17. Chris Cieslak, 38
Construction project manager

When it's time for a new building to go up, Chris Cieslak and her company, Chronicle Consulting, oversee all the details. "I provide 'big project' construction management and sustainable building services to clients with small projects," Cieslak says, citing work for local school districts, municipalities, nonprofits and government agencies. Her firm orchestrated the construction of CAPA High School for Pittsburgh Public Schools and is now beginning the new Penguins stadium for the Sports and Exhibition Authority. A major in the Army Reserves, Cieslak was deployed to Kuwait in 2003 and worked as chief of construction on a U.S. base that housed soldiers traveling to and from Iraq.

Cieslak also has a passion for green building. With planning upfront, she says, even small projects can minimize environmental impact while realizing the long-term cost benefits of energy efficiency. "What I want people to understand is they are able to do a green building," she says.

18. Geoff Webster, 39
Making health care safer

As a founding partner of Value Capture, Geoff Webster makes work in hospitals better places for patients and employees. "I challenge leaders to transform their organizations by leading with safety and respect for everyone so that people in the region - and beyond - have what they need to live healthy and productive lives." Webster coaches CEOs to change health care processes, eliminating steps that make providing care difficult and empowering their employees to take an active role in improvement. In just over two years, he's helped health care systems here and in other states create sustainable improvements in safety while reducing costs by 30 percent to 50 percent.

His focus on process improvement helped Allegheny General Hospital reduce one kind of common infection by 62 percent, a tremendous decrease that's sustained long-term. "What I know to be true from having done this work is that it's possible in health care to produce infinitely better outcomes...and that creates the opportunity to do that for everything," Webster says.

19. Royce W. Karpy, 38
Philanthropist

Royce Karpy sits on the front patio of his Grandview Avenue home. He mentions his work, opening new pharmacy locations for Rite Aid. But his face lights up when he talks about his faith and his philanthropic work - faith and work that he felt called to after his brother, a pilot, died in an airplane crash two years ago. "I'm being drawn toward the homeless, poor, needy, oppressed, the lonely," he says. To help them, he's raised $30,000 for local charities and is creating the Blue Skies Memorial Foundation. "I want to fund this with a million dollars initially...take the investment income from that million dollars every year and give it away to groups, organizations, individuals or families that are touching lives in those categories."

Noting that the Blue Skies project turns his family's loss into something positive, he continues: "It's really my time - my calling - to make a mark in other people's lives. I still feel my brother around me."

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