Foot skin blood flow following infrainguinal revascularization for critical lower limb ischemia.

INTRODUCTION: The aim of this study was to assess the blood flow in the feet before and after lower limb revascularization using laser Doppler imaging (LDI). METHODS: Ten patients with critical lower limb ischemia were prospectively enrolled from June to October 2004. All patients underwent successful unilateral surgical interventions including above-knee bypass, distal bypass and endarterectomy. Skin blood flow (SBF) over the plantar surface of both forefeet and heels was measured by LDI 24h before and 10 days after revascularization, expressed in perfusion units (PU), and reported as mean+/-SD. RESULTS: Measurements in the forefoot and heel were similar. Before revascularization mean SBF was significantly lower in the ischemic foot (130+/-71 PU) compared to the contralateral foot (212+/-68 PU), p<0.05. After revascularization a significant increase of the SBF in the forefoot (from 135+/-67 to 202+/-86 PU, p=0.001) and hindfoot (from 148+/-58 to 203+/-83, p=0.001) was observed on the treatment side. However, a large decrease of the SBF was seen in forefoot and hindfoot on the untreated side (from 250+/-123 PU to 176+/-83 and from 208+/-116 to 133+/-40, p=0.001, respectively). CONCLUSION: This study confirms the benefits of revascularization in patients with nonhealing foot lesions due to critical limb ischemia. A significant increase of the SBF was observed on the treatment side. However, an unexpected decrease was observed on the untreated side.

Impact médical hospitalier du pied diabétique en Suisse [Hospitalizations due to diabetic foot in Switzerland].

OBJECTIVE: Evaluate the hospital impact of diabetes, foot ulcers and amputations linked to diabetic foot in Switzerland. METHODS: Data from the medical statistics of Swiss hospitals between 2003 and 2008. RESULTS: Over 6 years, the annual hospital admission rate of diabetic patients increased by 38%, the number of hospitalised patients and of admissions by 44% and 51%, respectively. For ulcers, these figures were 112% and 194%, and for amputations 26% and 34%, respectively. Amongst patients hospitalised in 2005 with ulcer or for amputation, about 25% were hospitalised 2 years and 33% 1 year before or after. Length of stay decreased by 10%, but hospital mortality remained stable below 10%. CONCLUSION: Hospital admissions with diabetic foot problems are an important public health issue, and are getting worse.

Rubber Buffings for Bridge Approach Expansion Joints, MLR-01-01, 2001

Many of the bridges in the state of Iowa have type ‘CF’, ‘EE’, or ‘EF’ expansion joints installed in the bridge approach slabs. These joints, which are typically 4” wide, are currently filled with a foam expansion joint material that is covered with a sealant. Over time the sealant begins to pull off of the walls of the joint and it ultimately fails. The joint, which is now exposed to the weather, is then filled with water and solids. The foam joint material, which is lighter than water, floats out of the joint onto the highway. This foam resembles a large 4” X 6” plank and poses a threat to motorists. A possible solution to this problem would be to replace the foam material with rubber buffings. Rubber buffings are a by-product of the tire retread industry.

Improvement of Longitudinal Joints in Asphalt Pavement, HR-215, 1987

Research is reported which attempted to identify construction procedures that will provide an improved centerline joint on asphalt concrete pavements. Various construction procedures and their evaluation are described. Core densities were made and visual inspections were made 3 years after construction. Center cracking was measured at 4, 5, and 6 years. The only procedure to rank the same when comparing cracking and density (delete the 1:1 slope shoe on the edge) is described. This procedure had the highest average density and also the least cracking through 1985. This method provided the best performance for 4 years after construction and involved the removal of the 1:1 slope shoe from the paver when placing the surface course. This method had 9.0% cracked after 4 years and 100% cracked after 6 years of service.

Pavement Profiling by Milling, Addendum to HR-283, 1988

Iowa DOT research in 1986, demonstrated that carbide tooth milling can produce an acceptable surface texture. Based upon that research, specifications were developed for "Pavement Surface Repair (Milling)". This specification was applied to reprofile a nine-mile section of badly faulted portland cement concrete (pcc) pavement on route 163 just east of Des Moines. The Profile Index (measured with a 25-foot California Profilograph) was improved from an average of 55.2 inches per mile prior to milling to 10.6 inches per mile after milling. The bid price was $0.75 per square yard for pcc containing limestone coarse aggregate and $1.21 for pcc containing gravel coarse aggregate. Carbide tooth milling should be considered as an acceptable alternate method of reprofiling even though there is some spalling of joints.

A Study on the Use of Fabric to Retard Reflective Cracking Over Widened Joints, MLR-88-4, 1992

Reflective cracking of asphalt resurfacing has been a concern for a long time. Years ago wire mesh was used to control widening cracks. More recently it has been fabrics or fiberglass. In 1986, part of the proposed fabric was deleted from projects in different parts of Iowa with various histories and designs. These projects were monitored in 1988, 1989, 1990 and 1992 with only the thin (3 inch) overlays on newly widened pavements showing a significantly greater percentage of cracks in the areas where the fabric was deleted.

Pavement Instrumentation, HR-293, 1988

The report documents the development and installation of an instrumented pavement on I-80 in Iowa for the purposes of demonstration and answering current pavement questions. Its two primary objectives include documentation of the installation and verification of existing design procedures through monitoring of the continuous traffic stream reactions in the pavement. Some 120 instruments were installed in a forty foot segment of reconstructed pavement. The instruments included concrete strain gages, weldable strain gages on dowels, LVDT-deflection gages and temperature sensors in the concrete and base material. Five tubes were placed under three joints and two midslabs to measure the relative moisture and density at the interface between the pavement and base with atomic equipment. The instruments were placed ahead of the paving and over 92% of the instruments responded after paving. Planning requirements, problems encountered and costs of installation are presented. The site will use piezoelectric cables in a weigh-in-motion arrangement to trigger the data collection, a microcomputer controlled data acquisition system to analyze multiple sensors simultaneously, and telemetry to monitor the site remotely. Details provide the first time user of instrumentation with valuable information on the planning, problems, costs and coordination required to establish and operate such a site.

Use of a dynamic foot pressure index to monitor the effects of treatment for equinus gait in children with cerebral palsy.

The purpose of this study is to introduce and describe a newly developed index using foot pressure analysis to quantify the degree of equinus gait in children with cerebral palsy before and after injection with botulinum toxin. Data were captured preinjection and 12 weeks postinjection. Ten children aged 2(1/2) to 6(1/2) years took part (5 boys and 5 girls). Three of them had a diagnosis of spastic diplegia and 7 of congenital hemiplegia. In total, 13 limbs were analyzed. After orientation and segmentation of raw pedobarographic data, we determined a dynamic foot pressure index graded 0 to 100 that quantified the relative degree of heel and forefoot contact during stance. These data were correlated (Pearson correlation) with clinical measurements of dorsiflexion at the ankle (on a slow and fast stretch) and video observation (using the Observational Gait Scale). Pedobarograph data were strongly correlated with both the Observational Gait Scale scores (R = 0.79, P < 0.005) and clinical measurements of dorsiflexion on a fast stretch, which is reflective of spasticity (R = 0.70, P < 0.005). We demonstrated the index's sensitivity in detecting changes in spasticity and good correlation with video observations seems to indicate this technique's potential validity. When manipulated and segmented appropriately, and with the development of a simple ordinal index, we found that foot pressure data provided a useful tool in tracking changes in patients with spastic equinus.

Gait and foot clearance parameters obtained using shoe-worn inertial sensors in a large-population sample of older adults

In order to distinguish dysfunctional gait; clinicians require a measure of reference gait parameters for each population. This study provided normative values for widely used parameters in more than 1400 able-bodied adults over the age of 65. We also measured the foot clearance parameters (i.e., height of the foot above ground during swing phase) that are crucial to understand the complex relationship between gait and falls as well as obstacle negotiation strategies. We used a shoe-worn inertial sensor on each foot and previously validated algorithms to extract the gait parameters during 20 m walking trials in a corridor at a self-selected pace. We investigated the difference of the gait parameters between male and female participants by considering the effect of age and height factors. Besides; we examined the inter-relation of the clearance parameters with the gait speed. The sample size and breadth of gait parameters provided in this study offer a unique reference resource for the researchers.

Rapid Replacement of Bridge Deck Expansion Joints Study – Phase I, RB33-013, 2014

Bridge deck expansion joints are used to allow for movement of the bridge deck due to thermal expansion, dynamics loading, and other factors. More recently, expansion joints have also been utilized to prevent the passage of winter de-icing chemicals and other corrosives applied to bridge decks from penetrating and damaging substructure components of the bridge. Expansion joints are often one of the first components of a bridge deck to fail and repairing or replacing expansion joints are essential to extending the life of any bridge. In the Phase I study, the research team focused on the current means and methods of repairing and replacing bridge deck expansion joints. Research team members visited with Iowa Department of Transportation (DOT) Bridge Crew Leaders to document methods of maintaining and repairing bridge deck expansion joints. Active joint replacement projects around Iowa were observed to document the means of replacing expansion joints that were beyond repair, as well as, to identify bottlenecks in the construction process that could be modified to decrease the length of expansion joint replacement projects. After maintenance and replacement strategies had been identified, a workshop was held at the Iowa State Institute for Transportation to develop ideas to better maintain and replace expansion joints. Maintenance strategies were included in the discussion as a way to extend the useful life of a joint, thus decreasing the number of joints replaced in a year and reducing the traffic disruptions.

Transverse Joint Sealing with Various Sealants, HR-203, 1983

Iowa's first portland cement concrete pavement was constructed in 1904 in the City of LeMars. A portion of that pavement served traffic until 1974 at which time it was resurfaced. The first rural Iowa pee pavement (16' wide, 6" to 7" thick) was constructed under the direction of the Iowa State Highway Commission in 1913. Some of Iowa's early pavements had transverse joints at 25-foot spacings. At that time, joint spacings across the nation ranged from 24 to 100 ft. There have been many changes in joint design over the years with some pavements being constructed without transverse joints. Joint spacing on Iowa primary pavements has generally remained around 20 feet with this spacing having been adopted as an Iowa standard in 1954. Until 1978 it was common to specify a 40-foot joint spacing on secondary pavements. The performance of the pavements with joint spacings greater than 20 feet, and in some cases no contraction joints, generated a 1955 research project on joint spacing. This project was 16 miles long containing sections without contraction joints and sections with joints sawed at intervals of 20, 50 and 80 feet. Approximately half of the sawed joints were left unsealed. The results of this research supported the 20-foot spacing, but were inconclusive regarding the benefits of sealing. One of the desired characteristics of joint sealing material is that it should act as a moisture barrier and prevent the intrusion of surface water. It was generally accepted from past experience that the hot poured type joint seals did not provide this effective moisture barrier.

Evaluation of the Need for Longitudinal Median Joints in Bridge Decks on Dual Structures, TR-661, 2015

The primary objective of this project was to determine the effect of bridge width on deck cracking in bridges. Other parameters, such as bridge skew, girder spacing and type, abutment type, pier type, and number of bridge spans, were also studied. To achieve the above objectives, one bridge was selected for live-load and long-term testing. The data obtained from both field tests were used to calibrate a three-dimensional (3D) finite element model (FEM). Three different types of loading—live loading, thermal loading, and shrinkage loading—were applied. The predicted crack pattern from the FEM was compared to the crack pattern from bridge inspection results. A parametric study was conducted using the calibrated FEM. The general conclusions/recommendations are as follows: -- Longitudinal and diagonal cracking in the deck near the abutment on an integral abutment bridge is due to the temperature differences between the abutment and the deck. Although not likely to induce cracking, shrinkage of the deck concrete may further exacerbate cracks developed from thermal effects. -- Based upon a limited review of bridges in the Iowa DOT inventory, it appears that, regardless of bridge width, longitudinal and diagonal cracks are prevalent in integral abutment bridges but not in bridges with stub abutments. -- The parametric study results show that bridge width and skew have minimal effect on the strain in the deck bridge resulting from restrained thermal expansion. -- Pier type, girder type, girder spacing, and number of spans also appear to have no influence on the level of restrained thermal expansion strain in the deck near the abutment.

Fatigue Analysis of Welded Cruciform Joints with Cold Laps

Työssä on tutkittu vetojännityskuormituksen alaisena olevien hitsattujen kuormaa kantamattomien X-liitosten hitsin paikallisen geometrian variaation vaikutusta väsymislujuuteen. Muuttujina olivat reunan pyöristyssäde, kylmäjuoksun suuruus ja kylkikulma. Geometristen muuttujien parametrinen riippuvuussuhde on analysoitu usealla elementtimallilla. Väsymistarkastelu on suoritettu käyttämällä lineaaris-elastista murtumismekaniikkaa (LEFM) tasovenymätilassa ja materiaalina terästä. Särönkasvun suunnan ennustamisessaon käytetty maksimipääjännityskriteeriä sekä jännitysintensiteettikertoimet on määritetty J-integraalilla. Särön ydintymisvaihetta ei ole otettu huomioon. Rakenteen on oletettu olevan hitsatussa tilassa ja jännitysheilahdus on kokonaan tehollinen. Särön kasvunopeuden ennustamiseen on käytetty Paris'n lakia. Väsymislujuustulokset on esitetty karakteristisina väsymisluokkina (FAT) ja sovitettu parametriseksi yhtälöksi. Lopuksi väsymisanalyysin ennustamia tuloksia on verrattu saatavilla oleviin väsytystestituloksiin.

Multivariable regression analysis and hot-spot stress approach into fatigue life estimations of welded joints

Kolmen eri hitsausliitoksen väsymisikä arvio on analysoitu monimuuttuja regressio analyysin avulla. Regression perustana on laaja S-N tietokanta joka on kerätty kirjallisuudesta. Tarkastellut liitokset ovat tasalevy liitos, krusiformi liitos ja pitkittäisripa levyssä. Muuttujina ovat jännitysvaihtelu, kuormitetun levyn paksuus ja kuormitus tapa. Paksuus effekti on käsitelty uudelleen kaikkia kolmea liitosta ajatellen. Uudelleen käsittelyn avulla on varmistettu paksuus effektin olemassa olo ennen monimuuttuja regressioon siirtymistä. Lineaariset väsymisikä yhtalöt on ajettu kolmelle hitsausliitokselle ottaen huomioon kuormitetun levyn paksuus sekä kuormitus tapa. Väsymisikä yhtalöitä on verrattu ja keskusteltu testitulosten valossa, jotka on kerätty kirjallisuudesta. Neljä tutkimustaon tehty kerättyjen väsymistestien joukosta ja erilaisia väsymisikä arvio metodeja on käytetty väsymisiän arviointiin. Tuloksia on tarkasteltu ja niistä keskusteltu oikeiden testien valossa. Tutkimuksissa on katsottu 2mm ja 6mm symmetristäpitkittäisripaa levyssä, 12.7mm epäsymmetristä pitkittäisripaa, 38mm symmetristä pitkittäisripaa vääntökuormituksessa ja 25mm/38mm kuorman kantavaa krusiformi liitosta vääntökuormituksessa. Mallinnus on tehty niin lähelle testi liitosta kuin mahdollista. Väsymisikä arviointi metodit sisältävät hot-spot metodin jossa hot-spot jännitys on laskettu kahta lineaarista ja epälineaarista ekstrapolointiakäyttäen sekä paksuuden läpi integrointia käyttäen. Lovijännitys ja murtumismekaniikka metodeja on käytetty krusiformi liitosta laskiessa.