Palliative and supportive care: at the frontier of medical omnipotence.

Cancer patients have physical, social, spiritual an emotional needs. They may suffer from severe physical symptoms, from social isolation and a sense of spiritual abandonment, and emotions such as sadness and anxiety, or feeling of deception, helplessness, anger and guilt. In some of them, the disease is rapidly progressive and they ultimately die. Their demanding care evokes intense feelings in health care providers, the more so since these incurable patients represent a challenge, which can be characterized as one of 'medical omnipotence'. It may be assumed that the way health care providers cope with these circumstances profoundly influences the way these patients are cared for. Attitudes regarding the emerging heterogeneous movement of palliative and supportive care and its different models of implementation can be viewed form this vantage point. Here we look at these interrelations and discuss the potential pitfalls if they are ignored and remain unexamined.

What do we actually mean by talent in business? Does it really matter?

[spa] La conceptuación de talento ha ido cobrando cada vez más importancia tanto para académicos como profesionales, con el fin de avanzar en el estudio de la gestión del talento. De hecho, la confusión sobre el significado de talento en la realidad empresarial impide llegar a un consenso sobre el concepto y la práctica de la gestión del talento. En este estudio teórico revisamos el concepto de talento en el mundo de la empresa con el fin de resumir lo que hemos aprendido y discutir las ventajas y limitaciones de las diferentes acepciones. Concluimos con la formulación de una definición de este concepto, ya que una correcta interpretación de la gestión del talento—por no hablar de una exitosa gestión del talento— depende de tener una comprensión clara de lo que se entiende por talento en un contexto organizativo. Además, con la definición de talento propuesta delimitamos el concepto de talento evitando algunos problemas detectados en las definiciones anteriores (por ejemplo, generalidades y tautologías), y poniendo de relieve las variables importantes que le afectan y lo hacen más manejable.

What do we actually mean by talent in business? Does it really matter?

[spa] La conceptuación de talento ha ido cobrando cada vez más importancia tanto para académicos como profesionales, con el fin de avanzar en el estudio de la gestión del talento. De hecho, la confusión sobre el significado de talento en la realidad empresarial impide llegar a un consenso sobre el concepto y la práctica de la gestión del talento. En este estudio teórico revisamos el concepto de talento en el mundo de la empresa con el fin de resumir lo que hemos aprendido y discutir las ventajas y limitaciones de las diferentes acepciones. Concluimos con la formulación de una definición de este concepto, ya que una correcta interpretación de la gestión del talento—por no hablar de una exitosa gestión del talento— depende de tener una comprensión clara de lo que se entiende por talento en un contexto organizativo. Además, con la definición de talento propuesta delimitamos el concepto de talento evitando algunos problemas detectados en las definiciones anteriores (por ejemplo, generalidades y tautologías), y poniendo de relieve las variables importantes que le afectan y lo hacen más manejable.

An Integrated Study of Pervious Concrete Mixture Design for Wearing Course Applications, July 2011

This report presents the results of the largest and most comprehensive study to date on portland cement pervious concrete (PCPC). It is designed to be widely accessible and easily applied by designers, producers, contractors, and owners. The project was designed to begin with pervious concrete best practices and then to address the unanswered questions in a systematic fashion to allow a successful overlay project. Consequently, the first portion of the integrated project involved a combination of fundamental material property investigations, test method development, and addressing constructability issues before actual construction could take place. The second portion of the project involved actual construction and long-term testing before reporting successes, failures, and lessons learned. The results of the studies conducted show that a pervious concrete overlay can be designed, constructed, operated, and maintained. A pervious concrete overlay has several inherent advantages, including reduced splash and spray and reduced hydroplaning potential, as well as being a very quiet pavement. The good performance of this overlay in a particularly harsh freeze-thaw climate, Minnesota, shows pervious concrete is durable and can be successfully used in freeze-thaw climates with truck traffic and heavy snow plowing.

The immune space: a concept and template for rationalizing vaccine development.

Abstract Empirical testing of candidate vaccines has led to the successful development of a number of lifesaving vaccines. The advent of new tools to manipulate antigens and new methods and vectors for vaccine delivery has led to a veritable explosion of potential vaccine designs. As a result, selection of candidate vaccines suitable for large-scale efficacy testing has become more challenging. This is especially true for diseases such as dengue, HIV, and tuberculosis where there is no validated animal model or correlate of immune protection. Establishing guidelines for the selection of vaccine candidates for advanced testing has become a necessity. A number of factors could be considered in making these decisions, including, for example, safety in animal and human studies, immune profile, protection in animal studies, production processes with product quality and stability, availability of resources, and estimated cost of goods. The "immune space template" proposed here provides a standardized approach by which the quality, level, and durability of immune responses elicited in early human trials by a candidate vaccine can be described. The immune response profile will demonstrate if and how the candidate is unique relative to other candidates, especially those that have preceded it into efficacy testing and, thus, what new information concerning potential immune correlates could be learned from an efficacy trial. A thorough characterization of immune responses should also provide insight into a developer's rationale for the vaccine's proposed mechanism of action. HIV vaccine researchers plan to include this general approach in up-selecting candidates for the next large efficacy trial. This "immune space" approach may also be applicable to other vaccine development endeavors where correlates of vaccine-induced immune protection remain unknown.

Structural brain plasticity in Parkinson's disease induced by balance training.

We investigated morphometric brain changes in patients with Parkinson's disease (PD) that are associated with balance training. A total of 20 patients and 16 healthy matched controls learned a balance task over a period of 6 weeks. Balance testing and structural magnetic resonance imaging were performed before and after 2, 4, and 6 training weeks. Balance performance was re-evaluated after ∼20 months. Balance training resulted in performance improvements in both groups. Voxel-based morphometry revealed learning-dependent gray matter changes in the left hippocampus in healthy controls. In PD patients, performance improvements were correlated with gray matter changes in the right anterior precuneus, left inferior parietal cortex, left ventral premotor cortex, bilateral anterior cingulate cortex, and left middle temporal gyrus. Furthermore, a TIME × GROUP interaction analysis revealed time-dependent gray matter changes in the right cerebellum. Our results highlight training-induced balance improvements in PD patients that may be associated with specific patterns of structural brain plasticity. In summary, we provide novel evidence for the capacity of the human brain to undergo learning-related structural plasticity even in a pathophysiological disease state such as in PD.

Iowa Disaster Recovery Tabletop Exercise After Action Report/Improvement Plan, August 2010

On June 24, 2010, the Rebuild Iowa Office (RIO) held a discussion-based tabletop exercise for the purpose of creating a framework to support disaster recovery coordination within the State of Iowa. The exercise design team was composed of RIO and Iowa Homeland Security and Emergency Management Division (HSEMD) staff. Initial planning for the Iowa Disaster Recovery Tabletop Exercise began in February 2010, in response to recommendations by the Rebuild Iowa Advisory Commission and the Rebuild Iowa Coordinating Council. Both of these groups were organized in direct response to the 2008 Iowa disasters to help establish a path for Iowa’s recovery and monitor progress toward meeting established goals. Recommendations included formalizing the responsibilities of the RIO as they relate to 2008 disasters, capturing lessons learned, and determining what a recovery model should look like for Iowa’s future disasters.

A Qualitative Exploration of the Psychological Contents and Dynamics of Momentum in Sport

While studies on triggers and outcomes of Psychological Momentum (PM) exist, little is known about the dynamics by which PM emerges and develops over time. Based on video-assisted recalls of PM experiences in table tennis and swimming competitions, this research qualitatively explored the triggering processes, contents, and the development of PM over time. PM was found to be triggered by mechanisms of dissonance, consonance, or fear of not winning. During the PM experience, participants reported a variety of perceptions, affects and emotions, cognitions, and behaviors, and PM was found to develop through processes of amplification that sometimes ended with a reduction of efforts when the victory or defeat was perceived as certain. These findings are discussed in light of theories on self-regulation and reactance-helplessness. From a practical standpoint, achievement goal-based strategies are suggested, since mastery-approach goals were found to be endorsed to maintain positive PM and overcome negative PM

Preparing Tomorrow's Transportation Workforce: A Midwest Summit, 2010

regional transportation workforce development summits held across the United States in 2009 and 2010 as part of a coordinated initiative to ultimately develop a national strategy to address future transportation workforce issues. The initiative is being led by the U.S. Department of Transportation’s (DOT) Research and Innovative Technology Administration (RITA). This particular summit was hosted by Iowa State University’s Midwest Transportation Consortium (MTC) and Institute for Transportation (InTrans). The purpose of the Midwest summit was to assess the educational and training needs of the future transportation workforce and identify strategies to address those needs across various career paths. It addressed a broad spectrum of topics including strategies to attract women and under-represented minority groups, pre-college opportunities and strategies, post-secondary education, post-college continuing education, professional licensure, and specific industry perspectives. The goals of the summit were (1) to gain an improved understanding of the transportation workforce needs of Iowa and the surrounding states and (2) to identify best practices in addressing the workforce development needs. This event had two tracks: one focused on pre-college education and the other focused primarily on college education and practitioners. Attendees provided a good cross-section of the larger transportation industry. From what was learned at the summit, Iowa State University, like other regional hosts, can develop a “profile of needs” for Iowa including specific job categories over specific time horizons. The summit was also successful in identifying best practices in addressing the workforce needs that can be utilized by us and others as potential tools or in a “national-level list of attributes.” Each regional summit has provided some guidance in developing statewide profiles. The collection of best practices or tools from all the regional summits can be shared and applied to address state (or regional) needs profiles to attract, develop, and retain an effective workforce.

Apprentissage automatique de la morphologie : le cas des structures racine-schème

RÉSUMÉ Cette thèse porte sur le développement de méthodes algorithmiques pour découvrir automatiquement la structure morphologique des mots d'un corpus. On considère en particulier le cas des langues s'approchant du type introflexionnel, comme l'arabe ou l'hébreu. La tradition linguistique décrit la morphologie de ces langues en termes d'unités discontinues : les racines consonantiques et les schèmes vocaliques. Ce genre de structure constitue un défi pour les systèmes actuels d'apprentissage automatique, qui opèrent généralement avec des unités continues. La stratégie adoptée ici consiste à traiter le problème comme une séquence de deux sous-problèmes. Le premier est d'ordre phonologique : il s'agit de diviser les symboles (phonèmes, lettres) du corpus en deux groupes correspondant autant que possible aux consonnes et voyelles phonétiques. Le second est de nature morphologique et repose sur les résultats du premier : il s'agit d'établir l'inventaire des racines et schèmes du corpus et de déterminer leurs règles de combinaison. On examine la portée et les limites d'une approche basée sur deux hypothèses : (i) la distinction entre consonnes et voyelles peut être inférée sur la base de leur tendance à alterner dans la chaîne parlée; (ii) les racines et les schèmes peuvent être identifiés respectivement aux séquences de consonnes et voyelles découvertes précédemment. L'algorithme proposé utilise une méthode purement distributionnelle pour partitionner les symboles du corpus. Puis il applique des principes analogiques pour identifier un ensemble de candidats sérieux au titre de racine ou de schème, et pour élargir progressivement cet ensemble. Cette extension est soumise à une procédure d'évaluation basée sur le principe de la longueur de description minimale, dans- l'esprit de LINGUISTICA (Goldsmith, 2001). L'algorithme est implémenté sous la forme d'un programme informatique nommé ARABICA, et évalué sur un corpus de noms arabes, du point de vue de sa capacité à décrire le système du pluriel. Cette étude montre que des structures linguistiques complexes peuvent être découvertes en ne faisant qu'un minimum d'hypothèses a priori sur les phénomènes considérés. Elle illustre la synergie possible entre des mécanismes d'apprentissage portant sur des niveaux de description linguistique distincts, et cherche à déterminer quand et pourquoi cette coopération échoue. Elle conclut que la tension entre l'universalité de la distinction consonnes-voyelles et la spécificité de la structuration racine-schème est cruciale pour expliquer les forces et les faiblesses d'une telle approche. ABSTRACT This dissertation is concerned with the development of algorithmic methods for the unsupervised learning of natural language morphology, using a symbolically transcribed wordlist. It focuses on the case of languages approaching the introflectional type, such as Arabic or Hebrew. The morphology of such languages is traditionally described in terms of discontinuous units: consonantal roots and vocalic patterns. Inferring this kind of structure is a challenging task for current unsupervised learning systems, which generally operate with continuous units. In this study, the problem of learning root-and-pattern morphology is divided into a phonological and a morphological subproblem. The phonological component of the analysis seeks to partition the symbols of a corpus (phonemes, letters) into two subsets that correspond well with the phonetic definition of consonants and vowels; building around this result, the morphological component attempts to establish the list of roots and patterns in the corpus, and to infer the rules that govern their combinations. We assess the extent to which this can be done on the basis of two hypotheses: (i) the distinction between consonants and vowels can be learned by observing their tendency to alternate in speech; (ii) roots and patterns can be identified as sequences of the previously discovered consonants and vowels respectively. The proposed algorithm uses a purely distributional method for partitioning symbols. Then it applies analogical principles to identify a preliminary set of reliable roots and patterns, and gradually enlarge it. This extension process is guided by an evaluation procedure based on the minimum description length principle, in line with the approach to morphological learning embodied in LINGUISTICA (Goldsmith, 2001). The algorithm is implemented as a computer program named ARABICA; it is evaluated with regard to its ability to account for the system of plural formation in a corpus of Arabic nouns. This thesis shows that complex linguistic structures can be discovered without recourse to a rich set of a priori hypotheses about the phenomena under consideration. It illustrates the possible synergy between learning mechanisms operating at distinct levels of linguistic description, and attempts to determine where and why such a cooperation fails. It concludes that the tension between the universality of the consonant-vowel distinction and the specificity of root-and-pattern structure is crucial for understanding the advantages and weaknesses of this approach.

Evaluation of Rumble Stripes on Low-Volume Rural Roads in Iowa—Phase II Final Report, November 2011

Single-vehicle run-off-road crashes are the most common crash type on rural two-lane Iowa roads. Rumble strips have proven effective in mitigating these crashes, but the strips are commonly installed in paved shoulders on higher-volume roads that are owned by the State of Iowa. Lower-volume paved rural roads owned by local agencies do not commonly feature paved shoulders but frequently experience run-off-road crashes. This project involved installing rumble stripes, which are a combination of conventional rumble strips with a painted edge line placed on the surface of the milled area, along the edge of the travel lanes, but at a narrow width to avoid possible intrusion into the normal vehicle travel paths. The research described in this report was part of a project funded by the Federal Highway Administration, Iowa Highway Research Board, and Iowa Department of Transportation to evaluate the effectiveness of edge-line rumble strips in Iowa. The project evaluated the effectiveness of rumble stripes in reducing run-off-road crashes and in improving the longevity and wet-weather visibility of edge-line markings. This project consisted of two phases. The first phase was to select pilot study locations, select a set of test sites, install rumble stripes, summarize lessons learned during installation, and provide a preliminary assessment of the rumble stripes’ performance. The purpose of this report was to document results from Phase II. A before and after crash analysis was conducted to assess whether use of the treatment had resulted in fewer crashes. However, due to low sample size, results of the analysis were inconclusive. Lateral position was also evaluated before and after installation of the treatment to determine whether vehicles engaged in better lane keeping. Pavement marking wear was also assessed.

Concrete Overlay Field Application Program Iowa Task Report US 18 Concrete Overlay Construction Under Traffic, May 2012

The National Concrete Pavement Technology Center, Iowa Department of Transportation, and Federal Highway Administration set out to demonstrate and document the design and construction of portland cement concrete (PCC) overlays on two-lane roadways while maintaining two-way traffic. An 18.82 mile project was selected for 2011 construction in northeast Iowa on US 18 between Fredericksburg and West Union. This report documents planning, design, and construction of the project and lessons learned. The work included the addition of subdrains, full-depth patching, bridge approach replacement, and drainage structural repair and cleaning prior to overlay construction. The paving involved surface preparation by milling to grade and the placement of a 4.5 inch PCC overlay and 4 foot of widening to the existing pavement. In addition, the report makes recommendations on ways to improve the process for future concrete overlays.

Missouri River Flood Coordination Task Force Report, September 25, 2011

The Missouri River floods of 2011 will go down in history as the longest duration flooding event this state has seen to date. The combination of above normal snowfall in the upper Missouri River basin followed by the equivalent of nearly one year’s worth of rainfall in May created an above normal runoff situation which filled the Missouri River and the six main reservoirs within the basin. Compounding this problem was colder than normal temperatures which kept much of the snowpack in the upper basin on the ground longer into the spring, setting the stage for this historic event. The U.S. Army Corps of Engineers (USACE) began increasing the outflow at Gavin’s Point, near Yankton, South Dakota in May. On June 14, 2011, the outflow reached a record rate of over 160,000 cubic feet per second (cfs), over twice the previous record outflow set in 1997. This increased output from Gavin’s Point caused the Missouri River to flow out of its banks covering over 283,000 acres of land in Iowa, forcing hundreds of evacuations, damaging 255,000 acres of cropland and significantly impacting the levee system on the Missouri River basin. Over the course of the summer, approximately 64 miles of primary roads closed due to Missouri River flooding, including 54 miles of Interstate Highway. Many county secondary roads were closed by high water or overburdened due to the numerous detours and road closures in this area. As the Missouri River levels began to increase, municipalities and counties aided by State and Federal agencies began preparing for a sustained flood event. Citizens, businesses, state agencies, local governments and non‐profits made substantial preparations, in some cases expending millions of dollars on emergency protective measures to protect their facilities from the impending flood. Levee monitors detected weak spots in the levee system in all affected counties, with several levees being identified as at risk levees that could potentially fail. Of particular concern was the 28 miles of levees protecting Council Bluffs. Based on this concern, Council Bluffs prepared an evacuation plan for the approximately 30,000 residents that resided in the protected area. On May 25, 2011, Governor Branstad directed the execution of the Iowa Emergency Response Plan in accordance with Section 401 of the Stafford Act. On May 31, 2011, HSEMD Administrator, Brigadier General J. Derek Hill, formally requested the USACE to provide technical assistance and advanced measures for the communities along the Missouri River basin. On June 2, 2011 Governor Branstad issued a State of Iowa Proclamation of Disaster Emergency for Fremont, Harrison, Mills, Monona, Pottawattamie, and Woodbury counties. The length of this flood event created a unique set of challenges for Federal, State and local entities. In many cases, these organizations were conducting response and recovery operations simultaneously. Due to the length of this entire event, the State Emergency Operations Center and the local Emergency Operations Centers remained open for an extended period of time, putting additional strain on many organizations and resources. In response to this disaster, Governor Branstad created the Missouri River Recovery Coordination Task Force to oversee the State’s recovery efforts. The Governor announced the creation of this Task Force on October 17, 2011 and appointed Brigadier General J. Derek Hill, HSEMD Administrator as the chairman. This Task Force would be a temporary group of State agency representatives and interested stakeholders brought together to support the recovery efforts of the Iowa communities impacted by the Missouri River Flood. Collectively, this group would analyze and share damage assessment data, coordinate assistance across various stakeholders, monitor progress, capture best practices and identify lessons learned.

Cuatro casos, cuatro historias de uso educativo de las TIC

[spa] Este informe presenta parte de los procesos y los resultados del proyecto de I+D+I: Políticas y prácticas en torno a las TIC en la enseñanza obligatoria: Implicaciones para la innovación y la mejora, parcialmente financiado por Ministerio de Ciencia e Innovación. SEJ2007-67562. Recoge los cuatro estudios de caso llevados a cabo en dos Institutos de Enseñanza Secundaria Obligatoria y dos centros de educación primaria de Cataluña, que nos han posibilitado elucidar el impacto de las políticas de uso de las TIC y de otras iniciativas políticas para favorecer la innovación y la mejora en cada centro, prestando especial atención a: (a) los temas organizativos relacionados con el tiempo y el espacio; (b) el desarrollo del currículum en el centro (visiones sobre el conocimiento, el aprendizaje, el papel del alumnado y el profesorado, el lugar de las TIC, etc.); (c) las condiciones de trabajo del profesorado (acceso a formación, espacios y prácticas de colaboración; desarrollo profesional); (d) los resultados del aprendizaje (valor intelectual, social y personal de lo aprendido; capacidad de transferencia para seguir aprendiendo

Statistical Modeling of the Eye for Multimodal Treatment Planning for External Beam Radiation Therapy of Intraocular Tumors.

PURPOSE: Ocular anatomy and radiation-associated toxicities provide unique challenges for external beam radiation therapy. For treatment planning, precise modeling of organs at risk and tumor volume are crucial. Development of a precise eye model and automatic adaptation of this model to patients' anatomy remain problematic because of organ shape variability. This work introduces the application of a 3-dimensional (3D) statistical shape model as a novel method for precise eye modeling for external beam radiation therapy of intraocular tumors. METHODS AND MATERIALS: Manual and automatic segmentations were compared for 17 patients, based on head computed tomography (CT) volume scans. A 3D statistical shape model of the cornea, lens, and sclera as well as of the optic disc position was developed. Furthermore, an active shape model was built to enable automatic fitting of the eye model to CT slice stacks. Cross-validation was performed based on leave-one-out tests for all training shapes by measuring dice coefficients and mean segmentation errors between automatic segmentation and manual segmentation by an expert. RESULTS: Cross-validation revealed a dice similarity of 95% ± 2% for the sclera and cornea and 91% ± 2% for the lens. Overall, mean segmentation error was found to be 0.3 ± 0.1 mm. Average segmentation time was 14 ± 2 s on a standard personal computer. CONCLUSIONS: Our results show that the solution presented outperforms state-of-the-art methods in terms of accuracy, reliability, and robustness. Moreover, the eye model shape as well as its variability is learned from a training set rather than by making shape assumptions (eg, as with the spherical or elliptical model). Therefore, the model appears to be capable of modeling nonspherically and nonelliptically shaped eyes.