532 resultados para Corrective shoeing


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La regolazione dei sistemi di propulsione a razzo a propellente solido (Solid Rocket Motors) ha da sempre rappresentato una delle principali problematiche legate a questa tipologia di motori. L’assenza di un qualsiasi genere di controllo diretto del processo di combustione del grano solido, fa si che la previsione della balistica interna rappresenti da sempre il principale strumento utilizzato sia per definire in fase di progetto la configurazione ottimale del motore, sia per analizzare le eventuali anomalie riscontrate in ambito sperimentale. Variazioni locali nella struttura del propellente, difettosità interne o eterogeneità nelle condizioni di camera posso dare origine ad alterazioni del rateo locale di combustione del propellente e conseguentemente a profili di pressione e di spinta sperimentali differenti da quelli previsti per via teorica. Molti dei codici attualmente in uso offrono un approccio piuttosto semplificato al problema, facendo per lo più ricorso a fattori correttivi (fattori HUMP) semi-empirici, senza tuttavia andare a ricostruire in maniera più realistica le eterogeneità di prestazione del propellente. Questo lavoro di tesi vuole dunque proporre un nuovo approccio alla previsione numerica delle prestazioni dei sistemi a propellente solido, attraverso la realizzazione di un nuovo codice di simulazione, denominato ROBOOST (ROcket BOOst Simulation Tool). Richiamando concetti e techiche proprie della Computer Grafica, questo nuovo codice è in grado di ricostruire in processo di regressione superficiale del grano in maniera puntuale, attraverso l’utilizzo di una mesh triangolare mobile. Variazioni locali del rateo di combustione posso quindi essere facilmente riprodotte ed il calcolo della balistica interna avviene mediante l’accoppiamento di un modello 0D non-stazionario e di uno 1D quasi-stazionario. L’attività è stata svolta in collaborazione con l’azienda Avio Space Division e il nuovo codice è stato implementato con successo sul motore Zefiro 9.

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La presente tesi intende compiere un’indagine, dal punto di vista storico-educativo, sulla storia delle case di correzione. Nello specifico si è tentato di analizzare il “caso” del Discolato bolognese, operando un confronto con altre analoghe istituzioni, sorte in due città campione, come Roma e Milano, per quanto riguarda il contesto italiano, e con la situazione inglese, per quanto riguarda il contesto internazionale. Il focus della ricerca si è incentrato sul rapporto tra devianza e internamento, considerato secondo una declinazione pedagogica. A tal proposito si è cercato di far emergere le modalità educative, nonché i principi e le finalità che sottostavano agli interventi istituzionali, non solo soffermandosi su quanto i regolamenti e gli statuti prescrivevano all’interno delle strutture correzionali, ma analizzando la reclusione nella sua effettiva organizzazione quotidiana. Per quanto riguarda la situazione bolognese è stata analizzata un’ampissima documentazione, conservata presso l’Archivio storico Provinciale di Bologna, che ha permesso di svolgere un’analisi di tipo quantitativo su un totale di 1105 individui al fine di delineare le principali caratteristiche demografiche e sociali delle persone internate nel Discolato bolognese. L’interpretazione delle fonti ha permesso anche un’indagine qualitativa, nel tentativo di ricostruire le storie di vita dei singoli reclusi. Da questa ricerca emerge un’immagine complessa delle case di correzione. Nel corso dei secoli, in modo particolare nelle diverse realtà prese in esame, esse hanno assunto caratteristiche e peculiarità differenti. La loro inefficacia fu la motivazione principale che condusse alla definitiva chiusura, quando si fece via via sempre più evidente la difficoltà a tradurre in pratica ciò che regolamenti e statuti - a livello teorico - prescrivevano.

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Tractor rollover represent a primary cause of death or serious injury in agriculture and despite the mandatory Roll-Over Protective Structures (ROPS), that reduced the number of injuries, tractor accidents are still of great concern. Because of their versatility and wide use many studies on safety are concerned with the stability of tractors, but they often prefer controlled tests or laboratory tests. The evaluation of tractors working in field, instead, is a very complex issue because the rollover could be influenced by the interaction among operator, tractor and environment. Recent studies are oriented towards the evaluation of the actual working conditions developing prototypes for driver assistance and data acquisition. Currently these devices are produced and sold by manufacturers. A warning device was assessed in this study with the aim to evaluate its performance and to collect data on different variables influencing the dynamics of tractors in field by monitoring continuously the working conditions of tractors operating at the experimental farm of the Bologna University. The device consists of accelerometers, gyroscope, GSM/GPRS, GPS for geo-referencing and a transceiver for the automatic recognition of tractor-connected equipment. A microprocessor processes data and provides information, through a dedicated algorithm requiring data on the geometry of the tested tractor, on the level of risk for the operator in terms of probable loss of stability and suggests corrective measures to reduce the potential instability of the tractor.

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Immediate breast reconstruction (IBR) has become an established procedure for women necessitating mastectomy. Traditionally, the nipple-areola complex (NAC) is resected during this procedure. The NAC, in turn, is a principal factor determining aesthetic outcome after breast reconstruction, and due to its particular texture and shape, a natural-looking NAC can barely be reconstructed with other tissues. The aim of this study was to assess the oncological safety as well as morbidity and aesthetic outcome after replantation of the NAC some days after IBR. Retrospective analysis of 85 patients receiving 88 mastectomies and IBR between 1998 and 2007 was conducted. NAC (n=29) or the nipple alone (n=23) were replanted 7 days (median, range 2-10 days) after IBR in 49 patients, provided the subareolar tissue was histologically negative for tumour infiltration. Local recurrence rate was assessed after 49 months (median, range 6-120 months). Aesthetic outcome was evaluated by clinical assessment during routine follow-up at least 12 months after the last intervention. Malignant involvement of the subareolar tissue was found in eight cases (9.1%). Patients qualifying for NAC replantation were in stage 0 in 29%, stage I in 15%, stage IIa in 31%, stage IIb in 17% and stage III in 8%. Total or partial necrosis occurred in 69% and 26% if the entire NAC or only the nipple were replanted, respectively (P<0.01). Depigmentation was seen in 52% and corrective surgery was done in 11 out of 52 NAC or nipple replantations. Local recurrence and isolated regional lymph node metastasis were observed in one single case each. Another 5.8% of the patients showed distant metastases. We conclude that the replantation of the NAC in IBR is oncologically safe, provided the subareolar tissue is free of tumour. However, the long-term aesthetic outcome of NAC replantation is not satisfying, which advocates replanting the nipple alone.

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When healthy observers make a saccade that is erroneously directed toward a distracter stimulus, they often produce a corrective saccade within 100ms after the end of the primary saccade. Such short inter-saccadic intervals indicate that programming of the secondary saccade has been initiated prior to the execution of the primary saccade and hence that the two saccades have been programmed concurrently. Here we show that concurrent saccade programming is bilaterally impaired in left spatial neglect, a strongly lateralized disorder of visual attention resulting from extensive right cerebral damage. Neglect patients were asked to make saccades to targets presented left or right of fixation while disregarding a distracter presented in the opposite hemifield. We examined those experimental trials on which participants first made a saccade to the distracter, followed by a secondary (corrective) saccade to the target. Compared to healthy and right-hemisphere damaged control participants the proportion of secondary saccades directing gaze to the target instead of bringing it even closer to the distracter was bilaterally reduced in neglect patients. In addition, the characteristic reduction of secondary saccade latency observed in both control groups was absent in neglect patients, whether the secondary saccade was directed to the left or right hemifield. This pattern is consistent with a severe, bilateral impairment of concurrent saccade programming in left spatial neglect.

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In one popular devotional poster the Indian god-man Shirdi Sai Baba (d. 1918) gazes out at the viewer, his right hand raised in blessing. Behind him are a Hindu temple, a Muslim mosque, a Sikh gurdwara, and a Christian church; above him is the slogan, “Be United, Be Virtuous.” In his lifetime, Shirdi Sai Baba acquired a handful of Hindu and Muslim devotees in western India. Over the past several decades, he has been transformed from a regional figure into a revered persona of pan-Indian significance. While much scholarship on religion in modern India has focused on Hindu nationalist groups, new religious movements seeking to challenge sectarianism have received far less attention. Drawing upon primary devotional materials and ethnographic research, this article argues that one significant reason for the rapid growth of this movement is Shirdi Sai Baba’s composite vision of spiritual unity in diversity, construed by many devotees as a needed corrective to rigid sectarian ideologies.

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Aortic stenosis has become the most frequent type of valvular heart disease in Europe and North America and presents in the large majority of patients as calcified aortic stenosis in adults of advanced age. Surgical aortic valve replacement has been recognized to be the definitive therapy which improves considerably survival for severe aortic stenosis since more than 40 years. In the most recent period, operative mortality of isolated aortic valve replacement for aortic stenosis varies between 1–3% in low-risk patients younger than 70 years and between 4 and 8% in selected older adults. Long-term survival following aortic valve replacement is close to that observed in a control population of similar age. Numerous observational studies have consistently demonstrated that corrective surgery in symptomatic patients is invariably followed by a subjective improvement in quality of life and a substantial increase in survival rates. More recently, transcatheter aortic valve implantation (TAVI) has been demonstrated to be feasible in patients with high surgical risk using either a retrograde transfemoral or transsubclavian approach or an antegrade, transapical access. Reported 30-day mortality ranges between 5 and 15%) and is acceptable when compared to the risk predicted by the logistic EuroSCORE (varying between 20 and 35%) and the STS Score, although the EuroScore has been shown to markedly overestimate the effective operative risk. One major concern remains the high rate of paravalvular regurgitation which is observed in up to 85% of the patients and which requires further follow-up and critical evaluation. In addition, long-term durability of these valves with a focus on the effects of crimping remains to be addressed, although 3-5 year results are promising. Sutureless biological valves were designed to simplify and significantly accelerate the surgical replacement of a diseased valve and allow complete excision of the calcified native valve. Until now, there are 3 different sutureless prostheses that have been approved. The 3f Enable valve from ATS-Medtronic received CE market approval in 2010, the Perceval S from Sorin during Q1 of 2011 and the intuity sutureless prosthesis from Edwards in 2012. All these devices aim to facilitate valve surgery and therefore have the potential to decrease the invasivness and to shorten the conventional procedure without compromise in term of excision of the diseased valve. This review summarizes the history and the current knowledge of sutureless valve technology.

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OBJECTIVE: To assess the utility of nasotracheal tubes in postoperative oxygen supplementation in dogs following corrective surgery for brachycephalic syndrome. DESIGN: Retrospective study 2003-2007. SETTING: University teaching hospital. ANIMALS: Thirty-six client-owned dogs that underwent corrective surgery for brachycephalic syndrome. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Medical records were reviewed for animals that underwent surgical interventions for brachycephalic syndrome including palatoplasty, ventriculectomy, and rhinoplasty. Data collected included signalment, presenting complaints, analgesic and surgical interventions, type of supplemental oxygen therapy, complications and mortality occurring during hospitalization. A nasotracheal tube (NTT) was placed in 20 dogs at the end of surgery; 16 dogs received other forms of oxygen supplementation (8) or no oxygen supplementation (8) during recovery. The total number of postoperative complications was similar in both groups (8/20 dogs with NTTs and 7/16 in those without NTTs). However, respiratory distress was observed in 5 dogs without NTTs but was not observed in any dog while an NTT was in place. One dog in each group died postoperatively. CONCLUSION: Placement of an NTT was found to be easy and may offer benefit in dogs with brachycephalic syndrome as a noninvasive means of delivering oxygen. The use of NTT may minimize severe postoperative morbidity, in particular by reducing postoperative respiratory distress.

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The historical context in which saccades are made influences their latency and error rates, but less is known about how context influences their spatial parameters. We recently described a novel spatial bias for antisaccades, in which the endpoints of these responses deviate towards alternative goal locations used in the same experimental block, and showed that expectancy (prior probability) is at least partly responsible for this 'alternate-goal bias'. In this report we asked whether trial history also plays a role. Subjects performed antisaccades to a stimulus randomly located on the horizontal meridian, on a 40° angle downwards from the horizontal meridian, or on a 40° upward angle, with all three locations equally probable on any given trial. We found that the endpoints of antisaccades were significantly displaced towards the goal location of not only the immediately preceding trial (n - 1) but also the penultimate (n - 2) trial. Furthermore, this bias was mainly present for antisaccades with a short latency of <250 ms and was rapidly corrected by secondary saccades. We conclude that the location of recent antisaccades biases the spatial programming of upcoming antisaccades, that this historical effect persists over many seconds, and that it influences mainly rapidly generated eye movements. Because corrective saccades eliminate the historical bias, we suggest that the bias arises in processes generating the response vector, rather than processes generating the perceptual estimate of goal location.

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This project was stimulated by the unprecedented speed and scope of changes in Bulgarian higher education since 1989. The rapid growth of the student population and the emergence of a new private sector in higher education led to tightening governmental control and a growing criticism of autonomy and academic freedom. This raised questions about the need for diversification in the field, about the importance of recent innovations in terms of strategic choices for future development and so of how higher education governance could maintain diversity without the system deteriorating. The group first traced the extent of spontaneous processes of innovation at the level of content, of institutions, and the organisation of teaching and learning processes. They then identified the different parties in the struggle for institutionalisation and against diversification, and promising mechanisms for maintaining diversity in higher education. On this basis they outlined a basis for a wide-ranging public discussion of the issue which may serve as a corrective to the mechanisms of state control. Their work included analysis of the legislative framework laid down in the Higher Education Act, which effectively dispenses with the autonomy of universities. They then surveyed the views of both high-level executives in the field and the academics actually involved in the process, as well as of the "consumers" of the educational product, i.e. the students. In considering diversification, they focused on four different types of programmes, including those where diversification is largely limited to content level (e.g. Law), those where it operates mainly on structural levels (e.g. Industrial Management), those where it is often feigned (e.g. Social Work), and those where it is at best formal and sporadic (e.g. Mechanical Engineering). They conclude that the educational system in Bulgaria has considerable internal resources for development. The greatest need is for adequate statutory regulation of academic life which will provide incentives for responsible academic development of higher education institutions and create conditions for the institutionalisation of academic self-organisation and self-control, which will in turn limit the pathological trends in the diversification processes.

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BACKGROUND: Breast reconstruction by latissimus dorsi myocutaneous flap in combination with a prosthesis is a widely used, well-established procedure. Short- and medium-term evaluation after this procedure is well described in the literature, but there have been no evaluations of the late course (over 10 years) published until now. METHODS: In a retrospective study, 68 patients operated on by means of this technique at the authors' institution from 1981 to 1993 resulting in a minimal follow-up of 10 years were included. Patients were invited to an interrogation, clinical examination, and photographic documentation (n = 51). Incidence of late flap or prosthesis-related complications, number of and indications for corrective procedures, and the correlation of the patients' subjective judgment and objective results in the late course have been the main interest of the authors' survey. RESULTS: The authors found that 50 percent of the patients needed a late reoperation for change or removal of the prosthesis. Seven (10 percent) of 68 patients needed a definitive removal of the implant in the late course. Assessment of the photographic documentation of the late result by four nonprofessionals showed that the objective aesthetic results of a considerable number of the authors' reconstructions were not sufficient. CONCLUSION: The procedure combines two basic techniques of reconstructive surgery, the soft-tissue restoration by a pedicled flap as the autologous reconstructive component and the volume reconstruction by prosthesis. Therefore, these patients are subject to a cumulation of the basic morbidity of the two techniques. The authors conclude that the indication for this procedure should be restricted to patients not qualifying for "pure" reconstructive techniques.

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Myocardial dysfunction and arrhythmias may be induced by congenital heart defects, but also be the result of heart surgery with cardiopulmonary bypass (CPB), potentially caused by differential expression of connexin40 (Cx40) and connexin43 (Cx43). In 16 pediatric patients undergoing corrective heart surgery, connexin mRNA expression was studied in volume overloaded (VO group, n=8) and not overloaded (NO group, n=8) right atrial myocardium, excised before and after CPB. Additionally, in eight of these patients ventricular specimens were investigated. The atrial Cx43 expression decreased during CPB, which was restricted to the VO group (p=0.008). In contrast, atrial Cx40 mRNA did not change during CPB. In ventricular myocardium compared to atrial mRNA levels, Cx40 was lower (p=0.006) and Cx43 higher (p=0.017) expressed, without significant change during CPB. This study revealed a significant influence of CPB and the underlying heart defect on Cx43 expression.

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In an increasingly interconnected world characterized by the accelerating interplay of cultural, linguistic, and national difference, the ability to negotiate that difference in an equitable and ethical manner is a crucial skill for both individuals and larger social groups. This dissertation, Writing Center Handbooks and Travel Guidebooks: Redesigning Instructional Texts for Multicultural, Multilingual, and Multinational Contexts, considers how instructional texts that ostensibly support the negotiation of difference (i.e., accepting and learning from difference) actually promote the management of difference (i.e., rejecting, assimilating, and erasing difference). As a corrective to this focus on managing difference, chapter two constructs a theoretical framework that facilitates the redesign of handbooks, guidebooks, and similar instructional texts. This framework centers on reflexive design practices and is informed by literacy theory (Gee; New London Group; Street), social learning theory (Wenger), globalization theory (Nederveen Pieterse), and composition theory (Canagarajah; Horner and Trimbur; Lu; Matsuda; Pratt). By implementing reflexive design practices in the redesign of instructional texts, this dissertation argues that instructional texts can promote the negotiation of difference and a multicultural/multilingual sensibility that accounts for twenty-first century linguistic and cultural realities. Informed by the theoretical framework of chapter two, chapters three and four conduct a rhetorical analysis of two forms of instructional text that are representative of the larger genre: writing center coach handbooks and travel guidebooks to Hong Kong. This rhetorical analysis reveals how both forms of text employ rhetorical strategies that uphold dominant monolingual and monocultural assumptions. Alternative rhetorical strategies are then proposed that can be used to redesign these two forms of instructional texts in a manner that aligns with multicultural and multilingual assumptions. These chapters draw on the work of scholars in Writing Center Studies (Boquet and Lerner; Carino; DiPardo; Grimm; North; Severino) and Technical Communication (Barton and Barton; Dilger; Johnson; Kimball; Slack), respectively. Chapter five explores how the redesign of coach handbooks and travel guidebooks proposed in this dissertation can be conceptualized as a political act. Ultimately, this dissertation argues that instructional texts are powerful heuristic tools that can enact social change if they are redesigned to foster the negotiation of difference and to promote multicultural/multilingual world views.

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PURPOSE: In male patients with ileal bladder substitute we ascertained the likelihood of spontaneous voiding failure, the corrective procedures required and the eventual outcomes. MATERIALS AND METHODS: Following cystectomy and ileal bladder substitution for urothelial cancer between April 1985 and September 2002 male patients were identified and analyzed from the prospective departmental database. Four patients underwent ileum conduit conversion following urethral recurrence or pouch necrosis and were excluded from study. Funnel-shaped outlets were avoided during bladder substitute surgery after the first 4 patients with this configuration experienced voiding failure and required corrective procedures. Only patients with a minimum 5-year followup were assessed for voiding failure, corrective procedures and final outcomes. RESULTS: Of 354 patients with a median age of 65 years (range 36 to 84) treated with bladder substitute 180 (51%) were alive at 5 years. All 180 of these patients spontaneously voided within 3 months of surgery. During this 5-year observation period 22 (12%) patients experienced voiding problems requiring de-obstructive procedures. Following intervention 177 (98%) patients were spontaneously voiding by 5 years. Of 237 patients 77 (32%) were alive at 10 years. Of these 77 patients followed for another 5 years 10 (13%) had similar voiding problems requiring de-obstructive procedures. Subsequently 74 (96%) were voiding spontaneously by 10 years. CONCLUSIONS: Patients often fail to void spontaneously after ileal bladder substitution. However, if a funnel-shaped outlet is avoided and de-obstructive surgery is appropriately implemented, excellent long-term results are seen with spontaneous voiding and clean intermittent catheterization can be avoided.

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BACKGROUND: This study analyzed the impact of weight reduction method, preoperative, and intraoperative variables on the outcome of reconstructive body contouring surgery following massive weight reduction. METHODS: All patients presenting with a maximal BMI >/=35 kg/m(2) before weight reduction who underwent body contouring surgery of the trunk following massive weight loss (excess body mass index loss (EBMIL) >/= 30%) between January 2002 and June 2007 were retrospectively analyzed. Incomplete records or follow-up led to exclusion. Statistical analysis focused on weight reduction method and pre-, intra-, and postoperative risk factors. The outcome was compared to current literature results. RESULTS: A total of 104 patients were included (87 female and 17 male; mean age 47.9 years). Massive weight reduction was achieved through bariatric surgery in 62 patients (59.6%) and dietetically in 42 patients (40.4%). Dietetically achieved excess body mass index loss (EBMIL) was 94.20% and in this cohort higher than surgically induced reduction EBMIL 80.80% (p < 0.01). Bariatric surgery did not present increased risks for complications for the secondary body contouring procedures. The observed complications (26.9%) were analyzed for risk factors. Total tissue resection weight was a significant risk factor (p < 0.05). Preoperative BMI had an impact on infections (p < 0.05). No impact on the postoperative outcome was detected in EBMIL, maximal BMI, smoking, hemoglobin, blood loss, body contouring technique or operation time. Corrective procedures were performed in 11 patients (10.6%). The results were compared to recent data. CONCLUSION: Bariatric surgery does not increase risks for complications in subsequent body contouring procedures when compared to massive dietetic weight reduction.