Monitoring the clinical introduction of a glutamine and antioxidant solution in critically ill trauma and burn patients

OBJECTIVE: Enteral glutamine supplementation and antioxidants have been shown to be beneficial in some categories of critically ill patients. This study investigated the impact on organ function and clinical outcome of an enteral solution enriched with glutamine and antioxidant micronutrients in patients with trauma and with burns. METHODS: This was a prospective study of a historical control group including critically ill, burned and major trauma patients (n = 86, 40 patients with burns and 46 with trauma, 43 in each group) on admission to an intensive care unit in a university hospital (matching for severity, age, and sex). The intervention aimed to deliver a 500-mL enteral solution containing 30 g of glutamine per day, selenium, zinc, and vitamin E (Gln-AOX) for a maximum of 10 d, in addition to control treatment consisting of enteral nutrition in all patients and intravenous trace elements in all burn patients. RESULTS: Patients were comparable at baseline, except for more inhalation injuries in the burn-Gln-AOX group (P = 0.10) and greater neurologic impairment in the trauma-Gln-AOX group (P = 0.022). Intestinal tolerance was good. The full 500-mL dose was rarely delivered, resulting in a low mean glutamine daily dose (22 g for burn patients and 16 g for trauma patients). In burn patients intravenous trace element delivery was superior to the enteral dose. The evolution of the Sequential Organ Failure Assessment score and other outcome variables did not differ significantly between groups. C-reactive protein decreased faster in the Gln-AOX group. CONCLUSION: The Gln-AOX supplement was well tolerated in critically ill, injured patients, but did not improve outcome significantly. The delivery of glutamine below the 0.5-g/kg recommended dose in association with high intravenous trace element substitution doses in burn patients are likely to have blunted the impact by not reaching an efficient treatment dose. Further trials testing higher doses of Gln are required.

Compliance Monitoring Report Technical Assistance Tool, 2008

This form requests the minimum information required to demonstrate the extent of compliance with section 223(a)(11), 223(a)(12), 223(a)(13), 223(a)(14) of the JJDP Act of 2002. Many of these reporting requirements may be found in 28 C.F.R. 31.303(f)(5).

Compliance Monitoring Report Technical Assistance Tool, 2009

This form requests the minimum information required to demonstrate the extent of compliance with section 223(a)(11), 223(a)(12), 223(a)(13), 223(a)(14) of the JJDP Act of 2002. Many of these reporting requirements may be found in 28 C.F.R. 31.303(f)(5).

Impact of electronic monitoring of drug adherence on blood pressure control in primary care: a cluster 12-month randomised controlled study.

BACKGROUND: Poor long-term adherence is an important cause of uncontrolled hypertension. We examined whether monitoring drug adherence with an electronic system improves long-term blood pressure (BP) control in hypertensive patients followed by general practitioners (GPs). METHODS: A pragmatic cluster randomised controlled study was conducted over one year in community pharmacists/GPs' networks randomly assigned either to usual care (UC) where drugs were dispensed as usual, or to intervention (INT) group where drug adherence could be monitored with an electronic system (Medication Event Monitoring System). No therapy change was allowed during the first 2 months in both groups. Thereafter, GPs could modify therapy and use electronic monitors freely in the INT group. The primary outcome was a target office BP<140/90 mmHg. RESULTS: Sixty-eight treated uncontrolled hypertensive patients (UC: 34; INT: 34) were enrolled. Over the 12-month period, the likelihood of reaching the target BP was higher in the INT group compared to the UC group (p<0.05). At 4 months, 38% in the INT group reached the target BP vs. 12% in the UC group (p<0.05), and 21% vs. 9% at 12 months (p: ns). Multivariate analyses, taking account of baseline characteristics, therapy modification during follow-up, and clustering effects by network, indicate that being allocated to the INT group was associated with a greater odds of reaching the target BP at 4 months (p<0.01) and at 12 months (p=0.051). CONCLUSION: GPs monitoring drug adherence in collaboration with pharmacists achieved a better BP control in hypertensive patients, although the impact of monitoring decreased with time.

The Raccoon River Valley Trail user study: summary and recommendations,1992.

This study is a concise summary of a study of trail users on the Raccoon River Valley Trail commissioned by the Dallas County Conservation Board. It provides information associated with natural and cultural resources.

Western Iowa Missouri River Flooding -- Geo-Infrastructure Damage Assessment, Repair and Mitigation Strategies, TR-638, 2013

The 2011 Missouri River flooding caused significant damage to many geo-infrastructure systems including levees, bridge abutments/foundations, paved and unpaved roadways, culverts, and embankment slopes in western Iowa. The flooding resulted in closures of several interchanges along Interstate 29 and of more than 100 miles of secondary roads in western Iowa, causing severe inconvenience to residents and losses to local businesses. The main goals of this research project were to assist county and city engineers by deploying and using advanced technologies to rapidly assess the damage to geo-infrastructure and develop effective repair and mitigation strategies and solutions for use during future flood events in Iowa. The research team visited selected sites in western Iowa to conduct field reconnaissance, in situ testing on bridge abutment backfills that were affected by floods, flooded and non-flooded secondary roadways, and culverts. In situ testing was conducted shortly after the flood waters receded, and several months after flooding to evaluate recovery and performance. Tests included falling weight deflectometer, dynamic cone penetrometer, three-dimensional (3D) laser scanning, ground penetrating radar, and hand auger soil sampling. Field results indicated significant differences in roadway support characteristics between flooded and non-flooded areas. Support characteristics in some flooded areas recovered over time, while others did not. Voids were detected in culvert and bridge abutment backfill materials shortly after flooding and several months after flooding. A catalog of field assessment techniques and 20 potential repair/mitigation solutions are provided in this report. A flow chart relating the damages observed, assessment techniques, and potential repair/mitigation solutions is provided. These options are discussed for paved/unpaved roads, culverts, and bridge abutments, and are applicable for both primary and secondary roadways.

Integration of Bridge Damage Detection Concepts and Components (3 volumes), TR-636, 2013

This work is divided into three volumes: Volume I: Strain-Based Damage Detection; Volume II: Acceleration-Based Damage Detection; Volume III: Wireless Bridge Monitoring Hardware. Volume I: In this work, a previously-developed structural health monitoring (SHM) system was advanced toward a ready-for-implementation system. Improvements were made with respect to automated data reduction/analysis, data acquisition hardware, sensor types, and communication network architecture. The statistical damage-detection tool, control-chart-based damage-detection methodologies, were further investigated and advanced. For the validation of the damage-detection approaches, strain data were obtained from a sacrificial specimen attached to the previously-utilized US 30 Bridge over the South Skunk River (in Ames, Iowa), which had simulated damage,. To provide for an enhanced ability to detect changes in the behavior of the structural system, various control chart rules were evaluated. False indications and true indications were studied to compare the damage detection ability in regard to each methodology and each control chart rule. An autonomous software program called Bridge Engineering Center Assessment Software (BECAS) was developed to control all aspects of the damage detection processes. BECAS requires no user intervention after initial configuration and training. Volume II: In this work, a previously developed structural health monitoring (SHM) system was advanced toward a ready-for-implementation system. Improvements were made with respect to automated data reduction/analysis, data acquisition hardware, sensor types, and communication network architecture. The objective of this part of the project was to validate/integrate a vibration-based damage-detection algorithm with the strain-based methodology formulated by the Iowa State University Bridge Engineering Center. This report volume (Volume II) presents the use of vibration-based damage-detection approaches as local methods to quantify damage at critical areas in structures. Acceleration data were collected and analyzed to evaluate the relationships between sensors and with changes in environmental conditions. A sacrificial specimen was investigated to verify the damage-detection capabilities and this volume presents a transmissibility concept and damage-detection algorithm that show potential to sense local changes in the dynamic stiffness between points across a joint of a real structure. The validation and integration of the vibration-based and strain-based damage-detection methodologies will add significant value to Iowa’s current and future bridge maintenance, planning, and management Volume III: In this work, a previously developed structural health monitoring (SHM) system was advanced toward a ready-for-implementation system. Improvements were made with respect to automated data reduction/analysis, data acquisition hardware, sensor types, and communication network architecture. This report volume (Volume III) summarizes the energy harvesting techniques and prototype development for a bridge monitoring system that uses wireless sensors. The wireless sensor nodes are used to collect strain measurements at critical locations on a bridge. The bridge monitoring hardware system consists of a base station and multiple self-powered wireless sensor nodes. The base station is responsible for the synchronization of data sampling on all nodes and data aggregation. Each wireless sensor node include a sensing element, a processing and wireless communication module, and an energy harvesting module. The hardware prototype for a wireless bridge monitoring system was developed and tested on the US 30 Bridge over the South Skunk River in Ames, Iowa. The functions and performance of the developed system, including strain data, energy harvesting capacity, and wireless transmission quality, were studied and are covered in this volume.

Monitoring of aglycons of yew glycosides (3,5-dimethoxyphenol, myrtenol and 1-octen-3-ol) as first indicator of yew presence.

The toxicity of yew (Taxus spp) is well known from ancient times and is mainly due to taxins acting as inhibitors of calcium and sodium transport across the cell membrane of cardiac myocytes. The confirmation of yew taxins in body fluids can be carried out by liquid chromatography-tandem mass spectrometry (LC-MS/MS). However, before selecting this precise but expensive technique, an orientation test should be done to ascertain yew presence as toxic agent in the organism. As the 3,5-dimethoxyphenol (3,5-DMP), myrtenol and 1-octen-3-ol appear as glycosidically bound volatile compounds and are very yew specific, the detection of 3,5-DMP and the measurement of 1-octen-3-ol / myrtenol concentration ratio constitute reliable indicators of yew presence in forensic cases. The detection of these compounds is easily performed by gas chromatography-mass spectrometry (GC-MS) (SIM) after an enzymatic hydrolysis (β-glucosidase) allowing the release of volatile compounds from yew glycosides. Copyright © 2012 John Wiley & Sons, Ltd.

Monitoring network optimisation for spatial data classification using support vector machines

The paper presents a novel method for monitoring network optimisation, based on a recent machine learning technique known as support vector machine. It is problem-oriented in the sense that it directly answers the question of whether the advised spatial location is important for the classification model. The method can be used to increase the accuracy of classification models by taking a small number of additional measurements. Traditionally, network optimisation is performed by means of the analysis of the kriging variances. The comparison of the method with the traditional approach is presented on a real case study with climate data.

Sedimen-water nutrient fluxes: Preliminary results of in situ measurements in Alfaques Bay, Ebro River Delta.

Sediment-water exchanges of oxygen, ammonium, nitrate, total dissolved nitrogen, phosphate and total dissolved phosphorus were measured by means of an in situ incubator of 7 1 volume and 700 cm2 base area. The incubations lasted for three hours and were done over a whole season on different kinds of sediments in Alfaques Bay. We present some preliminary results on: i) methodological aspects, ii) spatial and temporal variability of fluxes, and iii) estimates of contribution of benthic nutrient regeneration relative to total nutrient loading of the Bay. Oxygen uptake averaged 1700 mmo1 m-2 h-1 (range 200-3500); no differences were found between sandy and muddy sediments. The release of ammonia from the sediment averaged 70 mmo1 m-2 h-1 and was higher in muddy sediments than in sandy ones. Very low to null nitrate and nitrite fluxes and only small fluxes of organic nitrogen were detected. We conclude that ammonium release from sediment is the major path of nitrogen regeneration. Some sediments removed dissolved reactive phosphorus (DRP) from the water and released dissolved organic phosphorus (DOP). Additional manipulative experiments revealed DRP release under particular conditions (turbulence, anoxia). From these data, we estimate that at least 50% of the nitrogen requirements of phytoplankton in the area may be supplied by benthic remineralization.

Trichoptera (INSECTA) collected in Mediterranean river basins in the Iberian Peninsula: taxonomic remarks and notes on ecology

As a result of the GUADALMED project, undertaken in Iberian Mediterranean basins, to which were added samples taken by the junior author in the area, we collected numerous caddisfly larvae, pupae and adults. Some larvae were also reared in the lab to obtain adults and allow proper identification. A total of 90 species were identified, which accounts for more than a fourth of the species known in the Iberian Peninsula and Balearic Islands. Here we confirm the presence of doubtful species in the Iberian Peninsula (Glyphotaelius pellucidus) and we expand the distribution range of others (Lype reducta, Micrasema minimum, Limnephilus guadarramicus, Sericostoma pyrenaicum). Moreover, because of the unconformity of morphological larval characteristics with present taxonomical keys (Mesophylax aspersus) or lack of larvae descriptions (Allogamus mortoni, Stenophylax espanioli), here we include some relevant taxonomical aspects that are useful to identify larvae. A brief description of the larva of a possible new species of Hydropsyche (from now on H. gr. instabilis) is also given. Los tricópteros (Insecta) recolectados en las cuencas mediterráneas de la Península Ibérica: notas taxonómicas y requerimientos ecológicos Como resultado de los estudios realizados en el proyecto GUADALMED en las cuencas de los ríos mediterráneos peninsulares y otros muestreos realizados por la primera autora del trabajo se han recolectado numerosas larvas, pupas y adultos de tricópteros. Algunas larvas fueron criadas en el laboratorio para la obtención de adultos y con ello asegurar su identificación. Se han identificado un total de 90 especies que suponen más de una cuarta parte de las especies actualmente conocidas en la Península Ibérica y Baleares. En este trabajo se confirma la presencia, hasta ahora dudosa en la Península Ibérica, de algunas especies (Glyphotaelius pellucidus) y se amplia el área de distribución de otras (Lype reducta, Micrasema minimum, Limnephilus guadarramicus, Sericostoma pyrenaicum). Además, se incluyen algunos aspectos taxonómicos relevantes para la identificación de algunas larvas en futuros estudios, debido a que las claves ya existentes no describen correctamente la larva (Mesophylax aspersus) o porque se trata de larvas sin describir (Allogamus mortoni, Stenophylax espanioli). Se añade también una somera descripción de la larva de una posible nueva especie de Hydropsyche (citada aquí como H. gr. instabilis) y que requiere un estudio más detallado.

Rockfall monitoring by Terrestrial Laser Scanning ¿ case study of the basaltic rock face at Castellfollit de la Roca (Catalonia, Spain)

This case study deals with a rock face monitoring in urban areas using a Terrestrial Laser Scanner. The pilot study area is an almost vertical, fifty meter high cliff, on top of which the village of Castellfollit de la Roca is located. Rockfall activity is currently causing a retreat of the rock face, which may endanger the houses located at its edge. TLS datasets consist of high density 3-D point clouds acquired from five stations, nine times in a time span of 22 months (from March 2006 to January 2008). The change detection, i.e. rockfalls, was performed through a sequential comparison of datasets. Two types of mass movement were detected in the monitoring period: (a) detachment of single basaltic columns, with magnitudes below 1.5 m3 and (b) detachment of groups of columns, with magnitudes of 1.5 to 150 m3. Furthermore, the historical record revealed (c) the occurrence of slab failures with magnitudes higher than 150 m3. Displacements of a likely slab failure were measured, suggesting an apparent stationary stage. Even failures are clearly episodic, our results, together with the study of the historical record, enabled us to estimate a mean detachment of material from 46 to 91.5 m3 year¿1. The application of TLS considerably improved our understanding of rockfall phenomena in the study area.

On the complementariness of infrasound and seismic sensors for monitoring snow avalanches

The paper analyses and compares infrasonic and seismic data from snow avalanches monitored at the Vallée de la Sionne test site in Switzerland from 2009 to 2010. Using a combination of seismic and infrasound sensors, it is possible not only to detect a snow avalanche but also to distinguish between the different flow regimes and to analyse duration, average speed (for sections of the avalanche path) and avalanche size. Different sensitiveness of the seismic and infrasound sensors to the avalanche regimes is shown. Furthermore, the high amplitudes observed in the infrasound signal for one avalanche were modelled assuming that the suspension layer of the avalanche acts as a moving turbulent sound source. Our results show reproducibility for similar avalanches on the same avalanche path.