High Priority Corridors for Access Management Near Large Urban Areas in Iowa, 2002

This research project was intended to produce a strategy for addressing current and future access management problems on state highway routes located just outside urban areas that serve as major routes for commuting into and out of major employment centers in Iowa. There were two basic goals: (1) to develop a ranking system for identifying high-priority segments for access management treatments on primary highways outside metro and urban areas and (2) to focus efforts on routes that are major commuting routes at present and in the future. The project focused on four-lane expressways and two-lane arterials most likely to serve extensive commuter traffic. Available spatial and statistical data were used to identify existing and possible future problem corridors with respect to access management. The research team developed a scheme for ranking commuter routes based on their need for attention to access management. This project was able to produce rankings for corridors based on a variety of factors, including proportion of crashes that appear to be access-related, severity of those crashes, and potential for improvement along corridors. Frequency and loss were found to be highly rank correlated; because of this, these indicators were not used together in developing final priority rankings. Most of the highest ranked routes are on two-lane rural cross sections, but a few are four-lane expressways with at-grade private driveways and public road intersections. The most important conclusion of the ranking system is that many of the poor-performing corridors are located in a single Iowa Department of Transportation district near two urban areas--Des Moines and Ames. A comprehensive approach to managing access along commuting corridors should be developed first in this district since the potential benefits would be highest in that region.

First trimester maternal level of PAPP-A, βhCG and ethnicity as predictive of Intrauterine Growth Restriction

Intrauterine growth restriction (IUGR) is one of the leading causes of perinatal mortality and morbidity. Nowadays, this condition is detected in the 3rt and last trimester of gestation when the pathology is already established and success of therapeutic strategies are limited. As the physiopathology of the disease suggests that the problem stems from poor placental implantation, it would be quite advantageous to identify women at increased risk in the first or second trimester of gestation because it then might be possible to offer treatment interventions or at least to establish increased surveillance for high risk pregnancies. Maternal levels of pregnancy-associated plasma protein-A (PAPP-A) and free β human chorionic gonadotropin (free βhCG) has been shown to be effective in first trimester screening for chromosomal abnormalities, primarily trisomies 21, 13 and 18. Previous studies evaluating PAPP-A and free βhCG measured in the first trimester in relation with IUGR have provided conflicting results. Moreover, it has been suggested that black ethnicity is another important predictive factor for fetal growth restriction.Objective: To analyse the association between first trimester serum analytes (PAPP-A and free βhCG) and ethnicity with Intrauterine Growth Restriction.Methods: The study consists in a retrospective cohort, including all singleton pregnancies with complete outcome data that had undergone first trimester screening (PAPP-A and free βhCG) at 11-13+6weeks of gestation between 1/1/2010 - 31/12/2012 in Hospital Universitari Dr Josep Trueta. Biochemical markers are converted to multiples of the median (MoMs) and percentiles 5 and 10 are calculated. The association between free βhCG and PAPP-A with the incidence of IUGR is evaluated in combination with maternal ethnicity. Bivariate and logistic regression analyses are performed to adjust this association for co variables

First trimester maternal level of PAPP-A, βhCG and ethnicity as predictive of Intrauterine Growth Restriction

Intrauterine growth restriction (IUGR) is one of the leading causes of perinatal mortality and morbidity. Nowadays, this condition is detected in the 3rt and last trimester of gestation when the pathology is already established and success of therapeutic strategies are limited. As the physiopathology of the disease suggests that the problem stems from poor placental implantation, it would be quite advantageous to identify women at increased risk in the first or second trimester of gestation because it then might be possible to offer treatment interventions or at least to establish increased surveillance for high risk pregnancies. Maternal levels of pregnancy-associated plasma protein-A (PAPP-A) and free β human chorionic gonadotropin (free βhCG) has been shown to be effective in first trimester screening for chromosomal abnormalities, primarily trisomies 21, 13 and 18. Previous studies evaluating PAPP-A and free βhCG measured in the first trimester in relation with IUGR have provided conflicting results. Moreover, it has been suggested that black ethnicity is another important predictive factor for fetal growth restriction.Objective: To analyse the association between first trimester serum analytes (PAPP-A and free βhCG) and ethnicity with Intrauterine Growth Restriction.Methods: The study consists in a retrospective cohort, including all singleton pregnancies with complete outcome data that had undergone first trimester screening (PAPP-A and free βhCG) at 11-13+6weeks of gestation between 1/1/2010 - 31/12/2012 in Hospital Universitari Dr Josep Trueta. Biochemical markers are converted to multiples of the median (MoMs) and percentiles 5 and 10 are calculated. The association between free βhCG and PAPP-A with the incidence of IUGR is evaluated in combination with maternal ethnicity. Bivariate and logistic regression analyses are performed to adjust this association for co variables

Relation between plaque type, plaque thickness, blood shear stress, and plaque stress in coronary arteries assessed by X-ray Angiography and Intravascular Ultrasound

Purpose: Atheromatic plaque progression is affected, among others phenomena, by biomechanical, biochemical, and physiological factors. In this paper, the authors introduce a novel framework able to provide both morphological (vessel radius, plaque thickness, and type) and biomechanical (wall shear stress and Von Mises stress) indices of coronary arteries. Methods: First, the approach reconstructs the three-dimensional morphology of the vessel from intravascular ultrasound(IVUS) and Angiographic sequences, requiring minimal user interaction. Then, a computational pipeline allows to automatically assess fluid-dynamic and mechanical indices. Ten coronary arteries are analyzed illustrating the capabilities of the tool and confirming previous technical and clinical observations. Results: The relations between the arterial indices obtained by IVUS measurement and simulations have been quantitatively analyzed along the whole surface of the artery, extending the analysis of the coronary arteries shown in previous state of the art studies. Additionally, for the first time in the literature, the framework allows the computation of the membrane stresses using a simplified mechanical model of the arterial wall. Conclusions: Circumferentially (within a given frame), statistical analysis shows an inverse relation between the wall shear stress and the plaque thickness. At the global level (comparing a frame within the entire vessel), it is observed that heavy plaque accumulations are in general calcified and are located in the areas of the vessel having high wall shear stress. Finally, in their experiments the inverse proportionality between fluid and structural stresses is observed.

Information and risk management during the first trimester care for pregnant women: Some reflections about the ethical challenges and the legal framework in Switzerland. [L'information et la gestion des risques dans le suivi de la grossesse lors du 1er trimestre : quelques réflexions sur le défi éthique et le cadre légal en Suisse.]

The progress in prenatal medicine raises complex questions with respect to the physician-patient relationship. The physician needs to reconcile medical aspects, ethical principles as well as judicial norms. Already, during the first trimester, the physician has to put into practice the schedule combining for each individual pregnancy physical, laboratory and other appropriate exams. Physicians are under the obligation to inform in a clear and comprehensive way without creating unnecessary anxiety for their patients. Legal requirements include informed consent, the respect for the patient's right to self-determination, and compliance with the Swiss federal law on genetic testing, especially with its articles on prenatal screening and diagnosis. This article discusses the complexity of obstetrical practice when it comes to delivering adequate information within the scope of ethical and legal requirements in Switzerland. L'évolution de la médecine prénatale soulève des enjeux complexes dans la relation médecin-patient. Il s'agit de concilier à la fois les aspects médicaux, les principes éthiques et les normes juridiques. Dès le premier trimestre de la grossesse le médecin doit poser le cadre du suivi et des examens appropriés pour chaque grossesse. Son devoir est d'informer de manière claire et précise sans inquiéter inutilement, en respectant l'exigence légale d'un consentement éclairé et plus largement le droit de la patiente à l'autodétermination ainsi que le cadre de la loi fédérale suisse sur l'analyse génétique humaine dans le domaine du dépistage et du diagnostic prénatal. Cet article discute de la complexité de l'information et de l'application des principes éthiques et légaux dans la pratique obstétricale en Suisse.

Mephedrone pharmacokinetics after intravenous and oral administration in rats: relation to pharmacodynamics

Rationale Mephedrone (4-methylmethcathinone) is a still poorly known drug of abuse, alternative to ecstasy or cocaine. Objective The major aims were to investigate the pharmacokineticsa and locomotor activity of mephedrone in rats and provide a pharmacokinetic/pharmacodynamic model. Methods Mephedrone was administered to male SpragueDawley rats intravenously (10 mg/kg) and orally (30 and 60 mg/kg). Plasma concentrations and metabolites were characterized using LC/MS and LC-MS/MS fragmentation patterns. Locomotor activity was monitored for 180240 min. Results Mephedrone plasma concentrations after i.v. administration fit a two-compartment model (α=10.23 h−1, β=1.86 h−1). After oral administration, peak mephedrone concentrations were achieved between 0.5 and 1 h and declined to undetectable levels at 9 h. The absolute bioavailability of mephedrone was about 10 % and the percentage of mephedrone protein binding was 21.59±3.67%. We have identified five phase I metabolites in rat blood after oral administration. The relationship between brain levels and free plasma concentration was 1.85±0.08. Mephedrone induced a dose-dependent increase in locomotor activity, which lasted up to 2 h. The pharmacokineticpharmacodynamic model successfully describes the relationship between mephedrone plasma concentrations and its psychostimulant effect. Conclusions We suggest a very important first-pass effect for mephedrone after oral administration and an easy access to the central nervous system. The model described might be useful in the estimation and prediction of the onset, magnitude,and time course of mephedrone pharmacodynamics as well as to design new animal models of mephedrone addiction and toxicity.

Size and fat content of gynes in relation to the mode of colony founding in ants (Hymenoptera; Formicidae)

In ants, there are two main processes of colony founding, the independent and the dependent modes. In the first case young queens start colony founding without the help of workers, whereas in the second case they are accompanied by workers. To determine the relation between the mode of colony founding and the physiology of queens, we collected mature gynes of 24 ant species. Mature gynes of species utilizing independent colony founding had a far higher relative fat content than gynes of species employing dependent colony founding. These fat reserves are stored during the period of maturation, i.e. between the time of emergence and mating, and serve as fuel during the time of colony founding to nurture the queen and the brood. Gynes of species founding independently but non claustrally were found to have a relative fat content intermediate between the values found for gynes founding independently and those founding dependently. This suggests that such gynes rely partially on their fat reserves and partially on the energy provided by prey they collect to nurture themselves and the first brood during the time of colony founding. Study of the fat content of mature gynes of all species has shown that it gives a good indication of the mode of colony founding.

Gait disturbances as specific predictive markers of the first fall onset in elderly people: a two-year prospective observational study

Falls are common in the elderly, and potentially result in injury and disability. Thus, preventing falls as soon as possible in older adults is a public health priority, yet there is no specific marker that is predictive of the first fall onset. We hypothesized that gait features should be the most relevant variables for predicting the first fall. Clinical baseline characteristics (e.g., gender, cognitive function) were assessed in 259 home-dwelling people aged 66 to 75 that had never fallen. Likewise, global kinetic behavior of gait was recorded from 22 variables in 1036 walking tests with an accelerometric gait analysis system. Afterward, monthly telephone monitoring reported the date of the first fall over 24 months. A principal components analysis was used to assess the relationship between gait variables and fall status in four groups: non-fallers, fallers from 0 to 6 months, fallers from 6 to 12 months and fallers from 12 to 24 months. The association of significant principal components (PC) with an increased risk of first fall was then evaluated using the area under the Receiver Operator Characteristic Curve (ROC). No effect of clinical confounding variables was shown as a function of groups. An eigenvalue decomposition of the correlation matrix identified a large statistical PC1 (termed "Global kinetics of gait pattern"), which accounted for 36.7% of total variance. Principal component loadings also revealed a PC2 (12.6% of total variance), related to the "Global gait regularity." Subsequent ANOVAs showed that only PC1 discriminated the fall status during the first 6 months, while PC2 discriminated the first fall onset between 6 and 12 months. After one year, any PC was associated with falls. These results were bolstered by the ROC analyses, showing good predictive models of the first fall during the first six months or from 6 to 12 months. Overall, these findings suggest that the performance of a standardized walking test at least once a year is essential for fall prevention.

Scheduling an European basketball competition. An application of graph theory

The object of this project is to schedule a ctitious European basketball competition with many teams situated a long distances. The schedule must be fair, feasible and economical, which means that the total distance trav- eled by every team must be the minimal possible. First, we de ne the sport competition terminology and study di erent competition systems, focusing on the NBA and the Euroleague systems. Then we de ne concepts of graph theory and spherical distance that will be needed. Next we propose a com- petition system, explaining where will be allocated the teams and how will be the scheduling. Then there is a description of the programs that have been implemented, and, nally, the complete schedule is displayed, and some possible improvements are mentioned.

A game theoretical approach to the algebraic counterpart of the Wagner hierarchy

La hiérarchie de Wagner constitue à ce jour la plus fine classification des langages ω-réguliers. Par ailleurs, l'approche algébrique de la théorie de langages formels montre que ces ensembles ω-réguliers correspondent précisément aux langages reconnaissables par des ω-semigroupes finis pointés. Ce travail s'inscrit dans ce contexte en fournissant une description complète de la contrepartie algébrique de la hiérarchie de Wagner, et ce par le biais de la théorie descriptive des jeux de Wadge. Plus précisément, nous montrons d'abord que le degré de Wagner d'un langage ω-régulier est effectivement un invariant syntaxique. Nous définissons ensuite une relation de réduction entre ω-semigroupes pointés par le biais d'un jeu infini de type Wadge. La collection de ces structures algébriques ordonnée par cette relation apparaît alors comme étant isomorphe à la hiérarchie de Wagner, soit un quasi bon ordre décidable de largeur 2 et de hauteur ω. Nous exposons par la suite une procédure de décidabilité de cette hiérarchie algébrique : on décrit une représentation graphique des ω-semigroupes finis pointés, puis un algorithme sur ces structures graphiques qui calcule le degré de Wagner de n'importe quel élément. Ainsi le degré de Wagner de tout langage ω-régulier peut être calculé de manière effective directement sur son image syntaxique. Nous montrons ensuite comment construire directement et inductivement une structure de n''importe quel degré. Nous terminons par une description détaillée des invariants algébriques qui caractérisent tous les degrés de cette hiérarchie. Abstract The Wagner hierarchy is known so far to be the most refined topological classification of ω-rational languages. Also, the algebraic study of formal languages shows that these ω-rational sets correspond precisely to the languages recognizable by finite pointed ω-semigroups. Within this framework, we provide a construction of the algebraic counterpart of the Wagner hierarchy. We adopt a hierarchical game approach, by translating the Wadge theory from the ω-rational language to the ω-semigroup context. More precisely, we first show that the Wagner degree is indeed a syntactic invariant. We then define a reduction relation on finite pointed ω-semigroups by means of a Wadge-like infinite two-player game. The collection of these algebraic structures ordered by this reduction is then proven to be isomorphic to the Wagner hierarchy, namely a well-founded and decidable partial ordering of width 2 and height $\omega^\omega$. We also describe a decidability procedure of this hierarchy: we introduce a graph representation of finite pointed ω-semigroups allowing to compute their precise Wagner degrees. The Wagner degree of every ω-rational language can therefore be computed directly on its syntactic image. We then show how to build a finite pointed ω-semigroup of any given Wagner degree. We finally describe the algebraic invariants characterizing every Wagner degree of this hierarchy.

Simultaneous use of alcohol, tobacco and cannabis in relation to severity of substance dependence: a study among young Swiss men

Objective: This study investigated patterns of the simultaneous use of alcohol, tobacco and cannabis among young polydrug users, and whether use of one substance might be a cue for use of another and associations with the severity of substance dependence. Methods: The study focused on 3 subsamples from the ongoing Swiss Cohort Study on Substance Use Risk Factors (C-SURF, N=5,990). It used 12 months of data on alcohol/tobacco co-users, alcohol/cannabis co-users and tobacco/cannabis co-users (N=2,660, 1,755 and 1,460 respectively. Simultaneous use, numbers of symptoms of substance dependence, and hazardous use of alcohol, tobacco and cannabis were assessed. The effect of simultaneous polydrug use (SPU) on the numbers of symptoms of substance dependence was tested using analysis of variance. Results: Polydrug use was most common as SPU, and less common as non/occasional SPU. Moreover, when participants started to use one substance while using another, the severity of substance dependence was more strongly associated with the triggered substance than with cue. Conclusions: This study highlights the necessity to take SPU into account. First, SPU rather than separate drug use was the most common pattern for polydrug users. Second, frequent SPU was associated with increased numbers of symptoms of substance dependence compared to non/occasional SPU. Furthermore, SPU may reveal the severity of substance use dependence, when substance use is triggered by a cue substance. For these reasons, SPU should be a serious cause for concern for prevention and intervention purposes.

Relation between plaque type, plaque thickness, blood shear stress, and plaque stress in coronary arteries assessed by X-ray Angiography and Intravascular Ultrasound

Purpose: Atheromatic plaque progression is affected, among others phenomena, by biomechanical, biochemical, and physiological factors. In this paper, the authors introduce a novel framework able to provide both morphological (vessel radius, plaque thickness, and type) and biomechanical (wall shear stress and Von Mises stress) indices of coronary arteries. Methods: First, the approach reconstructs the three-dimensional morphology of the vessel from intravascular ultrasound(IVUS) and Angiographic sequences, requiring minimal user interaction. Then, a computational pipeline allows to automatically assess fluid-dynamic and mechanical indices. Ten coronary arteries are analyzed illustrating the capabilities of the tool and confirming previous technical and clinical observations. Results: The relations between the arterial indices obtained by IVUS measurement and simulations have been quantitatively analyzed along the whole surface of the artery, extending the analysis of the coronary arteries shown in previous state of the art studies. Additionally, for the first time in the literature, the framework allows the computation of the membrane stresses using a simplified mechanical model of the arterial wall. Conclusions: Circumferentially (within a given frame), statistical analysis shows an inverse relation between the wall shear stress and the plaque thickness. At the global level (comparing a frame within the entire vessel), it is observed that heavy plaque accumulations are in general calcified and are located in the areas of the vessel having high wall shear stress. Finally, in their experiments the inverse proportionality between fluid and structural stresses is observed.

Bilateral deep brain stimulation: the placement of the second electrode is not necessarily less accurate than that of the first one.

BACKGROUND: Deep brain stimulation (DBS) is recognized as an effective treatment for movement disorders. We recently changed our technique, limiting the number of brain penetrations to three per side. OBJECTIVES: The first aim was to evaluate the electrode precision on both sides of surgery since we implemented this surgical technique. The second aim was to analyse whether or not the electrode placement was improved with microrecording and macrostimulation. METHODS: We retrospectively reviewed operation protocols and MRIs of 30 patients who underwent bilateral DBS. For microrecording and macrostimulation, we used three parallel channels of the 'Ben Gun' centred on the MRI-planned target. Pre- and post-operative MRIs were merged. The distance between the planned target and the centre of the implanted electrode artefact was measured. RESULTS: There was no significant difference in targeting precision on both sides of surgery. There was more intra-operative adjustment of the second electrode positioning based on microrecording and macrostimulation, which allowed to significantly approach the MRI-planned target on the medial-lateral axis. CONCLUSION: There was more electrode adjustment needed on the second side, possibly in relation with brain shift. We thus suggest performing a single central track with electrophysiological and clinical assessment, with multidirectional exploration on demand for suboptimal clinical responses.

Mephedrone pharmacokinetics after intravenous and oral administration in rats: relation to pharmacodynamics

Rationale Mephedrone (4-methylmethcathinone) is a still poorly known drug of abuse, alternative to ecstasy or cocaine. Objective The major aims were to investigate the pharmacokineticsa and locomotor activity of mephedrone in rats and provide a pharmacokinetic/pharmacodynamic model. Methods Mephedrone was administered to male Sprague-Dawley rats intravenously (10 mg/kg) and orally (30 and 60 mg/kg). Plasma concentrations and metabolites were characterized using LC/MS and LC-MS/MS fragmentation patterns. Locomotor activity was monitored for 180-240 min. Results Mephedrone plasma concentrations after i.v. administration fit a two-compartment model (α=10.23 h−1, β=1.86 h−1). After oral administration, peak mephedrone concentrations were achieved between 0.5 and 1 h and declined to undetectable levels at 9 h. The absolute bioavailability of mephedrone was about 10 % and the percentage of mephedrone protein binding was 21.59±3.67%. We have identified five phase I metabolites in rat blood after oral administration. The relationship between brain levels and free plasma concentration was 1.85±0.08. Mephedrone induced a dose-dependent increase in locomotor activity, which lasted up to 2 h. The pharmacokinetic-pharmacodynamic model successfully describes the relationship between mephedrone plasma concentrations and its psychostimulant effect. Conclusions We suggest a very important first-pass effect for mephedrone after oral administration and an easy access to the central nervous system. The model described might be useful in the estimation and prediction of the onset, magnitude,and time course of mephedrone pharmacodynamics as well as to design new animal models of mephedrone addiction and toxicity.