Iowa 2008 Summer Storms After Action Report, April 27, 2009

In the summer of 2008, the state of Iowa suffered from a series of severe storms that produced tornadoes and heavy rainfall, which resulted in widespread flooding. The Summer Storms1 lasted from late May through mid-August, with the most intense storms occurring over a month-long period from May 25 to June 25. The Summer Storms exacted a major human and economic toll on Iowa, resulting in 18 fatalities and 106 injuries, forcing the evacuation of approximately 38,000 Iowans, and impacting 21,000 housing units. Iowa’s public and private sectors suffered significant monetary damages. Eighty-six of the ninety-nine counties in the state were included in the Governor’s disaster declarations. Presidential disaster declarations made residents in 84 counties eligible for Public Assistance and 78 counties for Individual Assistance. The Rebuild Iowa Advisory Commission estimated $798.3 million in damages to publicly owned buildings and infrastructure, including damages of $53 million to public transportation and $342 million to public utilities.

Missouri River Floods After Action Report, December 20, 2011

In May 2011, very heavy rains combined with above average snowpack caused reservoirs throughout the Upper Missouri River basin to swell. The river carried more water in May and June than it does in an average year. The six Iowa counties bordering the river—Fremont, Harrison, Mills, Monona, Pottawattamie and Woodbury—suffered from major flooding which persisted throughout the spring and summer. On June 2, Governor Terry Branstad issued a Proclamation of Disaster Emergency for the six impacted counties. The Iowa Homeland Security and Emergency Management Division (HSEMD) activated the State Emergency Operations Center (SEOC) on June 10 to coordinate State, Federal, private sector, and voluntary agency preparedness and response activities in the affected area. The severity and duration of the flooding presented operational challenges for the SEOC and its partner agencies, which were further complicated by severe weather. The flooding forced the SEOC to conduct simultaneous response and recovery operations for an usually long period of time. The Missouri River floods caused major economic losses in Western Iowa. As a result of these economic losses, President Barack Obama issued a Major Disaster Declaration (FEMA-1998-DR) which made six counties eligible for Federal Public Assistance. The disaster declaration was subsequently amended on October 18, making five counties eligible for Federal Individual Assistance.

Effect of two microbial phytase preparations on phosphorus utilisation in broilers fed maize-soybean meal based diets

Selostus: Fytaasientsyymilisäyksen vaikutus fosforin hyväksikäyttöön maissi-soijarouhepohjaisessa broilerrehussa

Systematic review of delayed postoperative hemorrhage after pancreatic resection.

This review assesses the presentation, management, and outcome of delayed postpancreatectomy hemorrhage (PPH) and suggests a novel algorithm as possible standard of care.An electronic search of Medline and Embase databases from January 1990 to February 2010 was undertaken. A random-effect meta-analysis for success rate and mortality of laparotomy vs. interventional radiology after delayed PPH was performed.Fifteen studies comprising of 248 patients with delayed PPH were included. Its incidence was of 3.3%. A sentinel bleed heralding a delayed PPH was observed in 45% of cases. Pancreatic leaks or intraabdominal abscesses were found in 62%. Interventional radiology was attempted in 41%, and laparotomy was undertaken in 49%. On meta-analysis comparing laparotomy vs. interventional radiology, no significant difference could be found in terms of complete hemostasis (76% vs. 80%; P = 0.35). A statistically significant difference favored interventional radiology vs. laparotomy in term of mortality (22% vs. 47%; P = 0.02).Proper management of postoperative complications, such as pancreatic leak and intraabdominal abscess, minimizes the risk of delayed PPH. Sentinel bleeding needs to be thoroughly investigated. If a pseudoaneurysm is detected, it has to be treated by interventional angiography, in order to prevent a further delayed PPH. Early angiography and embolization or stenting is safe and should be the procedure of choice. Surgery remains a therapeutic option if no interventional radiology is available, or patients cannot be resuscitated for an interventional treatment.

Delayed Cyclic Activity Development on Early Amplitude-Integrated EEG in the Preterm Infant with Brain Lesions.

Background: Maturation of amplitude-integrated electroencephalogram (aEEG) activity is influenced by both gestational age (GA) and postmenstrual age. It is not fully known how this process is influenced by cerebral lesions. Objective: To compare early aEEG developmental changes between preterm newborns with different degrees of cerebral lesions on cranial ultrasound (cUS). Methods: Prospective cohort study on preterm newborns with GA <32.0 weeks, undergoing continuous aEEG recording during the first 84 h after birth. aEEG characteristics were qualitatively and quantitatively evaluated using pre-established criteria. Based on cUS findings three groups were formed: normal (n = 78), mild (n = 20), and severe cerebral lesions (n = 6). Linear mixed models for repeated measures were used to analyze aEEG maturational trajectories. Results: 104 newborns with a mean GA (range) 29.5 (24.4-31.7) weeks, and birth weight 1,220 (580-2,020) g were recruited. Newborns with severe brain lesions started with similar aEEG scores and tendentially lower aEEG amplitudes than newborns without brain lesions, and showed a slower development of the cyclic activity (p < 0.001), but a more rapid increase of the maximum and minimum aEEG amplitudes (p = 0.002 and p = 0.04). Conclusions: Preterm infants with severe cerebral lesions manifest a maturational delay in the aEEG cyclic activity already early after birth, but show a catch-up of aEEG amplitudes to that of newborns without cerebral lesions. Changes in the maturational aEEG pattern may be a marker of severe neurological lesions in the preterm infant.

Metabolic and hemodynamic changes during recovery and tracheal extubation in neurosurgical patients: immediate versus delayed recovery.

Delayed recovery has been advocated to limit the postoperative stress linked to awakening from anesthesia, but data on this subject are lacking. In this study, we measured oxygen consumption (V(O2)) and plasma catecholamine concentrations as markers of postoperative stress. We tested the hypothesis that delayed recovery and extubation would attenuate metabolic changes after intracranial surgery. Thirty patients were included in a prospective, open study and were randomized into two groups. In Group I, the patients were tracheally extubated as soon as possible after surgery. In Group II, the patients were sedated with propofol for 2 h after surgery. V(O2), catecholamine concentration, mean arterial pressure (MAP), and heart rate (HR) were measured during anesthesia, at extubation, and 30 min after extubation. V(O2) and noradrenaline on extubation and mean V(O2) during recovery were significantly higher in Group II than in Group I (V(O2) for Group I: preextubation 215 +/- 46 mL/min, recovery 198 +/- 38 mL/min; for Group II: preextubation 320 +/- 75 mL/min, recovery 268 +/- 49 mL/min; noradrenaline on extubation for Group I: 207 +/- 76 pg/mL, for Group II: 374 +/- 236 pg/ mL). Extubation induced a significant increase in MAP. MAP, HR, and adrenaline values were not statistically different between groups. In conclusion, delayed recovery after neurosurgery cannot be recommended as a mechanism of limiting the metabolic and hemodynamic consequences from emergence from general anesthesia. IMPLICATIONS: In this study, we tested the hypothesis that delayed recovery after neurosurgery would attenuate the consequences of recovery from general anesthesia. As markers of stress, oxygen consumption and noradrenaline blood levels were higher after delayed versus early recovery. Thus, delayed recovery cannot be recommended as a mechanism of limiting the metabolic and hemodynamic consequences from emergence after neurosurgery.

Membrane interaction of polymyxin B and synthetic analogues studied in biomimetic systems: implications for antibacterial action

Membrane-active antimicrobial peptides, such as polymyxin B (PxB), are currently in the spotlight as potential candidates toovercome bacterial resistance. We have designed synthetic analogs ofPxB in order to determine the structural requirements for membraneaction. Since the mechanism of action of PxB involves interaction withboth the outer membrane and the cytoplasmic membrane of Gramnegative bacteria, we have used an approach based on mimicking theouter layers of these membranes using monolayers, Langmuir-Blodgettfilms and unilamelar vesicles, and applying a battery of biophysicalmethods in order to dissect the different events of membraneinteraction. Collectively, results indicate that the PxB analogues act inthe bacterial membrane by the same mechanism than PxB, and that cationic amphipathicity determines peptide activity.

Détection des lésions focales hépatiques malignes. Comparaison de l'échographie, de la porto-tomodensitométrie, de la tomodensitométrie tardive et de l'imagerie par résonance magnétique [Detection of malignant focal hepatic lesions. Comparison of ultrasonography, computerized tomography during arterial portography, delayed computerized tomography and magnetic resonance imaging]

AIMS: This study was performed to compare the sensitivity of ultrasonography, computerized tomography during arterial portography, delayed computerized tomography, and magnetic resonance imaging to detect focal liver lesions. Forty three patients with primary or secondary malignant liver lesions were studied prior to surgical intervention. METHODS: The results of the imaging studies were compared with intraoperative examination of the liver, intraoperative ultrasonography and pathology results (29 patients). In the non-operated (14 patients) group, we compared the number of lesions detected by each technique. RESULTS: One hundred and forty six lesions were detected. There was 84% sensitivity with computerized tomography during arterial portography, 61.3% with delayed scan, 63.3% with magnetic resonance imaging and 51% with ultrasonography in operated patients. In patients who did not undergo surgery, magnetic resonance imaging was more sensitive in detecting lesions. CONCLUSIONS: In operated and non-operated patients series, CT during arterial portography had the highest sensitivity, but magnetic resonance imaging had the most consistent overall results.

Affirmative Action through Extra Prizes

Some affirmative action policies establish that a set of disadvantaged competitors has access to an extra prize. Examples are gender quotas or a prize for national competitors in an international competition. We analyse the effects of creating an extra prize by reducing the prize in the main competition. Contestants differ in ability and agents with relatively low ability belong to a disadvantaged minority. All contestants compete for the main prize, but only disadvantaged agents can win the extra prize. We show that an extra prize is a powerful tool to ensure participation of disadvantaged agents. Moreover, for intermediate levels of the disadvantage of the minority, introducing an extra prize increases total equilibrium effort compared to a standard contest. Thus, even a contest designer not interested in affirmative action might establish an extra prize in order to enhance competition. Keywords: Asymmetric contest, equality of opportunity, affirmative action, discrimination, prize structure, exclusion principle. JEL: C72, D72, I38, J78

Action Plan: For implementing the recommendations of the Iowa Governor's Pre-White House Conference on Library and Information Services, April 30, May 1 and 2, 1991 and the White House Conference on Library and Information Services, July 9-13, 1991

This report includes the objectives, implementation responsibilities and target dates recommended and passed by the delegates to the Iowa Governor's Pre-White House Conference on Library and Information Services (April 30-May 2, 1991) or the White House Conference on Library and Information Services (July 9-13, 1991. Text of the relevant recommendations is included for each objective.