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?

Un guide pratique au traitement des gliomes [A practical guide for the management of gliomas]

The management of gliomas in daily clinical practice is challenging. It requires a multidisciplinary and coordinated approach involving neurosurgery, radiotherapy and, finally, chemotherapy. Important progress has been made during the last years with the introduction of a combined treatment associating standard radiotherapy with concomitant chemotherapy using temozolomide, a novel alkylating agent. For the first time in many years a new treatment strategy translated into a significant prolongation of survival. In parallel, molecular markers (e.g. loss of heterozygosity on chromosomes 1p and 19q or methylation of the methyl-guanine methyl transferase [MGMT] gene promoter) allowed for identification of distinct subtypes of glioma or prediction of treatment response. In this "Practical Guide", we describe the daily practice and aim at answering some common questions in the management of patients suffering from glioblastoma, astrocytoma, oligodendroglioma and low grade glioma. The therapeutic options presented here are based on evidences from the literature. In the absence of documented evidence, the empirical choices from our local practice are explained and justified.

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.

New trends in the medical management of glioblastoma multiforme: the role of temozolomide chemotherapy.

Standard care for newly diagnosed glioblastoma multiforme (GBM) previously consisted of resection to the greatest extent feasible, followed by radiotherapy. The role of chemotherapy was controversial and its efficacy was marginal at best. Five years ago temozolomide (TMZ) was approved specifically for the treatment of recurrent malignant glioma. The role of TMZ chemotherapy administered alone or as an adjuvant therapy for newly diagnosed GBM has been evaluated in a large randomized trial whose results suggested a significant prolongation of survival following treatment. Findings of correlative molecular studies have indicated that methylguanine methyltransferase promoter methylation may be used as a predictive factor in selecting patients most likely to benefit from such treatment. In this short review the authors summarize the current role of TMZ chemotherapy in the management of GBM, with an emphasis on approved indications and practical aspects.

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.

Quantitative ultrasound in the management of osteoporosis: the 2007 ISCD Official Positions

Dual-energy X-ray absorptiometry (DXA) is commonly used in the care of patients for diagnostic classification of osteoporosis, low bone mass (osteopenia), or normal bone density; assessment of fracture risk; and monitoring changes in bone density over time. The development of other technologies for the evaluation of skeletal health has been associated with uncertainties regarding their applications in clinical practice. Quantitative ultrasound (QUS), a technology for measuring properties of bone at peripheral skeletal sites, is more portable and less expensive than DXA, without the use of ionizing radiation. The proliferation of QUS devices that are technologically diverse, measuring and reporting variable bone parameters in different ways, examining different skeletal sites, and having differing levels of validating data for association with DXA-measured bone density and fracture risk, has created many challenges in applying QUS for use in clinical practice. The International Society for Clinical Densitometry (ISCD) 2007 Position Development Conference (PDC) addressed clinical applications of QUS for fracture risk assessment, diagnosis of osteoporosis, treatment initiation, monitoring of treatment, and quality assurance/quality control. The ISCD Official Positions on QUS resulting from this PDC, the rationale for their establishment, and recommendations for further study are presented here.

Pharmacotherapeutic management of locally advanced prostate cancer: current status.

Locally advanced prostate cancer (LAPC) is a heterogeneous entity usually embracing T3-4 and/or pelvic lymph-node-positive disease in the absence of established metastases. Outcomes for LAPC with single therapies have traditionally been poor, leading to the investigation of adjuvant therapies. Prostate cancer is a hormonally sensitive tumour, which usually responds to pharmacological manipulation of the androgen receptor or its testosterone-related ligands. As such, androgen deprivation therapy (ADT) has become an important adjuvant strategy for the treatment of LAPC, particularly for patients managed primarily with radiotherapy. Such results have generally not been replicated in surgical patients. With increased use of ADT has come improved awareness of the numerous toxicities associated with long-term use of these agents, as well as the development of strategies for minimizing ADT exposure and actively managing adverse effects. Several trials are exploring agents to enhance radiation cell sensitivity as well as the application of adjuvant docetaxel, an agent with proven efficacy in the metastatic, castrate-resistant setting. The recent work showing activity of cabazitaxel, sipuleucel-T and abiraterone for castrate-resistant disease in the post-docetaxel setting will see these agents investigated in conjunction with definitive surgery and radiotherapy.

Young innovative firms and R&D strategies: is the Spanish case different?

This paper analyzes the profile of Spanish young innovative companies (YICs) and the determinants of innovation and imitation strategies. The results for an extensive sample of 2,221 Spanish firms studied during the period 2004–2010 show that YICs are found in all sectors, although they are more concentrated in high-tech sectors and, in particular, in knowledge-intensive services (KIS). Three of every four YICs are involved in KIS. Our results highlight that financial and knowledge barriers have much impact on the capacity of young, small firms to innovate and to become YICs, whereas market barriers are not obstacles to becoming a YIC. Public funding, in particular from the European Union, makes it easier for a new firm to become a YIC. In addition, YICs are more likely to innovate than mature firms, although they are more susceptible to sectoral and territorial factors. YICs make more dynamic use of innovation and imitation strategies when they operate in high-tech industries and are based in science parks located close to universities. Keywords: innovation strategies, public innovation policies, barriers to innovation, multinomial probit model. JEL Codes: D01, D22 , L60, L80, O31

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

An Investigation of the Chemical Method of Determining the Cement Content of Hardened Concrete, MLR-71-01 and R-248, 1971

The Iowa State Highway Commission Laboratory is called upon to determine the cement content of hardened concrete when field problems relating to batch weights are encountered. The standard test for determining the cement content is ASTM C-85. An investigation of this method by the New Jersey State Highway Department involving duplicate samples and four cooperating laboratories produced very erratic results, however, the results obtained by this method have not been directly compared to known cement contents of concrete made with various cements and various aggregates used in Iowa.