Improvement of cardiovascular risk prediction: time to review current knowledge, debates, and fundamentals on how to assess test characteristics.

Cardiovascular risk assessment might be improved with the addition of emerging, new tests derived from atherosclerosis imaging, laboratory tests or functional tests. This article reviews relative risk, odds ratios, receiver-operating curves, posttest risk calculations based on likelihood ratios, the net reclassification improvement and integrated discrimination. This serves to determine whether a new test has an added clinical value on top of conventional risk testing and how this can be verified statistically. Two clinically meaningful examples serve to illustrate novel approaches. This work serves as a review and basic work for the development of new guidelines on cardiovascular risk prediction, taking into account emerging tests, to be proposed by members of the 'Taskforce on Vascular Risk Prediction' under the auspices of the Working Group 'Swiss Atherosclerosis' of the Swiss Society of Cardiology in the future.

Fly Ash Concrete Compressive Strength and Freeze-Thaw Durability, MLR-81-06, 1981

The current study investigated the effect of fly ash class, source and amount on the compressive strength and freeze-thaw durability of fly ash concrete. Concrete aggregates of varying quality were also included as test variables. The current results and those obtained from previous laboratory and field work indicate that compressive strength can·be affected by fly ash class, source and amount while aggregate quality is shown to have no effect on strength. Freeze-thaw durability of fly ash concrete is strongly affected by aggregate quality and to a lesser degree by fly ash class, amount and source.

Rapid, simple and high yield production of recombinant proteins in mammalian cells using a versatile episomal system.

Many research projects in life sciences require purified biologically active recombinant protein. In addition, different formats of a given protein may be needed at different steps of experimental studies. Thus, the number of protein variants to be expressed and purified in short periods of time can expand very quickly. We have therefore developed a rapid and flexible expression system based on described episomal vector replication to generate semi-stable cell pools that secrete recombinant proteins. We cultured these pools in serum-containing medium to avoid time-consuming adaptation of cells to serum-free conditions, maintain cell viability and reuse the cultures for multiple rounds of protein production. As such, an efficient single step affinity process to purify recombinant proteins from serum-containing medium was optimized. Furthermore, a series of multi-cistronic vectors were designed to enable simultaneous expression of proteins and their biotinylation in vivo as well as fast selection of protein-expressing cell pools. Combining these improved procedures and innovative steps, exemplified with seven cytokines and cytokine receptors, we were able to produce biologically active recombinant endotoxin free protein at the milligram scale in 4-6weeks from molecular cloning to protein purification.

Evaluation of Control Structures for Stabilizing Degrading Stream Channels in Western Iowa, Phases II and III, HR-208A, 1985

Since the turn of the century, tributaries to the Missouri River in western Iowa have entrenched their channels to as much as six times their original depth. This channel degradation is accompanied by widening as the channel side slopes become unstable and landslides occur. The deepening and widening of these streams have endangered about 25% of the highway bridges in 13 counties [Lohnes et al. 1980]. Grade stabilization structures have been recommended as the most effective remedial measure for stream degradation [Brice et al., 1978]. In western Iowa, within the last seven years, reinforced concrete grade stabilization structures have cost between $300,000 and $1,200,000. Recognizing that the high cost of these structures may be prohibitive in many situations, the Iowa Department of Transportation (Iowa DOT) sponsored a study at Iowa State University (ISU) to find low-cost alternative structures. This was Phase I of the stream degradation study. Analytical and laboratory work led to the conclusion that alternative construction materials such as gabions and soil-cement might result in more economical structures [Lohnes et al. 1980]. The ISU study also recommended that six experimental structures be built and their performance evaluated. Phase II involved the design of the demonstration structures, and Phase III included monitoring and evaluating their performance.

Allergy to betalactam antibiotics in children: results of a 20-year study based on clinical history, skin and challenge tests.

To cite this article: Ponvert C, Perrin Y, Bados-Albiero A, Le Bourgeois M, Karila C, Delacourt C, Scheinmann P, De Blic J. Allergy to betalactam antibiotics in children: results of a 20-year study based on clinical history, skin and challenge tests. Pediatr Allergy Immunol 2011; 22: 411-418. ABSTRACT: Studies based on skin and challenge tests have shown that 12-60% of children with suspected betalactam hypersensitivity were allergic to betalactams. Responses in skin and challenge tests were studied in 1865 children with suspected betalactam allergy (i) to confirm or rule out the suspected diagnosis; (ii) to evaluate diagnostic value of immediate and non-immediate responses in skin and challenge tests; (iii) to determine frequency of betalactam allergy in those children, and (iv) to determine potential risk factors for betalactam allergy. The work-up was completed in 1431 children, of whom 227 (15.9%) were diagnosed allergic to betalactams. Betalactam hypersensitivity was diagnosed in 50 of the 162 (30.9%) children reporting immediate reactions and in 177 of the 1087 (16.7%) children reporting non-immediate reactions (p < 0.001). The likelihood of betalactam hypersensitivity was also significantly higher in children reporting anaphylaxis, serum sickness-like reactions, and (potentially) severe skin reactions such as acute generalized exanthematic pustulosis, Stevens-Johnson syndrome, and drug reaction with systemic symptoms than in other children (p < 0.001). Skin tests diagnosed 86% of immediate and 31.6% of non-immediate sensitizations. Cross-reactivity and/or cosensitization among betalactams was diagnosed in 76% and 14.7% of the children with immediate and non-immediate hypersensitivity, respectively. The number of children diagnosed allergic to betalactams decreased with time between the reaction and the work-up, probably because the majority of children with severe and worrying reactions were referred for allergological work-up more promptly than the other children. Sex, age, and atopy were not risk factors for betalactam hypersensitivity. In conclusion, we confirm in numerous children that (i) only a few children with suspected betalactam hypersensitivity are allergic to betalactams; (ii) the likelihood of betalactam allergy increases with earliness and/or severity of the reactions; (iii) although non-immediate-reading skin tests (intradermal and patch tests) may diagnose non-immediate sensitizations in children with non-immediate reactions to betalactams (maculopapular rashes and potentially severe skin reactions especially), the diagnostic value of non-immediate-reading skin tests is far lower than the diagnostic value of immediate-reading skin tests, most non-immediate sensitizations to betalactams being diagnosed by means of challenge tests; (iv) cross-reactivity and/or cosensitizations among betalactams are much more frequent in children reporting immediate and/or anaphylactic reactions than in the other children; (v) age, sex and personal atopy are not significant risk factors for betalactam hypersensitivity; and (vi) the number of children with diagnosed allergy to betalactams (of the immediate-type hypersensitivity especially) decreases with time between the reaction and allergological work-up. Finally, based on our experience, we also propose a practical diagnostic approach in children with suspected betalactam hypersensitivity.

Development of MASH TL-3 Transition Between Guardrail and Portable Concrete Barriers, TPF-5(081), 2014

Often, road construction causes the need to create a work zone. In these scenarios, portable concrete barriers (PCBs) are typically installed to shield workers and equipment from errant vehicles as well as prevent motorists from striking other roadside hazards. For an existing W-beam guardrail system installed adjacent to the roadway and near the work zone, guardrail sections are removed in order to place the portable concrete barrier system. The focus of this research study was to develop a proper stiffness transition between W-beam guardrail and portable concrete barrier systems. This research effort was accomplished through development and refinement of design concepts using computer simulation with LS-DYNA. Several design concepts were simulated, and design metrics were used to evaluate and refine each concept. These concepts were then analyzed and ranked based on feasibility, likelihood of success, and ease of installation. The rankings were presented to the Technical Advisory Committee (TAC) for selection of a preferred design alternative. Next, a Critical Impact Point (CIP) study was conducted, while additional analyses were performed to determine the critical attachment location and a reduced installation length for the portable concrete barriers. Finally, an additional simulation effort was conducted in order to evaluate the safety performance of the transition system under reverse-direction impact scenarios as well as to select the CIP. Recommendations were also provided for conducting a Phase II study and evaluating the nested Midwest Guardrail System (MGS) configuration using three Test Level 3 (TL-3) full-scale crash tests according to the criteria provided in the Manual for Assessing Safety Hardware, as published by the American Association of Safety Highway and Transportation Officials (AASHTO).

Optimization of Snow Drifting Mitigation and Control Methods for Iowa Conditions Part II, TR-626, 2015

Blowing and drifting of snow is a major concern for transportation efficiency and road safety in regions where their development is common. One common way to mitigate snow drift on roadways is to install plastic snow fences. Correct design of snow fences is critical for road safety and maintaining the roads open during winter in the US Midwest and other states affected by large snow events during the winter season and to maintain costs related to accumulation of snow on the roads and repair of roads to minimum levels. Of critical importance for road safety is the protection against snow drifting in regions with narrow rights of way, where standard fences cannot be deployed at the recommended distance from the road. Designing snow fences requires sound engineering judgment and a thorough evaluation of the potential for snow blowing and drifting at the construction site. The evaluation includes site-specific design parameters typically obtained with semi-empirical relations characterizing the local transport conditions. Among the critical parameters involved in fence design and assessment of their post-construction efficiency is the quantification of the snow accumulation at fence sites. The present study proposes a joint experimental and numerical approach to monitor snow deposits around snow fences, quantitatively estimate snow deposits in the field, asses the efficiency and improve the design of snow fences. Snow deposit profiles were mapped using GPS based real-time kinematic surveys (RTK) conducted at the monitored field site during and after snow storms. The monitored site allowed testing different snow fence designs under close to identical conditions over four winter seasons. The study also discusses the detailed monitoring system and analysis of weather forecast and meteorological conditions at the monitored sites. A main goal of the present study was to assess the performance of lightweight plastic snow fences with a lower porosity than the typical 50% porosity used in standard designs of such fences. The field data collected during the first winter was used to identify the best design for snow fences with a porosity of 50%. Flow fields obtained from numerical simulations showed that the fence design that worked the best during the first winter induced the formation of an elongated area of small velocity magnitude close to the ground. This information was used to identify other candidates for optimum design of fences with a lower porosity. Two of the designs with a fence porosity of 30% that were found to perform well based on results of numerical simulations were tested in the field during the second winter along with the best performing design for fences with a porosity of 50%. Field data showed that the length of the snow deposit away from the fence was reduced by about 30% for the two proposed lower-porosity (30%) fence designs compared to the best design identified for fences with a porosity of 50%. Moreover, one of the lower-porosity designs tested in the field showed no significant snow deposition within the bottom gap region beneath the fence. Thus, a major outcome of this study is to recommend using plastic snow fences with a porosity of 30%. It is expected that this lower-porosity design will continue to work well for even more severe snow events or for successive snow events occurring during the same winter. The approach advocated in the present study allowed making general recommendations for optimizing the design of lower-porosity plastic snow fences. This approach can be extended to improve the design of other types of snow fences. Some preliminary work for living snow fences is also discussed. Another major contribution of this study is to propose, develop protocols and test a novel technique based on close range photogrammetry (CRP) to quantify the snow deposits trapped snow fences. As image data can be acquired continuously, the time evolution of the volume of snow retained by a snow fence during a storm or during a whole winter season can, in principle, be obtained. Moreover, CRP is a non-intrusive method that eliminates the need to perform man-made measurements during the storms, which are difficult and sometimes dangerous to perform. Presently, there is lots of empiricism in the design of snow fences due to lack of data on fence storage capacity on how snow deposits change with the fence design and snow storm characteristics and in the estimation of the main parameters used by the state DOTs to design snow fences at a given site. The availability of such information from CRP measurements should provide critical data for the evaluation of the performance of a certain snow fence design that is tested by the IDOT. As part of the present study, the novel CRP method is tested at several sites. The present study also discusses some attempts and preliminary work to determine the snow relocation coefficient which is one of the main variables that has to be estimated by IDOT engineers when using the standard snow fence design software (Snow Drift Profiler, Tabler, 2006). Our analysis showed that standard empirical formulas did not produce reasonable values when applied at the Iowa test sites monitored as part of the present study and that simple methods to estimate this variable are not reliable. The present study makes recommendations for the development of a new methodology based on Large Scale Particle Image Velocimetry that can directly measure the snow drift fluxes and the amount of snow relocated by the fence.

Concrete Pavement Mixture Design and Analysis (MDA): An Innovative Approach To Proportioning Concrete Mixtures, TPF-5(205), 2015

Mixture proportioning is routinely a matter of using a recipe based on a previously produced concrete, rather than adjusting the proportions based on the needs of the mixture and the locally available materials. As budgets grow tighter and increasing attention is being paid to sustainability metrics, greater attention is beginning to be focused on making mixtures that are more efficient in their usage of materials yet do not compromise engineering performance. Therefore, a performance-based mixture proportioning method is needed to provide the desired concrete properties for a given project specification. The proposed method should be user friendly, easy to apply in practice, and flexible in terms of allowing a wide range of material selection. The objective of this study is to further develop an innovative performance-based mixture proportioning method by analyzing the relationships between the selected mix characteristics and their corresponding effects on tested properties. The proposed method will provide step-by-step instructions to guide the selection of required aggregate and paste systems based on the performance requirements. Although the provided guidance in this report is primarily for concrete pavements, the same approach can be applied to other concrete applications as well.

The Effects of Headcut and Knickpoint Propagation on Bridges in Iowa, TR-541, 2008

The overarching goal of the proposed research was to provide a predictive tool for knickpoint propagation within the HCA (Hungry Canyon Alliance) territory. Knickpoints threaten the stability of bridge structures in Western Iowa. The study involved detailed field investigations over two years in order to monitor the upstream migration of a knickpoint on Mud Creek in Mills County, IA and identify the key mechanisms triggering knickpoint propagation. A state-of-the-art laser level system mounted on a movable truss provided continuous measurements of the knickpoint front for different flow conditions. A pressure transducer found in proximity of the truss provided simultaneous measurements of the flow depth. The laser and pressure transducer measurements led to the identification of the conditions at which the knickpoint migration commences. It was suggested that negative pressures developed by the reverse roller flow near the toe of the knickpoint face triggered undercutting of the knickpoint at this location. The pressure differential between the negative pressure and the atmospheric pressure also draws the impinging jet closer to the knickpoint face producing scour. In addition, the pressure differential may induce suction of sediment from the face. Other contributing factors include slump failure, seepage effects, and local fluvial erosion due to the exerted fluid shear. The prevailing flow conditions and soil information along with the channel cross-sectional geometry and gradient were used as inputs to a transcritical, one dimensional, hydraulic/geomorphic numerical model, which was used to map the flow characteristics and shear stress conditions near the knickpoint. Such detailed flow calculations do not exist in the published literature. The coupling of field and modeling work resulted in the development of a blueprint methodology, which can be adopted in different parts of the country for evaluating knickpoint evolution. This information will assist local government agencies in better understanding the principal factors that cause knickpoint propagation and help estimate the needed response time to control the propagation of a knickpoint after one has been identified.

Review of Inconsistencies Between SUDAS and Iowa DOT Specifications Phase III: Continued Implementation of Recommendations into SUDAS Specifications, TR-607, 2010

The objective of the Phase 3 project was to re-write the identified sections of the SUDAS specifications into the imperative mood, consistent with the format utilized during the Phase 2 project and other work completed by SUDAS staff. Figures for the identified sections were updated to match the new SUDAS format, similar to the Iowa DOT Standard Road Plans. While the Iowa DOT does not intend to incorporate all of the following sections into their specification book, consistency with the Iowa DOT specifications was strived for wherever possible. Maintaining consistency between the specifications simplifies design, bidding, and construction.

Reflective Crack Mitigation Guide for Flexible Pavements, TR-641, 2015

Reflective cracks form in pavements when hot-mix asphalt (HMA) overlays are placed over jointed and/or severely cracked rigid and flexible pavements. In the first part of the research, survival analysis was conducted to identify the most appropriate rehabilitation method for composite pavements and to evaluate the influence of different factors on reflective crack development. Four rehabilitation methods, including mill and fill, overlay, heater scarification (SCR), and rubblization, were analyzed using three performance indicators: reflective cracking, international roughness index (IRI), and pavement condition index (PCI). It was found that rubblization can significantly retard reflective cracking development compared to the other three methods. No significant difference for PCI was seen among the four rehabilitation methods. Heater scarification showed the lowest survival probability for both reflective cracking and IRI, while an overlay resulted in the poorest overall pavement condition based on PCI. In addition, traffic level was found not to be a significant factor for reflective cracking development. An increase in overlay thickness can significantly delay the propagation of reflective cracking for all four treatments. Soil types in rubblization pavement sites were assessed, and no close relationship was found between rubblized pavement performance and subgrade soil condition. In the second part of the research, the study objective was to evaluate the modulus and performance of four reflective cracking treatments: full rubblization, modified rubblization, crack and seat, and rock interlayer. A total of 16 pavement sites were tested by the surface wave method (SWM), and in the first four sites both falling weight deflectometer (FWD) and SWM were conducted for a preliminary analysis. The SWM gave close concrete layer moduli compared to the FWD moduli on a conventional composite pavement. However, the SWM provided higher moduli for the rubblized concrete layer. After the preliminary analysis, another 12 pavement sites were tested by the SWM. The results showed that the crack and seat method provided the highest moduli, followed by the modified rubblization method. The full rubblization and the rock interlayer methods gave similar, but lower, moduli. Pavement performance surveys were also conducted during the field study. In general, none of the pavement sites had rutting problems. The conventional composite pavement site had the largest amount of reflective cracking. A moderate amount of reflective cracking was observed for the two pavement sites with full rubblization. Pavements with the rock interlayer and modified rubblization treatments had much less reflective cracking. It is recommended that use of the modified rubblization and rock interlayer treatments for reflective cracking mitigation are best.

Statewide Work-Based Learning Intermediary Network, FY2014, November 26, 2014

The Iowa Department of Education (DE) was appropriated $1.45 million for the development and implementation of a statewide work-based learning intermediary network. This funding was awarded on a competitive basis to 15 regional intermediary networks. Funds received by the regional intermediary networks from the state through this grant are to be used to develop and expand work-based learning opportunities within each region. A match of resources equal to 25 percent was a requirement of the funding. This match could include private donations, in-kind contributions, or public moneys. Funds may be used to support personnel responsible for the implementation of the intermediary network program components.

Evaluation of Work Zone Speed Reduction Measures, 2000

The Iowa Department of Transportation (DOT) has made improving work zone (WZ) safety a high priority. Managing vehicle speeds through work zones is perceived to be an important factor in achieving this goal. A number of speed reduction techniques are currently used by transportation agencies throughout the country to control speeds and reduce speed variation at work zones. The purpose of this project is to study these and other applicable work zone speed reduction strategies. Furthermore, this research explores transportation agencies' policies regarding managing speeds in long-term, short-term, and moving work zones. This report consists of three chapters. The first chapter, a literature review, examines the current speed reduction practices at work zones and provides a review of the relevant literature. The speed control strategies reviewed in this chapter range from posting regulatory and advisory speed limit signs to using the latest radar technologies to reduce speeds at work zones. The second chapter includes a short write-up for each identified speed control technique. The write-up includes a description, the results of any field tests, the benefits and the costs of the technology or technique. To learn more about other state policies regarding work zone speed reduction and management, the Center for Transportation Research and Education conducted a survey. The survey consists of six multipart questions. The third chapter provides summaries of the response to each question.

Work Zone Simulation Model, 1999

To support the analysis of driver behavior at rural freeway work zone lane closure merge points, Center for Transportation Research and Education staff collected traffic data at merge areas using video image processing technology. The collection of data and the calculation of the capacity of lane closures are reported in a companion report, "Traffic Management Strategies for Merge Areas in Rural Interstate Work Zones". These data are used in the work reported in this document and are used to calibrate a microscopic simulation model of a typical, Iowa rural freeway lane closure. The model developed is a high fidelity computer simulation with an animation interface. It simulates traffic operations at a work zone lane closure. This model enables traffic engineers to visually demonstrate the forecasted delay that is likely to result when freeway reconstruction makes it necessary to close freeway lanes. Further, the model is also sensitive to variations in driver behavior and is used to test the impact of slow moving vehicles and other driver behaviors. This report consists of two parts. The first part describes the development of the work zone simulation model. The simulation analysis is calibrated and verified through data collected at a work zone in Interstate Highway 80 in Scott County, Iowa. The second part is a user's manual for the simulation model, which is provided to assist users with its set up and operation. No prior computer programming skills are required to use the simulation model.

Traffic Management Strategies for Merge Area in Rural Interstate Work Zones, CTRE 97-12, 1999

The Iowa Department of Transportation, like many other state transportation agencies, is experiencing growing congestion and traffic delays in work zones on rural interstate highways. The congestion results in unproductive and wasteful delays for both motorists and commercial vehicles. It also results in hazardous conditions where vehicle stopped in queues on rural interstate highways are being approached by vehicles upstream at very high speeds. The delays also result in driver frustration, making some drivers willing to take unsafe risks in an effort to bypass delays. To reduce the safety hazards and unproductive delays of congested rural interstate work zones, the Iowa Department of Transportation would like to improve its traffic management strategies at these locations. Applying better management practices requires knowledge of the traffic flow properties and driver behavior in and around work zones, and knowledge of possible management strategies. The project reported here and in a companion report documents research which seeks to better understand traffic flow behavior at rural interstate highway work zones and to estimate the traffic carrying capacity of work zone lane closures. In addition, this document also reports on technology available to better manage traffic in and around work zones.