Ultrasound evaluation of synovitis in RA: Correlation with clinical disease activity and sensitivity to change in an observational cohort study.

OBJECTIVE: To evaluate the correlation between clinical measures of disease activity and a ultrasound (US) scoring system for synovitis applied by many different ultrasonographers in a daily routine care setting within the Swiss registry for RA (SCQM) and further to determine the sensitivity to change of this US Score. METHODS: One hundred and eight Swiss rheumatologists were trained in performing the Swiss Sonography in Arthritis and Rheumatism (SONAR) score. US B-mode and Power Doppler (PwD) scores were correlated with DAS28 and compared between the clinical categories in a cross-sectional cohort of patients. In patients with a second US (longitudinal cohort), we investigated if change in US score correlated with change in DAS and evaluated the responsiveness of both methods. RESULTS: In the cross-sectional cohort with 536 patients, correlation between the B-mode score and DAS28 was significant but modest (Pearson coefficient r=0.41, P<0.0001). The same was true for the PwD score (r=0.41, P<0.0001). In the longitudinal cohort with 183 patients we also found a significant correlation between change in B-mode and in PwD score with change in DAS28 (r=0.54, P<0.0001 and r=0.46, P<0.0001, respectively). Both methods of evaluation (DAS and US) showed similar responsiveness according to standardized response mean (SRM). CONCLUSIONS: The SONAR Score is practicable and was applied by many rheumatologists in daily routine care after initial training. It demonstrates significant correlations with the degree of as well as change in disease activity as measured by DAS. On the level of the individual, the US score shows many discrepancies and overlapping results exist.

The fixation of the cemented femoral component. Effects of stem stiffness, cement thickness and roughness of the cement-bone surface.

After cemented total hip arthroplasty (THA) there may be failure at either the cement-stem or the cement-bone interface. This results from the occurrence of abnormally high shear and compressive stresses within the cement and excessive relative micromovement. We therefore evaluated micromovement and stress at the cement-bone and cement-stem interfaces for a titanium and a chromium-cobalt stem. The behaviour of both implants was similar and no substantial differences were found in the size and distribution of micromovement on either interface with respect to the stiffness of the stem. Micromovement was minimal with a cement mantle 3 to 4 mm thick but then increased with greater thickness of the cement. Abnormally high micromovement occurred when the cement was thinner than 2 mm and the stem was made of titanium. The relative decrease in surface roughness augmented slipping but decreased debonding at the cement-bone interface. Shear stress at this site did not vary significantly for the different coefficients of cement-bone friction while compressive and hoop stresses within the cement increased slightly.

Precast Concrete Panel Thickness for Epoxy-Coated Prestressing Strands, Volume 2, HR-353, 1994

This final report for Phase 1 of the research on epoxy-coated, prestressing strands in precast prestressed concrete (PC) panels has been published in two volumes. Volume 1--Technical Report contains the problem description, literature review, and survey results; descriptions of the test specimens, experimental tests, and analytical models; discussions of the analytical and experimental results; summary, conclusions, and recommendations; list of references; and acknowledgments. Volume 2--Supplemental Report contains additional information in the form of appendix material for Volume 1 on the questionnaires, strand forces, geometry of the specimens, concrete crack patterns that formed in the strand transfer length and strand development length specimens, concrete strains in the strand transfer length specimens, and load-point deflections and strand-slip measurements for the strand development length specimens. Appendix A contains the questionnaires that were sent to the design agencies and precast concrete producers. A summary of the results to the questions on the surveys are given as the number of respondents who provided the same answers and as paraphrased comments from the respondents. Appendix B contains graphs of strand force versus time, strand force versus temperature, and strand force versus strand cutting sequence for the concrete castings. Appendix C contains figures that show the location of each specimen in the prestress bed, the geometrical configurations for the strand transfer length (T-type) specimens and strand development length (D-type) specimens, and the concrete cracks that developed in some of the T-type specimens when they were prestressed. Appendix D contains figures that show the concrete cracks that developed in the D-type specimens during the strand development length tests. For each of these tests, the sequence of the failure for the specimen is specified. Appendix E contains graphs of concrete strain versus distance from the end of the T-type specimens that were instrumented with internal embedment strain gages. Appendix F contains graphs of load versus load-point deflection and load versus strand-slip for the strand development length tests of the D-type specimens.

Cities, skills, and regional change

One approach to urban areas emphasizes the existence of certain immutable relationships, such as Zipf's or Gibrat's Law. An alternative view is that urban changereflects individual responses to changing tastes or technologies. This paper examinesalmost 200 years of regional change in the U.S. and finds that few, if any, growth relationships remain constant, including Gibrat's Law. Education does a reasonable jobof explaining urban resilience in recent decades, but does not seem to predict countygrowth a century ago. After reviewing this evidence, we present and estimate a simple model of regional change, where education increases the level of entrepreneurship.Human capital spillovers occur at the city level because skilled workers produce moreproduct varieties and thereby increase labor demand. We find that skills are associatedwith growth in productivity or entrepreneurship, not with growth in quality of life, atleast outside of the West. We also find that skills seem to have depressed housing supplygrowth in the West, but not in other regions, which supports the view that educatedresidents in that region have fought for tougher land-use controls. We also present evidence that skills have had a disproportionately large impact on unemployment duringthe current recession.

Sentence des juge et consuls de Paris, pour la forme des paiements des lettres et billets de change

[Acte. 1730-01-09. Paris]

Sentence des juges et consuls de Paris, qui condamne tous les Jésuites de France solidairement, à payer la somme de 30000 livres dûes en vertu d'une lettre de change tirée par le P. La Valette, supérieur des Missions aux Iles du Vent...

[Acte. 1760-01-30. Paris]

Sentence des juge et consuls de Paris ; qui condamne à payer deux lettres de change adhirées, quoiqu'elles ne soient point revêtues des signatures du tireur et de l'endosseur

[Acte. 1776-03-13. Paris]

Climate change and plant distribution: local models predict high-elevation persistence

Mountain ecosystems will likely be affected by global warming during the 21st century, with substantial biodiversity loss predicted by species distribution models (SDMs). Depending on the geographic extent, elevation range and spatial resolution of data used in making these models, different rates of habitat loss have been predicted, with associated risk of species extinction. Few coordinated across-scale comparisons have been made using data of different resolution and geographic extent. Here, we assess whether climate-change induced habitat losses predicted at the European scale (10x10' grid cells) are also predicted from local scale data and modeling (25x25m grid cells) in two regions of the Swiss Alps. We show that local-scale models predict persistence of suitable habitats in up to 100% of species that were predicted by a European-scale model to lose all their suitable habitats in the area. Proportion of habitat loss depends on climate change scenario and study area. We find good agreement between the mismatch in predictions between scales and the fine-grain elevation range within 10x10' cells. The greatest prediction discrepancy for alpine species occurs in the area with the largest nival zone. Our results suggest elevation range as the main driver for the observed prediction discrepancies. Local scale projections may better reflect the possibility for species to track their climatic requirement toward higher elevations.

Length Change of P. C. Concrete Due to Moisture Content, MLR-85-09, 1987

Portland cement concrete is an outstanding structural material but stresses and cracks often occur in large structures due to drying shrinkage. The objective of this research was to determine the change in length due to loss of moisture from placement through complete drying of portland cement concrete. The drying shrinkage was determined for four different combinations of Iowa DOT structural concrete mix proportions and materials. The two mix proportions used were an Iowa DOT D57 (bridge deck mix proportions) and a water reduced modified C4 mix. Three 4"x 4"x 18" beams were made for each mix. After moist curing for three days, all beams were maintained in laboratory dry air and the length and weight were measured at 73°F ± 3°F. The temperature was cycled on alternate days from 73°F to 90°F through four months. From four months through six months, the temperature was cycled one day at 73°F and six days at 130°F. It took approximately six months for the concrete to reach a dry condition with these temperatures. The total drying shrinkage for the four mixes varied from .0106 in. to .0133 in. with an average of .0120 in. The rate of shrinkage was approximately .014% shrinkage per 1% moisture loss for all four mixes. The rate and total shrinkage for all four mixes was very similar and did not seem to depend on the type of coarse aggregate or the use of a retarder.

Embankment Quality Phase IV: Application to Unsuitable Soils, TR-492, 2007

The Quality Management Earthwork (QM-E) special provision was implemented on a pilot project to evaluate quality control (QC) and quality assurance (QA) testing in predominately unsuitable soils. Control limits implemented on this pilot project included the following: 95% relative compaction, moisture content not exceeding +/- 2% of optimum moisture content, soil strength not exceeding a dynamic cone penetrometer (DCP) index of 70 mm/blow, vertical uniformity not exceeding a variation in DCP index of 40 mm/blow, and lift thickness not exceeding depth determined through construction of control strips. Four-point moving averages were used to allow for some variability in the measured parameter values. Management of the QC/QA data proved to be one of the most challenging aspects of the pilot project. Implementing use of the G-RAD data collection system has considerable potential to reduce the time required to develop and maintain QC/QA records for projects using the QM-E special provision. In many cases, results of a single Proctor test were used to establish control limits that were used for several months without retesting. While the data collected for the pilot project indicated that the DCP index control limits could be set more tightly, there is not enough evidence to support making a change. In situ borings, sampling, and testing in natural unsuitable cut material and compacted fill material revealed that the compacted fill had similar strength characteristics to that of the natural cut material after less than three months from the start of construction.

Independent relations of left ventricular structure with the 24-h urinary excretion of sodium and aldosterone

Objective: Previous studies reported on the association of left ventricular mass index (LVMI) with urinary sodium or with circulating or urinary aldosterone.We investigated the independent associations of LVMI with the urinary excretion of both sodium and aldosterone. Design and method: We randomly recruited 317 untreated subjects from a White population (45.1%women; mean age 48.2 years).Measurements included echocardiographic left ventricular (LV) properties, the 24 h urinary excretion of sodium and aldosterone, plasma renin activity (PRA), and proximal (RNaprox) and distal (RNadist) renal sodium reabsorption, assessed fromthe endogenous lithium clearance. Inmultivariable-adjusted models,we expressed changes in LVMI per 1 SD increase in the explanatory variables, while accounting for sex, age, systolic blood pressure and the waist-to-hip ratio. Results: LVMI increased independentlywith the urinary excretion of both sodium (+2.48 g/m2; P=0.005) and aldosterone (+2.63 g/m2; P=0.004). Higher sodium excretion was associated with increased mean wall thickness (MWT: +0.126 mm, P=0.054), but with no change in LV end-diastolic diameter (LVID: +0.12mm, P=0.64). In contrast, higher aldosterone excretion was associated with higher LVID (+0.54 mm; P=0.017), but with no change in MWT (+0.070mm; P=0.28).Higher RNadistwas associatedwith lower relativewall thickness (−0.81×10−2, P=0.017), because of opposite trends in LVID(+0.33 mm; P=0.13) and MWT (−0.130mm; P=0.040). LVMI was not associated with PRA or RNaprox. Conclusions: LVMI independently increased with both urinary sodium and aldosterone excretion. IncreasedMWT explained the association of LVMI with urinary sodium and increased LVID the association of LVMI with urinary aldosterone.

Economics of Using Calcium Chloride vs. Sodium Chloride for Deicing/Anti-Icing, TR-488, 2008

The use of chemicals is a critical part of a pro-active winter maintenance program. However, ensuring that the correct chemicals are used is a challenge. On the one hand, budgets are limited, and thus price of chemicals is a major concern. On the other, performance of chemicals, especially at lower pavement temperatures, is not always assured. Two chemicals that are used extensively by the Iowa Department of Transportation (Iowa DOT) are sodium chloride (or salt) and calcium chloride. While calcium chloride can be effective at much lower temperatures than salt, it is also considerably more expensive. Costs for a gallon of salt brine are typically in the range of $0.05 to $0.10, whereas calcium chloride brine may cost in the range of $1.00 or more per gallon. These costs are of course subject to market forces and will thus change from year to year. The idea of mixing different winter maintenance chemicals is by no means new, and in general discussions it appears that many winter maintenance personnel have from time to time mixed up a jar of chemicals and done some work around the yard to see whether or not their new mix “works.” There are many stories about the mixture turning to “mayonnaise” (or, more colorfully, to “snot”) suggesting that mixing chemicals may give rise to some problems most likely due to precipitation. Further, the question of what constitutes a mixture “working” in this context is a topic of considerable discussion. In this study, mixtures of salt brine and calcium chloride brine were examined to determine their ice melting capability and their freezing point. Using the results from these tests, a linear interpolation model of the ice melting capability of mixtures of the two brines has been developed. Using a criterion based upon the ability of the mixture to melt a certain thickness of ice or snow (expressed as a thickness of melt-water equivalent), the model was extended to develop a material cost per lane mile for the full range of possible mixtures as a function of temperature. This allowed for a comparison of the performance of the various mixtures. From the point of view of melting capacity, mixing calcium chloride brine with salt brine appears to be effective only at very low temperatures (around 0° F and below). However, the approach described herein only considers the material costs, and does not consider application costs or other aspects of the mixture performance than melting capacity. While a unit quantity of calcium chloride is considerably more expensive than a unit quantity of sodium chloride, it also melts considerably more ice. In other words, to achieve the same result, much less calcium chloride brine is required than sodium chloride brine. This is important in considering application costs, because it means that a single application vehicle (for example, a brine dispensing trailer towed behind a snowplow) can cover many more lane miles with calcium chloride brine than with salt brine before needing to refill. Calculating exactly how much could be saved in application costs requires an optimization of routes used in the application of liquids in anti-icing, which is beyond the scope of the current study. However, this may be an area that agencies wish to pursue for future investigation. In discussion with winter maintenance personnel who use mixtures of sodium chloride and calcium chloride, it is evident that one reason for this is because the mixture is much more persistent (i.e. it stays longer on the road surface) than straight salt brine. Operationally this persistence is very valuable, but at present there are not any established methods to measure the persistence of a chemical on a pavement. In conclusion, the study presents a method that allows an agency to determine the material costs of using various mixtures of salt brine and calcium chloride brine. The method is based upon the requirement of melting a certain quantity of snow or ice at the ice-pavement interface, and on how much of a chemical or of a mixture of chemicals is required to do that.

Pavement Thickness Design for Local Roads in Iowa, TR-586, 2010

Three pavement design software packages were compared with regards to how they were different in determining design input parameters and their influences on the pavement thickness. StreetPave designs the concrete pavement thickness based on the PCA method and the equivalent asphalt pavement thickness. The WinPAS software performs both concrete and asphalt pavements following the AASHTO 1993 design method. The APAI software designs asphalt pavements based on pre-mechanistic/empirical AASHTO methodology. First, the following four critical design input parameters were identified: traffic, subgrade strength, reliability, and design life. The sensitivity analysis of these four design input parameters were performed using three pavement design software packages to identify which input parameters require the most attention during pavement design. Based on the current pavement design procedures and sensitivity analysis results, a prototype pavement design and sensitivity analysis (PD&SA) software package was developed to retrieve the pavement thickness design value for a given condition and allow a user to perform a pavement design sensitivity analysis. The prototype PD&SA software is a computer program that stores pavement design results in database that is designed for the user to input design data from the variety of design programs and query design results for given conditions. The prototype Pavement Design and Sensitivity Analysis (PA&SA) software package was developed to demonstrate the concept of retrieving the pavement design results from the database for a design sensitivity analysis. This final report does not include the prototype software which will be validated and tested during the next phase.

Two new families with hereditary minimal change disease.

BACKGROUND: Steroid-sensitive idiopathic nephrotic syndrome (SSINS) is most often encountered in sporadic cases of minimal change disease (MCD). Only rare cases of familial forms of MCD have been reported and most of them only in one generation. The scarcity of data has precluded unraveling the underlying genetic defect and candidate gene approaches have been unsuccessful. Here we report two families with related SSINS cases and review the related literature. CASE PRESENTATION: Two siblings and a cousin (first family), and a father and his son (second family), are reported with SSINS due to MCD. Patients have been followed up for more than 12 years and a renal biopsy was performed in three cases, demonstrating typical features of MCD. The course of the disease was remarkable because of several relapses treated with steroids. In three cases, mycophenolate mofetil or cyclosporine was added. CONCLUSION: Familial SSINS due to MCD is extremely rare and no genetic defect has been identified so far. Reporting cases of hereditary MCD will allow further genetic studies which will ultimately help unravel the molecular basis of this disease.