Innovative Solutions for Slope Stability Reinforcement and Characterization: Vol. I, TR-489, 2005

Soil slope instability concerning highway infrastructure is an ongoing problem in Iowa, as slope failures endanger public safety and continue to result in costly repair work. Characterization of slope failures is complicated, because the factors affecting slope stability can be difficult to discern and measure, particularly soil shear strength parameters. While in the past extensive research has been conducted on slope stability investigations and analysis, this research consists of field investigations addressing both the characterization and reinforcement of such slope failures. The current research focuses on applying an infrequently-used testing technique comprised of the Borehole Shear Test (BST). This in-situ test rapidly provides effective (i.e., drained) shear strength parameter values of soil. Using the BST device, fifteen Iowa slopes (fourteen failures and one proposed slope) were investigated and documented. Particular attention was paid to highly weathered shale and glacial till soil deposits, which have both been associated with slope failures in the southern Iowa drift region. Conventional laboratory tests including direct shear tests, triaxial compression tests, and ring shear tests were also performed on undisturbed and reconstituted soil samples to supplement BST results. The shear strength measurements were incorporated into complete evaluations of slope stability using both limit equilibrium and probabilistic analyses. The research methods and findings of these investigations are summarized in Volume 1 of this report. Research details of the independent characterization and reinforcement investigations are provided in Volumes 2 and 3, respectively. Combined, the field investigations offer guidance on identifying the factors that affect slope stability at a particular location and also on designing slope reinforcement using pile elements for cases where remedial measures are necessary. The research findings are expected to benefit civil and geotechnical engineers of government transportation agencies, consultants, and contractors dealing with slope stability, slope remediation, and geotechnical testing in Iowa.

Innovative Solutions for Slope Stability Reinforcement and Characterization: Vol. II, TR-489, 2005

Soil slope instability concerning highway infrastructure is an ongoing problem in Iowa, as slope failures endanger public safety and continue to result in costly repair work. While in the past extensive research has been conducted on slope stability investigations and analysis, this current research study consists of field investigations addressing both the characterization and reinforcement of such slope failures. While Volume I summarizes the research methods and findings of this study, Volume II provides procedural details for incorporating an infrequently-used testing technique, borehole shear tests, into practice. Fifteen slopes along Iowa highways were investigated, including thirteen slides (failed slopes), one unfailed slope, and one proposed embankment slope (the Sugar Creek Project). The slopes are mainly comprised of either clay shale or glacial till, and are generally gentle and of small scale, with slope angle ranging from 11 deg to 23 deg and height ranging from 6 to 23 m. Extensive field investigations and laboratory tests were performed for each slope. Field investigations included survey of slope geometry, borehole drilling, soil sampling, in-situ Borehole Shear Testing (BST) and ground water table measurement. Laboratory investigations mainly comprised of ring shear tests, soil basic property tests (grain size analysis and Atterberg limits test), mineralogy analyses, soil classifications, and natural water contents and density measurements on the representative soil samples from each slope. Extensive direct shear tests and a few triaxial compression tests and unconfined compression tests were also performed on undisturbed soil samples for the Sugar Creek Project. Based on the results of field and lab investigations, slope stability analysis was performed on each of the slopes to determine the possible factors resulting in the slope failures or to evaluate the potential slope instabilities using limit equilibrium methods. Deterministic slope analyses were performed for all the slopes. Probabilistic slope analysis and sensitivity study were also performed for the slope of the Sugar Creek Project. Results indicate that while the in-situ test rapidly provides effective shear strength parameters of soils, some training may be required for effective and appropriate use of the BST. Also, it is primarily intended to test cohesive soils and can produce erroneous results in gravelly soils. Additionally, the quality of boreholes affects test results, and disturbance to borehole walls should be minimized before test performance. A final limitation of widespread borehole shear testing may be its limited availability, as only about four to six test devices are currently being used in Iowa. Based on the data gathered in the field testing, reinforcement investigations are continued in Volume III.

Project Newsletter Iowa Public Health Tracking, February 2014

The IDPH Public Health Tracking Program is an excellent way to collect data related to various indicators for Iowans, but those looking for national statistics or data from other states may want to check out the Health Indicators Warehouse (healthindicators.gov). Run and maintained by the CDC’s National Center for Health Statistics, this site is a centralized source for national, state, and county data for a wide variety of indicators. The data is available to the public, and can be accessed either through the tables and charts directly on the website, or indicators can be downloaded to use in a spreadsheet. Once on the site, users are able to search for their desired data either by topic or geographic region. Filters can then be applied to the chosen field to narrow down the user’s search and obtain the preferred statistics. In addition, users are also able to search for indicators derived from state and federal health indicator initiatives: County Health Rankings, Community Health Status Indicators, Healthy People 2020, and CMS Community Indicators. The warehouse provides an overview of each indicator after the user has made their selection. This overview includes information on how the data was calculated and what characteristics are being represented. For example, percent of binge drinking adults is prefaced in the overview that data was based on the question: “Considering all types of alcoholic beverages, how many times during the past 30 days did you have [5 for men, 4 for women] or more drinks on an occasion?" Data is viewable either in the basic table format, chart format, or for some indicators it is possible to view it in terms of a national map. The Health Indicators Warehouse updates indicators as data becomes available, but the collection of years varies amongst the indicators. Nonetheless, this site is a useful resource to anyone looking for comparative indicators throughout the nation or is interested in one of the hundreds of indicators housed by the site. For more information or to check out what the warehouse has to offer visit: http://healthindicators.gov/

Final Planning Report for City of Boone, Iowa, March 1962, Vol. 2

This is volume 2 of the final report on the Comprehensive Plan for the City of Boone. Contained in this report are reproductions of the important maps and charts prepared in connection with this study.

Final planning report for City of Boone, Iowa, 1962, Vol. 3

This is volume 3 of the final report on the Comprehensive Plan for the City of Boone. Contained in this report are reproductions of the important maps and charts prepared in connection with this study.

Resiliencia y persistencia académica en estudiantes inmigrantes

This article presents some of the results of a research project whose main objective was to analyse the relationship between resilience and school success of students of foreign origin at a time of special academic vulnerability: the transition from compulsory secondary education (ESO) to post-compulsory education (PO). By non-probabilistic-incidental sampling, the study was conducted in four schools of Barcelona and province, with 94 participants from 15 to 18 years old. This research of a longitudinal design had five phases combining strategies to collect qualitative and quantitative data. The results presented here are the result of the SV-RES adapted scale and two other self-produced toolsa center scale and a general questionnaire. The results obtained have confirmed the fulfilment of the hypothesis: immigrant students who manage to persevere in post-compulsory stages (Spanish Baccalaureate and/or Vocational Training) show higher levels of resilience.

Acute reversible Charles Bonnet syndrome precipitated by sudden severe anemia.

PURPOSE: To report the sudden onset of reversible Charles Bonnet syndrome precipitated byacute severe anemia. METHODS: The charts of three patients (Usher syndrome, bilateral macular degeneration, and bilateral retinal vein occlusion) with acute Charles Bonnet syndrome in the setting of severe anemia were reviewed. RESULTS: Anemia resulted from bladder surgery, recto-colitis, and severe urinary tract infection. Hemoglobin ranged from 78 to 86 g/L. Decreased visual acuity and formed visual hallucinations (giants, flowers, animals) were present in all three patients. Rapid reversal of Charles Bonnet syndrome and visual acuity improvement followed blood transfusion. CONCLUSIONS: Acute severe anemia can precipitate Charles Bonnet syndrome, which may be reversible by blood transfusion.

Project Newsletter Iowa Public Health Tracking, May 2014

The IDPH Public Health Tracking Program is an excellent way to collect data related to various indicators for Iowans, but those looking for national statistics or data from other states may want to check out the Health Indicators Warehouse (healthindicators.gov). Run and maintained by the CDC’s National Center for Health Statistics, this site is a centralized source for national, state, and county data for a wide variety of indicators. The data is available to the public, and can be accessed either through the tables and charts directly on the website, or indicators can be downloaded to use in a spreadsheet. Once on the site, users are able to search for their desired data either by topic or geographic region. Filters can then be applied to the chosen field to narrow down the user’s search and obtain the preferred statistics. In addition, users are also able to search for indicators derived from state and federal health indicator initiatives: County Health Rankings, Community Health Status Indicators, Healthy People 2020, and CMS Community Indicators. The warehouse provides an overview of each indicator after the user has made their selection. This overview includes information on how the data was calculated and what characteristics are being represented. For example, percent of binge drinking adults is prefaced in the overview that data was based on the question: “Considering all types of alcoholic beverages, how many times during the past 30 days did you have [5 for men, 4 for women] or more drinks on an occasion?" Data is viewable either in the basic table format, chart format, or for some indicators it is possible to view it in terms of a national map. The Health Indicators Warehouse updates indicators as data becomes available, but the collection of years varies amongst the indicators. Nonetheless, this site is a useful resource to anyone looking for comparative indicators throughout the nation or is interested in one of the hundreds of indicators housed by the site. For more information or to check out what the warehouse has to offer visit: http://healthindicators.gov/

The Individualized Genetic Barrier Predicts Treatment Response in a Large Cohort of HIV-1 Infected Patients.

The success of combination antiretroviral therapy is limited by the evolutionary escape dynamics of HIV-1. We used Isotonic Conjunctive Bayesian Networks (I-CBNs), a class of probabilistic graphical models, to describe this process. We employed partial order constraints among viral resistance mutations, which give rise to a limited set of mutational pathways, and we modeled phenotypic drug resistance as monotonically increasing along any escape pathway. Using this model, the individualized genetic barrier (IGB) to each drug is derived as the probability of the virus not acquiring additional mutations that confer resistance. Drug-specific IGBs were combined to obtain the IGB to an entire regimen, which quantifies the virus' genetic potential for developing drug resistance under combination therapy. The IGB was tested as a predictor of therapeutic outcome using between 2,185 and 2,631 treatment change episodes of subtype B infected patients from the Swiss HIV Cohort Study Database, a large observational cohort. Using logistic regression, significant univariate predictors included most of the 18 drugs and single-drug IGBs, the IGB to the entire regimen, the expert rules-based genotypic susceptibility score (GSS), several individual mutations, and the peak viral load before treatment change. In the multivariate analysis, the only genotype-derived variables that remained significantly associated with virological success were GSS and, with 10-fold stronger association, IGB to regimen. When predicting suppression of viral load below 400 cps/ml, IGB outperformed GSS and also improved GSS-containing predictors significantly, but the difference was not significant for suppression below 50 cps/ml. Thus, the IGB to regimen is a novel data-derived predictor of treatment outcome that has potential to improve the interpretation of genotypic drug resistance tests.

Prevalence of subfoveal nodules in Coat's disease

Purpose:Coats' disease is a non-hereditary condition characterized by idiopathic retinal telangiectasia, and exudative retinopathy. Although the exudation often spreads from the main areas of telangiectasia, there is a preferential accumulation of exudation in the macular area in Coats' disease. A subfoveal nodule has usually been described in the context of resolution of macular exudates after treatment of peripheral retinal telangiectasis. Nevertheless, a recent reports stressed out an uncommon prominent subfoveal nodule with peripheral exudates as initial presentation of Coats'disease. The purpose of this study was to report the prevalence of this presentation in a cohort of patients. Methods:All consecutive patients with Coats' disease referred to the Jules Gonin Eye Hospital between January 1979 and July 2006 were included. All charts were screened for a clear cut subfoveal circular lesion on fundus photographies at initial presentation. Results:95 patients suffering of Coat's disease were enrolled. 33 out of 95 patients had subtotal or total exudative retinal detachment, which impeded macular examination. 14 out of 62 (22.6%) resting patients presented with a clear cut prominent circular subfoveal lesion at initial presentation. All patients had unilateral disease. Mean age was 5.6 ± 3.5 year old at initial presentation. There were 4 females and 10 males. Pigmentation and size of the nodule were not homogenous. Mean diameter was 1.1 ± 0.5 optic disc diameter. Conclusions:The present study shows that subfoveal nodule is not such a rare primary presentation of Coats' disease in contrast to what it has been previously reported in the literature. Thus the initial finding of prominent subfoveal nodule associated with peripheral retinal findings made the diagnosis of Coats' disease highly likely.Physicians should be aware that a proeminent subfoveal nodule is a common initial presentation of Coats' disease as it can be confused clinically with Retinoblastoma.

Estudi comparatiu: errors de les infermeres en la preparació i l'administració de la medicació segons dos sistemes de distribució

Introducció: Els errors de medicació són definits com qualsevol incident prevenible que pot causar dany al pacient o donar lloc a una utilització inapropiada dels medicaments, quan aquests estan sota el control dels professionals sanitaris o del pacient. Els errors en la preparació i l’administració de medicació són els més comuns de l’àrea hospitalària i, tot i la llarga cadena per la qual passa el fàrmac, el professional d’infermeria és el últim responsable de l’acció, tenint així, un paper molt important en la seguretat del pacient. Les infermeres dediquen el 40% del temps de la seva jornada laboral en tasques relacionades amb la medicació. Objectiu: Determinar si les infermeres produeixen més errors si treballen amb sistemes de distribució de medicació de stock o en sistemes de distribució unidosis de medicació. Metodologia: Estudi quantitatiu, observacional i descriptiu, on la notificació d’errors (o oportunitats d’error) realitzats per la infermera, en les fases de preparació i administració de medicació, es farà mitjançant un qüestionari autoelaborat. Els elements a identificar seran: el tipus d’error, les causes que poden haver--‐lo produït, la seva potencial gravetat i qui l’ha pogut evitar; així com el tipus de professional que l’ha produït. Altres dades rellevants són: el medicament implicat junt amb la dosis i la via d’administració i el sistema de distribució utilitzat. Mostreig i mostra: El mostreig serà no probabilístic i per conveniència. S’escolliran aquelles infermeres que l’investigador consideri amb les característiques necessàries per participar en l’estudi, així que la mostra estarà formada per les infermeres les quals treballen a la unitat 40 de l’Hospital del Mar i utilitzen un sistema de distribució de medicació de dosis unitàries i les infermeres que treballen a urgències (concretament a l’àrea de nivell dos) de l’Hospital del Mar les quals treballen amb un sistema de distribució de medicació de stock.

Occurrence of sectoral choroidal occlusive vasculopathy and retinal arteriolar embolization after superselective ophthalmic artery chemotherapy for advanced intraocular retinoblastoma.

BACKGROUND:: Superselective ophthalmic artery chemotherapy (SOAC) has recently been proposed as an alternative to intravenous chemoreduction for advanced intraocular retinoblastoma. Preliminary results appear promising in terms of tumor control and eye conservation, but little is known regarding ocular toxicity and visual prognosis. In this study, we report on the vascular adverse effects observed in our initial cohort of 13 patients. METHODS:: The charts of 13 consecutive patients with retinoblastoma who received a total of 30 injections (up to 3 injections of a single agent per patient at 3-week interval) of melphalan (0.35 mg/kg) in the ophthalmic artery between November 2008 and June 2010 were retrospectively reviewed. RetCam fundus photography and fluorescein angiography were performed at presentation and before each injection. Vision was assessed at the latest visit. RESULTS:: Enucleation and external beam radiotherapy could be avoided in all cases but one, with a mean follow-up of 7 months. Sectoral choroidal occlusive vasculopathy leading to chorioretinal atrophy was observed temporally in 2 eyes (15%) 3 weeks to 6 weeks after the beginning of SOAC and retinal arteriolar emboli in 1 eye 2 weeks after injection. There was no stroke or other clinically significant systemic side effects except a peroperative transient spasm of the internal carotid artery in one patient. Vision ranged between 20/1600 and 20/32 depending on the status of the macula. CONCLUSION:: Superselective ophthalmic artery chemotherapy was effective in all patients with no stroke or other systemic vascular complications. Unlike intravenous chemoreduction, SOAC is associated with potentially sight-threatening adverse effects, such as severe chorioretinal atrophy secondary to subacute choroidal occlusive vasculopathy or central retinal artery embolism, not to mention the risk of ophthalmic artery obstruction, which was not observed in this series. Further analysis of the risks and benefits of SOAC will define its role within the therapeutic arsenal. Meanwhile, we suggest that SOAC should be given in one eye only and restricted to advanced cases of retinoblastoma, as an alternative to enucleation and/or external beam radiotherapy.

Preparació física específica en l'esport col·lectiu del futbol. Estudi de la millora i el manteniment del valor del VO2màx

En el treball que es mostra a continuació podrem observar un estudi sobre la preparació física aplicada a l’esport del futbol. A més, farem un estudi dels nivells del volum màxim d’Oxigen (Vo2màx) a través d’un procés d’obtenció de resultats indirecte (Test de Course Navette) tenint present el nombre de sessions setmanals. Observarem les diferències en la definició del paràmetre segons Zintl (1991), Diéguez (1997), Gómez, Aranda i Ferrer (2010), entre d’altres. També observarem els nivells que s’han de tenir a partir d’autors com Zintl (1991), Rivera i Avella (1992), Sánchez i Salas (2008). Per dur-ho a terme, farem un estudi hipotètic-deductiu a través d’un mostreig no probabilístic. Observarem els valors del Vo2màx. assolits en el període preparatori, comparats amb el manteniment, la millora o la pèrdua d’aquest després d’un període d’entrenament diferenciat entre una i tres sessions. Un cop realitzat el procés, hem pogut veure que els nivells assolits després del període preparatori (60.87+ 8.81 ml/kg/min) són majors respecte l’inici del període (44.38 +8.92 ml/kg/min.). Posteriorment, al observar les diferències entre els dos grups de la mostra, podem afirmar que amb tres sessions realitzades no es poden mantenir els nivells anteriors (57.80 +10.16) respecte els (56.73 +9.24) de l’últim test. Per últim, el grup 2, amb una única sessió setmanal els valors baixen més, es passa dels (63.93 + 6.24 ml/kg/min.) als (56.50 + 7.52 ml/kg/min)

A review of atlas-based segmentation for magnetic resonance brain images.

Normal and abnormal brains can be segmented by registering the target image with an atlas. Here, an atlas is defined as the combination of an intensity image (template) and its segmented image (the atlas labels). After registering the atlas template and the target image, the atlas labels are propagated to the target image. We define this process as atlas-based segmentation. In recent years, researchers have investigated registration algorithms to match atlases to query subjects and also strategies for atlas construction. In this paper we present a review of the automated approaches for atlas-based segmentation of magnetic resonance brain images. We aim to point out the strengths and weaknesses of atlas-based methods and suggest new research directions. We use two different criteria to present the methods. First, we refer to the algorithms according to their atlas-based strategy: label propagation, multi-atlas methods, and probabilistic techniques. Subsequently, we classify the methods according to their medical target: the brain and its internal structures, tissue segmentation in healthy subjects, tissue segmentation in fetus, neonates and elderly subjects, and segmentation of damaged brains. A quantitative comparison of the results reported in the literature is also presented.

Can 3T multiparametric magnetic resonance imaging accurately detect prostate cancer extracapsular extension?

BACKGROUND: Accurate staging is essential to determine the correct management of patients diagnosed with prostate cancer. We assess the accuracy of 3T multiparametric magnetic resonance imaging (MRI) with endorectal coil (3TemMRI) in detecting prostate cancer local extension. METHODS: We retrospectively reviewed charts from January 2008 to July 2012 from all patients undergoing radical prostatectomy. Patients were only included if 3TemMRI and radical prostatectomy were performed at our institution. Based on the presence of extracapsular extension (ECE) at 3TemMRI, prostate cancer was dichotomized into locally advanced or organ-confined disease. The accuracy of 3TemMRI local staging was then evaluated using definitive pathology as a reference. RESULTS: Overall, 177 radical prostatectomies were performed within the timeframe. After applying exclusion criteria, 60 patients were included in the final analysis. The mean patient age was 67 ± 7 (standard deviation) years. Mean prostate-specific antigen value was 12.7 ± 12.7 ng/L. Based on preoperative characteristics, we considered 38 of the 60 patients (63%) patients high risk. 3TemMRI identified an organ-confined tumour in 46 patients and locally advanced disease in 14 patients. When correlated to final pathology, 3TemMRI specificity, sensitivity, negative and positive predictive values, and accuracy in detecting locally advanced prostate cancer were 90%, 35%, 57%, 79% and 62%, respectively. INTERPRETATION: This study shows that the use of preoperative 3TemMRI can be used to identify organ-confined prostate cancer when locally advanced disease is suspected.