Lipid-lowering and anti-thrombotic therapy in patients with peripheral arterial disease

Summary: 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.

Out of the Shadows: The Women Countering Insurgency in Nigeria

Moving beyond the focus on violence against women and violence committed by women, this article interrogates violence countered by women. The article sheds new light on the gendered practices of counterinsurgency in northeast Nigeria, with critical attention to why women joined the civilian resistance to the Boko Haram insurgency and their complex role and agency as local security providers. Using the voices and lifeworlds of women who joined the Civilian Joint Task Force (yan gora) in Borno State as well as the Vigilante Group Nigeria and Hunters Association (kungiya marhaba) in Adamawa State, the article underscores the layered and gender-bending role of women as frontline fighters, knowledge brokers, state informants, and producers of vigilante technologies. The article finds that women counterinsurgents mobilized after Boko Haram shifted its strategy toward using female insurgents, especially as suicide bombers. Women joined the war against Boko Haram for complex reasons, including personal loss, revenge, family ties, community attachment, patriotism, and a collective yearning for normalcy.

SMART Subsea Cables for Observing the Ocean and Earth

The Joint Task Force (JTF) for Science Monitoring And Reliable Telecommunications (SMART) Subsea Cables will facilitate integration of sensors into commercial submarine telecommunications cables for climate monitoring and disaster warning. Our vision is a planetary scale array monitoring ocean heat and circulation and sea-level rise and revolutionizing real-time warning systems for earthquake and tsunami disaster mitigation. This is enabled by the trans-ocean cable infrastructure linking society together: 1.4 million km of cable, 20,000 repeaters every 70 km hosting the sensors, constantly being refreshed over 10‐25 years, without interfering with telecom. Initial sensors are ocean bottom temperature, pressure and seismic acceleration. System suppliers are on board, the first major SMART project is funded and underway in Portugal (2020), and seven others are in various stages of planning and funding—a perfect example of the Blue Economy in action for the UN Decade.JTF will provide coordination between ocean science, operational oceanography, hazard early warning centers, industry, and relevant government agencies. SMART cables will create profound opportunities for innovation—requiring people with appropriate depth and breadth of expertise. JTF will facilitate SMART cable projects that will catalyze and include education, training, and outreach programs to build necessary capacity

Boko Haram violence in northern Cameroon will persist

Significance The attack comes amid growing insecurity in the Far North region over the past year. Residents in Cameroon's north are increasingly the most vulnerable in the Lake Chad Basin to attacks by Boko Haram’s factions, suggesting that some of these are increasingly dependent on their cross-border activities for resources and recruits. Impacts Washington will pressure Yaounde further over its poor human rights record amid rising bipartisan congressional criticism. The Multinational Joint Task Force remains unwilling or unable to degrade Boko Haram in the Far North, undermining touted regional progress. Cameroon’s land border closures appear to have had little or no effect on the illicit movement of goods and people.