Iowa Board of Nursing Annual Report FY 10 (7/1/09 - 6/30/20)

The Iowa Bord of Nursing Annual Report includes information on legislation, rule changes and statistics related to all aspects of board business: licensing, education, continuing education, enforcement, administrative changes, financial report, general nursing demographics.

Molecular Proxies for Climate Maladaptation in a Long-Lived Tree (Pinus pinaster Aiton, Pinaceae).

Understanding adaptive genetic responses to climate change is a main challenge for preserving biological diversity. Successful predictive models for climate-driven range shifts of species depend on the integration of information on adaptation, including that derived from genomic studies. Long-lived forest trees can experience substantial environmental change across generations, which results in a much more prominent adaptation lag than in annual species. Here, we show that candidate-gene SNPs (single nucleotide polymorphisms) can be used as predictors of maladaptation to climate in maritime pine (Pinus pinaster Aiton), an outcrossing long-lived keystone tree. A set of 18 SNPs potentially associated with climate, 5 of them involving amino acid-changing variants, were retained after performing logistic regression, latent factor mixed models, and Bayesian analyses of SNP-climate correlations. These relationships identified temperature as an important adaptive driver in maritime pine and highlighted that selective forces are operating differentially in geographically discrete gene pools. The frequency of the locally advantageous alleles at these selected loci was strongly correlated with survival in a common garden under extreme (hot and dry) climate conditions, which suggests that candidate-gene SNPs can be used to forecast the likely destiny of natural forest ecosystems under climate change scenarios. Differential levels of forest decline are anticipated for distinct maritime pine gene pools. Geographically defined molecular proxies for climate adaptation will thus critically enhance the predictive power of range-shift models and help establish mitigation measures for long-lived keystone forest trees in the face of impending climate change.

Speed Limit Questions? Here’s Your Answer, February 8, 2010

Iowa’s speed regulations are based on the same basic speed law that is used in all 50 states: “Any person driving a motor vehicle on a highway shall drive the same at a careful and prudent speed not greater than nor less than is reasonable and proper, having due regard to the traffic, surface, and width of the highway and of any other conditions then existing, and no person shall drive any vehicle upon a highway at a speed greater than will permit the person to bring it to a stop within the assured clear distance ahead, such driver having the right to assume, however, that all persons using said highway will observe the law.” Statutory limits are based on the concept that uniform categories of highways can be traveled safely at certain preset maximum speeds under ideal conditions. Whether the speed limit is posted or unposted, drivers should reduce their speed below these values in poor weather, heavy traffic, and under other potentially hazardous conditions.

Médecine génomique et oncologie [Genomics medicine and oncology].

Progress in genomics with, in particular, high throughput next generation sequencing is revolutionizing oncology. The impact of these techniques is seen on the one hand the identification of germline mutations that predispose to a given type of cancer, allowing for a personalized care of patients or healthy carriers and, on the other hand, the characterization of all acquired somatic mutation of the tumor cell, opening the door to personalized treatment targeting the driver oncogenes. In both cases, next generation sequencing techniques allow a global approach whereby the integrality of the genome mutations is analyzed and correlated with the clinical data. The benefits on the quality of care delivered to our patients are extremely impressive.

Iowa Board of Nursing Annual Report FY 10 (7/1/09 - 6/30/10)

The Iowa Bord of Nursing Annual Report includes information on legislation, rule changes and statistics related to all aspects of board business: licensing, education, continuing education, enforcement, administrative changes, financial report, general nursing demographics.

Iowa Board of Nursing Annual Report FY 11 (7/1/10 - 6/30/11)

The Iowa Bord of Nursing Annual Report includes information on legislation, rule changes and statistics related to all aspects of board business: licensing, education, continuing education, enforcement, administrative changes, financial report, general nursing demographics.

Pavement Markings and Safety Final Report, November 2010

Previous research on pavement markings from a safety perspective tackled various issues such as pavement marking retroreflectivity variability, relationship between pavement marking retroreflectivity and driver visibility, or pavement marking improvements and safety. A recent research interest in this area has been to find a correlation between retroreflectivity and crashes, but a significant statistical relationship has not yet been found. This study investigates such a possible statistical relationship by analyzing five years of pavement marking retroreflectivity data collected by the Iowa Department of Transportation (DOT) on all state primary roads and corresponding crash and traffic data. This study developed a spatial-temporal database using measured retroreflectivity data to account for the deterioration of pavement markings over time along with statewide crash data to attempt to quantify a relationship between crash occurrence probability and pavement marking retroreflectivity. First, logistic regression analyses were done for the whole data set to find a statistical relationship between crash occurrence probability and identified variables, which are road type, line type, retroreflectivity, and traffic (vehicle miles traveled). The analysis looked into subsets of the data set such as road type, retroreflectivity measurement source, high crash routes, retroreflectivity range, and line types. Retroreflectivity was found to have a significant effect in crash occurrence probability for four data subsets—interstate, white edge line, yellow edge line, and yellow center line data. For white edge line and yellow center line data, crash occurrence probability was found to increase by decreasing values of retroreflectivity.

Pavement Markings and Safety,

This study explores the statistical relationship between crash occurrence probability and longitudinal pavement marking retroreflectivity. Problem Statement Previous research on pavement markings, from a safety perspective, tackled various issues, such as pavement marking retroreflectivity variability, relationship between pavement marking retroreflectivity and driver visibility, and pavement marking improvements and safety. A recent research interest in this area is to find a correlation between retroreflectivity and crashes, as a significant statistical relationship is undefined to date.

Senior Drivers' Workbook, April 21, 2009

This booklet is part of the Iowa Department of Transportation’s “Choices Not Chances - The Road to Driving Safer and Longer” series. These booklets and video were developed to help Iowa drivers remain safe and mobile as they age. For more information, contact the Department of Transportation’s Office of Driver Services.

Iowa Driver’s License Renewal, August 3, 2007

One-on-one communication with driver’s license customers is the most valuable tool Driver Services employees use to help drivers stay independent and safe. Driver Services employees understand that a sense of remaining independent, in everything from running errands to shopping to visits with friends, family and doctors, depends on a driver’s license. There are times when Driver Services personnel, or even the drivers themselves, determine it’s time to stop driving. In those cases, people are given a free identification card. There are also times when the DOT must suspend a person’s driving privilege. This can be caused by vision problems, a medical condition or unsafe driving. If the driver cannot be relicensed, DOT personnel make the commitment to work with the individual by providing information about available transportation alternatives. We are providing this information to make the renewal process understandable and less stressful. We hope that by explaining why the DOT screens vision, requires medical information and requests drive tests, and describing how these all relate to highway safety, drivers will know what to expect. Personnel are available to answer questions or discuss concerns at any of the Iowa Department of Transportation or County Treasurer driver’s license sites. Please contact one of the driver’s license stations listed in this booklet.

Lung Cancer That Harbors an HER2 Mutation: Epidemiologic Characteristics and Therapeutic Perspectives.

PURPOSE HER2 mutations are identified in approximately 2%of non-small-cell lung cancers (NSCLC). There are few data available that describe the clinical course of patients with HER2-mutated NSCLC. PATIENTS AND METHODS We retrospectively identified 65 NSCLC, diagnosed with a HER2 in-frame insertion in exon 20. We collected clinicopathologic characteristics, patients' outcomes, and treatments. Results HER2 mutation was identified in 65 (1.7%) of 3,800 patients tested and was almost an exclusive driver, except for one single case with a concomitant KRAS mutation. Our population presented with a median age of 60 years (range, 31 to 86 years), a high proportion of women (45 women v 20 men; 69%), and a high proportion of never-smokers (n= 34; 52.3%). All tumors were adenocarcinomas and 50% were stage IV at diagnosis. For these latter cases, 22 anti-human epidermal growth factor receptor 2 (HER2) treatments were administered after conventional chemotherapy in 16 patients. Subsequently, four patients experienced progressive disease, seven experienced disease stabilizations, and 11 experienced partial responses (overall response rate, 50%; disease control rate [DCR], 82%). Specifically, we observed a DCR of 93% for trastuzumab-based therapies (n = 15) and a DCR of 100% for afatinib (n = 3) but no response to other HER2-targeted drugs (n = 3). Progression-free survival for patients with HER2 therapies was 5.1 months. Median survival was of 89.6 and 22.9 months for early-stage and stage IV patients, respectively. CONCLUSION This study, the largest to date dedicated to HER2-mutated NSCLC, reinforces the importance of screening for HER2 mutations in lung adenocarcinomas and suggests the potential efficacy of HER2-targeted drugs in this population.

Wet-Reflective Pavement Marking Demonstration Project, November 2011

One of the leading complaints from drivers is the inability to see pavement markings under wet night conditions. This issue is a major source of dissatisfaction in state department of transportation (DOT) customer satisfaction surveys. Driving under wet night conditions is stressful and fatiguing for all drivers, but particularly so for the more vulnerable young and older driver age groups. This project focused on the development of a two-year, long-line test deck to allow for the evaluation and demonstration of a variety of wet-reflective pavement marking materials and treatments under wet night conditions. Having the opportunity to document the performance of these various products and treatments will assist the Iowa DOT and local agencies in determining when and where the use of these products might be most effective. Performance parameters included durability, presence, retroreflectivity, and wet night visibility. The test sections were located within Story County so that Iowa DOT management and staff, as well as local agencies, could drive these areas and provide input on the products and treatments.

Pulse wave analysis aortic pressure . distole should also be considered

La rigidité anormalement haute des artères à grande conductance est un marqueur de l'augmentation du risque cardiovasculaire et est typiquement retrouvée chez les patients diabétiques ou hypertendus. Ces vaisseaux deviennent plus rigides avec l'âge, expliquant la haute prévalence d'hypertension systolique chez les personnes âgées. Cette rigidification agit sur la pression sanguine de plusieurs façons. Notamment la fonction windkessel est gênée, menant à l'augmentation de la pression systolique et de la pression puisée, la diminution de la pression diastolique, et ainsi à l'augmentation de la postcharge ventriculaire gauche associée à une probable diminution de la perfusion coronarienne. De plus, la propagation des ondes de pression le long de l'arbre vasculaire est accélérée, de sorte que les ondes réfléchies générées au site de décalage d'impédance atteignent l'aorte ascendante plus tôt par rapport au début de l'éjection ventriculaire, aboutissant à une augmentation de la pression systolique centrale, ce qui n'arriverait pas en présence de vaisseaux moins rigides. Dans ce cas, au contraire, les ondes de pression antérogrades et réfléchies voyages plus lentement, de sorte que les ondes de réflexion tendent à atteindre l'aorte centrale une fois l'éjection terminée, augmentant la pression diastolique et contribuant à la perfusion coronarienne. La tonométrie d'applanation est une méthode non invasive permettant l'évaluation de la forme de l'onde de pression au niveau l'aorte ascendante, basée sur l'enregistrement du pouls périphérique, au niveau radial dans notre étude. Nous pouvons dériver à partir de cette méthode un index d'augmentation systolique (sAIX) qui révèle quel pourcentage de la pression centrale est du aux ondes réfléchies. Plusieurs études ont montré que cet index est corrélé à d'autres mesures de la rigidité artérielle comme la vitesse de l'onde de pouls, qu'il augmente avec l'âge et avec les facteurs de risques cardiovasculaires, et qu'il est capable de préciser le pronostic cardiovasculaire. En revanche, peu d'attention a été portée à l'augmentation de la pression centrale diastolique due aux ondes réfléchies (dAIX). Nous proposons donc de mesurer cet index par un procédé d'analyse développé dans notre laboratoire, et ce dans la même unité que l'index systolique. Etant donné que les modifications de la paroi artérielle modulent d'une part la vitesse de l'onde de pouls (PWV) et d'autre part le temps de voyage aller-retour des ondes de pression réfléchies aux sites de réflexion, toute augmentation de la quantité d'énergie réfléchie atteignant l'aorte pendant la systole devrait être associée à une diminution de l'énergie arrivant au même point pendant la diastole. Notre étude propose de mesurer ces deux index, ainsi que d'étudier la relation de l'index d'augmentation diastolique (dAIX) avec la vitesse de propagation de l'onde de pouls (PWV) et avec le rythme cardiaque (HR), ce dernier étant connu pour influencer l'index d'augmentation systolique (sAIX) . L'influence de la position couchée et assise est aussi étudiée. Les mesures de la PWV et des sAIX et dAIX est réalisée chez 48 hommes et 45 femmes âgées de 18 à 70 ans, classés en 3 groupes d'âges. Les résultats montrent qu'en fonction de l'âge, le genre et la position du corps, il y a une relation inverse entre sAIX et dAIX. Lorsque PWV et HR sont ajoutés comme covariables à un modèle de prédiction comprenant l'âge, le genre et la position du corps comme facteurs principaux, sAIX est directement lié à PWV (p<0.0001) et inversement lié à HR (p<0.0001). Avec la même analyse, dAIX est inversement lié à PWV (p<0.0001) et indépendant du rythme cardiaque (p=0.52). En conclusion, l'index d'augmentation diastolique est lié à la rigidité vasculaire au même degré que l'index d'augmentation systolique, alors qu'il est affranchi de l'effet confondant du rythme cardiaque. La quantification de l'augmentation de la pression aortique diastolique due aux ondes réfléchies pourrait être une partie utile de l'analyse de l'onde de pouls.

Rhumatologie. Denosumab: le joker du rhumatologue [Denosumab, the rheumatologist's joker?]

The number of molecules acting on bone turn over rapidly increasing. The idea to use them on bones erosions is not new, however this year a new molecule confirms the suitability of such an approach with the demonstration of efficency in both postmenopausal osteoporosis as well as in the prevention of bone erosions in rheumatoid arthritis. Denosumab, a human monoclonal antibody against RANKL (Receptor Activator of Nuclear factor-KB ligand), decreases the fracture risk in postmenopausal osteoporosis and prevents new bone erosions in rheumatoid arthritis. Of simple use, it appears to act rapidly, to be efficient with a sustain benefit. The tolerance seems excellent, and now we'll have just to wait for its licensing.

Restoration of Fricitonal Characteristics on Older Portland Cement Concrete Pavement:Final Report for Iowa Highway Research Board Project HR-224, June 1986

Safety i s a very important aspect o f the highway program. The Iowa DOT initiated an inventory o f the friction values of all paved primary roadways i n 1969. This inventory, with an ASTM E-274 test unit, has continued to the present time. The t e s t i n g frequency varies based upon traffic volume and the previous friction value. Historically , the state o f Iowa constructed a substantial amount o f pcc pavement during the 1928-30 period t o "get Iowa out o f the mud". Some of that pavement has never been resurfaced and has been subjected to more than 50 years o f wear. The textured surface has been worn away and has subsequently polished. Even though some pavements from 15 t o 50 years old continue t o function structurally , because of the loss of friction , they do not provide the desired level o f safety to the driver. As a temporary measure, "Sl ippery -When -Wet " signs have been posted on many older pcc roads due to friction numbers below t h e desirable level. These signs warn the motorist of the current conditions. An economical method of restoring the high quality frictional properties i s needed.