Air Formed Arch Culvert Construction - Washington County, HR-313, 1994

Iowa's secondary roads contain nearly 15,000 bridges which are less than 40 ft (12.2 m) in length. Many of these bridges were built several decades ago and need to be replaced. Box culvert construction has proven to be an adequate bridge replacement technique. Recently a new bridge replacement alternative, called the Air-O-Form method, has emerged which has several potential advantages over box culvert construction. This new technique uses inflated balloons as the interior form in the construction of an arch culvert. Concrete was then shotcreted onto the balloon form. The objective of research project HR-313 was to construct an air formed arch culvert to determine the applicability of the Air-O-Form technique as a county bridge replacement alternative. The project had the following results: The Air-O-Form method can be used to construct a structurally sound arch culvert; and the method must become more economical if it is to compete with box culverts. Continued monitoring should be conducted in order to evaluate the long-term performance of the Air-O-Form method.

Air Formed Arch Culvert Construction - Crawford County, HR-314, 1995

Iowa's secondary road network contains nearly 15,000 bridges which are less than 12 m (40 ft) long. Many of these bridges were built several decades ago and need to be replaced. Box culvert construction has proven to be an adequate bridge replacement technique. An alternative to box culverts is the Air-O-Form method of arch culvert construction. The Air-O-Form method has several potential advantages over box culvert construction. The new technique uses inflated balloons as the interior form in the construction of an arch culvert. Concrete is then shotcreted onto the balloon form to complete the arch culvert. The objective of the research project was to construct an air formed arch culvert to determine its applicability as an alternative county bridge replacement technique. The project had the following results: (1) The Air-O-Form method can be used to construct a structurally sound arch culvert; and (2) The method must become more economical if it is to compete with box culverts.

Prise en charge du carcinome hépatocettulaire en 2010 [Management of hepatocellular carcinoma]

Hepatocellular carcinoma (HCC) is one of the most frequent malignant tumors worldwide and its incidence has increased over the last years in most developed countries. The majority of HCCs occur in the context of liver cirrhosis. Therefore, patients with cirrhosis and those with hepatitis B virus infection should enter a surveillance program. Detection of a focal liver lesion by ultrasound should be followed by further investigations to confirm the diagnosis and to permit staging. A number of curative and palliative treatment options are available today. The choice of treatment will depend on the tumor stage, liver function and the presence of portal hypertension as well as the general condition of the patient. A multidisciplinary approach is mandatory to offer to each patient the best treatment.

Prise en charge des sténoses carotidiennes [Management of the carotid artery stenosis].

In the western world, the carotid-artery stenosis is one of the major causes of ischemic stroke in elderly people. The principal therapeutic indication is a symptomatic stenosis > 50% in the first two weeks and the surgical approach has shown the best results. Despite inferior results to carotid endarterectomy in terms of post-operative rate of stroke and/or death, except for young patients, carotid stenting remains the best choice in patients at high surgical risk. The best medical treatment, consisting in correction of cardiovascular risk factors, statin therapy and anti-aggregation led to a drastic reduction in the annual rate of stroke associated to carotid stenosis and thus limited the surgical intervention in asymptomatic patient to men with a life expectancy of at least 5 years and a stenosis > 70%.

Carcinomes épidermoïdes de l'hypopharynx et du larynx : prise en charge fondée sur les preuves Squamous cell carcinoma of the hypopharynx and larynx: evidence-based care.

Les carcinomes épidermoïdes de l'hypopharynx et du larynx peuvent être traités par chirurgie et/ou radiothérapie en fonction de la taille tumorale. Pour les petites tumeurs, les résultats sont équivalents. Pour les tumeurs localement avancées, l'approche chirurgicale est mutilante et nécessite une (pharyngo)laryngectomie totale. La chimioradiothérapie exclusive a montré tout son intérêt mais au prix de séquelles tardives. Dans le but de diminuer ces séquelles et les mutilations, la chimiothérapie d'induction par cisplatine, docétaxel et 5FU à visée de préservation d'organe devient le standard de traitement mais il manque des études solides de comparaison de cette approche avec la chimioradiothérapie exclusive. Il n'est pas possible de conclure quant à la supériorité d'un schéma en survie globale. Quand la chimiothérapie d'induction est choisie, les modalités de potentialisation éventuelle de la radiothérapie ne sont pas établies. Squamous cell carcinomas of larynx and hypopharynx can be treated by surgery and/or radiotherapy according to tumor size. For small tumors, the results are similar. For locally advanced tumors, the surgical approach is mutilating and requires a total (pharyngo)laryngectomy. Exclusive chemoradiotherapy has shown its interest at the cost of late sequelae. In order to reduce these effects and mutilation, induction chemotherapy with cisplatin, docetaxel and 5FU for organ preservation becomes the standard treatment but there are no solid studies comparing this approach with the exclusive chemoradiotherapy. And it is not possible to conclude as to the superiority of a scheme in terms of overall survival. When chemotherapy is chosen, the modalities of any potentiation of radiation have not been yet established.

Réplication cérébrale du VIH malgré une thérapie antirétrovirale efficace: impact clinique et prise en charge [Intracerebral HIV replication despite an efficient antiretroviral treatment: clinical impact and management].

Various neurological and neuropsychological manifestations are still relatively frequently reported in HIV infected patients in the highly active antiretroviral therapy era. A fraction of them could be related to HIV replication in the central nervous system (CNS) despite adequate peripheral viral suppression. This hypothesis is supported by numerous reports of detectable HIV RNA in the cerebrospinal fluid in the context of a low or undetectable viremia in association with neurological or neuropsychological complaints. In addition, some antiviral molecules may not achieve adequate levels in the CNS, thus potentially favoring intracerebral HIV replication and even antiretroviral resistance. Neurologic manifestations in the presence of CNS HIV replication often decrease after antiretroviral treatment CNS penetration optimization.

Evaluation of Air Pollution Control Devices for Asphalt Pavement Recycling Operations, HR-188, Progress Report, 1977

This report discusses the asphalt pavement recycling project designated Project HR-188 in Kossuth County, Iowa. Specific objectives were: (a) to determine the effectiveness of drum mixing plant modifications designed to control air pollution within limits specified by the Iowa Department of Environmental Quality; (b) to assess the impact of varying the proportions of recycled and virgin aggregates, (c) to assess the impact of varying the production rate of the plant, and (d) to assess the impact of varying the mixing temperature. The discussion includes information on the proposed use of research funds, project location and description, the project planning conference, plan development, bid letting, asphalt plant configuration, actual plant operation, why this method is successful, probable process limitations, pollution results, recycled pavement test results, and the cost of virgin vs. recycled asphalt pavements.

Image Analysis for Evaluating Air Void Parameters of Concrete, HR-396, 1998

This research project investigated the use of image analysis to measure the air void parameters of concrete specimens produced under standard laboratory conditions. The results obtained from the image analysis technique were compared to results obtained from plastic air content tests, Danish air meter tests (also referred to as Air Void Analyzer tests), high-pressure air content tests on hardened concrete, and linear traverse tests (as per ASTM C-457). Hardened concrete specimens were sent to three different laboratories for the linear traverse tests. The samples that were circulated to the three labs consisted of specimens that needed different levels of surface preparation. The first set consisted of approximately 18 specimens that had been sectioned from a 4 in. by 4 in. by 18 in. (10 cm by 10 cm by 46 cm) beam using a saw equipped with a diamond blade. These specimens were subjected to the normal sample preparation techniques that were commonly employed by the three different labs (each lab practiced slightly different specimen preparation techniques). The second set of samples consisted of eight specimens that had been ground and polished at a single laboratory. The companion labs were only supposed to retouch the sample surfaces if they exhibited major flaws. In general, the study indicated that the image analysis test results for entrained air content exhibited good to strong correlation to the average values determined via the linear traverse technique. Specimens ground and polished in a single laboratory and then circulated to the other participating laboratories for the air content determinations exhibited the strongest correlation between the image analysis and linear traverse techniques (coefficient of determination, r-squared = 0.96, for n=8). Specimens ground and polished at each of the individual laboratories exhibited considerably more scatter (coefficient of determination, r-squared = 0.78, for n=16). The image analysis technique tended to produce low estimates of the specific surface of the voids when compared to the results from the linear traverse method. This caused the image analysis spacing factor calculations to produce larger values than those obtained from the linear traverse tests. The image analysis spacing factors were still successful at distinguishing between the frost-prone test specimens and the other (more durable) test specimens that were studied in this research project.

Durability of Concrete as Affected by Variations in Air and W/C Ratio, R-258, 1975

Many times during the past four years we have seen ranges in the durability factor for a single coarse aggregate source that were too great to be explained by variations in the coarse aggregate alone. The durability test (ASTM C 666 Method B) as presently used is a test of the concrete system rather than that of a particular coarse aggregate. An informal study of current durability factor data indicates that w/c ratio and/or percentage of air may be critical to beam growth and durability factor. The purpose of this project, R-258, is to determine the extent w/c ratio and air content variations have on beam growth and durability factor when other factors including coarse aggregate gradation are held constant.

Infarctus myocardique aigu: importance du "networking" dans la prise en charge initiate [Acute myocardial infarction: importance of the networking in the initial management].

Early reperfusion with prompt re-establishment of coronary blood flow improves survival in patients suffering from acute ST-elevation myocardial infarction (STEMI). Leaving systemic thrombolysis for primary percutaneous coronary intervention (PCI) is justified by clinical results in favor of PCI. Nevertheless, primary PCI necessitates additional transfer time and requires an efficient territorial networking. The present article summarizes the up-to-dated management of patients with acute STEMI and/or overt cardiogenic shock.

Fatigue Behavior of Air-Entrained Concrete, HR-183, 1977

When a material fails under a number of repeated loads, each smaller than the ultimate static strength, a fatigue failure is said to have taken place. Many studies have been made to characterize the fatigue behavior of various engineering materials. The results of some of these studies have proved invaluable in the evaluation and prediction of the fatigue strength of structural materials. Considerable time and effort has gone into the evaluation of the fatigue behavior of metals. These early studies were motivated by practical considerations: The first fatigue tests were performed on materials that had been observed to fail after repeated loading of a magnitude less than that required for failure under the application of a single load. Mine-hoist chains, railway axles, and steam engine parts were among the first structural components to be recognized as exhibiting fatigue behavior. Since concrete is usually subjected to static loading rather than cyclic loading, need for knowledge of the fatigue behavior of concrete has lagged behind that of metals. One notable exception to this, however, is in the area of highway and airfield pavement design. Due to the fact that the fatigue behavior of concrete must be understood in the design of pavements and reinforced concrete bridges, highway engineers have provided the motivation for concrete fatigue studies since the 1920's.

Fatigue Behavior of Air-Entrained Concrete: Phase II, HR-197, 1979

When a material fails under a number of repeated loads, each smaller than the ultimate static strength, a fatigue failure is said to have taken place. Many studies have been made to characterize the fatigue behavior of various engineering materials. The results of some of these studies have proved invaluable in the evaluation and prediction of the fatigue strength of structural materials. Considerable time and effort have gone into the evaluation of the fatigue behavior of metals. These early studies were motivated by practical considerations: the first fatigue tests were performed on materials that had been observed to fail after repeated loading of a magnitude less than that required for failure under the application of a single load. Mine-hoist chains (1829), railway axles (1852), and steam engine parts were among the first structural components to be recognized as exhibiting fatigue behavior. Since concrete is usually subjected to static loading rather than cyclic loading, need for knowledge of the fatigue behavior of concrete has lagged behind that of metals. One notable exception to this, however, is in the area of highway and airfield pavement design. Due to the fact that the fatigue behavior of concrete must be understood in the design of pavements and reinforced concrete bridges, highway engineers have provided the motivation for concrete fatigue studies since the 1920s.

Surface-to-air signals.

Powerful volatile regulators of gene expression, pheromones and other airborne signals are of great interest in biology. Plants are masters of volatile production and release, not just from flowers and fruits, but also from vegetative tissues. The controlled release of bouquets of volatiles from leaves during attack by herbivores helps plants to deter herbivores or attract their predators, but volatiles have other roles in development and in the control of defence gene expression. Some of these roles may include long-distance signalling within and perhaps between plants.

Prise en charge de la pneumonie communautaire [Management of community acquired pneumonia]

Une grande partie des patients présentant une pneumonie communautaire ont un bon pronostic et peuvent être suivis dans la pratique ambulatoire moyennant un nombre limité d'examens paracliniques. Le diagnostic repose sur une clinique suggestive en présence d'un infiltrat compatible avec une pneumonie à la radiographie de thorax. Une anamnèse de voyage et une bonne connaissance de résistances locales du pneumocoque aux antibiotiques sont déterminantes pour le choix du traitement. Pour les patients de moins de 50 ans sans comorbidités et sans signes de sévérité, il est généralement recommandé de prescrire un macrolide ou une fluoroquinolone de 3e ou de 4e génération (fluoroquinolones «respiratoires»). Pour les patients plus âgés, et pour ceux qui présentent des comorbidités ou des critères de sévérité, une évaluation à l'hôpital est indiquée. La majorité des patients hospitalisés en soins généraux peuvent être traités par l'association d'une bêta-lactame et d'un macrolide, ou par une fluoroquinolone «respiratoire» seule, après prélèvements d'expectorations et de sang pour culture.

Tumeurs de l'appareil locomoteur: de la simple "bosse" a la prise en charge multidisciplinaire [Tumors of the musculoskeletal system: from the "lumps" to multidisciplinary care].

Management of musculoskeletal tumours usually begins with the appearance of a lump or bump, or the onset of unspecific symptoms. A poor initial work-up, a faulty biopsy or an inadequate resection may have a severe impact on the prognosis, including re-interventions, amputation, local recurrence or systemic spread of the disease. The patient with a suspicious lesion should be referred to a "sarcoma centers" where a planned and well-performed diagnostic work-up will allow a precise diagnosis in terms of histology and staging. After a multidisciplinary discussion of the case, an accurate treatment plan is established. Such an approach allows an adequate patient management, often with a positive impact on the survival and functional outcome.