Iowa EHDI News, Fall 2010

The purpose of the newsletter is to communicate with parents and professionals about newborn hearing screening and follow up in Iowa. We will share information about: Hearing screenings Early intervention, including communication opportunities Resources available for parents and professionals “Best practices” by hospitals, Area Education Agencies (AEAs), private practice audiology offi ces or other health and education providers working with children who are deaf or hard of hearing National research Iowa EHDI program goals EHDI program progress, system development, evaluation Family stories Highlights from the EHDI Advisory Committee

Iowa EHDI News, Fall 2011

The purpose of the newsletter is to communicate with parents and professionals about newborn hearing screening and follow up in Iowa. We will share information about: Hearing screenings Early intervention, including communication opportunities Resources available for parents and professionals “Best practices” by hospitals, Area Education Agencies (AEAs), private practice audiology offi ces or other health and education providers working with children who are deaf or hard of hearing National research Iowa EHDI program goals EHDI program progress, system development, evaluation Family stories Highlights from the EHDI Advisory Committee

Iowa EHDI News, Spring 2010

The purpose of the newsletter is to communicate with parents and professionals about newborn hearing screening and follow up in Iowa. We will share information about: Hearing screenings Early intervention, including communication opportunities Resources available for parents and professionals “Best practices” by hospitals, Area Education Agencies (AEAs), private practice audiology offi ces or other health and education providers working with children who are deaf or hard of hearing National research Iowa EHDI program goals EHDI program progress, system development, evaluation Family stories Highlights from the EHDI Advisory Committee

Iowa EHDI News, Spring 2011

The purpose of the newsletter is to communicate with parents and professionals about newborn hearing screening and follow up in Iowa. We will share information about: Hearing screenings Early intervention, including communication opportunities Resources available for parents and professionals “Best practices” by hospitals, Area Education Agencies (AEAs), private practice audiology offi ces or other health and education providers working with children who are deaf or hard of hearing National research Iowa EHDI program goals EHDI program progress, system development, evaluation Family stories Highlights from the EHDI Advisory Committee

Iowa EHDI News, Summer 2009

The purpose of the newsletter is to communicate with parents and professionals about newborn hearing screening and follow up in Iowa. We will share information about: Hearing screenings Early intervention, including communication opportunities Resources available for parents and professionals “Best practices” by hospitals, Area Education Agencies (AEAs), private practice audiology offi ces or other health and education providers working with children who are deaf or hard of hearing National research Iowa EHDI program goals EHDI program progress, system development, evaluation Family stories Highlights from the EHDI Advisory Committee

Iowa EHDI News, Summer 2010

The purpose of the newsletter is to communicate with parents and professionals about newborn hearing screening and follow up in Iowa. We will share information about: Hearing screenings Early intervention, including communication opportunities Resources available for parents and professionals “Best practices” by hospitals, Area Education Agencies (AEAs), private practice audiology offi ces or other health and education providers working with children who are deaf or hard of hearing National research Iowa EHDI program goals EHDI program progress, system development, evaluation Family stories Highlights from the EHDI Advisory Committee

Iowa EHDI News, Summer 2011

The purpose of the newsletter is to communicate with parents and professionals about newborn hearing screening and follow up in Iowa. We will share information about: Hearing screenings Early intervention, including communication opportunities Resources available for parents and professionals “Best practices” by hospitals, Area Education Agencies (AEAs), private practice audiology offi ces or other health and education providers working with children who are deaf or hard of hearing National research Iowa EHDI program goals EHDI program progress, system development, evaluation Family stories Highlights from the EHDI Advisory Committee

Iowa EHDI News, Winter 2009

The purpose of the newsletter is to communicate with parents and professionals about newborn hearing screening and follow up in Iowa. We will share information about: Hearing screenings Early intervention, including communication opportunities Resources available for parents and professionals “Best practices” by hospitals, Area Education Agencies (AEAs), private practice audiology offi ces or other health and education providers working with children who are deaf or hard of hearing National research Iowa EHDI program goals EHDI program progress, system development, evaluation Family stories Highlights from the EHDI Advisory Committee

Iowa EHDI News, Winter 2010

The purpose of the newsletter is to communicate with parents and professionals about newborn hearing screening and follow up in Iowa. We will share information about: Hearing screenings Early intervention, including communication opportunities Resources available for parents and professionals “Best practices” by hospitals, Area Education Agencies (AEAs), private practice audiology offi ces or other health and education providers working with children who are deaf or hard of hearing National research Iowa EHDI program goals EHDI program progress, system development, evaluation Family stories Highlights from the EHDI Advisory Committee

Maintenance Asset Management Project -- Phase II, July 31, 2013

Expanded abstract: Iowa Department of Transportation (IA DOT) is finalizing research to streamline field inventory/inspection of culverts by Maintenance and Construction staff while maximizing the use of tablet technologies. The project began in 2011 to develop some new best practices for field staff to assist in the inventory, inspection and maintenance of assets along the roadway. The team has spent the past year working through the complexities of identifying the most appropriate tablet hardware for field data collection. A small scale deployment of tablets occurred in spring of 2013 to collect several safety related assets (culverts, signs, guardrail, and incidents). Data can be collected in disconnected or connected modes and there is an associated desktop environment where data can be viewed and queried after being synced into the master database. The development of a deployment plan and related workflow processes are underway; which will eventually feed information into IA DOTs larger asset management system and make the information available for decision making. The team is also working with the IA DOT Design Office on Computer Aided Drafting (CAD) data processing and the IA DOT Construction office with a new digital As-Built plan process to leverage the complete data life-cycle so information can be developed once and leveraged by the Maintenance staff farther along in the process.

Acute life-threatening extrinsic allergic alveolitis in a paint controller.

BACKGROUND: Occupational diisocyanate-induced extrinsic allergic alveolitis (EAA) is a rare and probably underestimated diagnosis. Two acute occupational EAA cases have been described in this context, but neither of them concerned hexamethylene diisocyanate (HDI) exposure. AIMS: To investigate the cause of a life-threatening EAA arising at work in a healthy 30-year-old female paint quality controller. METHODS: Occupational medical assessment, workplace evaluation, airborne and biological monitoring and immunodermatological tests. RESULTS: Diagnosis of EAA relied on congruent clinical and radiological information, confirmed occupational HDI exposure and positive IgG antibodies and patch tests. The patient worked in a small laboratory for 7 years, only occasionally using HDI-containing hardeners. While working with HDI for 6 h, she developed breathlessness, rapidly progressing to severe respiratory failure. Workplace HDI airborne exposure values ranged from undetectable levels to 4.25 p.p.b. Biological monitoring of urinary hexamethylene diamine in co-workers ranged from <1.0 to 15.4 μg/g creatinine. Patch tests 8 months later showed delayed skin reaction to HDI at 48 h. Subsequent skin biopsy showed spongiotic dermatitis with infiltration of CD4(+) and CD8(+) T cells. CONCLUSIONS: We believe this is the first reported case of acute life-threatening EAA following exposure to HDI. Low concentrations of airborne HDI and relatively high urinary hexamethylene diamine suggest significant skin absorption of HDI could have significantly contributed to the development of this acute occupational EAA.

The Iowa State Capitol Fire 1904, November 2012

The twenty-first century Iowa State Capitol contains state-of-the-art fire protection. Sprinklers and smoke detectors are located in every room and all public hallways are equipped with nearby hydrants. The Des Moines Fire Department is able to fight fires at nearly any height. However, on Monday morning, January 4, 1904, the circumstances were much different. By the beginning of 1904, the Capitol Improvement Commission had been working in the Capitol for about two years. The commissioners were in charge of decorating the public areas of the building, installing the artwork in the public areas, installing a new copper roof, re-gilding the dome, replacing windows, and connecting electrical lines throughout. Electrician H. Frazer had been working that morning in Committee Room Number Five behind the House Chamber, drilling into the walls to run electrical wires and using a candle to light his way. The investigating committee determined that Frazer had left his work area and had neglected to extinguish his candle. The initial fire alarm sounded at approximately 10 a.m. Many citizen volunteers came to help the fire department. Capitol employees and state officials also assisted in fighting the fire, including Governor Albert Cummins. The fire was finally brought under control around 6 p.m., although some newspaper accounts at the time reported that the fire continued smoldering for several days. Crampton Linley was the engineer working with the Capitol Improvement Commission. He was in the building at the time of the fire and was credited with saving the building. Linley crawled through attic areas to close doors separating wings of the Capitol, an action which smothered the flames and brought the fire under control. Sadly, Linley did not live long enough to be recognized for his heroism. The day after the fire, while examining the damage, Linley fell through the ceiling of the House Chamber and died instantly from severe head injuries. The flames had burned through the ceiling and caused much of it to collapse to the floor below, while the lower areas of the building had been damaged by smoke and water. Elmer Garnsey was the artist hired by the Capitol Improvement Commission to decorate the public areas of the building. Therefore, he seemed the logical candidate to be given the additional responsibility of redecorating the areas damaged by the fire. Garnsey had a very different vision for the decoration, which is why the House Chamber, the old Supreme Court Room, and the old Agriculture offices directly below the House Chamber have a design that is very different from the areas of the building untouched by the fire.

Fast Geodesic Active Fields for Image Registration Based on Splitting and Augmented Lagrangian Approaches.

In this paper, we present an efficient numerical scheme for the recently introduced geodesic active fields (GAF) framework for geometric image registration. This framework considers the registration task as a weighted minimal surface problem. Hence, the data-term and the regularization-term are combined through multiplication in a single, parametrization invariant and geometric cost functional. The multiplicative coupling provides an intrinsic, spatially varying and data-dependent tuning of the regularization strength, and the parametrization invariance allows working with images of nonflat geometry, generally defined on any smoothly parametrizable manifold. The resulting energy-minimizing flow, however, has poor numerical properties. Here, we provide an efficient numerical scheme that uses a splitting approach; data and regularity terms are optimized over two distinct deformation fields that are constrained to be equal via an augmented Lagrangian approach. Our approach is more flexible than standard Gaussian regularization, since one can interpolate freely between isotropic Gaussian and anisotropic TV-like smoothing. In this paper, we compare the geodesic active fields method with the popular Demons method and three more recent state-of-the-art algorithms: NL-optical flow, MRF image registration, and landmark-enhanced large displacement optical flow. Thus, we can show the advantages of the proposed FastGAF method. It compares favorably against Demons, both in terms of registration speed and quality. Over the range of example applications, it also consistently produces results not far from more dedicated state-of-the-art methods, illustrating the flexibility of the proposed framework.

The Value of the County Engineer: Strategies to Expand the Shrinking Employment Pool, HR-338, 1993

The first phase of this research involved an effort to identify the issues relevant to gaining a better understanding of the County Engineering profession. A related objective was to develop strategies to attract responsible, motivated and committed professionals to pursue County Engineering positions. In an era where a large percentage of County Engineers are reaching retirement age, the shrinking employment pool may eventually jeopardize the quality of secondary road systems not only in Iowa, but nationwide. As we move toward the 21st century, in an era of declining resources, it is likely that professional staff members in charge of secondary roads will find themselves working with less flexible budgets for the construction and maintenance of roads and bridges. It was important to understand the challenges presented to them, and the degree to which those challenges will demand greater expertise in prioritizing resource allocations for the rehabilitation and maintenance of the 10 million miles of county roads nationwide. Only after understanding what a county engineer is and what this person does will it become feasible for the profession to begin "selling itself", i.e., attracting a new generation of County Engineers. Reaching this objective involved examining the responsibilities, goals, and, sometimes, the frustrations experienced by those persons in charge of secondary road systems in the nine states that agreed to participate in the study. The second phase of this research involved addressing ways to counter the problems associated with the exodus of County Engineers who are reaching retirement age. Many of the questions asked of participants asked them to compare the advantages and disadvantages of public sector work with the private sector. Based on interviews with nearly 50 County Engineers and feedback from 268 who returned surveys for the research, issues relevant to the profession were analyzed and recommendations were made to the profession as it prepares to attract a new generation. It was concluded that both State and Regional Associations for County Engineers, and the National Association of County Engineers are most well-situated to present opportunities for continued professional development. This factor is appealing for those who are interested in competitive advantages as professionals. While salaries in the public sector may not be able to effectively compete with those offered by the private sector, it was concluded that this is only one factor of concern to those who are in the business of "public service". It was concluded, however, that Boards of Supervisors and their equivalents in other states will need to more clearly understand the value of the contributions made by County Engineers. Then the selling points the profession can hope to capitalize on can focus on the strength of state organizations and a strong national organization that act as clearinghouses of information and advocates for the profession, as well as anchors that provide opportunities for staying current on issues and technologies.

Carotid sparing in t1-t2 no glottic cancer using helical tomotherapy

Objective: To study the dosimetric properties and clinical implementation of a carotid dose sparing irradiation protocol using helical Tomotherapy in early stage laryngeal cancer.Materials and Methods: We have developed a simple treatment planning algorithm for carotid sparing. We have compared carotid and critical organ doses and planned target volume (PTV) dose with our standard laryngeal irradiation protocol. Dose constraints were the following: maximum point dose to the carotids <35 Gy, to the spinal cord <30 Gy, and PTV was covered at >95% of the prescribed dose (70 Gy in 2 Gy per fraction). A daily megavoltage CT was done to account for patient movement and anatomy modification. To date, 7 patients have been treated with this protocol in our department.Results: Our early results showed a significant reduction in the carotid dose with an average maximum dose of 35.8 Gy. The average maximum spinal cord dose was 25.8 Gy. PTV was covered without important "hot spots". Average maximum dose in the PTV was 74.1 Gy with an average absolute maximum dose of 75.2 Gy. To date, the clinical outcomes have been excellent.Conclusion: Helical Tomotherapy allows a significant decrease of carotid dose without dangerous spinal cord overdose. There was no important overdose in the PTV that can potentially increase the late complication risks. Daily control imaging brings added security especially when working with such high-dose gradients. We think further studies and longer follow-up are needed to investigate the clinical outcomes such as the local control rate and the vascular late toxicities.