Agreed upon procedures report on the six Library Service Areas in the State of Iowa for the period July 1, 2010 through June 30, 2011

Agreed upon procedures report on the six Library Service Areas in the State of Iowa for the period July 1, 2010 through June 30, 2011

Executive Summary, Feasibility Report on Proposed Amtrak Service Quad Cities-Chicago, January 7, 2008

Since the introduction of expanded levels of intrastate service on October 30, 2006, Amtrak trains in Illinois have produced impressive gains in both ridership and ticket revenue. This success and continuing stakeholder support has given rise to a formal request from the Illinois Department of Transportation (“Ill. DOT”) to Amtrak to develop a feasibility study regarding possible service consisting of a morning and an evening train in each direction between Chicago and the Quad Cities. The area between Chicago and the Quad Cities includes many rapidly growing communities. From Chicago toward the West and South, many towns and cities have experienced double digit growth increases in population since the year 2000. Southern DuPage, Cook and Will counties have seen especially strong growth, pressuring highway infrastructure, utilities, and schools. Community development and highway congestion are readily apparent when traveling the nearly 3 hour, 175 mile route between Chicago and the Quad Cities. As information, there are only three weekday round trip bus frequencies available between Chicago and the Quad Cities. The Quad City International Airport offers a total of 10 daily scheduled round trip flights to Chicago's O'Hare International Airport via two separate carriers flying regional jets. The Quad Cities (Davenport, Moline, Rock Island, and Bettendorf) are located along the Mississippi River. Nearly 60% of its visitors are from the Chicago area. With dozens of miles of scenic riverfront, river boating, casinos, and thousands of acres of expansive public spaces, the Quad Cities area is a major draw from both Iowa and Illinois. The huge Rock Island Arsenal, one of the largest military arsenals in the country and located along the river, is transitioning to become the headquarters of the United States First Army. As will be discussed later in the report, there is only one logical rail route through the Quad Cities themselves. The Iowa Interstate Railroad operates through the Quad Cities along the river and heads west through Iowa. The Quad Cities are considering at least three potential locations for an Amtrak station. A study now underway supported by several local stakeholders will recommend a site which will then be considered, given available local and other financial support. If Amtrak service were to terminate in the Quad Cities, an overnight storage track of sufficient length along with ample parking and certain other requirements covered elsewhere in the report would be required.

Council Bluffs Interstate System Improvements Project Pottawatomie County, Iowa and Douglas County, Nebraska Project Number: IM-029-3(62)54-13-78, November 2004

The Iowa Department of Transportation (Iowa DOT), Nebraska Department of Roads (NDOR), and the Federal Highway Administration (FHWA) are proposing to improve the interstate system around Council Bluffs with improvements extending across the Missouri River on I-80 to east of the I-480 interchange in Omaha, Nebraska, see Figure 1-1. The study considers long-term, broad-based transportation improvements along I-80, I-29, and I-480, including approximately 18 mainline miles of interstate and 14 interchanges (3 system1, 11 service), that would add capacity and correct functional issues along the mainline and interchanges and upgrade the I-80 Missouri River Crossing. These improvements, once implemented, would bring the segments of I-80 and I-29 up to current engineering standards and modernize the roadway to accommodate future traffic needs. In 2001, Iowa DOT and FHWA initiated the Council Bluffs Interstate System (CBIS) Improvements Project. The agencies concluded that the environmental study process would be conducted in two stages; that is, a tiered approach would be applied. The project is being conducted pursuant to the National Environmental Policy Act (NEPA) regulations issued by the Council on Environmental Quality (CEQ), 40 Code of Federal Regulations (CFR) Part 1502.20, and FHWA 23 CFR Part 771.111, that permit tiering for large, complex NEPA studies. Tier 1 is an examination of the overall interstate system improvement needs, including a clear explanation of the area’s transportation needs, a study of alternatives to satisfy them, and broad consideration of potential environmental and social impacts. The Tier 1 evaluation is at a sufficient level of engineering and environmental detail to assist decision makers in selecting a preferred transportation strategy. Tier 1 includes preparation of a draft and final Environmental Impact Statement (EIS) that would disclose the potential environmental and social effects (evaluated at a planning level that considers a variety of conceptual designs) of the proposed improvements. The final EIS will conclude with a Record of Decision (ROD) that states the preferred plan for improvements to be implemented. Essentially, the Tier 1 document will establish the planning framework for the needed improvements. Because the scope of the overall system improvements is large, the interstate improvements would be implemented as a series of individual projects that fit into the overall planning framework. The Tier 1 Area of Potential Impact, which is discussed in detail in Section 4 is an alternative that considers a combination of the most reasonable concepts that have been developed, buffered by approximately 100 or more feet to ensure that any Tier 2 design modifications would remain inside the outer boundary.

Feasibility Study on Proposed Amtrak service from Chicago, to Iowa City, Iowa via Quad Cities, December 5, 2007

Soon after the Illinois Department of Transportation (“Ill. DOT”) requested Amtrak to conduct a feasibility study on proposed Amtrak service between Chicago and the Illinois Quad Cities, the Iowa Department of Transportation (“Iowa DOT”) asked that the study be extended to Iowa City and later to Des Moines. This report examines the feasibility of extending service to Iowa City. The completed report for the proposed Chicago – Quad Cities’ service was delivered to Ill. DOT in early January 2008. It assumes a stand-alone train operation strictly within the State of Illinois and makes no reference to extending the service into the State of Iowa. Therefore, there is no discussion about potential cost sharing allocations for capital improvements or operating losses between the two states which will become a matter of future negotiations between the two jurisdictions. That being said, this report on extending the service to Iowa City is simply an addendum to the Quad Cities report and covers such topics as additional capital infrastructure improvements that would be required in Iowa, impacts on operating expenses, revised ridership and revenue projections, and the like. With one minor exception, the recommended level of capital improvements within Illinois will still be required if the service to Iowa City is initiated. It is thus important for the readers of this report to refer to the Illinois study for detailed information on that state’s portion of the route alternatives.

Audit report on the Regional Utility Service Systems Commission for the year ended June 30, 2011

Audit report on the Regional Utility Service Systems Commission for the year ended June 30, 2011

Iowa Railroad Service Map, July 1, 2012

Iowa railroad service map of Iowa trains in color.

Midwest Regional Rail Passenger Initiative and Passenger Rail Service in Iowa Status Report

This report provides the status of the Passenger Rail Service Revolving Fund and the development and operation of the midwest regional rail system and the state's passenger rail service.

Audit report on the South Central Iowa Regional E-911 Service Board for the year ended June 30, 2012

Audit report on the South Central Iowa Regional E-911 Service Board for the year ended June 30, 2012

Audit report on the Regional Utility Service Systems Commission for the year ended June 30, 2012

Audit report on the Regional Utility Service Systems Commission for the year ended June 30, 2012

Prevalence of Acute Coronary Syndrome in Patients Suspected for Pulmonary Embolism or Acute Aortic Syndromes: Rational for "Double" and "Triple" Rule-Out Concepts

PURPOSE To evaluate the prevalence of acute coronary syndrome (ACS) in patients presenting initially with atypical chest pain and suspected to have pulmonary embolism (PE) or acute aortic syndromes (AAS). To evaluate the overlap between ACS, PE and AAS in routine practice and determine how many patients could have benefit from a single CT protocol to rule out ACS at the same time as PE and AAS. METHOD AND MATERIALS Our electronic hospital database revealed 1122 consecutive patients who underwent a thoracic CT angiography for PE or AAS from 2004 to 2006 (mean age, 63±13 years). Patients without chest pain were excluded from this study. Thus, 447 patients presented with isolated atypical chest were included in the analysis. All patients who underwent a thoracic CT scan previously received standard clinical care and were initially considered as non ACS. The final diagnosis was obtained by the hospital stay report. RESULTS Among the 447 patients with atypical chest pain, 25 (5.5%) were finally found to have ACS: 19 patients (4.2%) were suspected for PE and 6 (1. 3%) were suspected for AAS. There were 90 patients diagnosed to have PE, 89 (98.8%) of them were suspected for PE while only 1 (1%) was suspected for AAS. Eleven patients diagnosed to have AAS, 9 (82%) of them were suspected for AAS while 2 (18%) were suspected for PE. CONCLUSION In clinical practice, the overlap between PE, AAS and ACS is limited which make the triple rule-out studies less recommended to be done at the time being because of the high dose radiation. A double rule-out investigation is suggested to be done for patients being evaluated for atypical chest pain and suspected of having AAS or PE because of a significant overlap between the two entities as well it doesn't implicate any increment in radiation dose. CLINICAL RELEVANCE/APPLICATION With 64-slice CT, coronary circulation and total chest can be evaluated at the same time offering new opportunitie for the evaluation of three major life-threatening conditions :ACS,PE and AAS.