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"Heart benefits of statins outweigh diabetes risk," The Daily Telegraph says.
Statins are a type of medication widely used to lower blood cholesterol levels. While statins have proved reasonably effective in preventing cardiovascular disease (CVD), concerns have been raised that they could be associated with an increased risk of type 2 diabetes.
The Telegraph's story is based on a large, five-year study from the US that was seeking to clarify the 'risk-benefit balance' between:
- statin use
- reduced risk of CVD
- increased risk of type 2 diabetes
The key findings of the study were that:
- in people with no pre-existing risk factors for diabetes (such as obesity) statins decreased the risk of a major CVD outcome (such as a heart attack or a stroke) by 52%, but did not increase the risk of diabetes
- in people with one or more risk factors for diabetes, there was a 28% increase of diabetes, but this has to be balanced against a 39% decrease in a major CVD outcome
The researchers calculated that by treating the (roughly) 11,000 people in this trial who had risk factors for diabetes, 134 CVDs or deaths would be avoided for every 54 extra cases of diabetes caused.
The findings of this trial will need to be evaluated alongside other evidence, but do suggest the benefits of statins outweigh the potential risks.
Where did the story come from?
The study was carried out by researchers from the Center for Cardiovascular Disease Prevention and the Division of Cardiovascular Medicine at Brigham and Women's Hospital, Harvard Medical School, USA, and was funded by the drug company AstraZeneca. The study was published in the peer-reviewed medical journal, The Lancet.
The Telegraph accurately reported the main findings of this study, but it may have been more useful to readers if it had provided the actual numbers of people who might benefit. This would help both health professionals and patients to make a more informed decision about whether the benefits of statins are worth the risk.
What kind of research was this?
This was a randomised controlled trial which aimed to look at the benefit of statins in reducing the risk of cardiovascular events, and look at whether they increased the risk of type 2 diabetes, compared to an inactive placebo drug. The study population were people with no history of cardiovascular disease events; that is, the study was looking at the use of statins for primary prevention of cardiovascular disease (use of statins in people who have already had a heart attack or stroke would be secondary prevention).
A randomised controlled trial is the best way of looking at the risks and benefits of any intervention compared to a comparator. This particular trial further benefits from being of a large size, and including a reasonable length of follow-up (five years).
What did the research involve?
The JUPITER (Justification for Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin) trial included 17,802 men and women (average age 66 years) who were randomised to take either 20mg daily of rosuvastatin or an inactive placebo drug for five years.
All participants were healthy, without known heart disease or diabetes, although 65% did have one or more major risk factor for diabetes, including:
- metabolic syndrome (a combination of risk factors that increase risk of diabetes and other cardiovascular disease)
- body mass index (BMI) of 30 or higher (having a BMI of 30 or above is considered to be clinically obese)
- impaired fasting glucose and /or elevated glycated haemoglobin (a longer term measure of blood glucose control): the elevated levels suggest there are 'warning signs' that diabetes may develop in the future
Participants were followed over the course of the five years, and the main outcome of interest was a combined cardiovascular outcome, such as:
- any first events of heart attack
- stroke
- admission to hospital for unstable angina (similar to a heart attack but without the typical features on blood tests and ECG – suggests that a cardiac artery was blocked but has cleared by itself and that the person may be at risk of full heart attack)
- arterial revascularisation (surgery to unblock an artery)
- death resulting from a cardiovascular cause
Other outcomes of interest were doctors' diagnosis of diabetes, or venous thromboembolism (blood clot in the veins).
The trial was double blind, meaning that neither participants nor researchers knew whether statin or placebo had been taken.
After exclusion of those who were found to have diabetes at study start or who had missing data, 17,603 (99%) were included in the analyses. People with one or more major risk factor for diabetes (11,508) and those without (6,095) were analysed separately.
What were the basic results?
Overall, in all participants of the trial there were 270 reports of diabetes in people randomised to take rosuvastatin compared to 216 in the placebo group – a risk increase of 25% (hazard ratio [HR] 1.25, 95% confidence interval (CI) 1.05 to 1.49). The average time from randomisation to diagnosis of diabetes was 84.3 weeks in the rosuvastatin group vs. 89.7 weeks in the placebo group: an acceleration of 5.4 weeks.
When analysed separately by group, for people with one or more risk factor for diabetes, statin treatment gave:
- a 39% reduced risk of any of the major cardiovascular outcomes of trial (HR 0.61, 95% CI 0.47 to 0.79)
- a 28% increased risk of diabetes (HR 1.28, 95% CI 1.07 to 1.54)
- no significant effect on risk of venous thromboembolism or all-cause death
People without diabetes risk factors had:
- a 52% reduced risk of any of the major cardiovascular outcomes of trial (HR 0.48, 95% CI 0.33 to 0.68)
- no significant effect on risk of diabetes, venous thromboembolism or all-cause death
The researchers calculated that if the number of people in this trial who had diabetes risk factors take a statin, then 134 cardiovascular events or deaths would be avoided for every 54 new cases of diabetes diagnosed. If the number of people in this trial without diabetes risk factors take a statin, 86 cardiovascular events or deaths would be avoided with no new cases of diabetes diagnosed.
How did the researchers interpret the results?
The researchers conclude from their trial that the cardiovascular benefits of taking a statin outweigh the risk of diabetes, even in people at high risk of diabetes.
This is a well conducted trial intending to weigh up the cardiovascular benefit against the diabetes risk of taking a statin. The large trial benefits from being double blind (neither participants nor researchers aware of study treatment) and including a reasonable length of follow-up.
Overall, the researchers find that amongst roughly 11,000 people with diabetes risk factors (such as metabolic syndrome or raised fasting glucose levels in the blood) 134 cardiovascular events or deaths would be avoided for every 54 extra cases of diabetes caused by taking a statin. Amongst roughly 6,000 people without diabetes risk factors who take a statin, 86 cardiovascular events or deaths would be avoided with no new cases of diabetes diagnosed.
These are important findings which add to the evidence on the benefit of statins for reducing cardiovascular events, and to the risk increase for diabetes.
It must be noted that the trial was examining the use of one statin for 'primary prevention' – that is, in people who have not suffered a cardiovascular event such as heart attack or stroke. It has not examined use of statins for secondary prevention in people who have already had a cardiovascular event, although the researchers say that in this group the diabetes risk is considered to be low compared with the reduced risk of having another cardiovascular event.
Also, the study has only examined one statin – rosuvastatin – though previous research has suggested that all statin drugs are associated with a similar small increased risk. The study has also only examined the medium dose of 20mg, and other research suggests that the risks may be dose-dependent and higher doses may be associated with higher risk.
When prescribing any drug its benefits and potential risks need to be taken into account. The findings of this trial will need to be evaluated alongside other evidence of the risks and benefits of statins at different doses and in different treatment groups. However, overall the findings confirm the net benefits of statins.
Analysis by Bazian
Edited by NHS Website
Links to the science
Ridker PM, Pardhan A, MacFayden JG, et al.
Cardiovascular benefits and diabetes risks of statin therapy in primary prevention: an analysis from the JUPITER trial
The Lancet. Published online, August 10, 2012


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enumerate_it 0.7.10
Have a legacy database and need some enumerations in your models to match those stupid '4 rows/2 columns' tables with foreign keys and stop doing joins just to fetch a simple description? Or maybe use some integers instead of strings as the code for each value of your enumerations? Here's EnumerateIt.

subset: commoncrawl


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European Commission
Press release
Brussels, 11 July 2012
Further CO2 emission reductions from cars and vans: a win-win for the climate, consumers, innovation and jobs
The European Commission today put forward proposals to implement targets that will further considerably reduce carbon dioxide (CO2) emissions from new cars and light commercial vehicles (vans) by 2020.
The proposals will cut average emissions from new cars to 95 grams of CO2 per km (g CO2/km) in 2020 from 135.7g in 2011 and a mandatory target of 130g in 2015. Emissions from vans will be reduced to 147g CO2/km in 2020 from 181.4g in 2010 (the latest year for which figures are available) and a mandatory target of 175g in 2017.
The mandatory targets for 2020 are already envisaged in existing legislation but require implementation. Following thorough technical and economic analysis by the Commission, the Regulations proposed today establish the modalities by which the targets would be achieved.
Connie Hedegaard, EU Commissioner for Climate Action, said: ''With our proposals we are not only protecting the climate and saving consumers money. We are also boosting innovation and competitiveness in the European automotive industry. And we will create substantial numbers of jobs as a result. This is a clear win-win situation for everyone. This is one more important step towards a competitive, low-carbon economy. More CO2 reductions beyond 2020 need to be prepared and these will be considered in consultation with stakeholders."
Please note that a video is embedded in the online version of this press release
Net savings for consumers
The Commission's analysis shows that the 2020 targets are achievable, economically sound and cost effective: the technology is readily available, its cost is substantially lower than previously thought and its implementation should boost employment and GDP and benefit consumers and industry.
Each new car will on average save its owner around €340 in fuel costs in the first year, and an estimated total of €2904-3836 over the car's lifetime (13 years), as compared with the 2015 target. For vans the average fuel cost saving is estimated at around €400 in the first year and €3363-4564 over their 13-year lifetime.
Overall, consumers will save around €30bn per year in fuel costs and it is estimated that the targets could increase EU GDP by €12bn annually and spending on employment by some €9bn a year. The proposals would in total save 160 million tonnes of oil – worth around €70bn at today's prices - and around 420 million tonnes of CO2 in the period to 2030.
Spurring innovation and competitiveness
The European automotive industry is considered a global technology leader, largely due to its substantial investments in innovation in combination with a demanding home market. The Commission's impact assessment of the proposals shows the sector has a large capacity for innovation and enjoys a substantial comparative advantage over competitors.
The 2020 targets offer a clear and stable legal environment for investment, and will further stimulate innovation by vehicle producers and component suppliers, further strengthening the EU industry's competitive advantage. The introduction of similar CO2 or fuel efficiency standards in third countries would increase demand for CO2-reducing technologies and more efficient cars made in Europe.
Keeping and creating jobs
The need for new technologies and improvements in fuel efficiency will have positive impacts on demand for components. Fuel efficiency is expected to have a beneficial effect on employment as fuel efficiency increases the value of cars manufactured and leads to proportionally higher labour demand since vehicle manufacturing is labour-intensive.
What next?
The proposals will be submitted to the European Parliament and the Council for discussion and adoption under the normal legislative procedure. The proposals would amend two existing Regulations1 establishing binding requirements for manufacturers to meet the 2015 mandatory target for cars and the 2017 target for vans. Implementing measures for the Regulations are already in place and CO2 emissions from new vehicles are monitored annually.
The proposals represent a further contribution towards meeting the EU's goal of cutting overall greenhouse gas emissions to 20% below 1990 levels by 2020 and moving towards decarbonising the transport sector, in line with the EU's climate change policy and the Transport White Paper. Cars and vans together account for around 15% of EU CO2 emissions, including emissions from fuel supply.
For more information:
DG Climate Action CO2 from cars page:
DG Climate Action CO2 from light commercial vehicles page:
EEA monitoring report on car CO2 emissions for 2011:
See also
Regulation (EC) No 443/2009 (cars) and Regulation (EU) No 510/2011 (vans)
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DUBLIN, Ireland, Nov. 17 (UPI) -- Protesters at candlelight vigils for a woman who died in a Galway hospital after being denied an abortion called for called for a change in Irish abortion law.
Thousands of people, most of them women, rallied Saturday in Irish cities and in London, The Irish Times reported. In Dublin, marchers carried a banner with Savita Halappanavar's picture and the words "Never Again."
Halappanavar died in October at University Hospital Galway after doctors refused to terminate her pregnancy when she went into premature labor, saying they could only remove the fetus when they could no longer detect a heartbeat. Her husband says he was told Ireland is a "Catholic country" when he begged doctors to act.
The government has ordered an investigation into the death, which was only reported this week.
The Abortion Support Network says many of the Irish women who seek its help are desperate to end their pregnancies, The Guardian reported.
The organization provides assistance, and sometimes financial help, to women who must travel to England or Scotland for abortions. Abortion is illegal in both the Irish Republic and Northern Ireland.
The group said, it has helped 335 Irish women and 228 from Northern Ireland in the past three years. The Irish women included 19 who had become pregnant through rape, 21 with severe health problems, 21 who were under 16 years old and six with histories of recent suicide attempts.


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The Country Club Brookline, Brookline 1
Chestnut Hill, MA 02467-2903
Course Details/History
- Architect Name – Willie Campbell/(R) William S. Flynn/Geoffrey S. Cornish, ASGCA
- Greens Grass Type – Bent Grass
- Regulation Length Holes – 27
- Twitter – https://www.pga.com/
Golf.com Editorial
Private, 36 holes, $100.00 - $60.00
The Country Club is consistently ranked as one of the top courses in the U.S. and the World by Golf Magazine's panel of experts.
Start with the name: this place is so old and crammed full of Boston bluebloods that it didn't need any further qualifiers. Brookline, as it is often known, is the very first "country club" in the United States, dating to 1882, and was another of the USGA's founding clubs.
The club has a regulation 18 hole course and a nine hole executive course.
The 18 hole features small greens and wide fairways, with many deep bunkers and two water hazards. When special tournament play occurs and the club needs a championship length course, they combine different holes from each of the courses to create a temporary 7,010 yard course.
Originally founded in 1882, the course was the site of the famous 1913 U.S. Open, won by amateur Francis Quimet over Harry Vardon and Ted Ray in a playoff. The U.S. Open was also played here in 1963 (won by Julius Boros) and in 1988 (won by Curtis Strange). More recently, the Country Club was the site if the 1999 Ryder Cup, known as the Battle at Brookline, which was won in a thrilling comeback by the United States.
This Club has multiple courses:
- Main
- Primrose
- Year Built: 1882
- Designer: Willie Campbell
- Greens Grass Type: Bent Grass
- Fairways Grass Type: Bent Grass
- Water Hazards: Yes
- Sand Bunkers: 91-100
- Yardage Markers: 200, 150, 100 Yrd Markers and Sprinkler Heads Marked


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We went out for barbecue and then headed on to the Bluegrass Balloon Festival. Noah was so excited about getting to do this. He is completely mesmerized by hot air balloons and the prospect of seeing a balloon up close threw him into a frenzy! As soon as we finished dinner, he started saying (no less than 100 times), "I so cited! Let's go to the balloons!" He absolutely loved getting to see all the balloons glowing in the dark. His face was just aglow with wonder. I am a little sad that most of my pictures didn't come out- I just couldn't figure out what setting to put my camera on. The poor thing's being help together by tape, so I guess I should just be thankful it works at all! Anyways- here's a few shots from our super fun night out with Papaw Johnny.
We've also had some doctor's appointments this week. Noah went to the orthopaedist on Thursday. They said he's healing okay, but they wanted to put him in a brace for 3-4 weeks. He's actually tolerating having the brace on, which is a slight miracle. So hopefully in another month, he should be back to relative normalcy.
I went to the eye doctor this morning because for the last week my right eye has been drooping. My one eye only wants to look down and to the right. It takes serious effort just to hold my eyeball straight ahead. I have, however, been able to look at the floor with very minimal effort on my part. And I can tell you that the floor is in need of a good Swiffering. The doc said my vision is fine and that my droopy eyeball is caused by sinuses and allergies and will go away when allergy season is over. Whodda thought? I am convinced that allergies are the root of all evil and seem to cause pretty much every single ailment known to man. It had been about 12 years since I'd had my eyes dilated. I had forgotten what a weird experience that is. When my eyes were finally dilated and I was back up in the big chair the doctor started shining the lights in them. At first it wasn't so bad. Then he used this light that is a long vertical line
I keep hoping any day now that we should hear something about our referral. About 2 1/2 weeks ago we heard from Jilma, our amazing adoption attorney, that the director of the orphanage sent her a letter saying that she had 2 little boys under age 3 who were adoptable. One of those little boys is supposed to be ours!!! Unless they happen to be brothers, and then that's a whole other joyous can of worms! Jilma said she hoped to know more information about them in about 10 days (age, HIV status). Ten days came about 4 days ago. We are learning just how slowly information travels out of 3rd world countries. Last we heard, both boys were undergoing HIV testing, which is great! Progress is being made and we hope to get our referral any day now!!! I am seriously checking my email approximately ever 27 seconds and just waiting for the phone to ring, hoping for any shred of news. I know it might not be the best thing to get my hopes up so high, but I just can't seem to help it. So here's to high hopes!!! And maybe, just maybe, those high hopes will also help the Cats beat the Gators tonight. Is that too much to ask for? I think not.
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kathleenJ wrote:I like seeing higher numbers of votes too, just like I like high site traffic statistics even when they're irrelevant or deceptive.
al_fayyed wrote:See, you don't want to swallow a stack of twenties all at once. One at a time, in little rolled up straws, would probably work better.
kathleenJ wrote:Heh, maybe not thinking things through is this character's fatal flaw, and she'll become some kind of Shakespearian tragic hero.
al_fayyed wrote:Wow, that's a writing task for you right there -- how do you develop and emphasize a character whose actions are chosen by others?
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このビデオは 日本語 ではご利用いただけません。このビデオは English (US) でご利用いただけます。
Cloud Cover Episode 19 - Silverlight and Blob Storage
In this episode: Watch as we discuss how to get Silverlight clients working from blob storage. Learn the differences between hosting the XAP file in your web role as opposed to hosting from blob storage. Learn the tips and tricks we found in building Silverlight clients for Windows Azure. Discover how to use Fiddler to trace local dev storage.
Episode 129: What's New with in Azure Storage incl the Import Export Service CORS JSON Read from Secondary


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Learn a little more about our platform.
Liferay Portal is the market's leading open source portal for the enterprise. It is recognized as a leader in our space by Gartner's Magic Quadrant paper, and boasts a community of over 65,000 members around the world. Take a quick look through some of our introduction videos about the product used by the likes of Cisco, The United Nations, NASA, Sesame Street, and more!
Part 1: Getting Started with Liferay PortalThis is one of several short videos, hosted by Liferay's Community Manager, James Falkner, that introduce Liferay Portal's capabilities for a first time user. This segment runs you through the product after it is first downloaded and installed. It showcases the Dock Bar, the Control Panel, and the Liferay Marketplace with basic information about administration and configuration.
Part 2: Getting Started with Social OfficeThis second segment goes into more detail about SO, a full social collaboration suite available as a pluggable app in the Liferay Marketplace. James introduces the announcements, chat, wiki, forums, and dynamic content (sharing, storage, synching) features, one-by-one, demonstrating their seamless integration.
Part 3: Understand Your Audience with Social AnalyticsJames digs deeper into the collaboration scenario and demonstrates the social analytics capabilities in the Liferay platform. In particular, the video highlights Liferay's reporting capabilities, and the ease of creating and adding custom widgets to further surface user activity statistics and analytics. James also offers a quick overview of how to find more information about the Liferay platform and about building your own custom solutions by leveraging all the features shown (and more).


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Frequently Asked Questions
Free classified ads are a benefit of membership in the WCHA. For more information about becoming a WCHA member, visit wcha.org/membership.
If you are already a WCHA member and cannot place your ad, contact email@example.com to have your account configured (this is still a manual process).
I have a username and password, but I can't log into either the forums or the main website using them.
The main WCHA site and the WCHA forums are two separate systems that each require you to create an account for them separately.
I can see a button to update my shopping cart, but I can't check out. Why not?
In order to complete the checkout process for the WCHA Online Store, you must be a registered user of the website and be logged in.
It depends! There are a number of factors that contribute to the value of a wood canoe. Condition is perhaps the most significant factor. The builder of the canoe can play a role, either because of higher quality construction, or simple name recognition. Your location and potential market play a role as well. It is important to distinguish between market value and replacement value – the latter is usually higher and is important if you are insuring your canoe. For a more in-depth discussion of this topic, follow this link to the WCHA Forums.
The WCHA Classifieds are perhaps the best way to market your canoe, as it is targeted to the audience you want to address – namely wooden canoe enthusiasts! Ads are free for WCHA members, so you may want to consider joining the WCHA. Preparing a classified ad with a well-written description and good photographs will help you sell quickly and get top-dollar. Our members have also had success listing their canoes for sale on Ebay, Craig's List, and other outlets.
The following questions comes up regularly when planning the WCHA Annual Assembly:
"Where are we going to hold the Assembly in the year ____ ?" (fill in the blank)
"When can we have it in (insert your state here)?
The answer is in the form of a question: "What facility is there in your suggested location where we can hold the Assembly?
The Annual Assembly is a unique event with special requirements that contribute to its success. The criteria that the Assembly Committee uses to select the site for future events follows:
Assembly Site Specifications
- Lodging
- Housing for 400-500 people. Motel-style or dormitory-style is fine, barracks-style is not.
- Water
- MOST IMPORTANT. Canoeable river or lake. Readily accessible by foot from the lodging. Capable of handling frequent, spontaneous launchings by large numbers of people. Ideally also acceptable for swimming.
- Display
- Large lawn area suitable for the display of large numbers of canoes with easy access to the water and lodging facility.
- Dining
- Food service for 400-500 people with lodging not a requirement for dining.
- Meeting Rooms
- One auditorium capable of seating most of the group and one or two smaller classrooms for individual seminars. Access to classrooms must include the ability to get canoes in and out, and power. Tent space for outdoor covered activities (multiple tents, 20×20 minimum), including access to power for some of the tents.
- Parking
- Reasonably accessable parking for up to 300 vehicles (and trailers).
- Security
- Some thought should be given to security of the canoe in the display area and parking lot.
- Costs
- Lodging and meals should be economical. Currently costs range from $50 to $75 per person for lodging and 3 meals per day.
- Camping
- Camping facilities should be available on-site or nearby.
- Schedule
- Needs to be available during the middle of July.


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Host: Christopher Rose, Outreach Director, Center for Middle Eastern Studies
Guest: Miguel A. Levario, Assistant Professor of History, Texas Tech University
The words "Mexican immigration" are usually enough to start a vibrant, politically and emotionally charged debate. Yet, the history of Mexican migration to the U.S. involves a series of ups and downs—some Mexicans were granted citizenship by treaty after their lands were annexed to the U.S., and, until the 1970s, they were considered legally white—a privilege granted to no other group. At the same time, Mexicans crossing the border every day were subjected to invasive delousing procedures, and on at least two occasions were subjected to incentivized repatriation.
Guest Miguel A. Levario from Texas Tech University (and a graduate of UT's Department of History!) walks us through the "schizophrenic" relationship between the US and its southern neighbor and helps us ponder whether there are any new ideas to be had in the century long debate it has inspired—or any easy answers.
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