet Giray; Oltulu, Pembe; Kandemir, Abdülkadir; Kılıç, Mehmet; Gürbüz, Recai

2017-01-01

Xanthogranulomatous cystitis (XC) is a very rare chronic benign inflammatory disease of the bladder. It may cause local invasion although it is not a malign lesion and may occur together with malign lesions. It has a clinical importance as the distinction from malign lesions is difficult clinically and pathologically. Sharing a 37-year-old female case with giant XC imitating bladder tumor referring to the hospital with hematuria and stomach ache, together with current literature, we wanted to present that the disease can be treated with bladder-preserving approaches instead of radical approaches even though the mass is big in these cases. Application of basic excision and partial resection for small masses and radical cystectomy for large masses was reported in literature. We think that our case may provide a contribution to literature in treatment approach since we provided surgical cure with partial resection in a big mass with dimensions of 9 cm × 8 cm which is different from the present literature. Even though XC is a rare disease, it should be considered in prediagnosis for especially big dimensioned masses, and treatment should be planned according to the pathology result after together with cystoscopy in suitable patients.

A new polytopic approach for the unknown input functional observer design

NASA Astrophysics Data System (ADS)

Bezzaoucha, Souad; Voos, Holger; Darouach, Mohamed

2018-03-01

In this paper, a constructive procedure to design Functional Unknown Input Observers for nonlinear continuous time systems is proposed under the Polytopic Takagi-Sugeno framework. An equivalent representation for the nonlinear model is achieved using the sector nonlinearity transformation. Applying the Lyapunov theory and the ? attenuation, linear matrix inequalities conditions are deduced which are solved for feasibility to obtain the observer design matrices. To cope with the effect of unknown inputs, classical approach of decoupling the unknown input for the linear case is used. Both algebraic and solver-based solutions are proposed (relaxed conditions). Necessary and sufficient conditions for the existence of the functional polytopic observer are given. For both approaches, the general and particular cases (measurable premise variables, full state estimation with full and reduced order cases) are considered and it is shown that the proposed conditions correspond to the one presented for standard linear case. To illustrate the proposed theoretical results, detailed numerical simulations are presented for a Quadrotor Aerial Robots Landing and a Waste Water Treatment Plant. Both systems are highly nonlinear and represented in a T-S polytopic form with unmeasurable premise variables and unknown inputs.

[Clinical manifestations of 20 cases of the superior semicircular canal dehiscence syndrome and the intervention strategies].

PubMed

Zhang, X A; Li, Y; Dai, C F

2016-02-01

The objective of this study is to investigate the clinical manifestations of the superior semicircular canal dehiscence syndrome(SSCDS) and the treatment strategies. Data from 20 cases diagnosed with SSCDS from September 2004 to December 2014 were retrospectively analyzed in this study. The clinical presentations including symptoms, signs, audiological and vestibular function examination, and their imaging characteristics and treatment strategies were reviewed. All of the patients demonstrated variable degree of vertigo. Four patients could not tolerate the environmental noise. Autophony was noted in nine cases, among whom, two patients could feel their eye movements and heart beat, one patient could feel his footstep, one patient couldn't endure the singing by himself. Slow component vertical tortional eye movement away from the effected eye were observed in twelve patients when loud noise was given or middle ear or intracranial pressure increased. Head movement was induced by loud noise in one case. Ten patients presented with low frequency hearing loss. One case was concomitance with chronic otitis media and demonstrated severe sensorineural hearing loss. Nine patients demonstrated normal hearing. Decreased thresholds were showed by VEMP examination in six cases. Variable bone defect overlying in the SSCDS was confirmed by CT scans in all of the cases. The surgical repair of the superior semicircular canal dehiscence was performed through the middle cranial fossa approach in three cases and mastoid approach in two cases. The dizziness and the autophony were significantly alleviated after surgery. The clinical manifestations of SSCDS mainly demonstrate dizziness, autophony and loss of low frequency hearing. Treatment strategies are mainly composed of avoidance of environmental noise and shouting voice of the patients themselves. Surgical repair of the superior semicircular canal dehiscence was proposed to conduct, either through the middle cranial fossa approach or mastoid approach, when the patient couldn't tolerate the sypmtoms.

A Case Study of Environmental, Health and Safety Issues Involving the Burlington, Massachusetts Public School System. "Tips, Suggestions, and Resources for Investigating and Resolving EHS Issues in Schools."

ERIC Educational Resources Information Center

Dresser, Todd H.

An investigation was initiated concerning the environmental health within the Burlington, Massachusetts public school system to determine what specific environmental hazards were present and determine ways of eliminating them. This report presents 20 case studies that detail the environmental health issues involved, the approaches taken in…

Airway Management of Near-Complete Tracheal Transection by Through-the-Wound Intubation: A Case Report.

PubMed

Jean, Yuel-Kai; Potnuru, Paul; Diez, Christian

2018-06-11

We present an approach to airway management in a patient with machete injuries culminating in near-complete cricotracheal transection, in addition to a gunshot wound to the neck. Initial airway was established by direct intubation through the cricotracheal wound. Once the airway was secured, a bronchoscopy-guided orotracheal intubation was performed with simultaneous retraction of the cricotracheal airway to optimize the surgical field. This case offers insight into a rarely performed approach to airway management. Furthermore, our case report demonstrates that, in select airway injuries, performing through-the-wound intubation engenders a multitude of benefits.

Retrotracheal Extraskeletal Ewing's Sarcoma: Case Report and Discussion on Airway Management.

PubMed

Van Der Meer, Graeme; Linkhorn, Hannah; Gruber, Maayan; Mahadevan, Murali; Barber, Colin

2017-03-01

Extraskeletal Ewing's sarcoma is a rare tumor, and the management of airway compromise in case of cervical Ewing's sarcoma has not been established. This report describes the case of a patient with retrotracheal Ewing's sarcoma and discusses a successful approach to airway management. A 12-year-old male presented with a 2-week history of sore throat and sleep-disordered breathing and 48 hours of stridor. Imaging confirmed a retrotracheal soft tissue mass with airway compromise. A planned and controlled approach to his airway management resulted in a secure airway prior to definitive treatment.

Model-free methods to study membrane environmental probes: a comparison of the spectral phasor and generalized polarization approaches

PubMed Central

Malacrida, Leonel; Gratton, Enrico; Jameson, David M

2016-01-01

In this note, we present a discussion of the advantages and scope of model-free analysis methods applied to the popular solvatochromic probe LAURDAN, which is widely used as an environmental probe to study dynamics and structure in membranes. In particular, we compare and contrast the generalized polarization approach with the spectral phasor approach. To illustrate our points we utilize several model membrane systems containing pure lipid phases and, in some cases, cholesterol or surfactants. We demonstrate that the spectral phasor method offers definitive advantages in the case of complex systems. PMID:27182438

Lightweight approach to model traceability in a CASE tool

NASA Astrophysics Data System (ADS)

Vileiniskis, Tomas; Skersys, Tomas; Pavalkis, Saulius; Butleris, Rimantas; Butkiene, Rita

2017-07-01

A term "model-driven" is not at all a new buzzword within the ranks of system development community. Nevertheless, the ever increasing complexity of model-driven approaches keeps fueling all kinds of discussions around this paradigm and pushes researchers forward to research and develop new and more effective ways to system development. With the increasing complexity, model traceability, and model management as a whole, becomes indispensable activities of model-driven system development process. The main goal of this paper is to present a conceptual design and implementation of a practical lightweight approach to model traceability in a CASE tool.

Courseware Integration into Task-Based Learning: A Case Study of Multimedia Courseware-Supported Oral Presentations for Non-English Major Students

ERIC Educational Resources Information Center

Tsai, Shu-Chiao

2011-01-01

This study reports on the integration of English for Specific Purposes (ESP) multimedia courseware for oral presentations into a self-learning and elective program for non-English major students in an English as a Foreign Language (EFL) setting. A computer-aided instruction approach, combined with a task-based learning approach, was adopted.…

Counseling Deaf College Students: The Case of Shea

ERIC Educational Resources Information Center

Whyte, Aimee K.; Guiffrida, Douglas A.

2008-01-01

This case study describes developmental and psychosocial challenges experienced by a Deaf college student. A counseling intervention that combines person-centered and cognitive behavior approaches with psycho-educational strategies designed to educate the client about Deaf identity development and Deaf culture is presented.

Implementation of the New Approach for the Dose-Response Functions Development for the Case of Athens and Greece

NASA Astrophysics Data System (ADS)

Christodoulakis, J.; Tzanis, C. G.; Varotsos, C. A.; Kouremadas, G.

2016-08-01

Dose-response functions (DRFs) are functions used for estimating corrosion and/or soiling levels of materials used in constructions and cultural monuments. In order to achieve this, DRFs lean on ground-based measurements of specific air pollution and climatic parameters like nitrogen oxides, ozone, temperature and others. In DRAGON 3 2015 Symposium we presented a new approach which proposed a technique for using satellite-based data for the necessary parameters instead of ground-based expanding in this way: a) the usage of DRFs in cases/areas where there is no availability of in situ measurements, b) the applicability of satellite-based data. In this work we present mapping results of deterioration levels (corrosion and soiling) for the case of Athens, Greece but also for the whole Greece country.

A Multidisciplinary Approach to Dental Erosion: A Case Report

PubMed Central

Guldag, M. Ustun; Buyukkaplan, U. Sebnem; Ay, Zuhal Yetkin; Katirci, Gunseli

2008-01-01

Chemical erosion is the loss of superficial tooth structure by chemical action in the continued presence of demineralizing agents. This can be prominent in patients with oral habits such as constant citrus ingestion (like lemon chewing), chlorinated swimming pool water or gastrointestinal problems that produce repeated exposure of teeth to gastric acids. In this case report, a multidisciplinary approach to restore the severe wear due to dental erosion by proper techniques and materials was presented. PMID:19212520

Do Undergraduate Paramedic Students Embrace Case Based Learning Using a Blended Teaching Approach? A 3-Year Review

ERIC Educational Resources Information Center

Williams, Brett

2009-01-01

This paper presents the results of a descriptive longitudinal study which aimed to identify student paramedic perceptions of case based learning used in the clinical curriculum of the Bachelor of Emergency Health (BEH) degree at Monash University, Victoria, Australia. Case based learning and its integration within clinical curriculum is an…

Keeping It Local: Incorporating a Local Case Study in the Business Curriculum

ERIC Educational Resources Information Center

Johnson, Larry Alan; Helms, Marilyn M.

2008-01-01

Purpose: The purpose of this article is to evaluate the inclusion of team case analyses and presentations in undergraduate finance courses that usually focus on analyzing provided financial statement data. Design/methodology/approach: In this paper the authors argue the early use of a local company case can illustrate key course concepts while…

The Design and Development of a Multimedia Case-Based Environment on Parental Engagement

ERIC Educational Resources Information Center

Roushias, Christos; Barton, Angela Calabrese; Drake, Corey

2009-01-01

The purpose of this paper is to present the rationale and principles that guided the design and development of PARENTS, a multimedia case-based environment. Following a development research approach, the tenets of constructivist learning, and the advantages of case-based instruction, we developed a multimedia program in which we utilized and…

Planning in Education--A Systematic Approach

ERIC Educational Resources Information Center

Barker, L. J.

1977-01-01

Presents a case for and poses a procedure including techniques for a systematic approach to planning in education as a means of improving efficiency and effectiveness. Available from: Australian College of Education, 916 Swanston Street, Carlton, Victoria 3053, Australia, $2.50 single copy. (Author/MLF)

Deliverology

ERIC Educational Resources Information Center

Nordstrum, Lee E.; LeMahieu, Paul G.; Dodd, Karen

2017-01-01

Purpose: This paper is one of seven in this volume elaborating different approaches to quality improvement in education. This paper aims to delineate a methodology called Deliverology. Design/methodology/approach: The paper presents the origins, theoretical foundations, core principles and a case study showing an application of Deliverology in the…

Massive juvenile nasopharyngeal angiofibroma: ode to the open surgical approach.

PubMed

Meher, Ravi; Arora, Nikhil; Bhargava, Eishaan Kamta; Juneja, Ruchika

2017-08-01

The management of juvenile nasopharyngeal angiofibroma has undergone a significant evolution, with more surgeons moving towards the minimal invasive endoscopic approaches. Although considered the standard of care by most, an endoscopic approach may not be sufficient for extensive tumours, as exemplified by the current case of a young man presenting with the largest juvenile nasopharyngeal angiofibroma described in English literature until the present that was eventually excised via an anterior external approach. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Strategy Revitalization in Academe: A Balanced Scorecard Approach

ERIC Educational Resources Information Center

McDevitt, Roselie; Giapponi, Catherine; Solomon, Norman

2008-01-01

Purpose: The purpose of this paper is to present a unique version of the balanced scorecard developed and applied by the faculty of a university division. Design/methodology/approach: The paper uses a case study approach and uses the experiences of the faculty of a business school to describe the process and benefits of developing a custom…

Applying the Cultural Formulation Approach to Career Counseling with Latinas/os

ERIC Educational Resources Information Center

Flores, Lisa Y.; Ramos, Karina; Kanagui, Marlen

2010-01-01

In this article, the authors present two hypothetical cases, one of a Mexican American female college student and one of a Mexican immigrant adult male, and apply a culturally sensitive approach to career assessment and career counseling with each of these clients. Drawing from Leong, Hardin, and Gupta's cultural formulation approach (CFA) to…

Variables Influencing the Return on Investment in Management Training Programs: A Utility Analysis of 10 Swiss Cases

ERIC Educational Resources Information Center

Chochard, Yves; Davoine, Eric

2011-01-01

In this article, we present the utility analysis approach as an alternative and promising approach to measure the return on investment in managerial training programs. This approach, linking economic value with competencies developed by trainees, enables researchers and decision-makers to compare the return on investment from different programs in…

A Biochemical Approach to the Problem of Dyslexia.

ERIC Educational Resources Information Center

Baker, Sidney McDonald

1985-01-01

The paper presents the case of a sixth-grade boy, labeled dyslexic, who responded positively to a biochemical approach. Remedy of iron, zinc, and Vitamin B-6 deficiencies as well as an imbalance of fatty acids resulted in improvements in hair and skin and also in reading. A biochemical approach to behavior problems is proposed. (Author/CL)

Self-Monitoring Approach for the Modification of Smoking Behavior: A Case Study.

ERIC Educational Resources Information Center

Faherty, John K.

This paper presents a review of relevant literature on treatment approaches for the modification of smoking behavior, followed by an outline of an approach developed by the author to decrease his own rate of cigarette smoking. Studies are reviewed which have used various treatment methods: use of electric shock, satiation and/or use of cigarette…

Serving-Maids and Literacy: An Approach to Teaching Literacy through History and Music.

ERIC Educational Resources Information Center

Turner-Bisset, R.

2001-01-01

Presents a case study of an integrated approach to teaching history, literacy and music, in a Year 6 class. Suggests success was due to use of varied teaching approaches including storytelling, drama, singing and discussion. Emphasizes links between genuine historical tasks, and activities in the National Literacy Strategy. Suggests how music…

Multidisciplinary Approach in the Management of a Complex Case: Implant-Prosthetic Rehabilitation of a Periodontal Smoking Patient with Partial Edentulism, Malocclusion, and Aesthetic Diseases

PubMed Central

Di Francesco, Fabrizio; De Marco, Gennaro; Scognamiglio, Fabio; Aruta, Valeria; Itro, Angelo

2017-01-01

Complex periprosthetic cases are considered as challenges by clinicians. Clinical and radiographic parameters should be considered separately to make the right choice between an endodontically or periodontally compromised treated tooth and implant. Therefore, in order to decide whether the tooth is safe or not, data that have to be collected are specific parameters of both the patient and the clinician. In addition, the presence of periodontal, prosthetic, and orthodontic diseases requires patients to be set in multidisciplinary approach. The aim of this case report is to describe how the multidisciplinary approach could be the best way to manage difficult cases of implant-prosthetic rehabilitation. How to rehabilitate with fixed prosthesis on natural teeth and dental implants a smoker patient who presents with active periodontitis, multiple edentulous areas, dental malocclusion, and severe aesthetic problems was also described. PMID:28421148

A qualitative and quantitative assessment for a bone marrow harvest simulator.

PubMed

Machado, Liliane S; Moraes, Ronei M

2009-01-01

Several approaches to perform assessment in training simulators based on virtual reality have been proposed. There are two kinds of assessment methods: offline and online. The main requirements related to online training assessment methodologies applied to virtual reality systems are the low computational complexity and the high accuracy. In the literature it can be found several approaches for general cases which can satisfy such requirements. An inconvenient about those approaches is related to an unsatisfactory solution for specific cases, as in some medical procedures, where there are quantitative and qualitative information available to perform the assessment. In this paper, we present an approach to online training assessment based on a Modified Naive Bayes which can manipulate qualitative and quantitative variables simultaneously. A special medical case was simulated in a bone marrow harvest simulator. The results obtained were satisfactory and evidenced the applicability of the method.

Robot-assisted excision of cervical cystic hygroma through a retroauricular hairline approach: a case report.

PubMed

Lin, Frank Cheau-Feng; Yang, Tsung-Lin; Tung, Min-Che; Tsai, Stella Chin-Shaw

2016-06-09

Cystic hygroma is a rare benign abnormality of the lymphatic system generally occurring in young children less than 2 years old. The standard transcervical surgical treatment of cystic hygroma may often leave a permanent scar in the neck region. We report a case of cystic hygroma in a 19-month-old Asian baby girl successfully treated with robot-assisted excision through a hairline neck-lift approach. We present the use of the Yang's retractor as an instrumental advancement to this surgical approach. Treatment options for cystic hygroma may be surgical or nonsurgical. We report a case of cystic hygroma in a 19-month-old child successfully treated with robot-assisted excision through a small concealed retroauricular hairline approach. This is the first report in the medical literature of treating cystic hygroma with a minimally invasive robot-assisted excision via a small, concealed, hairline incision.

Surgical approach to the intrathoracic goiter.

PubMed

Vaiman, Michael; Bekerman, Inessa; Basel, Jabarin; Peer, Michael

2018-04-01

In a retrospective study, the authors analyzed the surgical approach to the intrathoracic goiter to avoid sternotomy or thoracotomy. We selected 70 intrathoracic cases of multinodular goiter out of 988 cases of thyroidectomy and compared them with cervical goiter cases. Surgical technique, results, and postsurgical complications were assessed. The analyzed cases presented the retrosternal goiter (n = 53; 75.7%), the retrotracheal goiter (n = 9; 12.8%), and the retroesophageal goiter (n = 8; 11.4%). Complaining of chest pressure or discomfort was specific for intrathoracic cases (50%; 35 of 70). All goiters except one were removed via cervical incision. The surgeons used head reclination and isthmus dissection when removing sizable goiters. Mean weight of goiters was 180 g. The recurrent laryngeal nerve was more often temporarily damaged in intrathoracic cases in comparison with cervical cases (4.3% vs. 2.8%, P  = .04), but the difference in permanent injury was less significant ( P  = .09). The incidence of temporary hypoparathyroidism was significantly higher in intrathoracic cases ( P  = .01). In cases of multinodular goiter the goiters of various extensions can be successfully removed via the cervical incision in most of the cases even if they occupy the retrosternal, retrotracheal, or retroesophageal position. The transthoracic approaches and sternotomy might be justified in malignant cases. 4.

Surgical approach to the intrathoracic goiter

PubMed Central

Bekerman, Inessa; Basel, Jabarin; Peer, Michael

2018-01-01

Objective In a retrospective study, the authors analyzed the surgical approach to the intrathoracic goiter to avoid sternotomy or thoracotomy. Methods We selected 70 intrathoracic cases of multinodular goiter out of 988 cases of thyroidectomy and compared them with cervical goiter cases. Surgical technique, results, and postsurgical complications were assessed. Results The analyzed cases presented the retrosternal goiter (n = 53; 75.7%), the retrotracheal goiter (n = 9; 12.8%), and the retroesophageal goiter (n = 8; 11.4%). Complaining of chest pressure or discomfort was specific for intrathoracic cases (50%; 35 of 70). All goiters except one were removed via cervical incision. The surgeons used head reclination and isthmus dissection when removing sizable goiters. Mean weight of goiters was 180 g. The recurrent laryngeal nerve was more often temporarily damaged in intrathoracic cases in comparison with cervical cases (4.3% vs. 2.8%, P = .04), but the difference in permanent injury was less significant (P = .09). The incidence of temporary hypoparathyroidism was significantly higher in intrathoracic cases (P = .01). Conclusion In cases of multinodular goiter the goiters of various extensions can be successfully removed via the cervical incision in most of the cases even if they occupy the retrosternal, retrotracheal, or retroesophageal position. The transthoracic approaches and sternotomy might be justified in malignant cases. Level of Evidence 4. PMID:29721546

Dental, dermatological and radiographic findings in a case of Gorlin-Goltz Syndrome: report and review.

PubMed

Nilesh, Kumar; Tewary, Shivsagar; Zope, Sameer; Patel, Jinesh; Vande, Aaditee

2017-01-01

Gorlin-Goltz syndrome (GGS) is a rare autosomal dominant disorder. The disease shows multiple organ involvement with variable clinical presentation. Thus a multidisciplinary approach is required for its prompt clinical diagnosis and management of this condition. This paper highlights a case of GGS presenting in a young male patient with cranial, facial, dermatological, dental and skeletal involvement. The diagnosis of the syndrome was based on its clinical presentation, radiological features and histopathological findings. A review of the diagnostic criteria is also presented.

Dental, dermatological and radiographic findings in a case of Gorlin-Goltz Syndrome: report and review

PubMed Central

Nilesh, Kumar; Tewary, Shivsagar; Zope, Sameer; Patel, Jinesh; Vande, Aaditee

2017-01-01

Gorlin-Goltz syndrome (GGS) is a rare autosomal dominant disorder. The disease shows multiple organ involvement with variable clinical presentation. Thus a multidisciplinary approach is required for its prompt clinical diagnosis and management of this condition. This paper highlights a case of GGS presenting in a young male patient with cranial, facial, dermatological, dental and skeletal involvement. The diagnosis of the syndrome was based on its clinical presentation, radiological features and histopathological findings. A review of the diagnostic criteria is also presented. PMID:28819517

Querying Safety Cases

NASA Technical Reports Server (NTRS)

Denney, Ewen W.; Naylor, Dwight; Pai, Ganesh

2014-01-01

Querying a safety case to show how the various stakeholders' concerns about system safety are addressed has been put forth as one of the benefits of argument-based assurance (in a recent study by the Health Foundation, UK, which reviewed the use of safety cases in safety-critical industries). However, neither the literature nor current practice offer much guidance on querying mechanisms appropriate for, or available within, a safety case paradigm. This paper presents a preliminary approach that uses a formal basis for querying safety cases, specifically Goal Structuring Notation (GSN) argument structures. Our approach semantically enriches GSN arguments with domain-specific metadata that the query language leverages, along with its inherent structure, to produce views. We have implemented the approach in our toolset AdvoCATE, and illustrate it by application to a fragment of the safety argument for an Unmanned Aircraft System (UAS) being developed at NASA Ames. We also discuss the potential practical utility of our query mechanism within the context of the existing framework for UAS safety assurance.

Navigation-guided optic canal decompression for traumatic optic neuropathy: Two case reports.

PubMed

Bhattacharjee, Kasturi; Serasiya, Samir; Kapoor, Deepika; Bhattacharjee, Harsha

2018-06-01

Two cases of traumatic optic neuropathy presented with profound loss of vision. Both cases received a course of intravenous corticosteroids elsewhere but did not improve. They underwent Navigation guided optic canal decompression via external transcaruncular approach, following which both cases showed visual improvement. Postoperative Visual Evoked Potential and optical coherence technology of Retinal nerve fibre layer showed improvement. These case reports emphasize on the role of stereotactic navigation technology for optic canal decompression in cases of traumatic optic neuropathy.

A Specialized Approach to the Case of Randall.

ERIC Educational Resources Information Center

Preston, Brian K.

1993-01-01

Responds to case of head-injured former engineering college student who presented for career counseling following automobile accident, three months in coma, and four years of rehabilitation therapy. Recommends vocational evaluation concentrating on a detailed work history, neuropsychological data, work samples, independent living skills…

Global Inequalities: Gender, Class, and Race/Ethnicity.

ERIC Educational Resources Information Center

Shope, Janet Hinson; Singer, Eric

1996-01-01

Discusses a case study approach to internationalizing an undergraduate interdisciplinary sociology course that explores the sources and consequences of inequality. Presents three case studies from Baltimore (Maryland), Japan, and Zimbabwe, each one detailing social and economic causes of inequality. Briefly covers class assignments and a…

Energy-Efficient Renovation of Educational Buildings

ERIC Educational Resources Information Center

Erhorn-Kluttig, Heike; Morck, Ove

2005-01-01

Case studies demonstrating energy-efficient renovation of educational buildings collected by the International Energy Agency (IEA) provide information on retrofit technologies, energy-saving approaches and ventilation strategies. Some general findings are presented here along with one case study, Egebjerg School in Denmark, which shows how natural…

A path-level exact parallelization strategy for sequential simulation

NASA Astrophysics Data System (ADS)

Peredo, Oscar F.; Baeza, Daniel; Ortiz, Julián M.; Herrero, José R.

2018-01-01

Sequential Simulation is a well known method in geostatistical modelling. Following the Bayesian approach for simulation of conditionally dependent random events, Sequential Indicator Simulation (SIS) method draws simulated values for K categories (categorical case) or classes defined by K different thresholds (continuous case). Similarly, Sequential Gaussian Simulation (SGS) method draws simulated values from a multivariate Gaussian field. In this work, a path-level approach to parallelize SIS and SGS methods is presented. A first stage of re-arrangement of the simulation path is performed, followed by a second stage of parallel simulation for non-conflicting nodes. A key advantage of the proposed parallelization method is to generate identical realizations as with the original non-parallelized methods. Case studies are presented using two sequential simulation codes from GSLIB: SISIM and SGSIM. Execution time and speedup results are shown for large-scale domains, with many categories and maximum kriging neighbours in each case, achieving high speedup results in the best scenarios using 16 threads of execution in a single machine.

Engaging novice researchers in the process and culture of science using a "Pass-the-Problem" case strategy.

PubMed

White, Harold B; Usher, David C

2015-01-01

Undergraduates having their first research experience frequently have little idea of what to expect. Institutions offering summer research experiences attempt to address this issue through programs that introduce students to the process and culture of science. However, didactic approaches frequently bore students who prefer more interactive sessions. We describe a "Pass-the-Problem" case study approach that engages groups of students in useful discussions about the research environment they are entering. The cases presented here include keeping a thorough laboratory notebook, balancing laboratory and personal time demands, anxiety about formal presentations, unexpected federal regulatory inspection, working in a lab with limited funds, being used as a technician rather than a researcher, frustration with failed experiments, effects of promotion and tenure on laboratory atmosphere, the importance of reading the research literature, and questioning a career in science. These cases alert students to different situations they might encounter and stimulate discussion about how to deal with them. © 2015 The International Union of Biochemistry and Molecular Biology.

Applying Real Options for Evaluating Investments in ERP Systems

NASA Astrophysics Data System (ADS)

Nakagane, Jun; Sekozawa, Teruji

This paper intends to verify effectiveness of real options approach for evaluating investments in Enterprise Resource Planning systems (ERP) and proves how important it is to disclose shadow options potentially embedded in ERP investment. The net present value (NPV) method is principally adopted to evaluate the value of ERP. However, the NPV method assumes no uncertainties exist in the object. It doesn't satisfy the current business circumstances which are filled with dynamic issues. Since the 1990s the effectiveness of option pricing models for Information System (IS) investment to solve issues in the NPV method has been discussed in the IS literature. This paper presents 3 business cases to review the practical advantages of such techniques for IS investments, especially ERP investments. The first case is EDI development. We evaluate the project by a new approach with lighting one of shadow options, EDI implementation. In the second case we reveal an ERP investment has an “expanding option” in a case of eliminating redundancy. The third case describes an option to contract which is deliberately slotted in ERP development to prepare transferring a manufacturing facility.

Benefit Indicators for Flood Regulation Services of Wetlands: A Modeling Approach

EPA Science Inventory

This report describes a method for developing indicators of the benefits of flood regulation services of wetlands and presents a companion case study. We demonstrate our approach through an application to the Woonasquatucket River watershed in northern Rhode Island. This work is ...

Building Scientific Confidence in the Development and ...

EPA Pesticide Factsheets

Building Scientific Confidence in the Development and Evaluation of Read-Across Using Tox21 Approaches Slide presentation at GlobalChem conference and workshop in Washington, DC on Case Study on Building Scientific Confidence in the Development and Evaluation of Read-Across Using Tox21 Approaches

Combining a Behavioral Approach with Reality Therapy

ERIC Educational Resources Information Center

Gronert, Richard R.

1970-01-01

Two comprehensive case studies present the careful use of a Time Out" approach to behavior modification with elementary school students. These sessions should be undertaken only under supervision of the school psychologist since a Time Out" can produce damaging psychological effects if used indiscriminately. (CJ)

Combined transpedal and transradial approach for treatment of iliac artery chronic total occlusion.

PubMed

Auguste, Uschi; Rosero, Hugo; Bertrand, Olivier F; Kwan, Tak W

2015-09-01

We present a case of a patient with total chronic occlusion of the right common iliac artery that underwent percutaneous stenting with combined transpedal and transradial approaches. With this novel strategy, femoral access can be avoided. Published by Elsevier Inc.

The preparedness level of final year medical students for an adequate medical approach to emergency cases: computer-based medical education in emergency medicine

PubMed Central

2014-01-01

Background We aimed to observe the preparedness level of final year medical students in approaching emergencies by computer-based simulation training and evaluate the efficacy of the program. Methods A computer-based prototype simulation program (Lsim), designed by researchers from the medical education and computer science departments, was used to present virtual cases for medical learning. Fifty-four final year medical students from Ondokuz Mayis University School of Medicine attended an education program on June 20, 2012 and were trained with Lsim. Volunteer attendants completed a pre-test and post-test exam at the beginning and end of the course, respectively, on the same day. Results Twenty-nine of the 54 students who attended the course accepted to take the pre-test and post-test exams; 58.6% (n = 17) were female. In 10 emergency medical cases, an average of 3.9 correct medical approaches were performed in the pre-test and an average of 9.6 correct medical approaches were performed in the post-test (t = 17.18, P = 0.006). Conclusions This study’s results showed that the readiness level of students for an adequate medical approach to emergency cases was very low. Computer-based training could help in the adequate approach of students to various emergency cases. PMID:24386919

Neurovascular compromise due to true brachial artery aneurysm at the site of a previously ligated arteriovenous fistula: Case report and review of literature.

PubMed

Cleveland, Emily C; Sinno, Sammy; Sheth, Sharvil; Sharma, Sheel; Mussa, Firas F

2015-12-01

True arterial aneurysms of the upper extremity are rare. The case described is that of a 48-year-old man presenting with median neuropathy and distal vascular compromise 4 years after ligation of a brachiocephalic arteriovenous fistula. We describe our approach and present a review of the relevant literature. © The Author(s) 2015.

Unilateral subfrontal approach to anterior communicating artery aneurysms: A review of 28 patients

PubMed Central

Petraglia, Anthony L.; Srinivasan, Vasisht; Moravan, Michael J.; Coriddi, Michelle; Jahromi, Babak S.; Vates, G Edward; Maurer, Paul K.

2011-01-01

Background: The pterional approach is the most common for AComm aneurysms, but we present a unilateral approach to a midline region for addressing the AComm complex. The pure subfrontal approach eliminates the lateral anatomic dissection requirements without sacrificing exposure. The subfrontal approach is not favored in the US compared to Asia and Europe. We describe our experience with the subfrontal approach for AComm aneurysms treated at a single institution. Methods: We identified 28 patients treated for AComm aneurysms through the subfrontal approach. Patient records and imaging studies were reviewed. Demographics and case data, as well as clinical outcome at 6 weeks and 1 year were collected. Results: Mean patient age was 48 (range 21–75) years and 64% suffered subarachnoid hemorrhage (SAH). All aneurysms were successfully clipped. Gyrus rectus was resected in 57% of cases, more commonly in ruptured cases. Intraoperative rupture occurred in 11% of cases. The average operative time was 171 minutes. There were two patient deaths. Ninety-two percent of patients had a Glasgow Outcome Scale (GOS) of 5 at 6 weeks. All unruptured patients had a GOS of 5. At 12 months, 96% of all patients had a GOS of 5. Conclusions: The subfrontal approach provides an efficient avenue to the AComm region, which reduces opening and closing friction but still yields a comprehensive operative window for access to the anterior communicating region. PMID:22059119

Scoliosis in Dandy-Walker syndrome: a case report and review of literature.

PubMed

Menon, Venugopal K; Sorur, Tamer M M; Al Ghafri, Khalifa A; Shahin, Marwan M H E

2017-12-01

This submission presents a case of scoliosis in a patient with established Dandy-Walker anomaly of the brain. A retrospective review of the patient's case notes was undertaken and the limited literature on this subject reviewed. The 13-year-old girl presented with a stiff right thoracic scoliosis typical of adolescent idiopathic scoliosis. The scoliotic segment also presented with significant lordosis. She had facial and truncal dysmorphism characteristic of Dandy-Walker complex and her brain images confirmed the diagnosis. She underwent scoliosis surgery by the posterior approach uneventfully. In conclusion scoliosis is hitherto unreported in the Dandy-Walker complex. The results of intervention appear satisfactory.

Performance analysis of a GPS equipment by general linear models approach

NASA Astrophysics Data System (ADS)

Teodoro, M. Filomena; Gonçalves, Fernando M.; Correia, Anacleto

2017-06-01

One of the major challenges in processing high-accurate long baselines is the presence of un-modelled ionospheric and tropospheric delays. There are effective mitigation strategies for ionospheric biases, such as the ionosphere-free linear combination of L1 and L2 carrier-phase, which can remove about 98% of the first-order ionospheric biases. With few exceptions this was the solution found by LGO for the 11760 baselines processed in this research. Therefore, for successful results, the appropriated approach to the mitigation of biases due to tropospheric delays is vital. The main aim of the investigations presented in this work was to evaluate the improvements, or not, of the rate of baselines successfully produced by adopting an advanced tropospheric bias mitigation strategy as opposed to a sample tropospheric bias mitigation approach. In both cases LGO uses as a priori tropospheric model the simplified Hopfield model, improved in the first case with a zenith tropospheric scale factor per station. Being aware that 1D and 2D present different behaviors, both cases are analyzed individually with each strategy.

A Hybrid Approach Using Case-Based Reasoning and Rule-Based Reasoning to Support Cancer Diagnosis: A Pilot Study.

PubMed

Saraiva, Renata M; Bezerra, João; Perkusich, Mirko; Almeida, Hyggo; Siebra, Clauirton

2015-01-01

Recently there has been an increasing interest in applying information technology to support the diagnosis of diseases such as cancer. In this paper, we present a hybrid approach using case-based reasoning (CBR) and rule-based reasoning (RBR) to support cancer diagnosis. We used symptoms, signs, and personal information from patients as inputs to our model. To form specialized diagnoses, we used rules to define the input factors' importance according to the patient's characteristics. The model's output presents the probability of the patient having a type of cancer. To carry out this research, we had the approval of the ethics committee at Napoleão Laureano Hospital, in João Pessoa, Brazil. To define our model's cases, we collected real patient data at Napoleão Laureano Hospital. To define our model's rules and weights, we researched specialized literature and interviewed health professional. To validate our model, we used K-fold cross validation with the data collected at Napoleão Laureano Hospital. The results showed that our approach is an effective CBR system to diagnose cancer.

Caseload management, work-related stress and case manager self-efficacy among Victorian mental health case managers.

PubMed

King, Robert

2009-05-01

In Australia and comparable countries, case management has become the dominant process by which public mental health services provide outpatient clinical services to people with severe mental illness. There is recognition that caseload size impacts on service provision and that management of caseloads is an important dimension of overall service management. There has been little empirical investigation, however, of caseload and its management. The present study was undertaken in the context of an industrial agreement in Victoria, Australia that required services to introduce standardized approaches to caseload management. The aims of the present study were therefore to (i) investigate caseload size and approaches to caseload management in Victoria's mental health services; and (ii) determine whether caseload size and/or approach to caseload management is associated with work-related stress or case manager self-efficacy among community mental health professionals employed in Victoria's mental health services. A total of 188 case managers responded to an online cross-sectional survey with both purpose-developed items investigating methods of case allocation and caseload monitoring, and standard measures of work-related stress and case manager personal efficacy. The mean caseload size was 20 per full-time case manager. Both work-related stress scores and case manager personal efficacy scores were broadly comparable with those reported in previous studies. Higher caseloads were associated with higher levels of work-related stress and lower levels of case manager personal efficacy. Active monitoring of caseload was associated with lower scores for work-related stress and higher scores for case manager personal efficacy, regardless of size of caseload. Although caseloads were most frequently monitored by the case manager, there was evidence that monitoring by a supervisor was more beneficial than self-monitoring. Routine monitoring of caseload, especially by a workplace supervisor, may be effective in reducing work-related stress and enhancing case manager personal efficacy.

Language and Recursion

NASA Astrophysics Data System (ADS)

Lowenthal, Francis

2010-11-01

This paper examines whether the recursive structure imbedded in some exercises used in the Non Verbal Communication Device (NVCD) approach is actually the factor that enables this approach to favor language acquisition and reacquisition in the case of children with cerebral lesions. For that a definition of the principle of recursion as it is used by logicians is presented. The two opposing approaches to the problem of language development are explained. For many authors such as Chomsky [1] the faculty of language is innate. This is known as the Standard Theory; the other researchers in this field, e.g. Bates and Elman [2], claim that language is entirely constructed by the young child: they thus speak of Language Acquisition. It is also shown that in both cases, a version of the principle of recursion is relevant for human language. The NVCD approach is defined and the results obtained in the domain of language while using this approach are presented: young subjects using this approach acquire a richer language structure or re-acquire such a structure in the case of cerebral lesions. Finally it is shown that exercises used in this framework imply the manipulation of recursive structures leading to regular grammars. It is thus hypothesized that language development could be favored using recursive structures with the young child. It could also be the case that the NVCD like exercises used with children lead to the elaboration of a regular language, as defined by Chomsky [3], which could be sufficient for language development but would not require full recursion. This double claim could reconcile Chomsky's approach with psychological observations made by adherents of the Language Acquisition approach, if it is confirmed by researches combining the use of NVCDs, psychometric methods and the use of Neural Networks. This paper thus suggests that a research group oriented towards this problematic should be organized.

Variable structure control of spacecraft reorientation maneuvers

NASA Technical Reports Server (NTRS)

Sira-Ramirez, H.; Dwyer, T. A. W., III

1986-01-01

A Variable Structure Control (VSC) approach is presented for multi-axial spacecraft reorientation maneuvers. A nonlinear sliding surface is proposed which results in an asymptotically stable, ideal linear sliding motion of Cayley-Rodriques attitude parameters. By imposing a desired equivalent dynamics on the attitude parameters, the approach is devoid of optimal control considerations. The single axis case provides a design scheme for the multiple axes design problem. Illustrative examples are presented.

Tapering chronic opioid therapy in neuropathic facial pain: an interdisciplinary approach.

PubMed

Chandwani, Brijesh P; Kulich, Ronald J; Andrew, Lainie; Scrivani, Steven

2008-01-01

This case report presents a patient with chronic orofacial pain who was considered to be an appropriate candidate for chronic opioid therapy, a treatment uncommonly considered at most facial pain centers. Her opioid treatment proved ineffectual, and conservative approaches were addressed. She was successfully tapered off the use of a long-acting opioid within a relatively short time, using an interdisciplinary approach involving an aggressive biobehavioral approach.

An alternative subspace approach to EEG dipole source localization

NASA Astrophysics Data System (ADS)

Xu, Xiao-Liang; Xu, Bobby; He, Bin

2004-01-01

In the present study, we investigate a new approach to electroencephalography (EEG) three-dimensional (3D) dipole source localization by using a non-recursive subspace algorithm called FINES. In estimating source dipole locations, the present approach employs projections onto a subspace spanned by a small set of particular vectors (FINES vector set) in the estimated noise-only subspace instead of the entire estimated noise-only subspace in the case of classic MUSIC. The subspace spanned by this vector set is, in the sense of principal angle, closest to the subspace spanned by the array manifold associated with a particular brain region. By incorporating knowledge of the array manifold in identifying FINES vector sets in the estimated noise-only subspace for different brain regions, the present approach is able to estimate sources with enhanced accuracy and spatial resolution, thus enhancing the capability of resolving closely spaced sources and reducing estimation errors. The present computer simulations show, in EEG 3D dipole source localization, that compared to classic MUSIC, FINES has (1) better resolvability of two closely spaced dipolar sources and (2) better estimation accuracy of source locations. In comparison with RAP-MUSIC, FINES' performance is also better for the cases studied when the noise level is high and/or correlations among dipole sources exist.

Short Hospitalization after Early Intervention in Managing Grade III Pancreatic Injuries in Children: A Possible New Trend

PubMed Central

Al-Jazaeri, Ayman H.

2011-01-01

The presence of ductal disruption in pancreatic trauma is a major indicator of severity leading to higher morbidities and prolonged hospital stay. However, the adoption of early interventional approach in selected cases of documented grade III pancreatic trauma could result in shorter hospitalization and early recovery. We are describing our approach of early presentation-tailored interventions in managing two consecutive children diagnosed with grade III pancreatic injuries, which constitute the two main ends of the presentations’ spectrum. For the early presenter a spleen preserving distal pancreatectomy was performed, while for the late presenter with large symptomatic pseudocyst endoscopic drainage was attempted. Both early and late presenting children had quick and uneventful recoveries leading to 5 and 6 days of hospitalization, respectively. Both cases continued to be asymptomatic at 4 and 12 months post procedure. In the pseudocyst case, the gastro-cystostomy stents were removed after 10 weeks, and 2.5 months later a completely healed pancreas was demonstrated by magnetic resonance cholangio-pancreatography. Unlike other abdominal solid organ injuries in children, adopting early presentation-tailored intervention can be associated with quicker recovery and short hospitalization for grade III pancreatic injuries. While the series is still small, achieving such remarkable outcomes in two consecutive cases is possible and could set a new trend in managing these injuries in children. PMID:21912067

Moral Conflicts and Religious Convictions: What Role for Clinical Ethics Consultants?

PubMed

Moskop, John C

2018-05-03

Moral conflicts over medical treatment that are the result of differences in fundamental moral commitments of the stakeholders, including religiously grounded commitments, can present difficult challenges for clinical ethics consultants. This article begins with a case example that poses such a conflict, then examines how consultants might use different approaches to clinical ethics consultation in an effort to facilitate the resolution of conflicts of this kind. Among the approaches considered are the authoritarian approach, the pure consensus approach, and the ethics facilitation approach described in the Core Competencies for Healthcare Ethics Consultation report of the American Society for Bioethics and Humanities, as well as a patient advocate approach, a clinician advocate approach, and an institutional advocate approach. The article identifies clear limitations to each of these approaches. An analysis of the introductory case illustrates those limitations, and the article concludes that deep-seated conflicts of this kind may reveal inescapable limits of current approaches to clinical ethics consultation.

Management of hyperfunctioning single thyroid nodules in the era of minimally invasive thyroid surgery.

PubMed

Tan, Charles; Sidhu, Stan; Sywak, Mark; Delbridge, Leigh

2009-05-01

Both surgical excision and radioiodine ablation are effective modalities in the management of hyperfunctioning thyroid nodules. Minimally invasive thyroid surgery (MITS) using the lateral mini-incision approach has previously been demonstrated to be a safe and effective technique for thyroid lobectomy. As such MITS may offer advantages as a surgical approach to hyperfunctioning thyroid nodules without the need for a long cervical incision or extensive dissection associated with formal open hemithyroidectomy. The aim of the present study was to assess the safety and efficacy of MITS for the treatment of hyperfunctioning thyroid nodules. This is a retrospective case study. Data were obtained from the University of Sydney Endocrine Surgical Unit Database from 2002 to 2007. There were 86 cases of hyperfunctioning thyroid nodules surgically removed during the study period, of which 10 (12%) were managed using the MITS approach. The ipsilateral recurrent laryngeal nerve was identified and preserved in all cases with no incidence of temporary or permanent nerve palsy. The external branch of the superior laryngeal nerve was visualized and preserved in eight cases (80%). There were no cases of postoperative bleeding. There was one clinically significant follicular thyroid carcinoma in the series (10%). In nine of 10 cases (90%) normalization of thyroid function followed surgery. MITS is a safe and effective procedure, achieving the benefits of a minimally invasive procedure with minimal morbidity. As such it now presents an attractive alternative to radioiodine ablation for the management of small hyperfunctioning thyroid nodules.

The Treatment of Anorexia Nervosa in a General Hospital: A Case Vignette of a Multi-Disciplinary General Hospital-Based Approach.

ERIC Educational Resources Information Center

Kronenberg, J.; And Others

1994-01-01

Describes anorexia nervosa as condition variable in etiology and resistant to treatment, which may lead to mortality in 5% of treated cases. Notes that efforts have been made for treating disorder in nonstigmatizing medical units outside psychiatric hospitals. Describes, through presentation of short case vignette, advantages of treating…

A Corpus-Based Discourse Information Analysis of Chinese EFL Learners' Autonomy in Legal Case Brief Writing

ERIC Educational Resources Information Center

Chen, Jinshi

2017-01-01

Legal case brief writing is pedagogically important yet insufficiently discussed for Chinese EFL learners majoring in law. Based on process genre approach and discourse information theory (DIT), the present study designs a corpus-based analytical model for Chinese EFL learners' autonomy in legal case brief writing and explores the process of case…

The Palatal Approach to Distraction Osteogenesis of the Anterior Maxillary Alveolus.

PubMed

Bell, Robert E

2015-07-01

This report describes the palatal approach to gain access for osteodistraction of the anterior maxilla to improve the vector of force during distraction. This case report illustrates a novel approach to anterior maxillary osteodistraction. The palatal approach allows the maxillary segment to be moved anteriorly and inferiorly. This is in contrast to the buccal approach, in which the palatal tissue creates a vector of force toward the palate. The vascular pedicle for the transport segment is the labial mucosa and musculature. In the present case, the alveolar segment was advanced 3.6 mm anteriorly and 12.2 mm inferiorly as measured by pre- and postoperative computed tomograms. This patient with a large vertical alveolar defect and high smile line had successful restoration with dental implants. The result has been stable for 14 months. In this case, the palatal approach to the anterior maxillary osteotomy was shown to be an effective method of reconstructing a large vertical anterior defect. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

NACASETAC BAY: AN INTERACTIVE CASE STUDY

EPA Science Inventory

This interactive case study or "game" was created to provide a "hands on" experience in the application of a weight of evidence approach to sediment assessment. The game proceeds in two phases. In each phase the players work together as a group. A scenario is presented, and the g...

Whole-of-society approach for public health policymaking: a case study of polycentric governance from Quebec, Canada.

PubMed

Addy, Nii A; Poirier, Alain; Blouin, Chantal; Drager, Nick; Dubé, Laurette

2014-12-01

In adopting a whole-of-society (WoS) approach that engages multiple stakeholders in public health policies across contexts, the authors propose that effective governance presents a challenge. The purpose of this paper is to highlight a case for how polycentric governance underlying the WoS approach is already functioning, while outlining an agenda to enable adaptive learning for improving such governance processes. Drawing upon a case study from Quebec, Canada, we employ empirically developed concepts from extensive, decades-long work of the 2009 Nobel laureate Elinor Ostrom in the governance of policy in nonhealth domains to analyze early efforts at polycentric governance in policies around overnutrition, highlighting interactions between international, domestic, state and nonstate actors and processes. Using information from primary and secondary sources, we analyze the emergence of the broader policy context of Quebec's public health system in the 20th century. We present a microsituational analysis of the WoS approach for Quebec's 21st century policies on healthy lifestyles, emphasizing the role of governance at the community level. We argue for rethinking prescriptive policy analysis of the 20th century, proposing an agenda for diagnostic policy analysis, which explicates the multiple sets of actors and interacting variables shaping polycentric governance for operationalizing the WoS approach to policymaking in specific contexts. © 2014 New York Academy of Sciences.

Integrating Student-Centered Learning in Finance Courses: The Case of a Malaysian Research University

ERIC Educational Resources Information Center

Janor, Hawati; Rahim, Ruzita Abdul; Rahman, Aisyah Abdul; Auzairy, Noor Azryani; Hashim, Noor Azuan; Yusof, Muhamad Zain

2013-01-01

The student-centered learning (SCL) approach is an approach to education that focuses on learners and their needs, rather than relying upon the input of the teacher's. The present paper examines how the SCL approach is integrated as a learner-centered paradigm into finance courses offered at a business school in a research university in Malaysia.…

Chronic total occlusion in ostium of right coronary artery – retrograde approach as the first-choice method of revascularization?

PubMed Central

Kameczura, Tomasz; Surowiec, Sławomir; Januś, Bogdan; Derlaga, Bogusław; Dudek, Dariusz; Czarnecka, Danuta

2013-01-01

Recanalization of chronic total occlusion (CTO) located in the ostium may require the operator's ability to use the retrograde approach. We present a case of opening a chronically occluded right coronary artery (RCA) by the retrograde approach after an unsuccessful attempt of recanalization by classic antegrade technique. PMID:24570749

An Adaptive Unstructured Grid Method by Grid Subdivision, Local Remeshing, and Grid Movement

NASA Technical Reports Server (NTRS)

Pirzadeh, Shahyar Z.

1999-01-01

An unstructured grid adaptation technique has been developed and successfully applied to several three dimensional inviscid flow test cases. The approach is based on a combination of grid subdivision, local remeshing, and grid movement. For solution adaptive grids, the surface triangulation is locally refined by grid subdivision, and the tetrahedral grid in the field is partially remeshed at locations of dominant flow features. A grid redistribution strategy is employed for geometric adaptation of volume grids to moving or deforming surfaces. The method is automatic and fast and is designed for modular coupling with different solvers. Several steady state test cases with different inviscid flow features were tested for grid/solution adaptation. In all cases, the dominant flow features, such as shocks and vortices, were accurately and efficiently predicted with the present approach. A new and robust method of moving tetrahedral "viscous" grids is also presented and demonstrated on a three-dimensional example.

Teamwork: Effectively Teaching an Employability Skill

ERIC Educational Resources Information Center

Riebe, Linda; Roepen, Dean; Santarelli, Bruno; Marchioro, Gary

2010-01-01

Purpose: The purpose of this paper is to present a case study on improvements to professional teaching practice within an undergraduate university business programme to more effectively teach an employability skill and enhance the student experience of teamwork. Design/methodology/approach: A three-phase approach to teaching teamwork was…

A Worksheet for Ethics Instruction and Exercises in Reason.

ERIC Educational Resources Information Center

Bivins, Thomas H.

1993-01-01

Argues that teaching applied mass media ethics requires two vital components: a grounding in the relevant ethical theories, and a structured approach to analyzing the issues in case-study format. Presents a worksheet model that provides such an approach over a wide range of issues. (SR)

Lean for Education

ERIC Educational Resources Information Center

LeMahieu, Paul G.; Nordstrum, Lee E.; Greco, Patricia

2017-01-01

Purpose: This paper is one of seven in this volume that aims to elaborate different approaches to quality improvement in education. It delineates a methodology called Lean for Education. Design/methodology/approach: The paper presents the origins, theoretical foundations, core concepts and a case study demonstrating an application in US education,…

User-Centric Approach for Benchmark RDF Data Generator in Big Data Performance Analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Purohit, Sumit; Paulson, Patrick R.; Rodriguez, Luke R.

This research focuses on user-centric approach of building such tools and proposes a flexible, extensible, and easy to use framework to support performance analysis of Big Data systems. Finally, case studies from two different domains are presented to validate the framework.

Sensemaking, Organizational Culture, and Sexual Harassment

ERIC Educational Resources Information Center

Dougherty, Debbie S.; Smythe, Mary Jeanette

2004-01-01

While EEOC guidelines for managing sexual harassment prescribe a strong sexual harassment policy and aggressive remedial action following complaints, a communication approach suggests a need for a more complex understanding of sexual harassment as diffused throughout an organizational culture. The present case study uses a sensemaking approach to…

Application of chitosan-covered gauze in combination with intrauterine balloon tamponade for postpartum hemorrhage treatment - Case report of a novel "uterine sandwich" approach.

PubMed

Seidel, Vera; Braun, Thorsten; Weizsäcker, Katharina; Henrich, Wolfgang

2018-05-26

Postpartum or peripartum hemorrhage (PPH) is a major cause of maternal death worldwide. Fertility preserving second stage interventions following uterotonic medications may include compression sutures, uterine balloon tamponade and ligation or embolization of arteries. We present a case of PPH where a novel "uterine sandwich" approach (combination of chitosan-covered gauze with intrauterine balloon tamponade) was effectively used to stop further blood loss and prevented more invasive second stage interventions. Furthermore, we present the ultrasonographic image of chitosan-covered gauze in the uterine cavity. Chitosan-covered gauze and intrauterine balloon tamponade are complementary in their mechanism of work, the balloon reducing blood flow into the uterus and the chitosan-covered gauze enhancing the coagulation. This novel "uterine sandwich" approach can be a useful method for fertility preserving management of PPH. Copyright © 2018. Published by Elsevier Ltd.

Linear time-dependent reference intervals where there is measurement error in the time variable-a parametric approach.

PubMed

Gillard, Jonathan

2015-12-01

This article re-examines parametric methods for the calculation of time specific reference intervals where there is measurement error present in the time covariate. Previous published work has commonly been based on the standard ordinary least squares approach, weighted where appropriate. In fact, this is an incorrect method when there are measurement errors present, and in this article, we show that the use of this approach may, in certain cases, lead to referral patterns that may vary with different values of the covariate. Thus, it would not be the case that all patients are treated equally; some subjects would be more likely to be referred than others, hence violating the principle of equal treatment required by the International Federation for Clinical Chemistry. We show, by using measurement error models, that reference intervals are produced that satisfy the requirement for equal treatment for all subjects. © The Author(s) 2011.

Infracolic Approach to the Superior Mesenteric Vessels for a Large Pancreatic Tumor with Right Colon Invasion - A Case Report and Literature Review.

PubMed

Bacalbasa, Nicolae; Balescu, Irina

2017-05-01

Pancreatic cancer remains one of the most aggressive malignancies and is frequently diagnosed in advanced stages when local invasion is already present. In such cases, curative resection is often not possible; however, in certain cases, local invasion will not preclude radical surgery. We present the case of a 63-year-old patient who was diagnosed with a large pancreatic tumor with right colonic invasion in whom a pancreatoduodenectomy en bloc with right colectomy was successfully performed. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Congenital costo-vertebral fibrous band and congenital kyphoscoliosis: a previously unreported combination.

PubMed

Eid, Tony; Ghostine, Bachir; Kreichaty, Gaby; Daher, Paul; Ghanem, Ismat

2013-05-01

Congenital kyphoscoliosis (CKS) results from abnormal vertebral chondrification. Congenital fibrous bands occur in several locations with variable impact on vertebral development. We report a previously unreported case of a female infant with CKS presenting with an L2 hypoplastic vertebra and a costo-vertebral fibrous band extending to the skin in the form of a dimple. We also describe the therapeutic approach, consisting of surgical excision of the fibrous band and postoperative fulltime bracing, with a 7-year follow-up. We recommend a high index of suspicion in any unusual presentation of CKS and insist on case by case management in such cases.

Snowball Vs. House-to-House Technique for Measuring Annual Incidence of Kala-azar in the Higher Endemic Blocks of Bihar, India: A Comparison

PubMed Central

Siddiqui, Niyamat A.; Rabidas, Vidya N.; Sinha, Sanjay K.; Verma, Rakesh B.; Pandey, Krishna; Singh, Vijay P.; Ranjan, Alok; Topno, Roshan K.; Lal, Chandra S.; Kumar, Vijay; Sahoo, Ganesh C.; Sridhar, Srikantaih; Pandey, Arvind; Das, Pradeep

2016-01-01

Background Visceral Leishmaniasis, commonly known as kala-azar, is widely prevalent in Bihar. The National Kala-azar Control Program has applied house-to-house survey approach several times for estimating Kala-azar incidence in the past. However, this approach includes huge logistics and operational cost, as occurrence of kala-azar is clustered in nature. The present study aims to compare efficiency, cost and feasibility of snowball sampling approach to house-to-house survey approach in capturing kala-azar cases in two endemic districts of Bihar, India. Methodology/Principal findings A community based cross-sectional study was conducted in two highly endemic Primary Health Centre (PHC) areas, each from two endemic districts of Bihar, India. Snowball technique (used to locate potential subjects with help of key informants where subjects are hard to locate) and house-to-house survey technique were applied to detect all the new cases of Kala-azar during a defined reference period of one year i.e. June, 2010 to May, 2011. The study covered a total of 105,035 households with 537,153 populations. Out of total 561 cases and 17 deaths probably due to kala-azar, identified by the study, snowball sampling approach captured only 221 cases and 13 deaths, whereas 489 cases and 17 deaths were detected by house-to-house survey approach. Higher value of McNemar’s χ² statistics (64; p<0.0001) for house-to-house survey approach than snowball sampling and relative difference (>1) indicates that most of the kala-azar cases missed by snowball sampling were captured by house-to-house approach with 13% of omission. Conclusion/Significance Snowball sampling was not found sensitive enough as it captured only about 50% of VL cases. However, it captured about 77% of the deaths probably due to kala-azar and was found more cost-effective than house-to-house approach. Standardization of snowball approach with improved procedure, training and logistics may enhance the sensitivity of snowball sampling and its application in national Kala-azar elimination programme as cost-effective approach for estimation of kala-azar burden. PMID:27681709

Snowball Vs. House-to-House Technique for Measuring Annual Incidence of Kala-azar in the Higher Endemic Blocks of Bihar, India: A Comparison.

PubMed

Siddiqui, Niyamat A; Rabidas, Vidya N; Sinha, Sanjay K; Verma, Rakesh B; Pandey, Krishna; Singh, Vijay P; Ranjan, Alok; Topno, Roshan K; Lal, Chandra S; Kumar, Vijay; Sahoo, Ganesh C; Sridhar, Srikantaih; Pandey, Arvind; Das, Pradeep

2016-09-01

Visceral Leishmaniasis, commonly known as kala-azar, is widely prevalent in Bihar. The National Kala-azar Control Program has applied house-to-house survey approach several times for estimating Kala-azar incidence in the past. However, this approach includes huge logistics and operational cost, as occurrence of kala-azar is clustered in nature. The present study aims to compare efficiency, cost and feasibility of snowball sampling approach to house-to-house survey approach in capturing kala-azar cases in two endemic districts of Bihar, India. A community based cross-sectional study was conducted in two highly endemic Primary Health Centre (PHC) areas, each from two endemic districts of Bihar, India. Snowball technique (used to locate potential subjects with help of key informants where subjects are hard to locate) and house-to-house survey technique were applied to detect all the new cases of Kala-azar during a defined reference period of one year i.e. June, 2010 to May, 2011. The study covered a total of 105,035 households with 537,153 populations. Out of total 561 cases and 17 deaths probably due to kala-azar, identified by the study, snowball sampling approach captured only 221 cases and 13 deaths, whereas 489 cases and 17 deaths were detected by house-to-house survey approach. Higher value of McNemar's χ² statistics (64; p<0.0001) for house-to-house survey approach than snowball sampling and relative difference (>1) indicates that most of the kala-azar cases missed by snowball sampling were captured by house-to-house approach with 13% of omission. Snowball sampling was not found sensitive enough as it captured only about 50% of VL cases. However, it captured about 77% of the deaths probably due to kala-azar and was found more cost-effective than house-to-house approach. Standardization of snowball approach with improved procedure, training and logistics may enhance the sensitivity of snowball sampling and its application in national Kala-azar elimination programme as cost-effective approach for estimation of kala-azar burden.

Case formulation and management using pattern-based formulation (PBF) methodology: clinical case 1.

PubMed

Fernando, Irosh; Cohen, Martin

2014-02-01

A tool for psychiatric case formulation known as pattern-based formulation (PBF) has been recently introduced. This paper presents an application of this methodology in formulating and managing complex clinical cases. The symptomatology of the clinical presentation has been parsed into individual clinical phenomena and interpreted by selecting explanatory models. The clinical presentation demonstrates how PBF has been used as a clinical tool to guide clinicians' thinking, that takes a structured approach to manage multiple issues using a broad range of management strategies. In doing so, the paper also introduces a number of patterns related to the observed clinical phenomena that can be re-used as explanatory models when formulating other clinical cases. It is expected that this paper will assist clinicians, and particularly trainees, to better understand PBF methodology and apply it to improve their formulation skills.

Importance of relationship context in HIV transmission: results from a qualitative case-control study in Rakai, Uganda.

PubMed

Higgins, Jenny A; Mathur, Sanyukta; Eckel, Elizabeth; Kelley, Laura; Kelly, Laura; Nakyanjo, Neema; Sekamwa, Richard; Namatovu, Josephine; Ddaaki, William; Nakubulwa, Rosette; Namakula, Sylvia; Nalugoda, Fred; Santelli, John S

2014-04-01

We present results from life history interviews with 60 young adults from southern Uganda. Using a novel qualitative case-control design, we compared newly HIV-positive cases with HIV-negative controls matched on age, gender, marital status, and place of residence. Relationship context was the most salient theme differentiating cases from controls. Compared with HIV-negative respondents, recent seroconverters described relationships marked by poorer communication, greater suspicion and mistrust, and larger and more transitory sexual networks. Results highlight the importance of dyadic approaches to HIV and possibly of couple-based interventions. Using HIV-matched pairs allowed additional understanding of the factors influencing transmission. This hybrid methodological approach holds promise for future studies of sexual health.

Importance of Relationship Context in HIV Transmission: Results From a Qualitative Case-Control Study in Rakai, Uganda

PubMed Central

Mathur, Sanyukta; Eckel, Elizabeth; Kelly, Laura; Nakyanjo, Neema; Sekamwa, Richard; Namatovu, Josephine; Ddaaki, William; Nakubulwa, Rosette; Namakula, Sylvia; Nalugoda, Fred; Santelli, John S.

2014-01-01

We present results from life history interviews with 60 young adults from southern Uganda. Using a novel qualitative case-control design, we compared newly HIV-positive cases with HIV-negative controls matched on age, gender, marital status, and place of residence. Relationship context was the most salient theme differentiating cases from controls. Compared with HIV-negative respondents, recent seroconverters described relationships marked by poorer communication, greater suspicion and mistrust, and larger and more transitory sexual networks. Results highlight the importance of dyadic approaches to HIV and possibly of couple-based interventions. Using HIV-matched pairs allowed additional understanding of the factors influencing transmission. This hybrid methodological approach holds promise for future studies of sexual health. PMID:24524490

A Comparison of Trajectory Optimization Methods for the Impulsive Minimum Fuel Rendezvous Problem

NASA Technical Reports Server (NTRS)

Hughes, Steven P.; Mailhe, Laurie M.; Guzman, Jose J.

2002-01-01

In this paper we present a comparison of optimization approaches to the minimum fuel rendezvous problem. Both indirect and direct methods are compared for a variety of test cases. The indirect approach is based on primer vector theory. The direct approaches are implemented numerically and include Sequential Quadratic Programming (SQP), Quasi-Newton, Simplex, Genetic Algorithms, and Simulated Annealing. Each method is applied to a variety of test cases including, circular to circular coplanar orbits, LEO to GEO, and orbit phasing in highly elliptic orbits. We also compare different constrained optimization routines on complex orbit rendezvous problems with complicated, highly nonlinear constraints.

The Special Place Project: Efficacy of a Place-Based Case Study Approach for Teaching Geoscience

NASA Astrophysics Data System (ADS)

Moosavi, Sadredin

2014-05-01

Achieving geoscience literacy of the general population has become increasingly important world wide as ever more connected and growing societies depend more and more on our planet's limited natural resource base. Building citizen understanding of their dependence on the local environment, and the geologic processes which created and continue to change it, has become a great challenge to educators at all levels of the education system. The Special Place Project described in this presentation explores use of a place-based case study approach combining instruction in geoscience content with development of observation, reasoning, writing and presentation skills. The approach allows students to select the locations for their individual case studies affording development of personal connections between the learner and his environment. The approach gives instructors at many grade levels the ability to develop core pedagogical content and skills while exploring the unique geologic environments relevant to the local population including such critical issues as land use, resource depletion, energy, climate change and the future of communities in a changing world. The geologic reasons for the location of communities and key events in their histories can be incorporated into the students' case studies as appropriate. The project is unique in placing all course instruction in the context of the quest to explore and gain understanding of the student's chosen location by using the inherently more generalized course content required by the curriculum. By modeling how scientists approach their research questions, this pedagogical technique not only integrates knowledge and skills from across the curriculum, it captures the excitement of scientific thinking on real world questions directly relevant to students' lives, increasing student engagement and depth of learning as demonstrated in the case study reports crafted by the students and exam results. Student learning of topics directly touched upon by the case study, such as geomorphologic features and processes observable at Earth's surface, is compared to learning on more abstract topics, such as subsurface Earth structure and tectonic processes, to provide a quantitative assessment of this pedagogical approach.

Inpainting approaches to fill in detector gaps in phase contrast computed tomography

NASA Astrophysics Data System (ADS)

Brun, F.; Delogu, P.; Longo, R.; Dreossi, D.; Rigon, L.

2018-01-01

Photon counting semiconductor detectors in radiation imaging present attractive properties, such as high efficiency, low noise, and energy sensitivity. The very complex electronics limits the sensitive area of current devices to a few square cm. This disadvantage is often compensated by tiling a larger matrix with an adequate number of detector units but this usually results in non-negligible insensitive gaps between two adjacent modules. When considering the case of Computed Tomography (CT), these gaps lead to degraded reconstructed images with severe streak and ring artifacts. This work presents two digital image processing solutions to fill in these gaps when considering the specific case of synchrotron radiation x-ray parallel beam phase contrast CT. While not discussed with experimental data, other CT modalities, such as spectral, cone beam and other geometries might benefit from the presented approaches.

Joint perceptual decision-making: a case study in explanatory pluralism

PubMed Central

Abney, Drew H.; Dale, Rick; Yoshimi, Jeff; Kello, Chris T.; Tylén, Kristian; Fusaroli, Riccardo

2014-01-01

Traditionally different approaches to the study of cognition have been viewed as competing explanatory frameworks. An alternative view, explanatory pluralism, regards different approaches to the study of cognition as complementary ways of studying the same phenomenon, at specific temporal and spatial scales, using appropriate methodological tools. Explanatory pluralism has been often described abstractly, but has rarely been applied to concrete cases. We present a case study of explanatory pluralism. We discuss three separate ways of studying the same phenomenon: a perceptual decision-making task (Bahrami et al., 2010), where pairs of subjects share information to jointly individuate an oddball stimulus among a set of distractors. Each approach analyzed the same corpus but targeted different units of analysis at different levels of description: decision-making at the behavioral level, confidence sharing at the linguistic level, and acoustic energy at the physical level. We discuss the utility of explanatory pluralism for describing this complex, multiscale phenomenon, show ways in which this case study sheds new light on the concept of pluralism, and highlight good practices to critically assess and complement approaches. PMID:24795679

Presenting the Iterative Curriculum Discourse Analysis (ICDA) Approach

ERIC Educational Resources Information Center

Iversen, Lars Laird

2014-01-01

The article presents a method for analysing recurring curriculum documents using discourse theory inspired by Ernesto Laclau and Chantal Mouffe. The article includes a presentation of the method in seven practical steps, and is illustrated and discussed throughout using the author's recent case study on religion, identity and values in Norwegian…

Personality Diagnosis for Personalized eHealth Services

NASA Astrophysics Data System (ADS)

Cortellese, Fabio; Nalin, Marco; Morandi, Angelica; Sanna, Alberto; Grasso, Floriana

In this paper we present two different approaches to personality diagnosis, for the provision of innovative personalized services, as used in a case study where diabetic patients were supported in the improvement of physical activity in their daily life. The first approach presented relies on a static clustering of the population, with a specific motivation strategy designed for each cluster. The second approach relies on a dynamic population clustering, making use of recommendation systems and algorithms, like Collaborative Filtering. We discuss pro and cons of each approach and a possible combination of the two, as the most promising solution for this and other personalization services in eHealth.

[Methods for exposure of recurrent laryngeal nerve in thyroid surgery].

PubMed

Ma, Xiangdong; Han, Xilin; Liu, Tao; Kou, Changhua

2014-10-01

To evaluate different methods to explose recurrent laryngeal nerve (RLN) based on the location of thyroid diseses and anatomic path of the RLN, to avoid the RLN damage in thyroid surgery. A total of 755 cases underwent total lobectomy was studied retrospectively. RLN was explosed in each case. A total of 963 RLN was exposed in 755 cases, among those 658 RLN were exposed by lateral approach, 106 by inferior approach, and 199 by superior approach. It was showed that 694 RLN traveled deep to the inferior throid artery and 119 superficial to the artery, 98 through between two branches of the artery, and 62 with the cross of the nerve branches and the artery branches. Before entering larynx, 578 RLN gave off branches and 385 had no branches. Non-recurrent laryngeal nerves were found in 2 cases. There were 6 cases who presented with hoarseness after thyroidectomy and undergoing reexploration, among them RLN were legated in 4 cases and severed in 2 cases. The anatomic relation of RLN is relatively complicated. Lateral, inferior or superior aproach may be used for exposure of RLN to decrease risks of injury to the nerve.

[Report of a case of megakaryoblastic leukemia].

PubMed

Monteiro, J A; Timóteo, T; Elisário, L

1990-01-01

We diagnosed a 20 year old young girl, with clinical and laboratorial evidence of pancytopenia, an acute megakaryoblastic leukemia. The difficulty in arriving at this conclusion was only surpassed with the help of monoclonal antibodies. With the presentation of this case we approach the problematics in obtaining the diagnostic of the megakaryoblastic leukemia. This is fundamental, owing to the possibilities of morphological presentation under undifferentiated blasts or of the type M1 or L2 (FAB).

[Outpatient treatment of selective mutism: long-standing selective mutism in a 17-year-old male].

PubMed

Herdener-Pinnekamp, Katharina; Gundelfinger, Ronnie; Steinhausen, Hans-Christoph

2010-01-01

The present case report describes the successful treatment of a 17 year old male adolescent suffering for 10 years from selective mutism. Following a summary review of recent publications on therapy approaches, the report describes the treatment concept in the present case, including detailed assessment of co-morbid disorders, motivation for change, behaviour therapy with supporting drug intervention, and intensive co-operation with parents and other caretakers.

Men Who Abuse Their Spouses: An Approach to Assessing Future Risk.

ERIC Educational Resources Information Center

Goldsmith, Herbert R.

1990-01-01

Studied risk assessment for abuse cases by examining cases (N=20) referred to local spouse treatment center. Focused on woman's perception of mate's personality/behavioral characteristics and relationship plus other situational factors. Confirmed majority of risk factors associated with spouse abuse as reported in the literature. Presents pilot…

Planning Additions to Academic Library Buildings: A Seamless Approach.

ERIC Educational Resources Information Center

Hawthorne, Pat, Ed.; Martin, Ron G., Ed.

This document presents three case studies that illustrate how library staffs and architectural design teams can work together to plan additions that are successful solutions to building problems. The case studies cover the experiences of Hope College, Holland, Michigan (David Jensen, Margaret Jensen), Western Maryland College, Westminster,…

Routines in School Organizations: Creating Stability and Change

ERIC Educational Resources Information Center

Conley, Sharon; Enomoto, Ernestine K.

2005-01-01

Purpose: This paper presents routinized action theory as a way to examine the regular, habitual activities that occur in school organizations. Using this theoretical lens, school routines were analyzed in order to understand organizational stability and change. Design/methodology/approach: Using case study methods, three discrete cases are…

Individual Multimodal Therapy for Weight Loss: A Case Example.

ERIC Educational Resources Information Center

Kilmartin, Christopher; Robbins, Steven

1987-01-01

Presents a case study highlighting a treatment model based on a multimodal conceptualization. Suggests that individual multimodal therapy provides a comprehensive approach to the treatment of overeating, helping to target social and emotional issues related to eating disorders as well as the eating behaviors themselves. (Author/ABB)

Attention Training with Auditory Hallucinations: A Case Study

ERIC Educational Resources Information Center

Valmaggia, Lucia R.; Bouman, Theo K.; Schuurman, Laura

2007-01-01

The case presented in this paper illustrates how Attention Training (ATT; [Wells, A. (1990). "Panic disorder in association with relaxation induced anxiety: An attentional training approach to treatment." "Behavior Therapy," 21, 273-280.]) can be applied in an outpatient setting in the treatment of auditory hallucinations. The 25-year-old male…

Innovations in the Teaching of Behavioral Sciences in the Preclinical Curriculum

ERIC Educational Resources Information Center

Mack, Kevin

2005-01-01

Objective: In problem-based learning curricula, cases are usually clustered into identified themes or organ systems. While this method of aggregating cases presents clear advantages in terms of resource alignment and student focus, an alternative "hidden cluster" approach provides rich opportunities for content integration. Method: The author…

Attributing Responsibility for Child Maltreatment when Domestic Violence Is Present

ERIC Educational Resources Information Center

Landsman, Miriam J.; Hartley, Carolyn Copps

2007-01-01

Objective: The purpose of this study was to examine factors that influence how child welfare workers attribute responsibility for child maltreatment and child safety in cases involving domestic violence. Methods: The study used a factorial survey approach, combining elements of survey research with an experimental design. Case vignettes were…

Construction of integrated case environments.

PubMed

Losavio, Francisca; Matteo, Alfredo; Pérez, María

2003-01-01

The main goal of Computer-Aided Software Engineering (CASE) technology is to improve the entire software system development process. The CASE approach is not merely a technology; it involves a fundamental change in the process of software development. The tendency of the CASE approach, technically speaking, is the integration of tools that assist in the application of specific methods. In this sense, the environment architecture, which includes the platform and the system's hardware and software, constitutes the base of the CASE environment. The problem of tools integration has been proposed for two decades. Current integration efforts emphasize the interoperability of tools, especially in distributed environments. In this work we use the Brown approach. The environment resulting from the application of this model is called a federative environment, focusing on the fact that this architecture pays special attention to the connections among the components of the environment. This approach is now being used in component-based design. This paper describes a concrete experience in civil engineering and architecture fields, for the construction of an integrated CASE environment. A generic architectural framework based on an intermediary architectural pattern is applied to achieve the integration of the different tools. This intermediary represents the control perspective of the PAC (Presentation-Abstraction-Control) style, which has been implemented as a Mediator pattern and it has been used in the interactive systems domain. In addition, a process is given to construct the integrated CASE.

A Two-Step Bayesian Approach for Propensity Score Analysis: Simulations and Case Study.

PubMed

Kaplan, David; Chen, Jianshen

2012-07-01

A two-step Bayesian propensity score approach is introduced that incorporates prior information in the propensity score equation and outcome equation without the problems associated with simultaneous Bayesian propensity score approaches. The corresponding variance estimators are also provided. The two-step Bayesian propensity score is provided for three methods of implementation: propensity score stratification, weighting, and optimal full matching. Three simulation studies and one case study are presented to elaborate the proposed two-step Bayesian propensity score approach. Results of the simulation studies reveal that greater precision in the propensity score equation yields better recovery of the frequentist-based treatment effect. A slight advantage is shown for the Bayesian approach in small samples. Results also reveal that greater precision around the wrong treatment effect can lead to seriously distorted results. However, greater precision around the correct treatment effect parameter yields quite good results, with slight improvement seen with greater precision in the propensity score equation. A comparison of coverage rates for the conventional frequentist approach and proposed Bayesian approach is also provided. The case study reveals that credible intervals are wider than frequentist confidence intervals when priors are non-informative.

Advances in adaptive control theory: Gradient- and derivative-free approaches

NASA Astrophysics Data System (ADS)

Yucelen, Tansel

In this dissertation, we present new approaches to improve standard designs in adaptive control theory, and novel adaptive control architectures. We first present a novel Kalman filter based approach for approximately enforcing a linear constraint in standard adaptive control design. One application is that this leads to alternative forms for well known modification terms such as e-modification. In addition, it leads to smaller tracking errors without incurring significant oscillations in the system response and without requiring high modification gain. We derive alternative forms of e- and adaptive loop recovery (ALR-) modifications. Next, we show how to use Kalman filter optimization to derive a novel adaptation law. This results in an optimization-based time-varying adaptation gain that reduces the need for adaptation gain tuning. A second major contribution of this dissertation is the development of a novel derivative-free, delayed weight update law for adaptive control. The assumption of constant unknown ideal weights is relaxed to the existence of time-varying weights, such that fast and possibly discontinuous variation in weights are allowed. This approach is particulary advantageous for applications to systems that can undergo a sudden change in dynamics, such as might be due to reconfiguration, deployment of a payload, docking, or structural damage, and for rejection of external disturbance processes. As a third and final contribution, we develop a novel approach for extending all the methods developed in this dissertation to the case of output feedback. The approach is developed only for the case of derivative-free adaptive control, and the extension of the other approaches developed previously for the state feedback case to output feedback is left as a future research topic. The proposed approaches of this dissertation are illustrated in both simulation and flight test.

Speckle: tool for diagnosis assistance

NASA Astrophysics Data System (ADS)

Carvalho, O.; Guyot, S.; Roy, L.; Benderitter, M.; Clairac, B.

2006-09-01

In this paper, we present a new approach of the speckle phenomenon. This method is based on the fractal Brownian motion theory and allows the extraction of three stochastic parameters to characterize the speckle pattern. For the first time, we present the results of this method applied to the discrimination of the healthy vs. pathologic skin. We also demonstrate, in case of the scleroderma, than this method is more accurate than the classical frequential approach.

Transformative Learning Approaches for Public Relations Pedagogy

ERIC Educational Resources Information Center

Motion, Judy; Burgess, Lois

2014-01-01

Public relations educators are frequently challenged by students' flawed perceptions of public relations. Two contrasting case studies are presented in this paper to illustrate how socially-oriented paradigms may be applied to a real-client project to deliver a transformative learning experience. A discourse-analytic approach is applied within the…

Six Sigma in Education

ERIC Educational Resources Information Center

LeMahieu, Paul G.; Nordstrum, Lee E.; Cudney, Elizabeth A.

2017-01-01

Purpose: This paper is one of seven in this volume that aims to elaborate different approaches to quality improvement in education. It delineates a methodology called Six Sigma. Design/methodology/approach: The paper presents the origins, theoretical foundations, core principles and a case study demonstrating an application of Six Sigma in a…

Positive Deviance: Learning from Positive Anomalies

ERIC Educational Resources Information Center

LeMahieu, Paul G.; Nordstrum, Lee E.; Gale, Dick

2017-01-01

Purpose: This paper is one of seven in this volume, each elaborating different approaches to quality improvement in education. The purpose of this paper is to delineate a methodology called positive deviance. Design/methodology/approach: The paper presents the origins, theoretical foundations, core principles and a case study demonstrating an…

Nutrition Education: Towards a Whole-School Approach

ERIC Educational Resources Information Center

Rowe, Fiona; Stewart, Donald; Somerset, Shawn

2010-01-01

Purpose: Schools are widely accepted as having the potential to make substantial contributions to promoting healthy eating habits in children and adolescents. This paper aims to present a case study from an Australian school of how a whole-school approach, planned and implemented through a health promoting school framework, can foster improved…

Pedagogical Approaches to Develop Critical Thinking and Crisis Leadership

ERIC Educational Resources Information Center

Powley, Edward H.; Taylor, Scott N.

2014-01-01

Management schools must be prepared to aid leaders and managers to succeed in uncertain environments. We offer two approaches, each designed for critical thinking skill development, to teach graduate management students about leading in and through potential disruption to organizational life. First, we present a personalized case method that…

Learning Families: Intergenerational Approach to Literacy Teaching and Learning

ERIC Educational Resources Information Center

Hanemann, Ulrike, Ed.

2015-01-01

Within a learning family, every member is a lifelong learner. A family literacy and learning approach is more likely to break the intergenerational cycle of low education and inadequate literacy skills, particularly among disadvantaged families and communities. The selection of case studies presented in this compilation show that for an…

Prosthetic rehabilitation of oral submucous fibrosis patients: A systematic review of published case reports and case series

PubMed Central

Patil, Shankargouda; Sarode, Gargi S.; Bhandi, Shilpa; Awan, Kamran Habib; Ferrari, Marco

2017-01-01

Background Oral submucous fibrosis (OSF) is an insidious chronic condition characterized by restricted mouth opening. Prosthetic rehabilitation is challenging for OSF patients as obtaining a good impression requires adequate mouth opening. The aim of the present review is to systematically present the data from case reports published in the English-language literature. Method A comprehensive search of the literature databases (PubMed, Medline, SCOPUS, Web of Science and Google Scholar) along with the references of published articles on prosthetic rehabilitation in OSF patients published to date was conducted. Keywords included a combination of ‘Oral submucous fibrosis’, ‘prosthesis’, ‘dentures’ and/or ‘restricted mouth opening’. Citations from selected references and bibliographic linkages taken from similar cases were included in this review. The inclusion criteria selected for case reports on prosthetic rehabilitation in OSF patients, and cases of restricted mouth opening due to causes other than OSF were excluded from the study. Results A total of 21 cases were identified and analysed from 17 papers published in the English-language literature. Of these, 9 cases employed the sectional denture technique, 4 cases emphasized the need-based treatment approach in which conventional methods were modified, and 4 cases used mouth exercising devices. Finally, 1 case each involved, flexible denture, oral screen prosthesis, oral stents, surgery in conjunction with dentures. Conclusion Prosthetic rehabilitation in OSF patients is a multifaceted approach and should be patient specific, although sectional dentures have achieved the best results. PMID:28877246

Prosthetic rehabilitation of oral submucous fibrosis patients: A systematic review of published case reports and case series.

PubMed

Patil, Shankargouda; Sarode, Sachin Chakradhar; Sarode, Gargi S; Bhandi, Shilpa; Awan, Kamran Habib; Ferrari, Marco

2017-01-01

Oral submucous fibrosis (OSF) is an insidious chronic condition characterized by restricted mouth opening. Prosthetic rehabilitation is challenging for OSF patients as obtaining a good impression requires adequate mouth opening. The aim of the present review is to systematically present the data from case reports published in the English-language literature. A comprehensive search of the literature databases (PubMed, Medline, SCOPUS, Web of Science and Google Scholar) along with the references of published articles on prosthetic rehabilitation in OSF patients published to date was conducted. Keywords included a combination of 'Oral submucous fibrosis', 'prosthesis', 'dentures' and/or 'restricted mouth opening'. Citations from selected references and bibliographic linkages taken from similar cases were included in this review. The inclusion criteria selected for case reports on prosthetic rehabilitation in OSF patients, and cases of restricted mouth opening due to causes other than OSF were excluded from the study. A total of 21 cases were identified and analysed from 17 papers published in the English-language literature. Of these, 9 cases employed the sectional denture technique, 4 cases emphasized the need-based treatment approach in which conventional methods were modified, and 4 cases used mouth exercising devices. Finally, 1 case each involved, flexible denture, oral screen prosthesis, oral stents, surgery in conjunction with dentures. Prosthetic rehabilitation in OSF patients is a multifaceted approach and should be patient specific, although sectional dentures have achieved the best results.

Defining datasets and creating data dictionaries for quality improvement and research in chronic disease using routinely collected data: an ontology-driven approach.

PubMed

de Lusignan, Simon; Liaw, Siaw-Teng; Michalakidis, Georgios; Jones, Simon

2011-01-01

The burden of chronic disease is increasing, and research and quality improvement will be less effective if case finding strategies are suboptimal. To describe an ontology-driven approach to case finding in chronic disease and how this approach can be used to create a data dictionary and make the codes used in case finding transparent. A five-step process: (1) identifying a reference coding system or terminology; (2) using an ontology-driven approach to identify cases; (3) developing metadata that can be used to identify the extracted data; (4) mapping the extracted data to the reference terminology; and (5) creating the data dictionary. Hypertension is presented as an exemplar. A patient with hypertension can be represented by a range of codes including diagnostic, history and administrative. Metadata can link the coding system and data extraction queries to the correct data mapping and translation tool, which then maps it to the equivalent code in the reference terminology. The code extracted, the term, its domain and subdomain, and the name of the data extraction query can then be automatically grouped and published online as a readily searchable data dictionary. An exemplar online is: www.clininf.eu/qickd-data-dictionary.html Adopting an ontology-driven approach to case finding could improve the quality of disease registers and of research based on routine data. It would offer considerable advantages over using limited datasets to define cases. This approach should be considered by those involved in research and quality improvement projects which utilise routine data.

Pleomorphic Adenoma of Base of Tongue: Is Midline Mandibulotomy Necessary for Approaching Benign Base Tongue Lesions?

PubMed Central

Bansal, Sandeep; Kalsotra, Gopika; Mohammed, Abdul Wadood; Bahl, Amanjit; Gupta, Ashok K.

2012-01-01

Objective. To report a rare presentation of pleomorphic adenoma, at base tongue, excised surgically by a transoral midline glossotomy technique without mandibulotomy. Case Report. Pleomorphic adenoma is a benign tumor of the salivary gland found rarely in the base of tongue. Surgery is the definitive treatment for this tumor, and different approaches have been mentioned in the literature. In our case we surgically excised the tumor by a transoral midline glossotomy technique without mandibulotomy where we combined the cosmetic advantage of transoral technique and the exposure advantage of a glossotomy technique. Discussion. We discuss the different approaches to oropharynx, their advantages and disadvantages. Primary transoral approach provides better cosmesis but less exposure whereas median labiomandibuloglossotomy approach provides more exposure but is cosmetically unacceptable. Conclusion. A transoral midline glossotomy approach without mandibulotomy provides wide exposure with acceptable cosmesis. PMID:22953125

The Place of Subject Matter Knowledge in Pedagogical Content Knowledge: A Case Study of South African Teachers Teaching the Amount of Substance and Chemical Equilibrium

ERIC Educational Resources Information Center

Rollnick, Marissa; Bennett, Judith; Rhemtula, Mariam; Dharsey, Nadine; Ndlovu, Thandi

2008-01-01

This paper presents two South African case studies designed to explore the influence of subject matter knowledge on pedagogical content knowledge (PCK). In the first case study on teaching the mole in two township schools, the findings illustrate that the participant teachers favoured procedural approaches at the expense of conceptual…

Mystery of the Toxic Flea Dip: An Interactive Approach to Teaching Aerobic Cellular Respiration

ERIC Educational Resources Information Center

Baines, A. T.; McVey, M.; Rybarczyk, B.; Thompson, J. T.; Wilkins, H. R.

2004-01-01

We designed an interrupted case study to teach aerobic cellular respiration to major and nonmajor biology students. The case is based loosely on a real-life incident of rotenone poisoning. It places students in the role of a coroner who must determine the cause of death of the victim. The case is presented to the students in four parts. Each part…

Small Data, Online Learning and Assessment Practices in Higher Education: A Case Study of Failure?

ERIC Educational Resources Information Center

Watson, Cate; Wilson, Anna; Drew, Valerie; Thompson, Terrie Lynn

2017-01-01

In this paper, we present an in-depth case study of a single student who failed an online module which formed part of a master's programme in Professional Education and Leadership. We use this case study to examine assessment practices in higher education in the online environment. In taking this approach, we go against the current predilection…

Tularaemia in Minnesota: case report and brief epidemiology.

PubMed

Scheftel, J M; Griffith, J M; Leppke, B A; Pantlin, G C; Snippes, P M; Wünschmann, A

2010-12-01

The 2008 case presented here of tularaemia in a cat and its owner occurred in an urban setting and was associated with animal contact, a relatively rare mode of transmission in Minnesota in recent years. Response to this case exemplified a 'One Health' approach involving pre-existing relationships, cooperation between multiple disciplines and laboratory infrastructure that facilitated information sharing. © 2010 Blackwell Verlag GmbH.

Goal Structured Notation in a Radiation Hardening Safety Case for COTS-Based Spacecraft

NASA Technical Reports Server (NTRS)

Witulski, Arthur; Austin, Rebekah; Reed, Robert; Karsai, Gabor; Mahadevan, Nag; Sierawski, Brian; Evans, John; LaBel, Ken

2016-01-01

A systematic approach is presented to constructing a radiation assurance case using Goal Structured Notation (GSN) for spacecraft containing COTS parts. The GSN paradigm is applied to an SRAM single-event upset experiment board designed to fly on a CubeSat November 2016. Construction of a radiation assurance case without use of hardened parts or extensive radiation testing is discussed.

Clinical Presentation, Diagnosis, and Surgical Treatment of Spontaneous Cervical Intradural Disc Herniations: A Review of the Literature.

PubMed

Gunasekaran, Arunprasad; de Los Reyes, Nova Kristine M; Walters, Jerry; Kazemi, Noojan

2018-01-01

Spontaneous cervical intradural disc herniation (IDH) is a rare occurrence with limited and disparate information available regarding its presentation, diagnosis, and treatment. However, its accurate detection is vital for planning surgical treatment. In this review of the literature, we collected data from all cervical IDHs described to date. Particular attention was paid to diagnostic findings, surgical approach, and causation for cervical IDH, especially at the cervicothoracic junction. A review for cases of cervical IDH was performed via the following search criteria: ("neck"[MeSH Terms] OR "neck"[All Fields] OR "cervical"[All Fields]) AND intradural[All Fields] AND disc[All Fields]. Thirty-seven cases of cervical disc herniation were identified. Demographic variables identified included age, sex, cervical level of herniation, history of associated cervical trauma, presence of Brown-Séquard syndrome, Horner syndrome, and other neurologic findings, radiographic findings, direction of surgical approach, and postoperative outcomes. A total of 37 cases of cervical IDH were identified. Most of the cases occurred at the lower levels of the cervical spine, with 35.1% at the C5-C6 level, followed by 24.3% at C6-C7, and lower still at other levels. Of the patients reviewed, 44.4% had a previous history of trauma before manifestation of symptom, with the majority being spontaneous IDH with no previous history of trauma or spine surgery. Brown-Séquard syndrome was present in 43.2% of the patients, whereas 10.8% of patients experienced Horner syndrome. The most common presentations of IDH included quadriplegia, finger/gait ataxia, radiculopathy, and nuchal pain. The degree of neurologic recovery was not associated with patient age. Most of the cervical IDHs in the literature were treated surgically via an anterior approach, but a larger portion of patients who underwent a posterior approach had improved recovery. Cervical IDH is a rare event, with this review of the literature outlining the clinical and radiographic parameters of its presentation as well as comparing common surgical strategies for treatment. We outline theories underlying the development of cervical IDH and argue for a posterior surgical approach in which the disc herniation is sequestrated with migration. Copyright © 2017 Elsevier Inc. All rights reserved.

Higher education provision using systems thinking approach - case studies

NASA Astrophysics Data System (ADS)

Dhukaram, Anandhi Vivekanandan; Sgouropoulou, Cleo; Feldman, Gerald; Amini, Ardavan

2018-01-01

The purpose of this paper is to highlight the complexities involved in higher education provision and how systems thinking and socio-technical systems (STS) thinking approach can be used to understand the education ecosystem. Systems thinking perspective is provided using two case studies: the development of European Learner Mobility (EuroLM) service and the delivery of Enterprise System Management (ESM) course at the Birmingham City University, UK. The case studies present how systems thinking using STS approaches like applied organisational change and Cognitive Work Analysis can be used to capture a conceptual model of the education system for understanding the interactions and relationships between the people, technology, processes and the organisations. Using systems thinking perspective, EuroLM has developed a set of technical standards addressed to the European systems developers and ESM delivery ensures that students communicate and collaborate.

Application of the endoscopic transsphenoidal approach to true type transsellar transsphenoidal meningoencephalocele in an adult: a case report and literature review.

PubMed

Saito, Katsuya; Toda, Masahiro; Sano, Keisho; Tomita, Toshiki; Ogawa, Kaoru; Yoshida, Kazunari

2012-08-01

Of the transsellar transsphenoidal meningoencephaloceles (TTSMEs), the true type presents with the hernial sac extending from the intracranium to the epipharynx through the sellar floor. The true type is the most serious and difficult to manage, especially when the hernial sac contains vital structures, such as the anterior cerebral artery, pituitary gland, optic nerve, hypothalamus, and third ventricle. Surgical outcome for true type TTSME is reported to be poor. We describe a successful case of endoscopic repair for a 36-year-old man with true type TTSME. Our success with endoscopic repair for true type TTSME in an adult is the first reported case. We believe that the endoscopic transsphenoidal approach allows less invasive surgery and provides an acceptable operative outcome in comparison with other microsurgical approaches.

Laser-Scanner Survey of Structural Disorders: AN Instrument to Inspect the History of Parma Cathedral's Central Nave

NASA Astrophysics Data System (ADS)

Bruno, N.; Coïsson, E.; Cotti, M.

2017-05-01

This paper presents the use of laser scanner derived data for the study of the structural disorders in the central nave of the Parma Cathedral. An accurate three-dimensional model of the entire nave was realized to investigate deformations, in order to reconstruct the original conformation and the subsequent evolutions, also in comparison with previous surveys. Specifically, for the analysis presented in the paper, seven scans were performed, one for each bay: the results allowed to compare the deformations on the seven vaults, on the transverse and diagonal arches, giving first hints on the possible differences in the behaviour between the different elements. The measures on the levels of floor and pillars bases were analysed in a historical monitoring approach, in order to retrace the evolution of the differential settlements in time, since the construction of the building. Moreover, a structural analysis has been carried out on one transverse arch with distinct element analysis, with two different approaches. In one case, the structure was inserted exactly as surveyed, and then subjected to the actions. In the second case, the original geometry, before the deformation, was retraced through a parametric approach and the structural analysis basically started at the beginning of the building's life, thus trying to model not only the present structural situation, but also the path which led to the current deformation. The results were particularly meaningful as they showed that in the first case, disregarding the footsteps of history, the stress pattern inside the masonry was very different from the one obtained in the second case, which is more likely to represent the present conditions.

Case study: Optimizing fault model input parameters using bio-inspired algorithms

NASA Astrophysics Data System (ADS)

Plucar, Jan; Grunt, Onřej; Zelinka, Ivan

2017-07-01

We present a case study that demonstrates a bio-inspired approach in the process of finding optimal parameters for GSM fault model. This model is constructed using Petri Nets approach it represents dynamic model of GSM network environment in the suburban areas of Ostrava city (Czech Republic). We have been faced with a task of finding optimal parameters for an application that requires high amount of data transfers between the application itself and secure servers located in datacenter. In order to find the optimal set of parameters we employ bio-inspired algorithms such as Differential Evolution (DE) or Self Organizing Migrating Algorithm (SOMA). In this paper we present use of these algorithms, compare results and judge their performance in fault probability mitigation.

Creating ISO/EN 13606 archetypes based on clinical information needs.

PubMed

Rinner, Christoph; Kohler, Michael; Hübner-Bloder, Gudrun; Saboor, Samrend; Ammenwerth, Elske; Duftschmid, Georg

2011-01-01

Archetypes model individual EHR contents and build the basis of the dual-model approach used in the ISO/EN 13606 EHR architecture. We present an approach to create archetypes using an iterative development process. It includes automated generation of electronic case report forms from archetypes. We evaluated our approach by developing 128 archetypes which represent 446 clinical information items from the diabetes domain.

Instrument Attitude Precision Control

NASA Technical Reports Server (NTRS)

Juang, Jer-Nan

2004-01-01

A novel approach is presented in this paper to analyze attitude precision and control for an instrument gimbaled to a spacecraft subject to an internal disturbance caused by a moving component inside the instrument. Nonlinear differential equations of motion for some sample cases are derived and solved analytically to gain insight into the influence of the disturbance on the attitude pointing error. A simple control law is developed to eliminate the instrument pointing error caused by the internal disturbance. Several cases are presented to demonstrate and verify the concept presented in this paper.

Scoliosis in Dandy-Walker syndrome: a case report and review of literature

PubMed Central

Sorur, Tamer M. M.; Al Ghafri, Khalifa A.; Shahin, Marwan M. H. E.

2017-01-01

This submission presents a case of scoliosis in a patient with established Dandy-Walker anomaly of the brain. A retrospective review of the patient’s case notes was undertaken and the limited literature on this subject reviewed. The 13-year-old girl presented with a stiff right thoracic scoliosis typical of adolescent idiopathic scoliosis. The scoliotic segment also presented with significant lordosis. She had facial and truncal dysmorphism characteristic of Dandy-Walker complex and her brain images confirmed the diagnosis. She underwent scoliosis surgery by the posterior approach uneventfully. In conclusion scoliosis is hitherto unreported in the Dandy-Walker complex. The results of intervention appear satisfactory. PMID:29354751

An Integrated Approach for Gear Health Prognostics

NASA Technical Reports Server (NTRS)

He, David; Bechhoefer, Eric; Dempsey, Paula; Ma, Jinghua

2012-01-01

In this paper, an integrated approach for gear health prognostics using particle filters is presented. The presented method effectively addresses the issues in applying particle filters to gear health prognostics by integrating several new components into a particle filter: (1) data mining based techniques to effectively define the degradation state transition and measurement functions using a one-dimensional health index obtained by whitening transform; (2) an unbiased l-step ahead RUL estimator updated with measurement errors. The feasibility of the presented prognostics method is validated using data from a spiral bevel gear case study.

Splenic Pregnancy: A New Minimally Invasive Approach to Treatment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Klang, Eyal, E-mail: eyalkla@hotmail.com; Keddel, Nicholas; Inbar, Yael

The spleen is a rare site of abdominal ectopic pregnancy. In a review of the literature, we found 16 published cases of primary splenic pregnancies. Of the cases identified, all received surgical intervention, with one case successfully treated with laparoscopic methotrexate injection, and the rest underwent splenectomy. We would like to present a case of primary splenic pregnancy in a 35-year-old woman successfully treated with percutaneous image-guided injection of methotrexate and KCl.

Fiducial marker placement via conventional or electromagnetic navigation bronchoscopy (ENB): an interdisciplinary approach to the curative management of lung cancer.

PubMed

Hagmeyer, Lars; Priegnitz, Christina; Kocher, Martin; Schilcher, Burkhart; Budach, Wilfried; Treml, Marcel; Stieglitz, Sven; Randerath, Winfried

2016-05-01

Conventional and electromagnetic navigation bronchoscopy (ENB) is generally used as a diagnostic tool in suspicious pulmonary nodules. The use of this technique for the placement of fiducial markers in patients with inoperable but early-stage lung cancer could present an innovative approach enabling risk-reduced therapy. We present seven clinical cases where conventional bronchoscopy and ENB were used as part of an experimental interdisciplinary approach to clinical management and therapy planning. In each case, we analyzed the clinical indication, endoscopic procedures and post-interventional outcome. In six patients (three females, three males) with peripheral non-small cell lung cancer (NSCLC), stage cT1cN0cM0, surgery and conventional stereotactic radiation therapy was not possible because of end-stage chronic obstructive pulmonary disease. ENB was used for fiducial marker placement prior to cyberknife radiotherapy. No procedure-related complications were observed. Complete remission could be achieved in four cases, partial remission in two cases and no relevant complications induced by radiotherapy were observed. In one male patient, an endoluminal relapse in the right lower lobe was diagnosed following a right upper lobe resection for a NSCLC. The tumor could not be clearly identified by computerized tomography, so that the bronchoscopic placement of a fiducial marker in the tumor was performed in order to allow stereotactic radiochemotherapy, by which complete remission could be achieved. Fiducial marker placement may be an interesting bronchoscopic technique in the interdisciplinary therapeutic approach to inoperable early-stage lung cancer. In the described cases, therapy planning was successful and no procedure-related complications were observed. © 2014 John Wiley & Sons Ltd.

Accessory wandering spleen: Report of a case of laparoscopic approach in an asymptomatic patient

PubMed Central

Perin, Alessandro; Cola, Roberto; Favretti, Franco

2014-01-01

INTRODUCTION Accessory wandering spleen is a rare but dangerous condition. Abnormalities of the ligamentous apparatus of an accessory spleen may evolve into torsion of its vascular axis, which can lead to a splenic infarct making surgery necessary. Patients are often asymptomatic and the diagnosis can be accidental. An early diagnosis and a correct treatment are fundamental. PRESENTATION OF CASE In this case report a young woman underwent laparoscopic surgery after an incidental finding at a Pelvic Ultrasound of an accessory wandering spleen. DISCUSSION In literature are reported cases of asymptomatic patients with an accessory wandering spleen treated with a conservative approach. However, a torsion or infarct of the accessory wandering spleen leads to emergency surgery. The presence of an independent vascular axis of the accessory spleen reduces the risk of postoperative complications (e.g. thrombocytosis) and the administration of low molecular weight heparin should prevent the risk of portal thrombosis. CONCLUSION We suggest performing surgery with a laparoscopic approach in patients with accessory wandering spleen, though asymptomatic, because of the risk of serious complications in case of accessory spleen torsion. PMID:25460427

Linking biomedical engineering ethics case study approach and policy.

PubMed

Dibrell, William; Dobie, Elizabeth Ann

2007-01-01

In this paper we link bioengineering case study methods to the development of policy. The case study approach to ethics is an excellent way to show the complex nature of practical/moral reasoning. This approach can, however, lead to a kind of overwhelming complexity. The individual nature of each case makes it difficult to identify the most important information and difficult to see what moral considerations are most relevant. In order to make the overwhelming complexity less debilitating, we present a framework for moral decision making derived from suggestions made by W.D. Ross and Virginia Held. Ross articulates the multiple sources of morality and Held deepens the discussion by reminding us of the foundational importance of care and sympathy to our moral natures. We show how to use the notion of prima facie duty and discuss moral conflict. In doing this, we show how the framework, applied to cases, can be of assistance in helping us develop policies and codes of ethics with sufficient plasticity to be useful in the complex world of the bioengineer.

An alternative approach for socio-hydrology: case study research

NASA Astrophysics Data System (ADS)

Mostert, Erik

2018-01-01

Currently the most popular approach in socio hydrology is to develop coupled human-water models. This article proposes an alternative approach, qualitative case study research, involving a systematic review of (1) the human activities affecting the hydrology in the case, (2) the main human actors, and (3) the main factors influencing the actors and their activities. Moreover, this article presents a case study of the Dommel Basin in Belgium and the Netherlands, and compares this with a coupled model of the Kissimmee Basin in Florida. In both basins a pendulum swing from water resources development and control to protection and restoration can be observed. The Dommel case study moreover points to the importance of institutional and financial arrangements, community values, and broader social, economic, and technical developments. These factors are missing from the Kissimmee model. Generally, case studies can result in a more complete understanding of individual cases than coupled models, and if the cases are selected carefully and compared with previous studies, it is possible to generalize on the basis of them. Case studies also offer more levers for management and facilitate interdisciplinary cooperation. Coupled models, on the other hand, can be used to generate possible explanations of past developments and quantitative scenarios for future developments. The article concludes that, given the limited attention they currently get and their potential benefits, case studies deserve more attention in socio-hydrology.

[Intraoperative ultrasonography, dissection with ultra-shears and trans-cystic choledochoscopy during laparoscopic approach in obstructive lithiasis icterus case].

PubMed

Alecu, L; Corodeanu, G; Costan, I; Lungu, C; Staicu, A

2001-01-01

The authors present the case of a 48 years old male with lithiasis obstructive icterus who was operated by laparoscopic transcystic approach with choledochoscopy. This minimally invasive technique was very spectacular trough the using of laparoscopic ultrasonography, dissection with Ultra-Shears device and transcystic choledochoscopy. Careful watching of abdominal laparoscopic view and transcystic choledochoscopic view is the particularity of laparoscopic transcystic management of choledocholithiasis. This metod don't let us to explore the biliary tract before the junction between common bile duct and cystic duct.

Lagrangian solution of supersonic real gas flows

NASA Technical Reports Server (NTRS)

Loh, Ching-Yuen; Liou, Meng-Sing

1993-01-01

The present extention of a Lagrangian approach of the Riemann solution procedure, which was originally proposed for perfect gases, to real gases, is nontrivial and requires the development of an exact real-gas Riemann solver for the Lagrangian form of the conservation laws. Calculations including complex wave interactions of various types were conducted to test the accuracy and robustness of the approach. Attention is given to the case of 2D oblique waves' capture, where a slip line is clearly in evidence; the real gas effect is demonstrated in the case of a generic engine nozzle.

A complicated case of amyand's hernia involving a perforated appendix and its management using minimally invasive laparoscopic surgery: A case report.

PubMed

Al-Ramli, Wisam; Khodear, Yahya; Aremu, Muyiwa; El-Sayed, Abdel Basset

2016-01-01

Amyand's hernia is a rare condition of inguinal hernia in which the appendix is incarcerated within the hernia sac through the internal ring. Complications include acute appendicitis and perforated appendicitis, which are rare in incidence, accounting for about 0.1% of cases. 1 These complications prove a diagnostic challenge due to their vague clinical presentation and atypical laboratory and radiological findings. Until recently, open appendectomy was the mainstay of treatment. Laparoscopic surgery offers a less invasive approach to confirming a diagnosis and serving as a therapeutic tool in equivocal cases. We report a case of a previously healthy 20-year-old male presenting with atypical signs and symptoms, as well as blood investigation results, and radiological findings of a perforated appendix within an Amyand's hernia. The patient was successfully managed using a minimally invasive laparoscopic appendectomy approach. Until recently, open appendectomy was considered the mainstay in the management of complicated Amyand's hernia. Laparoscopic surgery provides a new avenue for dealing with diagnostic uncertainty with advantages including faster recovery time, reduced hospital stay, and better quality of life. This case report highlights the concealing effects of an Amyand's hernia on a perforated appendix, the considerations required when an equivocal diagnosis present and the safe use of the minimally invasive laparoscopic surgery in the treatment of this rare condition. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Clinical reasoning and case-based decision making: the fundamental challenge to veterinary educators.

PubMed

May, Stephen A

2013-01-01

Confusion about the nature of human reasoning and its appropriate application to patients has hampered veterinary students' development of these skills. Expertise is associated with greater ability to deploy pattern recognition (type 1 reasoning), which is aided by progressive development of data-driven, forward reasoning (in contrast to scientific, backward reasoning), analytical approaches that lead to schema acquisition. The associative nature of type 1 reasoning makes it prone to bias, particularly in the face of "cognitive miserliness," when clues that indicate the need for triangulation with an analytical approach are ignored. However, combined reasoning approaches, from the earliest stages, are more successful than one approach alone, so it is important that those involved in curricular design and delivery promote student understanding of reasoning generally, and the situations in which reasoning goes awry, and develop students' ability to reason safely and accurately whether presented with a familiar case or with a case that they have never seen before.

Practical multimodal care for cancer cachexia.

PubMed

Maddocks, Matthew; Hopkinson, Jane; Conibear, John; Reeves, Annie; Shaw, Clare; Fearon, Ken C H

2016-12-01

Cancer cachexia is common and reduces function, treatment tolerability and quality of life. Given its multifaceted pathophysiology a multimodal approach to cachexia management is advocated for, but can be difficult to realise in practice. We use a case-based approach to highlight practical approaches to the multimodal management of cachexia for patients across the cancer trajectory. Four cases with lung cancer spanning surgical resection, radical chemoradiotherapy, palliative chemotherapy and no anticancer treatment are presented. We propose multimodal care approaches that incorporate nutritional support, exercise, and anti-inflammatory agents, on a background of personalized oncology care and family-centred education. Collectively, the cases reveal that multimodal care is part of everyone's remit, often focuses on supported self-management, and demands buy-in from the patient and their family. Once operationalized, multimodal care approaches can be tested pragmatically, including alongside emerging pharmacological cachexia treatments. We demonstrate that multimodal care for cancer cachexia can be achieved using simple treatments and without a dedicated team of specialists. The sharing of advice between health professionals can help build collective confidence and expertise, moving towards a position in which every team member feels they can contribute towards multimodal care.

Asymptotic-preserving Lagrangian approach for modeling anisotropic transport in magnetized plasmas for arbitrary magnetic fields

NASA Astrophysics Data System (ADS)

Chacon, Luis; Del-Castillo-Negrete, Diego; Hauck, Cory

2012-10-01

Modeling electron transport in magnetized plasmas is extremely challenging due to the extreme anisotropy between parallel (to the magnetic field) and perpendicular directions (χ/χ˜10^10 in fusion plasmas). Recently, a Lagrangian Green's function approach, developed for the purely parallel transport case,footnotetextD. del-Castillo-Negrete, L. Chac'on, PRL, 106, 195004 (2011)^,footnotetextD. del-Castillo-Negrete, L. Chac'on, Phys. Plasmas, 19, 056112 (2012) has been extended to the anisotropic transport case in the tokamak-ordering limit with constant density.footnotetextL. Chac'on, D. del-Castillo-Negrete, C. Hauck, JCP, submitted (2012) An operator-split algorithm is proposed that allows one to treat Eulerian and Lagrangian components separately. The approach is shown to feature bounded numerical errors for arbitrary χ/χ ratios, which renders it asymptotic-preserving. In this poster, we will present the generalization of the Lagrangian approach to arbitrary magnetic fields. We will demonstrate the potential of the approach with various challenging configurations, including the case of transport across a magnetic island in cylindrical geometry.

Introduction of a computer-based surgical platform in the surgical care of patients with newly diagnosed uterine cancer: outcomes and impact on approach.

PubMed

Leitao, Mario M; Briscoe, Gabriel; Santos, Kevin; Winder, Abigail; Jewell, Elizabeth L; Hoskins, William J; Chi, Dennis S; Abu-Rustum, Nadeem R; Sonoda, Yukio; Brown, Carol L; Levine, Douglas A; Barakat, Richard R; Gardner, Ginger J

2012-05-01

To assess the introduction of computer-based surgery (ie, robotic surgery [RBT]) in the treatment of patients with newly diagnosed uterine cancer. We identified all patients who presented to our institution for initial surgical care of newly diagnosed uterine cancer from 5/1/07-12/31/10. Perioperative outcomes of laparotomy cases were compared to those of laparoscopic (LSC) or RBT cases. Complications within 30 days of surgery were graded. Of 752 patients, the planned approach was laparotomy in 103 (14%), LSC in 302 (40%), and RBT in 347 (46%). The rate of laparotomy for any reason (planned or converted) was 39% in 2007 compared to 18% in 2010 (P<0.001). Preoperative characteristics for LSC and RBT cases were similar, except 10% versus 15%, respectively, were morbidly obese (P=0.049). The extent of procedure, total nodal counts, and overall complications were similar between the LSC and RBT cases. The median length of stay was shorter for RBT cases (P<0.001). The median total room and operative times were longer for RBT cases (P<0.001), mainly due to cases in which the surgeon had less than ~40 RBT cases of experience. Robotics can be efficiently introduced into the surgical care of patients with newly diagnosed uterine cancers. RBT cases require the same operative times as LSC cases after accounting for the 40-case learning curve. Both approaches result in similar excellent patient outcomes and remain reasonable approaches for this disease. The introduction of robotics may lead to further reduction in the rate of laparotomy. Copyright © 2012 Elsevier Inc. All rights reserved.

Assurance Arguments for the Non-Graphically-Inclined: Two Approaches

NASA Technical Reports Server (NTRS)

Heavner, Emily; Holloway, C. Michael

2017-01-01

We introduce and discuss two approaches to presenting assurance arguments. One approach is based on a monograph structure, while the other is based on a tabular structure. In today's research and academic setting, assurance cases often use a graphical notation; however for people who are not graphically inclined, these notations can be difficult to read. This document proposes, outlines, explains, and presents examples of two non-graphical assurance argument notations that may be appropriate for non-graphically-inclined readers and also provide argument writers with freedom to add details and manipulate an argument in multiple ways.

Pedophilia: an update on theory and practice.

PubMed

Travin, S; Bluestone, H; Coleman, E; Cullen, K; Melella, J

1985-01-01

The number of sexual attacks on children is staggering, yet it is extremely difficult to understand what effective treatments are available for the pedophile by reviewing the literature. Therefore, the authors present an update of the changing conceptualizations regarding the offenders and their victims. An overview of the currently used modalities to treat the pedophile is presented with emphasis on the promising cognitive-behavioral approach. A brief description of this approach is given with two case illustrations.

Giant scrotal elephantiasis of inflammatory etiology: a case report

PubMed Central

Denzinger, Stefan; Watzlawek, Elke; Burger, Maximilian; Wieland, Wolf F; Otto, Wolfgang

2007-01-01

Background Scrotal lymphedema is rare outside endemic filariasis regions in Africa and Asia. It is of variable origin in the western world. Case presentation We present a case of a 40-year-old European man with massive elephantiasis of the scrotum attributed to chronic inflammation of the lower urinary tract caused by urinary outlet obstruction and diabetes mellitus. The patient underwent subtotal scrotectomy saving penis, testes and spermatic cords and followed by scrotal reconstruction with adequate cosmetic and functional outcome. Conclusion In this report we discuss a rare case of scrotal elephantiasis in an European patient, reflect on the etiology and the diagnostic and therapeutic approaches. Surgery can be successful even in giant scrotal elephantiasis. PMID:17543128

Theory of the dynamical thermal conductivity of metals

NASA Astrophysics Data System (ADS)

Bhalla, Pankaj; Kumar, Pradeep; Das, Nabyendu; Singh, Navinder

2016-09-01

The Mori's projection method, known as the memory function method, is an important theoretical formalism to study various transport coefficients. In the present work, we calculate the dynamical thermal conductivity in the case of metals using the memory function formalism. We introduce thermal memory functions for the first time and discuss the behavior of thermal conductivity in both the zero frequency limit and in the case of nonzero frequencies. We compare our results for the zero frequency case with the results obtained by the Bloch-Boltzmann kinetic approach and find that both approaches agree with each other. Motivated by some recent experimental advancements, we obtain several new results for the ac or the dynamical thermal conductivity.

Analysis of eco-innovation with triple helix approach: case-study of biofloc catfish farming in Yogyakarta

NASA Astrophysics Data System (ADS)

Purwadi, D.; Nurlaily, I.

2018-03-01

Concerning environmental into focus of innovation process will expand the number of actor involved. Eco-innovation and triple helix are often frameworks applied to analyse how environmental concern are integrated in innovation process and how different stakeholder groups are having inter relation. Case study from biofloc catfish farming in Yogyakarta is presented to demonstrate a possible approach for researching the success of triple helix frameworks. This case is considered on basic of the result of a survey among farmers, academician and government. The paper concludes the creating of full triple helix encounters problem in practice. It also includes suggestion for further research on fisheries development.

Cultural Competence Development, Critical Service Learning, and Latino/a Youth Empowerment: A Qualitative Case Study

ERIC Educational Resources Information Center

Vargas, Lucila C.; Erba, Joseph

2017-01-01

As universities create service-learning programs, educators are experimenting with pedagogical approaches that enhance learning outcomes while benefiting communities. We present a qualitative case study of a radio-based, service-learning program, grounded in a Freirean foundation and aimed at developing the cultural competence and sense of…

Case Management of Adolescents with Chronic Disease.

ERIC Educational Resources Information Center

Lankard, Bettina A.

This training guide presents a model for optimum delivery of the primary duties, tasks, and steps required in the comprehensive case management of adolescents with chronic disease. Using a team approach to coordinated health care, the guide involves the patient and family as key members of the care team along with the physician, nurse, dietitian,…

Understanding and Treating Health Anxiety: A Cognitive-Behavioral Approach

ERIC Educational Resources Information Center

Taylor, Steven

2004-01-01

Mrs. A. presents with a textbook case of hypochondriasis. An additional diagnosis of OCD does not enhance our understanding or treatment of her problems, and is not indicated according to "DSM-IV." Cognitive-behavior therapy (CBT) is effective in treating hypochondriasis, although it is necessary to devise a case formulation for each patient to…

Trial and Error: Negotiating Manhood and Struggling to Discover True Self

ERIC Educational Resources Information Center

Foste, Zak; Edwards, Keith; Davis, Tracy

2012-01-01

Using a case study approach , this article explores how men become restricted in experiencing a full range of emotions and human potential. After reviewing current literature describing the pressures men face to conform to traditional ideologies of masculinity, the case study methodology is described, results presented, and implications for…

The Sociomateriality of Education Policy

ERIC Educational Resources Information Center

Landri, Paolo

2015-01-01

By drawing on sociomaterial approaches to education, this paper presents a case study on the creation, development and consolidation of the education zone, a new policy space in South Italy. The topological reading of the case study reveals the complex reassemblage of humans and non-humans in the enactment of the education zones, and its multiple…

Ideologies of Adventure: Authority and Decision Making in Sail Training

ERIC Educational Resources Information Center

McCulloch, Kenneth H.

2004-01-01

Case studies of the contemporary UK sail training movement are used to illustrate the competing expressions of purpose in this field. Two sail training organisations are described and a case study voyage under the aegis of each is presented. The differences between the approaches are analysed as "traditions" or ideologies, articulated…

Knowledge Management Model: Practical Application for Competency Development

ERIC Educational Resources Information Center

Lustri, Denise; Miura, Irene; Takahashi, Sergio

2007-01-01

Purpose: This paper seeks to present a knowledge management (KM) conceptual model for competency development and a case study in a law service firm, which implemented the KM model in a competencies development program. Design/methodology/approach: The case study method was applied according to Yin (2003) concepts, focusing a six-professional group…

Implementing Curriculum Evaluation: Case Study of a Generic Undergraduate Degree in Health Sciences

ERIC Educational Resources Information Center

Harris, Lynne; Driscoll, Peter; Lewis, Melinda; Matthews, Lynda; Russell, Cherry; Cumming, Steven

2010-01-01

This case study presents a longitudinal, evidence-based approach to health science curriculum reform and evaluation. Curriculum in higher education must meet the needs of diverse stakeholders and must respond to dynamic local, national and international contexts, and this creates challenges for evaluation. The long lead time prior to the…

A Case Study Approach to Ethics in Career Development, Second Edition. Monograph Series

ERIC Educational Resources Information Center

Makela, Julia Panke; Perlus, Jessamyn G.

2017-01-01

This second edition tackles some of the most vexing questions that career development professionals encounter today. Using a case study design, it offers a hands-on experience with ethical terminology, resources, and issues. Each dilemma presented includes detailed, guided discussion of key issues and recommendations, with direct connections to…

The Balance of Payments: A Case Study Approach

ERIC Educational Resources Information Center

McCulloch, D. W.

1977-01-01

An economic case study is presented of the balance of payments in Italy, Canada, and West Germany during the 1940s through 1960s. The study examines the circular flow of income, price level fluctuations, supply and demand theory, and basic considerations of financial markets. For journal availability, see SO 505 703. (Author/AV)

Inclusive Assessment at Point-of-Design

ERIC Educational Resources Information Center

Keating, Neil; Zybutz, Tanya; Rouse, Karl

2012-01-01

Recognising assessment as a driver for learning and a key part of the student learning experience, this case study considers the impact of opening the assessment process to active student engagement as well as placing inclusivity at the heart of the assessment task at point-of-design. This case study presents an approach to assessment that both…

Successful Ultra-Conservative Management of a Mandibular Premolar with Dens Invaginatus.

PubMed

Abazarpour, Ramin; Parirokh, Masoud; Farhadi, Aida; Jalali, Zahra; Kheirabadi, Nasir

2017-01-01

Dens invaginatus is one of the most common anomalies of tooth structure. It is caused by the invagination of the crown surface during odontogenesis that enters the pulp chamber of the affected tooth. Depending on the complexity of invagination, the tooth might present with pulp necrosis, open apex and a complicated root canal system. This case report presents an Oehlers' type 2 dens-invaginatus in a mandibular premolar with chronic apical abscess. In most cases, dens invaginatus is removed during treatment. However, in this case report, based on cone-beam computed tomography (CBCT) evaluation, non-surgical treatment and maintenance of the invaginated segment was chosen in order to prevent compromising the tooth structure and its susceptibility to future root fracture. This is a new treatment approach and has not been performed in previous reports. Calcium-enriched mixture (CEM) cement was used as an apical plug followed by gutta-percha in warm vertical compaction for root canal obturation. The case was followed up for 36 months after treatment. This report highlights the importance of selecting the appropriate treatment approach based on CBCT evaluation.

Successful Ultra-Conservative Management of a Mandibular Premolar with Dens Invaginatus

PubMed Central

Abazarpour, Ramin; Parirokh, Masoud; Farhadi, Aida; Jalali, Zahra; Kheirabadi, Nasir

2017-01-01

Dens invaginatus is one of the most common anomalies of tooth structure. It is caused by the invagination of the crown surface during odontogenesis that enters the pulp chamber of the affected tooth. Depending on the complexity of invagination, the tooth might present with pulp necrosis, open apex and a complicated root canal system. This case report presents an Oehlers’ type 2 dens-invaginatus in a mandibular premolar with chronic apical abscess. In most cases, dens invaginatus is removed during treatment. However, in this case report, based on cone-beam computed tomography (CBCT) evaluation, non-surgical treatment and maintenance of the invaginated segment was chosen in order to prevent compromising the tooth structure and its susceptibility to future root fracture. This is a new treatment approach and has not been performed in previous reports. Calcium-enriched mixture (CEM) cement was used as an apical plug followed by gutta-percha in warm vertical compaction for root canal obturation. The case was followed up for 36 months after treatment. This report highlights the importance of selecting the appropriate treatment approach based on CBCT evaluation. PMID:28808472

Percutaneous vertebroplasty at C2: case report of a patient with multiple myeloma and a literature review

PubMed Central

Blimark, Cecilie; Willén, Jan; Mellqvist, Ulf-H; Rödjer, Stig

2006-01-01

Percutaneous vertebroplasty (PVP) of the axis is a challenging procedure which may be performed by a percutaneous or a transoral approach. There are few reports of PVP at the C2 level. We report a case of unstable C2 fracture treated with the percutaneous approach. The fracture was the first manifestation of multiple myeloma in a previously healthy 47-year-old woman. After local radiotherapy and chemotherapy, the fracture was still unstable and the patient had been continuously wearing a stiff cervical collar for 9 months. Complication-free PVP resulted in pain relief and stabilization and use of the cervical collar could be discontinued. At 18 months follow-up the patient remained free from pain, the fracture was stable and she had returned to work. The purpose of this article is to present the technical facts and to highlight the benefits and potential complications of the procedure. The technical characteristics of the procedure, the indication and results of the present case are discussed together with previously reported cases of PVP treatment at C2. PMID:17160394

Complex and open fractures: a straightforward approach to management in the cat.

PubMed

Corr, Sandra

2012-01-01

Cats often present with traumatic injuries of the limbs, including complex and open fractures, frequently as a result of road traffic accidents. On initial assessment, complex and open fractures may appear to require expertise beyond the experience of the general practitioner and, in some cases, referral to a specialist may be indicated or amputation should be considered. Many cases, however, can be managed using straightforward principles. This review describes a logical and practical approach to treating such injuries. It discusses general principles of fracture management, highlights the treatment of open fractures, and describes the use of external skeletal fixation for stabilisation of both open and complex fractures. Most fractures can be stabilised using equipment and expertise available in general practice if the basic principles of fracture fixation are understood and rigorously applied. Many textbooks and journal articles have been published on the management of fractures in companion animals, presenting case studies, case series and original biomechanical research. The simple strategy for managing complex injuries that is provided in this review is based on the published literature and the author's clinical experience.

Unusual case of pheochromocytoma presenting with diabetic ketoacidosis.

PubMed

Sedhai, Yub Raj; Reddy, Kruthika; Patel, Dhruvan; Lozada, James A

2016-10-19

Pheochromocytoma is a rare catecholamine-secreting tumour that arises from chromaffin cells in the adrenal medulla or extra-adrenal sympathetic ganglia. It classically presents with paroxysmal headaches, hypertension, palpitations and sweating related to catecholamine excess. Diabetes is reported to be present in approximately one-third of patients with pheochromocytoma; however, diabetic ketoacidosis is an extremely rare complication. We present a case of an African-American male aged 30 years who initially presented with diabetic ketoacidosis and hypertensive urgency whose blood pressure and glycaemic control improved remarkably following tumour excision. We will discuss this unusual presentation of pheochromocytoma along with a management approach for such adrenal incidentalomas. 2016 BMJ Publishing Group Ltd.

Assessing compositional variability through graphical analysis and Bayesian statistical approaches: case studies on transgenic crops.

PubMed

Harrigan, George G; Harrison, Jay M

2012-01-01

New transgenic (GM) crops are subjected to extensive safety assessments that include compositional comparisons with conventional counterparts as a cornerstone of the process. The influence of germplasm, location, environment, and agronomic treatments on compositional variability is, however, often obscured in these pair-wise comparisons. Furthermore, classical statistical significance testing can often provide an incomplete and over-simplified summary of highly responsive variables such as crop composition. In order to more clearly describe the influence of the numerous sources of compositional variation we present an introduction to two alternative but complementary approaches to data analysis and interpretation. These include i) exploratory data analysis (EDA) with its emphasis on visualization and graphics-based approaches and ii) Bayesian statistical methodology that provides easily interpretable and meaningful evaluations of data in terms of probability distributions. The EDA case-studies include analyses of herbicide-tolerant GM soybean and insect-protected GM maize and soybean. Bayesian approaches are presented in an analysis of herbicide-tolerant GM soybean. Advantages of these approaches over classical frequentist significance testing include the more direct interpretation of results in terms of probabilities pertaining to quantities of interest and no confusion over the application of corrections for multiple comparisons. It is concluded that a standardized framework for these methodologies could provide specific advantages through enhanced clarity of presentation and interpretation in comparative assessments of crop composition.

Machining fixture layout optimization using particle swarm optimization algorithm

NASA Astrophysics Data System (ADS)

Dou, Jianping; Wang, Xingsong; Wang, Lei

2011-05-01

Optimization of fixture layout (locator and clamp locations) is critical to reduce geometric error of the workpiece during machining process. In this paper, the application of particle swarm optimization (PSO) algorithm is presented to minimize the workpiece deformation in the machining region. A PSO based approach is developed to optimize fixture layout through integrating ANSYS parametric design language (APDL) of finite element analysis to compute the objective function for a given fixture layout. Particle library approach is used to decrease the total computation time. The computational experiment of 2D case shows that the numbers of function evaluations are decreased about 96%. Case study illustrates the effectiveness and efficiency of the PSO based optimization approach.

A Nonverbal Intervention for the Severely Language Disordered Young Child: An Intensive Approach.

ERIC Educational Resources Information Center

Fraser, Diane Lynch

Designing therapeutic approaches for language-disordered young children calls for the coordination of communication skills across the three developmental pathways: motor, social-emotional, and language-cognitive. The case study presented in this document examines the effectiveness of a dance-movement therapy intervention conducted over a 2-year…

Cultural Demands of the Host-Nation: International Student Experience and the Public Diplomacy Consequences

ERIC Educational Resources Information Center

Triana, Benjamin

2015-01-01

Traditional approaches for hosting international students tend to focus on classroom achievement rather than on intercultural exchange and cultural immersion. Such approaches lessen the possibility of successful educational experiences which also hinders public diplomacy. Two case studies are presented that reveal how structural changes at a…

Making Sense of Competing Constructs of Teacher as Professional

ERIC Educational Resources Information Center

Sisson, Jamie Huff

2009-01-01

This paper presents a comparative case study involving eight teachers from two Reggio-inspired schools that focuses on how teachers negotiate a Reggio-inspired approach in the American context. This study first identifies the struggles these eight teachers faced in applying the philosophical beliefs borrowed from this Italian-born approach. With…

Psychotropic Medication Management in a Residential Group Care Program

ERIC Educational Resources Information Center

Spellman, Douglas F.; Griffith, Annette K.; Huefner, Jonathan C.; Wise, Neil, III; McElderry, Ellen; Leslie, Laurel K.

2010-01-01

This article presents a psychotropic medication management approach that is used within a residential care program. The approach is used to assess medications at youths' times of entry and to facilitate decision making during care. Data from a typical case study have indicated that by making medication management decisions slowly, systematically,…

The UFAIL Approach: Unconventional Technologies and Their "Unintended" Effects

ERIC Educational Resources Information Center

Agler, David W.

2010-01-01

This essay presents the use-first-and-investigate-later (UFAIL) approach to technological use through two case studies: the atomic bomb in World War II and chemical defoliants during the Vietnam War. The methodology of UFAIL is as follows: despite limited understanding of an array of potential effects (medical, environmental, etc.), technology…

Examining Writing Performance and Self-Perception for Low Socioeconomic Young Adolescents

ERIC Educational Resources Information Center

Barone, Toni-Ann; Sinatra, Richard; Eschenauer, Robert; Brasco, Robert

2014-01-01

The present case study investigated the impact of a short-term summer literacy approach on writing performance and self-perception of writing for young adolescents of low-income families residing in urban housing projects. The approach offered intensive literacy engagement to offset summer achievement loss; assisted ethnic-minority, low…

Engaging Students in Applied Electromagnetics at the University of San Diego

ERIC Educational Resources Information Center

Lumori, M. L. D.; Kim, E. M.

2010-01-01

Two possible topical approaches that have been applied to teaching an upper-division undergraduate electrical engineering applied electromagnetics course are presented. Each approach was applied to one of two offerings of the course, taught in different semesters. In either case, the course includes the study of electromagnetic theory and…

Using a Blended Approach to Facilitate Postgraduate Supervision

ERIC Educational Resources Information Center

de Beer, Marie; Mason, Roger B.

2009-01-01

This paper explores the feasibility of using a blended approach to postgraduate research-degree supervision. Such a model could reduce research supervisors' workloads and improve the quality and success of Masters and Doctoral students' research output. The paper presents a case study that is based on a framework that was originally designed for…

A Blended Learning Approach to Teach Fluid Mechanics in Engineering

ERIC Educational Resources Information Center

Rahman, Ataur

2017-01-01

This paper presents a case study on the teaching and learning of fluid mechanics at the University of Western Sydney (UWS), Australia, by applying a blended learning approach (BLA). In the adopted BLA, various flexible learning materials have been made available to the students such as online recorded lectures, online recorded tutorials, hand…

Gender and Infertility: A Relational Approach To Counseling Women.

ERIC Educational Resources Information Center

Gibson, Donna M.; Myers, Jane E.

2000-01-01

The Relational Model (J. V. Jordan, 1995) of women's development is a theory that explains women's development in a context of relationships, specifically relationships that promote growth for self and others. This model is applied to counseling women who are experiencing infertility, and a case presentation is provided to illustrate the approach.…

Use of a business case model for organizational change.

PubMed

Shirey, Maria R

2011-01-01

This department highlights change management strategies that may be successful in strategically planning and executing organizational change initiatives. With the goal of presenting practical approaches helpful to nurse leaders advancing organizational change, content includes evidence-based projects, tools, and resources that mobilize and sustain organizational change initiatives. In this article, the author discusses the concept of a business case and introduces a 3-phase business case model for organizational change.

Goal Structuring Notation in a Radiation Hardening Assurance Case for COTS-Based Spacecraft

NASA Technical Reports Server (NTRS)

Witulski, Arthur; Austin, Rebekah; Evans, John; Mahadevan, Nag; Karsai, Gabor; Sierawski, Brian; LaBel, Ken; Reed, Robert; Schrimpf, Ron

2016-01-01

A systematic approach is presented to constructing a radiation assurance case using Goal Structuring Notation (GSN) for spacecraft containing commercial-off-the-shelf (COTS) parts. The GSN paradigm is applied to an SRAM single-event upset experiment board designed to fly on a CubeSat November 2016. Construction of a radiation assurance case without use of hardened parts or extensive radiation testing is discussed.

Modelling in Action. Examining How Students Approach Modelling Real Life Situations. Three Case Studies. Model of the Movement of an Elevator

ERIC Educational Resources Information Center

Rivas, Eugenia Marmolejo

2015-01-01

By means of three case studies, we will present two mathematical modelling activities that are suitable for students enrolled in senior high school and the first year of mathematics at university level. The activities have been designed to enrich the learning process and promote the formation of vital modelling skills. In case studies one and two,…

Analysis of ToxCast data for food-relevant compounds by ...

EPA Pesticide Factsheets

The ToxCast program has generated a wealth of in vitro high throughput screening data, and best approaches for the interpretation and use of these data remain undetermined. We present case studies comparing the ToxCast and in vivo toxicity data for two food contact substances using the RISK21 approach. Available exposure data, toxicity data, and model predictions were analyzed for sodium pyrithione and dibutyltin dichloride. In-vitro to in-vivo extrapolation (IVIVE) was performed to determine oral equivalent doses (OEDs) for the ToxCast data bioactivity. For sodium pyrithione, calculated OEDs corresponded to doses that demonstrated toxicity in animal studies. For dibutyltin dichloride, calculated OEDs were below the doses that demonstrated toxicity in animals, but this was confounded by the conservative estimates used in the IVIVE calculations. These studies highlight the potential of the ToxCast approach while also indicating areas where additional data or predictive tools are needed. We present case studies comparing the ToxCast and in vivo toxicity data for two food contact substances using the RISK21 approach.

A New Perspective on Sustainable Soil Remediation-Case Study Suggests Novel Fungal Genera Could Facilitate in situ Biodegradation of Hazardous Contaminants.

PubMed

Czaplicki, L M; Cooper, E; Ferguson, P L; Stapleton, H M; Vilgalys, R; Gunsch, C K

2016-01-01

Deciding upon a cost effective and sustainable method to address soil pollution is a challenge for many remedial project managers. High pressure to quickly achieve cleanup goals pushes for energy-intensive remedies that rapidly address the contaminants of concern with established technologies, often leaving little room for research and development especially for slower treatment technologies, such as bioremediation, for the more heavily polluted sites. In the present case study, new genomic approaches have been leveraged to assess fungal biostimulation potential in soils polluted with particularly persistent hydrophobic contaminants. This new approach provides insights into the genetic functions available at a given site in a way never before possible. In particular, this article presents a case study where next generation sequencing (NGS) has been used to categorize fungi in soils from the Atlantic Wood Industries Superfund site in Portsmouth, Virginia. Data suggest that original attempts to harness fungi for bioremediation may have focused on fungal genera poorly suited to survive under heavily polluted site conditions, and that more targeted approaches relying on native indigenous fungi which are better equipped to survive under site specific conditions may be more appropriate.

A New Perspective on Sustainable Soil Remediation—Case Study Suggests Novel Fungal Genera Could Facilitate in situ Biodegradation of Hazardous Contaminants

PubMed Central

Czaplicki, L.M.; Cooper, E.; Ferguson, P.L.; Stapleton, H.M.; Vilgalys, R.; Gunsch, C.K.

2016-01-01

Deciding upon a cost effective and sustainable method to address soil pollution is a challenge for many remedial project managers. High pressure to quickly achieve cleanup goals pushes for energy-intensive remedies that rapidly address the contaminants of concern with established technologies, often leaving little room for research and development especially for slower treatment technologies, such as bioremediation, for the more heavily polluted sites. In the present case study, new genomic approaches have been leveraged to assess fungal biostimulation potential in soils polluted with particularly persistent hydrophobic contaminants. This new approach provides insights into the genetic functions available at a given site in a way never before possible. In particular, this article presents a case study where next generation sequencing (NGS) has been used to categorize fungi in soils from the Atlantic Wood Industries Superfund site in Portsmouth, Virginia. Data suggest that original attempts to harness fungi for bioremediation may have focused on fungal genera poorly suited to survive under heavily polluted site conditions, and that more targeted approaches relying on native indigenous fungi which are better equipped to survive under site specific conditions may be more appropriate. PMID:27917031

Minimally invasive surgical treatment of Bertolotti's Syndrome: case report.

PubMed

Ugokwe, Kene T; Chen, Tsu-Lee; Klineberg, Eric; Steinmetz, Michael P

2008-05-01

This article aims to provide more insight into the presentation, diagnosis, and treatment of Bertolotti's syndrome, which is a rare spinal disorder that is very difficult to recognize and diagnose correctly. The syndrome was first described by Bertolotti in 1917 and affects approximately 4 to 8% of the population. It is characterized by an enlarged transverse process at the most caudal lumbar vertebra with a pseudoarticulation of the transverse process and the sacral ala. It tends to present with low back pain and may be confused with facet and sacroiliac joint disease. In this case report, we describe a 40-year-old man who presented with low back pain and was eventually diagnosed with Bertolotti's syndrome. The correct diagnosis was made based on imaging studies which included computed tomographic scans, plain x-rays, and magnetic resonance imaging scans. The patient experienced temporary relief when the abnormal pseudoarticulation was injected with a cocktail consisting of lidocaine and steroids. In order to minimize the trauma associated with surgical treatment, a minimally invasive approach was chosen to resect the anomalous transverse process with the accompanying pseudoarticulation. The patient did well postoperatively and had 97% resolution of his pain at 6 months after surgery. As with conventional surgical approaches, a complete knowledge of anatomy is required for minimally invasive spine surgery. This case is an example of the expanding utility of minimally invasive approaches in treating spinal disorders.

An improved finite-difference analysis of uncoupled vibrations of tapered cantilever beams

NASA Technical Reports Server (NTRS)

Subrahmanyam, K. B.; Kaza, K. R. V.

1983-01-01

An improved finite difference procedure for determining the natural frequencies and mode shapes of tapered cantilever beams undergoing uncoupled vibrations is presented. Boundary conditions are derived in the form of simple recursive relations involving the second order central differences. Results obtained by using the conventional first order central differences and the present second order central differences are compared, and it is observed that the present second order scheme is more efficient than the conventional approach. An important advantage offered by the present approach is that the results converge to exact values rapidly, and thus the extrapolation of the results is not necessary. Consequently, the basic handicap with the classical finite difference method of solution that requires the Richardson's extrapolation procedure is eliminated. Furthermore, for the cases considered herein, the present approach produces consistent lower bound solutions.

Emergency surgical treatment of cervico-mediastinal lymph-haemangioma in a 2-month-old infant, indicated by acute inner tumour haemorrhage.

PubMed

Drebov, R; Stoichev, R; Argirova, M; Mitev, Pl; Gagov, E

2013-01-01

Cervico-Mediastinal Lymphangiomas (CML) are caused by atresia of the efferent lymphatics or lack of communication between lymphatics and venous channels. Cervico-Mediastinal Lymphangiomas in certain cases require emergency surgery to secure decompression of the airways. The purpose of this study is to present a multidisciplinary surgical approach in the treatment of urgently complicated Cervico-Mediastinal Lymphangiomas, and to asses the surgical tactics and satisfactory outcome after a two-stage operation. The paper presents a case of a 48-day-old girl with acute haemorrhage of Cervico-Mediastinal Lymphangioma, resulting from an increased arterial blood pressure due to thrombosis of the internal jugular vein. This condition required the convening of an emergency multidisciplinary surgical team which resolved emergency decompression by removal of the cervical tumour component. The authors discuss the reasons for the emergency indications for operation in this case, the dynamics in multi-stage treatment, the regression of the mediastinal component resulting from the developed inflammation, the intraoperative difficulties and functional complications resulting from the strife after radicalism. The presented case shows indications for emergency surgical intervention in acute growing CML. It illustrates the need for a multidisciplinary surgical approach involving a team of experts in paediatric, vascular, cardiac and aesthetic surgery.

Case Reports of Five Cancer Patients with Unusual Course.

PubMed

Payrhuber, Dietmar; Thieves, Karin; Sangaletti, Piero; Muehlmann, Josef; Frass, Michael

2018-06-16

 The analysis of the periodic table of elements by Jan Scholten opened the way for a new kind of classification and repertorisation of homeopathic remedies. Thereby, group analysis (resorting to series and stages) makes precise prescriptions possible. This approach appears to yield striking results, even in severe cases. Whereas Hahnemann stressed the emotional state ('Gemüthssymptome', Organon § 210) when choosing a remedy, Scholten 200 years later investigated the mental picture that represents a life conflict or even a life theme that may maintain the disease process. The person's environment, emotional traumas or a conflict drives him or her to suppress and dissect painful emotions. Such compensations can become subconscious and so strong that they can no longer be controlled; they then influence the patient with a highly destructive energy.  We present five case reports, each dealing with an unusual clinical course of severe cancer associated with homeopathic treatment using the Scholten method.  By presenting these cases, we consider how the constitution (lifelong signs and symptoms of the patient) and the mental state are interwoven and, as a complex mechanism, might provoke disease.  The appropriate homeopathic remedy, reflecting the Scholten approach, seemed to have beneficial impact on the disease process of the five individuals presented. The Faculty of Homeopathy.

Wartime Transitions: Historical Case Analyses Applied to the US Campaign in Afghanistan (2001 to Present)

DTIC Science & Technology

2017-05-25

operate independently without external nation support; (3) a custom approach is necessary in security forces development based on political requirements...independently without external nation support; (3) a custom approach is necessary in security forces development based on political requirements...interventions both successful and unsuccessful, that an external country must craft a custom approach to develop local security forces based on the

A Qualitative Case Study Approach To Examine Information Resources Management. (Utilisation d'une Approche Qualitative par Methode de cas pour Etudier la Gestion des Ressources D'information).

ERIC Educational Resources Information Center

Bergeron, Pierrette

1997-01-01

Illustrates how a qualitative approach was used to study the complex and poorly defined concept of information resources management. Explains the general approach to data collection, its advantages and limitations, and the process used to analyze the data. Presents results, along with lessons learned through using method. (Author/AEF)

Climate change impacts: The challenge of quantifying multi-factor causation, multi-component responses, and leveraging from extremes

NASA Astrophysics Data System (ADS)

Field, C. B.

2012-12-01

Modeling climate change impacts is challenging for a variety of reasons. Some of these are related to causation. A weather or climate event is rarely the sole cause of an impact, and, for many impacts, social, economic, cultural, or ecological factors may play a larger role than climate. Other challenges are related to outcomes. Consequences of an event are often most severe when several kinds of responses interact, typically in unexpected ways. Many kinds of consequences are difficult to quantify, especially when they include a mix of market, cultural, personal, and ecological values. In addition, scale can be tremendously important. Modest impacts over large areas present very different challenges than severe but very local impacts. Finally, impacts may respond non-linearly to forcing, with behavior that changes qualitatively at one or more thresholds and with unexpected outcomes in extremes. Modeling these potentially complex interactions between drivers and impacts presents one set of challenges. Evaluating the models presents another. At least five kinds of approaches can contribute to the evaluation of impact models designed to provide insights in multi-driver, multi-responder, multi-scale, and extreme-driven contexts, even though none of these approaches is a complete or "silver-bullet" solution. The starting point for much of the evaluation in this space is case studies. Case studies can help illustrate links between processes and scales. They can highlight factors that amplify or suppress sensitivity to climate drivers, and they can suggest the consequences of intervening at different points. While case studies rarely provide concrete evidence about mechanisms, they can help move a mechanistic case from circumstantial to sound. Novel approaches to data collection, including crowd sourcing, can potentially provide tools and the number of relevant examples to develop case studies as statistically robust data sources. A critical condition for progress in this area is the ability to utilize data of uneven quality and standards. Novel approaches to meta-analysis provide other options for taking advantage of diverse case studies. Techniques for summarizing responses across impacts, drivers, and scales can play a huge role in increasing the value of information from case studies. In some cases, expert elicitation may provide alternatives for identifying mechanisms or for interpreting multi-factor drivers or responses. Especially when designed to focus on a well-defined set of observations, a sophisticated elicitation can establish formal confidence limits on responses that are otherwise difficult to constrain. A final possible approach involves a focus on the mechanisms contributing to an impact, rather than the impact itself. Approaches based on quantified mechanisms are especially appealing in the context of models where the number of interactions makes it difficult to intuitively understand the chain of connections from cause to effect, when actors differ in goals or sensitivities, or when scale affects parts of the system differently. With all of these approaches, useful evidence may not conform to traditional levels of statistical confidence. Some of the biggest challenges in taking advantage of the potential tools will involve defining what constitutes a meaningful evaluation.

Goal Structuring Notation in a Radiation Hardening Assurance Case for COTS-Based Spacecraft

NASA Technical Reports Server (NTRS)

Witulski, A.; Austin, R.; Evans, J.; Mahadevan, N.; Karsai, G.; Sierawski, B.; LaBel, K.; Reed, R.; Schrimpf, R.

2016-01-01

A systematic approach is presented to constructing a radiation assurance case using Goal Structuring Notation (GSN) for spacecraft containing COTS parts. The GSN paradigm is applied to an SRAM single-event upset experiment board designed to fly on a CubeSat in January 2017. A custom software language for development of a GSN assurance case is under development at Vanderbilt. Construction of a radiation assurance case without use of hardened parts or extensive radiation testing is discussed.

An Integrative Approach to Treatment-Resistant Obsessive-Compulsive Disorder.

PubMed

Woon, Luke Sy-Cherng; Kanapathy, Anita; Zakaria, Hazli; Alfonso, César A

2017-01-01

Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder that often runs a chronic unremitting course. Treatment outcomes can be unsatisfactory despite the availability of various somatic and psychological therapies. Psychodynamic psychotherapy in combination with cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) could help patients with treatment-resistant OCD achieve better outcomes. An integrative approach can help patients gain insight, strengthen the therapeutic alliance, improve treatment adherence, and provide symptomatic relief when other treatments seem insufficient or have failed. We describe the treatment process of a person with treatment-resistant OCD who received pharmacotherapy, concurrent CBT/ERP, and a brief course of psychodynamic psychotherapy. Case formulations from cognitive behavioral and psychodynamic perspectives are presented. The authors discuss the advantages of doing a psychodynamic assessment and formulation in treatment refractory cases and the wisdom of integrating psychotherapy interventions for OCD, as well as the unique clinical features of cases that warrant a multimodal treatment approach.

A case study on open innovation on Procter & Gamble. Part I: Innovation strategy over years

NASA Astrophysics Data System (ADS)

Agafitei, I. G.; Avasilcai, S.

2015-11-01

The purpose of the present paper is to analyse how product innovation process has been organized by a multinational company, such as Procter & Gamble. Since open innovation is a new approach on the local market, we have chosen to conduct a research in form of a case study showing the steps that the company has taken in order to involve other organizations to contribute to the development of new products. The paper will first describe what innovation management theory is suggesting. Following this, the mission and vision of Procter & Gamble will be analysed emphasizing its innovation efforts in time. The approach that the company has nowadays, related to development of new products, has its roots in several complex initiatives in the past, initiatives that have in their central attention the customer. Finally, it provides the research limitations and implications for future analysis on the case of Procter & Gamble open innovation approach.

Surgical Resolution of Bilateral Hypertrophy of Masseter Muscle Through Intraoral Approach.

PubMed

Trento, Guilherme Dos Santos; Benato, Leonardo Silva; Rebellato, Nelson Luis Barbosa; Klüppel, Leandro Eduardo

2017-06-01

Masseter muscle hypertrophy is an untypical anomaly with no definite cause and its diagnosis is easily completed through physical examination and imaging examinations. In some cases, patient may report signs and symptoms of well-localizated pain. However, it is generally asymptomatic and patient's chief complaint is about esthetic because of facial asymmetry. In this case, surgery is carefully indicated. The aim of this article is to report a case of a male patient with no painful and functional complaints but an important unease over his facial asymmetry. Patient underwent surgery involving bilateral resection of mandibular angles and unilateral resection of masseter muscle through intraoral approach. Surgical approaches and techniques rely heavily on surgeon. There are few reports in the literature about this anomaly, but those available present several techniques. The surgeon's dexterity and knowledge become extremely important, whereas this procedure is essentiallyesthetic.

A combined modality therapeutic approach to metastatic anal squamous cell carcinoma with systemic chemotherapy and local therapy to sites of disease: case report and review of literature.

PubMed

Gnanajothy, Rosana; Warren, Graham W; Okun, Sherry; Peterson, Lindsay L

2016-06-01

Cases of metastatic anal carcinoma managed with a combination of systemic chemotherapy and local therapies to both solitary sites of metastases and the primary site have been reported in the literature. We present a case of a 55-year-old male with metastatic anal squamous cell carcinoma to the liver treated with induction chemotherapy with cisplatin (CDDP) and 5-fluorouracil (5FU) followed by liver resection and radiation to the anal primary with concurrent 5FU and mitomycin. This approach resulted in control of disease without evidence of recurrence, and no increased toxicities now 19 months from initial diagnosis to time of reporting. This novel approach resulted in a good treatment response as documented by imaging and symptom improvement and a long disease free interval.

Application of the Multicontextual Approach in Promoting Learning and Transfer of Strategy Use in an Individual with TBI and Executive Dysfunction.

PubMed

Toglia, Joan; Goverover, Yael; Johnston, Mark V; Dain, Barry

2011-01-01

The multicontext approach addresses strategy use and self-monitoring skills within activities and contexts that are systematically varied to facilitate transfer of learning. This article illustrates the application of the multicontext approach by presenting a case study of an adult who is 5 years post-traumatic brain injury with executive dysfunction and limited awareness. A single case study design with repeated pre-post measures was used. Methods to monitor strategy generation and specific awareness within intervention are described. Findings suggest improved functional performance and generalization of use of an external strategy despite absence of changes in general self-awareness of deficits. This case describes the multicontext intervention process and provides clinical suggestions for working with individuals with serious deficits in awareness and executive dysfunction following traumatic brain injury. Copyright 2011, SLACK Incorporated.

Evaluating the substantive effectiveness of SEA: Towards a better understanding

DOE Office of Scientific and Technical Information (OSTI.GOV)

Doren, D. van; Driessen, P.P.J., E-mail: p.driessen@uu.nl; Schijf, B.

Evaluating the substantive effectiveness of strategic environmental assessment (SEA) is vital in order to know to what extent the tool fulfills its purposes and produces expected results. However, the studies that have evaluated the substantive effectiveness of SEA produce varying outcomes as regards the tool's contribution to decision-making and have used a variety of approaches to appraise its effectiveness. The aim of this article is to discuss the theoretical concept of SEA substantive effectiveness and to present a new approach that can be applied for evaluation studies. The SEA effectiveness evaluation framework that will be presented is composed of conceptsmore » of, and approaches to, SEA effectiveness derived from SEA literature and planning theory. Lessons for evaluation can be learned from planning theory in particular, given its long history of analyzing and understanding how sources of information and decisions affect (subsequent) decision-making. Key concepts of this new approach are 'conformance' and 'performance'. In addition, this article presents a systematic overview of process and context factors that can explain SEA effectiveness, derived from SEA literature. To illustrate the practical value of our framework for the assessment and understanding of substantive effectiveness of SEA, three Dutch SEA case studies are examined. The case studies have confirmed the usefulness of the SEA effectiveness assessment framework. The framework proved helpful in order to describe the cumulative influence of the three SEAs on decision-making and the ultimate plan. - Highlights: Black-Right-Pointing-Pointer A new framework to evaluate the substantive effectiveness of SEA is presented. Black-Right-Pointing-Pointer The framework is based on two key concepts: 'conformance' and 'performance.' Black-Right-Pointing-Pointer The practical applicability of the framework is demonstrated by three Dutch cases. Black-Right-Pointing-Pointer The framework allows for a more systematic understanding of SEA effectiveness. Black-Right-Pointing-Pointer Finally, this paper presents explanations for SEA effectiveness.« less

Crusted scabies in remote Australia, a new way forward: lessons and outcomes from the East Arnhem Scabies Control Program.

PubMed

Lokuge, Buddhi; Kopczynski, Alex; Woltmann, Angela; Alvoen, Faye; Connors, Christine; Guyula, Terrence; Mulholland, Eddie; Cran, Samantha; Foster, Tim; Lokuge, Kamalini; Burke, Tanya; Prince, Sam

2014-06-16

Crusted scabies is a highly infectious, debilitating and disfiguring disease, and remote Aboriginal communities of northern Australia have the highest reported rates of the condition in the world. We draw on monitoring data of the East Arnhem Scabies Control Program to discuss outcomes and lessons learnt through managing the condition in remote communities. Using active case finding, we identified seven patients with crusted scabies in three communities and found most had not presented to health services despite active disease. We compared presentations and hospitalisations for a cumulative total of 99 months during a novel preventive program with 99 months immediately before the program for the seven cases and seven sentinel household contacts. Our preventive long-term case management approach was associated with a significant 44% reduction in episodes of recurrent crusted scabies (from 36 to 20; P = 0.025) in the seven cases, and a non-significant 80% reduction in days spent in hospital (from 173 to 35; P = 0.09). It was also associated with a significant 75% reduction in scabies-related presentations (from 28 to 7; P = 0.017) for the seven sentinel household contacts. We recommend active surveillance and wider adoption of this preventive case management approach, with ongoing evaluation to refine protocols and improve efficiency. Contacts of children presenting with recurrent scabies should be examined to exclude crusted scabies. In households where crusted scabies is present, a diagnosis of parental neglect due to recurrent scabies and weight loss in children should be made with extreme caution. Improved coordination of care by health services, and research and development of new therapies including immunotherapies for crusted scabies, must be a priority.

Efficient computational nonlinear dynamic analysis using modal modification response technique

NASA Astrophysics Data System (ADS)

Marinone, Timothy; Avitabile, Peter; Foley, Jason; Wolfson, Janet

2012-08-01

Generally, structural systems contain nonlinear characteristics in many cases. These nonlinear systems require significant computational resources for solution of the equations of motion. Much of the model, however, is linear where the nonlinearity results from discrete local elements connecting different components together. Using a component mode synthesis approach, a nonlinear model can be developed by interconnecting these linear components with highly nonlinear connection elements. The approach presented in this paper, the Modal Modification Response Technique (MMRT), is a very efficient technique that has been created to address this specific class of nonlinear problem. By utilizing a Structural Dynamics Modification (SDM) approach in conjunction with mode superposition, a significantly smaller set of matrices are required for use in the direct integration of the equations of motion. The approach will be compared to traditional analytical approaches to make evident the usefulness of the technique for a variety of test cases.

Promoting Good Psychiatric Management for Patients With Borderline Personality Disorder.

PubMed

Links, Paul S; Ross, James; Gunderson, John G

2015-08-01

General psychiatric management for patients with borderline personality disorder was devised to be an outpatient intervention that could be readily learned and easily delivered by independent community mental health professionals. To disseminate the approach, Drs. Gunderson and Links developed the Handbook of Good Psychiatric Management for Borderline Personality Disorder (Gunderson & Links, ) that presented the basics of the approach, videos to illustrate the appropriate clinical skills, and case examples to practice adherence to the approach. Unfortunately, the inclusion of "psychiatric" in the treatment's name may discourage psychologists and other mental health professionals from using this therapy. In this article, we review the basic principles and approaches related to general psychiatric management. With a case example, we illustrate how psychologists can use all the general psychiatric management principles for their patients with BPD, except medications and, as a result, provide and deliver this approach effectively. © 2015 Wiley Periodicals, Inc.

Muscle metastasis from non-small cell lung cancer: two cases and literature review.

PubMed

Tezcan, Y; Koc, M

2014-08-01

Non-small cell lung cancers (NSCLC) is the most commonly observed group among lung cancers. Adenocancers are histopathologically more common. Males are more affected than females, an effect which is directly related to smoking. They generally cause distant haematogenous and lymphatic metastasis. Distant haematogenous metastases are often seen in contralateral lung, brain, bone, adrenals, and liver. Muscle metastases from NSCLC are quite rare and male cases are more frequently affected compared to female cases. NSCLC cases with muscle metastasis are at the same time accompanied by distant organ metastases such as bone, brain, and liver. All treatment approaches are considered to be palliative in these cases, which are symptomatologically quite severe. In the present study, we presented the rarely observed cases of two male patients with muscle metastasis from NSCLC together with the related literature.

Mammography of ductal carcinoma in situ of the breast: review of 909 cases with radiographic-pathologic correlations.

PubMed

Barreau, Béatrice; de Mascarel, Isabelle; Feuga, Caroline; MacGrogan, Gaétan; Dilhuydy, Marie-Hélène; Picot, Véronique; Dilhuydy, Jean-Marie; de Lara, Christine Tunon; Bussières, Emmanuel; Schreer, I

2005-04-01

We retrospectively analysed mammographies of 909 ductal carcinoma in situ (DCIS) (1980-1999) and compared our results to those of literature. Microcalcifications were present in 75% of the cases, and soft-tissue abnormalities in 27% cases with association with calcifications in 14% of cases. Palpable masses were found in 12% of the cases and nipple discharge was present in 12% of the cases. The radiographic-pathologic correlation allowed to suspect the DCIS "aggressiveness" on radiologic signs. Granular, linear, branching and/or galactophoric topography of the microcalcifications were correlated with necrosis, grade 3, comedocarcinoma type. A number of microcalcifications higher than 20 was correlated with necrosis and grade 3. Mammographic size was correlated to histologic size. Masses were correlated with grade 1. A diagnosis strategy can be proposed with a multidisciplinar approach.

Combining knowledge discovery from databases (KDD) and case-based reasoning (CBR) to support diagnosis of medical images

NASA Astrophysics Data System (ADS)

Stranieri, Andrew; Yearwood, John; Pham, Binh

1999-07-01

The development of data warehouses for the storage and analysis of very large corpora of medical image data represents a significant trend in health care and research. Amongst other benefits, the trend toward warehousing enables the use of techniques for automatically discovering knowledge from large and distributed databases. In this paper, we present an application design for knowledge discovery from databases (KDD) techniques that enhance the performance of the problem solving strategy known as case- based reasoning (CBR) for the diagnosis of radiological images. The problem of diagnosing the abnormality of the cervical spine is used to illustrate the method. The design of a case-based medical image diagnostic support system has three essential characteristics. The first is a case representation that comprises textual descriptions of the image, visual features that are known to be useful for indexing images, and additional visual features to be discovered by data mining many existing images. The second characteristic of the approach presented here involves the development of a case base that comprises an optimal number and distribution of cases. The third characteristic involves the automatic discovery, using KDD techniques, of adaptation knowledge to enhance the performance of the case based reasoner. Together, the three characteristics of our approach can overcome real time efficiency obstacles that otherwise mitigate against the use of CBR to the domain of medical image analysis.

Gingival cyst of the adult: regenerative therapy of associated root exposure. A case report and literature review.

PubMed

Kelsey, W Patrick; Kalmar, John R; Tatakis, Dimitris N

2009-12-01

The gingival cyst of the adult (GCA) is an uncommon developmental cyst of odontogenic origin most frequently seen near mandibular canines and premolars and is routinely treated with excisional biopsy. This article presents a case of a GCA treated with a combined regenerative approach and reviews the GCA literature with an emphasis on the clinical aspects of this lesion. A 54 year-old man presented for treatment of generalized severe chronic periodontitis. Clinical examination revealed a cystic lesion in the gingiva of the mandibular canine-premolar area. Radiographs revealed a well-defined radiolucency in the coronal one-third of the tooth roots. Surgical enucleation of the lesion revealed root exposure of the second premolar. Because of the anatomy of the lesion-associated defect, regenerative treatment, using a combination of freeze-dried bone allograft and a collagen membrane, was considered the therapeutic approach of choice. The biopsy revealed histologic features consistent with a GCA. Clinical and radiographic examinations 1 year post-surgery indicated uneventful soft tissue healing and bone fill of the initial defect. The review of the literature revealed only one other case of root exposure associated with GCA and no previous report of regenerative therapy. In rare instances, a GCA lesion may result in tooth-root exposure. In such cases, a combined regenerative treatment approach may be used to achieve resolution.

A spectral-Tchebychev solution for three-dimensional dynamics of curved beams under mixed boundary conditions

NASA Astrophysics Data System (ADS)

Bediz, Bekir; Aksoy, Serdar

2018-01-01

This paper presents the application of the spectral-Tchebychev (ST) technique for solution of three-dimensional dynamics of curved beams/structures having variable and arbitrary cross-section under mixed boundary conditions. To accurately capture the vibrational behavior of curved structures, a three-dimensional (3D) solution approach is required since these structures generally exhibit coupled motions. In this study, the integral boundary value problem (IBVP) governing the dynamics of the curved structures is found using extended Hamilton's principle where the strain energy is expressed using 3D linear elasticity equation. To solve the IBVP numerically, the 3D spectral Tchebychev (3D-ST) approach is used. To evaluate the integral and derivative operations defined by the IBVP and to render the complex geometry into an equivalent straight beam with rectangular cross-section, a series of coordinate transformations are applied. To validate and assess the performance of the presented solution approach, two case studies are performed: (i) curved beam with rectangular cross-section, (ii) curved and pretwisted beam with airfoil cross-section. In both cases, the results (natural frequencies and mode shapes) are also found using a finite element (FE) solution approach. It is shown that the difference in predicted natural frequencies are less than 1%, and the mode shapes are in excellent agreement based on the modal assurance criteria (MAC) analyses; however, the presented spectral-Tchebychev solution approach significantly reduces the computational burden. Therefore, it can be concluded that the presented solution approach can capture the 3D vibrational behavior of curved beams as accurately as an FE solution, but for a fraction of the computational cost.

Pericarditis and pericardial effusion: management update.

PubMed

Sparano, Dina M; Ward, R Parker

2011-12-01

Prompt recognition of the signs and symptoms of pericardial disease is critical so that appropriate treatments can be initiated. Acute pericarditis has a classical presentation, including symptoms, physical examination findings, and electrocardiography abnormalities. Early recognition of acute pericarditis will avoid unnecessary invasive testing and prompt therapies that provide rapid symptom relief. Non-steroidal anti-inflammatory drugs (NSAIDs) remain first-line therapy for uncomplicated acute pericarditis, although colchicine can be used concomitantly with NSAIDS as the first-line approach, particularly in severely symptomatic cases. Colchicine should be used in all refractory cases and as initial therapy in all recurrences. Aspirin should replace NSAIDS in pericarditis complicating acute myocardial infarction. Systemic corticosteroids can be used in refractory cases or in those with immune-mediated etiologies, although generally should be avoided due to a higher risk of recurrence. Pericardial effusions have many etiologies and the approach to diagnosis and therapy depends on clinical presentation. Pericardial tamponade is a life-threatening clinical diagnosis made on physical examination and supported by characteristic findings on diagnostic testing. Prompt diagnosis and management is critical. Treatment consists of urgent pericardial fluid drainage with a pericardial drain left in place for several days to help prevent acute recurrence. Analysis of pericardial fluid should be performed in all cases as it may provide clues to etiology. Consultation of cardiac surgery for pericardial window should be considered in recurrent cases and may be the first-line approach to malignant effusions, although acute relief of hemodynamic compromise must not be delayed. Constrictive pericarditis is associated with symptoms that mimic many other cardiac conditions. Thus, correct diagnosis is critical and involves identification of pericardial thickening or calcification in association with characteristic hemodynamic alterations using noninvasive and invasive diagnostic approaches. Constrictive physiology may occur transiently and resolve with medical therapy. In chronic cases, definitive therapy requires referral to an experienced surgeon for pericardiectomy.

A Case of Undiagnosed Craniopharyngioma in an Army Mechanic.

PubMed

Lee, Douglas Y; Mathis, Derek A

2016-02-01

Primary care providers are often the initial evaluators of soldiers presenting with acute eye complaints. It is crucial for these providers to master performing the basic eye examination with a systematic approach. Obtaining a thorough history is an important first step to the eye examination, but providers need to be careful not to narrow the diagnosis solely based on the history. Regardless of the presentation of the ocular complaints, a complete ocular examination must be performed. This article presents a case of brain tumor in an active duty soldier who was initially undiagnosed because of its unusual presentation. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

[Injuries to permanent teeth. Part 3: Therapy of root fractures].

PubMed

von Arx, Thomas; Chappuis, Vivianne; Hänni, Stefan

2007-01-01

Diagnostic and therapeutic interventions following dental injuries are not part of the routine practice in the dental office. Quite often, these patients are emergency cases who seek treatment after normal office hours. The objective of this and the future papers is to present the current treatment concepts in dental traumatology at the School of Dental Medicine, University of Berne. The fruitful cooperation in the field of dental traumatology between the Department of Oral Surgery and Stomatology, and the Department of Conservative Dentistry (including pediatric dentistry and endodontology), is based on the interdisciplinary approach that has been established four years ago. Following discussion and evaluation of such treated cases, and considering current clinical and experimental studies, the said concepts have been worked out. The present paper describes the therapeutic approach for root fractures.

INVERSE MODEL ESTIMATION AND EVALUATION OF SEASONAL NH 3 EMISSIONS

EPA Science Inventory

The presentation topic is inverse modeling for estimate and evaluation of emissions. The case study presented is the need for seasonal estimates of NH₃ emissions for air quality modeling. The inverse modeling application approach is first described, and then the NH

Diagnostic uncertainty in a severely demented male patient: a case report

PubMed Central

Maiovis, Pantelis; Gavopoulou, Evgenia; Eleftheriou, Marina; Tsokanari, Ioanna; Tsolaki, Magda

2008-01-01

Introduction Current trends in dementia research focus on early and accurate diagnosis. In clinical practice however, this is not always possible, as multiple underlying pathologies produce mixed dementia syndromes. Furthermore, patients with severe dementia are often underestimated. Case presentation We present a case of a 71 year old Caucasian male with severe Alzheimer's Disease, bedridden and fully dependent in activities of everyday living, whose general cognitive function is almost intact. We emphasize on the diverse underlying pathologies contributing to this intriguing clinical presentation and to diagnostic uncertainty. Conclusion Understanding the complexity of the dementia process in every patient using a multidimensional approach, contributes to more rational management strategies and finally to high quality care for patients and caregivers. PMID:18928571

Improving ethical knowledge and sensemaking from cases through elaborative interrogation and outcome valence.

PubMed

Johnson, James F; Bagdasarov, Zhanna; MacDougall, Alexandra E; Steele, Logan; Connelly, Shane; Devenport, Lynn D; Mumford, Michael D

2014-01-01

The case-based approach to learning is popular among many applied fields. However, results of case-based education vary widely on case content and case presentation. This study examined two aspects of case-based education-outcome valence and case elaboration methods-in a two-day case-based Responsible Conduct of Research (RCR) ethics education program. Results suggest that outcome information is an integral part of a quality case. Furthermore, valence consistent outcomes may have certain advantages over mixed valence outcome information. Finally, students enjoy and excel working with case material, and the use of elaborative interrogation techniques can significantly improve internally-focused ethical sensemaking strategies associated with personal biases, constraints, and emotions.

Multidisciplinary approach to non-surgical management of inguinal disruption in a professional hockey player treated with platelet-rich plasma, manual therapy and exercise: a case report.

PubMed

St-Onge, Eric; MacIntyre, Ian G; Galea, Anthony M

2015-12-01

To present the clinical management of inguinal disruption in a professional hockey player and highlight the importance of a multidisciplinary approach to diagnosis and management. A professional hockey player with recurrent groin pain presented to the clinic after an acute exacerbation of pain while playing hockey. The patient received a clinical diagnosis of inguinal disruption. Imaging revealed a tear in the rectus abdominis. Management included two platelet-rich plasma (PRP) injections to the injured tissue, and subsequent manual therapy and exercise. The patient returned to his prior level of performance in 3.5 weeks. This case demonstrated the importance of a multidisciplinary team and the need for advanced imaging in athletes with groin pain. Research quality concerning the non-surgical management of inguinal disruption remains low. This case adds evidence that PRP, with the addition of manual therapy and exercise may serve as a relatively quick and effective non-surgical management strategy.

The Persistence of Sperm and the Development of Time Since Intercourse (TSI) Guidelines in Sexual Assault Cases at Forensic Science Ireland, Dublin, Ireland.

PubMed

Casey, David G; Domijan, Katarina; MacNeill, Sarah; Rizet, Damien; O'Connell, Declan; Ryan, Jennifer

2017-05-01

The persistence of sperm using confirmatory microscopic analysis, the persistence of sperm with tails, time since intercourse (TSI) analysis, and results from the acid phosphatase (AP) reaction from approximately 5581 swabs taken from circa 1450 sexual assault cases are presented. The observed proportions of sperm in the vagina and anus declines significantly after 48 h TSI, and sperm on oral swabs were observed up to 15 h TSI. The AP reaction as a predictor of sperm on intimate swabs is questioned. All AP reaction times gave a low true positive rate; 23% of sperm-positive swabs gave a negative AP reaction time. We show the AP reaction is an unsafe and an unreliable predictor of sperm on intimate swabs. We propose that TSI not AP informs precase assessment and the evaluative approach for sexual assault cases. To help inform an evaluative approach, TSI guidelines are presented. © 2016 American Academy of Forensic Sciences.

The Effect of Orifice Eccentricity on Instability of Liquid Jets

NASA Astrophysics Data System (ADS)

Amini, Ghobad; Dolatabadi, Ali

2011-11-01

The hydrodynamic instability of inviscid jets issuing from elliptic orifices is studied. A linear stability analysis is presented for liquid jets that includes the effect of the surrounding gas and an explicit dispersion equation is derived for waves on an infinite uniform jet column. Elliptic configuration has two extreme cases; round jet when ratio of minor to major axis is unity and plane sheet when this ratio approaches zero. Dispersion equation of elliptic jet is approximated for large and small aspect ratios considering asymptotic of the dispersion equation. In case of aspect ratio equal to one, the dispersion equation is analogous to one of the circular jets derived by Yang. In case of aspect ratio approaches zero, the behavior of waves is qualitatively similar to that of long waves on a two dimensional liquid jets and the varicose and sinuous modes are predicted. The growth rate of initial disturbances for various azimuthal modes has been presented in a wide range of disturbances. PhD Candidate.

Sphenoid Sinus Myxoma: Case Report and Literature Review

PubMed Central

Moore, Brian A.; Wine, Todd; Burkey, Brian B.; Amedee, Ronald G.; Butcher, R. Brent

2008-01-01

Objectives: We present the first known case in the English-language literature of a myxoma arising in the sphenoid sinus. By describing the patient's clinical course and the salient features of this rare neoplasm, we seek to increase the awareness of the presentation, histological features, and treatment considerations for myxomas of the head and neck. In the process, we intend to describe the work-up of isolated sphenoid sinus lesions and focus on the varying and evolving techniques for surgical access to the sphenoid sinus. Study Design and Methods: Case report and literature review. Results: We describe the clinical course of a patient with a myxoma of the sphenoid sinus. The patient underwent an external sphenoethmoidectomy through a lateral rhinotomy approach with medial maxillectomy under MRI-guidance. He remains without evidence of recurrent disease after 8 months. Conclusions: Myxomas of the head and neck are rare neoplasms. Their infiltrative nature and tendency to recur demand an aggressive surgical approach that may be accomplished with minimal morbidity using currently available image-guided techniques. PMID:21603497

Frontal sinus mucocele.

PubMed

Abrahamson, I A; Baluyot, S T; Tew, J M; Scioville, G

1979-02-01

Although not uncommon, and certainly not rare, frontal sinus mucocele was seen in 4 cases by the authors. Since one of the cases was rather unusual, we were prompted to evaluate the subject and prepare this manuscript. Gradual onset of unilateral proptosis should make one suspicious of a mucocele involving the paranasal sinuses, the frontal and ethmoid being the 2 most common locations. Diplopia, due to limited ocular motility on upward gaze, along with proptosis and epiphora are frequently the presenting symptoms which, in one particular case, paradoxically improved at first with topical anti-inflammatory therapy . A team approach (ophthalmologist, radiologist, otorhinolaryngologist, and neurosurgeon) are essential for an accurate diagnosis and therapeutic approach to this problem. The use of a precut template from the Caldwell projection is a very useful device to outline the contours of the frontal sinus during surgery. The not-so-frequent use of abdominal fat to fill the frontal sinus cavity is presented with no apparent postoperative fat necrosis. A 5-year follow-up has shown the patient to be free of recurrences.

A unique case of magnet ingestion with respect to presentation and management.

PubMed

Yalçin, Sule; Karnak, Ibrahim; Ekinci, Saniye; Senocak, Mehmet Emin

2012-01-01

Magnet ingestion may lead to serious complications with delay in diagnosis and treatment. The forceful attraction between magnets, with gastric and/or intestinal wall entrapped between them, can cause injury through pressure necrosis. The radiological appearance of more than one magnet on X-ray can be easily misinterpreted as belonging to only one rod-like radiopaque foreign body, even if the magnets are located in different parts of the gastrointestinal tract, thus delaying the management up to the onset of emergent surgical complications. A 17-month-old female with ingestion of a pair of magnets is presented, together with introduction of the clinical picture and therapeutic approach, which differed from the other previously reported cases. The ovoid shape of the magnets, their localization in the gastrointestinal tract (leading to entrapped gastric and intestinal wall between them), absence of any complication, and the therapeutic approach of endoscopic retrieval are the main distinguishing features of this case from those previously reported.

Retirement-from-sport considerations following pediatric sports-related concussion: case illustrations and institutional approach.

PubMed

Ellis, Michael J; McDonald, Patrick J; Cordingley, Dean; Mansouri, Behzad; Essig, Marco; Ritchie, Lesley

2016-04-01

The decision to advise an athlete to retire from sports following sports-related concussion (SRC) remains a persistent challenge for physicians. In the absence of strong empirical evidence to support recommendations, clinical decision making must be individualized and should involve a multidisciplinary team of experts in concussion and traumatic brain injury. Although previous authors have advocated for a more conservative approach to these issues in child and adolescent athletes, there are few reports outlining considerations for this process among this unique population. Here, the authors use multiple case illustrations to discuss 3 subgroups of clinical considerations for sports retirement among pediatric SRC patients including the following: those with structural brain abnormalities identified on neuroimaging, those presenting with focal neurological deficits and abnormalities on physical examination, and those in whom the cumulative or prolonged effects of concussion are suspected or demonstrated. The authors' evolving multidisciplinary institutional approach to return-to-play and retirement decision making in pediatric SRC is also presented.

Case Report: Laparoscopic Approach for Orchiopexy in a 26-Year-Old Man with Accidentally Discovered Persistent Müllerian Duct Syndrome and Bilateral Undescended Testis.

PubMed

Noureldin, Mohamed Essam; Tawfik, Ahmed Mohamed; Shaker, Hassan S

2018-01-01

Background: Persistent Müllerian duct syndrome (PMDS) is not a common form of disorder of sex development in which Müllerian duct derivatives (fallopian tubes, uterus, and the proximal vagina) are present in an otherwise normally differentiated 46 XY male. In most of cases, the challenge comes in the procedure of orchiopexy. Case Presentation: We report a case of a 26-year-old man with PMDS. It was accidentally discovered when the patient presented to our outpatient clinic concerning about his empty scrotum as a premarital check. Diagnostic laparoscopy discovered Mullerian remnants in the form of uterus, cervix, and fallopian tubes with two attached testes to the fallopian tubes. Staged laparoscopic orchiopexy was done. We discuss the presentation, the management of this case in the literature, and our intervention. Conclusion: PMDS is not a common condition. Several concerns present in the management of these cases. Malignant transformation of the testis is the main risk facing those patients. Few literature studies discussed the risk of changing of these remnants into malignant tissue. Thus discussion with the patient, tissue histopathology, expert opinions, and literature review are the main clues in management of such cases.

Remote sensing for site characterization

USGS Publications Warehouse

Kuehn, Friedrich; King, Trude V.; Hoerig, Bernhard; Peters, Douglas C.; Kuehn, Friedrich; King, Trude V.; Hoerig, Bernhard; Peters, Douglas C.

2000-01-01

This volume, Remote Sensing for Site Characterization, describes the feasibility of aircraft- and satellite-based methods of revealing environmental-geological problems. A balanced ratio between explanations of the methodological/technical side and presentations of case studies is maintained. The comparison of case studies from North America and Germany show how the respective territorial conditions lead to distinct methodological approaches.

Library Automation in Sub Saharan Africa: Case Study of the University of Botswana

ERIC Educational Resources Information Center

Mutula, Stephen Mudogo

2012-01-01

Purpose: This article aims to present experiences and the lessons learned from the University of Botswana (UB) library automation project. The implications of the project for similar libraries planning automation in sub Saharan Africa and beyond are adduced. Design/methodology/approach: The article is a case study of library automation at the…

Effective Practices in Continuing Professional Development: Lessons from Schools

ERIC Educational Resources Information Center

Earley, Peter; Porritt, Vivienne

2009-01-01

This book presents case studies of schools' journeys towards effective CPD practice as part of a TDA national project. It tells the story of the goals set and achieved, and the challenges and successes along the way. Each case study makes specific reference to the nine factors or approaches to CPD identified in the book as underpinning effective…

The Use of the Racial/Cultural Identity Development Model to Understand a Vietnamese American: A Research Case Study

ERIC Educational Resources Information Center

West-Olatunji, Cirecie A.; Frazier, Kimberly N.; Guy, Tanisha L.; Smith, Angie J.; Clay, Latasha; Breaux, Walter, III

2007-01-01

This article presents the sociohistorical experiences of Vietnamese Americans that contextualize the therapeutic relationship. Using a case study approach, researchers illustrate the use of the Racial/Cultural Identity Development model (D. W. Sue & D. Sue, 2003) in the analysis of an interview with a young, adult, Vietnamese immigrant.

Multidisciplinary management of hypohydrotic ectodermal dysplasia – a case report

PubMed Central

Joseph, Suja; Cherackal, George J; Jacob, Jose; Varghese, Alex K

2015-01-01

Key Clinical Message Hypohydrotic ectodermal dysplasia is a hereditary disorder, which affects ectodermal derivatives. It manifests several abnormalities of the teeth, and is commonly inherited through female carriers. This case report presents a patient with compromised esthetics and function. A multidisciplinary approach was planned involving an oral pathologist, endodontist, orthodontist and a prosthodontist. PMID:25984305

The Role of Response Art in the Case of an Adolescent Survivor of Developmental Trauma

ERIC Educational Resources Information Center

Miller, Rebecca Beers

2007-01-01

This article presents the art therapist's engagement in responsive art making as an effective approach in working with an adolescent survivor of developmental trauma. Through a case study illustration, the art therapist's response art was effective in two main areas. First, in-session response art helped facilitate treatment goals in accordance…

Toward Integrating Environmental and Economic Education: Lessons from the U.S. Acid Rain Program

ERIC Educational Resources Information Center

Ellerbrock, Michael J.; Regn, Ann M.

2004-01-01

This field report presents an actual case study which illustrates that the natural and social sciences, in this case ecology and economics, can and should be integrated in environmental education and the formulation of public policy. After outlining basic economic approaches for addressing environmental problems, we focus on the process and…

Macro-Language Planning for Multilingual Education: Focus on Programmes and Provision

ERIC Educational Resources Information Center

Taylor-Leech, Kerry; Liddicoat, Anthony J.

2014-01-01

This overview identifies some common features of macro-level language planning and briefly summarises the changing approaches to the analysis of macro-planning in the field. It previews six cases of language-in-education planning in response to linguistic diversity presented by the contributors to this issue. The cases show how macro-planning can…

At Issue: An Award-Winning Community College Instructor's Approach to Teaching and Learning

ERIC Educational Resources Information Center

Welsh, Hilarie B.

2015-01-01

The author presents themes that were identified from a case study that focused on the instructional practices of an award-winning community college composition/literature teacher. The themes for this case study focus on the importance of student-centered learning which involve: (1) writing peer response strategies; (2) student engagement in using…

Institutionalizing China's Research University through Academic Mobility: The Case of PKU

ERIC Educational Resources Information Center

Xiaoguang, Shi

2015-01-01

Academic mobility is becoming a tread in academic life and a professional development globally, regionally and nationally. This article makes use of a case university--Peking University (PKU)--as an analytical approach to explore how and why academic mobility can happen in China's research universities. The author first presents an overview of the…

Maximum Marginal Likelihood Estimation of a Monotonic Polynomial Generalized Partial Credit Model with Applications to Multiple Group Analysis.

PubMed

Falk, Carl F; Cai, Li

2016-06-01

We present a semi-parametric approach to estimating item response functions (IRF) useful when the true IRF does not strictly follow commonly used functions. Our approach replaces the linear predictor of the generalized partial credit model with a monotonic polynomial. The model includes the regular generalized partial credit model at the lowest order polynomial. Our approach extends Liang's (A semi-parametric approach to estimate IRFs, Unpublished doctoral dissertation, 2007) method for dichotomous item responses to the case of polytomous data. Furthermore, item parameter estimation is implemented with maximum marginal likelihood using the Bock-Aitkin EM algorithm, thereby facilitating multiple group analyses useful in operational settings. Our approach is demonstrated on both educational and psychological data. We present simulation results comparing our approach to more standard IRF estimation approaches and other non-parametric and semi-parametric alternatives.

Stable Direct Adaptive Control of Linear Infinite-dimensional Systems Using a Command Generator Tracker Approach

NASA Technical Reports Server (NTRS)

Balas, M. J.; Kaufman, H.; Wen, J.

1985-01-01

A command generator tracker approach to model following contol of linear distributed parameter systems (DPS) whose dynamics are described on infinite dimensional Hilbert spaces is presented. This method generates finite dimensional controllers capable of exponentially stable tracking of the reference trajectories when certain ideal trajectories are known to exist for the open loop DPS; we present conditions for the existence of these ideal trajectories. An adaptive version of this type of controller is also presented and shown to achieve (in some cases, asymptotically) stable finite dimensional control of the infinite dimensional DPS.

Evidence Arguments for Using Formal Methods in Software Certification

NASA Technical Reports Server (NTRS)

Denney, Ewen W.; Pai, Ganesh

2013-01-01

We describe a generic approach for automatically integrating the output generated from a formal method/tool into a software safety assurance case, as an evidence argument, by (a) encoding the underlying reasoning as a safety case pattern, and (b) instantiating it using the data produced from the method/tool. We believe this approach not only improves the trustworthiness of the evidence generated from a formal method/tool, by explicitly presenting the reasoning and mechanisms underlying its genesis, but also provides a way to gauge the suitability of the evidence in the context of the wider assurance case. We illustrate our work by application to a real example-an unmanned aircraft system- where we invoke a formal code analysis tool from its autopilot software safety case, automatically transform the verification output into an evidence argument, and then integrate it into the former.

Siegert-state expansion for nonstationary systems. IV. Three-dimensional case

NASA Astrophysics Data System (ADS)

Tolstikhin, Oleg I.

2008-03-01

The Siegert-state expansion approach [O. I. Tolstikhin, Phys. Rev. A 73, 062705 (2006)] is extended to the three-dimensional case. Coupled equations defining the time evolution of coefficients in the expansion of the solution to the time-dependent Schrödinger equation in terms of partial-wave Siegert states are derived, and physical observables (probabilities of transitions to discrete states and the momentum distribution of ejected particles) are expressed in terms of these coefficients. The approach is implemented in terms of Siegert pseudostates and illustrated by calculations of the photodetachment of H- by strong high-frequency laser pulses. The present calculations demonstrate that the interference effect in the laser-atom interaction dynamics found recently in the one-dimensional case [K. Toyota , Phys. Rev. A 76, 043418 (2007)] reveals itself in the three-dimensional case as well.

Making the Case for a Positive Approach to Improving Organizational Performance in Higher Education Institutions: The Community College Abundance Model

ERIC Educational Resources Information Center

Shults, Christopher

2008-01-01

Increasingly hostile and turbulent environments have rendered top-down, problem-focused management structures inadequate for competing in the ever-changing postsecondary knowledge industry. The community college abundance model (CCAM), a strengths-based approach to performance enhancement in community colleges, is presented as a viable…

The Case for Medieval Drama in the Classroom: An Approach through Performance.

ERIC Educational Resources Information Center

Lieblein, Leanore; Pare, Anthony

1983-01-01

Argues that medieval drama in performance suggests a number of important issues about the nature of literature, particularly about the way narrative and dramatic art can express the life of a community. Presents a series of exercises that start with familiar, nonthreatening situations in order to approach the richness of medieval plays and the…

The Use of Educational Game Design and Play in Higher Education to Influence Sustainable Behaviour

ERIC Educational Resources Information Center

Mercer, Theresa G.; Kythreotis, Andrew P.; Robinson, Zoe P.; Stolte, Terje; George, Sharon M.; Haywood, Stephanie K.

2017-01-01

Purpose: The purpose of this paper is to discuss a novel life cycle approach to education for sustainable development (ESD) where the students become "design thinkers". Design/methodology/approach: A case study on the creation, development and utilisation of educational games by university students is presented. The paper discusses the…

Getting to Grips with Bricolage: A Personal Account

ERIC Educational Resources Information Center

Wibberley, Christopher

2012-01-01

This paper presents a personal account of how a PhD supervisor came to an understanding of an approach to research that was unfamiliar to him. Additionally it addresses the question of what makes the approach, in this case bricolage, an acceptable format for academic work and in particular PhD study. Bricolage is a relatively little used approach…

Pilot-Scale Laboratory Instruction for Chemical Engineering: The Specific Case of the Pilot-Unit Leading Group

ERIC Educational Resources Information Center

Billet, Anne-Marie; Camy, Severine; Coufort-Saudejaud, Carole

2010-01-01

This paper presents an original approach for Chemical Engineering laboratory teaching that is currently applied at INP-ENSIACET (France). This approach, referred to as "pilot-unit leading group" is based on a partial management of the laboratories by the students themselves who become temporarily in charge of one specific laboratory. In…

Open Experimentation on Phenomena of Chemical Reactions via the Learning Company Approach in Early Secondary Chemistry Education

ERIC Educational Resources Information Center

Beck, Katharina; Witteck, Torsten; Eilks, Ingo

2010-01-01

Presented is a case study on the implementation of open and inquiry-type experimentation in early German secondary chemistry education. The teaching strategy discussed follows the learning company approach. Originally adopted from vocational education, the learning company method is used to redirect lab-oriented classroom practice towards a more…

How Teachers Teach the Writing Process. Final Report.

ERIC Educational Resources Information Center

Perl, Sondra; And Others

Presented in this report are the results of a three-year case study designed (1) to document what happened in the classrooms of 10 teachers who were trained in a process approach to the teaching of writing, and (2) to provide those teachers with occasions to deepen their understanding of the process approach, by collaborating with them in the…

Comparison of the Relative Effectiveness of Different Kinds of Reinforcers: A PEM Approach

ERIC Educational Resources Information Center

Ma, Hsen-Hsing

2009-01-01

The purpose of the present study was to apply the percentage of data points exceeding the median of baseline phase (PEM) approach for a meta-analysis of single-case experiments to compare the relative effectiveness of different kinds of reinforcers used in behavior modification. Altogether 153 studies were located, which produced 1091 effect…

A Holistic Approach to Supporting the Learning of Young Indigenous Students: One Case Study

ERIC Educational Resources Information Center

Warren, Elizabeth; Quine, Janine

2013-01-01

Due to the high turnover of teaching staff in remote schools, the long-term sustainability of educational initiatives that enhance Indigenous student's learning is a major concern. This article presents a study of a remote Indigenous school (Ischool) situated in Queensland. Ischool has changed its approach to leadership, particularly the…

Analysis of ToxCast data for food-relevant compounds by comparison with in vivo data using the RISK21 approach

EPA Science Inventory

The ToxCast program has generated a wealth of in vitro high throughput screening data, and best approaches for the interpretation and use of these data remain undetermined. We present case studies comparing the ToxCast and in vivo toxicity data for two food contact substances us...

Identifying and Tracing User Needs

NASA Astrophysics Data System (ADS)

To, C.; Tauer, E.

2017-12-01

Providing adequate tools to the user community hinges on reaching the specific goals and needs behind the intended application of the tool. While the approach of leveraging user-supplied inputs and use cases to identify those goals is not new, there frequently remains the challenge of tracing those use cases through to implementation in an efficient and manageable fashion. Processes can become overcomplicated very quickly, and additionally, explicitly mapping progress towards the achievement of the user demands can become overwhelming when hundreds of use-cases are at play. This presentation will discuss a demonstrated use-case approach that has achieved an initial success with a tool re-design and deployment, the means to apply use cases in the generation of a roadmap for future releases over time, and the ability to include and adjust to new user requirements and suggestions with minimal disruption to the traceability. It is hoped that the findings and lessons learned will help make use case employment easier for others seeking to create user-targeted capabilities.

Optic Nerve Sheath Meningocele: A Case Report

PubMed Central

Halimi, E.; Wavreille, O.; Rosenberg, R.; Bouacha, I.; Lejeune, J.-P.; Defoort-Dhellemmes, S.

2013-01-01

Abstract Isolated optic nerve sheath meningocele is a rare affection defined as the cystic enlargement of the optic nerve sheath filled with cerebrospinal fluid. We report the case of a 39-year-old woman presenting with bilateral meningocele uncovered during a routine examination for headache complaints. A 5-year follow-up validated the lesion’s clinical and imaging stability. Magnetic resonance imaging (MRI) is an essential tool in the diagnosis of this pathology, alongside characteristic symptoms indicating that the meningocele might have progressively expanded into the orbit. In this case we present a therapeutic approach based on pathophysiological hypotheses and review of the literature. PMID:28163760

Balloon-Occluded Retrograde Transvenous Obliteration of a Gastric Vascular Malformation: An Innovative Approach to Treatment of a Rare Condition

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hansing, Catherine E., E-mail: catherine.e.hansing.mil@mail.mil; Marquardt, Joseph P.; Sutton, Daniel M.

Arteriovenous malformations (AVMs) are a high-flow form of a vascular malformation, which can be found anywhere in the body. While historically treated surgically, a multidisciplinary approach utilizing multiple specialties and treatment modalities is now commonly employed. In order to effectively treat an AVM, the nidus must be targeted and eradicated, which can be done via multiple approaches. We present the case of a 43-year-old male with a gastric wall AVM, which was initially incompletely treated using a percutaneous transarterial approach. The gastric AVM was noted to have dominant drainage through a gastrorenal shunt; therefore, Balloon-occluded Retrograde Transvenous Obliteration (BRTO) wasmore » utilized to eradicate the AVM nidus. This case illustrates the utility of Interventional Radiology, specifically BRTO, as another treatment option for challenging AVMs.« less

It's Not All about Video-Conferencing

ERIC Educational Resources Information Center

Stodberg, Ulf; Orre, Carl Johan

2010-01-01

Purpose: This paper seeks to present the issue of e-learning development in a public university in Bolivia, together with challenges that could support the work of a sustainable development of practice and educational technologies. Design/methodology/approach: The paper presents the first phase of an interpretative case study. It comprises data…

Correcting Poor Posture without Awareness or Willpower

ERIC Educational Resources Information Center

Wernik, Uri

2012-01-01

In this article, a new technique for correcting poor posture is presented. Rather than intentionally increasing awareness or mobilizing willpower to correct posture, this approach offers a game using randomly drawn cards with easy daily assignments. A case using the technique is presented to emphasize the subjective experience of living with poor…

The Use of Music in Counseling Addictive Clients.

ERIC Educational Resources Information Center

Gallant, Wilfred; Siegel, Sammi; Holosko, Michael

1997-01-01

Explores a broad range of music interventions appropriate for addictive clients so as to fill a void in the music therapy and addictions counseling literature. Presents a rationale for the use of music intervention and presents case examples. Describes a social work intervention approach tested over a 10-year period. (RJM)

Personnel Performance Assessment in Information Systems Outsourcing Environments

ERIC Educational Resources Information Center

Casado-Lumbreras, Cristina; Soto-Acosta, Pedro; Colomo-Palacios, Ricardo; de Pablos, Patricia Ordonez

2011-01-01

Purpose: The aim of this paper is to present a tool which uses semantic technologies for personnel performance and workplace learning assessment in outsourced information technology environments. Design/methodology/approach: The paper presents the tool from a technical perspective and introduces a use case that depicts the main features related to…

Successful combined surgical approach in a rare case of retrotracheal goitre in a patient with anatomical impediments.

PubMed

Spartalis, E; Damaskos, C; Moris, D; Athanasiou, A; Spartalis, M; Karagkiouzis, G; Schizas, D; Dimitroulis, D; Tomos, P

2018-01-01

Diving goitres can descend the cervical region expanding directly into the thoracic cavity. In most cases, diving goitres extend into the anterosuperior compartment, but they may also extend behind the trachea. We herein present a case of a male patient with retrotracheal goitre and history of left thyroid lobectomy and median sternotomy for thoracic aortic aneurysm repair with graft placement. After detailed preoperative evaluation, the patient underwent surgical resection of the mass through a combined approach; the existing cervical incision and a right posterolateral mini-thoracotomy. The postoperative course of the patient was uncomplicated. One year after surgery, the patient is asymptomatic and disease-free. (Folia Morphol 2018; 77, 1: 166-169).

Narrating practice: reflective accounts and the textual construction of reality.

PubMed

Taylor, Carolyn

2003-05-01

Two approaches dominate current thinking in health and welfare: evidence-based practice and reflective practice. Whilst there is debate about the merits of evidence-based practice, reflective practice is generally accepted with critical debate as an important educational tool. Where critique does exist it tends to adopt a Foucauldian approach, focusing on the surveillance and self-regulatory aspects of reflective practice. This article acknowledges the critical purchase on the concept of reflective practice offered by Foucauldian approaches but argues that microsociological and discourse analytic approaches can further illuminate the subject and thus serve as a complement to them. The claims of proponents of reflective practice are explored, in opposition to the technical-rational approach of evidence-based practice. Reflective practice tends to adopt a naive or romantic realist position and fails to acknowledge the ways in which reflective accounts construct the world of practice. Microsociological approaches can help us to understand reflective accounts as examples of case-talk, constructed in a narrative form in the same way as case records and presentations.

Combining Model-Based and Feature-Driven Diagnosis Approaches - A Case Study on Electromechanical Actuators

NASA Technical Reports Server (NTRS)

Narasimhan, Sriram; Roychoudhury, Indranil; Balaban, Edward; Saxena, Abhinav

2010-01-01

Model-based diagnosis typically uses analytical redundancy to compare predictions from a model against observations from the system being diagnosed. However this approach does not work very well when it is not feasible to create analytic relations describing all the observed data, e.g., for vibration data which is usually sampled at very high rates and requires very detailed finite element models to describe its behavior. In such cases, features (in time and frequency domains) that contain diagnostic information are extracted from the data. Since this is a computationally intensive process, it is not efficient to extract all the features all the time. In this paper we present an approach that combines the analytic model-based and feature-driven diagnosis approaches. The analytic approach is used to reduce the set of possible faults and then features are chosen to best distinguish among the remaining faults. We describe an implementation of this approach on the Flyable Electro-mechanical Actuator (FLEA) test bed.

Microwave landing system autoland system analysis

NASA Technical Reports Server (NTRS)

Feather, J. B.; Craven, B. K.

1991-01-01

The objective was to investigate the ability of present day aircraft equipped with automatic flight control systems to fly advanced Microwave Landing Systems (MLS) approaches. The tactical approach used to achieve this objective included reviewing the design and autoland operation of the MD-80 aircraft, simulating the MLS approaches using a batch computer program, and assessing the performance of the autoland system from computer generated data. The results showed changes were required to present Instrument Landing System (ILS) procedures to accommodate the new MLS curved paths. It was also shown that in some cases, changes to the digital flight guidance systems would be required so that an autoland could be performed.

Inpatient rehabilitation approach for a young woman with conversion hemiparesis and sensory deficits.

PubMed

Kanarek, Samantha L; Stevenson, Jennifer E; Wakefield, Holly; Reite, Elizabeth; Zumsteg, Jennifer M; Brockway, Jo Ann

2013-01-01

In the treatment of conversion disorder, the inpatient rehabilitation setting supports interdisciplinary functional goals and a structured approach consistent with encouraging psychological well-being. This case presentation illustrates 1 approach to the rehabilitation of hemiparesis secondary to conversion disorder that includes a behavioral management plan, as well as protocols for "learning to walk" and "learning to use your arm." We provide a practical starting point for advancing function in patients with conversion disorder when functional loss is present in both upper and lower extremities. Copyright © 2013 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Percutaneous transhepatic drainage of lung abscess through a diaphragmatic fistula caused by a penetrating liver abscess.

PubMed

Taniguchi, Masako; Morita, Satoru; Ueno, Eiko; Hayashi, Mitsutoshi; Ishikawa, Motonao; Mae, Masahiro

2011-11-01

Liver abscesses occurring just below the diaphragm can penetrate or perforate the thoracic cavity, resulting in lung abscess or pyothorax. Although surgical or percutaneous transpleural drainage is often required in such cases, the latter approach has some risks, including hemothorax and bronchopleural fistula formation when the cavity is surrounded by normal lung parenchyma. The present report describes a treatment technique of percutaneous transhepatic drainage through the diaphragmatic fistula to avoid the risks of a transpulmonary approach in a case of lung abscess caused by a penetrating liver abscess.

Induction of Lactation in the Biological Mother After Gestational Surrogacy of Twins: A Novel Approach and Review of Literature.

PubMed

Farhadi, Roya; Philip, Roy K

One of the important challenges in surrogate pregnancies is the early bonding of genetic mother with her infant and the establishment of breastfeeding. A combination of pharmacological and nonpharmacological methods is often used for the induction of lactation. Reports of induced lactation in surrogacy are limited and scattered. In this report, we present a case of induced lactation and initiation of breastfeeding in preterm twins by the genetic mother, through her novel approach after a gestational surrogate pregnancy. Thematic approach of maternal account is summarized with context and rigor. We reviewed the reported literature of induced lactation in similar cases with an aim to address the various methods adopted.

Development of a State Machine Sequencer for the Keck Interferometer: Evolution, Development and Lessons Learned using a CASE Tool Approach

NASA Technical Reports Server (NTRS)

Rede, Leonard J.; Booth, Andrew; Hsieh, Jonathon; Summer, Kellee

2004-01-01

This paper presents a discussion of the evolution of a sequencer from a simple EPICS (Experimental Physics and Industrial Control System) based sequencer into a complex implementation designed utilizing UML (Unified Modeling Language) methodologies and a CASE (Computer Aided Software Engineering) tool approach. The main purpose of the sequencer (called the IF Sequencer) is to provide overall control of the Keck Interferometer to enable science operations be carried out by a single operator (and/or observer). The interferometer links the two 10m telescopes of the W. M. Keck Observatory at Mauna Kea, Hawaii. The IF Sequencer is a high-level, multi-threaded, Hare1 finite state machine, software program designed to orchestrate several lower-level hardware and software hard real time subsystems that must perform their work in a specific and sequential order. The sequencing need not be done in hard real-time. Each state machine thread commands either a high-speed real-time multiple mode embedded controller via CORB A, or slower controllers via EPICS Channel Access interfaces. The overall operation of the system is simplified by the automation. The UML is discussed and our use of it to implement the sequencer is presented. The decision to use the Rhapsody product as our CASE tool is explained and reflected upon. Most importantly, a section on lessons learned is presented and the difficulty of integrating CASE tool automatically generated C++ code into a large control system consisting of multiple infrastructures is presented.

Development of a state machine sequencer for the Keck Interferometer: evolution, development, and lessons learned using a CASE tool approach

NASA Astrophysics Data System (ADS)

Reder, Leonard J.; Booth, Andrew; Hsieh, Jonathan; Summers, Kellee R.

2004-09-01

This paper presents a discussion of the evolution of a sequencer from a simple Experimental Physics and Industrial Control System (EPICS) based sequencer into a complex implementation designed utilizing UML (Unified Modeling Language) methodologies and a Computer Aided Software Engineering (CASE) tool approach. The main purpose of the Interferometer Sequencer (called the IF Sequencer) is to provide overall control of the Keck Interferometer to enable science operations to be carried out by a single operator (and/or observer). The interferometer links the two 10m telescopes of the W. M. Keck Observatory at Mauna Kea, Hawaii. The IF Sequencer is a high-level, multi-threaded, Harel finite state machine software program designed to orchestrate several lower-level hardware and software hard real-time subsystems that must perform their work in a specific and sequential order. The sequencing need not be done in hard real-time. Each state machine thread commands either a high-speed real-time multiple mode embedded controller via CORBA, or slower controllers via EPICS Channel Access interfaces. The overall operation of the system is simplified by the automation. The UML is discussed and our use of it to implement the sequencer is presented. The decision to use the Rhapsody product as our CASE tool is explained and reflected upon. Most importantly, a section on lessons learned is presented and the difficulty of integrating CASE tool automatically generated C++ code into a large control system consisting of multiple infrastructures is presented.

[Recalibration via a postero-lateral approach in recent traumatic stenosis of the dorsal and lumbar spine. Modalities and results apropos of 31 cases].

PubMed

Richaud, J; Bousquet, P; Ealet, G; Clamens, J; Beltchika, K; Lazorthes, Y

1990-01-01

The authors present 31 cases of spinal trauma affecting thoraco lumbar level with severe spinal canal stenosis secondary to compressive trauma of the anterior disco-corpereal region. Associated neurological disorders were of varying severity. 23 cases were investigated by computed tomography. In all cases, the surgical procedure involved rectification of spinal deformities, with initially a unilateral postero-lateral approach permitting anterior spinal canal recalibration, either by impaction of protrusive fragments or ablation of free disc fragments. The stabilization was usually achieved by complementary bilateral plates using Roy-Camille or Privat material in 22 cases, associated with postero-lateral arthrodesis by grafting with reconstruction of the articulo-pedicular structure in 19 cases. Emergency operation was done in 14 cases; in 5 cases operation was done on the 2nd or 3rd day and in 11 cases after the 3rd day. The functional spinal result was excellent, and recalibration was verified by tomography in all cases. In those cases showing neurological deficiency, good and early recovery was attributable to the suppression of spinal canal stenosis, and a consequently neurological improvement was always obtained, even for the most serious of lesions except those at the thoracis level superior to T10. The application of this postero-lateral approach for severe spinal trauma seems to represent, in all cases of recent lesions, an alternative to the anterior or combined methods. We do not share the opinion that delay in decompression does not influence the neurological prognosis and emergency operation is advisable.

14D. The Epidemic of Diabesity: Functional Medicine Approaches to Treatment, Recovery, and Prevention

PubMed Central

2013-01-01

Focus Areas: Integrative Approaches to Care, Supporting Behavioral Change This brief presentation will offer a view of obesity and diabetes from a functional medicine approach. It will include the use of the Functional Medicine Matrix Model, the GO.TO.IT operating system, and the clinical timeline. Assessing pre-diabetes, diabetes, and obesity must include an evaluation of digestive function and nutritional status, the role of inflammation and insulin resistance, and the consideration of persistent organic pollutants (POPs) as a driver, as well as the relationship to mitochondrial energy production. This presentation will use a case-based format to highlight the unique Functional Medicine approach to assessing the root cause(s) of obesity and diabetes, as well as demonstrating appropriate treatment modalities.

A novel anisotropic inversion approach for magnetotelluric data from subsurfaces with orthogonal geoelectric strike directions

NASA Astrophysics Data System (ADS)

Schmoldt, Jan-Philipp; Jones, Alan G.

2013-12-01

The key result of this study is the development of a novel inversion approach for cases of orthogonal, or close to orthogonal, geoelectric strike directions at different depth ranges, for example, crustal and mantle depths. Oblique geoelectric strike directions are a well-known issue in commonly employed isotropic 2-D inversion of MT data. Whereas recovery of upper (crustal) structures can, in most cases, be achieved in a straightforward manner, deriving lower (mantle) structures is more challenging with isotropic 2-D inversion in the case of an overlying region (crust) with different geoelectric strike direction. Thus, investigators may resort to computationally expensive and more limited 3-D inversion in order to derive the electric resistivity distribution at mantle depths. In the novel approaches presented in this paper, electric anisotropy is used to image 2-D structures in one depth range, whereas the other region is modelled with an isotropic 1-D or 2-D approach, as a result significantly reducing computational costs of the inversion in comparison with 3-D inversion. The 1- and 2-D versions of the novel approach were tested using a synthetic 3-D subsurface model with orthogonal strike directions at crust and mantle depths and their performance was compared to results of isotropic 2-D inversion. Structures at crustal depths were reasonably well recovered by all inversion approaches, whereas recovery of mantle structures varied significantly between the different approaches. Isotropic 2-D inversion models, despite decomposition of the electric impedance tensor and using a wide range of inversion parameters, exhibited severe artefacts thereby confirming the requirement of either an enhanced or a higher dimensionality inversion approach. With the anisotropic 1-D inversion approach, mantle structures of the synthetic model were recovered reasonably well with anisotropy values parallel to the mantle strike direction (in this study anisotropy was assigned to the mantle region), indicating applicability of the novel approach for basic subsurface cases. For the more complex subsurface cases, however, the anisotropic 1-D inversion approach is likely to yield implausible models of the electric resistivity distribution due to inapplicability of the 1-D approximation. Owing to the higher number of degrees of freedom, the anisotropic 2-D inversion approach can cope with more complex subsurface cases and is the recommended tool for real data sets recorded in regions with orthogonal geoelectric strike directions.

Direct Linearization and Adjoint Approaches to Evaluation of Atmospheric Weighting Functions and Surface Partial Derivatives: General Principles, Synergy and Areas of Application

NASA Technical Reports Server (NTRS)

Ustino, Eugene A.

2006-01-01

This slide presentation reviews the observable radiances as functions of atmospheric parameters and of surface parameters; the mathematics of atmospheric weighting functions (WFs) and surface partial derivatives (PDs) are presented; and the equation of the forward radiative transfer (RT) problem is presented. For non-scattering atmospheres this can be done analytically, and all WFs and PDs can be computed analytically using the direct linearization approach. For scattering atmospheres, in general case, the solution of the forward RT problem can be obtained only numerically, but we need only two numerical solutions: one of the forward RT problem and one of the adjoint RT problem to compute all WFs and PDs we can think of. In this presentation we discuss applications of both the linearization and adjoint approaches

Surgical treatment for the aberrant internal carotid artery in the middle ear with pulsatile tinnitus.

PubMed

Honkura, Yohei; Hidaka, Hiroshi; Ohta, Jun; Gorai, Shigeki; Katori, Yukio; Kobayashi, Toshimitsu

2014-04-01

Many previous reports have indicated that pulsatile tinnitus caused by an aberrant internal carotid artery (ICA) should not be treated surgically because of the risk of infection or aneurysm formation. We herein describe a case of aberrant ICA treated by middle ear surgery for which we introduced a novel approach. An 84-year-old man was presented with a one-year history of tinnitus in his right ear. Otoscopic examination demonstrated a whitish mass in the antero-inferior quadrant of the tympanic membrane associated with rhythmic pulsation. Images obtained by CT, MRI and MRA revealed protrusion of the ICA into the tympanic cavity, making contact with the tympanic membrane. Surgery to separate the tympanic membrane from the ICA was performed in order to relieve the pulsatile tinnitus. After the operation, the patient's aural activity was preserved and the tinnitus did not recur within a follow-up period of one year. In the present case, delicate middle ear surgery was effective for relief of the tinnitus. When treating patients with aberrant IAC showing features similar to the present case, the surgical approach we have described is worth attempting. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Outcome of single-trajectory rigid endoscopic third ventriculostomy and biopsy in the management algorithm of pineal region tumors: a case series and review of the literature.

PubMed

Abbassy, Mahmoud; Aref, Khaled; Farhoud, Ahmed; Hekal, Anwar

2018-05-28

Tumors within the pineal region represent 1.5 to 8.5% of the pediatric brain tumors and 1.2% of all brain tumors. A management algorithm has been proposed in several publications. The algorithm includes endoscopic third ventriculostomy (ETV) and biopsy in cases presenting with hydrocephalus. In this series, we are presenting the efficacy of a single-trajectory approach for both ETV and biopsy. Eleven cases were admitted to Alexandria main university hospital from 2013 to 2016 presenting with pineal region tumors and hydrocephalus. Mean age at diagnosis was 11 years (1-27 years). All cases had ETV and biopsy using rigid ventriculoscope through a single trajectory from a burr hole planned on preoperative imaging. Follow-up period was 7-48 months. All 11 cases presented with hydrocephalus and increased intracranial pressure manifestations. Histopathological diagnosis was successful in 9 out of 11 cases (81.8%). Three cases were germ-cell tumors, two cases were pineoblastomas, two cases were pilocytic astrocytomas, and two cases were grade 2 tectal gliomas. Five of the ETV cases (45.5%) failed and required VPS later on. Other complications of ETV included one case of intraventricular hemorrhage and a case with tumor disseminated to the basal cisterns. In our series, we were able to achieve ETV and biopsy through a single trajectory and a rigid endoscope with results comparable to other studies in the literature.

Real life juvenile toxicity case studies: the good, the bad and the ugly.

PubMed

De Schaepdrijver, Luc; Rouan, Marie-Claude; Raoof, Araz; Bailey, Graham P; De Zwart, Loeckie; Monbaliu, Johan; Coogan, Timothy P; Lammens, Lieve; Coussement, Werner

2008-09-01

With the growing experience in the conduct of juvenile toxicity studies for multiple classes of compound, the 'case-by-case' approach has become under much more pressure. Instead, a general screen or 'standard design' is now commonly expected by regulatory authorities with more routine inclusion of neurological and reproductive assessments. Minor modifications or additions can be made to the design to address specific questions according to the class of drug or intended clinical use. This drift from a 'case-by-case' approach to a 'standard design' approach is present within certain reviewing divisions of the FDA, often requesting by default a rodent and non-rodent juvenile animal study. However, juvenile animal studies should be designed thoughtfully to fulfil a purpose based on scientific rationale, with each endpoint carefully considered in terms of practicality and interpretability of data generated. Only when using the appropriate strategy and design may juvenile studies add value by (1) identifying potential safety or pharmacokinetic issues for drugs intended for paediatric use, (2) suggesting additional clinical endpoints and (3) adding new information to the product label. As the knowledge from juvenile animal studies in various species grows, a better understanding of the significance/relevance of findings will be achieved.

Addressing uncertainty in adaptation planning for agriculture.

PubMed

Vermeulen, Sonja J; Challinor, Andrew J; Thornton, Philip K; Campbell, Bruce M; Eriyagama, Nishadi; Vervoort, Joost M; Kinyangi, James; Jarvis, Andy; Läderach, Peter; Ramirez-Villegas, Julian; Nicklin, Kathryn J; Hawkins, Ed; Smith, Daniel R

2013-05-21

We present a framework for prioritizing adaptation approaches at a range of timeframes. The framework is illustrated by four case studies from developing countries, each with associated characterization of uncertainty. Two cases on near-term adaptation planning in Sri Lanka and on stakeholder scenario exercises in East Africa show how the relative utility of capacity vs. impact approaches to adaptation planning differ with level of uncertainty and associated lead time. An additional two cases demonstrate that it is possible to identify uncertainties that are relevant to decision making in specific timeframes and circumstances. The case on coffee in Latin America identifies altitudinal thresholds at which incremental vs. transformative adaptation pathways are robust options. The final case uses three crop-climate simulation studies to demonstrate how uncertainty can be characterized at different time horizons to discriminate where robust adaptation options are possible. We find that impact approaches, which use predictive models, are increasingly useful over longer lead times and at higher levels of greenhouse gas emissions. We also find that extreme events are important in determining predictability across a broad range of timescales. The results demonstrate the potential for robust knowledge and actions in the face of uncertainty.

Addressing uncertainty in adaptation planning for agriculture

PubMed Central

Vermeulen, Sonja J.; Challinor, Andrew J.; Thornton, Philip K.; Campbell, Bruce M.; Eriyagama, Nishadi; Vervoort, Joost M.; Kinyangi, James; Jarvis, Andy; Läderach, Peter; Ramirez-Villegas, Julian; Nicklin, Kathryn J.; Hawkins, Ed; Smith, Daniel R.

2013-01-01

We present a framework for prioritizing adaptation approaches at a range of timeframes. The framework is illustrated by four case studies from developing countries, each with associated characterization of uncertainty. Two cases on near-term adaptation planning in Sri Lanka and on stakeholder scenario exercises in East Africa show how the relative utility of capacity vs. impact approaches to adaptation planning differ with level of uncertainty and associated lead time. An additional two cases demonstrate that it is possible to identify uncertainties that are relevant to decision making in specific timeframes and circumstances. The case on coffee in Latin America identifies altitudinal thresholds at which incremental vs. transformative adaptation pathways are robust options. The final case uses three crop–climate simulation studies to demonstrate how uncertainty can be characterized at different time horizons to discriminate where robust adaptation options are possible. We find that impact approaches, which use predictive models, are increasingly useful over longer lead times and at higher levels of greenhouse gas emissions. We also find that extreme events are important in determining predictability across a broad range of timescales. The results demonstrate the potential for robust knowledge and actions in the face of uncertainty. PMID:23674681

An unusual cause of cervical kyphosis.

PubMed

Raj, Mamtha S; Schwab, Joseph H

2017-02-01

Acute fixed cervical kyphosis may be a rare presentation of conversion disorder, psychogenic dystonia, and potentially as a side effect from typical antipsychotic drugs. Haldol has been associated with acute dystonic reactions. In some cases, rigid deformities ensue. We are reporting a case of a fixed cervical kyphosis after the use of Haldol. To present a case of a potential acute dystonic reaction temporally associated with Haldol ingestion leading to fixed cervical kyphosis. This is a case report. A patient diagnosed with bipolar disorder presented to the emergency room several times with severe neck pain and stiffness. The neck appeared fixed in flexion with extensive osteophyte formation over a 3-month period. The patient's condition was resolved by a posterior-anterior-posterior surgical approach. It corrected the patient's cervical curvature from 88° to 5°. Acute dystonic reactions have the potential to apply enough pressure on bone to cause rapid osteophyte formation. Copyright © 2016 Elsevier Inc. All rights reserved.

False penile fracture: report of 16 cases.

PubMed

Feki, W; Derouiche, A; Belhaj, K; Ouni, A; Ben Mouelhi, S; Ben Slama, M R; Ayed, M; Chebil, M

2007-01-01

We determined the value of diagnostic and therapeutic approaches of false penile fractures and the outcome of treatment. We retrospectively reviewed 16 cases of presumed penile fracture with a negative surgical exploration. Clinical presentation, technique of treatment and outcome were noted. The mean age was 39 years (17-64). Nine patients were injured during sexual intercourse. All the patients presented with the presumptive diagnosis of penile fracture. False penile fracture was evoked in one patient presenting a new erection. Surgical penile exploration was carried out for all the patients without any radiological explorations. It revealed nonspecific dartos bleeding in 10 cases and avulsed superficial dorsal vein in six cases requiring venous ends ligation. All the patients regained penile appearance and potency. We can hardly distinguish false penile fracture from 'true' penile fracture with certainty either clinically or radiologically, thus, surgical exploration is mostly necessary. The prognosis is excellent.

Best practices for evaluating the capability of nondestructive evaluation (NDE) and structural health monitoring (SHM) techniques for damage characterization

NASA Astrophysics Data System (ADS)

Aldrin, John C.; Annis, Charles; Sabbagh, Harold A.; Lindgren, Eric A.

2016-02-01

A comprehensive approach to NDE and SHM characterization error (CE) evaluation is presented that follows the framework of the `ahat-versus-a' regression analysis for POD assessment. Characterization capability evaluation is typically more complex with respect to current POD evaluations and thus requires engineering and statistical expertise in the model-building process to ensure all key effects and interactions are addressed. Justifying the statistical model choice with underlying assumptions is key. Several sizing case studies are presented with detailed evaluations of the most appropriate statistical model for each data set. The use of a model-assisted approach is introduced to help assess the reliability of NDE and SHM characterization capability under a wide range of part, environmental and damage conditions. Best practices of using models are presented for both an eddy current NDE sizing and vibration-based SHM case studies. The results of these studies highlight the general protocol feasibility, emphasize the importance of evaluating key application characteristics prior to the study, and demonstrate an approach to quantify the role of varying SHM sensor durability and environmental conditions on characterization performance.

Approach for computing 1D fracture density: application to fracture corridor characterization

NASA Astrophysics Data System (ADS)

Viseur, Sophie; Chatelée, Sebastien; Akriche, Clement; Lamarche, Juliette

2016-04-01

Fracture density is an important parameter for characterizing fractured reservoirs. Many stochastic simulation algorithms that generate fracture networks indeed rely on the determination of a fracture density on volumes (P30) to populate the reservoir zones with individual fracture surfaces. However, only 1D fracture density (P10) are available from subsurface data and it is then important to be able to accurately estimate this entity. In this paper, a novel approach is proposed to estimate fracture density from scan-line or well data. This method relies on regression, hypothesis testing and clustering techniques. The objective of the proposed approach is to highlight zones where fracture density are statistically very different or similar. This technique has been applied on both synthetic and real case studies. These studies concern fracture corridors, which are particular tectonic features that are generally difficult to characterize from subsurface data. These tectonic features are still not well known and studies must be conducted to better understand their internal spatial organization and variability. The presented synthetic cases aim at showing the ability of the approach to extract known features. The real case study illustrates how this approach allows the internal spatial organization of fracture corridors to be characterized.

Isolated laryngeal leishmaniasis in an immunocompetent patient: a case report.

PubMed

Bajraktari, A; Seccia, V; Casani, A P; Franceschini, S S

Isolated laryngeal leishmaniasis in an immunocompetent patient: a case report. Isolated laryngeal Leishmaniasis presents neither explicit laryngeal lesions nor specific symptoms. In fact, it may mimic many inflammatory and neoplastic diseases. Considering the low incidence of this atypical localization, laryngeal Leishmaniasis, is rarely contemplated by physicians in differential diagnoses of laryngeal tumour lesions. We present the case of a 62-year-old immunocompetent subject who developed a single Leishmania mucosal lesion on the left vocal cord, simulating a laryngeal cancer. A case report and discussion of the clinical case by referring to the literature. Specific therapy with miltefosine led to clinical and endoscopic improvement. We had no relapse after three years of follow-up. This clinical case highlights the need to consider isolated laryngeal Leishmaniasis in the differential diagnoses of laryngeal tumour lesions, even in immunocompetent subjects who live in endemic zones, in order to ensure an early and correct therapeutic approach.

Subclavian steal: Endovascular treatment of total occlusions of the subclavian artery using a retrograde transradial subintimal approach

PubMed Central

Golwala, Sohil N; Vance, Ansar Z; Tuerff, Sonya N

2016-01-01

Introduction In symptomatic subclavian steal syndrome, endovascular treatment is the first line of therapy prior to extra-anatomic surgical bypass procedures. Subintimal recanalization has been well described in the literature for the coronary arteries, and more recently, in the lower extremities. By modifying this approach, we present a unique retrograde technique using a heavy tip microwire to perform controlled subintimal dissection. Methods We present two cases of symptomatic subclavian steal related to chronic total occlusion of the left subclavian artery and right innominate artery, respectively. Standard crossing techniques were unsuccessful. Commonly at this point, the procedures would be aborted and open surgical intervention would have to be pursued. In our cases, retrograde access was easily achieved via an ipsilateral retrograde radial artery, using controlled subintimal dissection and a heavy-tipped wire. Results We were able to easily achieve recanalization in both attempted cases of chronic total occlusion of the subclavian and innominate artery, using a retrograde radial subintimal approach. Subsequent stent-supported angioplasty resulted in complete revascularization. No major complications were encountered during the procedures; however, one patient did develop thromboembolic stroke secondary to platelet aggregation to the stent graft, 9 days post-procedure. Conclusions Endovascular treatment is considered the first-line intervention in medically refractory patients with symptomatic subclavian steal syndrome. In the setting of chronic total occlusions, a retrograde radial subintimal approach using a heavy tip wire for controlled subintimal dissection is a novel technique that may be considered when standard approaches and wires have failed. PMID:26861024

Appendiceal diverticulum associated with chronic appendicitis

PubMed Central

Zubieta-O’Farrill, Gregorio; Guerra-Mora, José Raúl; Gudiño-Chávez, Andrés; Gonzalez-Alvarado, Carlos; Cornejo-López, Gilberto Bernabe; Villanueva-Sáenz, Eduardo

2014-01-01

INTRODUCTION Appendiceal diverticulosis is a rare entity, with a global incidence between 0.004% and 2.1% of all appendectomies. It has been related with an elevated risk of perforation in comparison to acute appendicitis, as well as an increased risk for synchronic appendicular cancer in 48% of the cases, and colonic cancer in 43%. The incidence of chronic appendicitis has been reported in 1.5% of all appendicitis cases. PRESENTATION OF CASE We present a 73-year-old female, with no relevant familial history, who presented due to a four-month-long oppressive, moderate pain in the lower right abdominal quadrant without irradiation or any other accompanying symptoms. DISCUSSION The documented incidence of appendiceal diverticula and chronic appendicitis by themselves is low; therefore the presence of both entities at the same time is extremely rare. CONCLUSION We present a case in which both diagnoses concurred in the same patient. The relevance of this case relies on the importance of the adequate knowledge of these pathologies, so we can approach them correctly. Although it does not represent an absolute surgical emergency, appendectomy represents the first therapeutic option. PMID:25460447

Diagnosis and management of oviductal disease in three red-eared slider turtles (Trachemys scripta elegans).

PubMed

Mans, C; Sladky, K K

2012-04-01

Three mature, female, red-eared slider turtles (Trachemys scripta elegans) were individually, and separately, diagnosed with different forms of oviductal disease. Case 1 presented with acute cloacal bleeding and was diagnosed with acute oviductal rupture and ectopic eggs in the coelom. Case 2 presented for repeated scratching in the direction of the cloaca and was diagnosed with chronic oviductal impaction and coelomitis. Both cases were treated successfully by endoscopy-assisted complete ovariosalpingectomy via a bilateral prefemoral approach. Case 3 presented with a reduced appetite and signs of nesting behaviour and was diagnosed with obstructive dystocia associated with bacterial salpingitis. Successful treatment consisted of transcloacal egg removal and systemic antibiotics. Complete recovery was achieved in all three turtles, which remained disease-free 23 to 33 months later. Oviductal disease can present with a variety of clinical signs, and an accurate diagnosis can be made based on a thorough history, physical examination and appropriate diagnostic techniques. © 2012 British Small Animal Veterinary Association.

Planum Sphenoidale and Tuberculum Sellae Meningiomas: Operative Nuances of a Modern Surgical Technique with Outcome and Proposal of a New Classification System.

PubMed

Mortazavi, Martin M; Brito da Silva, Harley; Ferreira, Manuel; Barber, Jason K; Pridgeon, James S; Sekhar, Laligam N

2016-02-01

The resection of planum sphenoidale and tuberculum sellae meningiomas is challenging. A universally accepted classification system predicting surgical risk and outcome is still lacking. We report a modern surgical technique specific for planum sphenoidale and tuberculum sellae meningiomas with associated outcome. A new classification system that can guide the surgical approach and may predict surgical risk is proposed. We conducted a retrospective review of the patients who between 2005 and March 2015 underwent a craniotomy or endoscopic surgery for the resection of meningiomas involving the suprasellar region. Operative nuances of a modified frontotemporal craniotomy and orbital osteotomy technique for meningioma removal and reconstruction are described. Twenty-seven patients were found to have tumors arising mainly from the planum sphenoidale or the tuberculum sellae; 25 underwent frontotemporal craniotomy and tumor removal with orbital osteotomy and bilateral optic canal decompression, and 2 patients underwent endonasal transphenoidal resection. The most common presenting symptom was visual disturbance (77%). Vision improved in 90% of those who presented with visual decline, and there was no permanent visual deterioration. Cerebrospinal fluid leak occurred in one of the 25 cranial cases (4%) and in 1 of 2 transphenoidal cases (50%), and in both cases it resolved with treatment. There was no surgical mortality. An orbitotomy and early decompression of the involved optic canal are important for achieving gross total resection, maximizing visual improvement, and avoiding recurrence. The visual outcomes were excellent. A new classification system that can allow the comparison of different series and approaches and indicate cases that are more suitable for an endoscopic transsphenoidal approach is presented. Copyright © 2016 Elsevier Inc. All rights reserved.

[Therapeutic factors affecting the healing process in patients with gangrene of the perineum].

PubMed

Baraket, Oussama; Triki, Wissem; Ayed, Karim; Hmida, Sonia Ben; Lahmidi, Mohamed Amine; Baccar, Abdelamjid; Bouchoucha, Samy

2018-01-01

Fournier gangrene is a rare and severe necrotizing fasciitis. It is burdened with high morbi-mortality, requiring early and massive medical and surgical management. Initial treatment is based on patient's resuscitation associated with surgical debridement. Subsequently, the main challenge is the healing process and its possible sequelae. Several therapeutic approaches are currently available to improve and accelerate the healing process. We conducted a retrospective study of 20 cases. The median age of our patients was 56 years. The study included 16 men and 7 women. Comorbidity was present in 15 patients. Antibiotic therapy was administered in all cases, with a median duration of 15 days. All patients underwent surgery. Iterative reviews were necessary in all patients, who needed, on average, 3 dressing changes. Colostomy was performed in 6 cases. Hyperbaric oxygen therapy was performed in 4 cases. Vacuum assisted closure was performed in 1 case. Soft tissue coverage was necessary in 2 cases. The mean duration of healing was 15 days with oxygen therapy versus 24 days in the absence of this treatment. The mean duration of hospitalization was 20 days. Four patients died. Healing process without sequelae is a therapeutic challenge. Despite the addition of new therapeutic approaches, outcomes are not satisfactory. However, multidisciplinary approach associated with oxygen therapy and vacuum assisted closure might improve patients outcomes.

Using Videoconferencing to Deliver Individual Therapy and Pediatric Psychology Interventions with Children and Adolescents

PubMed Central

Patton, Susana

2016-01-01

Abstract Background: Because of the widening access gap between need for individual and pediatric psychology services and child specialist availability, secure videoconferencing options are more needed than ever to address access challenges across underserved settings. Methods: The authors summarize real-time videoconferencing evidence to date across individual therapy with children and pediatric psychology interventions using videoconferencing. The authors summarize emerging guidelines that inform best practices for individual child therapy over videoconferencing. Results: The authors present three case examples to illustrate best practices. The first behavioral pediatrics case summarizes evidence-based approaches in treating a rural young adolescent with attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and hearing impairment. The second pediatric psychology case describes similarities and difference between on-site and videoconferencing services in treating a rural child with toileting concerns. The third adolescent case describes treatment of an urban honors student with depression. Conclusions: Videoconferencing is an effective approach to improving access to individual and pediatric psychology interventions for children and adolescents. Videoconferencing approaches are well accepted by families and show promise for disseminating evidence-based treatments to underserved communities. PMID:26745607

Using Videoconferencing to Deliver Individual Therapy and Pediatric Psychology Interventions with Children and Adolescents.

PubMed

Nelson, Eve-Lynn; Patton, Susana

2016-04-01

Because of the widening access gap between need for individual and pediatric psychology services and child specialist availability, secure videoconferencing options are more needed than ever to address access challenges across underserved settings. The authors summarize real-time videoconferencing evidence to date across individual therapy with children and pediatric psychology interventions using videoconferencing. The authors summarize emerging guidelines that inform best practices for individual child therapy over videoconferencing. The authors present three case examples to illustrate best practices. The first behavioral pediatrics case summarizes evidence-based approaches in treating a rural young adolescent with attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and hearing impairment. The second pediatric psychology case describes similarities and difference between on-site and videoconferencing services in treating a rural child with toileting concerns. The third adolescent case describes treatment of an urban honors student with depression. Videoconferencing is an effective approach to improving access to individual and pediatric psychology interventions for children and adolescents. Videoconferencing approaches are well accepted by families and show promise for disseminating evidence-based treatments to underserved communities.

Partial differential equation-based approach for empirical mode decomposition: application on image analysis.

PubMed

Niang, Oumar; Thioune, Abdoulaye; El Gueirea, Mouhamed Cheikh; Deléchelle, Eric; Lemoine, Jacques

2012-09-01

The major problem with the empirical mode decomposition (EMD) algorithm is its lack of a theoretical framework. So, it is difficult to characterize and evaluate this approach. In this paper, we propose, in the 2-D case, the use of an alternative implementation to the algorithmic definition of the so-called "sifting process" used in the original Huang's EMD method. This approach, especially based on partial differential equations (PDEs), was presented by Niang in previous works, in 2005 and 2007, and relies on a nonlinear diffusion-based filtering process to solve the mean envelope estimation problem. In the 1-D case, the efficiency of the PDE-based method, compared to the original EMD algorithmic version, was also illustrated in a recent paper. Recently, several 2-D extensions of the EMD method have been proposed. Despite some effort, 2-D versions for EMD appear poorly performing and are very time consuming. So in this paper, an extension to the 2-D space of the PDE-based approach is extensively described. This approach has been applied in cases of both signal and image decomposition. The obtained results confirm the usefulness of the new PDE-based sifting process for the decomposition of various kinds of data. Some results have been provided in the case of image decomposition. The effectiveness of the approach encourages its use in a number of signal and image applications such as denoising, detrending, or texture analysis.

A fuzzy case based reasoning tool for model based approach to rocket engine health monitoring

NASA Technical Reports Server (NTRS)

Krovvidy, Srinivas; Nolan, Adam; Hu, Yong-Lin; Wee, William G.

1992-01-01

In this system we develop a fuzzy case based reasoner that can build a case representation for several past anomalies detected, and we develop case retrieval methods that can be used to index a relevant case when a new problem (case) is presented using fuzzy sets. The choice of fuzzy sets is justified by the uncertain data. The new problem can be solved using knowledge of the model along with the old cases. This system can then be used to generalize the knowledge from previous cases and use this generalization to refine the existing model definition. This in turn can help to detect failures using the model based algorithms.

Reducing the worst case running times of a family of RNA and CFG problems, using Valiant's approach.

PubMed

Zakov, Shay; Tsur, Dekel; Ziv-Ukelson, Michal

2011-08-18

RNA secondary structure prediction is a mainstream bioinformatic domain, and is key to computational analysis of functional RNA. In more than 30 years, much research has been devoted to defining different variants of RNA structure prediction problems, and to developing techniques for improving prediction quality. Nevertheless, most of the algorithms in this field follow a similar dynamic programming approach as that presented by Nussinov and Jacobson in the late 70's, which typically yields cubic worst case running time algorithms. Recently, some algorithmic approaches were applied to improve the complexity of these algorithms, motivated by new discoveries in the RNA domain and by the need to efficiently analyze the increasing amount of accumulated genome-wide data. We study Valiant's classical algorithm for Context Free Grammar recognition in sub-cubic time, and extract features that are common to problems on which Valiant's approach can be applied. Based on this, we describe several problem templates, and formulate generic algorithms that use Valiant's technique and can be applied to all problems which abide by these templates, including many problems within the world of RNA Secondary Structures and Context Free Grammars. The algorithms presented in this paper improve the theoretical asymptotic worst case running time bounds for a large family of important problems. It is also possible that the suggested techniques could be applied to yield a practical speedup for these problems. For some of the problems (such as computing the RNA partition function and base-pair binding probabilities), the presented techniques are the only ones which are currently known for reducing the asymptotic running time bounds of the standard algorithms.

Reducing the worst case running times of a family of RNA and CFG problems, using Valiant's approach

PubMed Central

2011-01-01

Background RNA secondary structure prediction is a mainstream bioinformatic domain, and is key to computational analysis of functional RNA. In more than 30 years, much research has been devoted to defining different variants of RNA structure prediction problems, and to developing techniques for improving prediction quality. Nevertheless, most of the algorithms in this field follow a similar dynamic programming approach as that presented by Nussinov and Jacobson in the late 70's, which typically yields cubic worst case running time algorithms. Recently, some algorithmic approaches were applied to improve the complexity of these algorithms, motivated by new discoveries in the RNA domain and by the need to efficiently analyze the increasing amount of accumulated genome-wide data. Results We study Valiant's classical algorithm for Context Free Grammar recognition in sub-cubic time, and extract features that are common to problems on which Valiant's approach can be applied. Based on this, we describe several problem templates, and formulate generic algorithms that use Valiant's technique and can be applied to all problems which abide by these templates, including many problems within the world of RNA Secondary Structures and Context Free Grammars. Conclusions The algorithms presented in this paper improve the theoretical asymptotic worst case running time bounds for a large family of important problems. It is also possible that the suggested techniques could be applied to yield a practical speedup for these problems. For some of the problems (such as computing the RNA partition function and base-pair binding probabilities), the presented techniques are the only ones which are currently known for reducing the asymptotic running time bounds of the standard algorithms. PMID:21851589

Study of Super Dielectric Material for Novel Paradigm Capacitors

DTIC Science & Technology

2018-03-01

maximized. Interestingly, CHD protocol did not have a predictable or notable effect on performance in this study . In fact, in several cases shorter...measurement, such as dark matter and dark energy, the same inductive logic approach has been taken for the present study . In this case , we first applied...indicates the constant voltage hold duration. In two cases , a third term ‘No Weight’ indicates that a weight was not placed on top of the glass-capacitor

[Parathyroid disease: The full spectrum, from adenoma to carcinoma. Report of 3 cases].

PubMed

Stoopen-Margain, Enrique; Valanci-Aroesty, Sofía; Castañeda-Martínez, Leopoldo; Baquera-Heredia, Javier; Sainz-Hernández, Juan Carlos

Primary hyperparathyroidism is a disease characterised by the autonomous production of parathyroid hormone. The most common cause is an adenoma, followed by hyperplasia, and rarely carcinoma. Three cases are presented. The first case is associated with a brown tumour that was diagnosed as hyperplasia after study and surgery. The second case was related to pathological fractures, and a lower right adenoma 236 times bigger than a normal parathyroid was excised. The last case presented with abdominal pain and heartburn. Histopathology reported a carcinoma, which was removed using surgery en bloc. All patients have improved. Hyperparathyroidism symptoms are very difficult to identify and diagnose, thus a detailed and broad approach is needed when hyperparathyroidism is suspected. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

A prototype case-based reasoning human assistant for space crew assessment and mission management

NASA Technical Reports Server (NTRS)

Owen, Robert B.; Holland, Albert W.; Wood, Joanna

1993-01-01

We present a prototype human assistant system for space crew assessment and mission management. Our system is based on case episodes from American and Russian space missions and analog environments such as polar stations and undersea habitats. The general domain of small groups in isolated and confined environments represents a near ideal application area for case-based reasoning (CBR) - there are few reliable rules to follow, and most domain knowledge is in the form of cases. We define the problem domain and outline a unique knowledge representation system driven by conflict and communication triggers. The prototype system is able to represent, index, and retrieve case studies of human performance. We index by social, behavioral, and environmental factors. We present the problem domain, our current implementation, our research approach for an operational system, and prototype performance and results.

Bayesian approach for counting experiment statistics applied to a neutrino point source analysis

NASA Astrophysics Data System (ADS)

Bose, D.; Brayeur, L.; Casier, M.; de Vries, K. D.; Golup, G.; van Eijndhoven, N.

2013-12-01

In this paper we present a model independent analysis method following Bayesian statistics to analyse data from a generic counting experiment and apply it to the search for neutrinos from point sources. We discuss a test statistic defined following a Bayesian framework that will be used in the search for a signal. In case no signal is found, we derive an upper limit without the introduction of approximations. The Bayesian approach allows us to obtain the full probability density function for both the background and the signal rate. As such, we have direct access to any signal upper limit. The upper limit derivation directly compares with a frequentist approach and is robust in the case of low-counting observations. Furthermore, it allows also to account for previous upper limits obtained by other analyses via the concept of prior information without the need of the ad hoc application of trial factors. To investigate the validity of the presented Bayesian approach, we have applied this method to the public IceCube 40-string configuration data for 10 nearby blazars and we have obtained a flux upper limit, which is in agreement with the upper limits determined via a frequentist approach. Furthermore, the upper limit obtained compares well with the previously published result of IceCube, using the same data set.

Robotic-assisted vesicovaginal fistula repair using an extravesical approach without interposition grafting.

PubMed

Kelly, Erin; Wu, Maria Y; MacMillan, J Barry

2018-03-01

Post-hysterectomy vesicovaginal fistula (VVF) is rare. In addition to conventional abdominal and vaginal approaches, robotic-assisted VVF repairs have recently been described. We present a case of an extravesical, robotic-assisted VVF repair, without placement of an interposition graft performed in a Canadian teaching center. A 51-year-old woman presented with urinary incontinence 5 days after laparoscopic hysterectomy. Computed tomography cystogram, cystoscopy, and methylene blue dye test, confirmed a VVF above the bladder trigone. The patient underwent a robotic-assisted VVF repair 3 months after presentation, without complication. An abdominal, extravesical approach was used. Operative time was 116 min and repeat CT cystogram showed no evidence of persistent. We have demonstrated that a VVF repair, using a robotic-assisted, extravesical approach without interposition graft placement, can be safe, less invasive and have a successful outcome at 1 year of follow-up.

A 40-year-old woman with cauda equina syndrome caused by rectothecal fistula arising from an anterior sacral meningocele.

PubMed

Bergeron, Eric; Roux, Alain; Demers, Jacques; Vanier, Laurent E; Moore, Lynne

2010-11-01

We present a rare case of a rectothecal fistula arising from an anterior sacral meningocele in a patient with Currarino syndrome. The patient was a 40-year-old woman presenting with cauda equina syndrome and ascending meningitis. The meningocele was removed using an anterior abdominal approach. A sigmoid resection was performed with rectal on-table antegrade lavage followed by closure of the rectal fistula, closure of the rectal stump, and proximal colostomy. Closure of the sacral deficit was carried out by suturing a strip of well-vascularized omentum and fibrin glue. We discuss the characteristics, management, and evolution of this unusual case. Prompt surgical management using an anterior approach, resection of the sac, closure of the sacral deficit, and fecal diversion resulted in a satisfactory outcome.

Migraine with Aura or Sports-Related Concussion: Case Report, Pathophysiology, and Multidisciplinary Approach to Management.

PubMed

Ellis, Michael J; Cordingley, Dean; Girardin, Richard; Ritchie, Lesley; Johnston, Janine

The evaluation and management of athletes presenting with clinical features of migraine headache with aura in the setting of sports-related head trauma is challenging. We present a case report of a 15-yr-old boy with a history of migraine with visual aura that developed acute visual disturbance and headache after a head injury during an ice hockey game. The patient underwent comprehensive assessment at a multidisciplinary concussion program, including neuro-ophthalmological examination, neurocognitive testing, and graded aerobic treadmill testing. Clinical history and multidisciplinary assessment was consistent with the diagnosis of coexisting sports-related concussion and migraine with brainstem aura. The authors discuss the pearls and pitfalls of managing patients who develop migraine headache with visual aura after sports-related head injury and the value of a comprehensive multidisciplinary approach to this unique patient population.

Acute bacterial and viral meningitis.

PubMed

Bartt, Russell

2012-12-01

Most cases of acute meningitis are infectious and result from a potentially wide range of bacterial and viral pathogens. The organized approach to the patient with suspected meningitis enables the prompt administration of antibiotics, possibly corticosteroids, and diagnostic testing with neuroimaging and spinal fluid analysis. Acute meningitis is infectious in most cases and caused by a potentially wide range of bacterial and viral pathogens. Shifts in the epidemiology of bacterial pathogens have been influenced by changes in vaccines and their implementation. Seasonal and environmental changes influence the likely viral and rickettsial pathogens. The organized approach to the patient with suspected meningitis enables the prompt administration of antibiotics, possibly corticosteroids, and diagnostic testing with neuroimaging and spinal fluid analysis. Pertinent testing and treatment can vary with the clinical presentation, season, and possible exposures. This article reviews the epidemiology, clinical presentation, diagnosis, and treatment of acute meningitis.

Does the Use of Case-Based Learning Impact the Retention of Key Concepts in Undergraduate Biochemistry?

ERIC Educational Resources Information Center

Kulak, Verena; Newton, Genevieve; Sharma, Rahul

2017-01-01

Objective: Enhanced knowledge retention and a preference towards a deep learning approach are desirable pedagogical outcomes of case-based learning (CBL). The CBL literature is sparse with respect to these outcomes, and this is especially so in the area of biochemistry. The present study determined the effect of CBL vs. non CBL on knowledge…

Using Peer Reviews to Examine Micropolitics and Disciplinary Development of Engineering Education: A Case Study

ERIC Educational Resources Information Center

Beddoes, Kacey

2014-01-01

This article presents a case study of the peer review process for a feminist article submitted to an engineering education journal. It demonstrates how an examination of peer review can be a useful approach to further understanding the development of feminist thought in education fields. Rather than opposition to feminist thought per se, my…

A Comparison of Case Study and Traditional Teaching Methods for Improvement of Oral Communication and Critical-Thinking Skills

ERIC Educational Resources Information Center

Noblitt, Lynnette; Vance, Diane E.; Smith, Michelle L. DePoy

2010-01-01

This study compares a traditional paper presentation approach and a case study method for the development and improvement of oral communication skills and critical-thinking skills in a class of junior forensic science majors. A rubric for rating performance in these skills was designed on the basis of the oral communication competencies developed…

Necrotizing Pneumonia Caused by Chromobacterium violaceum Soil Bacterium: Report of a Rare Human Pathogen Causing Disease in a Previously Undiagnosed Immunodeficient Child.

PubMed

Frawley, Alean; Powell, Lauren; McQuiston, John R; Gulvik, Christopher A; Bégué, Rodolfo E

2018-04-23

Chromobacterium violaceum is a rare, potentially serious pathogen. Most clinicians have no experience with its clinical appearance or treatment. We describe a case of a child presenting with necrotizing pneumonia caused by C. violaceum . We describe case complexities, including the need for a multidisciplinary approach to diagnosis and treatment.

Innovative and Workable Ideas for Building Schools. Public/Private Partnerships: A New Way To Fund and Build Schools.

ERIC Educational Resources Information Center

Guhse, David

This report presents case studies illustrating successful public-private financing of school construction. The efforts occurred in Canada, Florida, South Carolina, New York, the District of Columbia, and Texas. The case studies are offered to encourage policy makers in Virginia to consider such an approach to meet the state's school construction…

When to Intervene in Selective Mutism: The Multimodal Treatment of a Case of Persistent Selective Mutism.

ERIC Educational Resources Information Center

Powell, Shawn; Dalley, Mahlono

1995-01-01

An identification and treatment model differentiating transient mutism from persistent selective mutism is proposed. The case study of a six-year-old girl is presented, who was treated with a multimodal approach combining behavioral techniques with play therapy and family involvement. At posttreatment and follow-up, she was talking in a manner…

Munchausen syndrome: Playing sick or sick player

PubMed Central

Prakash, Jyoti; Das, R. C.; Srivastava, K.; Patra, P.; Khan, S. A.; Shashikumar, R.

2014-01-01

Munchausen syndrome is rare factitious disorder which entails frequent hospitalization, pathological lying and intentional production of symptoms for sick role. Management requires collateral history taking, sound clinical approach, exclusion of organicity and addressing psychological issues. A case which presented with unusual symptoms of similar dimension is discussed here. The case brings out finer nuances in evaluation and management of this entity. PMID:25535450

The Economic Burden of Child Maltreatment in the United States and Implications for Prevention

ERIC Educational Resources Information Center

Fang, Xiangming; Brown, Derek S.; Florence, Curtis S.; Mercy, James A.

2012-01-01

Objectives: To present new estimates of the average lifetime costs per child maltreatment victim and aggregate lifetime costs for all new child maltreatment cases incurred in 2008 using an incidence-based approach. Methods: This study used the best available secondary data to develop cost per case estimates. For each cost category, the paper used…

Socio-Technical Relations in the Creation of an Interest-Driven Open Course

ERIC Educational Resources Information Center

Ponti, Marisa

2011-01-01

The aim of this article is to present the findings from a small exploratory case study of an open course on cyberpunk literature conducted at the Peer 2 Peer University (P2PU), an online grass-roots organisation that runs non-accredited courses. Employing actor network theory to inform an ethnographic-inductive approach, the case study sought to…

Young Workers and Their Dispositions towards Mathematics: Tensions of a Mathematical Habitus in the Retail Industry

ERIC Educational Resources Information Center

Jorgensen Zebenbergen, Robyn

2011-01-01

This paper presents a case study of contemporary retail industry and the ways in which young workers participate in that field. Public perceptions of low numeracy among young people provided the catalyst for the study. Drawing on a mixed-method approach involving survey, case studies, stimulated recall, observations, and interviews, it was found…

Treatment of a coronary artery aneurysm by use of a covered stent graft – a case report

PubMed Central

Gundoğdu, Fuat; Arslan, Sakir; Buyukkaya, Eyup; Senocak, Huseyin

2007-01-01

Coronary artery aneurysm is a rare finding at coronary angiography. Most coronary aneurysms remain asymptomatic. There is no consensus on its management; some advocate aggressive approach while others advocate conservative management. A case of coronary artery aneurysm successfully treated by implantation of a polytetrafluoroethylene-covered coronary stent is presented. PMID:22477247

Growing into the Role: Empowerment of a Music Educator through Application of a Symbolic Interaction Theory

ERIC Educational Resources Information Center

Cox, Patricia J.

2004-01-01

This article presents aspects of professional development, using a narrative case-history approach. It represents the author's own case as an illustration of the kind of integrative experience that may occur as women assume professional careers. In this article, the author weaves the scholarly and theoretical components into the reality of a lived…

Hepatic and skin metastases after laparoscopic radical prostatectomy for prostate cancer.

PubMed

Coman, Ioan; Crişan, Nicolae; Petrut, Bogdan; Bungărdean, Cătălina; Cristea, Tudor; Crişan, Dana

2007-09-01

Between 2004 and 2006, 50 radical prostatectomies were performed in our department, 46 of them through a laparoscopic approach addressed to early stage cancer (T1a,b,c and T2a,b,c N0 M0). We present the case of a 63 year old patient, who was initially diagnosed with prostate cancer in T1bN0M0 stage, Gleason score 8 and later presented atypical hepatic and trocar site metastases. This particular evolution of the case can be explained by the high value of the Gleason score and by the extension into microvessels observed on the sample prelevated by prostatectomy. The rarity of this atypical metastases and its association, the diagnostic and therapy problems are the reasons for the detailed presentation of this case.

Quantification and Visualization of Variation in Anatomical Trees

DOE Office of Scientific and Technical Information (OSTI.GOV)

Amenta, Nina; Datar, Manasi; Dirksen, Asger

This paper presents two approaches to quantifying and visualizing variation in datasets of trees. The first approach localizes subtrees in which significant population differences are found through hypothesis testing and sparse classifiers on subtree features. The second approach visualizes the global metric structure of datasets through low-distortion embedding into hyperbolic planes in the style of multidimensional scaling. A case study is made on a dataset of airway trees in relation to Chronic Obstructive Pulmonary Disease.

The da Vinci robotic surgical assisted anterior lumbar interbody fusion: technical development and case report.

PubMed

Beutler, William J; Peppelman, Walter C; DiMarco, Luciano A

2013-02-15

Technique development to use the da Vince Robotic Surgical System for anterior lumbar interbody fusion at L5-S1 is detailed. A case report is also presented. To evaluate and develop the da Vinci robotic assisted laparoscopic anterior lumbar stand-alone interbody fusion procedure. Anterior lumbar interbody fusion is a common procedure associated with potential morbidity related to the surgical approach. The da Vinci robot provides intra-abdominal dissection and visualization advantages compared with the traditional open and laparoscopic approach. The surgical techniques for approach to the anterior lumbar spine using the da Vinci robot were developed and modified progressively beginning with operative models followed by placement of an interbody fusion cage in the living porcine model. Development continued to progress with placement of fusion cage in a human cadaver, completed first in the laboratory setting and then in the operating room. Finally, the first patient with fusion completed using the da Vinci robot-assisted approach is presented. The anterior transperitoneal approach to the lumbar spine is accomplished with enhanced visualization and dissection capability, with maintenance of pneumoperitoneum using the da Vinci robot. Blood loss is minimal. The visualization inside the disc space and surrounding structures was considered better than current open and laparoscopic techniques. The da Vinci robot Surgical System technique continues to develop and is now described for the transperitoneal approach to the anterior lumbar spine. 4.

Intrinsic Decomposition of The Stretch Tensor for Fibrous Media

NASA Astrophysics Data System (ADS)

Kellermann, David C.

2010-05-01

This paper presents a novel mechanism for the description of fibre reorientation based on the decomposition of the stretch tensor according to a given material's intrinsic constitutive properties. This approach avoids the necessity for fibre directors, structural tensors or specialised model such as the ideal fibre reinforced model, which are commonly applied to the analysis of fibre kinematics in the finite deformation of fibrous media for biomechanical problems. The proposed approach uses Intrinsic-Field Tensors (IFTs) that build upon the linear orthotropic theory presented in a previous paper entitled Strongly orthotropic continuum mechanics and finite element treatment. The intrinsic decomposition of the stretch tensor therein provides superior capacity to represent the intermediary kinematics driven by finite orthotropic ratios, where the benefits are predominantly expressed in cases of large deformation as is typical in the biomechanical studies. Satisfaction of requirements such as Material Frame-Indifference (MFI) and Euclidean objectivity are demonstrated here—these factors being necessary for the proposed IFTs to be valid tensorial quantities. The resultant tensors, initially for the simplest case of linear elasticity, are able to describe the same fibre reorientation as would the contemporary approaches such as with use of structural tensors and the like, while additionally being capable of showing results intermediary to classical isotropy and the infinitely orthotropic representations. This intermediary case is previously unreported.

Successful Treatment of Gluteal Pain from Obturator Internus Tendinitis and Bursitis with Ultrasound-Guided Injection.

PubMed

Chen, Boqing; Rispoli, Leia; Stitik, Todd; Leong, Michelle

2017-10-01

This case report describes what the authors believe is the first case of a patient with obturator internus tendinitis and bursitis successfully treated with a corticosteroid injection using a trans-tendinous lateral to medial approach. The patient presented with right gluteal pain not relieved by physical therapy or right hip and ischial bursa corticosteroid injections. Pelvic and lumbar spine MRIs and EMG/NCS findings were unremarkable. Physical examination demonstrated tenderness to palpation at the right middle lower gluteal region. Ultrasound imaging with sonopalpation identified the maximal local tender point as the right obturator internus muscle and/or its underlying bursa. A 22-gauge 3.5-inch needle was inserted in-plane to the transducer and longitudinal to the obturator internus from a lateral to medial direction, an approach previously described in cadavers. The obturator internus tendon sheath and bursa were injected with 2.5 ml of 0.5% lidocaine combined with 10 mg of triamcinolone. The patient reported immediate complete relief of pain with continued relief at 2 and 6 months post-injection. This case report demonstrates an injection of the obturator internus tendon sheath and bursa using a trans-tendinous approach, which may be successful for treatment of patients presenting with persistent gluteal pain from obturator internus tendinitis and bursitis.

Alcohol Involvement in Suicide and Self-Harm.

PubMed

Larkin, Celine; Griffin, Eve; Corcoran, Paul; McAuliffe, Carmel; Perry, Ivan J; Arensman, Ella

2017-11-01

Alcohol misuse and alcohol consumption are significant risk factors for suicidal behavior. This study sought to identify factors associated with alcohol consumption in cases of suicide and nonfatal self-harm presentations. Suicide cases in Cork, Ireland, from September 2008 to June 2012 were identified through the Suicide Support and Information System. Emergency department presentations of self-harm in the years 2007-2013 were obtained from the National Self-Harm Registry Ireland. Alcohol consumption was detected in the toxicology of 44% out of 307 suicide cases. Only younger age was significantly associated with having consumed alcohol among suicides. Alcohol consumption was noted in the case notes in 21% out of 8,145 self-harm presentations. Logistic regression analyses indicated that variables associated with having consumed alcohol in a self-harm presentation included male gender, older age, overdose as a method, not being admitted to a psychiatric ward, and presenting out-of-hours. Data was limited to routinely collected variables by the two different monitoring systems. Alcohol consumption commonly precedes suicidal behavior, and several factors differentiated alcohol-related suicidal acts. Self-harm cases, in particular, differ in profile when alcohol is consumed and may require a tailored clinical approach to minimize risk of further nonfatal or fatal self-harm.

[Gas gangrene of the abdominal wall due to underlying GI pathology: seven cases].

PubMed

Monneuse, O; Gruner, L; Barth, X; Malick, P; Timsit, M; Gignoux, B; Tissot, E

2007-01-01

Gas gangrene of the abdominal wall is a rare clinical occurrence with high rates of morbidity and mortality. The primary source of the infection is often unknown. To analyze the primary underlying intestinal etiologies and diagnostic approaches of gas gangrene of the abdominal wall, and to highlight specific treatment problems, particularly that of constructing a colostomy exteriorized through a massively infected abdominal wall. Seven cases of abdominal wall gas gangrene due to a gastrointestinal etiology were identified. (Cases arising from proctologic sources or related to recent abdominal surgery were excluded.) During the same period, 39 other patients presenting with abdominal wall gangrene from non-intestinal sources were treated. The etiologies were: perforated sigmoid diverticulitis (n=2), perforated appendicitis (n=1), acute pancreatitis with associated cecal perforation (n=1), and perforated colorectal cancer (n=3). Four of the seven patients died despite treatment (mortality of 57%). The clinical presentations of these seven cases demonstrate that a GI source must be suspected whenever a patient presents with abdominal wall gas gangrene, even when there are no specific GI symptoms. Imaging, particularly with CT scan, is essential both to visualize the extent of tissue necrosis and to reveal underlying primary GI pathology. This optimizes the surgical approach both by allowing for complete debridement and drainage of infected tissue, and by focussing the intervention on correction of the underlying primary GI source of infection.

The Use of a School Value-Added Model for Educational Improvement: A Case Study from the Portuguese Primary Education System

ERIC Educational Resources Information Center

Ferrão, Maria Eugénia; Couto, Alcino Pinto

2014-01-01

This article focuses on the use of a value-added approach for promoting school improvement. It presents yearly value-added estimates, analyses their stability over time, and discusses the contribution of this methodological approach for promoting school improvement programmes in the Portuguese system of evaluation. The value-added model is applied…

A Delphi-Based Approach for Detecting Key E-Learning Trends in Postgraduate Education: The Spanish Case

ERIC Educational Resources Information Center

Lopez-Catalan, Blanca; Bañuls, Victor A.

2017-01-01

Purpose: The purpose of this paper is to present the results of national level Delphi study carried out in Spain aimed at providing inputs for higher education administrators and decision makers about key e-learning trends for supporting postgraduate courses. Design/methodology/approach: The ranking of the e-learning trends is based on a…

Students' Participation in Peer-to-Peer Communication Supported by Social Media

ERIC Educational Resources Information Center

Mikum, Siriporn; Suksakulchai, Surachai; Chaisanit, Settachai; Murphy, Elizabeth

2018-01-01

Social media (SM) support new approaches to learning that rely on voluntary, peer-to-peer communication using devices and software provided and managed by students rather than on institutional course management systems. We present one case of such an approach with first-year university students (n = 86) in Thailand using SM for asking and…

Using Constructivist Case Study Methodology to Understand Community Development Processes: Proposed Methodological Questions to Guide the Research Process

ERIC Educational Resources Information Center

Lauckner, Heidi; Paterson, Margo; Krupa, Terry

2012-01-01

Often, research projects are presented as final products with the methodologies cleanly outlined and little attention paid to the decision-making processes that led to the chosen approach. Limited attention paid to these decision-making processes perpetuates a sense of mystery about qualitative approaches, particularly for new researchers who will…

Cedar Middle School's Response to Intervention Journey: A Systematic, Multi-Tier, Problem-Solving Approach to Program Implementation

ERIC Educational Resources Information Center

Dulaney, Shannon Kay

2010-01-01

The purpose of the present study was to record Cedar Middle School's (CMS) response to intervention implementation journey. It is a qualitative case study that examines one school's efforts to bring school improvements under the response to inventory (RtI) umbrella in order to achieve a more systematic approach to providing high-quality…

Professional Engagement in Child Protection: Promoting Reflective Practice and Deeper Connection with the Lived Reality for Children

ERIC Educational Resources Information Center

Jones, Jocelyn

2015-01-01

This paper uses first person inquiry and presentational form to argue the case for a sensory approach to understanding professional connection and disconnection with children who may be being abused. The approach is underpinned by an epistemology or theory of knowledge which stems from a participatory world-view where appearances are not permanent…

Improving Readability in an Explicit Genre-Based Approach: The Case of an EFL Workplace Context

ERIC Educational Resources Information Center

Albino, Gabriel

2017-01-01

The present study investigates how learners of English as a foreign language (EFL) improve the readability of their texts in an explicit genre-based approach that is utilized in an oil and gas exploration workplace in Angola. By drawing on the English for Specific Purposes and Systemic Functional Linguistics genre traditions, the study engages 18…

Evaluating the Effects of Input-Based Approaches to the Teaching of Pragmalinguistics and Sociopragmatics in Second Language Pragmatics: A Case of English Request Hedges

ERIC Educational Resources Information Center

Takimoto, Masahiro

2014-01-01

The present study examined the effects of two types of input-based approaches--combination of pragmalinguistics- and sociopragmatics-focused instruction (CI) and sociopragmatics-focused instruction (SI) on learners' recognizing and producing English request hedges. 45 Japanese learners of English participated in the study. Treatment group…

An Integrated Skills Approach Using Feature Movies in EFL at Tertiary Level

ERIC Educational Resources Information Center

Tuncay, Hidayet

2014-01-01

This paper presents the results of a case study based on an integrated skills approach using feature movies (DVDs) in EFL syllabi at the tertiary level. 100 students took part in the study and the data was collected through a three - section survey questionnaire: demographic items, 18 likert scale questions and an open-ended question. The data…

Combining Event- and Variable-Centred Approaches to Institution-Facing Learning Analytics at the Unit of Study Level

ERIC Educational Resources Information Center

Kelly, Nick; Montenegro, Maximiliano; Gonzalez, Carlos; Clasing, Paula; Sandoval, Augusto; Jara, Magdalena; Saurina, Elvira; Alarcón, Rosa

2017-01-01

Purpose: The purpose of this paper is to demonstrate the utility of combining event-centred and variable-centred approaches when analysing big data for higher education institutions. It uses a large, university-wide data set to demonstrate the methodology for this analysis by using the case study method. It presents empirical findings about…

The Assessment of Math Learning Difficulties in a Primary Grade-4 Child with High Support Needs: Mixed Methods Approach

ERIC Educational Resources Information Center

Mundia, Lawrence

2012-01-01

This mixed-methods study incorporated elements of survey, case study and action research approaches in investigating an at-risk child. Using an in-take interview, a diagnostic test, an error analysis, and a think-aloud clinical interview, the study identified the child's major presenting difficulties. These included: inability to use the four…

Management Perception of Introducing Social Networking Sites as a Knowledge Management Tool in Higher Education: A Case Study

ERIC Educational Resources Information Center

Garcia, Elaine; Annansingh, Fenio; Elbeltagi, Ibrahim

2011-01-01

Purpose: The purpose of this paper is to present a study of the understanding and usage of social networking sites (SNS) as a knowledge management (KM) tool in knowledge-intensive enterprises. Design/methodology/approach: In terms of research approach, the study has taken an interpretitivist framework, using a higher education (HE) institution as…

Community Creation by Means of a Social Media Paradigm

ERIC Educational Resources Information Center

Fernando, Isuru

2010-01-01

Purpose: The purpose of this paper is to present a case study from which a framework for the purposeful building of knowledge communities by means of social media is formulated. Design/methodology/approach: The approach first takes the form of a literature review. Based on a review of literature as well as on various data sets and surveys within…

Third Ventricular Cerebrospinal Fluid Cysts of Thalamic Origin: Review of Embryologic Origin, Presentation, and Management Strategies with a Case Series.

PubMed

Vasquez, Ciro A; Casey, Michael; Folzenlogen, Zach; Ormond, David R; Lillehei, Kevin; Youssef, A Samy

2017-07-01

Third ventricular cerebrospinal fluid (CSF) cysts of thalamic origin are rare. The objective of this study is to review their possible pathogenesis, clinical presentation, and management strategies with a case series describing management via an endoscopic approach with fenestration using a single burr-hole technique. A systematic literature review of reported cases of thalamic cysts was conducted with further meta-analysis of CSF cysts that involve the third ventricle. The mode of presentation, pathologic analysis, surgical management, and outcomes were analyzed. Twenty-two studies reported between 1990 and 2013 described 42 cases of thalamic cyst. Of those cases, 13 were consistent with CSF cyst that originated in the thalamus and involved the third ventricle. Eight cases (61.5%) were treated via endoscopic fenestration, 2 cases (15.4%) were surgically drained, 2 cases (15.4%) were stereotactically aspirated, and 1 case (7.69%) was observed. The most common presenting symptoms were gait disturbance (26.3%) and headaches (26.3%) followed by tremors (15.8%) and weakness (15.8%). In our series, a single burr-hole technique was a successful definitive treatment, with an average period of 23 months. Third ventricular CSF cysts of thalamic origin most commonly present with hydrocephalus. They can be safely definitively treated via endoscopic fenestration to the CSF circulation using a single burr-hole technique. Long-term follow-up shows lasting improvement in symptoms without reaccumulation of the cyst. Copyright © 2017 Elsevier Inc. All rights reserved.

Negative-pressure and low-pressure hydrocephalus: the role of cerebrospinal fluid leaks resulting from surgical approaches to the cranial base.

PubMed

Filippidis, Aristotelis S; Kalani, M Yashar S; Nakaji, Peter; Rekate, Harold L

2011-11-01

Negative-pressure and low-pressure hydrocephalus are rare clinical entities that are frequently misdiagnosed. They are characterized by recurrent episodes of shunt failure because the intracranial pressure is lower than the opening pressure of the valve. In this report the authors discuss iatrogenic CSF leaks as a cause of low- or negative-pressure hydrocephalus after approaches to the cranial base. The authors retrospectively reviewed cases of low-pressure or negative-pressure hydrocephalus presenting after cranial approaches complicated with a CSF leak at their institution. Three patients were identified. Symptoms of high intracranial pressure and ventriculomegaly were present, although the measured pressures were low or negative. A blocked communication between the ventricles and the subarachnoid space was documented in 2 of the cases and presumed in the third. Shunt revisions failed repeatedly. In all cases, temporary clinical and radiographic improvement resulted from external ventricular drainage at subatmospheric pressures. The CSF leaks were sealed and CSF communication was reestablished operatively. In 1 case, neck wrapping was used with temporary success. Negative-pressure or low-pressure hydrocephalus associated with CSF leaks, especially after cranial base approaches, is difficult to treat. The solution often requires the utilization of subatmospheric external ventricular drains to establish a lower ventricular drainage pressure than the drainage pressure created in the subarachnoid space, where the pressure is artificially lowered by the CSF leak. Treatment involves correction of the CSF leak, neck wrapping to increase brain turgor and allow the pressure in the ventricles to rise to the level of the opening pressure of the valve, and reestablishing the CSF route.

Emotions and clinical ethics support. A moral inquiry into emotions in moral case deliberation.

PubMed

Molewijk, Bert; Kleinlugtenbelt, Dick; Pugh, Scott M; Widdershoven, Guy

2011-12-01

Emotions play an important part in moral life. Within clinical ethics support (CES), one should take into account the crucial role of emotions in moral cases in clinical practice. In this paper, we present an Aristotelian approach to emotions. We argue that CES can help participants deal with emotions by fostering a joint process of investigation of the role of emotions in a case. This investigation goes beyond empathy with and moral judgment of the emotions of the case presenter. In a moral case deliberation, the participants are invited to place themselves in the position of the case presenter and to investigate their own emotions in the situation. It is about critically assessing the facts in the case that cause the emotion and the related (moral) thoughts that accompany the emotion. It is also about finding the right emotion in a given situation and finding the right balance in dealing with that emotion. These steps in the moral inquiry give rise to group learning. It is a process of becoming open towards the perspectives of others, leading to new insights into what is an appropriate emotion in the specific situation. We show how this approach works in moral case deliberation. A physician presents a situation in which he is faced with a pregnant woman who is about to deliver multiple extremely premature infants at the threshold of viability. The moral deliberation of the case and the emotions therein leads to the participants' conclusion that "compassion" is a more adequate emotion than "sadness". The emotion "sadness" is pointed towards the tragedy that is happening to the woman. The emotion "compassion" is pointed towards the woman; it combines consideration and professional responsibility. Through the shift towards compassion, participants experienced more creativity and freedom to deal with the sad situation and to support the woman. The paper ends with an analysis and reflection on the deliberation process. In the conclusion we argue for more attention to emotions in clinical ethics support and offer some directions for doing this in the right way.

Application of asymmetric mapping and selective filtering (AM and SF) method to Cosmo/SkyMed images by implementation of a selective blocks approach for ship detection optimization in SEASAFE framework

NASA Astrophysics Data System (ADS)

Loreggia, D.; Tataranni, F.; Trivero, P.; Biamino, W.; Di Matteo, L.

2017-10-01

We present the implementation of a procedure to adapt an Asymmetric Wiener Filtering (AWF) methodology aimed to detect and discard ghost signal due to azimuth ambiguities in SAR images to the case for X-band Cosmo Sky Med (CSK) images in the framework of SEASAFE (Slick Emissions And Ship Automatic Features Extraction) project, developed at the Department of Science and Technology Innovation of the University of Piemonte Orientale, Alessandria, Italy. SAR is a useful tool to daily and nightly monitoring of the sea surface in all weather conditions. SEASAFE project is a software platform developed in IDL language able to process data in C- Land X-band SAR images with enhanced algorithm modules for land masking, sea pollution (oil spills) and ship detection; wind and wave evaluation are also available. In this contest, the need to individuate and discard false alarms is a critical requirement. The azimuth ambiguity is one of the main causes that generate false alarm in the ship detection procedure. Many methods to face with this problem were proposed and presented in recent literature. After a review of different approach to this problem, we describe the procedure to adapt the AWF approach presented in [1,2] to the case of X-band CSK images by implementing a selective blocks approach.

An intelligent case-adjustment algorithm for the automated design of population-based quality auditing protocols.

PubMed

Advani, Aneel; Jones, Neil; Shahar, Yuval; Goldstein, Mary K; Musen, Mark A

2004-01-01

We develop a method and algorithm for deciding the optimal approach to creating quality-auditing protocols for guideline-based clinical performance measures. An important element of the audit protocol design problem is deciding which guide-line elements to audit. Specifically, the problem is how and when to aggregate individual patient case-specific guideline elements into population-based quality measures. The key statistical issue involved is the trade-off between increased reliability with more general population-based quality measures versus increased validity from individually case-adjusted but more restricted measures done at a greater audit cost. Our intelligent algorithm for auditing protocol design is based on hierarchically modeling incrementally case-adjusted quality constraints. We select quality constraints to measure using an optimization criterion based on statistical generalizability coefficients. We present results of the approach from a deployed decision support system for a hypertension guideline.

Vienna international summer school on experimental and clinical oncology for medical students: an Austrian cancer education project.

PubMed

Fromm-Haidenberger, Sabine; Pohl, Gudrun; Widder, Joachim; Kren, Gerhard; Fitzal, Florian; Bartsch, Rupert; de Vries, Jakob; Zielinski, Christoph; Pötter, Richard

2010-03-01

The "International Summer School on Experimental and Clinical Oncology for Medical Students" is organised at the Medical University of Vienna to teach a multidisciplinary approach to oncology to medical students in the final phase of their studies. The program includes biology, diagnosis, clinical and psycho-oncology. Lectures are given by medical, radiation and surgical oncologists. Teaching includes case reports, poster presentations and role-play. As part of the organising committee, Austrian students organise a social program. Since 1999, six courses have been held (147 students from 19 countries). Students recorded high satisfaction with organisation, scientific content and topic range. Case presentations, poster presentations and role-play were very useful. Early criticism that the program was too intense (long lectures and little interaction) has been answered. The summer school has a high degree of acceptance and is a very useful tool to teach medical students about oncology and approaching a cancer patient.

Perioperative management of massive fat embolism syndrome presenting as refractory status epilepticus

PubMed Central

Watson, William; Louro, Jack; Dudaryk, Roman

2018-01-01

Fat embolism syndrome (FES) most commonly can occur after trauma in patients with long bone fractures. While the majority of FES cases present as a mild decrease in mental status, some may manifest as seizure activity. We describe a case of a young patient with traumatic fractures who developed FES leading to refractory status epilepticus and simultaneously required damage controlled orthopedic surgery. The role of imaging modalities including magnetic resonance imaging, transcranial Doppler, and transesophageal echocardiography in diagnosis is discussed, and a multidisciplinary approach to successful perioperative management is described.

[Rare benign space-occupying processes of the larynx].

PubMed

Daniilidis, I; Megas, I

1991-01-01

Two rare benign space occupying lesions of the larynx are presented. The first case was a big lateral saccular cyst in a female 68 years old and the second a myxolipom of the larynx in an old man, 80 years old. The presenting symptoms, in both cases, were progressive dyspnea und dysphagia. The therapy was the surgical removal of the lesion with the "open" approach. The importance of the CT scanning is emphasized as well its usefulness in the diagnosis and in the definition of the extension of the lesion.

Management of Post-Traumatic Phlegmasia Cerulea Dolens via Right-to-Left Femoral Vein to Femoral Vein Bypass (Palma Procedure).

PubMed

Dua, Anahita; Heller, Jennifer; Lee, Cheong

2017-11-01

Phlegmasia cerulea dolens (PCD) is a rare condition resulting from venous occlusion that impairs arterial flow. We report a rare case of post-traumatic PCD after ligation of the iliac vein with successful treatment by right-to-left femoral vein to femoral vein bypass using left great saphenous vein (Palma procedure). The clinical presentation, diagnostic process, and approach to management along with a literature review on the operative management of PCD are presented in this case report.

LAVA Simulations for the AIAA Sonic Boom Prediction Workshop

NASA Technical Reports Server (NTRS)

Housman, Jeffrey A.; Sozer, Emre; Moini-Yekta , Shayan; Kiris, Cetin C.

2014-01-01

Computational simulations using the Launch Ascent and Vehicle Aerodynamics (LAVA) framework are presented for the First AIAA Sonic Boom Prediction Workshop test cases. The framework is utilized with both structured overset and unstructured meshing approaches. The three workshop test cases include an axisymmetric body, a Delta Wing-Body model, and a complete low-boom supersonic transport concept. Solution sensitivity to mesh type and sizing, and several numerical convective flux discretization choices are presented and discussed. Favorable comparison between the computational simulations and experimental data of nearand mid-field pressure signatures were obtained.

Sudden Unilateral Vision Loss Arising from Calcified Amorphous Tumor of the Left Ventricle

PubMed Central

Nazli, Yunus; Colak, Necmettin; Atar, Inci Asli; Alpay, Mehmet Fatih; Haltas, Hacer; Eryonucu, Beyhan; Cakir, Omer

2013-01-01

Calcified amorphous tumor of the heart is a very rare non-neoplastic intracavitary mass. The clinical presentation is similar to that of other cardiac masses. The precise cause and best approach to treatment remain unclear. We describe a case of cardiac calcified amorphous tumor presenting with refractory unilateral vision loss that was successfully treated by surgical excision. To our knowledge, this is only the 2nd reported case of retinal arterial embolism due to cardiac calcified amorphous tumor in the English-language literature. PMID:24082378

Forequarter amputation (upper limb and shoulder girdle) in a synovial sarcoma case–case report

PubMed Central

Giuglea, C; Mihai, R; Oporanu, A; Manea, S; Florescu, IP

2010-01-01

We are often confronted with severe cases–patients with very aggressive tumours that suppose a complex and in the same time radical approach–in our medical practice. The correct approach and management of such cases ensure both the surgical success and the patient survival. In this paper, we present the case of a young woman, who has been admitted in our clinic with a giant, irradiated tumour involving left axilla, shoulder and scapula. Due to the vast size of the tumour and to the fact that surgical biopsy revealed a poorly differentiated sarcoma; other clinics considered that the case above belongs to surgical therapy. After the clinical examination, blood tests and diagnostic imaging, which allowed the correct evaluation of the case–tumour sizes and neighbouring tissue reports–we decided to perform tumour radical excision, respectively forequarter amputation, when the patient presented a satisfactory metabolic status. The presented case supports the idea that radical excision which might involve even mutilating amputations for extensive cancers can give patients a chance, even in desperate cases. PMID:21254746

Authoring Multimedia Learning Material Using Open Standards and Free Software

ERIC Educational Resources Information Center

Tellez, Alberto Gonzalez

2007-01-01

Purpose: The purpose of this paper is to describe the case of synchronized multimedia presentations. Design/methodology/approach: The proposal is based on SMIL as composition language. Particularly, the paper reuses and customizes the SMIL template used by INRIA on their technical presentations. It also proposes a set of free tools to produce…

Feet and Syllables in "Elephants" and "Missiles": A Reappraisal

ERIC Educational Resources Information Center

Zonneveld, Wim; van der Pas, Brigit; de Bree, Elise

2007-01-01

Using data from a case study presented in Chiat (1989), Marshall and Chiat (2003) compare two different approaches to account for the realization of intervocalic consonants in child phonology: "coda capture theory" and the "foot domain account". They argue in favour of the latter account. In this note, we present a reappraisal…

SMART NAS Test Bed Overview

NASA Technical Reports Server (NTRS)

Palopo, Kee

2016-01-01

These slides presents an overview of SMART NAS Test Bed. The test bed is envisioned to be connected to operational systems and to allow a new concept and technology to be evaluated in its realistic environment. Its role as an accelerator of concepts and technologies development, its use-case-driven development approach, and its state are presented.

Student Response to Hypermedia in the Lecture Theatre: A Case Study.

ERIC Educational Resources Information Center

Conway, Damian

The Computer Science Department at Monash University (Victoria, Australia) recently began presenting lectures using projection of a hypertext system, HyperLecture, running on a notebook computer as the primary medium. This paper presents a statistical analysis of student reactions to this approach, focusing on the effects, as perceived by the…

Striking the Right Note: The Cultural Preparedness Approach to Developing Resonant Career Guidance Programmes

ERIC Educational Resources Information Center

Arulmani, G.

2011-01-01

Cultural preparedness is presented as a conceptual framework that could guide the development of culture-resonant interventions. The "Jiva" careers programme is presented as a case study to illustrate a method of career and livelihood planning based upon Indian epistemology and cultural practices. Social cognitive environments and career beliefs…

The Importance of Teaching Ethics of Sustainability

ERIC Educational Resources Information Center

Biedenweg, Kelly; Monroe, Martha C.; Oxarart, Annie

2013-01-01

Purpose: The purpose of this paper is to describe the importance of a focus on ethics in sustainability education and present results from a pilot graduate-level course titled the Ethics of Sustainability. Design/methodology/approach: This is a case study presenting a qualitative evaluation from a pilot 14-week Ethics of Sustainability course.…

Teaching Design Patterns through Computer Game Development

ERIC Educational Resources Information Center

Gestwicki, Paul; Sun, Fu-Shing

2008-01-01

We present an approach for teaching design patterns that emphasizes object-orientation and patterns integration. The context of computer game development is used to engage and motivate students, and it is additionally rich with design patterns. A case study is presented based on "EEClone," an arcade-style computer game implemented in Java. Our…

Designing a Bridging Discourse: Re-Mediation of a Mathematical Learning Disability

ERIC Educational Resources Information Center

Lewis, Katherine E.

2017-01-01

Students with disabilities present a unique instructional design challenge. These students often have qualitatively different ways of processing information, meaning that standard instructional approaches may not be effective. In this study I present a case study of a student with a mathematical learning disability for whom standard instruction on…

Delayed Presentation of Submucosal Retained Toothbrush from Self-Inflicted Injury in Patient with Schizophrenia.

PubMed

Creswell, Caleb H; Kille, Tony L; Hoffman, Matthew R; Kennedy, Tabassum; Dailey, Seth H

2017-01-01

Foreign body ingestion occurs in not only children but also adults, particularly those with history of neurologic disease, alcohol use, or psychiatric disease. We present the case of a 40-year-old male with schizophrenia who presented to the emergency room with a long history of pharyngeal foreign body sensation which had recently progressed to include trismus, odynophagia, and dyspnea. Flexible laryngoscopy demonstrated fullness of the right posterior pharyngeal wall and computed tomography (CT) showed a linear opaque foreign body extending from the level of the oropharynx to the thyroid ala. Further history elicited that he stabbed himself in the pharynx two years prior with a toothbrush following a command hallucination. The toothbrush was removed uneventfully via an external approach. The patient was discharged with psychiatry follow-up. This case is unusual due to the submucosal location of the foreign body and the length of retention. It demonstrates the atypical nature which patients with comorbid psychiatric illness may present following foreign body injury and the use of an external surgical approach for the removal of a retained foreign body based on CT reconstruction.

A fuzzy Bayesian approach to flood frequency estimation with imprecise historical information

PubMed Central

Kiss, Andrea; Viglione, Alberto; Viertl, Reinhard; Blöschl, Günter

2016-01-01

Abstract This paper presents a novel framework that links imprecision (through a fuzzy approach) and stochastic uncertainty (through a Bayesian approach) in estimating flood probabilities from historical flood information and systematic flood discharge data. The method exploits the linguistic characteristics of historical source material to construct membership functions, which may be wider or narrower, depending on the vagueness of the statements. The membership functions are either included in the prior distribution or the likelihood function to obtain a fuzzy version of the flood frequency curve. The viability of the approach is demonstrated by three case studies that differ in terms of their hydromorphological conditions (from an Alpine river with bedrock profile to a flat lowland river with extensive flood plains) and historical source material (including narratives, town and county meeting protocols, flood marks and damage accounts). The case studies are presented in order of increasing fuzziness (the Rhine at Basel, Switzerland; the Werra at Meiningen, Germany; and the Tisza at Szeged, Hungary). Incorporating imprecise historical information is found to reduce the range between the 5% and 95% Bayesian credibility bounds of the 100 year floods by 45% and 61% for the Rhine and Werra case studies, respectively. The strengths and limitations of the framework are discussed relative to alternative (non‐fuzzy) methods. The fuzzy Bayesian inference framework provides a flexible methodology that fits the imprecise nature of linguistic information on historical floods as available in historical written documentation. PMID:27840456

A fuzzy Bayesian approach to flood frequency estimation with imprecise historical information

NASA Astrophysics Data System (ADS)

Salinas, José Luis; Kiss, Andrea; Viglione, Alberto; Viertl, Reinhard; Blöschl, Günter

2016-09-01

This paper presents a novel framework that links imprecision (through a fuzzy approach) and stochastic uncertainty (through a Bayesian approach) in estimating flood probabilities from historical flood information and systematic flood discharge data. The method exploits the linguistic characteristics of historical source material to construct membership functions, which may be wider or narrower, depending on the vagueness of the statements. The membership functions are either included in the prior distribution or the likelihood function to obtain a fuzzy version of the flood frequency curve. The viability of the approach is demonstrated by three case studies that differ in terms of their hydromorphological conditions (from an Alpine river with bedrock profile to a flat lowland river with extensive flood plains) and historical source material (including narratives, town and county meeting protocols, flood marks and damage accounts). The case studies are presented in order of increasing fuzziness (the Rhine at Basel, Switzerland; the Werra at Meiningen, Germany; and the Tisza at Szeged, Hungary). Incorporating imprecise historical information is found to reduce the range between the 5% and 95% Bayesian credibility bounds of the 100 year floods by 45% and 61% for the Rhine and Werra case studies, respectively. The strengths and limitations of the framework are discussed relative to alternative (non-fuzzy) methods. The fuzzy Bayesian inference framework provides a flexible methodology that fits the imprecise nature of linguistic information on historical floods as available in historical written documentation.

A fuzzy Bayesian approach to flood frequency estimation with imprecise historical information.

PubMed

Salinas, José Luis; Kiss, Andrea; Viglione, Alberto; Viertl, Reinhard; Blöschl, Günter

2016-09-01

This paper presents a novel framework that links imprecision (through a fuzzy approach) and stochastic uncertainty (through a Bayesian approach) in estimating flood probabilities from historical flood information and systematic flood discharge data. The method exploits the linguistic characteristics of historical source material to construct membership functions, which may be wider or narrower, depending on the vagueness of the statements. The membership functions are either included in the prior distribution or the likelihood function to obtain a fuzzy version of the flood frequency curve. The viability of the approach is demonstrated by three case studies that differ in terms of their hydromorphological conditions (from an Alpine river with bedrock profile to a flat lowland river with extensive flood plains) and historical source material (including narratives, town and county meeting protocols, flood marks and damage accounts). The case studies are presented in order of increasing fuzziness (the Rhine at Basel, Switzerland; the Werra at Meiningen, Germany; and the Tisza at Szeged, Hungary). Incorporating imprecise historical information is found to reduce the range between the 5% and 95% Bayesian credibility bounds of the 100 year floods by 45% and 61% for the Rhine and Werra case studies, respectively. The strengths and limitations of the framework are discussed relative to alternative (non-fuzzy) methods. The fuzzy Bayesian inference framework provides a flexible methodology that fits the imprecise nature of linguistic information on historical floods as available in historical written documentation.

GLISTRboost: Combining Multimodal MRI Segmentation, Registration, and Biophysical Tumor Growth Modeling with Gradient Boosting Machines for Glioma Segmentation.

PubMed

Bakas, Spyridon; Zeng, Ke; Sotiras, Aristeidis; Rathore, Saima; Akbari, Hamed; Gaonkar, Bilwaj; Rozycki, Martin; Pati, Sarthak; Davatzikos, Christos

2016-01-01

We present an approach for segmenting low- and high-grade gliomas in multimodal magnetic resonance imaging volumes. The proposed approach is based on a hybrid generative-discriminative model. Firstly, a generative approach based on an Expectation-Maximization framework that incorporates a glioma growth model is used to segment the brain scans into tumor, as well as healthy tissue labels. Secondly, a gradient boosting multi-class classification scheme is used to refine tumor labels based on information from multiple patients. Lastly, a probabilistic Bayesian strategy is employed to further refine and finalize the tumor segmentation based on patient-specific intensity statistics from the multiple modalities. We evaluated our approach in 186 cases during the training phase of the BRAin Tumor Segmentation (BRATS) 2015 challenge and report promising results. During the testing phase, the algorithm was additionally evaluated in 53 unseen cases, achieving the best performance among the competing methods.

Massive Submandibular Sialolith: Complete Radiographic Registration and Biochemical Analysis through X-Ray Diffraction

PubMed Central

de Carvalho Mattos, Mayara Jessica; Ferrari, Francine; dos Reis Neto, José Manoel; Carta Gambus, Luiz Carlos; Couto Souza, Paulo Henrique; Berti-Couto, Soraya de Azambuja

2014-01-01

Sialolithiasis is a pathologic condition that affects 60 million people per year, which is caused by the presence of calcified structures, named sialoliths, inside the salivary glands and their salivary ducts. Despite the large incidence of sialolithiasis, its etiology is still unknown. In the present case report, a 47-year-old female patient, presenting with local pain and hampered mouth opening, underwent a surgical approach for the removal of a 20 mm sialolith, which was further analyzed through X-ray diffraction. In parallel, a radiographic registration of 8 years, covering all the period for sialolith formation, is presented along the case report. PMID:25258693

Massive Submandibular Sialolith: Complete Radiographic Registration and Biochemical Analysis through X-Ray Diffraction.

PubMed

Franco, Ademir; de Carvalho Mattos, Mayara Jessica; Ferrari, Francine; Dos Reis Neto, José Manoel; Carta Gambus, Luiz Carlos; Couto Souza, Paulo Henrique; Berti-Couto, Soraya de Azambuja

2014-01-01

Sialolithiasis is a pathologic condition that affects 60 million people per year, which is caused by the presence of calcified structures, named sialoliths, inside the salivary glands and their salivary ducts. Despite the large incidence of sialolithiasis, its etiology is still unknown. In the present case report, a 47-year-old female patient, presenting with local pain and hampered mouth opening, underwent a surgical approach for the removal of a 20 mm sialolith, which was further analyzed through X-ray diffraction. In parallel, a radiographic registration of 8 years, covering all the period for sialolith formation, is presented along the case report.

[Course and treatment of infantile asthma in our milieu].

PubMed

Scrigni, A; Grenoville, M; de Sarasqueta, P; Verna, R; Breiter, P; Jimenez, C

1993-01-01

We studied the clinical evolution and therapeutic approach of 50 children who were treated at the Emergency Room for an asthmatic crisis. We observed a high frequency of early onset of asthma before one year of age (n:16), constant symptoms between the crisis (n:34) and previous admissions before the present crisis (n:34) and previous admissions before the present crisis (n:16). Most cases did not have a family doctor. In 16 cases, the present crisis had four or more days of duration. We observed a frequent administration of suboptimal doses of bronchodilator and antiinflammatory drugs. These results show a non satisfactory treatment of infantile asthma.

A model for prediction of STOVL ejector dynamics

NASA Technical Reports Server (NTRS)

Drummond, Colin K.

1989-01-01

A semi-empirical control-volume approach to ejector modeling for transient performance prediction is presented. This new approach is motivated by the need for a predictive real-time ejector sub-system simulation for Short Take-Off Verticle Landing (STOVL) integrated flight and propulsion controls design applications. Emphasis is placed on discussion of the approximate characterization of the mixing process central to thrust augmenting ejector operation. The proposed ejector model suggests transient flow predictions are possible with a model based on steady-flow data. A practical test case is presented to illustrate model calibration.

A Bayesian approach for parameter estimation and prediction using a computationally intensive model

DOE PAGES

Higdon, Dave; McDonnell, Jordan D.; Schunck, Nicolas; ...

2015-02-05

Bayesian methods have been successful in quantifying uncertainty in physics-based problems in parameter estimation and prediction. In these cases, physical measurements y are modeled as the best fit of a physics-based modelmore » $$\\eta (\\theta )$$, where θ denotes the uncertain, best input setting. Hence the statistical model is of the form $$y=\\eta (\\theta )+\\epsilon ,$$ where $$\\epsilon $$ accounts for measurement, and possibly other, error sources. When nonlinearity is present in $$\\eta (\\cdot )$$, the resulting posterior distribution for the unknown parameters in the Bayesian formulation is typically complex and nonstandard, requiring computationally demanding computational approaches such as Markov chain Monte Carlo (MCMC) to produce multivariate draws from the posterior. Although generally applicable, MCMC requires thousands (or even millions) of evaluations of the physics model $$\\eta (\\cdot )$$. This requirement is problematic if the model takes hours or days to evaluate. To overcome this computational bottleneck, we present an approach adapted from Bayesian model calibration. This approach combines output from an ensemble of computational model runs with physical measurements, within a statistical formulation, to carry out inference. A key component of this approach is a statistical response surface, or emulator, estimated from the ensemble of model runs. We demonstrate this approach with a case study in estimating parameters for a density functional theory model, using experimental mass/binding energy measurements from a collection of atomic nuclei. Lastly, we also demonstrate how this approach produces uncertainties in predictions for recent mass measurements obtained at Argonne National Laboratory.« less

When symptoms don't fit: a case series of conversion disorder in the pediatric otolaryngology practice.

PubMed

Caulley, Lisa; Kohlert, Scott; Gandy, Hazen; Olds, Janet; Bromwich, Matthew

2018-05-29

Conversion disorder refers to functional bodily impairments that can be precipitated by high stress situations including trauma and surgery. Symptoms of conversion disorder may mimic or complicate otolaryngology diseases in the pediatric population. In this report, the authors describe 3 cases of conversion disorder that presented to a pediatric otolaryngology-head and neck surgery practice. This report highlights a unique population of patients who have not previously been investigated. The clinical presentation and management of these cases are discussed in detail. Non-organic otolaryngology symptoms of conversion disorder in the pediatric population are reviewed. In addition, we discuss the challenges faced by clinicians in appropriately identifying and treating these patients and present an approach to management of their care. In this report, the authors highlight the importance of considering psychogenic illnesses in patients with atypical clinical presentations of otolaryngology disorders.

Craniocervical Junction Meningiomas without Hydrocephalus Presenting Solely with Syncope: Report of 2 Cases.

PubMed

Champagne, Pierre-Olivier; Bojanowski, Michel W

2018-06-01

To our knowledge, there have not been any reported cases of a meningioma of the craniocervical region presenting solely with syncope as its initial symptom. Only 1 case of meningioma presenting with syncope has been published, but it was associated with hydrocephalus. We report 2 cases of syncope caused by a craniocervical junction meningioma, with syncope being the sole presenting symptom and without hydrocephalus. We discuss the possible pathophysiology, as well as the clinical relevance of this type of presentation. We reviewed the charts, operative details, and imagery of 2 cases of meningioma in the region of the craniocervical junction, with syncope as their sole presenting feature. We also reviewed the literature. In 1 case the syncope occurred spontaneously. In the other, it occurred during a Valsalva maneuver. Both meningiomas were surgically removed via a retromastoid approach. There was no recurrence of syncope following surgery. Following a literature review, we found 1 case of posterior fossa meningioma presenting with syncope, but hydrocephalus was also present. Syncope can be the sole manifestation of a meningioma of the craniocervical junction. Such syncopes are a consequence of transient dysfunction of the autonomous pathways in the medulla and/or of the medulla's output. In the absence of other causes of syncope, a meningioma in this region, even in the absence of hydrocephalus, should not be considered as fortuitous, but rather as the actual cause of syncope. Recognizing this possibility offers the potential for proper diagnosis and appropriate treatment of the syncope. Copyright © 2018 Elsevier Inc. All rights reserved.

Female monozygotic twins with selective mutism--a case report.

PubMed

Sharkey, L; Mc Nicholas, F

2006-04-01

Selective mutism is a rare social anxiety disorder characterized by a total lack of speech in certain specific situations despite the ability to speak in others. Both genetic and psychosocial factors are thought to be involved in its presentation, persistence, and response to treatment. This case report describes a case of young female monozygotic twins who presented with selective mutism and their treatment spanning a 2-year period. It highlights the strong genetic association along with environmental factors such as social isolation and consequences of maternal social phobia, all contributing to treatment resistance, despite an intensive multimodal biopsychosocial approach. General issues related to the difficulties in treating monozygotic twins are also addressed.

Intestinal obstruction caused by omphalomesenteric duct remnant: usefulness of laparoscopy.

PubMed

Bueno Lledó, J; Serralta Serra, A; Planeéis Roig, M; Dobón Giménez, F; Ibáñez Palacín, F; Rodero Rodero, R

2003-10-01

The anomalies related to omphalomesenteric duct remnant constitute an uncommon cause of intestinal obstruction, of which Meckel"s diverticulum and its variants represent the most important clinical presentation. In most cases they are asymptomatic and usually affect young patients. When symptomatic, they usually present episodes of gastrointestinal bleeding or acute abdomen syndromes caused by strangulation of intestinal loops as a result of fibrous intraabdominal remnants or inflammation produced by the diverticulum. In most cases, the unexpected presence of these alterations makes intraoperative diagnosis necessary. Treatment is surgical and consists in exeresis of the diverticulum or the fibrous band causing the clinical picture. We report two cases of persistence of the vitelline duct resolved by laparoscopic approach.

Facing the challenges of ventricular hypertrophy: the eyes don't lie.

PubMed

Rodrigues, Patrícia; Santos, Mário; Marinho, António; Cabral, Sofia; Vieira, Miguel; Reis, Hipólito; Palma, Paulo; Torres, Severo

2014-10-01

We describe the case of a 47-year-old man with new-onset heart failure who was found to have severe biventricular wall thickening. We present comprehensive data from invasive and non-invasive multimodality imaging, genetic and histologic tests, and briefly describe their importance in the final diagnosis. To our knowledge, this is the first case of the Portuguese variant of familial amyloid polyneuropathy presenting with heart failure in the fifth decade of life. This is an unusual case report, but also an illustration of how to approach any patient with suspected infiltrative cardiomyopathy. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

Nasal cavity ossifying fibrosarcoma: an unusual fibro-osseous neoplasm.

PubMed

Alameda, Yadiel A; Perez-Mitchell, Carlos; Busquets, José M

2010-11-01

We describe the case of a 65-year-old woman who presented with left nasal obstruction. Clinical and radiographic examinations revealed the presence of a soft-tissue mass that had obliterated the left nasal cavity. The mass was completely excised via an endoscopic approach. Histopathologic examination identified the tumor as an ossifying fibrosarcoma. The patient recovered uneventfully and remained free of disease at the 2-year postoperative follow-up. To the best of our knowledge, no case of an ossifying fibrosarcoma of the nasal cavity has been previously reported in the English-language literature. We discuss the features of this case and the clinical presentation, diagnosis, and management of fibrosarcomas of the nasal cavity and paranasal sinuses.

Deriving Safety Cases from Automatically Constructed Proofs

NASA Technical Reports Server (NTRS)

Basir, Nurlida; Denney, Ewen; Fischer, Bernd

2009-01-01

Formal proofs provide detailed justification for the validity of claims and are widely used in formal software development methods. However, they are often complex and difficult to understand, because the formalism in which they are constructed and encoded is usually machine-oriented, and they may also be based on assumptions that are not justified. This causes concerns about the trustworthiness of using formal proofs as arguments in safety-critical applications. Here, we present an approach to develop safety cases that correspond to formal proofs found by automated theorem provers and reveal the underlying argumentation structure and top-level assumptions. We concentrate on natural deduction style proofs, which are closer to human reasoning than resolution proofs, and show how to construct the safety cases by covering the natural deduction proof tree with corresponding safety case fragments. We also abstract away logical book-keeping steps, which reduces the size of the constructed safety cases. We show how the approach can be applied to the proofs found by the Muscadet prover.

Asymmetric Anterior Distraction for Transversely Distorted Maxilla and Midfacial Anteroposterior Deficiency in a Patient With Cleft Lip/Palate: Two-Stage Surgical Approach.

PubMed

Hirata, Kae; Tanikawa, Chihiro; Aikawa, Tomonao; Ishihama, Kohji; Kogo, Mikihiko; Iida, Seiji; Yamashiro, Takashi

2016-07-01

The present report describes a male patient with a unilateral cleft lip and palate who presented with midfacial anteroposterior and transverse deficiency. Correction involved a two-stage surgical-orthodontic approach: asymmetric anterior distraction of the segmented maxilla followed by two-jaw surgery (LeFort I and bilateral sagittal splitting ramus osteotomies). The present case demonstrates that the asymmetric elongation of the maxilla with anterior distraction is an effective way to correct a transversely distorted alveolar form and midfacial anteroposterior deficiency. Furthermore, successful tooth movement was demonstrated in the new bone created by distraction.

Next Generation Sequencing Approach in a Prenatal Case of Cardio-Facio-Cutaneus Syndrome.

PubMed

Mucciolo, Mafalda; Dello Russo, Claudio; D'Emidio, Laura; Mesoraca, Alvaro; Giorlandino, Claudio

2016-06-16

Cardiofaciocutaneous syndrome (CFCS) belongs to a group of developmental disorders due to defects in the Ras/Mitogen-Activated Protein Kinase (RAS/MAPK) signaling pathway named RASophaties. While postnatal presentation of these disorders is well known, the prenatal and neonatal characteristics are less recognized. Noonan syndrome, Costello syndrome, and CFCS diagnosis should be considered in pregnancies with a normal karyotype and in the case of ultrasound findings such as increased nuchal translucency, polyhydramnios, macrosomia and cardiac defect. Because all the RASopathies share similar clinical features, their molecular characterization is complex, time consuming and expensive. Here we report a case of CFCS prenatally diagnosed through Next Generation Prenatal Diagnosis (NGPD), a new targeted approach that allows us to concurrently investigate all the genes involved in the RASophaties.

Next Generation Sequencing Approach in a Prenatal Case of Cardio-Facio-Cutaneus Syndrome

PubMed Central

Mucciolo, Mafalda; Dello Russo, Claudio; D’Emidio, Laura; Mesoraca, Alvaro; Giorlandino, Claudio

2016-01-01

Cardiofaciocutaneous syndrome (CFCS) belongs to a group of developmental disorders due to defects in the Ras/Mitogen-Activated Protein Kinase (RAS/MAPK) signaling pathway named RASophaties. While postnatal presentation of these disorders is well known, the prenatal and neonatal characteristics are less recognized. Noonan syndrome, Costello syndrome, and CFCS diagnosis should be considered in pregnancies with a normal karyotype and in the case of ultrasound findings such as increased nuchal translucency, polyhydramnios, macrosomia and cardiac defect. Because all the RASopathies share similar clinical features, their molecular characterization is complex, time consuming and expensive. Here we report a case of CFCS prenatally diagnosed through Next Generation Prenatal Diagnosis (NGPD), a new targeted approach that allows us to concurrently investigate all the genes involved in the RASophaties. PMID:27322245

Towards a precise test for malaria diagnosis in the Brazilian Amazon: comparison among field microscopy, a rapid diagnostic test, nested PCR, and a computational expert system based on artificial neural networks

PubMed Central

2010-01-01

Background Accurate malaria diagnosis is mandatory for the treatment and management of severe cases. Moreover, individuals with asymptomatic malaria are not usually screened by health care facilities, which further complicates disease control efforts. The present study compared the performances of a malaria rapid diagnosis test (RDT), the thick blood smear method and nested PCR for the diagnosis of symptomatic malaria in the Brazilian Amazon. In addition, an innovative computational approach was tested for the diagnosis of asymptomatic malaria. Methods The study was divided in two parts. For the first part, passive case detection was performed in 311 individuals with malaria-related symptoms from a recently urbanized community in the Brazilian Amazon. A cross-sectional investigation compared the diagnostic performance of the RDT Optimal-IT, nested PCR and light microscopy. The second part of the study involved active case detection of asymptomatic malaria in 380 individuals from riverine communities in Rondônia, Brazil. The performances of microscopy, nested PCR and an expert computational system based on artificial neural networks (MalDANN) using epidemiological data were compared. Results Nested PCR was shown to be the gold standard for diagnosis of both symptomatic and asymptomatic malaria because it detected the major number of cases and presented the maximum specificity. Surprisingly, the RDT was superior to microscopy in the diagnosis of cases with low parasitaemia. Nevertheless, RDT could not discriminate the Plasmodium species in 12 cases of mixed infections (Plasmodium vivax + Plasmodium falciparum). Moreover, the microscopy presented low performance in the detection of asymptomatic cases (61.25% of correct diagnoses). The MalDANN system using epidemiological data was worse that the light microscopy (56% of correct diagnoses). However, when information regarding plasma levels of interleukin-10 and interferon-gamma were inputted, the MalDANN performance sensibly increased (80% correct diagnoses). Conclusions An RDT for malaria diagnosis may find a promising use in the Brazilian Amazon integrating a rational diagnostic approach. Despite the low performance of the MalDANN test using solely epidemiological data, an approach based on neural networks may be feasible in cases where simpler methods for discriminating individuals below and above threshold cytokine levels are available. PMID:20459613

Towards a precise test for malaria diagnosis in the Brazilian Amazon: comparison among field microscopy, a rapid diagnostic test, nested PCR, and a computational expert system based on artificial neural networks.

PubMed

Andrade, Bruno B; Reis-Filho, Antonio; Barros, Austeclino M; Souza-Neto, Sebastião M; Nogueira, Lucas L; Fukutani, Kiyoshi F; Camargo, Erney P; Camargo, Luís M A; Barral, Aldina; Duarte, Angelo; Barral-Netto, Manoel

2010-05-06

Accurate malaria diagnosis is mandatory for the treatment and management of severe cases. Moreover, individuals with asymptomatic malaria are not usually screened by health care facilities, which further complicates disease control efforts. The present study compared the performances of a malaria rapid diagnosis test (RDT), the thick blood smear method and nested PCR for the diagnosis of symptomatic malaria in the Brazilian Amazon. In addition, an innovative computational approach was tested for the diagnosis of asymptomatic malaria. The study was divided in two parts. For the first part, passive case detection was performed in 311 individuals with malaria-related symptoms from a recently urbanized community in the Brazilian Amazon. A cross-sectional investigation compared the diagnostic performance of the RDT Optimal-IT, nested PCR and light microscopy. The second part of the study involved active case detection of asymptomatic malaria in 380 individuals from riverine communities in Rondônia, Brazil. The performances of microscopy, nested PCR and an expert computational system based on artificial neural networks (MalDANN) using epidemiological data were compared. Nested PCR was shown to be the gold standard for diagnosis of both symptomatic and asymptomatic malaria because it detected the major number of cases and presented the maximum specificity. Surprisingly, the RDT was superior to microscopy in the diagnosis of cases with low parasitaemia. Nevertheless, RDT could not discriminate the Plasmodium species in 12 cases of mixed infections (Plasmodium vivax + Plasmodium falciparum). Moreover, the microscopy presented low performance in the detection of asymptomatic cases (61.25% of correct diagnoses). The MalDANN system using epidemiological data was worse that the light microscopy (56% of correct diagnoses). However, when information regarding plasma levels of interleukin-10 and interferon-gamma were inputted, the MalDANN performance sensibly increased (80% correct diagnoses). An RDT for malaria diagnosis may find a promising use in the Brazilian Amazon integrating a rational diagnostic approach. Despite the low performance of the MalDANN test using solely epidemiological data, an approach based on neural networks may be feasible in cases where simpler methods for discriminating individuals below and above threshold cytokine levels are available.