Essential role of Smad3 in the inhibition of inflammation-induced PPARbeta/delta expression.

Wound healing proceeds by the concerted action of a variety of signals that have been well identified. However, the mechanisms integrating them and coordinating their effects are poorly known. Herein, we reveal how PPARbeta/delta (PPAR: peroxisome proliferator-activated receptor) follows a balanced pattern of expression controlled by a crosstalk between inflammatory cytokines and TGF-beta1. Whereas conditions that mimic the initial inflammatory events stimulate PPARbeta/delta expression, TGF-beta1/Smad3 suppresses this inflammation-induced PPARbeta/delta transcription, as seen in the late re-epithelialization/remodeling events. This TGF-beta1/Smad3 action involves an inhibitory effect on AP-1 activity and DNA binding that results in an inhibition of the AP-1-driven induction of the PPARbeta/delta promoter. As expected from these observations, wound biopsies from Smad3-null mice showed sustained PPARbeta expression as compared to those of their wild-type littermates. Together, these findings suggest a mechanism for setting the necessary balance between inflammatory signals, which trigger PPARbeta/delta expression, and TGF-beta1/Smad3 that governs the timely decrease of this expression as wound healing proceeds to completion.

A Multi-Project Scheduling Procedure for Transportation Projects, Part II, HR-339, 1994

The Iowa Department of Transportation (IDOT) has been requiring Critical Path Method (CPM) schedules on some larger or more schedule sensitive projects. The Office of Construction's expectations for enhanced project control and improved communication of project objectives have not been fully met by the use of CPM. Recognizing that the current procedures might not be adequate for all projects, IDOT sponsored a research project to explore the state-of-the-art in transportation scheduling and identify opportunities for improvement. The first phase of this project identified a technique known as the Linear Scheduling Method (LSM) as an alternative to CPM on certain highway construction projects. LSM graphically displays the construction process with respect to the location and the time in which each activity occurs. The current phase of this project was implemented to allow the research team the opportunity to evaluate LSM on all small groups of diverse projects. Unlike the first phase of the project, the research team was closely involved in the project from early in the planning phase throughout the completion of the projects. The research strongly suggests that the linear scheduling technique has great potential as a project management tool for both contractors and IDOT personnel. However, before this technique can become a viable weapon in the project management arsenal, a software application needs to be developed. This application should bring to linear scheduling a degree of functionality as rich and as comprehensive as that found in microcomputer based CPM software on the market today. The research team recommends that the IDOT extend this research effort to include the development of a linear scheduling application.

Investigation of Two Bridge Alternatives for Low Volume Roads Volume 2 of 2 Concept 2: Beam In Slab Bridge, HR-382, 1997

Recent reports have indicated that 23.5% of the nation's highway bridges are structurally deficient and 17.7% are functionally obsolete. A significant number of these bridges are on the Iowa secondary road system where over 86% of the rural bridge management responsibilities are assigned to the counties. Some of the bridges can be strengthened or otherwise rehabilitated, but many more are in need of immediate replacement. In a recent investigation (HR-365 "Evaluation of Bridge Replacement Alternatives for the County Bridge System") several types of replacement bridges that are currently being used on low volume roads were identified. It was also determined that a large number of counties (69%) have the ability and are interested in utilizing their own forces to design and construct short span bridges. After reviewing the results from HR-365, the research team developed one "new" bridge replacement concept and a modification of a replacement system currently being used. Both of these bridge replacement alternatives were investigated in this study, the results of which are presented in two volumes. This volume (Volume 2) presents the results of Concept 2 - Modification of the Beam-in-Slab Bridge. Concept 1 - Steel Beam Precast Units is presented in Volume 1. Concept 2 involves various laboratory tests of the Beam-in-Slab bridge (BISB) currently being used by Benton County and several other Iowa counties. In this investigation, the behavior and strength of the BISB were determined; a new method of obtaining composite action between the steel beams and concrete was also tested. Since the Concept 2 bridge is primarily intended for use on low-volume roads, the system can be constructed with new or used beams. In the experimental part of the investigation, there were three types of laboratory tests: push-out tests, service and ultimate load tests of models of the BISB, and composite beam tests utilizing the newly developed shear connection. In addition to the laboratory tests, there was a field test in which an existing BISB was service load tested. An equation was developed for predicting the strength of the shear connection investigated; in addition, a finite element model for analyzing the BISB was also developed. Push-out tests were completed to determine the strength of the recently developed shear connector. A total of 36 specimens were tested, with variables such as hole diameter, hole spacing, presence of reinforcement, etc. being investigated. In the model tests of the BISB, two and four beam specimens [L=9,140 mm (30 ft)] were service load tested for behavior and load distribution data. Upon completion of these tests, both specimens were loaded to failure. In the composite beam tests, four beams, one with standard shear studs and three using the shear connection developed, were tested. Upon completion of the service load tests, all four beams were loaded to failure. The strength and behavior of the beams with the new shear connection were found to be essentially the same as that of the specimen with standard shear studs.

Bonded, Thin-Lift, Non-Reinforced Portland Cement Concrete Resurfacing, MLR-77-2, 1977

A research project involving 2, 3, 4, and 5 in. (5.1, 7.6, 10.2, and 12.7 cm) of bonded portland cement concrete (PCC) overlay on a 1.3 mile (2.1 km) PCC pavement was conducted in Clayton County, Iowa, during September 1977, centering on the following objectives: (1) Determine the mixing and proportioning procedures required in using a conventional, central mix proportioning plant to produce a dense PCC mixture using standard mixes with super water reducing admixtures; (2) Determine the economics, longevity and maintenance performance of a bonded, thin-lift, non-reinforced PCC resurfacing course using conventional procedures, equipment and concrete paving mixtures both with and without super water reducing admixtures; and (3) Determine if an adequate bond between the existing pavement and an overlay of thin-lift, dense, non-reinforced PCC can be obtained with only special surface cleaning and no surface removal or grinding. The conclusions are as follows: (1) Normal mixing equipment and proportioning procedures could be used using a conventional central-mix proportioning plant. This was successful when used with super water reducing admixtures. Only minor changes need be made in procedures and timing. (2) The time has been too short since the completion of the project to determine how the new pavement will perform, however, initially it appears that the method is economical and no reason is seen at this time why the life of the pavement should not be comparable to an all new pavement. (3) The initial test results show that bond strength, regardless of which method of cleaning is used, scarifying, sand blasting or water blasting, far exceed what is considered the minimum bond strength of 200 psi (1379 kPa) except where the paint stripes were intentionally left, thus showing that the paint must be removed. (4) It appears that either cement and water grout or sand, cement and water grout may be used and still obtain the required bond.

Evaluation of Rapid Determination of the Chloride Permeability of Portland Cement Concrete by AASHTO T277-83, MLR-86-11, 1987

An Iowa D.O.T. Laboratory built machine was constructed for the chloride permeability testing of concrete by measuring electric current through a specimen between a salt solution and a base solution. This study had two purposes. The first was to evaluate the machine's performance. To do this, three concrete mixes were made consisting of different cement factors and water/cement ratios. Each mix was tested for chloride ion content by the 90- day salt ponding method and for chloride permeability at a 28-day cure by the permeability machine. The results from each test were evaluated to see if there was correlation between chloride ion content and the chloride permeability. It was determined that there was a correlation and that the permeability machine was satisfactory for determining chloride permeability in concrete. The second purpose of this study was to examine the effects that pozzolans have on the chloride permeability of concrete. Four mixes were made: one without any pozzolans as a control, one with class C fly ash, one with class F fly ash, and one with silica fume. Specimens from each mix were evaluated for chloride ion content by the 90-day salt ponding test and by the laboratory built machine for chloride permeability after curing 28 days. Specimens from these mixes were also taken from the salt ponding slabs after completion of the ponding test to examine the effect chloride ion content has on the operation of the chloride permeability machine. Specimens containing pozzolans were also examined for chloride permeability after a cure of 180 days. It was determined that the addition of pozzolans to concrete lowers the chloride permeability as measured by the permeability machine. Class F fly ash and silica fume in the concrete had a major effect in lowering the chloride permeability in concrete as measured by the permeability machine.

Superficial femoral vein as substitute for pulmonary artery reconstruction after resection for bronchovascular fistula

Post-lobectomy bronchovascular fistula (BVF) associated with massive hemoptysis is a rare but life-threatening complication. Surgical options include completion pneumonectomy or BVF resection with end-to-end anastomosis of the airways and reconstruction of the pulmonary artery (PA) by interposition of an appropriate substitute. We report PA resection and successful reconstruction by interposition of an autologous reversed superficial femoral vein (SFV) segment for this purpose.

The effect of endocrine responsiveness on high-risk breast cancer treated with dose-intensive chemotherapy: results of International Breast Cancer Study Group Trial 15-95 after prolonged follow-up.

BACKGROUND: The role of adjuvant dose-intensive chemotherapy and its efficacy according to baseline features has not yet been established. PATIENTS AND METHODS: Three hundred and forty-four patients were randomized to receive seven courses of standard-dose chemotherapy (SD-CT) or three cycles of dose-intensive epirubicin and cyclophosphamide (epirubicin 200 mg/m(2) plus cyclophosphamide 4 mg/m(2) with filgrastim and progenitor cell support). All patients were assigned tamoxifen at the completion of chemotherapy. The primary end point was disease-free survival (DFS). This paper updates the results and explores patterns of recurrence according to predicting baseline features. RESULTS: At 8.3-years median follow-up, patients assigned DI-EC had a significantly better DFS compared with those assigned SD-CT [8-year DFS percent 47% and 37%, respectively, hazard ratio (HR) 0.76; 95% confidence interval 0.58-1.00; P = 0.05]. Only patients with estrogen receptor (ER)-positive disease benefited from the DI-EC (HR 0.61; 95% confidence interval 0.39, 0.95; P = 0.03). CONCLUSIONS: After prolonged follow-up, DI-EC significantly improved DFS, but the effect was observed only in patients with ER-positive disease, leading to the hypothesis that efficacy of DI-EC may relate to its endocrine effects. Further studies designed to confirm the importance of endocrine responsiveness in patients treated with dose-intensive chemotherapy are encouraged.

Learning from failure - rationale and design for a study about discontinuation of randomized trials (DISCO study).

BACKGROUND: Randomized controlled trials (RCTs) may be discontinued because of apparent harm, benefit, or futility. Other RCTs are discontinued early because of insufficient recruitment. Trial discontinuation has ethical implications, because participants consent on the premise of contributing to new medical knowledge, Research Ethics Committees (RECs) spend considerable effort reviewing study protocols, and limited resources for conducting research are wasted. Currently, little is known regarding the frequency and characteristics of discontinued RCTs. METHODS/DESIGN: Our aims are, first, to determine the prevalence of RCT discontinuation for specific reasons; second, to determine whether the risk of RCT discontinuation for specific reasons differs between investigator- and industry-initiated RCTs; third, to identify risk factors for RCT discontinuation due to insufficient recruitment; fourth, to determine at what stage RCTs are discontinued; and fifth, to examine the publication history of discontinued RCTs.We are currently assembling a multicenter cohort of RCTs based on protocols approved between 2000 and 2002/3 by 6 RECs in Switzerland, Germany, and Canada. We are extracting data on RCT characteristics and planned recruitment for all included protocols. Completion and publication status is determined using information from correspondence between investigators and RECs, publications identified through literature searches, or by contacting the investigators. We will use multivariable regression models to identify risk factors for trial discontinuation due to insufficient recruitment. We aim to include over 1000 RCTs of which an anticipated 150 will have been discontinued due to insufficient recruitment. DISCUSSION: Our study will provide insights into the prevalence and characteristics of RCTs that were discontinued. Effective recruitment strategies and the anticipation of problems are key issues in the planning and evaluation of trials by investigators, Clinical Trial Units, RECs and funding agencies. Identification and modification of barriers to successful study completion at an early stage could help to reduce the risk of trial discontinuation, save limited resources, and enable RCTs to better meet their ethical requirements.

Determinantes del progreso en los estudios de doctorado. Diferencias entre disciplinas científico-tecnológicas versus ciencias sociales y humanidades

En numerosos países, incluido España, existen problemas en relación con las tasas de éxito en los estudios de doctorado. El trabajo que aquí se presenta fue diseñado con el fin de identificar los factores asociados con el progreso durante el tercer ciclo y la elaboración de las tesis doctorales en dos grupos disciplinares: científico-tecnológico versus humanidades y ciencias sociales. El artículo presenta la información obtenida a partir de un cuestionario aplicado a 81 estudiantes de doctorado de la Universidad de Girona, en relación con tres áreas de interés: variables económicas, personales y académicas que condicionan el éxito en el tercer ciclo. Los resultados muestran diferencias substanciales entre disciplinas. Los factores responsables de estas diferencias son, principalmente: la vinculación profesional a la universidad, la planificación del proyecto de investigación y los objetivos personales.

Structural Characterization of UHPC Waffle Bridge Deck and Connections, TR-614, 2014

The AASHTO strategic plan in 2005 for bridge engineering identified extending the service life of bridges and accelerating bridge construction as two of the grand challenges in bridge engineering. These challenges have the objective of producing safer and more economical bridges at a faster rate with a minimum service life of 75 years and reduced maintenance cost to serve the country’s infrastructure needs. Previous studies have shown that a prefabricated full-depth precast concrete deck system is an innovative technique that accelerates the rehabilitation process of a bridge deck, extending its service life with reduced user delays and community disruptions and lowering its life-cycle costs. Previous use of ultra-high performance concrete (UHPC) for bridge applications in the United States has been considered to be efficient and economical because of its superior structural characteristics and durability properties. Full-depth UHPC waffle deck panel systems have been developed over the past three years in Europe and the United States. Subsequently, a single span, 60-ft long and 33-ft wide prototype bridge with full-depth prefabricated UHPC waffle deck panels has been designed and built for a replacement bridge in Wapello County, Iowa. The structural performance characteristics and the constructability of the UHPC waffle deck system and its critical connections were studied through an experimental program at the structural laboratory of Iowa State University (ISU). Two prefabricated full-depth UHPC waffle deck (8 feet by 9 feet 9 inches by 8 inches) panels were connected to 24-ft long precast girders, and the system was tested under service, fatigue, overload, and ultimate loads. Three months after the completion of the bridge with waffle deck system, it was load tested under live loads in February 2012. The measured strain and deflection values were within the acceptable limits, validating the structural performance of the bridge deck. Based on the laboratory test results, observations, field testing of the prototype bridge, and experience gained from the sequence of construction events such as panel fabrication and casting of transverse and longitudinal joints, a prefabricated UHPC waffle deck system is found to be a viable option to achieve the goals of the AASHTO strategic plan.

Impact of Duration of Primary Education on School Enrollment, Graduation and Drop-outs: A Cross- Country Analysis

Using a panel data for non-OECD countries covering the period 1970-2012, this chapter analyzes the impact of the duration of primary education on school enrollment, drop-out and completion rates. The empirical results show that for children in elementary school one ad- ditional grade of primary education have a negative impact on the enrollment rate, while the e ect on drop-outs is positive. Analogously, it is obtained that an additional grade in primary education reduces the enrollment rate in secondary education. These results are in line with the fertility model approach, that is, in developing and underdeveloped countries parents do not have incentive to send children to school given the high perceived economic value of children.

Group motivational intervention in overweight/obese patients in primary prevention of cardiovascular disease in the primary healthcare area

Background The global mortality caused by cardiovascular disease increases with weight. The Framingham study showed that obesity is a cardiovascular risk factor independent of other risks such as type 2 diabetes mellitus, dyslipidemia and smoking. Moreover, the main problem in the management of weight-loss is its maintenance, if it is achieved. We have designed a study to determine whether a group motivational intervention, together with current clinical practice, is more efficient than the latter alone in the treatment of overweight and obesity, for initial weight loss and essentially to achieve maintenance of the weight achieved; and, secondly, to know if this intervention is more effective for reducing cardiovascular risk factors associated with overweight and obesity. Methods This 26-month follow up multi-centre trial, will include 1200 overweight/obese patients. Random assignment of the intervention by Basic Health Areas (BHA): two geographically separate groups have been created, one of which receives group motivational intervention (group intervention), delivered by a nurse trained by an expert phsychologist, in 32 group sessions, 1 to 12 fortnightly, and 13 to 32, monthly, on top of their standard program of diet, exercise, and the other (control group), receiving the usual follow up, with regular visits every 3 months. Discussion By addressing currently unanswered questions regarding the maintenance in weight loss in obesity/overweight, upon the expected completion of participant follow-up in 2012, the IMOAP trial should document, for the first time, the benefits of a motivational intervention as a treatment tool of weight loss in a primary care setting.

08021-012 Sands Timber Final Report

Sands Timber Lake is a 60 acre man made impoundment near Blockton, Iowa. The lake is the centerpiece of a 235 acre park, which is owned and managed by the Taylor County Conservation Board. The park is equipped with modern campsites, hiking trails, picnic areas, and a playground. Bordering the western shoreline of the lake is a beautiful hardwood timber which inspired the parks name. Sands Timber Lake has a 4,100 acre drainage area comprised of timber, grassland, and row crop. The lake is fed by four large classic gullies which branch off into many smaller gullies dissecting the drainage area. Since construction in 1993, Sands Timber Lake has been an extremely poor fishery. In 2006 Sands Timber Lake was added to the EPA’s 303d list of impaired water bodies. Turbid water was identified as the primary stressor. In 2007 a bathometric map was made which depicts lake-bottom contours and elevations which, when compared to the original survey of the area, revealed an alarming amount of siltation. What was once a twenty-three foot deep lake in 1994 has now been reduced to a mere fourteen feet. In addition to depth being lost, the lake’s surface has been reduced by nearly ten acres, destroying vital fish habitats. Local interest in preserving and enhancing the lake has led to the completion of a thorough watershed assessment and treatment plan. Included in the plan are several elements, the first being upland treatment. Locals are insistent that if conservation is not implemented in the watershed the lake will continue to degrade and park usage will continue to decline.

Evaluation of the compliance with recommended procedures in newborns exposed to HBsAg-positive mothers: a multicenter collaborative study.

BACKGROUND: Maternal-infant transmission of hepatitis B virus (HBV) during birth carries a high risk for chronic HBV infection in infants with frequent subsequent development of chronic disease. This can be efficiently prevented by early immunization of exposed newborns. The purpose of this study was to determine the compliance with official recommendations for prevention of perinatal HBV transmission in hepatitis B surface antigen (HBsAg) exposed infants. METHODS: Records of pregnant women at 4 sites in Switzerland, admitted for delivery in 2005 and 2006, were screened for maternal HBsAg testing. In HBsAg-exposed infants, recommended procedures (postnatal active and passive immunization, completion of immunization series, and serological success control) were checked. RESULTS: Of 27,131 women tested for HBsAg, 194 (0.73%) were positive with 196 exposed neonates. Of these neonates, 143 (73%) were enrolled and 141 (99%) received simultaneous active and passive HBV immunization within 24 hours of birth. After discharge, the HBV immunization series was completed in 83%. Only 38% of children were tested for anti-HBs afterwards and protective antibody values (>100 U/L) were documented in 27% of the study cohort. No chronically infected child was identified. Analysis of hospital discharge letters revealed significant quality problems. CONCLUSIONS: Intensified efforts are needed to improve the currently suboptimal medical care in HBsAg-exposed infants. We propose standardized discharge letters, as well as reminders to primary care physicians with precise instructions on the need to complete the immunization series in HBsAg-exposed infants and to evaluate success by determination of anti-HBs antibodies after the last dose.

Systematic assessment of factors influencing preferences of crohn's disease patients in selecting an anti-tumor necrosis factor agent (CHOOSE TNF TRIAL).

BACKGROUND: Infliximab (IFX), adalimumab (ADA), and certolizumab pegol (CZP) have similar efficacy in induction and maintenance of clinical remission in Crohn's disease (CD). Given the comparable nature of these drugs, patient preferences may influence the choice of the product. We aimed to identify factors that may contribute to CD patients' decision in selecting one anti-tumor necrosis factor (TNF) agent over the others. METHODS: A prospective survey was performed among anti-TNF-naïve CD patients. Prior to completion of a questionnaire, patients were provided with a written description of the three anti-TNF agents, focusing on indications, mode of administration, side effects, and scientific evidence of efficacy and safety for each drug. RESULTS: One hundred patients (47 females, mean age 45 ± 16 years, range 19-81) with an ileal, colonic, or ileocolonic (33%, 40%, and 27%, respectively) disease location completed the questionnaire. Based on the information provided, 36% of patients preferred ADA, 28% CZP, and 25% IFX, whereas 11% were undecided. The patients' decision in selecting a specific anti-TNF drug was influenced by the following factors: ease of use (69%), time required for therapy (34%), time interval between application of the drug (31%), scientific evidence for efficacy (19%), and fear of syringes (10%). CONCLUSIONS: The majority of patients preferred anti-TNF medications that were administered by subcutaneous injection rather than by intravenous infusion. Ease of use and time required for therapy were two major factors influencing the patients' selection of a specific anti-TNF drug. Patients' individual preferences should be taken into account when prescribing anti-TNF drugs. (Inflamm Bowel Dis 2012).