Potential impact of single-risk-factor versus total risk management for the prevention of cardiovascular events in Seychelles.

OBJECTIVE: To assess the prevalence of cardiovascular (CV) risk factors in Seychelles, a middle-income African country, and compare the cost-effectiveness of single-risk-factor management (treating individuals with arterial blood pressure >/= 140/90 mmHg and/or total serum cholesterol >/= 6.2 mmol/l) with that of management based on total CV risk (treating individuals with a total CV risk >/= 10% or >/= 20%).METHODS: CV risk factor prevalence and a CV risk prediction chart for Africa were used to estimate the 10-year risk of suffering a fatal or non-fatal CV event among individuals aged 40-64 years. These figures were used to compare single-risk-factor management with total risk management in terms of the number of people requiring treatment to avert one CV event and the number of events potentially averted over 10 years. Treatment for patients with high total CV risk (>/= 20%) was assumed to consist of a fixed-dose combination of several drugs (polypill). Cost analyses were limited to medication.FINDINGS: A total CV risk of >/= 10% and >/= 20% was found among 10.8% and 5.1% of individuals, respectively. With single-risk-factor management, 60% of adults would need to be treated and 157 cardiovascular events per 100 000 population would be averted per year, as opposed to 5% of adults and 92 events with total CV risk management. Management based on high total CV risk optimizes the balance between the number requiring treatment and the number of CV events averted.CONCLUSION: Total CV risk management is much more cost-effective than single-risk-factor management. These findings are relevant for all countries, but especially for those economically and demographically similar to Seychelles.

Iowa Power Fund Board Project Report Update, July 29, 2009

Climate refers to the long-term course or condition of weather, usually over a time scale of decades and longer. It has been documented that our global climate is changing (IPCC 2007, Copenhagen Diagnosis 2009), and Iowa is no exception. In Iowa, statistically significant changes in our precipitation, streamflow, nighttime minimum temperatures, winter average temperatures, and dewpoint humidity readings have occurred during the past few decades. Iowans are already living with warmer winters, longer growing seasons, warmer nights, higher dew-point temperatures, increased humidity, greater annual streamflows, and more frequent severe precipitation events (Fig. 1-1) than were prevalent during the past 50 years. Some of the impacts of these changes could be construed as positive, and some are negative, particularly the tendency for greater precipitation events and flooding. In the near-term, we may expect these trends to continue as long as climate change is prolonged and exacerbated by increasing greenhouse gas emissions globally from the use of fossil fuels and fertilizers, the clearing of land, and agricultural and industrial emissions. This report documents the impacts of changing climate on Iowa during the past 50 years. It seeks to answer the question, “What are the impacts of climate change in Iowa that have been observed already?” And, “What are the effects on public health, our flora and fauna, agriculture, and the general economy of Iowa?”

Climate Change Impacts on Iowa, 2010, January 1, 2011

Today, perhaps without their realization, Iowans are factoring climate change into their lives and activities. Current farming practices and flood mitigation efforts, for example, are reflecting warmer winters, longer growing seasons, warmer nights, higher dew-point temperatures, increased humidity, greater annual stream flows, and more frequent severe precipitation events (Fig. 1) than were prevalent during the past 50 years. Some of the effects of these changes (such as longer growing season) may be positive, while others (particularly the tendency for greater precipitation events that lead to flooding) are negative. Climate change embodies all of these results and many more in a complex manner. The Iowa legislature has been proactive in seeking advice about climate change and its impacts on our state. In 2007, Governor Culver and the Iowa General Assembly enacted Senate File 485 and House File 2571 to create the Iowa Climate Change Advisory Council (ICCAC). ICCAC members reported an emissions inventory and a forecast for Iowa’s greenhouse gases (GHGs), policy options for reducing Iowa’s GHG, and two scenarios charting GHG reductions of 50% and 90% by 2050 from a baseline of 2005. Following issuance of the final report in December 2008, the General Assembly enacted a new bill in 2009 (Sec. 27, Section 473.7, Code 2009 amended) that set in motion a review of climate change impacts and policies in Iowa. This report is the result of that 2009 bill. It continues the dialogue between Iowa’s stakeholders, scientific community, and the state legislature that was begun with these earlier reports.

Preoperative percutaneous portal vein embolization: evaluation of adverse events in 188 patients.

PURPOSE: To retrospectively assess the frequency of adverse events related to percutaneous preoperative portal vein embolization (PPVE). MATERIALS AND METHODS: Institutional review board did not require its approval or patient informed consent for this study. The adverse events that occurred during PPVE or until planned hepatic surgery was performed or cancelled were retrospectively obtained from clinical, imaging, and laboratory data files in 188 patients (109 male and 79 female patients; mean age, 60 years; range, 16-78 years). Liver resection was planned for metastases (n = 137), hepatocarcinoma (n = 31), cholangiocarcinoma (n = 15), fibrolamellar hepatoma (n = 1), and benign disease (n = 4). PPVE was performed with a single-lumen 5-F catheter and a contralateral approach with n-butyl cyanoacrylate mixed with iodized oil as the main embolic agent. The rate of complications in patients with cirrhosis was compared with that in patients without cirrhosis by using the chi(2) test. RESULTS: Adverse events occurred in 24 (12.8%) of 188 patients, including 12 complications and 12 incidental imaging findings. Complications included thrombosis of the portal vein feeding the future remnant liver (n = 1); migration of emboli in the portal vein feeding the future remnant liver, which necessitated angioplasty (n = 2); hemoperitoneum (n = 1); rupture of a metastasis in the gallbladder (n = 1); transitory hemobilia (n = 1); and transient liver failure (n = 6). Incidental findings were migration of small emboli in nontargeted portal branches (n = 10) and subcapsular hematoma (n = 2). Among the 187 patients in whom PPVE was technically successful, there was a significant difference (P < .001) between the occurrence of liver failure after PPVE in patients with cirrhosis (five of 30) and those without (one of 157). Sixteen liver resections were cancelled due to cancer progression (n = 12), insufficient hypertrophy of the nonembolized liver (n = 3), and complete portal thrombosis (n = 1). CONCLUSION: PPVE is a safe adjuvant technique for hypertrophy of the initially insufficient liver reserve. Post-PPVE transient liver failure is more common in patients with cirrhosis than in those without cirrhosis.

Special investigation of the University of Northern Iowa Events Complex Concessions for the period October 1, 2006 through March 31, 2012

Special investigation of the University of Northern Iowa Events Complex Concessions for the period October 1, 2006 through March 31, 2012

Díaz-Andreu, Margarita: A world history of nineteenth century archaeology. Nationalism, Colonialism, and the Past.

M. Díaz-Andreu plantea un análisis de las implicaciones académicas, sociales y políticas de la arqueología (entendiendo como tal la investigación estricta, pero también el coleccionismo de obras de arte) entre finales del siglo XVIII y el inicio de la Primera Guerra Mundial, período durante el cual la formación y expansión de los imperios coloniales constituyó uno de los elementos clave en el discurso ideológico de los estados europeos. Su trabajo continúa la línea marcada por estudios suyos anteriores, esencialmente Nationalism and Archaeology in Europe (Díaz-Andreu & T. Champion [eds.], 1996) y Excavating Women. A History in European Archaeology (Díaz-Andreu & M. L. S. Sorensen, 1998), en los que combinaba el análisis historiográfico de diferentes aspectos y personajes clave de la arqueología europea desde la perspectiva de la organización de las redes sociales entre investigadores, con la reflexión sobre las implicaciones de la arqueología como ciencia en la definición y defensa de diferentes credos políticos, y el papel de la mujer en la investigación.

Pieces of Iowa’s Past, January 16, 2008

Pieces of Iowa’s Past, published by the Iowa State Capitol Tour Guides weekly during the legislative session, features historical facts about Iowa, the Capitol, and the early workings of state government. All historical publications are reproduced here with the actual spelling, punctuation, and grammar retained. January 16, 2008

Pieces of Iowa’s Past, January 16, 2008

Pieces of Iowa’s Past, published by the Iowa State Capitol Tour Guides weekly during the legislative session, features historical facts about Iowa, the Capitol, and the early workings of state government. All historical publications are reproduced here with the actual spelling, punctuation, and grammar retained. January 30, 2008

Pieces of Iowa’s Past, January 23, 2008

Pieces of Iowa’s Past, published by the Iowa State Capitol Tour Guides weekly during the legislative session, features historical facts about Iowa, the Capitol, and the early workings of state government. All historical publications are reproduced here with the actual spelling, punctuation, and grammar retained. January 23, 2008 THIS WEEK: Capitol Quotations

Pieces of Iowa’s Past, February 6, 2008

Pieces of Iowa’s Past, published by the Iowa State Capitol Tour Guides weekly during the legislative session, features historical facts about Iowa, the Capitol, and the early workings of state government. All historical publications are reproduced here with the actual spelling, punctuation, and grammar retained. February 6, 2008 THIS WEEK: “War of the Rebellion”

Pieces of Iowa’s Past, February 13, 2008

Pieces of Iowa’s Past, published by the Iowa State Capitol Tour Guides weekly during the legislative session, features historical facts about Iowa, the Capitol, and the early workings of state government. All historical publications are reproduced here with the actual spelling, punctuation, and grammar retained. February 13, 2008 THIS WEEK: “The Great Tornado of 1860”

Pieces of Iowa’s Past, February 20, 2008

Pieces of Iowa’s Past, published by the Iowa State Capitol Tour Guides weekly during the legislative session, features historical facts about Iowa, the Capitol, and the early workings of state government. All historical publications are reproduced here with the actual spelling, punctuation, and grammar retained. February 20, 2008 THIS WEEK: “The Old Brick Capitol”

Pieces of Iowa’s Past, February 27, 2008

Pieces of Iowa’s Past, published by the Iowa State Capitol Tour Guides weekly during the legislative session, features historical facts about Iowa, the Capitol, and the early workings of state government. All historical publications are reproduced here with the actual spelling, punctuation, and grammar retained. February 27, 2008 THIS WEEK: Tunnel of Progress