Embankment Quality Phase II Final Report, TR-401, 1999

Phase II research included the following: (1) develop and evaluate alternative soil design and embankment construction specifications based on soil type, moisture, density, stability, and compaction process; (2) assess various quality control and acceptance procedures with a variety of in-situ test methods including the Dual-mass Dynamic Cone Penetrometer (DCP); and (3) develop and design rapid field soil identification methods. At the start of the research, soils were divided into cohesive and cohesionless soil types, with each category being addressed separately. Cohesionless soils were designated as having less than 36% fines content (material passing the No. 200 sieve) and cohesive soils as having greater than 36% fines content. Subsequently, soil categories were refined based not only on fines content but soil plasticity as well. Research activities included observations of fill placement, in-place moisture and density testing, and dual-mass DCP index testing on several highway embankment projects throughout Iowa. Experiments involving rubber-tired and vibratory compaction, lift thickness changes, and disk aeration were carried out for the full range of Iowa soils. By testing for soil stability the DCP was found to be a valuable field tool for quality control, whereby shortcomings from density testing (density gradients) were avoided. Furthermore, critical DCP index values were established based on soil type and compaction moisture content.

Superpave Mix Designs for Low Volume Roads, Construction Report, TR-414, 2001

Most research current to the time of these projects was focused on use of Superpave mix designs on higher volume roads. Low volume roads have different requirements in terms of mix design, aggregate types, aggregate sources and project budgets. The purpose of this research was to determine if the Superpave mix design strategy for low volume roads was practical and economical. Eight projects were selected in five counties. The projects were completed in the summer of 1998. Performance evaluation of the resulting pavements was carried out annually. There was no significant increase in costs related to the use of Superpave. Nor were there any significant construction issues. There were some differences noted in placement and compaction in the field, but these were not serious.

Determination of the Optimum Base Characteristics for Pavements, TR-482, 2004

In recent years, it has become apparent that the design and maintenance of pavement drainage extends the service life of pavements. Most pavement structures now incorporate subsurface layers. Part of the function of these subsurface layers is to drain away excess water, which can be extremely deleterious to the life of the pavement. To assure the effectiveness of such drainage layers after they have been spread and compacted, simple, rapid, in-situ permeability and stability testing and end-result specification are needed. This report includes conclusions and recommendations related to four main study objectives: (1) Determine the optimal range for in-place stability and in-place permeability based on Iowa aggregate sources; (2) Evaluate the feasibility of an air permeameter for determining the permeability of open and well-graded drainage layers in situ; (3) Develop reliable end-result quality control/quality assurance specifications for stability and permeability; and (4) Refine aggregate placement and construction methods to optimize uniformity.

Construction of a Bridge Floor Using High Range Water Reducer, Construction Report, HR-192, 1978

The use of a high range water reducer in bridge floors was initiated by an Iowa Highway Research Board project (HR-192) in 1977 for two basic reasons. One was to determine the feasibility of using a high range water reducer (HRWR) in bridge floor concrete using conventional concrete proportioning, transporting and finishing equipment. The second was to determine the performance and protective qualities against chloride intrusion of a dense concrete bridge floor by de-icing agents used on Iowa's highways during winter months. This project was basically intended to overcome some problems that developed in the original research project. The problems alluded to are the time limits from batching to finishing; use of a different type of finishing machine; need for supplemental vibration on the surface of the concrete during the screeding operation and difficulty of texturing. The use of a double oscillating screed finishing machine worked well and supplemental vibration on one of the screeds was not needed. The limit of 45 minutes from batching the concrete to placement on the deck was verified. This is a maximum when the HRWR is introduced at the batch plant. The problem of texturing was not solved completely but is similar to our problems on the dense "Iowa System" overlay used on bridge deck repair projects. This project reinforced some earlier doubts about using truck transit mixers for mixing and transporting concrete containing HRWR when introduced at the batch plant.

Thin Bonded Concrete Overlay with Fast Track Concrete, Final Report, HR-531, 1990

Pavements have been overlaid with thin bonded portland cement concrete (PCC) for several years. These projects have had traffic detoured for a period of 5-10 days. These detours are unacceptable to the traveling public and result in severe criticism. The use of thin bonded fast track overlay was promoted to allow a thin bonded PCC overlay with minimal disruption of local traffic. This project demonstrated the concept of using one lane of the roadway to maintain traffic while the overlay was placed on the other and then with the rapid strength gain of the fast track concrete, the construction and local traffic is maintained on the newly placed, thin bonded overlay. The goals of this project were: 1. Traffic usage immediately after placement and finishing. 2. Reduce traffic disruption on a single lane to less than 5 hours. 3. Reduce traffic disruption on a given section of two-lane roadway to less than 2 days. 4. The procedure must be economically viable and competitive with existing alternatives. 5. Design life for new construction equivalent to or in excess of conventional pavements. 6. A 20 year minimum design life for rehabilitated pavements.

Initial and Extended Use of Femoral Versus Nonfemoral Double-Lumen Vascular Catheters and Catheter-Related Infection During Continuous Renal Replacement Therapy.

BACKGROUND: The risk of catheter-related infection or bacteremia, with initial and extended use of femoral versus nonfemoral sites for double-lumen vascular catheters (DLVCs) during continuous renal replacement therapy (CRRT), is unclear. STUDY DESIGN: Retrospective observational cohort study. SETTING & PARTICIPANTS: Critically ill patients on CRRT in a combined intensive care unit of a tertiary institution. FACTOR: Femoral versus nonfemoral venous DLVC placement. OUTCOMES: Catheter-related colonization (CRCOL) and bloodstream infection (CRBSI). MEASUREMENTS: CRCOL/CRBSI rates expressed per 1,000 catheter-days. RESULTS: We studied 458 patients (median age, 65 years; 60% males) and 647 DLVCs. Of 405 single-site only DLVC users, 82% versus 18% received exclusively 419 femoral versus 82 jugular or subclavian DLVCs, respectively. The corresponding DLVC indwelling duration was 6±4 versus 7±5 days (P=0.03). Corresponding CRCOL and CRBSI rates (per 1,000 catheter-days) were 9.7 versus 8.8 events (P=0.8) and 1.2 versus 3.5 events (P=0.3), respectively. Overall, 96 patients with extended CRRT received femoral-site insertion first with subsequent site change, including 53 femoral guidewire exchanges, 53 new femoral venipunctures, and 47 new jugular/subclavian sites. CRCOL and CRBSI rates were similar for all such approaches (P=0.7 and P=0.9, respectively). On multivariate analysis, CRCOL risk was higher in patients older than 65 years and weighing >90kg (ORs of 2.1 and 2.2, respectively; P<0.05). This association between higher weight and greater CRCOL risk was significant for femoral DLVCs, but not for nonfemoral sites. Other covariates, including initial or specific DLVC site, guidewire exchange versus new venipuncture, and primary versus secondary DLVC placement, did not significantly affect CRCOL rates. LIMITATIONS: Nonrandomized retrospective design and single-center evaluation. CONCLUSIONS: CRCOL and CRBSI rates in patients on CRRT are low and not influenced significantly by initial or serial femoral catheterizations with guidewire exchange or new venipuncture. CRCOL risk is higher in older and heavier patients, the latter especially so with femoral sites.

Concurrent use of cisplatin or cetuximab with definitive radiotherapy for locally advanced head and neck squamous cell carcinomas. Strahlentherapie in Kombination mit platinbasierter Chemotherapie oder Cetuximab zur Behandlung von lokal fortgeschrittenen Plattenepithelkarzinomen im Kopf-Hals-Bereich.

AIM: The goal of the present work was to compare outcomes of definitive concurrent cisplatin-based chemoradiotherapy (CRT) with cetuximab-based bioradiotherapy (BRT) in locally advanced head-and-neck squamous cell carcinoma (HNSCC). PATIENTS AND METHODS: Between 2006 and 2012, 265 patients with locally advanced HNSCC were treated at our institution with CRT (n = 194; 73 %) with three cycles of cisplatin (100 mg/m(2), every 3 weeks) or BRT (n = 71; 27 %) with weekly cetuximab. Patients receiving BRT had more pre-existing conditions (Charlson index ≥ 2) than the CRT group (p = 0.005). RESULTS: Median follow-up was 29 months. In all, 56 % of patients treated with CRT received the planned three cycles (92 % at least two cycles) and 79 % patients treated with BRT received six cycles or more. The 2-year actuarial overall survival (OS) and progression-free survival (PFS) were 72 % and 61 %, respectively. In the multivariate analysis (MVA), T4 stage, N2-3 stage, smoking status (current smoker as compared with never smoker), and non-oropharyngeal locations predicted for OS, whereas BRT association with OS was of borderline significance (p = 0.054). The 2-year actuarial locoregional control (LRC) and distant control (DC) rates were 73 and 79 %, respectively. CRT was independently associated with an improved LRC (2-year LRC: 76 % for CRT vs. 61 % for BRT) and DC (2-year LRC: 81 % for CRT vs. 68 % for BRT) in comparison with BRT (p < 0.001 and p = 0.01 in the MVA). Subgroup analyses showed that T4 patients benefited significantly from CRT (vs. BRT) in LRC, while T1-3 did not. BRT patients had more G3-4 skin complications (p < 0.001) and CRT patients had higher rates of feeding tube placement (p = 0.006) and G3-4 gastrointestinal toxicities (p < 0.001). CONCLUSION: This retrospective analysis showed a better LRC in locally advanced HNSCC treated by cisplatin-based CRT than cetuximab-based BRT, and a nonsignificant trend towards an improved OS.

La réinsertion professionnelle des bénéficiaires de l'aide sociale en Suisse et en Allemagne

Parmi les régimes sociaux pour les personnes sans emploi en âge de travailler, l'aide sociale compte parmi ceux qui ont été confrontés aux plus grands changements au cours des vingt dernières années. Durant cette période, le nombre et le profil des bénéficiaires a évolué à un tel point qu'il devient aujourd'hui difficile de considérer l'aide sociale uniquement sous le prisme d'un dernier filet de protection sociale intervenant pour une minorité d'individus fortement marginalisés socialement. Aujourd'hui, accompagnant une hausse régulière du nombre de bénéficiaires, le public de l'aide sociale est devenu beaucoup plus hétérogène, incorporant une frange de plus en plus importante de personnes pour qui le chômage de longue durée ou le sous-emploi constituent de fait le principal problème. Loin d'être un phénomène typiquement suisse, la transformation radicale du public touchant des prestations d'aide sociale a en fait touché l'ensemble des pays européens. Ces développements questionnent fondamentalement la mission de l'aide sociale. Traditionnellement, deux missions ont été au centre de l'aide sociale : garantir le minimum vital et favoriser l'intégration sociale des personnes les plus marginalisées socialement. Toutefois, aujourd'hui, avec l'émergence de nouveaux publics, se pose crucialement la question de la réorientation des régimes d'aide sociale vers une prise en charge visant le retour sur le premier marché du travail à plus ou moins long terme. De quels types de mesures de réinsertion professionnelle et de services de placement les bénéficiaires de l'aide sociale disposent-ils en Suisse ? Quels dispositifs organisationnels permettent-ils de garantir une prise en charge orientée vers l'emploi adaptée aux bénéficiaires de l'aide sociale ? En Suisse, bien que la réinsertion professionnelle soit désormais considérée comme une mission intégrale de l'aide sociale au niveau politique, il existe encore peu d'études empiriques sur les pratiques effectives mises en place dans les différents cantons en matière d'aide à la réinsertion professionnelle des bénéficiaires de l'aide sociale. Sans prétendre à l'exhaustivité, cette étude dresse un état des lieux de la situation actuelle en Suisse sur la base des quelques études existantes et d'une enquête par questionnaire réalisée auprès des responsables cantonaux en 2011. Malgré d'importantes différences entre et à l'intérieur des cantons et de nombreuses lacunes dans les données statistiques, un des principaux résultats qui ressort de cette étude est que l'accès des bénéficiaires de l'aide sociale à une prise en charge orientée emploi en Suisse reste problématique à plusieurs égards. En effet, alors que l'offre développée par les services sociaux en matière de mesures de réinsertion professionnelle reste souvent restreinte, d'autres pratiques telles que la collaboration interinstitutionnelle ou le recours aux ORP pour les services de placement présentent aussi plusieurs limites. Une comparaison avec la situation en Allemagne, qui a complètement réorganisé la prise en charge de ses chômeurs de longue durée en 2005 en créant une prestation financière et une structure de prise en charge spécifique à cette catégorie de sans-emplois, confirme le potentiel d'amélioration des efforts réalisés en Suisse, particulièrement en ce qui concerne l'importance accordée au retour à l'emploi et l'accès aux mesures de réinsertion professionnelle les plus prometteuses. Toutefois, et malgré une réduction significative du nombre de chômeurs de longue durée depuis l'introduction de la réforme Hartz IV en 2005, l'expérience allemande indique que la mise sur pied d'une structure spécialisée n'est pas non plus sans créer des problèmes, et que, plus généralement, il est difficile d'imputer le succès d'une politique de réinsertion professionnelle pour les bénéficiaires de l'aide sociale uniquement à son modèle organisationnel.

What influence do anticoagulants have on oral implant therapy? A systematic review.

OBJECTIVES: This systematic review aims to assess the risks (both thromboembolic and bleeding) of an oral anticoagulation therapy (OAT) patient undergoing implant therapy and to provide a management protocol to patients under OAT undergoing implant therapy. MATERIAL AND METHODS: Medline, Cochrane Data Base of Systematic Reviews, the Cochrane Central Register of Controlled Trials and EMBASE (from 1980 to December 2008) were searched for English-language articles published between 1966 and 2008. This search was completed by a hand research accessing the references cited in all identified publications. RESULTS: Nineteen studies were identified reporting outcomes after oral surgery procedures (mostly dental extractions in patients on OAT following different management protocols and haemostatic therapies). Five studies were randomized-controlled trials (RCTs), 11 were controlled clinical trials (CCTs) and three were prospective case series. The OAT management strategies as well as the protocols during and after surgery were different. This heterogeneity prevented any possible data aggregation and synthesis. The results from these studies are very homogeneous, reporting minor bleeding in very few patients, without a significant difference between the OAT patients who continue with the vitamin K antagonists vs. the patients who stopped this medication before surgery. These post-operative bleeding events were controlled only with local haemostatic measures: tranexamic acid mouthwashes, gelatine sponges and cellulose gauzes's application were effective. Post-operative bleeding did not correlate with the international normalised ratio (INR) status. In none of the studies was a thromboembolic event reported. CONCLUSIONS: OAT patients (INR 2-4) who do not discontinue the AC medication do not have a significantly higher risk of post-operative bleeding than non-OAT patients and they also do not have a higher risk of post-operative bleeding than OAT patients who discontinue the medication. In patients with OAT (INR 2-4) without discontinuation, topical haemostatic agents were effective in preventing post-operative bleeding. OAT discontinuation is not recommended for minor oral surgery, such as single tooth extraction or implant placement, provided that this does not involve autogenous bone grafts, extensive flaps or osteotomy preparations extending outside the bony envelope. Evidence does not support that dental implant placement in patients on OAT is contraindicated.

Standards for Single Span Prefabricated Bridges, Phase I - Concept Development, TR-663, 2014

In coordination with a Technical Advisory Committee (TAC) consisting of County Engineers and Iowa DOT representatives, the Iowa DOT has proposed to develop a set of standards for a single span prefabricated bridge system for use on the local road system. The purpose of the bridge system is to improve bridge construction, accelerate project delivery, improve worker safety, be cost effective, reduce impacts to the travelling public by reducing traffic disruptions and the duration of detours, and allow local forces to construct the bridges. HDR Inc. was selected by the Iowa DOT to perform the initial concept screening of the bridge system. This Final Report summarizes the initial conceptual effort to investigate potential systems, make recommendations for a preferred system and propose initial details to be tested in the laboratory in Phase 2 of the project. The prefabricated bridge components were to be based on the following preliminary criteria set forth by the TAC. The criteria were to be verified and/ or modified as part of the conceptual development. - 24’ and 30’ roadway widths - Skews of 0o, 15o, and 30o - Span lengths of 30’ – 70’ in 10’ increments using precast concrete beams - Voided box beams could be considered - Limit precast element weight to 45,000 pounds for movement and placement of beams - Beams could be joined transversely with threaded rods - Abutment concepts may included precast as well as an option for cast-in-place abutments with pile foundations In addition to the above criteria, there was an interest to use a single-width prefabricated bridge component to simplify fabrication as well as a desire to utilize non-prestressed concrete systems where possible to allow for precasting of the beam modules by local forces or local precast plants. The SL-1 modular steel bridge rail was identified for use with this single span prefabricated bridge system.

Rearranging Phrasal Verbs

This paper starts from the fact that everyone who has studied English as a second languagehas noticed that the study of phrasal verbs poses a challenge for both teachers andstudents. Students are offered a list of phrasal verbs without any other explanation; theyjust have to learn them by heart. Those lists differ from one another due to the fact thateach author/teacher chooses the phrasal verbs that they consider the most common. Sincethis approach to phrasal verbs is not the most effective, it is going to be the center of thisstudy. After describing what a phrasal verb is –a compound verb formed by a main verband a particle–, although the particle placement will also be treated, the work will befocused on analyzing the particle in terms of meaning. Moreover, a comparison among itstreatment in different dictionaries will be carried out, and, since the particle is the keycomponent, we aim to reorganize the lists provided to students according to the particle inorder to make its study easier.

Utility accommodation policy of the Iowa State Highway Commission, 1970

This policy covers initial placement, adjustment, relocation and replacement of utility facilities in, on, above or below all highway right of way over which the Iowa State Highway Commission exercises control of access. It embodies the basic specifications and standards needed, to insure the safety of the highway user and the integrity of the highway.

Utility accommodation policy of the Iowa State Highway Commission, 1973

This policy covers initial placement, adjustment, relocation and replacement of utility facilities in, on, above or below all highway right of way over which the Iowa State Highway Commission exercises control of access. It embodies the basic specifications and standards needed, to insure the safety of the highway user and the integrity of the highway. (1973 revision to 1970 policy.)

Policy for Accommodating Utilities on State Highway Rights-of-Way, 1985

This policy covers initial placement, adjustment, relocation and replacement of utility facilities in, on, above or below all highway right of way over which the Iowa Department of Transportation exercises control of access. It embodies the basic specifications and standards needed, to insure the safety of the highway user and the integrity of the highway. (1985 revision to 1973 policy.)

Policy of the Iowa Department of Transportation Highway Division For Accommodating Utilities on Primary Road System, 1990

This policy covers initial placement, adjustment, relocation and replacement of utility facilities in, on, above or below all highway right of way over which the Iowa Department of Transportation exercises control of access. It embodies the basic specifications and standards needed, to insure the safety of the highway user and the integrity of the highway. (1990 revision to 1985 policy.)