Road Safety Audit for County Road W-55 in Washington County, Iowa, 2009

A road safety audit was conducted for a seven-mile section of County Road W-55 in Washington County, Iowa. In 2006, the average annual daily traffic on this roadway was found to be 1,290 vehicles per day. Using crash data from 2001 to 2007, the Iowa Department of Transportation (Iowa DOT) has identified this roadway as being in the top 5% of Iowa secondary rural roads with the highest density of serious (fatal and major injury) crashes for single-vehicle run-off-road incidents. Considering these safety data, the Washington County Engineer requested that a road safety audit be conducted to identify areas with safety concerns and to recommend low-cost mitigation to address those concerns. Staff and officials from the Iowa DOT, Iowa State Patrol, Governor’s Traffic Safety Bureau, Federal Highway Administration, Institute for Transportation, and local law enforcement and transportation agencies met to review crash data and discuss potential safety improvements to this segment of W-55. This report outlines the findings and recommendations of the road safety audit team to address the safety concerns on this W-55 corridor and explain several selected mitigation strategies.

Road Safety Audit for Intersection of US 218 and County Road C-57 (West Cedar Wapsi Road) in Black Hawk County, Iowa, 2009

Beginning on June 22, 2009, a road safety audit was initiated for the intersection of US 218 and County Road C-57 in Black Hawk County, Iowa. Due to the traffic volumes and the number of conflicting traffic movements on these two roadways, this intersection has developed a crash history that concerns the Iowa Department of Transportation (Iowa DOT), Iowa State Patrol, and local agencies. This intersection is ranked seventh in Iowa for the highest number of at-grade expressway intersection crashes. Considering this, Black Hawk County and the Iowa DOT requested that a road safety audit be conducted to address the safety concerns and recommend possible mitigation strategies.

Road Safety Audit for Intersection of IA 1 and County Road R-67 in Johnson County, Iowa, 2009

On August 3, 2009, a road safety audit was initiated for the intersection of IA 1 and County Road F-67 in Johnson County, Iowa. Due to the high volume of traffic accessing the cheese producing plant (Twin County Dairy, Inc.), a grocery store east of the intersection, and a large Amish community with horse-drawn wagons and carriages frequently sharing the roads with motorized vehicles, this intersection has developed a crash history that concerns the Iowa Department of Transportation (Iowa DOT), Iowa State Patrol, and local agencies. Considering this, Johnson County and the Iowa DOT requested that a road safety audit be conducted to address the safety concerns and recommend possible mitigation strategies.

Road Safety Audit for IA 150/US 52 from I-380 to the Minnesota Border, 2009

On June 9, 2009, the Northeast Iowa Highway 150/52 Coalition met with the Iowa Department of Transportation (Iowa DOT) in Cedar Falls, Iowa to discuss concerns regarding roadway conditions and safety which has become a concern because of the potential economic development in the area. In response to the issues raised by the coalition, the Iowa DOT requested that a road safety audit be conducted on the corridor to identify where low-cost improvements could be beneficially applied to address safety concerns.

Variability of voriconazole plasma levels measured by new high-performance liquid chromatography and bioassay methods, [and] Voriconazole therapeutic drug monitoring in patients with invasive mycoses improves efficacy and safety outcomes

Rapport de synthèse1. Partie de laboratoireCette première étude décrit le développement et la validation, selon les standards internationaux, de deux techniques de mesure des concentrations sanguines de voriconazole, un nouvel agent antifongique à large spectre: 1) la chromatographic en phase liquide à haute pression et 2) le bio-essai utilisant une souche mutante de Candida hypersensible au voriconazole. Ce travail a aussi permis de mettre en évidence une importante et imprévisible variabilité inter- et intra-individuelle des concentrations sanguines de voriconazole malgré l'utilisation des doses recommandées par le fabriquant. Ce travail a été publié dans un journal avec "peer-review": "Variability of voriconazole plasma levels measured by new high- performance liquid chromatography and bioassay methods" by A. Pascual, V. Nieth, T. Calandra, J. Bille, S. Bolay, L.A. Decosterd, T. Buclin, P.A. Majcherczyk, D. Sanglard, 0. Marchetti. Antimicrobial Agents Chemotherapy, 2007; 51:137-432. Partie CliniqueCette deuxième étude a évalué de façon prospective l'impact clinique des concentrations sanguines de voriconazole sur l'efficacité et sécurité thérapeutique chez des patients atteints d'infections fongiques. Des concentrations sanguines élevées étaient significativement associés à la survenue d'une toxicité neurologique (encéphalopathie avec confusion, hallucinations et myoclonies) et des concentrations sanguines basses à une réponse insuffisante au traitement antifongique (persistance ou progression des signes cliniques et radiologiques de l'infection). Dans la majorité des cas, un ajustement de la dose de voriconazole, sur la base des concentrations mesurées, a abouti à une récupération neurologique complète ou à une résolution de l'infection, respectivement. Ce travail a été publié dans un journal avec "peer-review": " Voriconazole Therapeutic Drug Monitoring in Patients with Invasive Mycoses Improves Efficacy and Safety Outcomes" by A. Pascual, T. Calandra, S. Bolay, T. Buclin, J. Bille, and O. Marchetti. Clinical Infectious Diseases, 2008 January 15; 46(2): 201-11.Ces deux études, financées de façon conjointe par un "grant" international de la Société suisse d'infectiologie et la Société internationale de maladies infectieuses et par la Fondation pour le progrès en microbiologie médicale et maladies infectieuses (FAMMID, Lausanne), ont été réalisées au sein du Service des Maladies Infectieuses, Département de Médecine, au CHUV, en étroite collaboration avec la Division de Pharmacologie Clinique, Département de Médecine, au CHUV et l'Institut de Microbiologie du CHUV et de l'Université de Lausanne.

Road Safety Audit for I-380 through the Cities of Cedar Rapids and Hiawatha in Linn County, Iowa, 2009

Interstate 380 (I-380) through Cedar Rapids and Hiawatha, Iowa, is a multilane divided urban freeway that was constructed in 1976 to the Cedar River and in 1981 from that point northerly. Traffic volumes vary from 47,000 to 83,500 vehicles per day, with about 8%–15% trucks and buses. Based on concern for the high number of crash incidents, particularly serious crashes, and increased traffic volumes on this roadway, the City of Cedar Rapids and the Iowa Department of Transportation (Iowa DOT) District 6 Office requested that a road safety audit be conducted for this roadway section. Representatives from the Iowa DOT, Federal Highway Administration, Center for Transportation Research and Education, local law enforcement, local government, and area businesses met to review crash data and discuss potential safety improvements to this segment of I-380. This report outlines the findings and recommendations of the road safety audit team for addressing the safety concerns on this I-380 corridor and explains several selected mitigation strategies.

Implementation of the Federal Highway Administration Final Rule on Work Zone Safety and Mobility, 2007

The Federal Highway Administration published the final rule updating 23 CFR 630 Subpart J in September 2004. The revised rule requires agencies using federal funding to address both safety and mobility in planning and construction of roadway improvements. The Iowa Department of Transportation (Iowa DOT) requested the assistance of the Center for Transportation and Research in developing guidance for a policy and procedures to comply with the final rule. This report describes an in-depth examination of current Iowa DOT project development processes for all types of improvements, including maintenance, as well as a detailed characterization of work zone impact considerations throughout project completion. To comply with both the letter and perceived intent of the final rule on safety and mobility, the report features a suggested work zone policy statement and suggested revisions in the Iowa DOT project development processes, including a definition of the key element: significant projects.

Safety Analysis of Low-Volume Rural Roads in Iowa, 2010

Iowa features an extensive surface transportation system, with more than 110,000 miles of roadway, most of which is under the jurisdiction of local agencies. Given that Iowa is a lower-population state, most of this mileage is located in rural areas that exhibit low traffic volumes of less than 400 vehicles per day. However, these low-volume rural roads also account for about half of all recorded traffic crashes in Iowa, including a high percentage of fatal and major injury crashes. This study was undertaken to examine these crashes, identify major contributing causes, and develop low-cost strategies for reducing the incidence of these crashes. Iowa’s extensive crash and roadway system databases were utilized to obtain needed data. Using descriptive statistics, a test of proportions, and crash modeling, various classes of rural secondary roads were compared to similar state of Iowa controlled roads in crash frequency, severity, density, and rate for numerous selected factors that could contribute to crashes. The results of this study allowed the drawing of conclusions as to common contributing factors for crashes on low-volume rural roads, both paved and unpaved. Due to identified higher crash statistics, particular interest was drawn to unpaved rural roads with traffic volumes greater than 100 vehicles per day. Recommendations for addressing these crashes with low-cost mitigation are also included. Because of the isolated nature of traffic crashes on low-volume roads, a systemic or mass action approach to safety mitigation was recommended for an identified subset of the entire system. In addition, future development of a reliable crash prediction model is described.

Road Safety Audit for County Road H-46 from Redwood Avenue to the Southerly Corporate Limits of Fairfield in Jefferson County, Iowa, 2010

Jefferson County Road H-46 from Redwood Avenue to the southeast corporate limits (SCL) of Fairfield, Iowa, is a paved roadway approximately 6.5 miles long made of asphaltic concrete pavement with curvilinear alignment. The roadway consists of a 22 ft wide pavement, last overlaid in 2002, with 3 to 4 ft wide earth shoulders. Traffic estimates indicated volumes ranging from 500 to 1,590 vehicles per day, with numbers increasing as the route nears Fairfield. This roadway was found to be among the highest 5 percent of similar Iowa roadways in terms of severity of run-off-road crashes. In response, Iowa Department of Transportation (Iowa DOT) requested a road safety audit to examine the roadway and suggest possible mitigation. Representatives from the Iowa DOT, Federal Highway Administration, Institute for Transportation, local law enforcement, and local government met to review crash data and discuss potential safety improvements to this segment H-46. This report outlines the findings and recommendations of the road safety audit team for addressing the safety concerns on this roadway.

Road Safety Audits for County Road X-23 from IA 2 to the South Corporate Limits of West Point and for County Road W-62 from US 218 to IA 27 in Lee County, Iowa, 2010

On October 20–21, 2009, two road safety audits were conducted in Lee County, Iowa: one for a 6 mile section of County Road X-23 from IA 2 to the south corporate limits of West Point and one for a 9.7 mile section of County Road W-62 from US 218 to IA 27. Both roads have high severe crash histories for the years of 2001 through 2008. Using these crash data, the Iowa Department of Transportation (Iowa DOT) has identified County Road X-23 as being in the top 5 percent of similar roads for run-off-road crashes. The Iowa DOT lists County Road W-62 as a high-risk rural road that has above-average crash numbers and is eligible for funding under the Federal High-Risk Rural Road Program. Considering these issues, the Lee County Engineer and Iowa DOT requested that road safety audits be conducted to address the safety concerns and to suggest possible mitigation strategies.

Road Safety Audit for US 151 from Amana to US 30 in Cedar Rapids in Benton, Iowa and Linn Counties, Iowa, 2010

US 151 was originally constructed as IA 149 in 1931-1934 and has been rehabilitated several times. The most recent major improvements, which were completed in 2005-2006, consisted of hot mix asphalt resurfacing and partial shoulder paving. Major widening and resurfacing improvements were also completed in 2007 between Fairfax and US 30 in Cedar Rapids. According to a preliminary 2009 estimate, traffic volumes range from about 5,900 vehicles per day (vpd) north of Amana to about 14,400 vpd at the US 30 interchange in Cedar Rapids. In response to high crash densities and medium to medium-high crash rates along the route, the Iowa Department of Transportation (Iowa DOT) requested a road safety audit to examine the roadway and suggest possible mitigation. Representatives from the Iowa DOT, Federal Highway Administration, Institute for Transportation, local law enforcement, and state government met to review crash data and discuss potential safety improvements to this segment of US 151. This report outlines the findings and recommendations of the road safety audit team for addressing the safety concerns on this roadway.

Road Safety Audit for James Avenue NW and 250th Street NW, from the North Corporate Limits of Tiffin to I-380, in Johnson County, Iowa, 2010

To address safety concerns on James Avenue NW and 250th Street NW, from the North Corporate Limits (NCL) of Tiffin, north and east to I-380 (at North Liberty), the Johnson County engineer requested a road safety audit (RSA). The audit was conducted on September 1, 2010, through a program supported by the Office of Traffic and Safety at the Iowa Department of Transportation (DOT). This road is a seal-coated roadway, about 25-ft wide, but with only about 0-1 ft of earth shoulders. According to 2006 Iowa DOT estimates, traffic volume is about 820 vehicles per day, north from Tiffin to a commercial entrance on 250th Street, then increasing to 2,990 vehicles per day to the on-ramp of Interstate 380 (I-380). Local traffic uses this road as a short-cut to Cedar Rapids, North Liberty, and the I-380/I-80 interchange (to avoid congestion on IA 965). This report outlines the findings and recommendations of the road safety audit team for addressing the safety concerns on this roadway.

Immunogenicity and safety of yellow fever vaccination for 102 HIV-infected patients.

BACKGROUND: Yellow fever vaccine (17DV) has been investigated incompletely in human immunodeficiency virus (HIV)-infected patients, and adequate immunogenicity and safety are of concern in this population. METHODS: In the Swiss HIV Cohort Study, we identified 102 patients who received 17DV while they were HIV infected. We analyzed neutralization titers (NTs) after 17DV administration using the plaque reduction neutralization test. NTs of 1:>or=10 were defined as reactive, and those of 1:<10 were defined as nonreactive, which was considered to be nonprotective. The results were compared with data for HIV-uninfected individuals. Serious adverse events were defined as hospitalization or death within 6 weeks after receipt of 17DV. RESULTS: At the time of 17DV administration, the median CD4 cell count was 537 cells/mm(3) (range, 11-1730 cells/mm(3)), and the HIV RNA level was undetectable in 41 of 102 HIV-infected patients. During the first year after vaccination, fewer HIV-infected patients (65 [83%] of 78; P = .01) than HIV-uninfected patients revealed reactive NTs, and their NTs were significantly lower (P < .001) than in HIV-uninfected individuals. Eleven patients with initially reactive NTs lost these reactive NTs <or= 5 years after vaccination. Higher NTs during the first year after vaccination were associated with undetectable HIV RNA levels, increasing CD4 cell count, and female sex. We found no serious adverse events after 17DV administration among HIV-infected patients. CONCLUSION: Compared with HIV-uninfected individuals, HIV-infected patients respond to 17DV with lower reactive NTs, more often demonstrate nonprotective NTs, and may experience a more rapid decline in NTs during follow-up. Vaccination with 17DV appears to be safe in HIV-infected individuals who have high CD4 cell counts, although rate of serious adverse events of up to 3% cannot be excluded.

A prospective observational safety study on MF59(®) adjuvanted cell culture-derived vaccine, Celtura(®) during the A/H1N1 (2009) influenza pandemic.

BACKGROUND: The present study was a prospective observational study to evaluate the safety profile of Celtura(®), a monovalent, cell culture-derived, inactivated subunit influenza vaccine prepared from A/California/07/2009(H1N1) with the adjuvant MF59(®). Subjects were enrolled prospectively during the H1N1 2009 influenza pandemic at medical centres in Colombia, Chile, Switzerland, and Germany during the period December 2009 to June 2010. METHODS: Subjects ages 18 and older were followed for the occurrence of adverse events (AEs) for six months after vaccination. Adverse events of special interest (AESIs) were neuritis, convulsion (seizure), anaphylaxis, encephalitis, vasculitis, Guillain-Barre syndrome, demyelinating conditions, Bell's palsy, and laboratory-confirmed vaccination failure. RESULTS: Overall, 7348 AEs were reported in 2296 of 3989 enrolled subjects (57.6%). Only two AEs were considered related to injection site reactions. No laboratory-confirmed cases of influenza were reported. There were 108 medically confirmed serious adverse events (SAEs) reported among 73 subjects with 6 such SAEs described as possibly or probably related to vaccination. Three fatal cases were reported and assessed as not related to vaccination. Two AESIs classified as convulsion were reported and assessed as not related to vaccination. Both AESIs occurred well outside the pre-specified 7 day risk window representing the likely timeframe of the occurrence of seizure following vaccination. CONCLUSIONS: The results of this study support the overall good safety profile of MF59 adjuvanted cell culture-derived influenza vaccine as administered in adults during the 2009-2010 H1N1 influenza pandemic. No concern is raised regarding the occurrence of AESIs.