T wave abnormalities, high body mass index, current smoking and high lipoprotein (a) levels predict the development of major abnormal Q/QS patterns 20 years later. A population-based study

BACKGROUND: Most studies on risk factors for development of coronary heart disease (CHD) have been based on the clinical outcome of CHD. Our aim was to identify factors that could predict the development of ECG markers of CHD, such as abnormal Q/QS patterns, ST segment depression and T wave abnormalities, in 70-year-old men, irrespective of clinical outcome. METHODS: Predictors for development of different ECG abnormalities were identified in a population-based study using stepwise logistic regression. Anthropometrical and metabolic factors, ECG abnormalities and vital signs from a health survey of men at age 50 were related to ECG abnormalities identified in the same cohort 20 years later. RESULTS: At the age of 70, 9% had developed a major abnormal Q/QS pattern, but 63% of these subjects had not been previously hospitalized due to MI, while 57% with symptomatic MI between age 50 and 70 had no major Q/QS pattern at age 70. T wave abnormalities (Odds ratio 3.11, 95% CI 1.18–8.17), high lipoprotein (a) levels, high body mass index (BMI) and smoking were identified as significant independent predictors for the development of abnormal major Q/QS patterns. T wave abnormalities and high fasting glucose levels were significant independent predictors for the development of ST segment depression without abnormal Q/QS pattern. CONCLUSION: T wave abnormalities on resting ECG should be given special attention and correlated with clinical information. Risk factors for major Q/QS patterns need not be the same as traditional risk factors for clinically recognized CHD. High lipoprotein (a) levels may be a stronger risk factor for silent myocardial infarction (MI) compared to clinically recognized MI

The biological weapons regime

This chapter looks at the web of measures in place to prohibit and prevent biological weapons. It argues that theoretically this web most closely resembles a type of “strong global prohibition regime”, yet at the same time, the notion of strength suggests a level of confidence in the regime that is misplaced at this current juncture when, in fact, there is little room for complacency concerning biological weapons. Shifts in the wider disarmament landscape, combined with changes in the capacity and geography of the life sciences, on the one hand, and the wider security context on the other, could result in the biological weapons regime being profoundly weakened in the future if it is not adequately “tended” by stakeholders. After a short introduction to biological weapons, the chapter proceeds to outline the origins of the 1925 Geneva Protocol. It then proceeds to look at the genesis of the 1972 Biological and Toxin Weapons Convention. The third section looks at the evolution and expansion of the BW regime in three different areas: domestic measures; effective verification; and international cooperation. The penultimate section of this chapter provides some reflections on the limitations of the biological weapons prohibition regime and the means whereby a changing scientific and security milieu present a potential challenge to the maintenance of a strong global regime

Between Informality and Organized Crime: Criminalization of Small-Scale Mining in the Peruvian Rainforest

“Mining, like other types of resource extraction, is often carried out by a number of actors ranging from licit to illicit. Laws governing resource extraction have to balance the interests of the local economy, the environment, and law enforcement. In Peru, the government has attempted to tackle the increasing involvement of organized crime groups (OCGs) in the jungle region of Madre de Dios by placing “illegal mining” under the organized crime legislation, thereby elevating the seriousness of illegal mining to an activity classified as “organized crime.” This chapter studies the implications of this classification in the local context of Madre de Dios, focusing on the impact this legislative change is having on the local population involved in artisanal and small-scale gold mining (ASGM). Ethnographic fieldwork and qualitative interviews reveal how conflicting policies have erased the line between the informal and the illegal, victimizing those local miners willing to make the step toward environmental sustainability through the formalization process