Derivation and validation of a prognostic model for pulmonary embolism.

RATIONALE: An objective and simple prognostic model for patients with pulmonary embolism could be helpful in guiding initial intensity of treatment. OBJECTIVES: To develop a clinical prediction rule that accurately classifies patients with pulmonary embolism into categories of increasing risk of mortality and other adverse medical outcomes. METHODS: We randomly allocated 15,531 inpatient discharges with pulmonary embolism from 186 Pennsylvania hospitals to derivation (67%) and internal validation (33%) samples. We derived our prediction rule using logistic regression with 30-day mortality as the primary outcome, and patient demographic and clinical data routinely available at presentation as potential predictor variables. We externally validated the rule in 221 inpatients with pulmonary embolism from Switzerland and France. MEASUREMENTS: We compared mortality and nonfatal adverse medical outcomes across the derivation and two validation samples. MAIN RESULTS: The prediction rule is based on 11 simple patient characteristics that were independently associated with mortality and stratifies patients with pulmonary embolism into five severity classes, with 30-day mortality rates of 0-1.6% in class I, 1.7-3.5% in class II, 3.2-7.1% in class III, 4.0-11.4% in class IV, and 10.0-24.5% in class V across the derivation and validation samples. Inpatient death and nonfatal complications were <or= 1.1% among patients in class I and <or= 1.9% among patients in class II. CONCLUSIONS: Our rule accurately classifies patients with pulmonary embolism into classes of increasing risk of mortality and other adverse medical outcomes. Further validation of the rule is important before its implementation as a decision aid to guide the initial management of patients with pulmonary embolism.

Elgard Cathodic Protection System, HR-553, 1995

Following is the Operations Manual for the Pennsylvania Ave Bridge over I-235 located in Des Moines, Iowa, which was installed from July 1992 to October 1992. The project uses ELGARD™ 210 Anode Mesh and is divided into 3 zones. Periodic data collection and/or inspection of the cathodic protection system is required to insure proper operation and a long life. This Operation Manual contains a schedule, operation procedures, operation log forms, a rectifier panel drawing, and pertinent reference matenal. Operation procedures and operating records are contained in the body of the manual, while blank operation forms, as built drawings, and pertinent reference material are contained in the appendices.

Synthesis Study: Effectiveness of Safety Corridor Programs, Report on Tasks 1-3, 2008

This report synthesizes the safety corridor programs of 13 states that currently have some type of program: Alaska, California, Florida, Kentucky, Minnesota, New Jersey, New Mexico, New York, Ohio, Oregon, Pennsylvania, Virginia, and Washington. This synthesis can help Midwestern states implement their own safety corridor programs and select pilot corridors or enhance existing corridors. Survey and interview information about the states’ programs was gathered from members of each state department of transportation (DOT) and Federal Highway Administration (FHWA) division office. Topics discussed included definitions of a safety corridor; length and number of corridors in the program; criteria for selection of a corridor; measures of effectiveness of an implemented safety corridor; organizational structure of the program; funding and legislation issues; and engineering, education, enforcement, and emergency medical service strategies. Safety corridor programs with successful results were then examined in more detail, and field visits were made to Kansas, Oregon, Pennsylvania, and Washington for first-hand observations. With the survey and field visit information, several characteristics of successful safety corridor programs were identified, including multidisciplinary (3E and 4E) efforts; selection, evaluation, and decommissioning strategies; organization structure, champions, and funding; task forces and Corridor Safety Action Plans; road safety audits; and legislation and other safety issues. Based on the synthesis, the report makes recommendations for establishing and maintaining a successful safety corridor program.

Shrouded costs of government: The political economy of state and local public pensions

Why do public-sector workers receive so much of their compensation in the formof pensions and other benefits? This paper presents a political economy model inwhich politicians compete for taxpayers' and government employees' votes by promising compensation packages, but some voters cannot evaluate every aspect of promisedcompensation. If pension packages are "shrouded", so that public-sector workers better understand their value than ordinary taxpayers, then compensation will be highlyback-loaded. In equilibrium, the welfare of public-sector workers could be improved,holding total public-sector costs constant, if they received higher wages and lowerpensions. Centralizing pension determination has two offsetting effects on generosity:more state-level media attention helps taxpayers better understand pension costs, andthat reduces pension generosity; but a larger share of public-sector workers will votewithin the jurisdiction, which increases pension generosity. A short discussion of pensions in two decentralized states (California and Pennsylvania) and two centralizedstates (Massachusetts and Ohio) suggests that centralization appears to have modestlyreduced pensions, but, as the model suggests, this is unlikely to be universal.

Report of the 4th Workshop for Technology Transfer for Intelligent Compaction Consortium, TPF-5(233), 2015

This document summarizes the discussion and findings of the 4th workshop held on October 27–28, 2015 in Frankfort, Kentucky as part of the Technology Transfer Intelligent Compaction Consortium (TTICC) Transportation Pooled Fund (TPF-5(233)) study. The TTICC project is led by the Iowa Department of Transportation (DOT) and partnered by the following state DOTs: California, Georgia, Iowa, Kentucky, Missouri, Ohio, Pennsylvania, Virginia, and Wisconsin. The workshop was hosted by the Kentucky Transportation Cabinet and was organized by the Center for Earthworks Engineering Research (CEER) at Iowa State University of Science and Technology. The objective of the workshop was to generate a focused discussion to identify the research, education, and implementation goals necessary for advancing intelligent compaction for earthworks and asphalt. The workshop consisted of a review of the TTICC goals, state DOT briefings on intelligent compaction implementation activities in their state, voting and brainstorming sessions on intelligent compaction road map research and implementation needs, and identification of action items for TTICC, industry, and Federal Highway Administration (FHWA) on each of the road map elements to help accelerate implementation of the technology. Twenty-three attendees representing the state DOTs participating in this pooled fund study, the FHWA, Iowa State University, University of Kentucky, and industry participated in this workshop.

Miten mongolit valloittivat maailman?

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Media in the Ubiquitous Era: Ambient, Social and Gaming Media

http://www.igi-global.com/book/media-ubiquitous-era/49581

Distributed Repositories of Medieval Calendars and Crowd-Sourcing of Transcription

Presentation at Open Repositories 2014, Helsinki, Finland, June 9-13, 2014

Introduction to Hydra for Developers

Workshop at Open Repositories 2014, Helsinki, Finland, June 9-13, 2014

Implementing RDF metadata in Hydra

Workshop at Open Repositories 2014, Helsinki, Finland, June 9-13, 2014

Pienkoulut, lokaalit yhteisöt ja globaalit yhteiskunnat

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Herrnhutilaisuuden seulonta-aika uudelleen arvioitavana

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Pariisilaisbegiinien sirpaleinen menneisyys

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