Friday Facts, August 28, 2009, vol. 34

Bureau of Nutrition and Health Promotion part of the Iowa Department of Public Health produces of weekly newsletter about the Iowa WIC Program for the State of Iowa citizen.

Endovascular aortic repair versus open surgical repair for descending thoracic aortic disease a systematic review and meta-analysis of comparative studies.

OBJECTIVES: The purpose of this study was to determine whether thoracic endovascular aortic repair (TEVAR) reduces death and morbidity compared with open surgical repair for descending thoracic aortic disease. BACKGROUND: The role of TEVAR versus open surgery remains unclear. Metaregression can be used to maximally inform adoption of new technologies by utilizing evidence from existing trials. METHODS: Data from comparative studies of TEVAR versus open repair of the descending aorta were combined through meta-analysis. Metaregression was performed to account for baseline risk factor imbalances, study design, and thoracic pathology. Due to significant heterogeneity, registry data were analyzed separately from comparative studies. RESULTS: Forty-two nonrandomized studies involving 5,888 patients were included (38 comparative studies, 4 registries). Patient characteristics were balanced except for age, as TEVAR patients were usually older than open surgery patients (p = 0.001). Registry data suggested overall perioperative complications were reduced. In comparative studies, all-cause mortality at 30 days (odds ratio [OR]: 0.44, 95% confidence interval [CI]: 0.33 to 0.59) and paraplegia (OR: 0.42, 95% CI: 0.28 to 0.63) were reduced for TEVAR versus open surgery. In addition, cardiac complications, transfusions, reoperation for bleeding, renal dysfunction, pneumonia, and length of stay were reduced. There was no significant difference in stroke, myocardial infarction, aortic reintervention, and mortality beyond 1 year. Metaregression to adjust for age imbalance, study design, and pathology did not materially change the results. CONCLUSIONS: Current data from nonrandomized studies suggest that TEVAR may reduce early death, paraplegia, renal insufficiency, transfusions, reoperation for bleeding, cardiac complications, pneumonia, and length of stay compared with open surgery. Sustained benefits on survival have not been proven.

Evaluación económica de la determinación del propéptido natriurético cerebral N-terminal (NT-proBNP) en pacientes con disnea en los servicios de urgencias españoles

Introducción: Analizar la eficiencia de añadir la determinación NT-proBNP al examen clínico convencional (ECC) para el diagnóstico de insuficiencia cardíaca (IC) en pacientes con disnea que acuden a servicios de urgencias (SU) españoles. Material y métodos: Se desarrolló un árbol de decisión para evaluar los resultados clínicos y económicos de ambas alternativas durante 60 días de seguimiento desde la visita al SU en pacientes hospitalizados y no hospitalizados. Los parámetros clínicos fueron principalmente obtenidos del estudio PRIDE y validados por médicos de SU y cardiólogos. El punto de corte de la determinación NT-proBNP fue de 900 pg/mL (sensibilidad del 90% y especificidad del 85%). En base a datos espa noles publicados, se asumió que el 65% de pacientes con disnea sufrían IC. El uso de recursos fue identificado mediante opinión de expertos y evaluado desde la perspectiva del Sistema Nacional de Salud (SNS). El análisis comparó el diagnóstico final del paciente con el diagnóstico realizado en el SU. Se realizaron diversos análisis de sensibilidad para evaluar la incertidumbre del modelo. Resultados: El diagnóstico incorporando la determinación NT-proBNP fue correcto en el 91,96% de los pacientes (59,09% verdaderos positivos y 32,87% verdaderos negativos) frente al 85,53% mediante ECC (50,79% verdaderos positivos y 34,74% verdaderos negativos). La incorporación de la determinación NT-proBNP resultó tener un coste menor (3.720 versus 5.188 ). Los análisis de sensibilidad realizados confirmaron los resultados.

Long-term C-CO2 emissions and carbon crop residue mineralization in an oxisol under different tillage and crop rotation systems

Soil C-CO2 emissions are sensitive indicators of management system impacts on soil organic matter (SOM). The main soil C-CO2 sources at the soil-plant interface are the decomposition of crop residues, SOM turnover, and respiration of roots and soil biota. The objectives of this study were to evaluate the impacts of tillage and cropping systems on long-term soil C-CO2 emissions and their relationship with carbon (C) mineralization of crop residues. A long-term experiment was conducted in a Red Oxisol in Cruz Alta, RS, Brazil, with subtropical climate Cfa (Köppen classification), mean annual precipitation of 1,774 mm and mean annual temperature of 19.2 ºC. Treatments consisted of two tillage systems: (a) conventional tillage (CT) and (b) no tillage (NT) in combination with three cropping systems: (a) R0- monoculture system (soybean/wheat), (b) R1- winter crop rotation (soybean/wheat/soybean/black oat), and (c) R2- intensive crop rotation (soybean/ black oat/soybean/black oat + common vetch/maize/oilseed radish/wheat). The soil C-CO2 efflux was measured every 14 days for two years (48 measurements), by trapping the CO2 in an alkaline solution. The soil gravimetric moisture in the 0-0.05 m layer was determined concomitantly with the C-CO2 efflux measurements. The crop residue C mineralization was evaluated with the mesh-bag method, with sampling 14, 28, 56, 84, 112, and 140 days after the beginning of the evaluation period for C measurements. Four C conservation indexes were used to assess the relation between C-CO2 efflux and soil C stock and its compartments. The crop residue C mineralization fit an exponential model in time. For black oat, wheat and maize residues, C mineralization was higher in CT than NT, while for soybean it was similar. Soil moisture was higher in NT than CT, mainly in the second year of evaluation. There was no difference in tillage systems for annual average C-CO2 emissions, but in some individual evaluations, differences between tillage systems were noticed for C-CO2 evolution. Soil C-CO2 effluxes followed a bi-modal pattern, with peaks in October/November and February/March. The highest emission was recorded in the summer and the lowest in the winter. The C-CO2 effluxes were weakly correlated to air temperature and not correlated to soil moisture. Based on the soil C conservation indexes investigated, NT associated to intensive crop rotation was more C conserving than CT with monoculture.

Modeling changes in organic carbon stocks for distinct soils in southeastern brazil after four eucalyptus rotations using the century model

Soil organic matter (SOM) plays an important role in carbon (C) cycle and soil quality. Considering the complexity of factors that control SOM cycling and the long time it usually takes to observe changes in SOM stocks, modeling constitutes a very important tool to understand SOM cycling in forest soils. The following hypotheses were tested: (i) soil organic carbon (SOC) stocks would be higher after several rotations of eucalyptus than in low-productivity pastures; (ii) SOC values simulated by the Century model would describe the data better than the mean of observations. So, the aims of the current study were: (i) to evaluate the SOM dynamics using the Century model to simulate the changes of C stocks for two eucalyptus chronosequences in the Rio Doce Valley, Minas Gerais State, Brazil; and (ii) to compare the C stocks simulated by Century with the C stocks measured in soils of different Orders and regions of the Rio Doce Valley growing eucalyptus. In Belo Oriente (BO), short-rotation eucalyptus plantations had been cultivated for 4.0; 13.0, 22.0, 32.0 and 34.0 years, at a lower elevation and in a warmer climate, while in Virginópolis (VG), these time periods were 8.0, 19.0 and 33.0 years, at a higher elevation and in a milder climate. Soil samples were collected from the 0-20 cm layer to estimate C stocks. Results indicate that the C stocks simulated by the Century model decreased after 37 years of poorly managed pastures in areas previously covered by native forest in the regions of BO and VG. The substitution of poorly managed pastures by eucalyptus in the early 1970´s led to an average increase of C of 0.28 and 0.42 t ha-1 year-1 in BO and VG, respectively. The measured C stocks under eucalyptus in distinct soil Orders and independent regions with variable edapho-climate conditions were not far from the values estimated by the Century model (root mean square error - RMSE = 20.9; model efficiency - EF = 0.29) despite the opposite result obtained with the statistical procedure to test the identity of analytical methods. Only for lower soil C stocks, the model over-estimated the C stock in the 0-20 cm layer. Thus, the Century model is highly promising to detect changes in C stocks in distinct soil orders under eucalyptus, as well as to indicate the impact of harvest residue management on SOM in future rotations.

[Illustrations des Poètes maudits] / Luque, grav. ; Paul Verlaine, aut. du texte

Comprend : [Frontispice : portrait de] Paul Verlaine. [Cote : microfilm R 89553] ; [Fig. au chap. I : portrait de] Tristan Corbière. [Cote : microfilm R 89553] ; [Fig. au chap. II : portrait d'] Arthur Rimbaud. [Cote : microfilm R 89553] ; [Fig. au chap. III : portrait de] Stéphane Mallarmé. [Cote : microfilm R 89553] ; [Fig. au chap. IV : portrait de] Marceline Desbordes-Valmore. [Cote : microfilm R 89553] ; [Fig. au chap. V : portrait de] Villiers de l'Isle-Adam. [Cote : microfilm R 89553]

Secure and Prepared Newsletter, October 28, 2011, Vol. 7, no. 17

A bi-weekly newsletter for those involved in the fields of homeland security and/or emergency management

Report on a special investigation of the Webster County Metropolitan Law Enforcement Telecommunications Board for the period July 1, 2006 to January 28, 2011

Report on a special investigation of the Webster County Metropolitan Law Enforcement Telecommunications Board for the period July 1, 2006 to January 28, 2011