Prospective assessment of trocar-specific morbidity in laparoscopy.

BACKGROUND: The purpose of the present study was to challenge the hypothetical advantage of single port laparoscopy (SPL) over conventional laparoscopy by measuring prospectively the morbidity specifically related to conventional trocar sites (TS). METHODS: From November 2010 to December 2011, 300 patients undergoing various laparoscopic procedures were enrolled. Patient, surgery, and trocar characteristics were recorded. We evaluated at three time points (in-hospital and at 1 and 6 months postoperatively) specifically for each TS, pain (Visual Analog Scale), morbidity (infection, hematoma, hernia), and cosmesis (Patient Scar Assessment Score; PSAS). Patients designated their "worst TS," and a composite endpoint "bad TS" was defined to include any adverse outcome at a TS. RESULTS: We analyzed 1,074 TS. Follow-up was >90 %. Pain scores of >3/10 at 1 and 6 months postoperatively, were reported by 3 and 1 % of patients at the 5 mm TS and by 9 and 1 % at the larger TS, respectively (5 mm TS vs larger TS; p = 0.001). Pain was significantly lower for TS located in the lower abdomen than for the upper abdomen or the umbilicus (p = 0.001). The overall complication rate was <1 % and significantly lower for the 5 mm TS (hematoma p = 0.046; infection p = 0.0001). No hernia was found. The overall PSAS score was low and significantly lower for the 5 mm TS (p = 0.0001). Significant predictors of "bad TS" were larger TS (p = 0.001), umbilical position (p = 0.0001), emergency surgery (p = 0.0001), accidental trocar exit (p = 0.022), fascia closure (p = 0.006), and specimen extraction site (p = 0.0001). CONCLUSIONS: Specific trocar morbidity is low and almost negligible for 5 mm trocars. The umbilicus appears to be an unfavorable TS.

Compressed Natural Gas in Iowa State of Iowa Requirements and Procedures For Commercialization and Sale, June 2015

This document is specific to the state of Iowa and outlines the requirements and procedures necessary to use, distribute, and service compressed natural gas (CNG) and the equipment associated with it. Four state agencies’ requirements for CNG are covered in this document: The Iowa Utilities Board (IUB), Iowa Department of Agriculture and Land Stewardship (IDALS)/ Weights and Measures Bureau, Iowa Department of Revenue (IDR) and Iowa Department of Public Safety (IDPS) / Division of the State Fire Marshal.

Agreed-upon procedures report on the City of Whitten, Iowa for the period January 1, 2015 through December 31, 2015

Agreed-upon procedures report on the City of Whitten, Iowa for the period January 1, 2015 through December 31, 2015

Agreed-upon procedures report on the City of Granger, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Granger, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Breda, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Breda, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Ainsworth, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Ainsworth, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Victor, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Victor, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Ely, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Ely, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Remsen, Iowa and the Remsen Municipal Utilities for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Remsen, Iowa and the Remsen Municipal Utilities for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Wall Lake, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Wall Lake, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Bedford, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Bedford, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Manly, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Manly, Iowa for the period July 1, 2014 through June 30, 2015

Practical Data Collection: Establishing Methods and Procedures for Measuring Water Clarity and Turbidity of Storm Water Run-Off from Active Major Highway Construction Sites, 2014

In anticipation of regulation involving numeric turbidity limit at highway construction sites, research was done into the most appropriate, affordable methods for surface water monitoring. Measuring sediment concentration in streams may be conducted a number of ways. As part of a project funded by the Iowa Department of Transportation, several testing methods were explored to determine the most affordable, appropriate methods for data collection both in the field and in the lab. The primary purpose of the research was to determine the exchangeability of the acrylic transparency tube for water clarity analysis as compared to the turbidimeter.

Investigation of Rapid Thermal Analysis Procedures for Prediction of the Service Life of PCCP Carbonate Coarse Aggregate: Phase I, Progress Report, HR-337, 1992

The major objective of this research project is to utilize thermal analysis techniques in conjunction with x-ray analysis methods to identify and explain chemical reactions that promote aggregate related deterioration in Portland cement concrete. The first year of this project has been spent obtaining and analyzing limestone and dolomite samples that exhibit a wide range of field service performance. Most of the samples chosen for the study also had laboratory durability test information (ASTM C 666, method B) that was readily available. Preliminary test results indicate that a strong relationship exists between the average crystallite size of the limestone (calcite) specimens and their apparent decomposition temperatures as measured by thermogravimetric analysis. Also, premature weight loss in the thermogravimetric analysis tests appeared to be related to the apparent decomposition temperature of the various calcite test specimens.

Agreed-upon procedures report on the City of Riverdale, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Riverdale, Iowa for the period July 1, 2014 through June 30, 2015