Impact of COVID-19 on Disadvantaged Business Enterprises in Minnesota

1044724Minnesota\u2019s Office of Civil Rights at the Minnesota Department of Transportation administers the Disadvantaged Business Enterprise (DBE) program. The DBE program is intended to remedy past and current discrimination against disadvantaged business enterprises, ensure a level playing field and foster equal opportunity in DOT-assisted contracts, improve the flexibility and efficiency of the DBE program, and reduce burdens on small businesses. The last Needs Assessment of The Minnesota Department of Transportation\u2019s (MnDOT) Office of Civil Rights Disadvantaged Business Enterprise (DBE) and On-the-Job Training/Supportive Services (OJT/SS) programs was conducted in 2020. With the emergence of the COVID-19 global pandemic, MnDOT\u2019s Office of Civil Rights partnered with The Improve Group, a research and evaluation firm, to develop and conduct an analysis on the impact of COVID-19 on disadvantaged business enterprises in Minnesota engaged in highway heavy construction and providing professional and technical services. In assessing this impact, The Improve Group utilized both quantitative and qualitative data collection methods to outline the effects of COVID-19 on business stability, support received from MnDOT to alleviate impact, and generate recommendations for MnDOT to consider for use in the future

Controversies in the Use of Beta Blockers in Heart Failure

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/94510/1/j.1527-5299.2003.00294.x.pd

Controversies in Atherosclerosis Imaging: Serial CIMT Imaging and Plaque Quantitation

Presentazione su invito senza abstrac

Impact of COVID-19 on Disadvantaged Business Enterprises in Minnesota

Minnesota\u2019s Office of Civil Rights at the Minnesota Department of Transportation administers the Disadvantaged Business Enterprise (DBE) program. The DBE program is intended to remedy past and current discrimination against disadvantaged business enterprises, ensure a level playing field and foster equal opportunity in DOT-assisted contracts, improve the flexibility and efficiency of the DBE program, and reduce burdens on small businesses. The last Needs Assessment of The Minnesota Department of Transportation\u2019s (MnDOT) Office of Civil Rights Disadvantaged Business Enterprise (DBE) and On-the-Job Training/Supportive Services (OJT/SS) programs was conducted in 2020. With the emergence of the COVID-19 global pandemic, MnDOT\u2019s Office of Civil Rights partnered with The Improve Group, a research and evaluation firm, to develop and conduct an analysis on the impact of COVID-19 on disadvantaged business enterprises in Minnesota engaged in highway heavy construction and providing professional and technical services. In assessing this impact, The Improve Group utilized both quantitative and qualitative data collection methods to outline the effects of COVID-19 on business stability, support received from MnDOT to alleviate impact, and generate recommendations for MnDOT to consider for use in the future

Atherosclerosis Imaging-Clinical: Serial CIMT imaging. Present Status, the IMPROVE Trial

Presentazione su invito senza abstrac

Carotid intima media thickness (IMT) and IMT-progression as predictors of vascular events in a high risk european population

The intima-media thickness (IMT) of extracranial carotid arteries, assessed by ultrasound techniques, has been shown to be associated with most vascular risk factors for atherosclerosis and with the prevalence and extent of cardiovascular disease and coronary atherosclerosis. On this basis, this ultrasonic variable has been proposed as a surrogate index of atherosclerosis of other vascular regions. Studies have supported this hypothesis showing that IMT is a good predictor of new myocardial infarction and stroke. However, limited information has been provided on the relationship between IMT-progression, that is the real end point used in pharmacological studies, and cardiovascular events. Generally, attempts to delay IMT-progression using "anti-atherosclerotic" agents have provided encouraging results. However, no one of the studies so far published has been able to address, on a prospective basis, whether IMT-progression may effectively reflect the efficacy of the treatment in reducing the rate of cardiovascular events. To address these issues we designed \u201cthe IMPROVE study\u201d, a currently on going prospective multicenter, longitudinal, long-term, observational study funded by the European community. The major objective of the IMPROVE study is to evaluate the association between IMT, IMT-progression and the rate of new vascular events in subjects at high risk of atherosclerosis. The effect of gene polymorphisms, lipid peroxidation, socio-economic and psychological variables on the same ultrasonic end points will be also evaluated. In order to achieve the project objectives, 3600 patients will be recruited in 7 European countries and followed ultrasonically and clinically for 30 months. Clinical events will be monitored up to 36 months. Data will be analysed with conventional statistics and with innovative approaches based on artificial neural networks. The study is considered as positive if a difference of at least 3% in the cumulative incidence of acute vascular events between the lowest and the highest quintiles of IMT or IMT-progression is detected. A summary of aims and design of the study will be presented

Baseline determinants of carotid intima media thickness (IMT) in a high risk European population: the baseline results of the IMPROVE study

Aim: The \u201cIMPROVE study\u201d is a prospective, multicenter, longitudinal, observational study designed to investigate whether cross-sectional carotid artery intima media thickness (IMT) and overall IMT-progression are predictors of future vascular events in European individuals at high risk of cardiovascular diseases. The present report describes the results of the baseline analyses aimed to identify the major determinants of increased carotid IMT. Methods:. A total of 3711 subjects (age range 54-79 years) with at least 3 vascular risk factors (VRFs) were recruited in 7 centers of 5 European countries (Finland, France, Italy, the Netherlands and Sweden). Collected variables included clinical, biochemical, genetic, socio-economic, psychological, nutritional, and educational data, personal and family history of diseases, drug intake and physical activity. Results: By multiple linear regression analyses, carotid IMT was strongly and positively associated with centre-latitude, age, gender, pulse pressure, pack-years and hypertension, and inversely with educational level. Latitude was the strongest independent determinant of carotid IMT and alone accounted for nearly half of the variation explained by the regression model. The geographical gradient for carotid IMT paralleled the North to South cardiovascular mortality gradient. Conclusions: Latitude is a major determinant of carotid IMT which is not explained by between-country differences in established VRFs. Other unknown contributory mechanisms such as heritable, nutritional or environmental factors may be important in the genesis of this geographical gradient. Funding: European Project, IMPROVE QLG1-CT-2002-0089

Issue with models of integration : "The IMPROVE Study"

Epidemiological and clinical evidence indicates that < 50% of cardiovascular events are explained by vascular risk factors (VRFs), thus justifying for the need of alternative or integrated biomarkers to better stratify the patient risk. The intima-media thickness (IMT) of extracranial carotid arteries, measured by high-resolution B-mode ultrasound, is widely used to investigate the effects of conventional and non-conventional VRFs as well as the association with end-organ damage. In view of its correlation with coronary atherosclerosis, IMT has been proposed as an useful surrogate marker of atherosclerosis in carotid arteries and in other vascular regions. IMT is a good predictor of new myocardial infarction and it has been shown to be influenced by drugs known to reduce cardiovascular events, which supports the concept that IMT represents a biomarker of atherosclerosis. Carotid IMT alone has the same predictive capacity of VRFs. In a longitudinal - observational study, we have shown that the integrated use of VRFs included into the Framingham risk score and ultrasonic measurements of carotid IMT significantly increase their capacity to predict cardiovascular events in patients at low/intermediate risk. The integration of carotid IMT with non conventional VRFs (gene polymorphisms, oxidative burden, psyco or socioeconomic aspects etc.) may further optimize the stratification of patient risk. Another important carotid ultrasonic variable that may have predictive capacity, alone or when integrated with conventional or non conventional risk factors, is the progression of carotid IMT. A prospective, multicenter, longitudinal, long-term, observational study (The IMPROVE study) is currently ongoing. It aims to investigate the capacity of both cross sectional carotid IMT and overall IMT-progression to predict alone, or after integration with both conventional and non conventional VRF, the rate of new vascular events in an European population classified at high risk of cardiovascular disease for the presence of at least 3 VRFs. The patients\u2019 enrolment ended in April 2005 and a total of 3711 patients were recruited in 6 European countries (1095 in Italy, 504 in France and 2140 in northern Europe). Funding: Research describing correlations between carotid and coronary atherosclerosis is supported by the Italian Ministry of Health. The improve study is supported by European Union (IMPROVE: QLG1-CT-2002-00896) References: 1. Measurement of carotid artery intima-media thickness in dyslipidemic patients increases the power of traditional risk factors to predict cardiovascular events. Baldassarre D, Amato M, Pustina L, Castelnuovo S, sancito S; Gerosa L; Veglia F, Keidar S, Tremoli E, Sirtori CR. Atherosclerosis. 2006 May 6; [Epub ahead of print]. 2. Carotid intima media thickness (IMT) and IMT-progression as predictors of vascular events in a high risk european population: \u201cthe IMPROVE study\u201d. Tremoli E, Baldassarre D, on behalf of the \u201cIMPROVE Study Group\u201d. Atherosclerosis. 2006;7(3):42. 3. Baldassarre D, Amato M, Bondioli A, Sirtori CR, Tremoli E. Carotid artery intima-media thickness measured by ultrasonography in normal clinical practice correlates well with atherosclerosis risk factors. Stroke 2000;31:2426-2430. 4. Baldassarre D, Amato M, Pustina L, Tremoli E, Sirtori CR, Calabresi L, Franceschini G. Increased carotid artery intima-media thickness in subjects with primary hypoalphalipoproteinemia. Arterioscler Thromb Vasc Biol 2002;22:317-322

Common carotid artery diameter as a promising new candidate marker of cardiovascular risk in the IMPROVE study cohort

Aim: To explore whether inter-adventitial common carotid artery diameter (CCAD) detected by B-mode ultrasound may be considered a candidate marker of cardiovascular risk. Methods: The baseline data of the IMPROVE study cohort, including 1776 men and 1935 women representative of an European population at high risk of cardiovascular diseases, were analysed to explore whether CCAD is associated with the extent of carotid atherosclerosis, independently of traditional vascular risk factors and anthropometric variables. Results: After adjustment for possible confounders (height, centre, reader and sonographer), CCAD was positively associated with male gender, age, weight, body mass index, waist, hip, waist/hip ratio, systolic and diastolic blood pressure, pulse pressure, triglycerides, blood glucose, uric acid, cigarette packyears and family history of peripheral vascular disease (all p<0.0001). In contrast, years elapsed since smoking cessation, total-, HDL- and LDL-cholesterol were negatively related to CCAD (all p<0.0001). In the full model adjusted for all these confounders, CCAD was positively associated with carotid wall thickness (p<0.0001 for both IMTmean and IMTmax) and with the prevalence of carotid segments with plaques (p<0.04). Conclusion: Inter-adventitial CCAD is positively associated with carotid atherosclerosis and with most vascular risk factors. These results suggest that CCAD is a promising candidate marker of cardiovascular risk. Completion of the IMPROVE study will allow to assess prospectively the value of CCAD to predict new vascular events, independently to VRFs and carotid IMT. Funding: European Project, IMPROVE QLG1-CT-2002-0089