Technological, biopharmaceutical and pharmacokinetic advances: new formulations of application on the skin and oral mucosa

Currently a growing interest to improve the pharmacological therapy exists, not only by the production and the appearance of new drugs, but guaranteeing that the uses of those which already exist, become more effective. In fact, the conventional pharmaceutical formulations of different drugs present a few secondary effects due to oral administration. In order to avoid these undesired side effects, the purpose of current therapeutic is the development and research of formulations as an alternative to others routes of administration. Therefore, in spite of the undoubtedly complete parenteral absorption, the transdermal and transbuccal routes appear to be a rather attractive alternative to provide an efficient absorption. In this chapter a new technological, biopharmaceutical and pharmacokinetic approach of strategies for application on skin and buccal mucosa are reported. In the future new transdermal drug delivery systems will emerge to be more effective, equipped with an improved aesthetic appearance, better adherence and greater diffusion. But to reach these aims, it is necessary previous knowledge of histology and physiology of skin, and factors involved in the penetration of drugs through it.

A Study of Curing Methods and Type II Cements on the Durability of Concrete, R-11-Z(1), 1969

A program of A (90 day moist room), B (14 day moist room) and C (7 day moist room and 7 day 50%_humidity) type curing for the R-11-Z program of durability of concrete using the automatic freeze and thaw machine (ASTM C-291) has been used in the Materials Department of the Iowa State Highway Commission since December 6, 1966. A summary of the results obtained from then until March 25, 1968, indicates that the B and C type curing are yielding very little valuable information. However, the A cure exhibits a wide range of durability factors and also groups the aggregates in an order which is related to the service record (there are definite exceptions. The biggest disadvantage to the A cure is the length of time that it takes to complete the test (90 day cure and 38 day test). The Kansas Highway Department has experimented with different cements and aggregates in order to determine which combination offers a concrete with the best durability factor possible. In an experimental test section of highway, concrete made with a Type II cement appeared to have better durability than others made with Type I cements. Because of this, a question has been raised at the Iowa State Highway Commission - Can concrete made with Type II cements, because of a lesser amount of tricalcium aluminate, yield better durability than concrete made with Type I cements?

Diagnosis and management of blunt great vessel trauma.

Traditionally, thoracic aortic rupture, suspected after blunt thoracic trauma, is characterized by a chest radiograph showing a widened mediastinum. The diagnostic machinery consecutively activated still depends heavily on the pressure as additional traumatic lesions. A patient with additional cranio-cerebral trauma would typically undergo contrast-enhanced computed tomography or magnetic resonance imaging of head, chest, and other regions. In a number of patients these analyses would confirm the presence of blood in the mediastinum without formal proof of an aortic disruption. This is because mediastinal hematomas may be caused not only by an aortic rupture, but also by numerous other blood sources including fractures of the spine and other macro- and microvascular lesions providing similar images. Therefore, aortic angiography became our preferred diagnostic tool to identify or rule out acute traumatic lesions of not only the aorta but with great vessels. However recently, a number of traumatic aortic transsections have been identified by transoesophageal echocardiography (TEE). TEE has the additional advantage of being a bed-side procedure providing additional information about cardiac function. The latter analysis allows for identification and quantification of cardiac contusions, post-traumatic myocardial infarctions, and valvar lesions which are of prime importance to develop an adequate surgical strategy and to assess the risk of the numerous emergency procedures required in patients with polytrauma. The standard approach for repair of isthmic aortic rupture is through a lateral thoracotomy. Distal and proximal control of the aorta can be achieved in a substantial number of cases before complete aortic rupture occurs and a higher proportion of direct suture repair can be achieved under such circumstances. Most proximal descending aortic procedures are performed without cardiopulmonary bypass (clamp and go) but paraplegia may occur before, during, or after the procedure. Ascending aortic lesions and disruption of the aortic arch, the supra-aortic vessels, the main pulmonary arteries, the great veins as well as cardiac lesions are best approached through a sternotomy, which may have to be extended. Cardiopulmonary bypass allowing for deep hypothermia and circulatory arrest is often required and carries its own complications. It is not clear whether the increasing proportion of ascending aortic and cardiac lesions which are observed nowadays are due to a change in trauma mechanics (i.e., speed limits, seat belts, air-bags), an improvement of the diagnostic tools or both.

Morphogenetic characteristics and management of Tanzania grass

The objective of this work was to evaluate the effect of grazing interval and period of evaluation over tissue turnover in Tanzania grass pastures (Panicum maximum cv. Tanzania) and to ascertain if herbage accumulation rate can be used as a criterion to establish a defoliation schedule for this grass in Southeast of Brazil. A randomized block design with a split-plot arrangement was used. The effect of three grazing intervals was evaluated within seven periods between October 1995 and September 1996. Responses monitored were leaf and stem elongation rates, leaf senescence rate, stem length, and tiller density. Net herbage accumulation rate was calculated using tissue turnover data. The grazing intervals for Tanzania grass should be around 38 days between October and April (spring and early autumn) and 28 days during the reproductive phase of the grass (April/May). Between May and September (late autumn and winter), grazing interval should be around 48 days. Herbage accumulation rate is not a good criterion to establish defoliation time for Tanzania grass. Studies on the effects of stem production in grazing efficiency, animal intake and forage quality are needed to improve Tanzania grass management.

The Mixed Management of Patients' Medical Records: Responsibility Sharing Between the Patient and the Physician

Through this article, we propose a mixed management of patients' medical records, so as to share responsibilities between the patient and the Medical Practitioner by making Patients responsible for the validation of their administrative information, and MPs responsible for the validation of their Patients' medical information. Our proposal can be considered a solution to the main problem faced by patients, health practitioners and the authorities, namely the gathering and updating of administrative and medical data belonging to the patient in order to accurately reconstitute a patient's medical history. This method is based on two processes. The aim of the first process is to provide a patient's administrative data, in order to know where and when the patient received care (name of the health structure or health practitioner, type of care: out patient or inpatient). The aim of the second process is to provide a patient's medical information and to validate it under the accountability of the Medical Practitioner with the help of the patient if needed. During these two processes, the patient's privacy will be ensured through cryptographic hash functions like the Secure Hash Algorithm, which allows pseudonymisation of a patient's identity. The proposed Medical Record Search Engines will be able to retrieve and to provide upon a request formulated by the Medical ractitioner all the available information concerning a patient who has received care in different health structures without divulging the patient's identity. Our method can lead to improved efficiency of personal medical record management under the mixed responsibilities of the patient and the MP.

Bypass gastrique: prise en charge des complications et désagrements alimentaires [Gastric bypass: management of complications and food tolerance]

La chirurgie bariatrique est le seul traitement qui permette une perte pondérale significative sur le long terme mais le succès d'une telle intervention repose avant tout dans une sélection et une préparation attentive du patient. Une bonne connaissance des implications de l'opération permet de favoriser un changement de comportement alimentaire et par là aussi de diminuer les complications et les désagréments alimentaires. L'éducation du patient n'a de sens que si elle s'inscrit dans une prise en charge pluridisciplinaire, comprenant également un suivi diététique, planifié sur le long terme. La mastication, la vitesse d'ingestion des aliments, le fait de renoncer aux boissons gazeuses et de devoir boire régulièrement entre les repas, sont les éléments les plus difficiles à mettre en place pour le patient. Bariatric surgery is the only treatment inducing effective weight loss on the long term. The success of such an intervention is possible by carefully selecting and educating the candidates. Good understanding of the bariatric surgery implications allows the patients to modify their eating habits and thus decrease complications and food intolerance. Therefore patient education requires a multidisciplinary approach which implies the follow-up of a dietician on the long term. Mastication, speed of food ingestion, avoidance of carbonated beverages as well as the obligation to drink at frequent and regular intervals are the most difficult aspects to be taught to the patients

Rethinking study and management of agricultural systems for policy design

There is a concern that agriculture will no longer be able to meet, on a global scale, the growing demand for food. Facing such a challenge requires new patterns of thinking in the context of complexity and sustainability sciences. This paper, focused on the social dimension of the study and management of agricultural systems, suggests that rethinking the study of agricultural systems entails analyzing them as complex socio-ecological systems, as well as considering the differing thinking patterns of diverse stakeholders. The intersubjective nature of knowledge, as studied by different philosophical schools, needs to be better integrated into the study and management of agricultural systems than it is done so far, forcing us to accept that there are no simplistic solutions, and to seek a better understanding of the social dimension of agriculture. Different agriculture related problems require different policy and institutional approaches. Finally, the intersubjective nature of knowledge asks for the visualization of different framings and the power relations taking place in the decision-making process. Rethinking management of agricultural systems implies that policy making should be shaped by different principles: learning, flexibility, adaptation, scale-matching, participation, diversity enhancement and precaution hold the promise to significantly improve current standard management procedures.

Audit report on the Wireless E911 Emergency Communications Fund of the Iowa Department of Homeland Security and Emergency Management for the year ended June 30, 2014

Audit report on the Wireless E911 Emergency Communications Fund of the Iowa Department of Homeland Security and Emergency Management for the year ended June 30, 2014

Investigation of Video Crack and Patch Surveying for Pavement Management, MLR-92-01, 1992

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.

Optimization and Management of Materials in Earthwork Construction, TR-501, 2010

As a result of forensic investigations of problems across Iowa, a research study was developed aimed at providing solutions to identified problems through better management and optimization of the available pavement geotechnical materials and through ground improvement, soil reinforcement, and other soil treatment techniques. The overall goal was worked out through simple laboratory experiments, such as particle size analysis, plasticity tests, compaction tests, permeability tests, and strength tests. A review of the problems suggested three areas of study: pavement cracking due to improper management of pavement geotechnical materials, permeability of mixed-subgrade soils, and settlement of soil above the pipe due to improper compaction of the backfill. This resulted in the following three areas of study: (1) The optimization and management of earthwork materials through general soil mixing of various select and unsuitable soils and a specific example of optimization of materials in earthwork construction by soil mixing; (2) An investigation of the saturated permeability of compacted glacial till in relation to validation and prediction with the Enhanced Integrated Climatic Model (EICM); and (3) A field investigation and numerical modeling of culvert settlement. For each area of study, a literature review was conducted, research data were collected and analyzed, and important findings and conclusions were drawn. It was found that optimum mixtures of select and unsuitable soils can be defined that allow the use of unsuitable materials in embankment and subgrade locations. An improved model of saturated hydraulic conductivity was proposed for use with glacial soils from Iowa. The use of proper trench backfill compaction or the use of flowable mortar will reduce the potential for developing a bump above culverts.

Prognostic factors and role of adjuvant therapies in the management of parasagittal meningiomas

L'objectif du présent travail de thèse est d'analyser rétrospectivement la série de méningiomes parasagittaux traités au CHUV, soit par traitements simples ou combinés (chirurgie et / ou radiochirurgie et radiothérapie fractionnée), afin de déterminer les facteurs qui influencent leur pronostic. Méthode: Entre Janvier 1999 et mai 2007, 37 méningiomes parasagittaux ont été traités dans notre centre. Nous avons analysé de manière rétrospective les différents paramètres du traitement de ces méningiomes ainsi que leur emplacement le long du sinus sagittal supérieur, leur volume, leur grade histologique et le degré de résection ainsi que le sexe et l'âge du patient afin de comprendre les facteurs qui influencent leur histoire naturelle. Résultats: Le suivi médian était de 6,7 ans (2,4 -12 ans). Les grades histologiques et le degré de résection tumorale (Simpson) étaient répartis uniformément le long du sinus sagittal supérieur. Le taux actuariel de contrôle global des tumeurs était de 65,9%. L'analyse de régression montre que le grade tumoral et le degré de résection sont deux facteurs extrêmement importants pour déterminer le contrôle tumoral (p <0,002 et ρ <0,008). La localisation le long du sinus sagittal supérieur a montré une baisse du taux de contrôle dans le tiers postérieur (p <0,002). Le sexe, l'âge et le volume de la tumeur n'étaient quand à eux pas des facteurs significatifs. Par ailleurs, et de façon inattendue, dans notre série, la proportion du traitement adjuvant a été beaucoup plus élevée que dans les séries décrites jusqu'à maintenant (39% vs 7%) mais avec un taux de contrôle similaire et diminution de la morbidité et la mortalité. Conclusions: Dans notre série, le grade histologique et le degré de résection tumorale (Simpson) sont des facteurs indépendants de récidive et de contrôle tumoral. Fait intéressant, l'emplacement dans le tiers postérieur du sinus sagittal supérieur semble être un autre facteur indépendant de récidive. Afin d'éviter les morbidités importantes liées à la chirurgie nous préconisons une utilisation précoce de traitements adjuvants pour les tumeurs grade histologique élevé et pour les tumeurs situées dans la partie postérieure du sinus sagittal supérieur

Report on a review of selected general and application controls over the Iowa Department of Human Services’ Targeted Case Management System (TCM) for the period March 31, 2014 through April 18, 2014

Report on a review of selected general and application controls over the Iowa Department of Human Services’ Targeted Case Management System (TCM) for the period March 31, 2014 through April 18, 2014

Road Safety Audit for Intersection of IA 1 and County Road R-67 in Johnson County, Iowa, 2009

On August 3, 2009, a road safety audit was initiated for the intersection of IA 1 and County Road F-67 in Johnson County, Iowa. Due to the high volume of traffic accessing the cheese producing plant (Twin County Dairy, Inc.), a grocery store east of the intersection, and a large Amish community with horse-drawn wagons and carriages frequently sharing the roads with motorized vehicles, this intersection has developed a crash history that concerns the Iowa Department of Transportation (Iowa DOT), Iowa State Patrol, and local agencies. Considering this, Johnson County and the Iowa DOT requested that a road safety audit be conducted to address the safety concerns and recommend possible mitigation strategies.