INTRODUCTION: The treatment of chronic intramedullary infection of the long bones relies on microbe-specific antibiotics in conjunction with surgical removal of infected necrotic material. We discuss the use of reamer-irrigator-aspirator(RIA) for debridement of the intramedullary canal instead of conventional reaming techniques. This is the first case report to explore the use of RIA for osteomyelitis. CASE REPORT: We discuss the use of the RIA in treatment of a 26-year-old female presenting with chronic osteomyelitis of the left distal femoral shaft. She had normalization of infection laboratories at 6 weeks and complete resolution of symptoms at 3 months and was released at 6 months. CONCLUSION: Recent exploration of the RIA system's (Synthes®, Inc. West Chester, Philadelphia) multipurpose applications has indicated use in long bone debridement. While further exploration and high-quality studies are needed to make robust claims of efficacy, we believe that the use of RIA in the context of chronic osteomyelitis is a superior alternative to conventional reaming techniques.

The effects of energy balance on hormonal patterns and recovered oocytes were evaluated in 20 lactating Holstein cows during two trial periods (fall/spring). Cows were randomly selected and assigned to one of two dietary treatments formulated so that cows consumed 3.6% BW (HE- 1.78 mcal/kg; n=6 in fall, n=5 in spring) and 3.2% BW (LE-1.52 mcal/kg; n= 5 in fall, n=4 in spring). Body weight and body condition score (BCS) were recorded prior to parturition and weekly throughout the fall trial. Ultrasound guided transvaginal follicular aspirations were conducted twice weekly between d 30 and 100 of lactation. Follicle size and number were recorded. Follicular fluid (FF) was aspirated from the largest follicle, and serum samples were collected for hormone assay (IGF-1; estradiol (E2); progesterone (P4, serum ); LH and FSH). Oocytes were collected and graded based upon cumulus density and ooplasm homogeneity, then fertilized and cultured in vitro. Milk yield averaged 41.64 ± .3 kg/d (mean ± SE) for HE and 32.8 ± .3 kg/d for LE. There was a significant cubic day postpartum by treatment interaction for milk yield. Dry matter intake and BW treatment by week interactions were significant for the cubic and linear components, respectively. Oocyte numbers increased linearly from d 30 to 100 postpartum. HE cows produced more good + oocytes (1.5 ± .2 ) than LE cows (1.4 ± .1). Follicles less than or equal to 5 mm predominated throughout the study (6.4 ± 3.0). However, greater numbers of follicles 10 to 14 mm and greater than or equal to 15 mm were found in the fall (1.98 ± .08 and .50 ± .06) than spring (1.11 ± .3 and .23 ± .07). Follicular fluid IGF-1 was higher in HE (2.3 ± .2 ng/ml) than in LE cows (1.6 ± .2 ng/ml). Mean basal serum FSH concentration was lower at 28 d postpartum (173 ± 8 pg/ml) compared to later (521 ± 25 at d 60 and 650 ± 25 pg/ml at d 110). Serum P4 peaked at 35 d postpartum, with HE cows having 1 ng/ml higher P4 than LE cows. Low dietary energy reduced milk yield, DMI, BCS, FF IGF-1 and serum P4 and had a negative impact on oocyte quality. / Master of Science

The development of oocytes of differing quality retrieved using transvaginal follicular aspiration (TVFA) and following DNA injection was examined. Eight cows were subjected to twice weekly TVF A for 16 wk. Oocytes retrieved were graded and placed in an in-vitro maturation, fertilization and co-culture (IVMIIVFIIVC) program. Two thirds of oocytes were injected with DNA. Good quality oocytes from slaughtered cows (SH) were obtained once monthly and processed the same way. Good quality TVF A oocytes had a higher mean development score than poor quality oocytes, but not different from that of good quality SH oocytes. Good quality TVF A oocytes produced more viable embryos (31.7% blastocysts) than poor quality oocytes or SH oocytes (12.8% and 20.4% blastocysts, respectively). Embryo development following injection of DNA was the same for oocytes for each source-quality group (TVF A-good, 8.4; TVF A-poor, 5.5; SH-good, 6.3 % blastocysts). Development of good quality TVFA oocytes increased during the last 9 wk of the 16 wk collection period. Poor oocyte development increased slightly to 9 wk and then decreased. Development of TVF A oocytes injected with DNA did not vary during the experiment. However, development of controls increased from a mean score of2.50 at wk 1 to 4.17 at wk 16. Oocytes from TVFA produced more PCR positive blastocysts (95.0%) than SH oocytes (61.5%). More calves were born from the transfer of embryos injected with DNA from TVF A oocytes (3/5) than from SH oocytes (116), although not statistically significant. One calf was PCR positive in bone-marrow, but was negative in other tissues. The use of oocytes obtained by TVF A may improve the efficiency of producing transgenic cattle. / Master of Science

This thesis argues for a reformulated concept of nationality in order to avoid the problem of multiple national identities, which Lior Erez has shown to constitute a severe problem for the theory of liberal nationalism. At first, the problem’s plausibility is through idékritik, finding aspects of self-determination at its core. Thereafter, through a process of reflective equilibrium, the thesis concludes that the inclusion of Margaret Moore’s criterion of political aspiration, together with Ludvig Beckman’s all-affected principle, would avoid the problem. The thesis thereby highlights nationalism’s relationship to questions of self-determination, -rule, and sovereignty, a domain of nationalism that seems to be hitherto undertheorized.

Att bestämma långsiktiga mål är en livslång process som påverkar hur en person styr sitt liv och strävar efter olika mål. Studien undersöker sambandet mellan individens långsiktiga mål och personlighetsfaktorer, med fokus på Self-Determination Theory som ram. 234 svenska universitetsstudenter besvarade en enkät som inkluderade fem bakgrundsfrågor, Big Five Inventory och Aspiration Index. Majoriteten av deltagarna var kvinnor (n=184 %=78.6). Resultaten analyserades för att undersöka hur personlighetsdimensionerna samt bakgrundsvariablerna korrelerar med sju delar av långsiktiga mål. Det utfördes Pearsons korrelations test och sju separata hierarkiska regressionsanalyser. Resultatet visade att vissa delar av personlighetsdimensionerna hade en relation till samtliga livsmålen. Resultaten indikerar att Utåtriktning och Emotionell instabilitet korrelerar med yttre strävan, medan Vänlighet, Samvetsgrannhet och Öppenhet relaterar till inre strävan. En observation var hur faktorerna kön och ålder påverkade individers långsiktiga livsmål. Sammantaget bidrar denna studie till en fördjupad insikt om kopplingen mellan Big Five dimensionerna, bakgrundsfaktorer och individens långsiktiga livsmål.

Aims: The purpose of this thesis was to synthesize the current literature on alpha amylase as an emerging biomarker of microaspiration in mechanically ventilated patient. Methods: The methodology included a review and synthesis of pertinent research articles from 1981-2018, written in English language. Criteria for inclusion in the review were all articles that evaluated α- amylase in tracheal secretions or bronchoalveolar lavage fluid (BAL) as a diagnostic tool for identifying microaspiration. The search yielded 11 studies that were reviewed. Findings: The findings suggest that once aspiration occurs, the duration of α-amylase in the lungs requires further exploration to assist in interpretation of positive values. After these values are identified they need be used consistently used throughout practice of mechanically ventilated patients. Inconsistencies in the defining parameters of α-amylase were used with the thirteen studies. Conclusion: Testing amylase levels can require financial stability, standardized training, and timeliness of collecting the specimen. Alpha-amylase is a biomarker of microaspiration. Further research should be conducted to evaluate the biomarker capabilities of α-amylase to assist in early identification and/or prevention of microaspiration in mechanically ventilated patients. Implications for nursing policy practice, education, and considerations for upcoming research of α-amylase were reviewed with limitations to the study.

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