private function doInstitution(Institution $institution, $em)
 {
     //$this->output->write("Institution #{$institution->getId()}");
     $oldState = \trim($institution->getStateBak());
     if ($oldState == '') {
         //$this->output->writeln('[No old state]');
         return;
     }
     $country = $institution->getCountry();
     // find a state with the same name for this country in chromedia_global
     $connection = $this->doctrine->getConnection();
     $sql = "SELECT gs.* FROM `chromedia_global`.`geo_states` gs WHERE `name` LIKE :state AND `geo_country_id` = :geoCountryId";
     $statement = $connection->prepare($sql);
     $statement->bindValue('state', $oldState);
     $statement->bindValue('geoCountryId', $country->getId());
     $statement->execute();
     if (!($rowCount = $statement->rowCount())) {
         //$this->output->writeln('[No matching state]');
         $this->nonMatchingInstitutions[] = $institution;
         return;
     } else {
         if ($rowCount == 1) {
             $globalStateData = $statement->fetch();
             $hcaState = $this->getHcaState($globalStateData, $country);
             $institution->setState($hcaState);
             $em->persist($institution);
             //$this->output->writeln("[Set to {$hcaState->getName()} ]");
         } else {
             if (strtolower($oldState) == 'singapore') {
                 // manual for singapore
                 while ($globalStateData = $statement->fetch()) {
                     if ($globalStateData['id'] == 2732) {
                         $hcaState = $this->getHcaState($globalStateData, $country);
                         $institution->setState($hcaState);
                         $em->persist($institution);
                         //$this->output->writeln("[Set to {$hcaState->getName()} ]");
                         break;
                     }
                 }
             } else {
                 $this->nonUniqueStates[] = array('country_id' => $country->getId(), 'state' => $oldState);
                 //$this->output->writeln("[Non unique state {$oldState}]");
                 $this->nonMatchingInstitutions[] = $institution;
             }
         }
     }
 }