Community Engagement in Climate Change: Models of Culturally Appropriate Citizen Science: Theorizing From the Literature

Climate change is increasingly affecting people in rural and indigenous communities. This paper explores opportunities for adult educators to develop and support community programs related to environmental change and preservation

Conceptualizing Entrepreneurial Education as a Social Justice Endeavor

Entrepreneurial education is typically capitalist and overlooks social change efforts. Grounded in the literature, we argue progressive adult education has potential to transform entrepreneurial education into a social justice endeavor

Gender Bias at the Intersection of Engineering and Business: Implications for Workplace Education

Abstract: STEM and business fields historically include pervasive gender biases. To better integrate women, and based on results of an industry survey, we propose ways adult education may address such biases

Morbidity and mortality associated with atherosclerotic peripheral artery disease: A systematic review.

BACKGROUND AND AIMS It is unclear whether improvements in the detection/treatment of peripheral artery disease (PAD) affect overall survival and morbidity. We undertook a systematic review to describe survival and morbidity in contemporary PAD cohorts. METHODS Electronic databases were searched for randomised and observational studies reporting mortality/morbidity events between 1 May 2003 and 31 December, 2017 in patients with PAD, diagnosed by intermittent claudication (IC), critical limb ischaemia (CLI), or an ankle brachial index (ABI) < 0.9. Pooled event rates for all-cause and cardiovascular (CV) mortality, non-fatal myocardial infarction (MI), non-fatal stroke, major CV events (MACE; non-fatal MI/stroke, CV death), and major amputation were calculated per 1000 person-years. RESULTS 124 eligible studies were identified (570,856 patients; 855,894 person-years of follow-up). Statin use was reported in 67% of the overall cohort and antiplatelet use in 79%. Pooled event rates for all-cause and CV mortality, MI, stroke, MACE, and major amputation were 113, 39, 20, 12, 71, and 70 per 1000 person-years, respectively. Compared with patients with an ABI <0.9, the presence of CLI was associated with increased rates of all-cause and CV mortality, MI, MACE, and major amputation. Event rates for stroke were similar between patients with an ABI <0.9 and CLI. CONCLUSIONS Our data show PAD patients have a high risk of all-cause and CV mortality, and imply the risk of stroke or MI is at least equivalent to the risk in patients with coronary artery disease. Moreover, our data underline the need for improved treatments to attenuate CV risk in PAD patients

Preserve the Taste of Summer—Canning: Meat, Poultry, Wild Game and Fish

A jar of home preserved meat is a delicious and convenient way to start a quick and easy meal. Canning meat, poultry, wild game, and fish must be done correctly to assure that food is safe to eat. Find guidelines and recipes to follow to achieve the best product.https://lib.dr.iastate.edu/extension_families_pubs/1046/thumbnail.jp

238 A randomized, double-blind placebo-controlled study of NV1FGF gene therapy in critical limb ischemia patients (TAMARIS Study) Rationale, design and baseline patient characteristics

BackgroundPatients with critical limb ischemia (CLI) unsuitable for revascularization have a high rate of amputation and mortality (30% and 25% at 1 year respectively Local gene therapy using plasmid DNA encoding acidic fibroblast growth factor (NV1FGF, riferminogene pacaplasmid) showed promising results in a phase II trial on amputation free survival. This report provides the rationale, design and baseline characteristics of CLI patients enrolled to the pivotal phase III trial (TAMARIS). It also describes baseline characteristics by diabetes status and region of origin.Table: Comparison of 6 modes of ABI calculation to predict the 5-years mortality (abstract 237).ABI mode of calculationHigh/HighMean/HighLow/HighHigh/MeanMean/MeanLow/MeanAUC0.632*0.6200.6150.6100.6180.598Sensitivity with 0.9055.7%56.7%60.4%53.6%60.8%58.8%Specificity with 0.9065.1%62.3%60.2%63.6%58.5%58.6%Optimal cutpoint0.940.970.921.000.970.92Sensitivity for optimal cutpoint63.9%72.2%64.6%72.2%74.2%62.9%Specificity for optimal cutpoint60.3%50.6%58.7%48.3%50.3%57.5%*p<0.05 vs. High/Mean and Low/MeanMethodsAn international, double-blind, placebo-controlled, randomized study included 525 CLI patients worldwide who were unsuitable for revascularization and had non-healing skin lesions, to evaluate whether repeated intramuscular administration of NV1FGF results in reduction of major amputations or deaths at 1 year.ResultsMean age of the population was 70 ± 10 years including 70% males and 53% diabetic patients. Fifty four percent of the population had previous lower extremity revascularization and 22% had previous minor amputation of the index leg. Ninety six percent of patients had an ankle pressure < 70mmHg and/or a toe pressure < 50mmHg or a TcPO2 < 30mmHg. In 94% the index leg had distal occlusive disease affecting arteries below the knee. Statins were prescribed in 54% of patients, and antiplatelet drugs in 80%. Variation in region of origin resulted in only minor demographic imbalance. Patients with diabetes had more risk factors including history of coronary artery disease, but were similar to non-diabetic patients regarding limb haemodynamics and vascular lesions.ConclusionThe clinical and vascular anatomy presentation of patients with CLI with ischemic skin lesions who were unsuitable for revascularization was homogeneous with little imbalance according to region of origin or diabetic status. The findings from this large CLI cohort are important for the understanding of the epidemiology of the disease

Lipid-lowering and anti-thrombotic therapy in patients with peripheral arterial disease:European Atherosclerosis Society/European Society of Vascular Medicine Joint Statement

Patients with peripheral arterial disease (PAD) are at very high risk of cardiovascular events, but risk factor management is usually suboptimal. This Joint Task Force from the European Atherosclerosis Society and the European Society of Vascular Medicine has updated evidence on the management on dyslipidaemia and thrombotic factors in patients with PAD. Guidelines recommend a low-density lipoprotein cholesterol (LDLC) goal of more than 50% reduction from baseline and <1.4 mmol/L (<55 mg/dL) in PAD patients. As demonstrated by randomized controlled trials, lowering LDL-C not only reduces cardiovascular events but also major adverse limb events (MALE), including amputations, of the order of 25%. Addition of ezetimibe or a PCSK9 inhibitor further decreases the risk of cardiovascular events, and PCSK9 inhibition has also been associated with reduction in the risk of MALE by up to 40%. Furthermore, statin- based treatment improved walking performance, including maximum walking distance, and pain-free walking distance and duration. This Task Force recommends strategies for managing statin-associated muscle symptoms to ensure that PAD patients benefit from lipid-lowering therapy. Antiplatelet therapy, either daily clopidogrel 75 mg or the combination of aspirin 100 mg and rivaroxaban (2×2.5 mg) is also indicated to prevent cardiovascular events. Dual pathway inhibition (aspirin and rivaroxaban) may be considered following revascularization, taking into account bleeding risk. This Joint Task Force believes that adherence with these recommendations for lipid-lowering and antithrombotic therapy will improve the morbidity and mortality in patients with PAD

Deep Chandra X-ray Imaging of a Nearby Radio Galaxy 4C+29.30: X-ray/Radio Connection

We report results from our deep Chandra X-ray observations of a nearby radio galaxy, 4C+29.30 (z=0.0647). The Chandra image resolves structures on sub-arcsec to arcsec scales, revealing complex X-ray morphology and detecting the main radio features: the nucleus, a jet, hotspots, and lobes. The nucleus is absorbed (N(H)=3.95 (+0.27/-0.33)x10^23 atoms/cm^2) with an unabsorbed luminosity of L(2-10 keV) ~ (5.08 +/-0.52) 10^43 erg/s characteristic of Type 2 AGN. Regions of soft (<2 keV) X-ray emission that trace the hot interstellar medium (ISM) are correlated with radio structures along the main radio axis indicating a strong relation between the two. The X-ray emission beyond the radio source correlates with the morphology of optical line-emitting regions. We measured the ISM temperature in several regions across the galaxy to be kT ~ 0.5 with slightly higher temperatures (of a few keV) in the center and in the vicinity of the radio hotspots. Assuming these regions were heated by weak shocks driven by the expanding radio source, we estimated the corresponding Mach number of 1.6 in the southern regions. The thermal pressure of the X-ray emitting gas in the outermost regions suggest the hot ISM is slightly under-pressured with respect to the cold optical-line emitting gas and radio-emitting plasma, which both seem to be in a rough pressure equilibrium. We conclude that 4C+29.30 displays a complex view of interactions between the jet-driven radio outflow and host galaxy environment, signaling feedback processes closely associated with the central active nucleus.Comment: ApJ in pres