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pneumonia case study Department of Pediatrics, University of Hawaii John A. Burns School of Medicine. Chapter VI.11. Divorce Yourself Long After? Pulmonary Infections. Return to Table of Contents. A previously healthy 4 year old boy is brought to Help, an urgent care center by divorce papers after, his mother for difficulty breathing for one day. Three days prior he had developed a runny nose, cough, and Teach five essay, low grade fevers with a temperature maximum of 101 degrees F (38.3 degrees C). He continued to take liquids well, but his solid intake has decreased. His temperature this morning was 103 degrees F (39.4 degrees C) and Filing divorce after, he was breathing fast and working hard to breathe. Best Essays Online? He does not have any ill contacts. He has never been hospitalized or had any surgeries.

He was born at term without any complications. He is not taking medications other than acetaminophen. His immunizations are up to date for Filing divorce papers long after his age (except he had not received the college entrance pneumococcal conjugate vaccine). Filing Divorce Long After? His parents and 10 year old sister are healthy and the remainder of his family history is non-contributory. There are no smokers in the household, and uk, he has not traveled recently. He does not have a history of choking or vomiting. He has not had frequent ear or skin infections. He does not have a history of foul-smelling stools.

Exam: VS T 40 degrees C (104 degrees F), P 130, RR 40, BP 100/70, oxygen saturation 87% in room air. His height and weight are in the 50th percentile for his age. He is awake and alert, in moderate distress. Papers After? His conjunctiva and Best college entrance essays online, TMs are normal. His nasal mucosa is erythematous with yellowish discharge. His lips and mucous membranes are dry. His neck is supple, with several small anterior cervical lymph nodes.

Lungs: Moderate subcostal, intercostal, and supraclavicular retractions, symmetric expansion, dullness to percussion at the right base, increased vocal fremitus over the right base, decreased air entry over right lower lobe with crackles, no wheezes. Heart: Tachycardia, regular rhythm without murmur. Pulses are 2+, and yourself long, capillary refill time is 3 seconds. His abdomen, skin, and neurological examinations are unremarkable. CBC WBC 20,000, 70% segs, 11% bands, 15% lymphs, 3% monos, 1% eos. Hemoglobin 12.4, platelet count 280,000. Chest x-ray (CXR): Right lower lobe opacity consistent with a round pneumonia (technically air/space disease, commonly called infiltrates by most physicians). Because of the hypoxia, he is given supplemental oxygen (with subsequent improvement in oxygen saturation), as hospitalization arrangements are made. A 20 cc/kg infusion of normal saline was given through an intravenous (IV) line and then maintenance fluids are started. A blood culture is obtained and How to write review, he is started on IV cefuroxime. He improves over the next day.

His respiratory distress slowly resolves and Filing divorce after, he is weaned off supplemental oxygen over the next two days. His blood culture shows no growth. He is discharged home on high dose amoxicillin for a total of 10 days of therapy. Writing? His discharge diagnosis is probably pneumococcal pneumonia. Acute childhood respiratory infections cause significant morbidity and mortality worldwide. Mortality is high in developing countries with up to papers, one-third of Report writing pay low, deaths in children less than 5 years caused by acute respiratory infections (ARI) (1). Filing? The disparity in mortality is due to the severity of infection (perhaps due to differences in an opinion for college, nutrition, overall health, immunization practices, and medical care availability) since the incidence of acute respiratory infections is similar between developed and after, developing countries with infants experiencing about 4-8 episodes per year (1). In the How to for college US, mortality from ARIs has declined since 1968 (1,2). There are 2 basic classification systems used for Filing divorce papers yourself long after acute respiratory tract infections: the case-management classification system used by the World Health Organization (WHO) and the traditional clinical classification system (1). The case management system divides ARIs by symptoms (i.e., stridor, wheezing, and no wheezing) and their severity (i.e., mild, moderate, severe, and very severe). Five Paragraph Essay? The traditional system classifies ARIs by upper respiratory tract infections (e.g., acute otitis media, pharyngitis), middle respiratory tract infections (e.g., croup and epiglottitis), and Filing papers yourself, lower respiratory tract infections (e.g., bronchiolitis, bronchitis, pneumonia).

Therefore, studies evaluating ARIs are not uniform and use different definitions from clinical findings alone to clinical findings in combination with other various ancillary tests (e.g., chest radiography). Of the acute respiratory infections, pneumonia has the highest mortality rate accounting for approximately 70% of the worldwide 4.5 million deaths from acute respiratory infections (4). Pay Low? Although mortality from pneumonia in children in the United States has declined by 97% between 1939 and 1996 (5), pneumonia continues to be a leading cause of morbidity in children. The risk of acquiring pneumonia is highest in children less than 5 years of age (1). The etiology of pneumonia varies and depends on: the age of the child, where the pneumonia was acquired (i.e., community vs. nosocomial), local epidemiology (e.g., influenza epidemics), host factors (e.g., immunologic status, recent or intercurrent antibiotic use, vaccination, and overall health status of the child), and environmental factors (e.g., travel, season of the year, daycare, or crowded living conditions) (4,6-9). Determination of the Filing divorce yourself long precise etiology of pneumonia often requires invasive testing (e.g., lung biopsy), and therefore, this is done infrequently. Rather the etiology of pneumonia is usually based on generalizations in the relevant clinical setting. In the neonatal period, the most common cause of bacterial pneumonia is group B beta-hemolytic streptococci (GBS) and gram negative enteric bacilli (e.g., E.coli), the article same organisms associated with neonatal sepsis (4). In infants and Filing papers yourself long after, children outside of the neonatal period, viruses are the most common cause of pneumonia (4,6,10-11) and respiratory syncytial virus (RSV) is one of the most common causes in infancy, especially in premature infants (9,12).

Of the bacterial pathogens, Streptococcus pneumoniae (pneumococcus) occurs most frequently (6,9,11,13); however, the speeches studies isolating S. pneumoniae were performed prior to the licensure of the divorce papers yourself long after pneumococcal conjugate vaccine (6). Outcome analysis of the 7-valent pneumococcal conjugate vaccine demonstrated that up to 33% of chest radiograph confirmed pneumonia were prevented in immunized patients compared to those who were not immunized (14). Therefore, a different bacterial pathogen may supersede S. pneumoniae as the most common cause of bacterial pneumonia in the coming years. How To Write? Other organisms to consider are Chlamydia trachomatis in infants 3-19 months of age (4) and Mycoplasma and Chlamydia pneumoniae in children and adolescents (8-9,11-12). In special cases, for example, patients with neuromuscular impairment and impaired swallowing, aspiration pneumonia with anaerobic bacteria should be considered (15). The etiology of pneumonia varies in divorce papers yourself after, other conditions including immunosuppressed patients, nosocomial infections, cystic fibrosis patients, and anatomic airway anomalies (e.g., tracheostomies). In addition, the etiology of pneumonia is complicated since mixed infections (e.g., viral-bacterial) can occur in 16-34% of patients (7,11,13). The lower respiratory tract in healthy persons is sterile (16). College Entrance Essays? Bacteria access the papers yourself respiratory tract by inhalation, microaspiration, or by hematogenous spread. An Opinion Paper For College History? If bacteria gain access to alveoli, host immunologic systems begin to work on eliminating bacteria.

There are 2 major mechanisms by which lung defenses work to keep the airways sterile: physical defenses (i.e., mucociliary clearance and lymphatic drainage) and mechanisms that destroy bacteria (i.e., opsonization, specific immunoglobulin G antibody (IgG), alveolar macrophage ingestion, or complement mediated bacterial lysis) (17). If these mechanisms fail, polymorphonuclear leukocytes (PMNs) are recruited with a resultant inflammatory response. Perpetuation of this inflammatory response leads to pneumonia. There are 4 major histologic steps seen in pneumococcal pneumonia described by divorce after, Tuomanen, et al (18): engorgement, red hepatization, grey hepatization, and resolution. Engorgement is associated with presence of bacteria in the alveoli and an associated serous exudate. This then progresses to red hepatization secondary to leakage of erythrocytes into the alveoli. The next phase, grey hepatization, results from leukocyte migration to on writing, the affected area with intravascular fibrin deposition disrupting perfusion to the area. The final phase results in resolution, with phagocytosis of pneumococci and clearance of fibrin and other debris.

Outside of the Filing divorce yourself long after neonatal period, pneumonia is college entrance online, suspected in patients with clinical signs and after, symptoms suggestive of impairment of the lower respiratory tract. Distinguishing bacterial from other causes of pneumonia cannot be accomplished by write an opinion paper, clinical findings alone (7). Symptoms of pneumonia are nonspecific and include: fever, ill appearance, cough, fatigue, decreased appetite and sometimes, abdominal pain. Signs of lower respiratory tract involvement include: tachypnea (greater than 50 breaths/minute in children less than 12 months, and greater than 40 breaths/minute for older children) (4), cyanosis, increased work of breathing (i.e., use of accessory muscles, grunting), pleuritic pain, and abnormal auscultatory findings. These signs do not differentiate a viral from bacterial process.

A chest radiograph is used to verify the clinical suspicion of pneumonia and characterize the disease process, but may not be performed on every patient. Viral respiratory tract infections are often associated with hyperinflation, perihilar peribronchial infiltrates, segmental or lobar atelectasis, and hilar adenopathy (19). Lobar consolidation and fluffy alveolar infiltrates with air bronchograms are more characteristic of bacterial infection (13). Filing Papers Yourself After? However, there is overlap between these two groups (13). Computed tomography and ultrasound of the chest are used in Report pay low, special circumstances (e.g., evaluate for pleural effusion, adenopathy, improved imaging of lung architecture) but these are not routinely obtained (4). Filing Divorce Yourself? Commonly used screening laboratory tests such as white blood cell count with differential, erythrocyte sedimentation rate (ESR), and the C-reactive protein (CRP) are not accurate in differentiating between bacterial, viral, mixed, or idiopathic causes of childhood pneumonia (7). Determination of precise etiology of pneumonia is difficult due to the lack of sensitive and specific tests. Many clinicians treat pneumonia empirically with minimal laboratory or radiographic evaluation and thus up to 80% of Teach paragraph essay, non-bacterial pneumonia may be treated with antibiotics (6). This approach is satisfactory when clinical risk is deemed to be low.

When a more precise diagnosis is required, more invasive techniques are required. Bacteria found in the blood, pleural fluid (thoracentesis), or lung tissue is considered diagnostic in a patient presumed to have pneumonia (4). Blood cultures are only positive in 1-8% of pneumonia (11) but continue to be recommended (4). Some question the Filing papers yourself long necessity of blood culture after cost-based analyses (6, 11). Transthoracic needle aspirates, transtracheal aspirates, and essays online, open lung biopsy (the gold standard for Filing long after diagnosis) are rarely performed due to the risk involved for these procedures (11,20), except in severe cases or in immunocompromised hosts (4).

Sputum is often contaminated with organisms unrelated to the specific etiology (16) and is difficult to obtain in Essay writing service, children less than 8 years old (4). A sputum sample that may be helpful is Filing long, characterized by many polymorphonuclear cells and Help speeches, a bacteria of single morphology on gram stain (4). Filing Yourself Long After? Bronchoalveolar lavage from bronchoscopy is difficult to Teach five, interpret as well. The results are non-specific (i.e., higher neutrophil counts than lymphocyte counts in Filing divorce long, patients with infection) and the organism found may or may not be the etiologic agent (16). Teach Essay? Bacterial serology and bacterial antigen testing are often difficult to papers long after, interpret (4,6). Bacterial cultures of the nasopharynx or throat correlate poorly with lung tissue cultures and on writing, are not helpful in establishing a diagnosis (16). Specific viral antigen testing, along with cultures for suspected pathogens, serologies for Mycoplasma and Chlamydia, and PPD skin testing for tuberculosis may be helpful (6).

Pneumonia is treated with antimicrobials when the clinical suspicion for bacterial etiology is high. Greater pneumonia severity and findings that are consistent with bacterial pneumonia (e.g., lobar consolidation, leukocytosis, high fever) are more likely to warrant antimicrobial treatment. Young infants, unreliable parents, poor access to yourself long after, medical care, and more severe infections often require hospitalization. College Entrance Online? Treatment of pneumonia is often empirically based and thus, information on Filing divorce antibiotic resistance patterns and mechanisms of resistance is write article, important to determine the most appropriate treatment. Filing Divorce Papers Long After? For S. pneumoniae, the most common mechanism of resistance to penicillins is Help, alteration of penicillin-binding sites that can be overcome with higher doses of the drug (6). Filing Divorce Yourself Long? For macrolides, alteration to the 50S ribosomal binding site of the macrolide inhibits binding of the antibiotic and thus, prevents protein synthesis inhibition (6). Help On Writing Speeches? In addition, there is also an increase in Filing divorce papers after, efflux pumps for macrolides and writing, this property can be overcome by using macrolides that achieve high tissue concentrations at the site of infection (e.g. azithromycin) (6). Penicillin resistant pneumococci are often resistant to multiple drugs including macrolides and trimethoprim-sulfamethoxazole (21). Therefore, high-dose amoxicillin and/or azithromycin are recommended for empiric treatment of community-acquired pneumonia in children (6,8-9,11-12,20). Some clinicians will use clinical factors and ancillary tests in papers, aggregate such as age, exposures, CXR pattern, fever, and leukocytosis, to stratify the risk to favor pneumococcus (high dose amoxicillin would be better) or Mycoplasma/Chlamydia (macrolide would be better). For those children requiring hospitalization, a second or third generation cephalosporin, occasionally in combination with a macrolide, is generally recommended (8,20).

Most treatment regimens are continued for a total of 7-14 days although this is based on little evidence (4). Pneumonia due to Staphylococcus aureus is uncommon, but particularly severe. S. aureus pneumonia usually results from inhalation of organisms, but it may also occur in patients with a cutaneous source (e.g., impetigo, boils, abscesses) with hematogenous spread or staphylococcal bacteremia from another source (e.g. osteomyelitis, central line infection). If S. aureus pneumonia is suspected, vancomycin should be started empirically. Culture and Report, sensitivity data permits changing to an alternate antibiotic later. Yourself After? Pleural effusion (empyema), pneumothorax, and pneumatoceles often complicate S. aureus pneumonia. Pleural effusions can be classified in several ways. They can be a transudate or an exudate based on their protein content. A subpulmonic effusion versus an empyema is more clinically relevant. The former implies a transudate which is usually sterile, while the for college term empyema is usually used to describe pus (purulent exudate) with a positive gram stain and culture.

The overall outcome in children with pneumonia is excellent. The majority of children will recover without complications (11). Follow up chest radiographs are not required routinely, but should be performed for patients with complicated pneumonia, persistent respiratory problems, pleural involvement, and neonates (4,22). About 80% of infiltrates on CXR will resolve by 3-4 weeks and the remainder will usually resolve by 3 months (22). Recurrent pneumonia with radiologic clearance between episodes requires further evaluation (e.g., immunodeficiencies, gastroesophageal reflux, pulmonary anomalies, etc.) (4). Bronchiolitis is the leading cause of hospitalization for respiratory tract infections in young children (4,23-25). Respiratory syncytial virus (RSV) is the primary cause of bronchiolitis, but parainfluenza virus, human metapneumovirus, and adenovirus may also cause bronchiolitis (23-24). In the United States, the majority of RSV infections occur during the Filing yourself long after months of November to March (4,23).

RSV infections account for How to article essay a significant amount of morbidity and health care expense in the young age group (24). RSV is transmitted by direct contact with large droplets or fomites. Transmission can be limited by good handwashing (23). Filing Divorce Papers Yourself Long After? RSV bronchiolitis results from the speeches spread of RSV to the lower respiratory tract after an incubation period 2-8 days where the virus undergoes replication in the nasopharynx (23). Filing Divorce Papers Yourself Long? The infection results in infiltration of the paragraph respiratory epithelium with resultant inflammation and necrosis, sloughing of the epithelium and increased mucus production causing airflow limitation in the small airways leading to the hallmarks of the disease (23). Divorce Long After? Thus, affected infants have signs of airflow limitation including hyperinflation, atelectasis, and wheezing. The diagnosis is speeches, often made on clinical grounds during the RSV season. Diagnostic testing can be done by immunofluorescence and enzyme-linked immunoabsorbent assay (ELISA) tests if the diagnosis is unclear. Divorce Papers? Therapy is often supportive which may include: supplemental oxygen, fluids, and speeches, upright positioning.

Aerosolized ribavirin is the only known proven therapy for RSV infection, but its expense, potential toxicity, difficulty of administration, and lack of papers yourself, conclusive evidence for Report writing pay low its efficacy (24,26) limit its use. Filing Divorce Yourself? The use of bronchodilators and on writing, corticosteroids are controversial and may only be mildly effective at best (i.e., not been proven to be highly efficacious) (24-26). For those with moderate to Filing divorce papers long, severe disease, helium-oxygen mixtures or nasal continuous positive airway pressure may be beneficial in improving gas-exchange and symptomatology (27-30). Montelukast, a leukotriene antagonist, has recently been reported to make a difference in canada uk, future wheezing episodes (31). Prophylaxis with palivizumab (RSV monoclonal antibody) or RSV-IVIG is given to Filing yourself, select pediatric populations recommended by the American Academy of Pediatrics during RSV season to reduce RSV infection risk (32). How To Write Article? Growing premature infants and infants with congenital heart disease and other chronic lung conditions are at increased risk for RSV pneumonia, apnea and respiratory failure. Healthy term infants with RSV usually develop mild bronchiolitis. Older children, teens and adults with RSV will usually have cold symptoms. Bronchiolitis is Filing after, usually a self limited disease and complete resolution takes about 4-8 weeks. In neonates and young infants, bronchiolitis may present with apnea and minimal respiratory symptoms, but the apnea is usually short-lived (33).

Although bronchiolitis self-resolves, patients with RSV bronchiolitis may be predisposed to future episodes of for college history, wheezing (34). RSV infection can recur since there is an papers, incomplete and poorly sustained immune response (23). In summary, bronchiolitis and pneumonia significantly impact the pediatric population. Essay Uk? Determining likely etiologies of pneumonia and understanding effective treatment modalities will improve patient outcomes. Acknowledgments: I would like to after, thank Edward Fong, MD, Leslie Barton, MD and John Mark, MD for their critical review of the on writing speeches chapter. 1. Which of the following is the Filing divorce papers long most common cause of pneumonia outside of the Report neonatal period? 2. S. pneumonia resistance to penicillins is due to: . . . . . a. Production of beta-lactamase. . . . . . Divorce After? b. Alteration of penicillin binding proteins. . . . . . c. Increased efflux pumps.

. Best College Online? . . . . d. Filing Papers After? Low tissue bioavailability. 3. Report Writing? True/False: Nasopharyngeal and throat cultures are useful in Filing yourself after, determining etiology of How to essay, bacterial pneumonia. 4. Divorce Yourself Long After? True/False: Lobar consolidation on chest x-ray provides conclusive evidence for Report writing bacterial pneumonia. 5. Which factor does not appear to affect the etiology of pneumonia? . . . . . b. Vaccination status. . . Divorce Papers Yourself Long After? . . . c. Current antibiotic use. 6. The most common cause of bronchiolitis is: . . . . . a. Respiratory syncytial virus.

. . . . . Best College? b. Human Metapneumovirus. 7. Filing Divorce Long After? True/False: Bronchiolitis may initially present with apnea and minimal respiratory symptoms. 8. Teach Paragraph? Treatment of bronchiolitis should include all of the following except: a. Supplemental oxygen for infants with hypoxia. b. Intravenous fluids and close monitoring of nutritional status. c. Good handwashing. d. Antibiotics. 9. True/False: Corticosteroids and bronchodilators are highly efficacious therapies for RSV bronchiolitis. Pneumonia case presenting with abdominal pain: Yamamoto LG. Abdominal Pain with a Negative Abdominal Examination. In: Yamamoto LG, Inaba AS, DiMauro R (eds). Radiology Cases In Pediatric Emergency Medicine, 1994, volume 1, case 3. Available online at: www.hawaii.edu/medicine/pediatrics/pemxray/v1c03.html. Staph pneumonia case: Yamamoto LG, Young LL. Tachypnea and Abdominal Pain.

In: Yamamoto LG, Inaba AS, DiMauro R (eds). Radiology Cases In Pediatric Emergency Medicine, 1995, volume 2, case 5. Available online at: www.hawaii.edu/medicine/pediatrics/pemxray/v2c05.html. Series of pediatric chest radiographs: Yamamoto LG. Test Your Skill In Reading Pediatric Chest Radiographs. In: Yamamoto LG, Inaba AS, DiMauro R (eds). Radiology Cases In Pediatric Emergency Medicine, 1995, volume 3, case 20. Yourself After? Available online at: www.hawaii.edu/medicine/pediatrics/pemxray/v3c20.html.

Another series of pediatric chest radiographs: Yamamoto LG. Test Your Skill In Reading Pediatric Chest Radiographs. Best College Entrance? In: Yamamoto LG, Inaba AS, DiMauro R (eds). Radiology Cases In Pediatric Emergency Medicine, 1996, volume 4, case 5. Available online at: www.hawaii.edu/medicine/pediatrics/pemxray/v4c05.html. 1. Graham NMH. The Epidemiology of divorce after, Acute Respiratory Infection in Children and write article essay, Adults: A Global Perspective. Epidemiol Rev 1990;12:149-178. 2. National Center for Health Statistics. National Vital Statistics report (www.cdc.gov) 2001;49(1):14. 3. Dixon RE.

Economic Costs of Respiratory Tract Infections in the United States. Am J Med 1985;78(6B): 45-51. 4. After? Miller MA, Ben-Ami T, Daum RS. Chapter 39-Bacterial Pneumonia in How to essay, Neonates and Older Children. In: Taussig LM, Landau LI (eds). Pediatric Respiratory Medicine, first edition. 1999, St.

Louis: Mosby, pp. 595-664. 5. Dowell SF, Kupronis BA, Zell ER, Shay DK. Mortality From Pneumonia in Children in the United States, 1939 Through 1996. N Engl J Med 2000;342(19):1399-1407. 6. Bradley JS. Management of Community-Acquired Pediatric Pneumonia in an Era of Increasing Antibiotic Resistance and Conjugate Vaccines. Pediatr Infect Dis J 2002;21(6):592-598. 7. Nohynek H, Valkeila E, Leinonen M, Eskola J. Erythrocyte Sedimentation Rate, White Blood Cell Count and Serum C-reactive Protein in Assessing Etiologic Diagnosis of Acute Lower Respiratory Infections in Children. Pediatr Infect Dis J 1995;14(6): 484-490.

8. Nelson J. Community-Acquired Pneumonia in Children: Guidelines for Treatment. Divorce Papers Yourself Long After? Pediatr Infect Dis J 2000;19(3):251-253. 9. Heiskanen-Kosma T, Korppi MN, Jokinen C, et al. Etiology of Essay service uk, Childhood Pneumonia: Serologic Results of a Prospective, Population-Based Study. Pediatr Infect Dis J 1998;17(11):986-991. 10. McIntosh K. Community-Acquired Pneumonia in Children. N Engl J Med 2002;346(6);429-437. 11.

Ruuskanen O, Mertsolon J. Childhood Community-Acquired Pneumonia. Sem Resp Infect 1999;14(2):163-172. 12. McCraken, GH Jr. Filing? Etiology and Treatment of How to write, Pneumonia. Pediatr Infect Dis J 2000;19(4):373-377. 13.

Korppi M, Kiekara O, Heiskanen-Kosma T, Soimakallio S. Comparison of Filing divorce papers, Radiological Findings and Microbial Aetiology of write an opinion for college, Childhood Pneumonia. Filing Divorce Long After? Acta Paediatr 1993;82: 360-363. 14. How To Write Article? Overturf GD, Committee on Infectious Diseases, American Academy of Pediatrics. Technical Report: Prevention of Pneumococcal Infections, Including the Use of Pneumococcal Conjugate and Polysaccharide Vaccines and Filing divorce papers long, Antibiotic Prophylaxis. How To? Pediatrics 2000;106(2):367-376. 15. Brook I, Finegold SM. Bacteriology of Aspiration Pneumonia in Children.

Pediatrics 1980;65(6):1115-1120. 16. Laurenzi GA, Potter RT, Kass EH. Bacteriologic Flora of the Lower Respiratory Tract. N Engl J Med 1961;265:1271-1278. 17. Green GM, Kass EH.

The Role of the Alveolar Macrophage in the Clearance of Bacteria from the yourself Lung. J Exp Med 1964;119:167-175. 18. Tuomanen EI, Austrian R, Masure HR. Pathogenesis of Pneumococcal Infection. Paper For College History? N Engl J Med 1995(19);332:1280-1284. 19. Divorce Papers? Wildin SR, Chonmaitree T, Swischuk LE. Roentgenographic Features of Common Pediatric Viral Respiratory Tract Infections.

Am J Dis Child 1988;142:43-46. 20. Hart CA, Duerden BI. Respiratory Infections. J Med Microbiol 2002;51:903-914. 21. Whitney CG, Farley MM, Hadler J, et al. Increasing Prevalence of Multidrug-Resistant Streptococcus Pneumoniae in the United States. N Engl J Med 2000;343(26):1917-1924. 22. Grossman LK, Wald ER, Nair P, Papiez J. Report Writing Pay Low? Roentgenographic Follow-Up of Acute Pneumonia in Filing divorce long after, Children.

Pediatrics 1979(1);63:30-31. 23. Write Article? Hall CB. Respiratory Syncytial Virus and Parainfluenza virus. N Engl J Med 2001;344(25):1917-1928. 24.

Greenough A. Respiratory Syncytial Virus Infection: Clinical Features, Management, and Prophylaxis. Curr Opin in Pulm Med 2002;8:214-217. 25. Jartti T, van den Hoogen B, Garofalo RP, et al. Metapneumovirus and Acute Wheezing in Children. Lancet 2002;360:1393-1394.

26. Patel H, Platt RW, Pekeles GS, Ducharme FM. A Randomized Controlled Trial of the Effectiveness of papers yourself after, Nebulized Therapy with Epinephrine Compared with Albuterol and Saline in Infants Hospitalized for Acute Viral Bronchiolitis. J Pediatr 2002(6);141:818-824. 27. Hollman G, Shen G, Zeng L, et al.

Helium-Oxygen Improves Clinical Asthma Scores in Children with Acute Bronchiolitis. Crit Care Med 1998;26(10):1731-1736. 28. Martinon-Torres F, Rodriguez-Nunez A, Martinon-Sanchez JM. How To Write An Opinion Paper? Heliox Therapy in Infants with Acute Bronchiolitis.

Pediatrics 2002(1);109:68-73. 29. Divorce Papers Yourself Long? Beasley JM, Jones SEF. Continuous Positive Airway Pressure in Bronchiolitis. British Medical Journal 1981;283:1506-1508. 30.

Soong W, Hwang B, Tang R. Continuous Positive Airway Pressure by Nasal Prongs in Bronchiolitis. Pediatr Pulmonol 1993;16:163-166. 31. Bisgaard H for college entrance online the Study Group on Montelukast and Respiratory Syncytial Virus. A Randomized Trial of Montelukast in Respiratory Syncytial Virus Postbronchiolitis. Am J Respir Crit Care Med 2003;167:379-383. 32. Halsey NA, Abramson JS, Chesney PJ, et al.

American Academy of Pediatrics: Prevention of Respiratory Syncytial Virus Infections: Indications for the Use of Palivizumab and Update on the Use of RSV-IGIV. Pediatrics 1998;102(5):1211-1216. 33. Bruhn FW, Mokrohisky ST, McIntosh K. Filing Divorce Long After? Apnea Associated with Respiratory Syncytial Virus Infection in Young Infants. How To Write Essay? J Pediatr 1977;90:382-386. 34. Sigurs N, Bjarnason R, Sigurbergsson F, Kjellman B. Respiratory Syncytial Virus Bronchiolitis in Infancy is an Important Risk Factor for Asthma and Allergy at Age 7. Am J Respir Crit Care Med 2000;161:1501-1507. Answers to long, questions. 1.c. Review Essay? Overall, viruses cause the divorce long after majority of pneumonias in children; however, the incidence of viral pneumonia decreases with age, becoming less common in older children and adolescents. 4.False.

Lobar pneumonias are more likely to be of bacterial etiology, but this is not definitive since some lobar pneumonias will still be viral.

Planning and conducting a dissertation research project. This guide addresses the Filing divorce yourself, task of planning and conducting a small research project, such as for an undergraduate or masters’ level dissertation. It aims to service help you develop a clear sense of Filing divorce papers yourself, direction early on in the project, and to support you in organising, planning, and monitoring your project. The companion guide Writing a dissertation focuses on the preparation of the written report or thesis. A dissertation is a particular kind of academic task. You will usually be asked to generate a topic for yourself; to plan and execute a project investigating that topic; and to write-up what you did and what your findings were. Important stages in the dissertation process include: choosing a topic; developing a research question; effective planning of the research; being organised and methodical while conducting your research; and reporting the research.

While some students come to their research project with a clear research question to address, many others arrive at this point with several ideas, but with no specific research question. In view of the How to, pressure to Filing papers long after get started fairly quickly, this can cause anxiety and writing canada even panic. It is, however, a common situation to be in. There are several ways forward: Remember that a research study can: This list is not exhaustive, and you need to papers yourself after check whether your department has a preference for particular kinds of How to article review essay, research study. Discuss your proposed topic with a member of academic staff who you think might be appropriate to supervise the project. Provided they feel that they know enough about the subject to supervise it, and provided that it can be interpreted as falling within the broad fields of your degree subject, academic staff are generally open to suggestions. You should think realistically about the practical implications of your choice, in papers long, terms of: For example, a project on coal mining in the North East of England may require you to visit Newcastle’s Record Office, or to interview coal miners from the region.

Is this something that you are prepared and able to do? If the write, practical considerations associated with your research ideas are unrealistic, you need to consider whether you are willing to modify or reconsider your project. Once your topic has been accepted by your department, you need to begin the process of refining the topic and turning it into something that is focused enough to papers guide your project. Entrance Essays! Try describing it as a research problem that sets out: It is important that you establish a research problem at, or close to the start of, your project. It is one of the key tools you have, to ensure that your project keeps going in the right direction. Papers Long After! Every task you undertake should begin with you checking your research problem and asking “will this help me address this problem?”.

You should be willing to revise your research problem as you find out more about your topic. You may, for Teach five paragraph essay, example, discover that the data you were hoping to Filing yourself analyse is not available, or you may encounter a new piece of information or a new concept while undertaking a literature search, that makes you rethink the write review, basis of Filing divorce after, your research problem. You should always talk to your supervisor before you make any substantial revision to your plans, and explain why you think you need to Teach essay make the change. Effective planning of the research. A research proposal is a more detailed description of the project you are going to undertake. Some departments require you to long after submit a research proposal as part of the assessment of your dissertation, but it is How to write article worth preparing one even if it is not a formal requirement of your course. It should build on the thinking that you have done in Filing papers long, defining your research problem; on Teach five essay the discussions that you have had with your supervisor; and on early reading that you have done on papers long after the topic. A comprehensive research proposal will make you think through exactly what it is that you are going to write history do, and will help you when you start to write up the long, project. You could try outlining your project under the following headings (Booth, Williams, Colomb, 2003. The craft of research. Essays Online! Chicago: The University of Chicago Press.):

You may find that some of these headings are difficult to papers long fill in right at write review the start of your project. However, you can use the gaps to help identify where you need to begin work. Papers Yourself Long! If, for example, you are unsure about the limitations of your methodology you should talk to your supervisor and read a bit more about that methodology before you start. A dissertation is an extended project that asks you to manage your time and undertake a variety of tasks. Write An Opinion Paper For College! Some courses schedule the dissertation at the end, while others have it running along concurrently with other modules. Whichever way your course is organised, it is essential that you create a plan that helps you allocate enough time to each task you have to complete.

It is useful to work out how many weeks you have until you need to submit your completed dissertation, and draw a chart showing these weeks. Block out the weeks when you know you will be unable to work, and papers yourself long mark in other main commitments you have that will take time during this period. Then allocate research tasks to Essay the remaining time. It is very important to divorce long after be realistic about how long each task is likely to take. Some focused thought at the beginning, then at the planning stage of each phase, could save hours later on. Write down the entrance essays online, resources needed for each stage. It could be time in divorce papers yourself, the library; the resource of essays online, your working hours; or the use of equipment or room space that needs to be booked in Filing papers long after, advance.

Some people find that they procrastinate more than they would like. This is a common problem, so it is probably best to be well-prepared to college entrance essays online identify it and deal with it if it does start to happen. People procrastinate for various reasons for example: poor time management dauted by divorce papers yourself long after the scale of the task negative beliefs loss of motivation perfectionism difficulty concentrating need to feel under pressure personal problems. Early identification of the signs of procrastination will give you the Report writing, best chance of minimising any negative effects. Once you suspect that you are procrastinating, it can be helpful to review what you are expecting of yourself, and papers yourself after check that those expectations are realistic.

This is where planning is How to review vital. To improve the Filing divorce yourself long, prospect of Teach, completing on Filing papers long time, and avoiding procrastination, you need to: Your research plan should also include information about what equipment you will need to How to article review complete your project, and any travel costs or other expenses that you are likely to incur through the pursuit of your research. You should also think about Filing divorce papers long, whether you are dependent on any one else to complete your project, and think about Best online, what you are going to divorce yourself long after do if they are unable to help you. Once you have created your plan it is Report writing pay low a good idea to show it to someone else. Filing Divorce Papers Yourself Long! Ideally you will be able to show it to a member of academic staff or bring it to the Learning Development, but talking it over with a friend may also help you to spot anything that you have forgotten or anywhere that you have been unrealistic in your planning. Being organised and methodical while conducting your research. Although a dissertation is an opportunity for you to work independently, you will usually be allocated a member of Essay writing service, academic staff as a supervisor. Supervisors are there to help you shape your ideas and give you advice on how to conduct the research for your dissertation. They are not there to teach you the topic you have chosen to investigate: this is your project. They are, however, one of the resources that you can call on Filing divorce long after during your research.

Academics are busy people, so to get the most out of your supervisor you will need to How to write review be organised and to take responsibility for the relationship. It is not your supervisor’s job to chase you into completing your dissertation, or to Filing after tell you how to manage the different stages of the project. To ensure that you get the most out of your supervisor you need to: If you are not happy with the way you are being supervised, explain why to your supervisor or discuss the issue with your personal tutor. Regardless of whether you have been given a dissertation topic or you have developed your own ideas, you will need to be able to Report writing demonstrate the rationale for Filing papers, your research, and to describe how it fits within the wider research context in entrance, your area. To support you in doing this you will need to undertake a literature review, which is a review of material that has already been published, either in hard copy or electronically, that may be relevant for your research project. Key tools that are available to help you, include: It is a good idea to make an appointment to see the librarian specialising in your subject.

An information librarian should be able to Filing divorce papers yourself give you advice on your literature search, and on how to manage the information that you generate. You will probably generate more references than you can read. Use the titles and abstracts to decide whether the reference is paper for college history worth reading in detail. Divorce Yourself Long! Be selective by concentrating on references that: Once you start reading, ensure that you think about what you are trying to get out of entrance essays online, each article or book that you read.

Your notes should enable you to write up your literature search without returning to the books you have read. Refer to the guides Effective Note Making, Referencing and long Bibliographies, and Avoiding Plagiarism, for further help with note-making. For most research projects the data collection phase feels like the most important part. However, you should avoid jumping straight into this phase until you have adequately defined your research problem, and the extent and entrance limitations of your research. If you are too hasty you risk collecting data that you will not be able to use.

Consider how you are going to long after store and retrieve your data. You should set up a system that allows you to: There are many systems that support effective data collection and Report pay low retrieval. Divorce Papers Long! These range from card indexes and cross-referenced exercise books, through electronic tools like spreadsheets, databases and entrance essays online bibliographic software, to discipline-specific tools. Yourself Long! You should talk about how you plan to store your data with your supervisor, an information librarian, or a study adviser in the Learning Development. As you undertake your research you are likely to come up with lots of ideas. It can be valuable to keep a record of these ideas on index cards, in a dedicated notebook, or in an electronic file. You can refer back to this ‘ideas store’ when you start to How to article essay write. They may be useful as ideas in Filing divorce papers, themselves, and may be useful as a record of how your thinking developed through the research process.

A pilot study involves preliminary data collection, using your planned methods, but with a very small sample. It aims to test out your approach, and identify any details that need to be addressed before the How to, main data collection goes ahead. For example, you could get a small group to fill in your questionnaire, perform a single experiment, or analyse a single novel or document. When you complete your pilot study you should be cautious about reading too much into the results that you have generated (although these can sometimes be interesting). Yourself After! The real value of your pilot study is what it tells you about Report writing pay low, your method. Spend time reflecting on the implications that your pilot study might have for your research project, and make the necessary adjustment to your plan. Even if you do not have the time or opportunity to run a formal pilot study, you should try and reflect on your methods after you have started to generate some data. Once you start to generate data you may find that the research project is yourself not developing as you had hoped. Do not be upset that you have encountered a problem. Best! Research is, by its nature, unpredictable. Analyse the situation.

Think about what the Filing divorce yourself after, problem is and how it arose. Is it possible that going back a few steps may resolve it? Or is it something more fundamental? If so, estimate how significant the problem is to answering your research question, and Best college try to calculate what it will take to resolve the situation. Changing the title is not normally the answer, although modification of some kind may be useful. If a problem is intractable you should arrange to meet your supervisor as soon as possible.

Give him or her a detailed analysis of the problem, and always value their recommendations. Divorce Papers! The chances are they have been through a similar experience and can give you valuable advice. Never try to writing ignore a problem, or hope that it will go away. Papers Long After! Also don’t think that by seeking help you are failing as a researcher. Finally, it is write article essay worth remembering that every problem you encounter, and successfully solve, is potentially useful information in writing up your research. So don’t be tempted to skirt around any problems you encountered when you come to write-up. Rather, flag up these problems and show your examiners how you overcame them. As you conduct research, you are likely to realise that the topic that you have focused on is more complex than you realised when you first defined your research question. The research is still valid even though you are now aware of the greater size and complexity of the Filing divorce papers yourself long, problem. A crucial skill of the researcher is to define clearly the boundaries of essays online, their research and to stick to them . Divorce Papers Yourself Long! You may need to Report writing pay low refer to wider concerns; to Filing divorce papers yourself long after a related field of literature; or to alternative methodology; but you must not be diverted into Best essays, spending too much time investigating relevant, related, but distinctly separate fields. Starting to write up your research can be intimidating, but it is essential that you ensure that you have enough time not only to write up your research, but also to review it critically, then spend time editing and improving it.

The following tips should help you to make the divorce yourself long, transition from research to writing: Remember that you can not achieve everything in your dissertation. A section where you discuss ‘Further Work’ at the end of your dissertation will show that you are thinking about the implications your work has for the academic community. The companion study guide Writing a Dissertation focuses on the process of writing up the research from your research project. Share this page:

You can make an appointment to come and Help see us about papers long, any study-related queries you have. (if you are a University of Leicester student please use your university e-mail address)

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¢Hydraulic pliers(for crimping copper nose and cable) and 6 mm2 die, one couple, 10mm wrench, 2 sets, Phillips screwdriver, 1 set, cutting pliers, 1set. ¢Cut the cables according to the cabling requirement. Use hydraulic and die to connect the copper nose and cables tightly, and prepare all the cables well. ¢If breaker is divorce papers yourself after, installed in the battery loop, please make the breaker open. If fuse is installed, please take out the fuse to prevent the phenomena of contact ignition. ¢Use the prepared cables to connect the +,- polarity of battery to the battery terminals on Best college essays online, the controller. Papers Long. Please make sure the connecting of the polarity is correct. ¢Use the prepared cables to connect the solar panel output of the main convergence box to Teach five paragraph, the solar panes terminals on the controller. Please make sure the connecting of the polarity is papers, correct. ¢Use the prepared cables to connect the ground terminals to the ground box of the college system. ¢ Insert the temperature sensor to the right place on the controller.

¢Close the divorce after breaker of the battery loop or insert the fuse of the battery loop, if the controller LCD screen starts to show the signal, the controller will start to work. And if the LCD has no signal, please check whether the connecting of the Teach paragraph essay polarity is correct, whether the papers long connecting cables is in good condition, whether the breaker is closed, whether the fuse is Report, inserter. Wait until the LCD has signal, and then go to next step. ¢Close the breaker of the solar panels loop or insert the fuse of the divorce long solar panels loop, then the controller LCD screen will show the solar panels voltage. If the LCD shows the voltage is 0V, please check whether the breaker in the solar panels loop is closed. EMPPT-60 60A 12V 24V 48V Solar Charge Controller MPPT. The product adopts DC/DC converting technology and MCU technology. How To For College. It can adjust the working point of the Filing solar panels array intelligently to pay low, make the solar panels array realize the maximum power output. When the external condition changes, eMPPT controller bases on the MCU theory to track the divorce yourself long after maximum working point of the Essay service uk solar panels, this can improve the Filing divorce after using efficiency of the solar panels and write article review essay decrease the solar generating cost.

Compared with average solar charge controllers, eMPPT can improve the output efficiency of the Filing divorce yourself long after solar panels by entrance online 5% to 30 %( the output increasing proportion affected by the factors such as the attribute of the solar panels, environmental temperature and after lighting conditions). The product adopts in big screen lattice LCD, and uses the vivid icons to indicate the parameters. It has concise and vivid interface. College Entrance Online. The product is wall mounting installation. Please refer to chapter 2.1 for the installing dimensions. maximum power point tracking.

Adopting DC/DC converting technology and divorce papers long MCU technology to realize the writing maximum output of the solar panels. battery reversed connection protection. Battery polarity connecting to divorce papers yourself long, the controller reversely (under the condition not connecting solar panels) will not cause damage to Essay writing service canada uk, controller. It can work normally after connecting right. Anti-battery reverse discharge. When solar panels voltage is less than battery voltage, the battery will not charge to the solar panels array. Anti-solar panels reverse connection. Solar panels array polarity connecting to the controller reversely will not cause damage to divorce yourself, controller.

It can work normally after connecting right. three-stage charge control. Bulk Absorption Float. float charging voltage adjustable. The users can adjust the float charging voltage within a certain scope.

temperature compensation for online, float charging voltage. Referring to the current battery temperature, take 25 ¡ as a benchmark, the Filing long controller will compensate the float charging voltage by -4mV/Cell/ ¡ . For 12V battery, compensation voltage U=(t-25)*6*(-0.004)V £» For 24V battery, compensation voltage U=(t-25)*12*(-0.004)V £» For 48V battery, compensation voltage U=(t-25)*24*(-0.004)V. Elevating charging voltage adjustable. The users can adjust the elevating charging voltage within a certain scope. solar panel input deviated from maximum power point.

When solar panel input power is over the acceptable power for the controller, the controller will make the Teach five essay solar panel work deviated from the maximum power to Filing after, prevent itself damaged. So the controller charges the battery by rated current. internal overheating protection. When the internal temperature sensor detects excessive temperature, the controller will stop working to prevent it being damaged. Report. It will resume working again when the internal temperature drops to a certain degree. temperature controlling fan. When the internal temperature sensor detects the temperature exceeding a certain degree, the controller will start the Filing divorce yourself long cooling fan until the writing pay low temperature drops to a certain degree. panel over voltage protection. When the input voltage of the solar panels exceeds the rated voltage, the divorce papers yourself after controller will start protection automatically and stop working until the input voltage resumes back to the normal scope. remote controlling function.

This optional function can make it possible to view and set the parameters of the entrance online system on PC. We suggest installing the controller on Filing divorce papers long, the vertical wall, and ensure there is the space over 10cm around the entrance essays controller for heat emission. 1. We suggest the user to use the sheathed cable with the divorce papers yourself cross-sectional area over Teach five essay, 6mm2. 2. We suggest installing breaker and fuse on the negative loop of battery and solar panels. 3. Set the controller¡¯s ground terminal to Filing yourself long after, reliably connect to writing pay low, the system ground bus. 4. The capacity of the controller internal over voltage absorption is limited. Divorce Papers Long After. Please make sure connect the pay low solar panel to papers yourself, the controller after connecting to the mine exchange line box. ¢Prepare 6 mm2 black and red sheathed cables, each one roll.

Prepare several copper noses of§¶6-6mm2 since controller adopts in§¶6 terminals. ¢Hydraulic pliers(for crimping copper nose and How to article essay cable) and 6 mm2 die, one couple, 10mm wrench, 2 sets, Phillips screwdriver, 1 set, cutting pliers, 1set. ¢Cut the Filing divorce papers long after cables according to paragraph essay, the cabling requirement. Use hydraulic and die to connect the copper nose and cables tightly, and prepare all the cables well. ¢If breaker is installed in the battery loop, please make the breaker open. Divorce Papers Yourself Long After. If fuse is installed, please take out the fuse to writing service uk, prevent the Filing papers yourself long phenomena of contact ignition. ¢Use the prepared cables to connect the +,- polarity of battery to the battery terminals on on writing speeches, the controller. Please make sure the connecting of the polarity is Filing papers yourself, correct.

¢Use the prepared cables to connect the solar panel output of the main convergence box to the solar panes terminals on write essay, the controller. Please make sure the connecting of the polarity is correct. ¢Use the yourself long after prepared cables to connect the ground terminals to the ground box of the system. ¢ Insert the temperature sensor to the right place on the controller. ¢Close the paragraph essay breaker of the battery loop or insert the Filing fuse of the Best college entrance essays online battery loop, if the controller LCD screen starts to papers after, show the signal, the controller will start to work. And if the LCD has no signal, please check whether the connecting of the polarity is correct, whether the connecting cables is in good condition, whether the breaker is closed, whether the fuse is inserter. Wait until the LCD has signal, and then go to next step. ¢Close the breaker of the solar panels loop or insert the five paragraph fuse of the solar panels loop, then the divorce controller LCD screen will show the solar panels voltage. If the LCD shows the voltage is 0V, please check whether the breaker in writing canada uk, the solar panels loop is papers, closed. Tracer A series MPPT solar charge controller.

Tracer A series adopts common positive design and advanced MPPT control algorithm. The products can track the Best college entrance essays online MPP point fast and Filing papers yourself long accurately in any situation which will improve energy efficiency and Report writing obtain the maximum solar energy. • Advanced MPPT technology. • High tracking efficiency no less than 99.5% • Peak conversion efficiency of papers after 98% • Ultra-fast tracking speed. • Accurately recognizing and pay low tracking of multiple power point. • Multi-function LCD displays system information intuitively. • User programmable for battery types, load control etc. • 3-Stage charge with PWM output. • Common positive grounding design.

• RS485 port with industrial standard MODBUS open architecture. • Fully programmable function via PC software or remote meter. • PV reverse polarity protection. • PV short circuit protection. • PV over current alarm protection. • Battery overcharge protection. • Battery over discharge protection.

• Battery reverse polarity protection. • Load short circuit protection. • Load overload protection. • Controller overheating protection. Nominal system voltage. 12/24V auto work. Rated battery current.

Rated load current. Max. PV open circuit voltage. 100V(at minimum operating environment temperature) 92V(at 25¡ environment temperature) Battery input voltage range. Max. Papers Long After. PV input power. Equalize charging voltage.

Sealed: 14.6V, Flooded: 14.8V. Boost charging voltage. Gel: 14.2V,Sealed: 14.4V,Flooded: 14.6. Float charging voltage. Low voltage reconnect voltage. Low voltage disconnect voltage. RS485 / RJ45 interface. Tracer BN series MPPT solar charge controller Negative controller) New Tracer series is the second generation of MPPT controller. Compared with CLASSIC Tracer series, it has extensive communication ability. And the die-cast aluminum design ensures excellent heat dispersion.

¡¤Innovative MPPT technology. ¡¤Peak conversion efficiency of 98% ¡¤High tracking efficiency up to 99% ¡¤Several seconds tracking speed. ¡¤Die-cast aluminum design and nature cooling. ¡¤Diversified load control to meet different requirements. ¡¤Four battery type options: Sealed, Gel, Flooded, and uk USER. ¡¤Intelligent lighting and timer control for solar lighting system. ¡¤Energy statistics function. ¡¤RS485 ports with MODBUS communication protocol. ¡¤Optional PC monitoring software and divorce papers yourself after remote meter for real-time monitoring and battery management parameter setting.

¡¤Field upgradable firmware. ¡¤PV short circuit protection. ¡¤PV overvoltage alarm protection. ¡¤PV current limiting protection. ¡¤PV reverse polarity protection. ¡¤Battery overcharge protection. ¡¤Battery over discharge protection. ¡¤Battery reverse polarity protection. ¡¤Load overload protection. ¡¤Load short circuit protection. Nominal system voltage.

12/24V auto work. Rated battery current. Rated load current. Max. PV open circuit voltage. Max. battery voltage. Max. PV input power. Equalize charging voltage.

Sealed: 14.6V, Flooded: 14.8V,USER: 9. Boost charging voltage. Gel: 14.2V,Sealed: 14.4V,Flooded: 14.6VUSER: 9. Float charging voltage. Gel /Sealed /Flooded: 13.8V, USER: 9. Low voltage reconnect voltage. Gel /Sealed /Flooded: 12.6V, USER: 9. Low voltage disconnect voltage. Gel /Sealed /Flooded: 11.1V, USER: 9. RS485 / RJ45 interface. Tracer Series MPPT solar charge controller.

¡¤Peak conversion efficiency of 97% ¡¤High Tracking efficiency of 99% ¡¤Several seconds tracking speed. ¡¤4-Stage charge with PWM output. ¡¤Nature convection cooling. ¡¤Full power output in How to write an opinion paper for college, ambient temperature up to 45 ¡. ¡¤Sealed, Gel and divorce papers yourself long after Flooded battery option. ¡¤Widely used, automatically recognize day/night. ¡¤Diversified load control. ¡¤RJ45 interface optional meter. ¡¤2 years warranty. ¡¤PV short circuit protection. ¡¤PV reverse polarity protection. ¡¤PV overvoltage alarm protection.

¡¤PV over current protection. ¡¤Battery overcharge protection. ¡¤Battery over How to review essay, discharge protection. ¡¤Battery reverse polarity protection. ¡¤Load short circuit protection. ¡¤Load overload protection. Rated system voltage.

12/24V auto work. Rated battery current. Rated load current. Max.PV open circuit voltage. Max.PV input power. 12V 130W; 24V 260W. Charge Circuit Voltage Drop. Discharge Circuit Voltage Drop. TTL232 / 8 pin RJ45. Storage temperature range.

156mm x 97mm x 68mm. Mounting hole size. Rated system voltage. 12/24V auto work. Rated battery current. Rated load current. Max.PV open circuit voltage. Max.PV input power. 12V 260W£¬ 24V 520W. Charge Circuit Voltage Drop. Discharge Circuit Voltage Drop.

TTL232 / 8 pin RJ45. Storage temperature range. 169mm x 118mm x 83mm. Mounting hole size. Rated system voltage. 12/24V auto work. Rated battery current. Rated load current. Max.PV open circuit voltage. Max.PV input power.

12V 390W£¬ 24V 780W. Charge Circuit Voltage Drop. Discharge Circuit Voltage Drop. TTL232 / 8 pin RJ45. Storage temperature range. 242mm x 169mm x 91mm. Mounting hole size. Rated system voltage. 12/24V auto work. Rated battery current.

Rated load current. Max.PV open circuit voltage. Max.PV input power. 12V 500W£¬ 24V 1000W. Charge Circuit Voltage Drop. Discharge Circuit Voltage Drop. TTL232 / 8 pin RJ45.

Storage temperature range. 242mm x 169mm x 91mm. Mounting hole size. Itracer MPPT solar charge controller. iTracer is an divorce papers industrial grade product with advanced Maximum Power Point Tracking (MPPT) algorithm. It can deliver the maximum available power for charging batteries and charge a lower nominal voltage battery from a higher nominal voltage array. Advanced MPPT algorithm with the writing max. tracking efficiency of 99% Multi-phase synchronous rectification technology realizing peak conversion efficiency 98% Dual-core(ARM CPU+DSP) control architecture improves the system response speed and optimizes the performance of the Filing papers yourself long after system. Multiphase control technology, optimizes charging current smoothness, reduces ripple and improves the system efficiency. 128*64 dot-matrix LCD intuitively displays data and state, 6 buttons combinations for easy operation.

Four battery type options: Sealed, Gel, Flooded and User-defined. Energy statistics recording, it is convenient for users to view charging and discharging energy of each day, month, year and Report writing pay low total value. Diversified load control mode. Programmable battery management parameters. Built-in running data and event logging, max. 15 months. Extensive communication capabilities (RS232,RS485 with Modbus protocol, CAN Bus extendable) PC software available for real time monitoring and parameter setting. Field upgradable firmware. PV short circuit protection. PV overvoltage protection.

PV over Filing divorce yourself, current protection. PV reverse polarity protection. Reverse current protection at night. Over temperature protection. Battery reverse polarity protection. Load overload protection. Load short circuit protection.

Rated system voltage. 12V/24V /36V/48V auto work. Rated battery current. Rated load current. Max. PV open circuit voltage. Max.PV input power. Equalize charging voltage. Sealed: 14.6V, Flooded: 14.8V, User-defined: 9. Boost charging voltage.

Gel: 14.2V, Sealed: 14.4V, Flooded: 14.6V, Float charging voltage. Gel /Sealed /Flooded: 13.8V, User-defined: 9. Low voltage reconnect voltage. Gel /Sealed /Flooded: 12.6V, User-defined: 9. Low voltage disconnect voltage. Gel /Sealed /Flooded: 11.1V, User-defined: 9.

Peak conversion efficiency. Storage temperature range. Etracer MPPT Solar Charge controller. eTracer is an advanced Maximum Power Point Tracking (MPPT) controller for off-grid photovoltaic (PV) systems up to 3KW. The controller features a smart tracking algorithm that maximizes the energy harvest from the PV by rapidly finding the solar array peak power point in Best entrance essays online, all the weather condition. ¡¤12/24/36/48V auto work. ¡¤Advanced MPPT technology. ¡¤Several seconds tracking speed.

¡¤High Tracking efficiency of 99% ¡¤Multiphase synchronous rectification technology. ¡¤Peak conversion efficiency of 98% ¡¤DSPARM processors architecture ensures high speed and performance. ¡¤Gel, Sealed, Flooded battery option. ¡¤Max. 450 days data logging by connection to PC. ¡¤Multifunction LCD displays system data and Filing papers yourself long after status.

¡¤Three kinds of communication ports :RS232, CAN BUS and Ethernet. ¡¤Three stages charging optimizes battery performance.