Protection of Structural Concrete Substructures, Construction Report, HR-220, 1981

It is the objective of this project to determine, via field tests, the long term effectiveness of several available systems as their ability to protect concrete surfaces against the intrusion of chloride ions. Early concepts of this project included utilizing personnel from several offices within the Highway Division of the Iowa Department of Transportation. Cooperation and coordination with regularly scheduled activities were considered imperative. A meeting for this purpose was held on April 16, 1980. This meeting was attended by the investigators, Mr. Bernard C. Brown, Office of Materials, Mr. Richard Merritt, District 6 Materials Engineer, Mr. John Saunders, District 6 Maintenance Engineer, and Mr. James Phinney, Resident Maintenance Engineer.

Riverine Wetland Summary Report, November 2015

The condition of Iowa’s riverine wetlands is poorly known. No historic baseline information about the physical conditions, vegetation communities, and wildlife use in these ecosystems exists in the state. The primary goals of this project were to assess the ecological condition of riverine wetlands in Iowa, and improve the quality and quantity of data available to resource managers. Iowa’s remaining riverine wetlands represent a valuable set of resources, and their continued monitoring and assessment is imperative to future management decisions.

Comparison of quality of life after stereotactic body radiotherapy and surgery for early-stage prostate cancer

Background: As the long-term efficacy of stereotactic body radiation therapy (SBRT) becomes established and other prostate cancer treatment approaches are refined and improved, examination of quality of life (QOL) following prostate cancer treatment is critical in driving both patient and clinical treatment decisions. We present the first study to compare QOL after SBRT and radical prostatectomy, with QOL assessed at approximately the same times pre- and post-treatment and using the same validated QOL instrument. Methods: Patients with clinically localized prostate cancer were treated with either radical prostatectomy (n = 123 Spanish patients) or SBRT (n = 216 American patients). QOL was assessed using the Expanded Prostate Cancer Index Composite (EPIC) grouped into urinary, sexual, and bowel domains. For comparison purposes, SBRT EPIC data at baseline, 3 weeks, 5, 11, 24, and 36 months were compared to surgery data at baseline, 1, 6, 12, 24,and 36 months. Differences in patient characteristics between the two groups were assessed using Chi-squared tests for categorical variables and t-tests for continuous variables. Generalized estimating equation (GEE) models were constructed for each EPIC scale to account for correlation among repeated measures and used to assess the effect of treatment on QOL. Results: The largest differences in QOL occurred in the first 16 months after treatment, with larger declines following surgery in urinary and sexual QOL as compared to SBRT, and a larger decline in bowel QOL following SBRT as compared to surgery. Long-term urinary and sexual QOL declines remained clinically significantly lower for surgery patients but not for SBRT patients. Conclusions: Overall, these results may have implications for patient and physician clinical decision making which are often influenced by QOL. These differences in sexual, urinary and bowel QOL should be closely considered in selecting the right treatment, especially in evaluating the value of non-invasive treatments, such as SBRT.

Surgical interventions with fatal outcome: Utility of multi-phase postmortem CT angiography

Cases of fatal outcome after surgical intervention are autopsied to determine the cause of death and to investigate whether medical error caused or contributed to the death. For medico-legal purposes, it is imperative that autopsy findings are documented clearly. Modern imaging techniques such as multi-detector computed tomography (MDCT) and postmortem CT angiography, which is used for vascular system imaging, are useful tools for determining cause of death. The aim of this study was to determine the utility of postmortem CT angiography for the medico-legal death investigation. This study investigated 10 medico-legal cases with a fatal outcome after surgical intervention using multi-phase postmortem whole body CT angiography. A native CT scan was performed as well as three angiographic phases (arterial, venous, and dynamic) using a Virtangio((R)) perfusion device and the oily contrast agent, Angiofil((R)). The results of conventional autopsy were compared to those from the radiological investigations. We also investigated whether the radiological findings affected the final interpretation of cause-of-death. Causes of death were hemorrhagic shock, intracerebral hemorrhage, septic shock, and a combination of hemorrhage and blood aspiration. The diagnoses were made by conventional autopsy as well as by postmortem CT angiography. Hemorrhage played an important role in eight of ten cases. The radiological exam revealed the exact source of bleeding in seven of the eight cases, whereas conventional autopsy localized the source of bleeding only generally in five of the seven cases. In one case, neither conventional autopsy nor CT angiography identified the source of hemorrhage. We conclude that postmortem CT angiography is extremely useful for investigating deaths following surgical interventions. This technique helps document autopsy findings and allows a second examination if it is needed; specifically, it detects and visualizes the sources of hemorrhages in detail, which is often of particular interest in such cases.

The role of laparoscopic biopsies in lumbar spondylodiscitis.

Infection of an intervertebral disk is a serious condition. Diagnosis often is elusive and difficult. It is imperative to obtain appropriate microbiological specimens before initiation of treatment. The authors describe a 51-year-old woman with lumbar spondylodiscitis that was because of infection after the placement of an epidural catheter for postoperative analgesia. A spinal magnetic resonance imaging confirmed the diagnosis, but computed tomography-guided fine needle biopsy did not provide adequate material for a microbiologic diagnosis. Laparoscopic biopsies of the involved disk provided good specimens and a diagnosis of Propionibacterium acnes infection. The authors believe that this minimally invasive procedure should be performed when computed tomography-guided fine needle biopsy does not provide a microbiologic diagnosis in spondylodiscitis.

Termination of pregnancy among teenagers - why more surgical terminations?

Introduction: In 2012, a study by K. Chatziioannidou and S-C. Renteria showed that teenagers chose to undergo a surgical termination of pregnancy (TOP) more often than a medical TOP (mifepristone followed by misoprostol) when they decided to terminate a pregnancy. It also showed that the teenagers' choice for a medical versus surgical method is inversely proportional to the adults' choice although the efficiency of the medical method showed even better results for teenagers than for adults. According to the hypothesis made, the reasons for this choice might be influenced by the following facts: (i) the belated call to make an appointment, the medical procedure not being available after 9 weeks of gestation; (ii) the imperative request for confidentiality; (iii) the beliefs and subjective appreciation of the medical staff. Objectives: The aim of this retrospective and qualitative study is to analyse the reasons why, in case of a TOP, teenagers chose the surgical method more often than their adult counterparts. Material: (i) All teenagers who were admitted for an abortive procedure during 2011 in the in- or outpatient ward. (ii) The professional team (midwives and sexual and reproductive counsellors) in charge in the case of a TOP request. Methods: The information about the patient's history and the biopsycho- social data was retrieved from the patient files filled out by midwives and sexual and reproductive health counsellors during the first appointment for a TOP request or during its process. The professionals' appreciation was evaluated by means of a semi-structured questionnaire. Results: Concerning the choice of the method for a pregnancy termination, the results of our research show that: (i) Out of 47 teenagers, 27 chose the surgical method and 17 the medical method. (ii) Three had a second trimester abortion (which includes use of the medical method). (iii) Fifteen teenagers out of the 27 who chose a surgical method consulted between the 9th and 14th weeks of amenorrhoea and therefore did not have any other choice. The reasons for their 'late arrival' will be explained in detail. The 12 teenagers who arrived before the 8th week of amenorrhoea and chose to undertake abortion by suction & curettage under general anaesthesia did it for the following reasons: (i) Four were afraid of bleeding and pain. (ii) Five thought that the organisation of the surgical procedure was easier. (iii) Two did not trust the abortion pill. (iv) One was taken to her mother's gynaecologist where she had a D&C. Confidentiality was requested nine times out of 27 when choosing the surgical method, and six times out of 17 when choosing the medical method. Therefore, although confidentiality concerns a third of the teenagers' pregnancy termination requests, it does not seem to be a significant element for the choice of the method. As for the subjective appreciation of the professionals, the first results of the discussions seem to show that teenagers were reluctant or resistant towards the medical method. Conclusion: This study shows that the reasons why teenagers still prefer the use of the surgical over the medical method compared to adults, seem to include the late request for an appointment, fear of pain and bleeding and organisational issues. Confidentiality does not seem to greatly influence the teenagers' choice. Nonetheless, medical professionals seem to favour the suction curettage procedure performed under anesthesia because they associate young age with vulnerability and psychological frailty and consequently diminished ability to cope with pain and emotional distress during the medical procedures.

Monitoimipystysorvin NC- ohjelmoinnin kehittäminen CAM käyttöönotolla

Diplomityön tavoitteena oli tehostaa venttiilipesien koneistuksessa käytettävän monitoimipystysorvin NC - ohjelmointia CAM - ohjelman käyttöönotolla. Tutkimus on osa laajempaa kokonaisuutta liittyen koneistusalihankinnan kehittämiseen ja yrityksen kilpailukyvyn ylläpitoon ja parantamiseen liiketoiminta-alueella, jolla on tällä hetkellä hyvät kasvunäkymät. Tavoite rajattiin yritykseen jo aiemmin hankitun WinCAM - ohjelman päivittämiseen ja hyödyntämiseen monitoimipystysorvin NC - ohjelmoinnissa. Tutkimuksen käytännön tavoitteena oli selvittää CAM - ohjelmoinnin käyttömahdollisuudet, sekä luoda CAM - ohjelmistoon pohjautuva, räätälöity NC - ohjelmointikonsepti pilottikohteeseen. Tutkimuksen kokeellisen osuuden muodostivat tällöin nykyisen tuotannon ongelmakohtien löytäminen, koneen ohjelmointitarpeiden kartoitus,sekä menetelmäkehitys. Tutkimuksen päämääränä oli tuotannon tasolla käytettävä järjestelmä, jolla koneen ohjelmointi olisi mahdollista myös vähemmällä konekohtaisella kokemuksella. Nykyisen toimintatavan ongelmina olivat yhtenäisen NC - ohjelmointikäytännön puute, niin valmiiden ohjelmien käytössä kuin uusienkin ohjelmien tekemisessä. Tähän olivat syynä NC - ohjauksen heikko käytettävyys erityisesti sorvauksen osalta. Nämä tekijät yhdistettynä monitoimityöstökoneessa tarvittavaan koordinaatiston hallintaan vaikeuttivat ohjelmointia. Työntekijäkohtaiset erot NC - ohjelmien käytössä, sekä laadultaan vaihtelevat valuaihiot aiheuttivat tuotannon läpäisyaikaan merkittävää vaihtelua. Siten myös koneen kuormituksen säätely oli vaikeaa. Uuden ohjelmointikonseptin toteutuksessa pidettiin etusijalla hyvää käytettävyyttä, sekä uuden menetelmän aukotonta liittymistä olemassa oleviin tuotantojärjestelmiin. Ohjelmointikonseptin toteutuksessa, osaperheestä haettiin selkeästi parametroitaviksi soveltuvat työvaiheet, jotka voitiin hallita yleiskäyttöisillä aliohjelmilla. Tuotteiden muidengeometrioiden hallintaan laadittiin geometriakirjasto, jota voitiin käyttää tavanomaisen graafisen ohjelmoinnin pohjana. Vanhaa toimintatapaa ja diplomityön aikana kehitettyä CAM - ohjelmointijärjestelmää vertailtiin perustuen NC - ohjelmien tehokkuuteen, jota tarkasteltiin saman työvaiheen työstöaikaan perustuen. Tämän lisäksi tärkeän tuloksen muodostavat myös kvalitatiivisetseikat, jotka liittyvät ohjelmointiympäristön käytettävyyteen. CAM - ohjelmoinnin kehittäminen ja käyttöönotto pilottikohteessa sujui pääosin hyvin ja laaditunsuunnitelman mukaisesti. Aiemmin hankalasti ohjelmoitavat työvaiheet, kuten erilaisten laippatasopintojen ja reikäpiirien ohjelmointi muutettiin makrokäyttöön soveltuviksi. Sorvauksessa ongelmia aiheuttaneen tiivistelilan koneistukseen sovellettiin graafista ohjelmointia. Koko tuotannon mittakaavassa NC - ohjelmoinninosuus oli kuitenkin vähäinen, mistä johtuen koneen tuottavuuteen ei tutkimuksenajanjaksolla voitu vaikuttaa. Sen sijaan tuotannon sujuvuuteen oleellisesti vaikuttavaa työtekijöiden 'hiljaisen tiedon' määrää voitiin vähentää vakioimalla ohjelmointia ja siirtämällä tehokkaiksi havaitut menetelmät ohjelmointijärjestelmään.

Promoting good practices for handling nanomaterials : an international wiki project

As production and use of nanomaterials in commercial products grow it is imperative to ensure these materials are used safely with minimal unwanted impacts on human health or the environment. Foremost among the populations of potential concern are workers who handle nanomaterials in a variety of occupational settings, including university laboratories, industrial manufacturing plants and other institutions. Knowledge about prudent practices for handling nanomaterials is being developed by many groups around the world but may be communicated in a way that is difficult for practitioners to access or use. The GoodNanoGuide is a collaborative, open-access project aimed at creating an international forum for the development and discussion of prudent practices that can be used by researchers, workers and their representatives, occupational safety professionals, governmental officials and even the public. The GoodNanoGuide is easily accessed by anyone with access to a web browser and aims to become a living repository of good practices for the nanotechnology enterprise. Interested individuals are invited to learn more about the GoodNanoGuide at http://goodnanoguide.org.

Immune Antibodies and Helminth Products Drive CXCR2-Dependent Macrophage-Myofibroblast Crosstalk to Promote Intestinal Repair.

Helminth parasites can cause considerable damage when migrating through host tissues, thus making rapid tissue repair imperative to prevent bleeding and bacterial dissemination particularly during enteric infection. However, how protective type 2 responses targeted against these tissue-disruptive multicellular parasites might contribute to homeostatic wound healing in the intestine has remained unclear. Here, we observed that mice lacking antibodies (Aid-/-) or activating Fc receptors (Fcrg-/-) displayed impaired intestinal repair following infection with the murine helminth Heligmosomoides polygyrus bakeri (Hpb), whilst transfer of immune serum could partially restore chemokine production and rescue wound healing in Aid-/- mice. Impaired healing was associated with a reduced expression of CXCR2 ligands (CXCL2/3) by macrophages (MΦ) and myofibroblasts (MF) within intestinal lesions. Whilst antibodies and helminths together triggered CXCL2 production by MΦ in vitro via surface FcR engagement, chemokine secretion by intestinal MF was elicited by helminths directly via Fcrg-chain/dectin2 signaling. Blockade of CXCR2 during Hpb challenge infection reproduced the delayed wound repair observed in helminth infected Aid-/- and Fcrg-/- mice. Finally, conditioned media from human MΦ stimulated with infective larvae of the helminth Ascaris suum together with immune serum, promoted CXCR2-dependent scratch wound closure by human MF in vitro. Collectively our findings suggest that helminths and antibodies instruct a chemokine driven MΦ-MF crosstalk to promote intestinal repair, a capacity that may be harnessed in clinical settings of impaired wound healing.

Essential surgery: the way forward.

INTRODUCTION: Very little surgical care is performed in low- and middle-income countries (LMICs). An estimated two billion people in the world have no access to essential surgical care, and non-surgeons perform much of the surgery in remote and rural areas. Surgical care is as yet not recognized as an integral aspect of primary health care despite its self-demonstrated cost-effectiveness. We aimed to define the parameters of a public health approach to provide surgical care to areas in most need. METHODS: Consensus meetings were held, field experience was collected via targeted interviews, and a literature review on the current state of essential surgical care provision in Sub-Saharan Africa (SSA) was conducted. Comparisons were made across international recommendations for essential surgical interventions and a consensus-driven list was drawn up according to their relative simplicity, resource requirement, and capacity to provide the highest impact in terms of averted mortality or disability. RESULTS: Essential Surgery consists of basic, low-cost surgical interventions, which save lives and prevent life-long disability or life-threatening complications and may be offered in any district hospital. Fifteen essential surgical interventions were deduced from various recommendations from international surgical bodies. Training in the realm of Essential Surgery is narrow and strict enough to be possible for non-physician clinicians (NPCs). This cadre is already active in many SSA countries in providing the bulk of surgical care. CONCLUSION: A basic package of essential surgical care interventions is imperative to provide structure for scaling up training and building essential health services in remote and rural areas of LMICs. NPCs, a health cadre predominant in SSA, require training, mentoring, and monitoring. The cost of such training is vastly more efficient than the expensive training of a few polyvalent or specialist surgeons, who will not be sufficient in numbers within the next few generations. Moreover, these practitioners are used to working in the districts and are much less prone to gravitate elsewhere. The use of these NPCs performing "Essential Surgery" is a feasible route to deal with the almost total lack of primary surgical care in LMICs.

Comparison of quality of life after stereotactic body radiotherapy and surgery for early-stage prostate cancer

Background: As the long-term efficacy of stereotactic body radiation therapy (SBRT) becomes established and other prostate cancer treatment approaches are refined and improved, examination of quality of life (QOL) following prostate cancer treatment is critical in driving both patient and clinical treatment decisions. We present the first study to compare QOL after SBRT and radical prostatectomy, with QOL assessed at approximately the same times pre- and post-treatment and using the same validated QOL instrument. Methods: Patients with clinically localized prostate cancer were treated with either radical prostatectomy (n = 123 Spanish patients) or SBRT (n = 216 American patients). QOL was assessed using the Expanded Prostate Cancer Index Composite (EPIC) grouped into urinary, sexual, and bowel domains. For comparison purposes, SBRT EPIC data at baseline, 3 weeks, 5, 11, 24, and 36 months were compared to surgery data at baseline, 1, 6, 12, 24,and 36 months. Differences in patient characteristics between the two groups were assessed using Chi-squared tests for categorical variables and t-tests for continuous variables. Generalized estimating equation (GEE) models were constructed for each EPIC scale to account for correlation among repeated measures and used to assess the effect of treatment on QOL. Results: The largest differences in QOL occurred in the first 1-6 months after treatment, with larger declines following surgery in urinary and sexual QOL as compared to SBRT, and a larger decline in bowel QOL following SBRT as compared to surgery. Long-term urinary and sexual QOL declines remained clinically significantly lower for surgery patients but not for SBRT patients. Conclusions: Overall, these results may have implications for patient and physician clinical decision making which are often influenced by QOL. These differences in sexual, urinary and bowel QOL should be closely considered in selecting the right treatment, especially in evaluating the value of non-invasive treatments, such as SBRT.

Strategisen tuotteen materiaalitoimittajan valintaprosessi

Työn tavoitteena on esittää strategisen tuotteen toimittajan valintaprosessi. Tavoitteena on esittää valintaprosessin eri vaiheet ja niissä huomioitavat asiat sekä eri vaiheisiin sovellettavia menetelmiä ja työkaluja.Valintaprosessi alkaa tarpeen määrittämisellä, joka käsittää sekä tuotteen ominaisuuksien että toimittajasuhteen kuvaamisen. Strategisten tuotteiden kohdalla tavoitteena on useimmiten pitkäaikainen yhteistyömuoto valitun toimittajan kanssa. Tarpeen määrittämisen jälkeen etsitään eri lähteistä, kuten erilaisista kaupallisista hakemistoista, internetistä, ammattijulkaisuista sekä henkilökohtaisten kontaktien avulla, potentiaalisia toimittajia, joista luodaan ehdokaslista. Seuraavana on vuorossa sovellettavien valintakriteerien määrittäminen. Tyypillisesti tarkastellaan ainakin toimittajan taloudellista tilannetta, laatua, tuotantoa, kuljetusta, palvelua ja raportointia ja tiedonvälitystä. Tämän jälkeen suoritetaan ensimmäinen seulonta, jossa karsitaan epäsopivimmat ehdokkaat pois prosessin jatkovaiheista. Tarvittavia tietoja voidaan hankkia kirjallisten kyselyiden sekä puhelin- ja henkilöhaastatteluiden avulla. Yksityiskohtaisessa arvioinnissa suoritetaan perusteellinen toimittajien vertailu aikaisemmin valittujen valintakriteerien mukaan. Toimittajan yksityiskohtaiseen arviointiin on tarjolla erilaisia menetelmiä, kuten luokiteltu arviointi, painotettu pistearviointi ja kustannussuhdearviointi. Neuvotteluihin valitaan tyypillisesti muutama sopivin toimittaja ja neuvotteluiden jälkeen on pystyttävä valitsemaan sopivin toimittaja tai vaihtoehtoisesti pari toimittajaa, joiden kesken sopimus jaetaan.

Annonaceae substitution rates: a codon model perspective

The Annonaceae includes cultivated species of economic interest and represents an important source of information for better understanding the evolution of tropical rainforests. In phylogenetic analyses of DNA sequence data that are used to address evolutionary questions, it is imperative to use appropriate statistical models. Annonaceae are cases in point: Two sister clades, the subfamilies Annonoideae and Malmeoideae, contain the majority of Annonaceae species diversity. The Annonoideae generally show a greater degree of sequence divergence compared to the Malmeoideae, resulting in stark differences in branch lengths in phylogenetic trees. Uncertainty in how to interpret and analyse these differences has led to inconsistent results when estimating the ages of clades in Annonaceae using molecular dating techniques. We ask whether these differences may be attributed to inappropriate modelling assumptions in the phylogenetic analyses. Specifically, we test for (clade-specific) differences in rates of non-synonymous and synonymous substitutions. A high ratio of nonsynonymous to synonymous substitutions may lead to similarity of DNA sequences due to convergence instead of common ancestry, and as a result confound phylogenetic analyses. We use a dataset of three chloroplast genes (rbcL, matK, ndhF) for 129 species representative of the family. We find that differences in branch lengths between major clades are not attributable to different rates of non-synonymous and synonymous substitutions. The differences in evolutionary rate between the major clades of Annonaceae pose a challenge for current molecular dating techniques that should be seen as a warning for the interpretation of such results in other organisms.

From bird to sparrow: Learning-induced modulations in fine-grained semantic discrimination.

Recognition of environmental sounds is believed to proceed through discrimination steps from broad to more narrow categories. Very little is known about the neural processes that underlie fine-grained discrimination within narrow categories or about their plasticity in relation to newly acquired expertise. We investigated how the cortical representation of birdsongs is modulated by brief training to recognize individual species. During a 60-minute session, participants learned to recognize a set of birdsongs; they improved significantly their performance for trained (T) but not control species (C), which were counterbalanced across participants. Auditory evoked potentials (AEPs) were recorded during pre- and post-training sessions. Pre vs. post changes in AEPs were significantly different between T and C i) at 206-232ms post stimulus onset within a cluster on the anterior part of the left superior temporal gyrus; ii) at 246-291ms in the left middle frontal gyrus; and iii) 512-545ms in the left middle temporal gyrus as well as bilaterally in the cingulate cortex. All effects were driven by weaker activity for T than C species. Thus, expertise in discriminating T species modulated early stages of semantic processing, during and immediately after the time window that sustains the discrimination between human vs. animal vocalizations. Moreover, the training-induced plasticity is reflected by the sharpening of a left lateralized semantic network, including the anterior part of the temporal convexity and the frontal cortex. Training to identify birdsongs influenced, however, also the processing of C species, but at a much later stage. Correct discrimination of untrained sounds seems to require an additional step which results from lower-level features analysis such as apperception. We therefore suggest that the access to objects within an auditory semantic category is different and depends on subject's level of expertise. More specifically, correct intra-categorical auditory discrimination for untrained items follows the temporal hierarchy and transpires in a late stage of semantic processing. On the other hand, correct categorization of individually trained stimuli occurs earlier, during a period contemporaneous with human vs. animal vocalization discrimination, and involves a parallel semantic pathway requiring expertise.

Elaboración de un sistema de categorías para el análisis sociométrico: su aplicación en aulas multiculturales

That contribution shows a categorisation system in order to analyse the psicosocial setup of people inside a group. It implies a kind of information analysis more qualitative and dinamic than the traditional and well known sociometric indexes. The categories present not only the quantity of recieved choices, rejections and perceptions, but the quality of established relations. Studied the intern consistency by different analistds, the elaborated categorical system can by applied to the study of sociometric tests to the primary students in multicultural classroom, in order to study the level and nature of integration among different ethnic minorities. A least, that contribution ofers the outcomes from the analysis of the integration of a simple of 95 students (girls and boys) from several ethnic minorities and describes their limits and conclusions.