Five years of sleep apnea treatment with a mandibular advancement device. Side effects and technical complications

Objective: To determine the variation in prevalence of temporomandibular disorders (TMD), other side effects, and technical complications during 5 years of sleep apnea treatment with a mandibular advancement device. Materials and Methods: Forty patients diagnosed with obstructive sleep apnea received an adjustable appliance at 70% of the maximum protrusion. The protrusion was then progressively increased. TMD (diagnosed according to the Research Diagnostic Criteria for TMD), overjet, overbite, occlusal contacts, subjective side effects, and technical complications were recorded before and a mean of 14, 21, and 58 months after treatment and analyzed by the Wilcoxon test (P Less-than .05). Results: Fifteen patients still used the oral appliance at the 5-year follow-up, and no significant variation in TMD prevalence was observed. Subjective side effects were common, and a significant reduction was found in overjet, overbite, and in the number of occlusal contacts. Furthermore, the patients made a mean of 2.5 unscheduled dental visits per year and a mean of 0.8 appliance repairs/relines per year by a dental technician. The most frequent unscheduled visits were needed during the first year and were a result of acrylic breakage on the lateral telescopic attachment, poor retention, and other adjustments to improve comfort. Conclusions: Five-year oral appliance treatment does not affect TMD prevalence but is associated with permanent occlusal changes in most sleep apnea patients during the first 2 years. Patients seek several unscheduled visits, mainly because of technical complications.

Forestry Practices Manual Technical Guide, June 24, 2005

Technical Guide to Forestry Practices Manual.

Iowa Local Technical Assistance Program 2010 Summary Report and 2011 Continuation Funding Proposal, HR-296, 2010

This document includes a summary of the initiatives and activities that are ongoing or have been completed by the Iowa Local Technical Assistance Program (LTAP) in 2010. It also contains a request for the 2011 continuation of LTAP funding. A brief history of Iowa LTAP is below. In addition, its mission/vision and objectives are noted and an explanation of the new organization used for this report is provided. The remainder of this document includes a description of the Iowa LTAP operations in 2010 and 2011. More specifically, staffing changes and several major initiatives are presented. This is then followed by a discussion of task-by-task 2010 outcomes and proposed 2011 activities.

Video Inspection of Highway Edgedrain Systems, HR-317, 1998

Minimizing infiltration of water in pavement structures has long been a priority of pavement designers. Incorporation of subsurface edgedrains is frequently an integral part of an pavement drainage system. In order for such a system to be effective however, it must be properly installed and maintained. With advances in video technology, inspection of edgedrain systems can now be conducted quite efficiently. This report documents the results of 287 video inspections of highway edgedrain systems in 29 states. These inspections were conducted to both demonstrate the capabilities of the technology as well as demonstrating some of the common problems associated with the performance of edgedrain systems. Findings indicated not only that the equipment was quite effective in identifying edgedrain performance concerns, but also how widespread the concerns of edgedrain performance are. Almost one third of the systems inspected had nonfunctional outlets, another third were either found to have non-functional mainlines or the mainlines could not be inspected due to physical obstructions. Only one third of the systems inspected were found to be performing as intended. Recommendations are provided for edgedrain design improvements to facilitate performance of the system and their inspections as well as recommendations to improve quality control during construction. Suggestions are also provided for maintenance procedures to address concerns identified in the inspection process. A Draft Guide Specification For Video Edgedrain Inspection and Acceptance is also provided as an Appendix.

Sub- or intertrochanteric fracture following screw fixation of an intracapsular proximal femoral fracture: true complication or technical error?

PURPOSE: To review, retrospectively, the possible causes of sub- or intertrochanteric fractures after screw fixation of intracapsular fractures of the proximal femur. METHODS: Eighty-four patients with an intracapsular fracture of proximal femur were operated between 1995 and 1998 by using three cannulated 6.25 mm screws. The screws were inserted in a triangular configuration, one screw in the upper part of the femoral neck and two screws in the inferior part. Between 1999 and 2001, we use two screws proximally and one screw distally. RESULTS: In the first series, two patients died within one week after operation. Sixty-four fractures healed without problems. Four patients developed an atrophic non-union; avascular necrosis of the femoral head was found in 11 patients. Three patients (3.6%) suffered a sub- and/or intertrochanteric fracture after a mean postoperative time of 30 days, in one case without obvious trauma. In all three cases surgical revision was necessary. Between 1999 and 2001 we did not observe any fracture after screwing. CONCLUSION: Two screws in the inferior part of the femoral neck create a stress riser in the subtrochanteric region, potentially inducing a fracture in the weakened bone. For internal fixation for proximal intracapsular femoral fracture only one screw must be inserted in the inferior part of neck.

Occupational research : selected bibliography of Iowa research in vocational-technical education and related areas -- 1960-1967

The Iowa RCU has developed this selected bibliography of Iowa research in Vocational-Technical Education and related areas. Contract research as well as abstracts of masters theses and doctoral dissertations are included. For the most part, these abstracts have been gleaned from research at the three state universities and Drake University.

Occupational research supplement no. 1 : selected bibliography of Iowa research in vocational-technical education and related areas -- 1963-1968

This is a supplement to the selected bibliography of Iowa research in Vocational-Technical Education and related areas that the Iowa RCU developed. Contract research as well as abstracts of masters theses and doctoral dissertations are included.

Occupational research supplement no. 2 : selected bibliography of Iowa research in vocational-technical education and related areas -- 1966-1968

This is supplement no. 2 to the selected bibliography of Iowa research in Vocational-Technical Education and related areas that the Iowa RCU developed. Contract research as well as abstracts of masters theses and doctoral dissertations are included.

The Deleterious Chemical Effects of Concentrated Deicing Solutions on Portland Cement Concrete, Technical Appendices, TR-480, 2008

This research project investigated the effects of concentrated brines of magnesium chloride, calcium chloride, sodium chloride, and calcium magnesium acetate on portland cement concrete. Although known to be effective at deicing and anti-icing, the deleterious effects these chemicals may have on concrete have not been well documented. As a result of this research, it was determined that there is significant evidence that magnesium chloride and calcium chloride chemically interact with hardened portland cement paste in concrete resulting in expansive cracking, increased permeability, and a significant loss in compressive strength. Although the same effects were not seen with sodium chloride brines, it was shown that sodium chloride brines have the highest rate of ingress into hardened concrete. This latter fact is significant with respect to corrosion of embedded steel. The mechanism for attack of hardened cement paste varies with deicer chemical but in general, a chemical reaction between chlorides and cement hydration products results in the dissolution of the hardened cement paste and formation of oxychloride phases, which are expansive. The chemical attack of the hardened cement paste is significantly reduced if supplementary cementitious materials are included in the concrete mixture. Both coal fly ash and ground granulated blast furnace slag were found to be effective at mitigating the chemical attack caused by the deicers tested. In the tests performed, ground granulated blast furnace slag performed better as a mitigation strategy as compared to coal fly ash. Additionally, siloxane and silane sealants were effective at slowing the ingress of deicing chemicals into the concrete and thereby reducing the observed distress. In general, the siloxane sealant appeared to be more effective than the silane, but both were effective and should be considered as a maintenance strategy.

Re-Engineering CTE in Iowa: Aligning Career and Technical Education Reform, Workforce Development and Economic Development, August 2007

Iowa is a relatively small state and is on the rebound economically. It has an overall population that is stable, but which is shifting within the state from more rural areas to suburban and urban centers. There is a very tight labor market with high levels of employment. Iowa now has a time-sensitive opportunity to exert global leadership in renewable energy, while maintaining its leadership in other key industries like finance and agriculture.