Agreed-upon procedures report on the City of Bedford, Iowa for the period July 1, 2013 through June 30, 2014

Agreed-upon procedures report on the City of Bedford, Iowa for the period July 1, 2013 through June 30, 2014

Agreed-upon procedures report on the City of Pleasant Plain, Iowa for the period January 1, 2014 through December 31, 2014

Agreed-upon procedures report on the City of Pleasant Plain, Iowa for the period January 1, 2014 through December 31, 2014

Agreed-upon procedures report on the City of Patterson, Iowa for the period December 1, 2013 through November 30, 2014

Agreed-upon procedures report on the City of Patterson, Iowa for the period December 1, 2013 through November 30, 2014

Agreed upon procedures report on the City of Galt, Iowa for the period August 1, 2013 through July 31, 2014

Agreed upon procedures report on the City of Galt, Iowa for the period August 1, 2013 through July 31, 2014

Agreed-upon procedures report on the City of Cambridge, Iowa for the period August 1, 2013 through July 31, 2014

Agreed-upon procedures report on the City of Cambridge, Iowa for the period August 1, 2013 through July 31, 2014

Agreed-upon procedures report on the City of Gilman, Iowa for the period September 1, 2013 through August 31, 2014

Agreed-upon procedures report on the City of Gilman, Iowa for the period September 1, 2013 through August 31, 2014

Agreed-upon procedures report on the City of Mount Ayr, Iowa for the period July 1, 2013 through June 30, 2014

Agreed-upon procedures report on the City of Mount Ayr, Iowa for the period July 1, 2013 through June 30, 2014

Investigation of Rapid Thermal Analysis Procedures for Prediction of the Service Life of PCCP Carbonate Coarse Aggregate, HR-337, 1993

The major objective of this research project was to use thermal analysis techniques in conjunction with x-ray analysis methods to identify and explain chemical reactions that promote aggregate related deterioration in portland cement concrete. Twenty-two different carbonate aggregate samples were subjected to a chemical testing scheme that included: • bulk chemistry (major, minor and selected trace elements) • bulk mineralogy (minor phases concentrated by acid extraction) • solid-solution in the major carbonate phases • crystallite size determinations for the major carbonate phases • a salt treatment study to evaluate the impact of deicer salts Test results from these different studies were then compared to information that had been obtained using thermogravimetric analysis techniques. Since many of the limestones and dolomites that were used in the study had extensive field service records it was possible to correlate many of the variables with service life. The results of this study have indicated that thermogravimetric analysis can play an important role in categorizing carbonate aggregates. In fact, with modern automated thermal analysis systems it should be possible to utilize such methods on a quality control basis. Strong correlations were found between several of the variables that were monitored in this study. In fact, several of the variables exhibited significant correlations to concrete service life. When the full data set was utilized (n = 18), the significant correlations to service life can be summarized as follows ( a = 5% level): • Correlation coefficient, r, = -0.73 for premature TG loss versus service life. • Correlation coefficient, r, = 0.74 for relative crystallite size versus service life. • Correlation coefficient, r, = 0.53 for ASTM C666 durability factor versus service life. • Correlation coefficient, r, = -0.52 for acid-insoluble residue versus service life. Separation of the carbonate aggregates into their mineralogical categories (i.e., calcites and dolomites) tended to increase the correlation coefficients for some specific variables (r sometimes approached 0.90); however, the reliability of such correlations was questionable because of the small number of samples that were present in this study.

The effect of n-3 enriched nutrition therapy on post-operative cognitive dysfunction after cardiac surgery

Background: Postoperative cognitive dysfunction (POCD) occurs frequently after cardiac surgery. Some data suggest that inflammation plays a key role in the development of POCD. N-3 fatty acids have been shown to have a beneficial effect on inflammation. We hypothesised that perioperative n-3 enriched nutrition therapy would reduce the incidence of POCD in this group of patients. Methods: Randomized, double blind placebo controlled trial in patients aged 65 or older undergoing elective cardiac surgery with cardiopulmonary bypass. 2x 250 mL placebo (Ensure Plus™, Abbott Nutrition) or n-3 enriched nutrition therapy (ProSure™ Abbott Nutrition) were administered for ten days starting 5 days prior to surgery. Cognition was assessed preoperatively and 7 days after surgery with the Consortium to Establish a Registry for Alzheimer's Disease - Neuropsychological Assessment Battery (CERAD-NAB) [1]. Results: 16 patients were included. Mean age was 72 } 5.3 for placebo and 75 } 4.8 for ProSure™ respectively. CRP and IL-6 did not differ significantly between groups preoperatively and on postoperative days 1, 3, and 7. Preoperative CERAD total scores were 86 } 10 and 81 } 9 (p = n.s.) for Placebo and ProSure™, respectively. Postoperative scores were 88 } 12, and 77 } 19 (p = n.s.) The change in score was not different between the two groups (Placebo: +3 } 5; ProSure: -5 } 11). Conclusion: In this very small sample no effect of preoperatively started n-3 enriched nutritional supplements on inflammation or cognitive functions were detected. However, there is a large likelihood of a type II error and more patients need to be included to assess possible beneficial effects of this intervention in elderly patients undergoing elective cardiac surgery. 1 Chandler MJ, et al. Neurology. 2005;65:102-6.

Agreed-upon procedures report on the City of Lacona, Iowa for the period December 1, 2013 through November 30, 2014

Agreed-upon procedures report on the City of Lacona, Iowa for the period December 1, 2013 through November 30, 2014

Agreed-upon procedures report on the City of Lansing, Iowa for the period July 1, 2013 through June 30, 2014

Agreed-upon procedures report on the City of Lansing, Iowa for the period July 1, 2013 through June 30, 2014

Agreed-upon procedures report on the City of Armstrong, Iowa for the period October 1, 2013 through September 30, 2014

Agreed-upon procedures report on the City of Armstrong, Iowa for the period October 1, 2013 through September 30, 2014

Tracheo-carinal reconstructions using extrathoracic muscle flaps.

OBJECTIVES: Prospective evaluation of tracheo-carinal airway reconstructions using pedicled extrathoracic muscle flaps for closing airway defects after non-circumferential resections and after carinal resections as part of the reconstruction for alleviation of anastomotic tension. METHODS: From January 1996 to June 2006, 41 patients underwent tracheo-carinal airway reconstructions using 45 extrathoracic muscle flaps (latissimus dorsi, n=25; serratus anterior, n=18; pectoralis major, n=2) for closing airway defects resulting from (a) bronchopleural fistulas (BPF) with short desmoplastic bronchial stumps after right upper lobectomy (n=1) and right-sided (pleuro) pneumonectomy (n=13); (b) right (n=9) and left (n=3) associated with partial carinal resections for pre-treated centrally localised tumours; (c) partial non-circumferential tracheal resections for pre-treated tracheal tumours, tracheo-oesophageal fistulas (TEF) and chronic tracheal injury with tracheomalacia (n=11); (d) carinal resections with the integration of a muscle patch in specific parts of the anastomotic reconstruction for alleviation of anastomotic tension (n=4). The airway defects ranged from 2 x 1 cm to 8 x 4 cm and involved up to 50% of the airway circumference. The patients were followed by clinical examination, repeated bronchoscopy, pulmonary function testing and CT scans. The minimum follow-up time was 6 months. RESULTS: Ninety-day mortality was 7.3% (3/41 patients). Four patients (9.7%) sustained muscle flap necrosis requiring re-operation and flap replacement without subsequent mortality, airway dehiscence or stenosis. Airway dehiscence was observed in 1/41 patients (2.4%) and airway stenosis in 1/38 surviving patients (2.6%) responding well to topical mitomycin application. Follow-up on clinical grounds, by CT scans and repeated bronchoscopy, revealed airtight, stable and epithelialised airways and no recurrence of BPF or TEF in all surviving patients. CONCLUSIONS: Tracheo-carinal airway defects can be closed by use of pedicled extrathoracic muscle flaps after non-circumferential resections and after carinal resections with the muscle patch as part of the reconstruction for alleviation of anastomotic tension.

Stabilization Procedures to Mitigate Edge Rutting for Granular Shoulders - Phase II, TR-591, 2011

A multifaceted investigation was undertaken to develop recommendations for methods to stabilize granular road shoulders with the goal of mitigating edge ruts. Included was reconnaissance of problematic shoulder locations, a laboratory study to develop a method to test for changes in granular material stability when stabilizing agents are used, and the construction of three sets of test sections under traffic at locations with problematic granular shoulders. Full results of this investigation are included in this report and its appendices. This report also presents conclusions and recommendations based on the study results.

Agreed-upon procedures report on the City of Hills, Iowa for the period October 1, 2013 through September 30, 2014

Agreed-upon procedures report on the City of Hills, Iowa for the period October 1, 2013 through September 30, 2014