Independent Living Services Report, December 2015

Independent Living foster care is a foster care type of placement in which youth served must be at least 16 years of age and have the capacity to function outside the structure of a foster family or group care setting. This is a annual report about these living arrangements and how the Department of Human Services contracts them.

Performance of Nongrouted Thin Bonded PCC Overlays, Construction Report, HR-291, 1986

The Iowa road system has approximately 13,000 miles of Portland Cement Concrete Pavements, many of which are reaching the stage where major rehabilitation is required. Age, greater than anticipated traffic, heavier loads and deterioration related to coarse aggregate in the original pavement are some of the reasons that these pavements have reached this level of distress. One method utilized to rehabilitate distressed or underdesigned PCC pavements is the thin bonded Portland Cement Concrete overlay. Since the introduction of thin bonded overlays on highway pavements in 1973, the concrete paving industry has made progress in reducing the construction costs of this rehabilitation technique. With the advent of the shotblast machine, surface preparation costs have decreased from over $4.00 per square yard to most recently $1.42 per square yard. Other construction costs, including placement, grouting and sawing, have also declined. With each project, knowledge and efficiency have improved.

Iowa Development of Rubblized Concrete Pavement Base Mills County, Construction Report, HR-315, 1990

The concept of rubblizing existing concrete pavement prior to the placement of an asphaltic cement concrete overlay has been around for several years and, in fact, has been tried successfully in the states of New York, Michigan, and Ohio. With available construction and maintenance dollars usually not meeting the demands of the needed work, much of the necessary rehabilitation of existing Portland cement concrete pavements is not being completed when it would be most beneficial. Research project HR-315, "Iowa Development of Rubblized Concrete", has been undertaken to determine the effects of rubblized concrete pavement base as it affects the cracking pattern and longevity of the ACC overlay.

Initial experience with hybrid surgery in congenital heart disease in a single center : P171

Introduction: A hybrid intervention is a joint procedure involving the interventional cardiologist and the cardiac surgeon. At our institution we have opted for this type of approach in congenital heart disease since 2005. We report here our initial experience. Cases: 1. A 3 year old boy with double aortic arch and multiple muscular ventricular septal defects (VSD),was readdressed for pulmonary band (PAB) removal and residual VSD closure after previous palliation. After surgical removal of the PAB, the surgeon provided a minimal transventricular access for placement of a 6mm Amplatzer® muscular VSD occluder by the cardiologist under transoesophageal guidance. The patient was extubated the same day and discharged after 5 days. 2. An 8 year old girl with Williams syndrome was followed for two large VSDs and severe peripheral pulmonary arteries (PA) stenosis. The membranous VSD was closed surgically, the muscular VSD during the same operation by direct placement of a 12 mm Amplatzer® muscular VSD occluder. During rewarming, balloon angioplasty of peripheral PA stenosis was achieved under fluoroscopy. Patient was extubated the following day and discharged after 8 days. 3. A 9 year old boy post tetralogy of Fallot repair had severe distal stenosis of the right ventricular to PA conduit.With patient on partial cardiopulmonary bypass, an incision was made on the conduit and a CP 8 Zig 16 stent placed on the stenosis. The child passed on full bypass and the definitive placement of the stent achieved. The child was extubated at the end of the intervention and discharged after 6 days. 4. A newborn presented at 2 days life with complex aortic arch anatomy: left aortic arch and right descending thoracic aorta perfused directly from a right arterial duct and left PA atresia. The arterial duct was stented with a Genesis XD stent dilated at 7mm. Two days later the cardiac surgeon made banded the right PA. The child was extubated after the operation and discharged a week later. Conclusion: Hybrid approach opens new ways of correction or palliation in congenital heart disease with encouraging results and less morbidity.

The role of laparoscopic biopsies in lumbar spondylodiscitis.

Infection of an intervertebral disk is a serious condition. Diagnosis often is elusive and difficult. It is imperative to obtain appropriate microbiological specimens before initiation of treatment. The authors describe a 51-year-old woman with lumbar spondylodiscitis that was because of infection after the placement of an epidural catheter for postoperative analgesia. A spinal magnetic resonance imaging confirmed the diagnosis, but computed tomography-guided fine needle biopsy did not provide adequate material for a microbiologic diagnosis. Laparoscopic biopsies of the involved disk provided good specimens and a diagnosis of Propionibacterium acnes infection. The authors believe that this minimally invasive procedure should be performed when computed tomography-guided fine needle biopsy does not provide a microbiologic diagnosis in spondylodiscitis.

Maternal exposure to polychlorinated biphenyls and the secondary sex ratio: an occupational cohort study.

Background: Though commercial production of polychlorinated biphenyls was banned in the United States in 1977, exposure continues due to their environmental persistence. Several studies have examined the associationbetween environmental polychlorinated biphenyl exposure and modulations of the secondary sex ratio, with conflicting results.Objective: Our objective was to evaluate the association between maternal preconceptional occupational polychlorinated biphenyl exposure and the secondary sex ratio.Methods: We examined primipara singleton births of 2595 women, who worked in three capacitor plants at least one year during the period polychlorinated biphenyls were used. Cumulative estimated maternal occupationalpolychlorinated biphenyl exposure at the time of the infant's conception was calculated from plant-specific job exposure matrices. A logistic regression analysis was used to evaluate the association between maternalpolychlorinated biphenyl exposure and male sex at birth (yes/no).Results: Maternal body mass index at age 20, smoking status, and race did not vary between those occupationally exposed and those unexposed before the child's conception. Polychlorinated biphenyl-exposed mothers were, however, more likely to have used oral contraceptives and to have been older at the birth of their first child than non-occupationally exposed women. Among 1506 infants liveborn to polychlorinated biphenyl-exposedprimiparous women, 49.8% were male; compared to 49.9% among those not exposed (n = 1089). Multivariate analyses controlling for mother's age and year of birth found no significant association between the odds of amale birth and mother's cumulative estimated polychlorinated biphenyl exposure to time of conception.Conclusions: Based on these data, we find no evidence of altered sex ratio among children born to primiparous polychlorinated biphenyl-exposed female workers.

Computer-aided volume measurement of posttraumatic orbits reconstructed with AO titanium mesh plates: accuracy and reliability

PURPOSE: To prospectively evaluate the accuracy and reliability of "freehand" posttraumatic orbital wall reconstruction with AO (Arbeitsgemeinschaft Osteosynthese) titanium mesh plates by using computer-aided volumetric measurement of the bony orbits. METHODS: Bony orbital volume was measured in 12 patients from coronal CT scan slices using OsiriX Medical Image software. After defining the volumetric limits of the orbit, the segmentation of the bony orbital region of interest of each single slice was performed. At the end of the segmentation process, all regions of interest were grouped and the volume was computed. The same procedure was performed on both orbits, and thereafter the volume of the contralateral uninjured orbit was used as a control for comparison. RESULTS: In all patients, the volume data of the reconstructed orbit fitted that of the contralateral uninjured orbit with accuracy to within 1.85 cm3 (7%). CONCLUSIONS: This preliminary study has demonstrated that posttraumatic orbital wall reconstruction using "freehand" bending and placement of AO titanium mesh plates results in a high success rate in re-establishing preoperative bony volume, which closely approximates that of the contralateral uninjured orbit.

Kuivatusmenetelmien vaikutus heatset offset- ja syväpainetun SC-paperin laatuun

Työssä tutkittiin heatset offset- ja syväpainetun SC-paperin painojäljen laatua, kun koepaperikoneella valmistetun SC-paperin valmistuksessa käytettiin eri kuivatus-menetelmiä. Erityisesti kiinnostus kohdistui eri kuiva-ainepitoisuuksissa käytetyn ilmakuivatuksen aiheuttamiin painojäljen laatuvaikutuksiin. Painojäljen lisäksi työssä tarkasteltiin pohjapaperin ominaisuuksia kuivatuksen jakalanteroinnin jälkeen. Perinteisen sylinterikuivatuksen kuivatuskapasiteettia voidaan nostaa kuivattamalla paperia kuuman ilman avulla, jolloin paperin haihdutusnopeus nousee yli viisinkertaiseksi sylinterikuivatukseenverrattuna. Ilmakuivatus voidaan sijoittaa välittömästä kuivatusosan alkuun ennen ensimmäistä kuivatussylinteriä tai korkeampaan kuiva-ainepitoisuuteen sylinterikuivatuksen keskelle. Kuivattua paperia tarkasteltaessa kuuman ilman avulla kuivatun paperin ominaisuudet poikkesivat huokoisuuden ja öljynabsorption suhteen sylinterikuivatusta paperista sekä heatset offset- että syväpainopaperilla. Kalanterointi tasoitti koepisteiden välisiä muutoksia. Kalanteroidusta paperista havaittiin, että ilmakuivatuksen sijoittuminen välittömästi puristimen jälkeen kasvatti paperin molempien pintojen opasiteettia. Vastaavasti paperin tiheys kasvoi, kun paperia kuivattiin kuumalla ilmalla sekä ennen sylinterikuivatusta että sylinterikuivatuksen keskellä. Yhteistä ilmakuivatuksen käytölle kaikissa koepisteissä oli paperin huokoisuuden pieneneminen. Heatset offsetpainoprosessissa käytettävä kostutusvesi asettaa paperin kuitu-karhenemiselle vaatimuksia. Tutkimuksessa havaittiin, että puristimen jälkeen sijoitettu ilmakuivatus pienensi paperin taipumusta karhentua painoprosessissa. Muiden ominaisuuksien osalta paperin kuivatus kuuman ilman avulla yhdessä sylinterikuivatuksen kanssa ei jättänyt paperiin sellaisia jälkiä, jotka näkyisivät heatset offset- ja syväpainetun SC-paperin painojäljessä verrattuna kokonaan yksiviira-vientisesti sylinterikuivattuun paperiin.

Moniensiöinen muuntaja taajuudenmuuttajakäytössä

Suuritehoisissa pumppu- ja puhallinkäytöissä käytetään usein suurnopeusmoottoria,jota syötetään välijännitteellä. Suurjännitetaajuudenmuuttajat ovat kalliita, eikä niitä ole aina edes mahdollista valmistaa. Tutkimuksen kohteena on rinnakkaisilla pienjännitetaajuudenmuuttajilla toteutettu sähkökäyttö, jossa pienjännite nostetaan moniensiöisellä muuntajalla suurjännitteeksi (6,6 kV) ja syötetään edelleen kuormana olevalle suurnopeusmoottorille. Opinnäytetyössä tutkitaan moniensiöisen muuntajan syöttöä rinnakkaisilla taajuudenmuuttajilla sekä niiden aiheuttamia häiriöitä toisilleen. Työssä tutkitaan myös harmonisten yliaaltojen vaikutuksia muuntajan häviöihin ja magnetointiominaisuuksiin. Taajuudenmuuttajan lähtöjännite ja -virta suodatetaan sinisuotimella, jonka parametreja simuloidaan Simulink- ohjelmistolla. Tavoite on löytää optimaaliset parametrit taajuudenmuuttajanlähtösuotimelle käyrämuotojen ja suotimeen jäävän tehon suhteen. Työssä tarkasteltiin sinisuodinta, johon jää 3 prosenttia syöttöjännitteestä. LC-suodin kompensoi sähkökäytön loistehon lähes kokonaan, joten taajuudenmuuttajien antotehon kannalta suotimet ovat perusteltuja. Taajuudenmuuttajan näennäisteho putoaa 22 prosenttia, joten taajuudenmuuttajat voidaan vastaavasti mitoittaa pienemmiksi.

Endovascular coiling compared with surgical clipping for the treatment of unruptured middle cerebral artery aneurysms: an update.

OBJECT: In 1999 we reported that 94% of unruptured middle cerebral artery (MCA) aneurysms managed prospectively between 1993 and 1997, according to a protocol favoring endovascular coiling, were best treated by surgical clipping. The goal of the current study was to delineate the most appropriate treatment option for unruptured MCA aneurysms today, considering the technical advances in imaging and in endovascular treatment. METHODS: 35 consecutive patients harboring 40 unruptured MCA aneurysms were treated between 1997 and December 2000. Patients with unruptured cerebral aneurysms are managed prospectively according to the same protocol as reported previously [1]: the primary treatment recommendation is endovascular packing with Guglielmi detachable coils (GDCs). Surgical clipping is recommended after failed attempt at coil placement or in the presence of angioanatomical features that contraindicate that type of endovascular therapy. RESULTS: One unruptured MCA aneurysm was treated by endovascular embolization, 37 unruptured MCA aneurysms were clipped, whereas 2 unruptured MCA aneurysms were trapped with simultaneous extracranial-intracranial revascularization. Postoperative angiography revealed complete exclusion of all aneurysms. Preservation of vascular permeability was demonstrated in all clip-reconstructed aneurysms, despite arterial branches frequently originating from the aneurysmal base. Cerebral revascularization of the distal MCA was successful in the 2 patients with giant aneurysms. None of the patients presented permanent disabling complications from the treatment of the unruptured MCA aneurysm. CONCLUSION: Despite major technical advances in imaging and in endovascular treatment of cerebral aneurysms, surgical clipping still is the most efficient treatment for unruptured MCA aneurysms at the beginning of the new millennium.

Buccal mucosa graft for laryngotracheal reconstruction in severe laryngeal stenosis.

OBJECTIVE: An operative technique is described as a salvage treatment for severe subglottic and supraglottic laryngeal stenosis. In addition to expansion of the laryngeal framework with an anterior cartilage graft, as used in a classical laryngotracheal reconstruction, the scar tissue obliterating the airway lumen is excised and a mucosal graft is placed to reconstruct the inner lining of the airway. The graft is harvested from buccal mucosa. METHODS: The operative technique is outlined. Three cases, 2 paediatric and one adult, with complete or near complete laryngeal stenosis are presented where this operative technique was employed. In all patients several surgeries had been performed previously which were unsuccessful. RESULTS: In all 3 patients a patent airway was achieved with decannulation of the tracheostomy in the 2 paediatric patients. CONCLUSIONS: In patients with severe subglottic or supraglottic airway stenosis where other surgeries have failed, excision of endoluminal scar tissue and placement of a buccal mucosal graft, in addition to conventional laryngotracheal reconstruction, is a promising technique. In revision cases of subglottic stenosis cricotracheal resection might not be an option because of scarring from previous surgeries. This operation is an alternative, which allows an increase in the airway lumen by excising the scar tissue then re-lining the exposed internal lumen. The buccal mucosa reduces granulation formation and re-stenosis.

Resistance Switching in Transparent Magnetic MgO Films

We have studied the abrupt and hysteretic changes of resistance in MgO-based capacitor devices. The switching behavior is discussed in terms of the formation and rupture of conduction filaments due to the migration of structural defects in the electric field, together with the redox events which affects the mobile carriers. The results presented in this paper suggest that MgO transparent films combining ferromagnetism and multilevel switching characteristics might pave the way for a new method for spintronic multibit data storage.

Päätöspuun käyttö tutkamaalien initialisoinnissa

Suomen ilmatilaa valvotaan reaaliaikaisesti, pääasiassa ilmavalvontatutkilla. Ilmatilassa on lentokoneiden lisäksi paljon muitakin kohteita, jotka tutka havaitsee. Tutka lähettää nämä tiedot edelleen ilmavalvontajärjestelmään. Ilmavalvontajärjestelmä käsittelee tiedot, sekä lähettää ne edelleen esitysjärjestelmään. Esitysjärjestelmässä tiedot esitetään synteettisinä merkkeinä, seurantoina joista käytetään nimitystä träkki. Näiden tietojen puitteissa sekä oman ammattitaitonsa perusteella ihmiset tekevät päätöksiä. Tämän työn tarkoituksena on tutkia tutkan havaintoja träkkien initialisointipisteessä siten, että voitaisiin määritellä tyypillinen rakenne sille mikä on oikea ja mikä väärä tai huono träkki. Tämän lisäksi tulisi ennustaa, mitkä Irakeista eivät aiheudu ilma- aluksista. Saadut tulokset voivat helpottaa työtä havaintojen tulkinnassa - jokainen lintuparvi ei ole ehdokas seurannaksi. Havaintojen luokittelu voidaan tehdä joko neurolaskennalla tai päätöspuulla. Neurolaskenta tehdään neuroverkoilla, jotka koostuvat neuroneista. Päätöspuu- luokittelijat ovat oppivia tietorakenteita kuten neuroverkotkin. Yleisin päätöpuu on binääripuu. Tämän työn tavoitteena on opettaa päätöspuuluokittelija havaintojen avulla siten, että se pystyy luokittelemaan väärät havainnot oikeista. Neurolaskennan mahdollisuuksia tässä työssä ei käsitellä kuin teoreettisesti. Työn tuloksena voi todeta, että päätöspuuluokittelijat ovat erittäin kykeneviä erottamaan oikeat havainnot vääristä. Vaikka tulokset olivat rohkaiseva, lisää tutkimusta tarvitaan määrittelemään luotettavammin tekijät, jotka parhaiten suorittavat luokittelun.

Lämmöntalteenottokattilan kehittäminen kaasumoottoreille ja teollisuuskaasuturbiineille

Tässä diplomityössä on kehitetty kustannustehokas lämmöntalteenottokattila savukaasun virtaukselle alle 150 kg/s. Kehitettävä kattila on luonnonkiertoinen ja pystyrakenteinen. Valitun kattilatyypin etuja muihin kattilatyyppeihin nähden on tarkasteltu. Erityistä huomiota kattilassa on kiinnitetty vedenkäsittelyn yksinkertaistamiseen. Tämä on saavutettu tulistinratkaisulla, jonka säätötarve on vähäinen. Tuorehöyryn lämpötilan säätöön käytettyjä säätömenetelmiä on tarkasteltu ja eri tulistinratkaisuja käyttämällä saavutettavia tuorehöyrymääriä ja säätötarvetta on tutkittu simulointiohjelmaa hyväksi käyttäen. Tulistinratkaisun lisäksi työssä on tarkasteltu syöttöveden käyttöä ulkoiseen lämmitykseen sekä lämmönsiirrinpakettien tuentaa. Lisäpolton toteutusta sekä syöttövesiventtiilin sijoittamista ja syöttövesipumpun valintaa on myös tarkasteltu. Osana työtä on lisäksi tehty kehitettyä kattilaa varten mitoitusohjelma ja mitoitettu sitä käyttäen esimerkkilaitos.

A comparative study of silver amalgam and compomer as retrograde filling materials in periapical surgery

Objective: A comparative study is made of the histological effects of silver amalgam versus compomer (Dyract®) 90 days after placement as retrograde filling materials in experimental animals. Method: Six Beagle dogs were used, with total pulpectomy and orthograde material filling followed by periapical surgery of the 6 upper and 6 lower incisors (for a total of 72 teeth). Thirty-six teeth corresponded to the right side and were filled with the control material (silver amalgam), while the 36 teeth on the left side were filled with the compomer study material (Dyract®). After three months the animals were sacrificed and the histological study was carried out, with evaluation of bone formation, inflammation, and the tissue in contact with the filler material. The results obtained were subjected to a descriptive and comparative statistical analysis (chi-square test). Results: The samples retrogradely filled with compomer showed significantly greater percentage inflammation (76.19% versus 26.66% in the control group). On the other hand, a large proportion of samples with root cement growth were found in the compomer group. Filler material expulsion was also significantly more common when compomer was used. Conclusions: the comparative study of the histological findings showed greater inflammation but also greater root cement growth in the compomer group versus the controls