Evaluation of an online, case-based interactive approach to teaching pathophysiology

Rapport de synthèse : L'article qui fait l'objet de ma thèse évalue une nouvelle approche pédagogique pour l'apprentissage de certains chapitres de physiopathologie. Le dispositif pédagogique se base sur l'alternance d'apprentissage ex-cathedra et de l'utilisation d'un site web comprenant des vignettes cliniques. Lors de la consultation de ces-dernières, l'étudiant est invité à demander des examens de laboratoire dont il pourrait justifier la pertinence selon le cas clinique étudié. La nouveauté du procédé réside dans le fait que, préalablement à son cours ex-cathedra, l'enseignant peut consulter les statistiques de demandes de laboratoire et ainsi orienter son cours selon les éléments mal compris par les étudiants. A la suite du cours ex-cathedra, les étudiants peuvent consulter sur internet la vignette clinique complète avec des explications. A l'issue de tout le cours, une évaluation auprès des étudiants a été conduite. Le procédé a été mis en place durant deux années consécutives et l'article en discute notamment les résultats. Nous avons pu conclure que cette méthode innovatrice d'enseignement amène les étudiants à mieux se préparer pour les cours ex-cathedra tout en permettant à l'enseignant d'identifier plus précisément quelles thématiques étaient difficiles pour les étudiants et donc d'ajuster au mieux son cours. Mon travail de thèse a consisté à créer ce dispositif d'apprentissage, à créer l'application web des vignettes cliniques et à l'implanter durant deux années consécutives. J'ai ensuite analysé les données des évaluations et écrit l'article que j'ai présenté à la revue 'Medical Teacher'. Après quelques corrections et précisions demandées par le comité de lecture, l'article a été accepté et publié. Ce travail a débouché sur une seconde version de l'application web qui est actuellement utilisée lors du module 3.1 de 3è année à l'Ecole de Médecine à Lausanne. Summary : Since the early days of sexual selection, our understanding of the selective forces acting on males and females during reproduction has increased remarkably. However, despite a long tradition of experimental and theoretical work in this field and relentless effort, numerous questions remain unanswered and many results are conflicting. Moreover, the interface between sexual selection and conservation biology has to date received little attention, despite existing evidence for its importance. In the present thesis, I first used an empirical approach to test various sexual selection hypotheses in a population of whitefish of central Switzerland. This precise population is characterized by a high prevalence of gonadal alterations in males. In particular, I challenged the hypothesis that whitefish males displaying peculiar gonadal features are of lower genetic quality than other seemingly normal males. Additionally, I also worked on identifying important determinant of sperm behavior. During a second theoretical part of my work, which is part of a larger project on the evolution of female mate preferences in harvested fish populations, I developed an individual-based simulation model to estimate how different mate discrimination costs affect the demographical behavior of fish populations and the evolutionary trajectories of female mate preferences. This latter work provided me with some insight on a recently published article addressing the importance of sexual selection for harvesting-induced evolution. I built upon this insight in a short perspective paper. In parallel, I let some methodological questions drive my thoughts, and wrote an essay about possible synergies between the biological, the philosophical and the statistical approach to biological questions.

Design and Evaluation of a Single-Span Bridge Using Ultra- High Performance Concrete, September 2009

Research presented herein describes an application of a newly developed material called Ultra-High Performance Concrete (UHPC) to a single-span bridge. The two primary objectives of this research were to develop a shear design procedure for possible code adoption and to provide a performance evaluation to ensure the viability of the first UHPC bridge in the United States. Two other secondary objectives included defining of material properties and understanding of flexural behavior of a UHPC bridge girder. In order to obtain information in these areas, several tests were carried out including material testing, large-scale laboratory flexure testing, large-scale laboratory shear testing, large-scale laboratory flexure-shear testing, small-scale laboratory shear testing, and field testing of a UHPC bridge. Experimental and analytical results of the described tests are presented. Analytical models to understand the flexure and shear behavior of UHPC members were developed using iterative computer based procedures. Previous research is referenced explaining a simplified flexural design procedure and a simplified pure shear design procedure. This work describes a shear design procedure based on the Modified Compression Field Theory (MCFT) which can be used in the design of UHPC members. Conclusions are provided regarding the viability of the UHPC bridge and recommendations are made for future research.

Chaotic, memory, and cooling rate effects in spin glasses: Evaluation of the Edwards-Anderson model

We investigate chaotic, memory, and cooling rate effects in the three-dimensional Edwards-Anderson model by doing thermoremanent (TRM) and ac susceptibility numerical experiments and making a detailed comparison with laboratory experiments on spin glasses. In contrast to the experiments, the Edwards-Anderson model does not show any trace of reinitialization processes in temperature change experiments (TRM or ac). A detailed comparison with ac relaxation experiments in the presence of dc magnetic field or coupling distribution perturbations reveals that the absence of chaotic effects in the Edwards-Anderson model is a consequence of the presence of strong cooling rate effects. We discuss possible solutions to this discrepancy, in particular the smallness of the time scales reached in numerical experiments, but we also question the validity of the Edwards-Anderson model to reproduce the experimental results.

Comprehensive Bridge Deck Deterioration Mapping of Nine Bridges by Nondestructive Evaluation Technologies Final Report, January 2011

The primary objective of this research was to demonstrate the benefits of NDT technologies for effectively detecting and characterizing deterioration in bridge decks. In particular, the objectives were to demonstrate the capabilities of ground-penetrating radar (GPR) and impact echo (IE), and to evaluate and describe the condition of nine bridge decks proposed by Iowa DOT. The first part of the report provides a detailed review of the most important deterioration processes in concrete decks, followed by a discussion of the five NDT technologies utilized in this project. In addition to GPR and IE methods, three other technologies were utilized, namely: half-cell (HC) potential, electrical resistivity (ER), and ultrasonic surface waves (USW) method. The review includes a description of the principles of operation, field implementation, data analysis, and interpretation; information regarding their advantages and limitations in bridge deck evaluations and condition monitoring are also implicitly provided.. The second part of the report provides descriptions and bridge deck evaluation results from the nine bridges. The results of the NDT surveys are described in terms of condition assessment maps and are compared with the observations obtained from the recovered cores or conducted bridge deck rehabilitation. Results from this study confirm that the used technologies can provide detailed and accurate information about a certain type of deterioration, electrochemical environment, or defect. However, they also show that a comprehensive condition assessment of bridge decks can be achieved only through a complementary use of multiple technologies at this stage,. Recommendations are provided for the optimum implementation of NDT technologies for the condition assessment and monitoring of bridge decks.

Evaluation of uptake and transport of ultrasmall superparamagnetic iron oxide nanoparticles by human brain-derived endothelial cells.

Aim: Ultrasmall superparamagnetic iron oxide nanoparticles (USPIO-NPs) are under development for imaging and drug delivery; however, their interaction with human blood-brain barrier models is not known. Materials & Methods: The uptake, reactive oxygen species production and transport of USPIO-NPs across human brain-derived endothelial cells as models of the blood-brain tumor barrier were evaluated for either uncoated, oleic acid-coated or polyvinylamine-coated USPIO-NPs. Results: Reactive oxygen species production was observed for oleic acid-coated and polyvinylamine-coated USPIO-NPs. The uptake and intracellular localization of the iron oxide core of the USPIO-NPs was confirmed by transmission electron microscopy. However, while the uptake of these USPIO-NPs by cells was observed, they were neither released by nor transported across these cells even in the presence of an external dynamic magnetic field. Conclusion: USPIO-NP-loaded filopodia were observed to invade the polyester membrane, suggesting that they can be transported by migrating angiogenic brain-derived endothelial cells.

Evaluation of Temporary Ramp Metering for Work Zones, 2012

Ramp metering has been successfully implemented in many states to improve traffic operations on freeways. Studies have documented the positive mobility and safety benefits of ramp metering. However, there have been no studies on the use of ramp metering for work zones. This report documents the results from the first deployment of temporary ramp meters in work zones in the United States. Temporary ramp meters were deployed at seven urban short-term work zones in Missouri. Safety measures such as driver compliance, merging behavior, and speed differentials were extracted from video-based field data. Mobility analysis was conducted using a calibrated simulation model and the total delays were obtained for under capacity, at capacity, and over capacity conditions. This evaluation suggests that temporary ramp meters should only be deployed at work zone locations where there is potential for congestion and turned on only during above-capacity conditions. The compliance analysis showed that non-compliance could be a major safety issue in the deployment of temporary ramp meters for under-capacity conditions. The use of a three-section instead of a traditional two-section signal head used for permanent ramp metering produced significantly higher compliance rates. Ramp metering decreased ramp platoons by increasing the percentage of single-vehicle merges to over 70% from under 50%. The accepted-merge-headway results were not statistically significant even though a slight shift towards longer headways was found with the use of ramp meters. Mobility analysis revealed that ramp metering produced delay savings for both mainline and ramp vehicles for work zones operating above capacity. On average a 24% decrease in total delay (mainline plus ramp) at low truck percentage and a 19% decrease in delay at high truck percentage conditions resulted from ramp metering.

Evaluation of Variable Advisory Speed Limits in Work Zones, TPF-5(081), 2013

Variable advisory speed limit (VASL) systems could be effective at both urban and rural work zones, at both uncongested and congested sites. At uncongested urban work zones, the average speeds with VASL were lower than without VASL. But the standard deviation of speeds with VASL was higher. The increase in standard deviation may be due to the advisory nature of VASL. The speed limit compliance with VASL was about eight times greater than without VASL. At the congested sites, the VASL were effective in making drivers slow down gradually as they approached the work zone, reducing any sudden changes in speeds. Mobility-wise the use of VASL resulted in a decrease in average queue length, throughput, number of stops, and an increase in travel time. Several surrogate safety measures also demonstrated the benefits of VASL in congested work zones. VASL deployments in rural work zones resulted in reductions in mean speed, speed variance, and 85th percentile speeds downstream of the VASL sign. The study makes the following recommendations based on the case studies investigated: 1. The use of VASL is recommended for uncongested work zones to achieve better speed compliance and lower speeds. Greater enforcement of regulatory speed limits could help to decrease the standard deviation in speeds; 2. The use of VASL to complement the static speed limits in rural work zones is beneficial even if the VASL is only used to display the static speed limits. It leads to safer traffic conditions by encouraging traffic to slow down gradually and by reminding traffic of the reduced speed limit. A well-designed VASL algorithm, like the P5 algorithm developed in this study, can significantly improve the mobility and safety conditions in congested work zones. The use of simulation is recommended for optimizing the VASL algorithms before field deployment.

Diagnostic Tools for Identifying Sleepy Drivers in the Field, RB21-012, 2013

The overarching goal of this project was to identify and evaluate cognitive and behavioral indices that are sensitive to sleep deprivation and may help identify commercial motor vehicle drivers (CMV) who are at-risk for driving in a sleep deprived state and may prove useful in field tests administered by officers. To that end, we evaluated indices of driver physiognomy (e.g., yawning, droopy eyelids, etc.) and driver behavioral/cognitive state (e.g. distracted driving) and the sensitivity of these indices to objective measures of sleep deprivation. The measures of sleep deprivation were sampled on repeated occasions over a period of 3.5-months in each of 44 drivers diagnosed with Obstructive Sleep Apnea (OSA) and 22 controls (matched for gender, age within 5 years, education within 2 years, and county of residence for rural vs. urban driving). Comprehensive analyses showed that specific dimensions of driver physiognomy associated with sleepiness in previous research and face-valid composite scores of sleepiness did not: 1) distinguish participants with OSA from matched controls; 2) distinguish participants before and after PAP treatment including those who were compliant with their treatment; 3) predict levels of sleep deprivation acquired objectively from actigraphy watches, not even among those chronically sleep deprived. Those findings are consistent with large individual differences in driver physiognomy. In other words, when individuals were sleep deprived as confirmed by actigraphy watch output they did not show consistently reliable behavioral markers of being sleep deprived. This finding held whether each driver was compared to him/herself with adequate and inadequate sleep, and even among chronically sleep deprived drivers. The scientific evidence from this research study does not support the use of driver physiognomy as a valid measure of sleep deprivation or as a basis to judge whether a CMV driver is too fatigued to drive, as on the current Fatigued Driving Evaluation Checklist.. Fair and accurate determinations of CMV driver sleepiness in the field will likely require further research on alternative strategies that make use of a combination of information sources besides driver physiognomy, including work logs, actigraphy, in vehicle data recordings, GPS data on vehicle use, and performance tests.

Performance Evaluation Of Iowa Bridge Decks Constructed With Epoxy-Coated Reinforcing Bars, RB06-011, 2011

Epoxy coatings have been used on the embedded reinforcing bars of bridge decks since the mid-1970s to mitigate deterioration caused by chloride-induced corrosion. The use of chloride-based deicers became common in the early 1960s and caused corrosion of conventional uncoated bars in bridge decks within 5 to 10 years of commencement of deicer applications. In response to this rapid deterioration, the National Bureau of Standards researched coatings to protect the reinforcement (National Bureau of Standards, 1975), resulting in the development of epoxy-coated reinforcing bars, which were used in bridge decks beginning in 1973. While corrosion-related deterioration has been prevalent on bridge decks with uncoated reinforcing bars in northern climates where the use of deicing salts is common, bridge decks constructed after 1973 with epoxy-coated reinforcing have shown good corrosion resistance with only limited exceptions. On the whole, previous laboratory and field studies regarding the performance of epoxy-coated reinforcing bars are very promising; however, some laboratory and field studies have yielded differing results. In recent years, maintenance personnel for the Iowa Department of Transportation (Iowa DOT) have reportedly performed patch repairs to some bridge decks reinforced with epoxy-coated bars. At one such bridge, the southbound US 65 bridge (Bridge No. 7788.5L065) over the Union Pacific Railroad near Bondurant in Polk County, Iowa, deck repairs were performed by Iowa DOT maintenance personnel in the Spring of 2010, based on our communications regarding this topic with Mr. Gordon Port of the Iowa DOT. These repairs were observed by engineers from the Iowa DOT Office of Bridges and Structures, who reported that significant corrosion was found at a number of epoxy-coated reinforcing bars uncovered during this patch work. These repairs were reportedly performed at spalls and delaminated areas corresponding to cracks over transverse reinforcing bars, and involved careful removal of the concrete from over the bars. Figures 1 through 4 contain photographs provided by Iowa DOT personnel showing the removal process (Figure 1), the conditions encountered (Figures 2 and 3), and close-up views of the corroded reinforcing (Figure 4). As a result of these observations, the Iowa Department of Transportation has requested this study to gain further understanding of the long-term performance of bridge decks reinforced with epoxy-coated bars. The two main objectives of this study are to determine the long-term effectiveness of the epoxy coatings and to determine the potential causes for the deterioration at locations where corrosion has occurred. Wiss, Janney, Elstner Associates, Inc. (WJE) and the Iowa DOT identified eight different bridge decks across Iowa for this study that were constructed using epoxy-coated reinforcing bars. A field investigation consisting of visual inspections, a delamination survey, a concrete cover survey, electrical testing for susceptibility to corrosion, and concrete sampling was conducted within a survey area deemed to be representative of the condition of each bridge deck. Laboratory testing, including chloride ion content testing, characterization of the extracted bars, petrographic examination of the concrete, and carbonation testing, was conducted on the core samples taken from each bridge deck.

Deicer Scaling Resistance of Concrete Mixtures Containing Slag Cement Phase 2: Evaluation of Different Laboratory Scaling Test Methods, TPF-5(100), 2012

With the use of supplementary cementing materials (SCMs) in concrete mixtures, salt scaling tests such as ASTM C672 have been found to be overly aggressive and do correlate well with field scaling performance. The reasons for this are thought to be because at high replacement levels, SCM mixtures can take longer to set and to develop their properties: neither of these factors is taken into account in the standard laboratory finishing and curing procedures. As a result, these variables were studied as well as a modified scaling test, based on the Quebec BNQ scaling test that had shown promise in other research. The experimental research focused on the evaluation of three scaling resistance tests, including the ASTM C672 test with normal curing as well as an accelerated curing regime used by VDOT for ASTM C1202 rapid chloride permeability tests and now included as an option in ASTM C1202. As well, several variations on the proposed draft ASTM WK9367 deicer scaling resistance test, based on the Quebec Ministry of Transportation BNQ test method, were evaluated for concretes containing varying amounts of slag cement. A total of 16 concrete mixtures were studied using both high alkali cement and low alkali cement, Grade 100 slag and Grade 120 slag with 0, 20, 35 and 50 percent slag replacement by mass of total cementing materials. Vinsol resin was used as the primary air entrainer and Micro Air® was used in two replicate mixes for comparison. Based on the results of this study, a draft alternative test method to ASTM C762 is proposed.

Field Demonstration of Foamed Asphalt Muscatine County, HR-257, 1988

The foamed asphalt concept has been around since the 1950's. Rising oil prices have created a renewed interest in this process. The purpose of this project was to construct an asphalt base using the foamed asphalt process and to evaluate its performance. A 4.2 mile length of Muscatine County road A-91 was selected for the research project. Asphalt contents of 4.5% and 5.5%, moisture contents of 70% and 90% of optimum, and fog, single chip, and double chip seal coats were used in various combinations to lay 9 test sections of 4-inch foamed asphalt base. After five years of service and evaluation, several conclusions can be made concerning the performance of the foamed asphalt bases: (1) the foamed asphalt process can work as shown by the excellent performance of Sections 2 and 3; (2) foamed asphalt base requires a well compacted subgrade and a road profile suitable for good drainage of water--test section failures were mostly due to a poor subgrade and subsurface moisture; and (3) when the base is placed in two or more lifts, extreme care must be exercised to insure adequate bonding is achieved between lifts. Any future research with foamed asphalt should include various asphalt depths in order to determine a thickness/strength relationship for foamed asphalt.

Stream Stabilization in Western Iowa: Structure Evaluation and Design Manual, HR-385, 1998

Stream degradation is the action of deepening the stream bed and widening the banks due to the increasing velocity of water flow. Degradation is pervasive in channeled streams found within the deep to moderately deep loess regions of the central United States. Of all the streams, however, the most severe and widespread entrenchment occurs in western Iowa streams that are tributaries to the Missouri River. In September 1995 the Iowa Department of Transportation awarded a grant to Golden Hills Resource Conservation and Development, Inc. The purpose of the grant, HR-385 "Stream Stabilization in Western Iowa: Structure Evaluation and Design Manual", was to provide an assessment of the effectiveness and costs of various stabilization structures in controlling erosion on channeled streams. A review of literature, a survey of professionals, field observations and an analysis of the data recorded on fifty-two selected structures led to the conclusions presented in the project's publication, Design Manual, Streambed Degradation and Streambank Widening in Western Iowa. Technical standards and specifications for the design and construction of stream channel stabilization structures are included in the manual. Additional information on non-structural measures, monitoring and evaluation of structures, various permit requirements and further resources are also included. Findings of the research project and use and applications of the Design Manual were presented at two workshops in the Loess Hills region. Participants in these workshops included county engineers, private contractors, state and federal agency personnel, elected officials and others. The Design Manual continues to be available through Golden Hills Resource Conservation and Development.

Evaluation of the Argentine Nondestructive Test for Determining Concrete Compressive Strength, R-269 and MLR-75-2, 1975

The compressive strength of concrete is an important factor in the design of concrete structures and pavements. To assure the quality of the concrete placed at the project, concrete compressive cylinders are made at the jobsite. These cylinders undergo a destructive test to determine their compressive strength. However, the determination of concrete compressive strength of the concrete actually in the structure or pavement is frequently desirable. For this reason, a nondestructive test of the concrete is required. A nondestructive test of concrete compressive strength should be economical, easily performed by field personnel, and capable of producing accurate, reproducible results. The nondestructive test should be capable of detecting the extent of poor concrete in a pavement or structure due to improper handling, placement, or variations in mixing or materials.

Evaluation of Preformed Neoprene Joint Seals, HR-318, 1994

Most pavement contraction joint seals in Iowa, in general, have been performing in less than a satisfactory manner. The effective life of the seals, in maintaining a watertight joint, has been only from two to five years. In search of improvements, research was proposed to evaluate preformed neoprene joint seals. The performance of those seals was to be compared mainly with the hot poured rubberized asphalt sealants and cold applied silicone sealants or other sealants commonly used at the time this research began. Joint designs and methods of sawing were also investigated. All evaluations were done in new portland cement concrete (PCC) pavements. Three projects were initially selected and each included a research section of joint sealing. Some additional sites were later added for evaluation. Several joint sealants were evaluated at each research site. The various sites included high, medium and low levels of traffic. Evaluations were done over a five-year period. Neoprene joint seals provided better performance than hot or cold field formed joints.

Evaluation of Calcium Magnesium Acetate Deicer in Scott County, HR-253, Progress Report, 1987

The field testing of the noncorrosive alternative deicing agent, calcium magnesium acetate is described. Seventy three tons were produced of one part CMA and three parts sand deicer which was field tested on I-280 from I-80 to the Mississippi River (7,000 ADT with 50% trucks). A comparative application was made with one part sand and one part sodium chloride. The study found that CMA deicer required a longer time for the pavement to reach normal conditions, and 20-25% more CMA deicer to provide the desired deicing. It was concluded that the CMA deicer was not as dependable as the sodium chloride deicing agent, and it was more difficult to clean up the equipment for spreading the CMA deicer.