838 resultados para Spasticity - Rating of
Resumo:
The report compares and contrasts the automated PASCO method of pavement evaluation to the manual procedures used by the Iowa Department of Transportation (DOT) to evaluate pavement condition. Iowa DOT's use of IJK and BPR roadmeters and manual crack and patch surveys are compared to PASCO's use of 35-mm photography, artificial lighting and hairline projection, tracking wheels and lasers to measure ride, cracking and patching, rut depths, and roughness. The Iowa DOT method provides a Present Serviceability Index (PSI) value and PASCO provides a Maintenance Control Index (MCI). Seven sections of Interstate Highway, county roads and city streets, and one shoulder section were tested with different speeds of data collection, surface types and textures, and stop and start conditions. High correlation of results between the two methods in the measurement of roughness (0.93 for the tracking wheel and 0.84 for the laser method) were recorded. Rut depth correlations of 0.61 and cracking of 0.32 are attributed to PASCO's more comprehensive measurement techniques. A cost analysis of the data provided by both systems indicates that PASCO is capable of providing a comparable result with improved accuracy at a cost of $125-$150 or less per two-lane mile depending on survey mileage. Improved data collection speed, accuracy, and reliability, and a visible record of pavement condition for comparable costs are available. The PASCO system's ability to provide the data required in the Highway Pavement Distress Identification Manual, the Pavement Condition Rating Guide, and the Strategic Highway Research Program Long Term Pavement Performance (LTPP) Studies, is also outlined in the report.
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The use of High Performance Concrete (HPC) in Iowa has consisted of achieving slightly higher compressive strengths with an emphasis on reduced permeability. Concrete with reduced permeability has increased durability by slowing moisture and chloride ingress. Achieving reduced permeability has typically been accomplished with combinations of slag and Class C fly ash, or the use of blended cements such as locally available Type IS(20), IS(25) and Type IP(25) in conjunction with Class C fly ash. Fly ash has been used in the majority of concrete placed in Iowa since 1984 and slag has been available in Iowa since 1995. During the economic downturn in 2008, one of the cement plants that produced a Type IS(25) cement was forced to shut down, which reduced the availability of blended cements, typically used on HPC deck overlays. Recently, a source of high reactivity metakaolin has been made available. Metakaolin is produced by heating a pure kaolinite clay to 650 to 700 °C in a rotary kiln (calcining). Metakaolin is a white pozzolan that is used to produce concrete with increased strengths, reduced permeability, reduced efflorescence, and resistance to alkali silica reactivity. The W.R. Grace MK-100 metakaolin will likely be available in dissolvable bags between 25 and 50 pounds. Thus, the mix designs were based on the anticipated bag size range for field use. This research evaluated metakaolin mixes with and without Class C fly ash. Results indicated a seven percent replacement with metakaolin produced concrete with increased strengths and low permeability. When used with Class C fly ash, permeability is reduced to very low rating. Metakaolin may be used to enhance hardened concrete properties for use in high performance concrete (HPC).
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The Iowa DOT has been using the AASHTO Present Serviceability Index (PSI) rating procedure since 1968 to rate the condition of pavement sections. A ride factor and a cracking and patching factor make up the PSI value. Crack and patch surveys have been done by sending crews out to measure and record the distress. Advances in video equipment and computers make it practical to videotape roads and do the crack and patch measurements in the office. The objective of the study was to determine the feasibility of converting the crack and patch survey operation to a video recording system with manual post processing. The summary and conclusions are as follows: Video crack and patch surveying is a feasible alternative to the current crack and patch procedure. The cost per mile should be about 25 percent less than the current procedure. More importantly, the risk of accidents is reduced by getting the people and vehicles off the roadway and shoulder. Another benefit is the elimination of the negative public perceptions of the survey crew on the shoulder.
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Recent reports indicate that of the over 25,000 bridges in Iowa, slightly over 7,000 (29%) are either structurally deficient or functionally obsolete. While many of these bridges may be strengthened or rehabilitated, some simply need to be replaced. Before implementing one of these options, one should consider performing a diagnostic load test on the structure to more accurately assess its load carrying capacity. Frequently, diagnostic load tests reveal strength and serviceability characteristics that exceed the predicted codified parameters. Usually, codified parameters are very conservative in predicting lateral load distribution characteristics and the influence of other structural attributes. As a result, the predicted rating factors are typically conservative. In cases where theoretical calculations show a structural deficiency, it may be very beneficial to apply a "tool" that utilizes a more accurate theoretical model which incorporates field-test data. At a minimum, this approach results in more accurate load ratings and many times results in increased rating factors. Bridge Diagnostics, Inc. (BDI) developed hardware and software that are specially designed for performing bridge ratings based on data obtained from physical testing. To evaluate the BDI system, the research team performed diagnostic load tests on seven "typical" bridge structures: three steel-girder bridges with concrete decks, two concrete slab bridges, and two steel-girder bridges with timber decks. In addition, a steel-girder bridge with a concrete deck previously tested and modeled by BDI was investigated for model verification purposes. The tests were performed by attaching strain transducers on the bridges at critical locations to measure strains resulting from truck loading positioned at various locations on the bridge. The field test results were used to develop and validate analytical rating models. Based on the experimental and analytical results, it was determined that bridge tests could be conducted relatively easy, that accurate models could be generated with the BDI software, and that the load ratings, in general, were greater than the ratings, obtained using the codified LFD Method (according to AASHTO Standard Specifications for Highway Bridges).
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Based on the conclusions of IHRB Project TR-444, Demonstration Project Using Railroad Flat Car Bridges for Low Volume Road Bridges, additional research on the use of RRFC bridges was undertaken. This portion of the project investigated the following: (1) Different design and rating procedures; (2) Additional single span configurations plus multiple span configurations; (3) Different mechanisms for connecting adjacent RRFCs and the resulting lateral load distribution factors; (4) Sheet pile abutments; and (5) Behavior RRFCs that had been strengthened so that they could be used on existing abutments. A total of eight RRFC bridges were tested (five single span bridges, two two-span bridges, and one three-span bridge). Based on the results of this study a simplified design and rating procedure has been developed for the economical replacement bridge alternative. In Volume 1, this volume, the results from the testing of four single span RRFC bridges are presented, while in Volume 2 the results from the testing of the strengthened single span bridge plus the three multiple span bridges are presented.
Resumo:
Based on the conclusions of IHRB Project TR-444, Demonstration Project Using Railroad Flat Car Bridges for Low Volume Road Bridges, additional research on the use of RRFC bridges was undertaken. This portion of the project investigated the following: (1) Different design and rating procedures; (2) Additional single span configurations plus multiple span configurations; (3) Different mechanisms for connecting adjacent RRFCs and the resulting lateral load distribution factors; (4) Sheet pile abutments; and (5) Behavior RRFCs that had been strengthened so that they could be used on existing abutments. A total of eight RRFC bridges were tested (five single span bridges, two two-span bridges, and one three-span bridge). Based on the results of this study a simplified design and rating procedure has been developed for the economical replacement bridge alternative. In Volume 1, the results from the testing of four single span RRFC bridges are presented, while in Volume 2,this volume, the results from the testing of the strengthened single span bridge plus the three multiple span bridges are presented.
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Recent data compiled by the National Bridge Inventory revealed 29% of Iowa's approximate 24,600 bridges were either structurally deficient or functionally obsolete. This large number of deficient bridges and the high cost of needed repairs create unique problems for Iowa and many other states. The research objective of this project was to determine the load capacity of a particular type of deteriorating bridge – the precast concrete deck bridge – which is commonly found on Iowa's secondary roads. The number of these precast concrete structures requiring load postings and/or replacement can be significantly reduced if the deteriorated structures are found to have adequate load capacity or can be reliably evaluated. Approximately 600 precast concrete deck bridges (PCDBs) exist in Iowa. A typical PCDB span is 19 to 36 ft long and consists of eight to ten simply supported precast panels. Bolts and either a pipe shear key or a grouted shear key are used to join adjacent panels. The panels resemble a steel channel in cross-section; the web is orientated horizontally and forms the roadway deck and the legs act as shallow beams. The primary longitudinal reinforcing steel bundled in each of the legs frequently corrodes and causes longitudinal cracks in the concrete and spalling. The research team performed service load tests on four deteriorated PCDBs; two with shear keys in place and two without. Conventional strain gages were used to measure strains in both the steel and concrete, and transducers were used to measure vertical deflections. Based on the field results, it was determined that these bridges have sufficient lateral load distribution and adequate strength when shear keys are properly installed between adjacent panels. The measured lateral load distribution factors are larger than AASHTO values when shear keys were not installed. Since some of the reinforcement had hooks, deterioration of the reinforcement has a minimal affect on the service level performance of the bridges when there is minimal loss of cross-sectional area. Laboratory tests were performed on the PCDB panels obtained from three bridge replacement projects. Twelve deteriorated panels were loaded to failure in a four point bending arrangement. Although the panels had significant deflections prior to failure, the experimental capacity of eleven panels exceeded the theoretical capacity. Experimental capacity of the twelfth panel, an extremely distressed panel, was only slightly below the theoretical capacity. Service tests and an ultimate strength test were performed on a laboratory bridge model consisting of four joined panels to determine the effect of various shear connection configurations. These data were used to validate a PCDB finite element model that can provide more accurate live load distribution factors for use in rating calculations. Finally, a strengthening system was developed and tested for use in situations where one or more panels of an existing PCDB need strengthening.
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Stage-discharge relations constitute a viable, alternative technique for estimating accurately flow for ungaged sites. In this research, we have utilized pressure transducers and Large Scale Particle Image Velocimetry techniques to develop stage-discharge relations at eleven sites in the Hungry Canyon Area (HCA) of southwestern Iowa under different hydrologic conditions. We have employed these data to calibrate and verify an established hydrologic model and then we have used this model to provide a stage discharge relation for different hydrologic conditions (i.e. rating curves). The benefits of the project are numerous including that the discharge data will be used for a number of purposes, including operational decision making in the HCA about the design of water-control and conveyance structures, input for hydraulic and hydrologic models, and calculation of sediment and other water quality constituents transport and “loads”, and for decision making. This project has also pointed out the difficulties in measuring flows in ungaged streams with ice jams, steep banks, erodible beds, and floating debris.
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The objective of this work was to test a simple method for root hair evaluation of 21 common bean (Phaseolus vulgaris) genotypes, most of them used in breeding programs in Brazil. Hairs of basal and primary roots of 5-day old seedlings, produced on germination paper with no phosphorus addition, were visually evaluated by a rating scale after staining with 0.05% trypan blue. The method reveals variability among the genotypes, and the standard error of the mean is relatively low.
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BACKGROUND: To explore whether poor initial insight during a first episode of mania with psychotic features was predictive of poor psychosocial and clinical outcomes at 18 months. METHODS: Secondary analysis was performed on data collected during an 8-week RCT comparing the efficacy of olanzapine versus chlorpromazine as an adjunct to lithium, and at 18-month follow-up. 74 participants were divided into three groups (no insight, partial insight, and full insight) according to the insight item from the Young Mania Rating Scale (YMRS). Differences between these three groups were examined at baseline and at 18 months on measures of symptoms (YMRS, HAMD-21, and CGI-S), and social and occupational functioning (SOFAS). Baseline differences between the three groups were determined using general linear models and chi-squared analyses. Group differences from baseline to 18-month follow-up were determined using repeated measures general linear models. RESULTS: At baseline there were significant differences between the three insight groups in terms of mania and functioning, but at 18 months all groups had improved significantly in terms of psychopathology, mania, depression and social and occupational functioning. There were no significant differences between the three groups at study completion with respect to these domains. LIMITATIONS: The study was limited by the lack of availability of a more detailed rating scale for insight, and it did not account for the duration of untreated psychosis (DUI). CONCLUSIONS: Poor initial insight during a first episode of mania with psychotic features does not predict poor clinical and psychosocial outcome at 18 months.
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BACKGROUND: Prurigo nodularis (PN), or nodular prurigo, is a chronic, debilitating, inflammatory skin disease. It can be very difficult to manage, and represents a challenge for the physician. Methotrexate (MTX) is a safe folic acid antagonist widely used in the management of inflammatory skin diseases such as psoriasis. Weekly administration of 7.5-20 mg methotrexate (low-dose methotrexate, LD-MTX) represents an attractive treatment option, and could therefore find a place in the management of PN. AIM: To evaluate the efficacy of LD-MTX as a treatment option for PN. METHODS: Thirteen patients who had failed to respond to conventional therapies such as topical steroids, phototherapy and antipruritic agents were treated with LD-MTX. The mean age of the patients was 75.83. Objective symptoms (Prurigo Nodularis Area and Severity Index; PNASI) and subjective symptoms (Pruritus Numeric Rating Scale; PNRS) were recorded. Treatment consisted of one subcutaneous injection of MTX 7.5-20 mg once weekly for a minimum of 6 months. Adjuvant application of emollients and topical steroids was maintained where needed. RESULTS: There was remission or marked improvement (decrease in both PNRS or PNASI of > 75%) in 10 cases, a trend to improvement in 2 cases and relapse in 1 case after treatment discontinuation. CONCLUSIONS: LD-MTX may allow improvement of PN in some patients, with long-lasting remission.
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Subjective response to neuroleptics is essential to long term observance of treatment and quality of life of patients. Numerous factors (pharmacological, relational and psychopathological) are responsible of this subjective response. Objectives of this study are: (a) to examine psychometric features of the french version of the Drug Attitude Inventory (DAI-30) [13] and (b) to explore pharmacological, relational and psychopathological factors related to this subjective response. Subjects and methods: 78 subjects were rated (self rated response rate 61% (n = 48)) for (a) subjective response to neuroleptics, (b) compliance, (c) therapeutic alliance, (d) symptoms (e) severity of disorder. RESULTS: Factor analysis yielded 2 main clinically relevant factors, similar to the original version: (I) global subjective response and (II) specific subjective response. Internal consistency is high. Correspondance analysis showed two important dimensions in the treatment of schizophrenic patients: (I) Recovery--aggravation, (II) Therapeutic ambition--positive or negative symptoms. CONCLUSION: French version of DAI-30 seems to have a similar structure and psychometric features as the original version. It shows concordance with the degree of compliance. Pharmacological factors are not the only factors implicated in subjective response, but are still to be identified. Limitations of our study are: (a) nonhomogenous indication for treatment, (b) small rate and degree of non compliance in our sample. Relationships between therapeutic ambition, type of symptoms and treatment outcome should be further studied.
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Randomized, controlled trials have demonstrated efficacy for second-generation antipsychotics in the treatment of acute mania in bipolar disorder. Despite depression being considered the hallmark of bipolar disorder, there are no published systematic reviews or meta-analyses to evaluate the efficacy of modern atypical antipsychotics in bipolar depression. We systematically reviewed published or registered randomized, double-blind, placebo-controlled trials (RCTs) of modern antipsychotics in adult bipolar I and/or II depressive patients (DSM-IV criteria). Efficacy outcomes were assessed based on changes in the Montgomery-Asberg Depression Rating Scale (MADRS) during an 8-wk period. Data were combined through meta-analysis using risk ratio as an effect size with a 95% confidence interval (95% CI) and with a level of statistical significance of 5% (p<0.05). We identified five RCTs; four involved antipsychotic monotherapy and one addressed both monotherapy and combination with an antidepressant. The two quetiapine trials analysed the safety and efficacy of two doses: 300 and 600 mg/d. The only olanzapine trial assessed olanzapine monotherapy within a range of 5-20 mg/d and olanzapine-fluoxetine combination within a range of 5-20 mg/d and 6-12 mg/d, respectively. The two aripiprazole placebo-controlled trials assessed doses of 5-30 mg/d. Quetiapine and olanzapine trials (3/5, 60%) demonstrated superiority over placebo (p<0.001). Only 2/5 (40%) (both aripiprazole trials) failed in the primary efficacy measure after the first 6 wk. Some modern antipsychotics (quetiapine and olanzapine) have demonstrated efficacy in bipolar depressive patients from week 1 onwards. Rapid onset of action seems to be a common feature of atypical antipsychotics in bipolar depression. Comment in The following popper user interface control may not be accessible. Tab to the next button to revert the control to an accessible version.Destroy user interface controlEfficacy of modern antipsychotics in placebo-controlled trials in bipolar depression: a meta-analysis--results to be interpreted with caution.
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Complex psychopathological and behavioral symptoms, such as delusions and aggression against care providers, are often the primary cause of acute hospital admissions of elderly patients to emergency units and psychiatric departments. This issue resembles an interdisciplinary clinically highly relevant diagnostic and therapeutic challenge across many medical subjects and general practice. At least 50% of the dramatically growing number of patients with dementia exerts aggressive and agitated symptoms during the course of clinical progression, particularly at moderate clinical severity. METHODS: Commonly used rating scales for agitation and aggression are reviewed and discussed. Furthermore, we focus in this article on benefits and limitations of all available data of anticonvulsants published in this specific indication, such as valproate, carbamazepine, oxcarbazepine, lamotrigine, gabapentin and topiramate. RESULTS: To date, most positive and robust data are available for carbamazepine, however, pharmacokinetic interactions with secondary enzyme induction limit its use. Controlled data of valproate do not seem to support the use in this population. For oxcarbazepine only one controlled but negative trial is available. Positive small series and case reports have been reported for lamotrigine, gabapentin and topiramate. CONCLUSION: So far, data of anticonvulsants in demented patients with behavioral disturbances are not convincing. Controlled clinical trials using specific, valid and psychometrically sound instruments of newer anticonvulsants with a better tolerability profile are mandatory to verify whether they can contribute as treatment option in this indication.
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Rapid assessment methods are valuable tools for collecting information about the quality and status of natural systems. However, they are not a substitute for detailed surveys of those systems. Users of this method should consider that the method may under-score or over-score the site that’s assessed, especially when the site is not a typical fen (i.e. a sedge meadow could score lower than fens, but in-fact be a relatively high quality sedge meadow). This assessment can be used throughout most of the spring, summer and fall period, however the ideal “index period” would be from late May through early October when native plant communities, as well as invasive species, are most apparent.