Benchmarking therapeutic drug monitoring software: A systematic evaluation of available computer tools

Objectives: Therapeutic drug monitoring (TDM) aims at optimizing treatment by individualizing dosage regimen based on blood concentrations measurement. Maintaining concentrations within a target range requires pharmacokinetic (PK) and clinical capabilities. Bayesian calculation represents a gold standard in TDM approach but requires computing assistance. The aim of this benchmarking was to assess and compare computer tools designed to support TDM clinical activities.¦Methods: Literature and Internet were searched to identify software. Each program was scored against a standardized grid covering pharmacokinetic relevance, user-friendliness, computing aspects, interfacing, and storage. A weighting factor was applied to each criterion of the grid to consider its relative importance. To assess the robustness of the software, six representative clinical vignettes were also processed through all of them.¦Results: 12 software tools were identified, tested and ranked. It represents a comprehensive review of the available software characteristics. Numbers of drugs handled vary from 2 to more than 180, and integration of different population types is available for some programs. Nevertheless, 8 programs offer the ability to add new drug models based on population PK data. 10 computer tools incorporate Bayesian computation to predict dosage regimen (individual parameters are calculated based on population PK models). All of them are able to compute Bayesian a posteriori dosage adaptation based on a blood concentration while 9 are also able to suggest a priori dosage regimen, only based on individual patient covariates. Among those applying Bayesian analysis, MM-USC*PACK uses a non-parametric approach. The top 2 programs emerging from this benchmark are MwPharm and TCIWorks. Others programs evaluated have also a good potential but are less sophisticated or less user-friendly.¦Conclusions: Whereas 2 software packages are ranked at the top of the list, such complex tools would possibly not fit all institutions, and each program must be regarded with respect to individual needs of hospitals or clinicians. Programs should be easy and fast for routine activities, including for non-experienced users. Although interest in TDM tools is growing and efforts were put into it in the last years, there is still room for improvement, especially in terms of institutional information system interfacing, user-friendliness, capability of data storage and automated report generation.

Evaluation of Low Cost Traffic Calming for Rural Communities – Phase II, April 2013

The main goal of the research described in this report was to evaluate countermeasures that agencies can use to reduce speeds as drivers enter rural communities located on high-speed roadways. The objectives of this study were as follows: * Identify and summarize countermeasures used to manage speeds in transition zones * Demonstrate the effectiveness of countermeasures that are practical for high- to low-speed transition zones * Acquire additional information about countermeasures that may show promise but lack sufficient evidence of effectiveness * Develop an application toolbox to assist small communities in selecting appropriate transition zones and effective countermeasures for entrances to small rural communities The team solicited small communities that were interested in participating in the Phase II study and several communities were also recommended. The treatments evaluated were selected by carefully considering traffic-calming treatments that have been used effectively in other countries for small rural communities, as well as the information gained from the first phase of the project. The treatments evaluated are as follows: * Transverse speed bars * Colored entrance treatment * Temporary island * Radar-activated speed limit sign * Speed feedback sign The toolbox publication and four focused tech briefs also cover the results of this work.

Energy Information Report, 2011

In its 2007 Session, the Iowa General Assembly passed, and Governor Culver signed into law, extensive and far-reaching state energy policy legislation. This legislation created the Iowa Office of Energy Independence and the Iowa Power Fund. It also required a report to be issued each year detailing: • The historical use and distribution of energy in Iowa. • The growth rate of energy consumption in Iowa, including rates of growth for each energy source. • A projection of Iowa’s energy needs through the year 2025 at a minimum. • The impact of meeting Iowa’s energy needs on the economy of the state, including the impact of energy production and use on greenhouse gas emissions. • An evaluation of renewable energy sources, including the current and future technological potential for such sources. Much of the energy information for this report has been derived from the on-line resources of the Energy Information Administration (EIA) of the United States Department of Energy (USDOE). The EIA provides policy-independent data, forecasts and analyses on energy production, stored supplies, consumption and prices. For complete, economy-wide information, the most recent data available is for the year 2008. For some energy sectors, more current data is available from EIA and other sources and, when available, such information has been included in this report.

Evaluation of Low Cost Traffic Calming for Rural Communities – Phase II [Updated], TR-630, October, 2013

The main goal of the research described in this report was to evaluate countermeasures that agencies can use to reduce speeds as drivers enter rural communities located on high-speed roadways. The objectives of this study were as follows: * Identify and summarize countermeasures used to manage speeds in transition zones * Demonstrate the effectiveness of countermeasures that are practical for high- to low-speed transition zones * Acquire additional information about countermeasures that may show promise but lack sufficient evidence of effectiveness * Develop an application toolbox to assist small communities in selecting appropriate transition zones and effective countermeasures for entrances to small rural communities The team solicited small communities that were interested in participating in the Phase II study and several communities were also recommended. The treatments evaluated were selected by carefully considering traffic-calming treatments that have been used effectively in other countries for small rural communities, as well as the information gained from the first phase of the project. The treatments evaluated are as follows: * Transverse speed bars * Colored entrance treatment * Temporary island * Radar-activated speed limit sign * Speed feedback sign The toolbox publication and four focused tech briefs also cover the results of this work.

Stream Stabilization in Western Iowa: Structure Evaluation and Design Manual, HR-385, 1998

Stream degradation is the action of deepening the stream bed and widening the banks due to the increasing velocity of water flow. Degradation is pervasive in channeled streams found within the deep to moderately deep loess regions of the central United States. Of all the streams, however, the most severe and widespread entrenchment occurs in western Iowa streams that are tributaries to the Missouri River. In September 1995 the Iowa Department of Transportation awarded a grant to Golden Hills Resource Conservation and Development, Inc. The purpose of the grant, HR-385 "Stream Stabilization in Western Iowa: Structure Evaluation and Design Manual", was to provide an assessment of the effectiveness and costs of various stabilization structures in controlling erosion on channeled streams. A review of literature, a survey of professionals, field observations and an analysis of the data recorded on fifty-two selected structures led to the conclusions presented in the project's publication, Design Manual, Streambed Degradation and Streambank Widening in Western Iowa. Technical standards and specifications for the design and construction of stream channel stabilization structures are included in the manual. Additional information on non-structural measures, monitoring and evaluation of structures, various permit requirements and further resources are also included. Findings of the research project and use and applications of the Design Manual were presented at two workshops in the Loess Hills region. Participants in these workshops included county engineers, private contractors, state and federal agency personnel, elected officials and others. The Design Manual continues to be available through Golden Hills Resource Conservation and Development.

Production and Evaluation of Calcium Magnesium Acetate, HR-243, 1982

Calcium magnesium acetate (CMA) has been identified by Bjorksten Research Laboratories as an environmentally harmless alternative to sodium or calcium chloride for deicing highways. Their study found CMA to be noncorrosive to steel, aluminum and zinc with little or no anticipated environmental impact. When used, it degrades into elements found in abundance in nature. The deicing capabilities were found to be similar to sodium chloride. The neutralized CMA they produced did cause scaling of PC concrete, but they did not expect mildly alkaline CMA to have this effect. In the initial investigation of CMA at the Iowa DOT laboratory, it was found that CMA produced from hydrated lime and acetic acid was a light, fluffy material. It was recognized that a deicer in this form would be difficult to effectively distribute on highways without considerable wind loss. A process was developed to produce CMA in the presence of sand to increase particle weight. In this report the product of this process, which consists of sand particles coated with CMA, is referred to as "CMA deicer". The mixture of salts, calcium magnesium acetate, is referred to as "CMA". The major problems with CMA for deicing are: (1) it is not commercially available, (2) it is expensive with present production methods and (3) there is very little known about how it performs on highways under actual deicing conditions. In view of the potential benefits this material offers, it is highly desirable to find solutions or answers to these problems. This study provides information to advance that effort. The study consisted of four principal tasks which were: 1. Production of CMA Deicer The objective was to further develop the laboratory process for producing CMA deicer on a pilot plant basis and to produce a sufficient quantity for field trials. The original proposal called for producing 20 tons of CMA deicer. 2. Field Evaluation of CMA Deicer The objective was to evaluate the effectiveness of CMA deicer when used under field conditions and obtain information on application procedures. Performance was compared with a regular 50/50 mixture of sand and sodium chloride. 3. Investigation of Effects of CMA on PC Concrete The objective was to determine any scaling effect that mildly alkaline CMA might have on PC concrete. Comparison was made with calcium chloride. 4. Determine Feasibility of Producing High Magnesium CMA The objective was to investigate the possibility of producing a CMA deicer with magnesium acetate content well above that produced from dolomitic lime. A high magnesium acetate content is desirable because pure magnesium acetate has a water eutectic of -22 F° as compared with +5 F° for calcium acetate and is therefore a more effective deicer.

Engineering Study for the Evaluation of Public Road Administration and Maintenance Alternatives, HR-265, 1985

Iowa's public road system of 112,000 miles is one of the largest and the best in the nation. It represents a considerable financial investment of taxpayer revenues over the years. And, it requires a sustained investment to preserve an economical level of transport service into the future. In 1982, a Governor's Blue Ribbon Transportation Task Force evaluated the effectiveness of Iowa's entire transportation system. Four important Task Force recommendations dealt with public road administrative issues in Iowa. These issues were related to: (1) Design criteria and levels of maintenance; (2) Consistency in the use of standards among jurisdictions; (3) Consolidation of maintenance operations at one jurisdiction level; and (4) Jurisdicational authority for roads; The issues formed the background for Research Project HR-265.

User's Manual for the County Road Evaluation Program - Volume I, HR-242, 1986

Provides instructions for using the computer program which was developed under the research project, "The Economics of Reducing the County Road System: Three Case Studies In Iowa". This program operates on an IBP personal computer with 300K storage. A fixed disk is required with at least 3 megabytes of storage. The computer must be equipped with DOS version 3.0; the programs are written in Fortran. The user's manual describes all data requirements including network preparation, trip information, cost for maintenance, reconstruction, etc. Program operation instructions are presented, as well as sample solution output and a listing of the computer programs.

Evaluation of Limestone Filler in Gravel Mixtures "Asphaltic Concrete", R-228, 1968

This study was designed to provide background information on asphaltic concrete mixtures peculiar to northwest Iowa. This background is necessary to provide the basis for future specifications. There were several projects let in 1967 involving l", 3/4" and 3/8" mixes of Type "B'' asphaltic concrete which specified in part, II Not less than 40% of the material passing the No. 200 sieve shall be pulverized limestone or mineral filler, but in no case shall the per cent of pulverized limestone or mineral filler passing the No. 200 sieve be less than 2%. No credit will be allowed for limestone in gravel - II Northwest Iowa has no suitable limestone or mineral filler locally available. As a result, this material has to be imported, raising the cost of the mix approximately twenty-five cents per ton. The purpose of this study, therefore, was designed to compare some original job mix samples with alternate mixes from the same local material, but without the addition of pulverized limestone or mineral filler. Since the filler from the crushed gravel does not have the same crushing characteristics or sieve analysis as the pulverized limestone or mineral filler, they could not be compared on an equal percentage basis. Therefore, the alternate mixes were made to conform to the following proposed specification, "No less than 40% of the material passing No. 200 sieve shall be pulverized limestone or mineral filler or a 100% crushed gravel, but in no case shall the per cent of pulverized limestone or mineral filler or a 100% crushed gravel passing the No. 200 sieve be less than 2%."

Video Evaluation of Highway Drainage Systems, HR-317, 1991

Since 1978 the concept of longitudinal edge drains along Iowa primary and Interstate highways has been accepted as a cost-effective way of prolonging pavement life. Edge-drain installations have increased over the years, reaching a total of nearly 3,000 mi by 1989. With so many miles of edge drain installed, the development of a system for inspection and evaluation of the drains became essential. Equipment was purchased to evaluate 4-in.-diameter and geocomposite edge drains. Initial evaluations at various sites supported the need for a postconstruction inspection program to ensure that edge-drain installations were in accord with plans and specifications. Information disclosed by video inspections in edge drains and in culverts was compiled on videotape to be used as an informative tool for personnel in the design, construction, and maintenance departments. Video evaluations have influenced changes in maintenance, design, and construction inspection for highway drainage systems in Iowa.

Evaluation of Air Pollution Control Devices for Asphalt Pavement Recycling Operations, HR-188, Progress Report, 1977

This report discusses the asphalt pavement recycling project designated Project HR-188 in Kossuth County, Iowa. Specific objectives were: (a) to determine the effectiveness of drum mixing plant modifications designed to control air pollution within limits specified by the Iowa Department of Environmental Quality; (b) to assess the impact of varying the proportions of recycled and virgin aggregates, (c) to assess the impact of varying the production rate of the plant, and (d) to assess the impact of varying the mixing temperature. The discussion includes information on the proposed use of research funds, project location and description, the project planning conference, plan development, bid letting, asphalt plant configuration, actual plant operation, why this method is successful, probable process limitations, pollution results, recycled pavement test results, and the cost of virgin vs. recycled asphalt pavements.

Evaluation of Recycled Rubber in Asphalt Concrete - Plymouth County, HR-330A, 1992

The Iowa Department of Transportation is evaluating the use of ground recycled crumb rubber from discarded tires in asphalt rubber cement. There were four projects completed during 1991 and another one constructed in 1992. This project is located on IA 140 north of Kingsley in Plymouth County. The project contains one section with reacted asphalt rubber cement (ARC) used in both binder and surface courses, one with reacted ARC used in the surface course and a conventional binder course, and a conventional mix control section. The reacted rubber binder course was placed on October 17, 1991 and the reacted rubber surface course was placed on October 17, 18, and 19. Inclement weather caused a slight delay in placing or constructing the surface. There was a minor problem with shoving and cracking of the binder course. The construction went well otherwise. Information included in this report consists of test results, construction reports, and cost comparisons.

Evaluation of Recycled Rubber in Asphalt Concrete - Dubuque County, HR-330C, 1992

The Iowa Department of Transportation is evaluating the use of discarded tires in asphalt rubber cement. There have been five projects completed in Iowa. This project is located on US 151 north of Cascade to US 61 in Dubuque. One section consists of an asphalt rubber cement surface and a conventional binder and two sections contain both asphalt rubber cement surface and binder. The control section of conventional asphalt was completed this spring. Information included in this report consists of test results, construction reports, and cost comparisons.

Evaluation of Cohesion and Swell Characteristics of Asphalt Treated Base Mixtures, R-223, 1968

This study was undertaken to evaluate the suitability of various stones which play an important role in the properties of compacted mixtures in asphalt treated bases. The determination of the effect of water temperature on the cohesion of the mixes is investigated. A number of stones were prepared for the test. Attention is paid to the particular source of stone with the corresponding test results. A preliminary study of the effect of lime when added to mixed aggregate was also conducted. The purpose of this study is to provide needed information on the cohesive characteristics of asphalt treated bases using a wide range of stones. This study is also to evaluate the suitability of the various stone sources.

Maximizing the Use of Roadway Weather Information Systems: Final Report, TR-404, 1998

This project was proposed as Phase I of a 2-phase program to evaluate the present use of weather information by Iowa Department of Transportation (IaDOT) personnel, recommend revised procedures, and then implement the resulting recommendations. Midway through Phase I (evaluation phase) the FORETELL project was funded. This project is a multi-state venture that engages the National Weather Service (NWS) and the Forecast Systems Laboratory of the National Oceanic and Atmospheric Administration and proposes to supplant the current weather information-generation and distribution system with an advanced system based on state-of-the-art technologies. The focus of the present project was therefore refined to consider use of weather data by IaDOT personnel, and the training programs needed to more effectively use these data. Results of the survey revealed that two major areas - training of personnel on use of data from whatever source and more precise information of frost formation - are not addressed in the FORETELL project. These aspects have been the focus of the present project.