Audit report on the City of Guthrie Center, Iowa for the year ended June 30, 2015

Audit report on the City of Guthrie Center, Iowa for the year ended June 30, 2015

Audit report on the Guthrie Center Fire Fighters Association for the year ended December 31, 2014

Audit report on the Guthrie Center Fire Fighters Association for the year ended December 31, 2014

Prévalence des maladies infectieuses au Centre hospitalier universitaire vaudois [Prevalence of infectious diseases at the Vaud University Hospital Center].

The prevalence of infectious diseases at our hospital (Centre hospitalier universitaire vaudois, Lausanne [CHUV], 900 beds) was studied retrospectively over a two years period (1980-1981). The medical diagnosis of 30203 patients recorded in the computerized medical archives, representing 93% of the patients admitted during the period of observation, was reviewed. To assess the reliability of the computerized data, quality control was carried out through detailed analysis of all the histologically proven appendicitis recorded during 1981. 88% of the histologically proven appendicitis were registered in the computer and the diagnosis was specific in 87% of cases. An infectious disease was the primary reason for admission in 12.8% of the patients (3873) during the study period. Altogether, 20.2% of patients presented with an infection during their hospital stay. Because of the retrospective nature of the study it was not possible to determine whether these additional infections were nosocomially acquired. The organ systems most frequently infected were the respiratory tract (28.5% of all infections), the digestive tract (20.5%), the skin and osteoarticular system (16%) and the urogenital tract (11.6%). An infection was the primary reason for admission of 40.2% of the patients hospitalized in the dermatology service, of 19.7% of patients admitted in internal medicine, of 15-17% of the patients admitted in pediatrics, ENT and general surgery, and of 1-2% of the patients admitted in neurosurgery and radiotherapy. These observations highlight the continuing importance of infectious diseases in a modern hospital, in spite of high socio-economic levels, stringent hygiene and epidemiologic measures, and modern antibiotic availability.

Quantitative multi-parameter mapping of R1, PD(*), MT, and R2(*) at 3T: a multi-center validation.

Multi-center studies using magnetic resonance imaging facilitate studying small effect sizes, global population variance and rare diseases. The reliability and sensitivity of these multi-center studies crucially depend on the comparability of the data generated at different sites and time points. The level of inter-site comparability is still controversial for conventional anatomical T1-weighted MRI data. Quantitative multi-parameter mapping (MPM) was designed to provide MR parameter measures that are comparable across sites and time points, i.e., 1 mm high-resolution maps of the longitudinal relaxation rate (R1 = 1/T1), effective proton density (PD(*)), magnetization transfer saturation (MT) and effective transverse relaxation rate (R2(*) = 1/T2(*)). MPM was validated at 3T for use in multi-center studies by scanning five volunteers at three different sites. We determined the inter-site bias, inter-site and intra-site coefficient of variation (CoV) for typical morphometric measures [i.e., gray matter (GM) probability maps used in voxel-based morphometry] and the four quantitative parameters. The inter-site bias and CoV were smaller than 3.1 and 8%, respectively, except for the inter-site CoV of R2(*) (<20%). The GM probability maps based on the MT parameter maps had a 14% higher inter-site reproducibility than maps based on conventional T1-weighted images. The low inter-site bias and variance in the parameters and derived GM probability maps confirm the high comparability of the quantitative maps across sites and time points. The reliability, short acquisition time, high resolution and the detailed insights into the brain microstructure provided by MPM makes it an efficient tool for multi-center imaging studies.

Initial experience with hybrid surgery in congenital heart disease in a single center : P171

Introduction: A hybrid intervention is a joint procedure involving the interventional cardiologist and the cardiac surgeon. At our institution we have opted for this type of approach in congenital heart disease since 2005. We report here our initial experience. Cases: 1. A 3 year old boy with double aortic arch and multiple muscular ventricular septal defects (VSD),was readdressed for pulmonary band (PAB) removal and residual VSD closure after previous palliation. After surgical removal of the PAB, the surgeon provided a minimal transventricular access for placement of a 6mm Amplatzer® muscular VSD occluder by the cardiologist under transoesophageal guidance. The patient was extubated the same day and discharged after 5 days. 2. An 8 year old girl with Williams syndrome was followed for two large VSDs and severe peripheral pulmonary arteries (PA) stenosis. The membranous VSD was closed surgically, the muscular VSD during the same operation by direct placement of a 12 mm Amplatzer® muscular VSD occluder. During rewarming, balloon angioplasty of peripheral PA stenosis was achieved under fluoroscopy. Patient was extubated the following day and discharged after 8 days. 3. A 9 year old boy post tetralogy of Fallot repair had severe distal stenosis of the right ventricular to PA conduit.With patient on partial cardiopulmonary bypass, an incision was made on the conduit and a CP 8 Zig 16 stent placed on the stenosis. The child passed on full bypass and the definitive placement of the stent achieved. The child was extubated at the end of the intervention and discharged after 6 days. 4. A newborn presented at 2 days life with complex aortic arch anatomy: left aortic arch and right descending thoracic aorta perfused directly from a right arterial duct and left PA atresia. The arterial duct was stented with a Genesis XD stent dilated at 7mm. Two days later the cardiac surgeon made banded the right PA. The child was extubated after the operation and discharged a week later. Conclusion: Hybrid approach opens new ways of correction or palliation in congenital heart disease with encouraging results and less morbidity.

Endovascular treatment of symptomatic intracranial arterial stenosis: six-year experience in a single-center series of 42 consecutive patients with acute and mid-term results.

BACKGROUND: The limitations of the medical management of symptomatic intracranial arterial stenosis encourage the development of new therapeutic strategies such as intracranial stenting. OBJECTIVE: To report and analyze the results of a series of 42 patients treated with 3 different endovascular techniques: isolated angioplasty, balloon-expandable coronary stents, and the Wingspan self-expandable intracranial stent system. METHODS: Forty-two patients presenting with symptomatic intracranial arterial stenosis were treated with one of these techniques. Computed tomography angiography was performed 6 months after the procedure, and the clinical neurological statuses were categorized using the modified Rankin Scale and the National Institutes of Health Stroke Scale. RESULTS: A total of 42 lesions were treated: 9 with isolated angioplasty, 14 with balloon-expandable coronary stents, and 19 with Wingspan self-expandable intracranial stents. The mean patient age was 62.9 years, and the mean arterial diameter stenosis was 73.9%. Technical success was achieved in 97.6% of the patients. The overall incidence of procedural complications was 21.4%, and the postoperative permanent morbidity/mortality rate was 7.1%. There were 3 cases of in-stent thrombosis (1 fatal) and 5 cases of asymptomatic restenosis (11.9%), 3 in the isolated angioplasty group and 2 in the Wingspan self-expandable intracranial stent group (mean follow-up 20.4 months). The rate of restenosis was higher in the angioplasty group (33%) than in the coronary (0%) and Wingspan stent (10.5%) groups. CONCLUSION: Endovascular treatment of symptomatic intracranial stenosis has significant overall morbidity and mortality rates. Nevertheless, the very critical natural history of severe refractory lesions and the relatively favorable postoperative evolution suggest that it should be considered the first alternative strategy in cases in which medical therapy has failed.

Organisaation innovatiivisuutta edistävät ja estävät tekijät. Case Technology Business Research Center

Tämän työn toimeksiantajaorganisaatio oli Lappeenrannan teknillisen yliopiston alainen, kauppatieteitä, teknologiaa ja tuotantotaloutta työssään yhdistävä tutkimusyksikkö, Technology Business Research Center, TBRC. Erään innovatiivisuustutkimusprojektin (InnoSpring) yhteydessä haluttiin selvittää myös oman tutkimusyksikön innovatiivisuuteen vaikuttavia, edistäviä ja estäviä tekijöitä. Tutkielman tavoitteena oli kartoittaa niitä seikkoja, jotka organisaation - tässä tapauksessa yliopiston tutkimusyksikön - henkilökunnan, projektityöntekijöiden, projektipäälliköiden sekä johdon mukaan vaikuttavat yksikön kykyyn luoda ja omaksua uutta, sen innovatiivisuuteen. Työ toteutettiin focus group-ryhmähaastattelumenetelmällä (kvalitatiivinen tutkimus), joihin osallistuivat omina ryhminään työntekijätaso, projektipäälliköt sekä johto.Haastattelut äänitettiin, litteroitiin ja koodattiin Atlas-Ti-ohjelmistolla. Loppuraportti verkostokuvineen luovutettiin tutkimuslaitokselle heinäkuussa 2005. Ryhmäkeskustelun teemoista ja kysymysten muodosta johtuen tulokset käsittelivät niin tutkimusyksikön nykyistä tilaa kuin eräänlaista "toivetilaa", millainen olisi ihanteellinen ja innovatiivinen työpaikka. Merkillepantavaa oli, että työssä tuli systemaattisesti esiin enemmän innovatiivisuutta edistäviä kuin ehkäiseviä seikkoja - vaikka osa edistävistä seikoista koskikin nimenomaan "toivetilaa". Keskustelluimpia teemoja olivat johtajuus,tavoitteellisuus ja strategian, yhteisen suunnan tarve. Samoin olemassa olevienprosessien kehittäminen, osaamisen (niin oman kuin koko organisaationkin) kokoaminen ja kehittäminen edelleen sekä tulosten jalkauttaminen.

Del gimnàs al lleure-salut. Centres de Fitness, Fitness Center, Fitness & Wellness, Spa, Balnearis, Centres de Talassoteràpia, Curhotel

Actualment, el sector “gimnasos i centres esportius” constitueix una parcel·la de gran importància dins del panorama de la indústria del lleure. L’apogeu creixent del sector lleure-salut s’està produint des de fa diverses dècades, de manera que a hores d’ara el lleure i el temps de lleure, i l’exercici físic i l’esport com a lleure són predictors de qualitat de vida. En aquest sentit, podem relacionar i hem de relacionar el lleure amb la qualitat de vida, un concepte multidimensional que inclou tots els àmbits de la vida humana (estat de la salut, benestar, participació social, condicions de vida...). En aquest treball analitzem de quina forma han anat evolucionat els centres dedicats a la practica esportiva i a la salut. Un sector que des de l’antiguitat fins als nostres dies ha hagut d’anar adaptant i ampliant la seva oferta d’activitats i productes, segons les necessitats dels usuaris.

Cyclicity versus center problem

We prove that there are one-parameter families of planar differential equations for which the center problem has a trivial solution and on the other hand the cyclicity of the weak focus is arbitrarily high. We illustrate this phenomenon in several examples for which this cyclicity is computed.

Integrability of a linear center perturbed by a fourth degree homogeneous polynomial

In this work we study the integrability of a two-dimensional autonomous system in the plane with linear part of center type and non-linear part given by homogeneous polynomials of fourth degree. We give sufficient conditions for integrability in polar coordinates. Finally we establish a conjecture about the independence of the two classes of parameters which appear in the system; if this conjecture is true the integrable cases found will be the only possible ones.

Integrability of a linear center perturbed by a fifth degree homogeneous polynomial

In this work we study the integrability of two-dimensional autonomous system in the plane with linear part of center type and non-linear part given by homogeneous polynomials of fifth degree. We give a simple characterisation for the integrable cases in polar coordinates. Finally we formulate a conjecture about the independence of the two classes of parameters which appear on the system; if this conjecture is true the integrable cases found will be the only possible ones.