Reconditioning of the trabeculo-descemet's membrane with the 532-nm Nd : YAG (SLT) laser after deep sclerectomy.

The purpose of this study was to evaluate the intraocular pressure (IOP)-lowering effect of modified goniopuncture with the 532-nm Nd : YAG selective laser trabeculoplasty (SLT) laser on eyes after deep sclerectomy with collagen implant (DSCI). This was an interventional cased series. The effects of modified goniopuncture on eyes with insufficient IOP-lowering after DSCI were observed. Goniopuncture was performed using a Q-switched, frequency-doubled 532-nm Nd : YAG laser (SLT-goniopuncture, SLT-G). Outcome measures were amount of IOP-lowering and rapidity of decrease after laser intervention. In all, 10 eyes of 10 patients with a mean age of 71.0±7.7 (SD) years were treated with SLT-G. The mean time of SLT-G after DSCI procedure was 7.1±10.9 months. SLT-G decreased IOP from an average of 16.1±3.4 mm Hg to 14.2±2.8 mm Hg (after 15 min), 13.6±3.9 mm Hg (at 1 day), 12.5±4.1 mm Hg (at 1 month), and 12.6±2.5 (at 6 months) (P<0.0125). There were no complications related to the intervention. Patients in this series achieved an average 22.5% of IOP reduction after SLT-G. The use of the SLT laser appears to be an effective and safe alternative to the traditional Nd : YAG laser for goniopuncture in eyes after DSCI, with potential advantages related to non-perforation of trabeculo-descemet's membrane (TDM).

Investigation of the Lane-Wells Road Logger, HR-113, 1966

The Lane-Wells Road Logger was utilized primarily to determine the feasibility of employing such a device for moisture and density control in Iowa highway construction. A secondary objective was the use of the Road Logger to obtain information concerning moisture content and density during and after construction. Correlation studies with conventional test results required a small portion of the lease period. Practically all phases of construction and most materials utilized in base and surface courses were surveyed. Results of this study were good, in general, with the Road Logger indicating dry density slightly higher and the moisture content slightly lower than conventional results in most instances. Economic feasibility seemed to pose the greatest problem for the acceptance of the Road Logger as a standard compaction control device. It would appear from the findings of this study that probably only large projects, or several smaller contracts tested simultaneously, could justify the expense of the Logger. A total of about 128 miles were surveyed with the Logger during the lease period. Approximately 16 days of downtime due to minor breakdowns were recorded. Inclement weather forcing construction delays resulted in several idle days in which the Logger's full capabilities were not realized.

Design and Performance Verification of UHPC Piles for Deep Foundations, TR-558, 2008

The strategic plan for bridge engineering issued by AASHTO in 2005 identified extending the service life and optimizing structural systems of bridges in the United States as two grand challenges in bridge engineering, with the objective of producing safer bridges that have a minimum service life of 75 years and reduced maintenance cost. Material deterioration was identified as one of the primary challenges to achieving the objective of extended life. In substructural applications (e.g., deep foundations), construction materials such as timber, steel, and concrete are subjected to deterioration due to environmental impacts. Using innovative and new materials for foundation applications makes the AASHTO objective of 75 years service life achievable. Ultra High Performance Concrete (UHPC) with compressive strength of 180 MPa (26,000 psi) and excellent durability has been used in superstructure applications but not in geotechnical and foundation applications. This study explores the use of precast, prestressed UHPC piles in future foundations of bridges and other structures. An H-shaped UHPC section, which is 10-in. (250-mm) deep with weight similar to that of an HP10×57 steel pile, was designed to improve constructability and reduce cost. In this project, instrumented UHPC piles were cast and laboratory and field tests were conducted. Laboratory tests were used to verify the moment-curvature response of UHPC pile section. In the field, two UHPC piles have been successfully driven in glacial till clay soil and load tested under vertical and lateral loads. This report provides a complete set of results for the field investigation conducted on UHPC H-shaped piles. Test results, durability, drivability, and other material advantages over normal concrete and steel indicate that UHPC piles are a viable alternative to achieve the goals of AASHTO strategic plan.

Reconstruction of the recent history of a large deep prealpine lake (Lake Bourget, France) using subfossil chironomids, diatoms, and organic matter analysis: towards the definition of a lake-specific reference state

This paper presents the recent history of a large prealpine lake (Lake Bourget) using chironomids, diatoms and organic matter analysis, and deals with the ability of paleolimnological approach to define an ecological reference state for the lake in the sense of the European Framework Directive. The study at low resolution of subfossil chironomids in a 4-m-long core shows the remarkable stability over the last 2.5 kyrs of the profundal community dominated by a Micropsectra-association until the beginning of the twentieth century, when oxyphilous taxa disappeared. Focusing on this key recent period, a high resolution and multiproxy study of two short cores reveals a progressive evolution of the lake's ecological state. Until AD 1880, Lake Bourget showed low organic matter content in the deep sediments (TOC less than 1%) and a well-oxygenated hypolimnion that allowed the development of a profundal oxyphilous chironomid fauna (Micropsectra-association). Diatom communities were characteristic of oligotrophic conditions. Around AD 1880, a slight increase in the TOC was the first sign of changes in lake conditions. This was followed by a first limited decline in oligotrophic diatom taxa and the disappearance of two oxyphilous chironomid taxa at the beginning of the twentieth century. The 1940s were a major turning point in recent lake history. Diatom assemblages and accumulation of well preserved planktonic organic matter in the sediment provide evidence of strong eutrophication. The absence of profundal chironomid communities reveals permanent hypolimnetic anoxia. From AD 1995 to 2006, the diatom assemblages suggest a reduction in nutrients, and a return to mesotrophic conditions, a result of improved wastewater management. However, no change in hypolimnion benthic conditions has been shown by either the organic matter or the subfossil chironomid profundal community. Our results emphasize the relevance of the paleolimnological approach for the assessment of reference conditions for modern lakes. Before AD 1900, the profundal Micropsectra-association and the Cyclotella dominated diatom community can be considered as the Lake Bourget reference community, which reflects the reference ecological state of the lake.

Ultrasound-assisted versus conventional catheter-directed thrombolysis for acute iliofemoral deep vein thrombosis.

BACKGROUND: For patients with acute iliofemoral deep vein thrombosis, it remains unclear whether the addition of intravascular high-frequency, low-power ultrasound energy facilitates the resolution of thrombosis during catheter-directed thrombolysis. METHODS AND RESULTS: In a controlled clinical trial, 48 patients (mean age 50 ± 21 years, 52% women) with acute iliofemoral deep vein thrombosis were randomized to receive ultrasound-assisted catheter-directed thrombolysis (N = 24) or conventional catheter-directed thrombolysis (N = 24). Thrombolysis regimen (20 mg r-tPA over 15 hours) was identical in all patients. The primary efficacy end point was the percentage of thrombus load reduction from baseline to 15 hours according to the length-adjusted thrombus score, obtained from standardized venograms and evaluated by a core laboratory blinded to group assignment. The percentage of thrombus load reduction was 55% ± 27% in the ultrasound-assisted catheter-directed thrombolysis group and 54% ± 27% in the conventional catheter-directed thrombolysis group (P = 0.91). Adjunctive angioplasty and stenting was performed in 19 (80%) patients and in 20 (83%) patients, respectively (P > 0.99). Treatment-related complications occurred in 3 (12%) and 2 (8%) patients, respectively (P > 0.99). At 3-month follow-up, primary venous patency was 100% in the ultrasound-assisted catheter-directed thrombolysis group and 96% in the conventional catheter-directed thrombolysis group (P = 0.33), and there was no difference in the severity of the post-thrombotic syndrome (mean Villalta score: 3.0 ± 3.9 [range 0-15] versus 1.9 ± 1.9 [range 0-7]; P=0.21), respectively. CONCLUSIONS: In this randomized controlled clinical trial of patients with acute iliofemoral deep vein thrombosis treated with a fixed-dose catheter thrombolysis regimen, the addition of intravascular ultrasound did not facilitate thrombus resolution. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT01482273.

Surgical outcomes of deep sclerectomy versus Baerveldt aqueous shunt implantation following initial failed deep sclerectomy

Purpose: To examine the efficacy and safety of repeat deep sclerectomy (DS) versus Baerveldt shunt (BS) implantation as second line surgery following failed primary DS. Methods: Fifty one patients were prospectively recruited to undergo BS implantation following failed DS and 51 patients underwent repeat DS, for which data was collected retrospectively. All eyes had at least one failed DS. Surgical success was defined as IOP≤21mmHg and 20% reduction in IOP from baseline. Success rates, number of glaucoma medications (GMs), IOP, and complication rates were compared between the two groups at year 1, post-operatively. Results: Mean age, sex and the proportion of glaucoma subtypes were similar between groups. Preoperatively IOP was significantly lower in DS group vs BS group (18.8mmHg vs 23.8mmHg, p<0.01, two sample t-test). Postoperatively IOP was significantly higher in DS group than BS group (14.6mmHg vs 12.0mmHg, p<0.01, two-sample t-test). In the DS group, 47% of eyes did not achieve 20% reduction in IOP from baseline, as a result the success rates were significantly lower in eyes with DS (51%) than in eyes with BS (88%) (p=0.02, log-rank test). Preoperatively the number of GMs used in DS and BS groups were similar (2.2 vs 2.7 p=0.02, two sample t-test). Postoperatively there remained no significant difference in GMs between groups (0.9 vs 1.1, p= 0.58, two sample t-test). Complication rates were similar between the two groups (12% vs 10%). Conclusions: Baerveldt tube implantation was more effective in lowering IOP than repeat deep sclerectomy in eyes with failed primary DS, at year one. Complications were minor and infrequent in both groups

Effectiveness of Dynamic Messaging on Driver Behavior for Late Merge Lane Road Closures, 2009

Efforts to improve safety and traffic flow through merge areas on high volume/high speed roadways have included early merge and late merge concepts and several studies of the effectiveness of these concepts, many using Intelligent Transportation Systems for implementation. The Iowa Department of Transportation (Iowa DOT) planned to employ a system of dynamic message signs (DMS) to enhance standard temporary traffic control for lane closures and traffic merges at two bridge construction projects in western Iowa (Adair County and Cass County counties) on I-80 during the 2008 construction season. To evaluate the DMS system’s effectiveness for impacting driver merging actions, the Iowa DOT contracted with Iowa State University’s Center for Transportation Research and Education to perform the evaluation and make recommendations for future use of this system based on the results. Data were collected over four weekends, beginning August 1–4 and ending October 16–20, 2008. Two weekends yielded sufficient data for evaluation, one of transition traffic flow and the other with a period of congestion. For both of these periods, a statistical review of collected data did not indicate a significant impact on driver merging actions when the DMS messaging was activated as compared to free flow conditions with no messaging. Collection of relevant project data proved to be problematic for several reasons. In addition to personnel safety issues associated with the placement and retrieval of counting devices on a high speed roadway, unsatisfactory equipment performance and insufficient congestion to activate the DMS messaging hampered efforts. A review of the data that was collected revealed different results taken by the tube counters compared to the older model plate counters. Although variations were not significant from a practical standpoint, a statistical evaluation showed that the data, including volumes, speeds, and classifications from the two sources were not comparable at a 95% level of confidence. Comparison of data from the Iowa DOT’s automated traffic recorders (ATRs) in the area also suggested variations in results from these data collection systems. Additional comparison studies were recommended.

Cross validation of experts versus registration methods for target localization in deep brain stimulation.

In the last five years, Deep Brain Stimulation (DBS) has become the most popular and effective surgical technique for the treatent of Parkinson's disease (PD). The Subthalamic Nucleus (STN) is the usual target involved when applying DBS. Unfortunately, the STN is in general not visible in common medical imaging modalities. Therefore, atlas-based segmentation is commonly considered to locate it in the images. In this paper, we propose a scheme that allows both, to perform a comparison between different registration algorithms and to evaluate their ability to locate the STN automatically. Using this scheme we can evaluate the expert variability against the error of the algorithms and we demonstrate that automatic STN location is possible and as accurate as the methods currently used.

Residual venous obstruction, alone and in combination with D-dimer, as a risk factor for recurrence after anticoagulation withdrawal following a first idiopathic deep vein thrombosis in the prolong study.

OBJECTIVE: This study aims to assess the predictive value of residual venous obstruction (RVO) for recurrent venous thrombo-embolism (VTE) in a study using D-dimer to predict outcome. DESIGN: This is a multicentre randomised open-label study. METHODS: Patients with a first episode of idiopathic VTE were enrolled on the day of anticoagulation discontinuation when RVO was determined by compression ultrasonography in those with proximal deep vein thrombosis (DVT) of the lower limbs. D-dimer was measured after 1 month. Patients with normal D-dimer did not resume anticoagulation while patients with abnormal D-dimer were randomised to resume anticoagulation or not. The primary outcome measure was recurrent VTE over an 18-month follow-up. RESULTS: A total of 490 DVT patients were analysed (after excluding 19 for different reasons and 118 for isolated pulmonary embolism (PE)). Recurrent DVT occurred in 19% (19/99) of patients with abnormal D-dimer who did not resume anticoagulation and 10% (31/310) in subjects with normal D-dimer (adjusted hazard ratio: 2.1; p = 0.02). Recurrences were similar in subjects either with (11%, 17/151) or without RVO (13%, 32/246). Recurrent DVT rates were also similar for normal D-dimer, with or without RVO, and for abnormal D-dimer, with or without RVO. CONCLUSIONS: Elevated D-dimer at 1 month after anticoagulation withdrawal is a risk factor for recurrence, while RVO at the time of anticoagulation withdrawal is not.

Evaluation of Low-Cost Treatments on Rural Two-Lane Curves, TR-579, 2012

The objective of this project was to evaluate low-cost measures to reduce speeds on high-crash horizontal curves. The researchers evaluated two low-cost treatments in Iowa to determine their effectiveness in reducing speeds on rural two-lane roadways. This report summarizes how the research team selected sites and collected data, and the results. The team selected six sites. Retroreflective post treatments were added to existing chevrons at four sites and on-pavement curve markings were added at two sites. The researchers collected speed data before and after installation of the two treatments. The study compared several speed metrics to assess the effectiveness of the treatments. Overall, both were moderately effective in reducing speeds. The most significant impact of the treatments was in reducing the percentage of vehicles traveling over the posted or advisory speed by 5, 10, 15, or 20 or more mph. This result suggests that the treatments are most effective in reducing high-end speeds.

Long-term results of deep sclerectomy with collagen implant.

PURPOSE: To study prospectively the success rate and complications of deep sclerectomy with collagen implant (DSCI). SETTING: Glaucoma Unit, Department of Ophthalmology, Hôpital Ophtalmique Jules Gonin, University of Lausanne, Lausanne, Switzerland. METHODS: This nonrandomized prospective trial comprised 105 eyes of 105 patients with medically uncontrolled primary and secondary open-angle glaucoma. Visual acuity, intraocular pressure (IOP), and slitlamp examinations were performed before surgery and after surgery at 1 and 7 days, and 1, 3, 6, 9, 12, 18, 24, 30, 36, 48, 54, 60, 66, 72, 78, 84, 90, and 96 months. Visual field examinations were repeated every 6 months. RESULTS: Mean follow-up period was 64 months +/- 26.6 (SD). Mean preoperative IOP was 26.8 +/- 7.7 mm Hg, and mean postoperative IOP was 5.2 +/- 3.35 mm Hg at day 1 and 12 +/- 3 mm Hg at month 78. At 96 months, the qualified success rate (ie, patients who achieved IOP <21 mm Hg with and without medication) was 91%, and the complete success rate (ie, IOP <21 mm Hg without medication) was 57%. At 96 months, 34% of patients had an IOP <21 mm Hg with medication. Fifty-one patients (49%) achieved an IOP < or =15 mm Hg without medication. Neodymium:YAG goniopuncture was performed in 54 patients (51%); mean time of goniopuncture performance was 21 months, and mean IOP before goniopuncture was 20 mm Hg, dropping to 11 mm Hg after goniopuncture. No shallow or flat anterior chamber, endophthalmitis, or surgery-induced cataract was observed. However, 26 patients (25%) showed a progression of preexisting senile cataract (mean time 26 months; range 18 to 37 months). Injections of 5-fluorouracil were administered to 25 patients (23%) who underwent DSCI to salvage encysted blebs. Mean number of medications per patient was reduced from 2.3 +/- 0.7 to 0.5 +/- 0.7 (signed rank P<.0001). CONCLUSION: Deep sclerectomy with collagen implant appears to provide stable and reasonable control of IOP at long-term follow-up with few immediate postoperative complications.

Detection and characterization of hydraulically active fractures in a carbonate aquifer: Results from self-potential, temperature and fluid conductivity logging along a 260-m-deep borehole in the Combioula hydrothermal system in the southwestern Swiss Alps

A geophysical and geochemical study has been conducted in a fractured carbonate aquifer located at Combioula in the southwestern Swiss Alps with the objective to detect and characterize hydraulically active fractures along a 260-m-deep borehole. Hydrochemical analyses, borehole diameter, temperature and fluid electrical conductivity logging data were integrated in order to relate electrokinetic self-potential signals to groundwater flow inside the fracture network. The results show a generally good, albeit locally variable correlation of variations of the self-potential signals with variations in temperature, fluid electrical conductivity and borehole diameter. Together with the hydrochemical evidence, which was found to be critical for the interpretation of the self-potential data, these measurements not only made it possible to detect the hydraulically active fractures but also to characterize them as zones of fluid gain or fluid loss. The results complement the available information from the corresponding litholog and illustrate the potential of electrokinetic self-potential signals in conjunction with temperature, fluid electrical conductivity and hydrochemical analyses for the characterization of fractured aquifers, and thus may offer a perspective for an effective quantitative characterization of this increasingly important class of aquifers and geothermal reservoirs.

Deep incision in an Aptian carbonate succession indicates major sea-level fall in the Cretaceous

Long-term relative sea-level cycles (0 5 to 6 Myr) have yet to be fully understood for the Cretaceous. During the Aptian, in the northern Maestrat Basin (Eastern Iberian Peninsula), fault-controlled subsidence created depositional space, but eustasy governed changes in depositional trends. Relative sea-level history was reconstructed by sequence stratigraphic analysis. Two forced regressive stages of relative sea-level were recognized within three depositional sequences. The first stage is late Early Aptian age (intra Dufrenoyia furcata Zone) and is characterized by foreshore to upper shoreface sedimentary wedges, which occur detached from a highstand carbonate platform, and were deposited above basin marls. The amplitude of relative sea-level drop was in the order of tens of metres, with a duration of <1 Myr. The second stage of relative sea-level fall occurred within the Late Aptian and is recorded by an incised valley that, when restored to its pre-contractional attitude, was >2 km wide and cut 115 m down into the underlying Aptian succession. With the subsequent transgression, the incision was back-filled with peritidal to shallow subtidal deposits. The changes in depositional trends, lithofacies evolution and geometric relation of the stratigraphic units characterized are similar to those observed in coeval rocks within the Maestrat Basin, as well as in other correlative basins elsewhere. The pace and magnitude of the two relative sea-level drops identified fall within the glacio-eustatic domain. In the Maestrat Basin, terrestrial palynological studies provide evidence that the late Early and Late Aptian climate was cooler than the earliest part of the Early Aptian and the Albian Stage, which were characterized by warmer environmental conditions. The outcrops documented here are significant because they preserve the results of Aptian long-term sea-level trends that are often only recognizable on larger scales (i.e. seismic) such as for the Arabian Plate.

Deep incision in an Aptian carbonate succession indicates major sea-level fall in the Cretaceous

Long-term relative sea-level cycles (0 5 to 6 Myr) have yet to be fully understood for the Cretaceous. During the Aptian, in the northern Maestrat Basin (Eastern Iberian Peninsula), fault-controlled subsidence created depositional space, but eustasy governed changes in depositional trends. Relative sea-level history was reconstructed by sequence stratigraphic analysis. Two forced regressive stages of relative sea-level were recognized within three depositional sequences. The first stage is late Early Aptian age (intra Dufrenoyia furcata Zone) and is characterized by foreshore to upper shoreface sedimentary wedges, which occur detached from a highstand carbonate platform, and were deposited above basin marls. The amplitude of relative sea-level drop was in the order of tens of metres, with a duration of <1 Myr. The second stage of relative sea-level fall occurred within the Late Aptian and is recorded by an incised valley that, when restored to its pre-contractional attitude, was >2 km wide and cut 115 m down into the underlying Aptian succession. With the subsequent transgression, the incision was back-filled with peritidal to shallow subtidal deposits. The changes in depositional trends, lithofacies evolution and geometric relation of the stratigraphic units characterized are similar to those observed in coeval rocks within the Maestrat Basin, as well as in other correlative basins elsewhere. The pace and magnitude of the two relative sea-level drops identified fall within the glacio-eustatic domain. In the Maestrat Basin, terrestrial palynological studies provide evidence that the late Early and Late Aptian climate was cooler than the earliest part of the Early Aptian and the Albian Stage, which were characterized by warmer environmental conditions. The outcrops documented here are significant because they preserve the results of Aptian long-term sea-level trends that are often only recognizable on larger scales (i.e. seismic) such as for the Arabian Plate.