Malignant epitheliod hemangioendothelioma of the thyroid: a case report

Primary malignant epithelioid hemangioendothelioma (MEH) of the thyroid is a rare neoplasia with only a few cases reported in the literature. We report a 75 year old man, who presented with a substernal goiter and compressive symptoms. Ultrasonographic evaluation revealed a hypoechogenic nodule in the left lobe, measuring 4.1 cm in maximum diameter, and associated gross calcifications. Fine needle aspiration yielded hemorrhagic material. A left thyroid lobectomy and isthmusectomy was performed. The surgical specimen contained a malignant epithelioid hemangioendothelioma measuring 6 x 4 x 3 cm that had infiltrated about 50% of the thyroidal parenchyma, and surrounded a necrotic nodule. Immunohistochemistry results corroborated the histopathological findings; staining was positive for AE1/AE3, CD31, CD34, factor VIII-related antigen, and Ki-67 expression. Because of the patient’s comorbidities, surgical complementation was not undertaken and he has been undergoing conservative treatment.

From core rigidities to dynamic capabilities: the role of external knowledge. A multiple case study

This study focuses on the processes of change that firms undertake to overcome conditions of organizational rigidity and develop new dynamic capabilities, thanks to the contribution of external knowledge. When external contingencies highlight firms’ core rigidities, external actors can intervene in change projects, providing new competences to firms’ managers. Knowledge transfer and organizational learning processes can lead to the development of new dynamic capabilities. Existing literature does not completely explain how these processes develop and how external knowledge providers, as management consultants, influence them. Dynamic capabilities literature has become very rich in the last years; however, the models that explain how dynamic capabilities evolve are not particularly investigated. Adopting a qualitative approach, this research proposes four relevant case studies in which external actors introduce new knowledge within organizations, activating processes of change. Each case study consists of a management consulting project. Data are collected through in-depth interviews with consultants and managers. A large amount of documents supports evidences from interviews. A narrative approach is adopted to account for change processes and a synthetic approach is proposed to compare case studies along relevant dimensions. This study presents a model of capabilities evolution, supported by empirical evidence, to explain how external knowledge intervenes in capabilities evolution processes: first, external actors solve gaps between environmental demands and firms’ capabilities, changing organizational structures and routines; second, a knowledge transfer between consultants and managers leads to the creation of new ordinary capabilities; third, managers can develop new dynamic capabilities through a deliberate learning process that internalizes new tacit knowledge from consultants. After the end of the consulting project, two elements can influence the deliberate learning process: new external contingencies and changes in the perceptions about external actors.

Comparison between analytical and numerical methods for the assessment of masonry arch bridges: Case study of Clemente Bridge on Savio river

This research has focused on the study of the behavior and of the collapse of masonry arch bridges. The latest decades have seen an increasing interest in this structural type, that is still present and in use, despite the passage of time and the variation of the transport means. Several strategies have been developed during the time to simulate the response of this type of structures, although even today there is no generally accepted standard one for assessment of masonry arch bridges. The aim of this thesis is to compare the principal analytical and numerical methods existing in literature on case studies, trying to highlight values and weaknesses. The methods taken in exam are mainly three: i) the Thrust Line Analysis Method; ii) the Mechanism Method; iii) the Finite Element Methods. The Thrust Line Analysis Method and the Mechanism Method are analytical methods and derived from two of the fundamental theorems of the Plastic Analysis, while the Finite Element Method is a numerical method, that uses different strategies of discretization to analyze the structure. Every method is applied to the case study through computer-based representations, that allow a friendly-use application of the principles explained. A particular closed-form approach based on an elasto-plastic material model and developed by some Belgian researchers is also studied. To compare the three methods, two different case study have been analyzed: i) a generic masonry arch bridge with a single span; ii) a real masonry arch bridge, the Clemente Bridge, built on Savio River in Cesena. In the analyses performed, all the models are two-dimensional in order to have results comparable between the different methods taken in exam. The different methods have been compared with each other in terms of collapse load and of hinge positions.

The Role of Science in Controlling Invasive Species: A Case Study on Wild Pigs

Presentation by Dr. Stephen Ditchkoff.

Value Chain Dynamics and Growth of Local Firms:The Case of Motorcycle Industry in Vietnam

Vietnam’s burgeoning market for motorcycles has attracted global industry eaders,players from developing countries, and local firms. This has led to a dynamic evolution of value chains. This paper presents an explanation of the varieties of the growth patterns xperienced by the local suppliers, focusing on the roles of customer and local supplier strategies. Case studies showed that while the role of customers may be important, strategies of suppliers to improve the ompetitive edge in the production of otorcycle components and to diversify into other products account for important ariations of growth trajectories among local suppliers. Findings presented in this paper suggest the need to direct more attention to strategy that local firms use to boost their competitive edge in business.

Energy- and environmentally efficient road management: The case of the Spanish motorway network

Transport is responsible for 41% of CO2 emissions in Spain, and around 65% of that figure is due to road traffic. Tolled motorways are currently managed according to economic criteria: minimizing operational costs and maximizing revenues from tolls. Within this framework, this paper develops a new methodology for managing motorways based on a target of maximum energy efficiency. It includes technological and demand-driven policies, which are applied to two case studies. Various conclusions emerge from this study. One is, that the use of intelligent payment systems is recommended; and another, is that the most sustainable policy would involve defining the most efficient strategy for each motorway section, including the maximum use of its capacity, the toll level which attracts the most vehicles, and the optimum speed limit for each type of vehicle.

The online case study development for the teaching of building structures reinforcement

The Reinforcement of Building Structures is one of the topics of the Master in Building Innovation Technology (MBIT) of Universidad Politécnica de Madrid (UPM). Since the beginning of the delivery of this master, case studies have been chosen as the teaching methodology. For the 2011-2012 course the online education of this subject was implemented, instead of the classical learning based on attendance. Through ICT’s (Information and Communication Technologies) students are provided with much more and more selective information than through the classical learning. ICT’s can be used for search, enquiries and reporting. Using the online tools has been proved, through the results obtained and based on the surveys made amongst students, to be a successful experience.

Drivers in adopting adaptation strategies to face increased water scarcity in agriculture. A case study in Doñana (Spain) and Makueni (Kenya)

La agricultura es uno de los sectores más afectados por el cambio climático. A pesar de haber demostrado a lo largo de la historia una gran capacidad para adaptarse a nuevas situaciones, hoy en día la agricultura se enfrenta a nuevos retos tales como satisfacer un elevado crecimiento en la demanda de alimentos, desarrollar una agricultura sostenible con el medio ambiente y reducir las emisiones de gases de efecto invernadero. El potencial de adaptación debe ser definido en un contexto que incluya el comportamiento humano, ya que éste juega un papel decisivo en la implementación final de las medidas. Por este motivo, y para desarrollar correctamente políticas que busquen influir en el comportamiento de los agricultores para fomentar la adaptación a estas nuevas condiciones, es necesario entender previamente los procesos de toma de decisiones a nivel individual o de explotación, así como los efectos de los factores que determinan las barreras o motivaciones de la implementación de medidas. Esta Tesis doctoral trata de profundizar en el análisis de factores que influyen en la toma de decisiones de los agricultores para adoptar estrategias de adaptación al cambio climático. Este trabajo revisa la literatura actual y desarrolla un marco metodológico a nivel local y regional. Dos casos de estudio a nivel local (Doñana, España y Makueni, Kenia) han sido llevados a cabo con el fin de explorar el comportamiento de los agricultores hacia la adaptación. Estos casos de estudio representan regiones con notables diferencias en climatología, impactos del cambio climático, barreras para la adaptación y niveles de desarrollo e influencia de las instituciones públicas y privadas en la agricultura. Mientras el caso de estudio de Doñana representa un ejemplo de problemas asociados al uso y escasez del agua donde se espera que se agraven en el futuro, el caso de estudio de Makueni ejemplifica una zona fuertemente amenazada por las predicciones de cambio climático, donde adicionalmente la falta de infraestructura y la tecnología juegan un papel crucial para la implementación de la adaptación. El caso de estudio a nivel regional trata de generalizar en África el comportamiento de los agricultores sobre la implementación de medidas. El marco metodológico que se ha seguido en este trabajo abarca una amplia gama de enfoques y métodos para la recolección y análisis de datos. Los métodos utilizados para la toma de datos incluyen la implementación de encuestas, entrevistas, talleres con grupos de interés, grupos focales de discusión, revisión de estudios previos y bases de datos públicas. Los métodos analíticos incluyen métodos estadísticos, análisis multi‐criterio para la toma de decisiones, modelos de optimización de uso del suelo y un índice compuesto calculado a través de indicadores. Los métodos estadísticos se han utilizado con el fin de evaluar la influencia de los factores socio‐económicos y psicológicos sobre la adopción de medidas de adaptación. Dentro de estos métodos se incluyen regresiones logísticas, análisis de componentes principales y modelos de ecuaciones estructurales. Mientras que el análisis multi‐criterio se ha utilizado con el fin de evaluar las opciones de adaptación de acuerdo a las opiniones de las diferentes partes interesadas, el modelo de optimización ha tenido como fin analizar la combinación óptima de medidas de adaptación. El índice compuesto se ha utilizado para evaluar a nivel regional la implementación de medidas de adaptación en África. En general, los resultados del estudio ponen de relieve la gran importancia de considerar diferentes escalas espaciales a la hora de evaluar la implementación de medidas de adaptación al cambio climático. El comportamiento de los agricultores es diferente entre lugares considerados a una escala local relativamente pequeña, por lo que la generalización de los patrones del comportamiento a escalas regionales o globales resulta relativamente compleja. Los resultados obtenidos han permitido identificar factores determinantes tanto socioeconómicos como psicológicos y calcular su efecto sobre la adopción de medidas de adaptación. Además han proporcionado una mejor comprensión del distinto papel que desempeñan los cinco tipos de capital (natural, físico, financiero, social y humano) en la implementación de estrategias de adaptación. Con este trabajo se proporciona información de gran interés en los procesos de desarrollo de políticas destinadas a mejorar el apoyo de la sociedad a tomar medidas contra el cambio climático. Por último, en el análisis a nivel regional se desarrolla un índice compuesto que muestra la probabilidad de adoptar medidas de adaptación en las regiones de África y se analizan las causas que determinan dicha probabilidad de adopción de medidas. ABSTRACT Agriculture is and will continue to be one of the sectors most affected by climate change. Despite having demonstrated throughout history a great ability to adapt, agriculture today faces new challenges such as meeting growing food demands, developing sustainable agriculture and reducing greenhouse gas emissions. Adaptation policies planned on global, regional or local scales are ultimately implemented in decision‐making processes at the farm or individual level so adaptation potentials have to be set within the context of individual behaviour and regional institutions. Policy instruments can play a formative role in the adoption of such policies by addressing incentives/disincentives that influence farmer’s behaviour. Hence understanding farm‐level decision‐making processes and the influence of determinants of adoption is crucial when designing policies aimed at fostering adoption. This thesis seeks to analyse the factors that influence decision‐making by farmers in relation to the uptake of adaptation options. This work reviews the current knowledge and develops a methodological framework at local and regional level. Whilst the case studies at the local level are conducted with the purpose of exploring farmer’s behaviour towards adaptation the case study at the regional level attempts to up‐scale and generalise theory on adoption of farmlevel adaptation options. The two case studies at the local level (Doñana, Spain and Makueni, Kenya) encompass areas with different; climates, impacts of climate change, adaptation constraints and limits, levels of development, institutional support for agriculture and influence from public and private institutions. Whilst the Doñana Case Study represents an area plagued with water‐usage issues, set to be aggravated further by climate change, Makueni Case study exemplifies an area decidedly threatened by climate change where a lack of infrastructure and technology plays a crucial role in the uptake of adaptation options. The proposed framework is based on a wide range of approaches for collecting and analysing data. The approaches used for data collection include the implementation of surveys, interviews, stakeholder workshops, focus group discussions, a review of previous case studies, and public databases. The analytical methods include statistical approaches, multi criteria analysis for decision‐making, land use optimisation models, and a composite index based on public databases. Statistical approaches are used to assess the influence of socio‐economic and psychological factors on the adoption or support for adaptation measures. The statistical approaches used are logistic regressions, principal component analysis and structural equation modelling. Whilst a multi criteria analysis approach is used to evaluate adaptation options according to the different perspectives of stakeholders, the optimisation model analyses the optimal combination of adaptation options. The composite index is developed to assess adoption of adaptation measures in Africa. Overall, the results of the study highlight the importance of considering various scales when assessing adoption of adaptation measures to climate change. As farmer’s behaviour varies at a local scale there is elevated complexity when generalising behavioural patterns for farmers at regional or global scales. The results identify and estimate the effect of most relevant socioeconomic and psychological factors that influence adoption of adaptation measures to climate change. They also provide a better understanding of the role of the five types of capital (natural, physical, financial, social, and human) on the uptake of farm‐level adaptation options. These assessments of determinants help to explain adoption of climate change measures and provide helpful information in order to design polices aimed at enhancing societal support for adaptation policies. Finally the analysis at the regional level develops a composite index which suggests the likelihood of the regions in Africa to adopt farm‐level adaptation measures and analyses the main causes of this likelihood of adoption.

Acceptance and Commitment Therapy-Based Exposure Treatment of Choking Phobia: A Case Study

One might choke if they observed the lack of research on choking phobia. McNally's (1994) review of the literature on choking phobia found only 25 studies addressing the treatment of choking phobia. The vast majority of these were case studies and none were randomized controlled trials. A search of the literature since then yielded only a few more studies. Given the dearth of information available about choking phobia and its treatment, it is important to document cases treated successfully with novel approaches. My goal in this paper is therefore to illustrate the use of exposure therapy augmented by Acceptance and Commitment Therapy (ACT; e.g., see Hayes, Strosahl, & Wilson, 1999; Hayes and Strosahl, 2004) in the treatment of an adult male presenting with fear of choking and to offer suggestions for the optimal treatment of choking phobia. To my knowledge, there are no documented cases of elements of ACT being used in the treatment of choking phobia to be found in the literature.

Anaerobic Digestion Project Working Guide: A Case Study Analysis and Procedural Summary of Anaerobic Digester Projects for the United States Agricultural Sector

Renewable energy such as biomass has given markets, including dairy farms, an effective approach to reducing the costs of sustaining a profitable business. Anaerobic digestion systems offer dairy farms a very effective way to reduce manure odor, comply with soil and water pollution regulations, manufacture compost for general market sales, produce irrigation capacity and generate on-site electricity as well as the ability to sell excess electricity back to the local utilities. This project defines anaerobic digestion technologies and practices, analyzes case studies and presents a step-by-step anaerobic digestion project startup checklist. The result is an anaerobic digestion project working guide that acts as a tool to aid dairy farmers in their own potential anaerobic digestion project.

The Case Law of the ECJ concerning the Free Provision of Services : 2000 - 2005. Research Papers in Law, 2/2006

Introduction. The present overview covers the period starting from 2000 until the end of 2005.1 This is the follow-up to our overview covering the 1995-1999 period.2 The first striking feature of the present contribution is that it has to deal with almost 3,5 times as many cases as the previous one. Hence, the ECJ has gone from deciding 40 cases in the five year period between 1995- 1999 to deciding over 140 cases based on Art 49 between 2000-2005. This confirms, beyond any doubt, the tendency already observed in our previous overview, that a “third generation” case law on services is being developed at a very rapid pace by the ECJ. This third generation case law is based on the idea that Article 49 EC is not limited to striking down discriminatory measures but extends to the elimination of all hindrances to the free provision of services. This idea was first expressed in the Tourist Guide cases, the Greek and Dutch TV cases and most importantly in the Säger case.3 It has been confirmed ever since. As was to be expected, this broad brush approach of the Court’s has led to an ever-increasing amount of litigation reaching Luxemburg. It is clear that, if indicators were used to weight the importance of the Court’s case law during the relevant period, services would score much higher than goods, both from a quantitative and from a qualitative perspective.4 Hence, contrary to the previous overview, this one cannot deal in detail with any of the judgments delivered during the reference period. The aim of the present contribution is restricted to presenting the basic trends of the Court’s case law in the field of services Therefore, the analysis follows a fundamentally horizontal approach, fleetingly considering the facts of individual cases, with a view to identifying the conceptual premises of the Court’s approach to the free movement of services. Nonetheless, the substantial solutions adopted by the Court in some key topics, such as concession contracts, healthcare services, posted workers and gambling, are also presented as case studies. In this regard, the analysis is organized in four sections. First we explore the (ever expanding) scope of the freedom to provide services (Section 2), then we go on to identify the nature of the violations and of justifications thereto (Section 3), before carrying out some case studies to concretely illustrate the above (Section 4). Then, for the sake of completeness, we try to deduce the general principles running through the totality of the relevant case law (Section 5). Inevitably, some concluding remarks follow (Section 6).5

The Composition and Drivers of Energy Prices and Costs in Energy-Intensive Industries: The Case of Ceramics, Glass and Chemicals. CEPS Special Report No. 85, 27 March 2014

In May 2013, the European Commission received a mandate from the European Council to “to present an analysis of the composition and drivers of energy prices and costs in Member States, with a particular focus on the impact on households, SMEs and energy intensive industries, and looking more widely at the EU's competitiveness vis-à-vis its global economic counterparts”. Following such mandate and in view of the preparation by the Commission of a Communication and a Staff Working Document, DG Enterprise and Industry commissioned CEPS to carry out a set of studies aimed at providing well-grounded evidence about the evolution and composition of energy prices and costs at plant level within individual industry sectors. A team of CEPS researchers conducted the research, led by Christian Egenhofer and Lorna Schrefler. Vasileios Rizos served as Project Coordinator. Other CEPS researchers contributing to the project included: Fabio Genoese, Andrea Renda, Andrei Marcu, Julian Wieczorkiewicz, Susanna Roth, Federico Infelise, Giacomo Luchetta, Lorenzo Colantoni, Wijnand Stoefs, Jacopo Timini and Felice Simonelli. In addition to an introductory report entitled “About the Study and Cross-Sectoral Analysis”, CEPS prepared five sectoral case studies: two on ceramics (wall and floor tiles and bricks and roof tiles), two on chemicals (ammonia and chlorine) and one on flat glass. Each of these six studies has been consolidated in this single volume for free downloading on the CEPS website. The specific objective was to complement information already available at macro level with a bottom-up perspective on the operating conditions that industry stakeholders need to deal with, in terms of energy prices and costs. The approach chosen was based on case studies for a selected set (sub-)sectors amongst energy-intensive industries. A standard questionnaire was circulated and respondents were sampled according to specified criteria. Data and information collected were finally presented in a structured format in order to guarantee comparability of results between the different (sub-)sectors analysed. The complete set of files can also be downloaded from the European Commission’s website: http://ec.europa.eu/enterprise/newsroom/cf/itemdetail.cfm?item_id=7238&lang=en&title=Study-on-composition-and-drivers-of-energy-prices-and-costs-in-energy-intnsive-industries The results of the studies were presented at a CEPS Conference held on February 26th along with additional evidence from other similar studies. The presentations can be downloaded at: http://www.ceps.eu/event/level-and-drivers-eu-energy-prices-energy-inten...

Evaluation and system description of ASAP judicial systems. Volume II: Puerto Rico case study. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Evaluation and system description of ASAP judicial systems. Volume III: Idaho case study. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Evaluation and system description of ASAP judicial systems. Volume IV: Hennepin County, Minnesota, case study. Final report.

National Highway Traffic Safety Administration, Washington, D.C.