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The government of Cape Verde, an archipelagic Small Island Developing State (SIDS) off the coast of Senegal, has established a goal to achieve 100% of its electricity from renewable sources by 2025. Several islands in the archipelago have suitable wind and solar resources and nationally these compose about 25% of the electricity output. However, not all islands are equally endowed with these resources and the lack of grid connections among islands poses challenges for integrating additional variable energy generation. Integrating desalination and storage (pumped hydro or battery) could enable greater penetration of wind and solar energy. Ocean thermal energy conversion (OTEC) is an emerging technology that could be suitable for Cape Verde. Microgrids and self-generation could prove to be more cost effective than grid connections outside of the large cities. Achieving the 100% renewable energy goal would require a US$1 billion investment. Cape Verde has a variety of resources that can contribute to achieving its 100% renewable electricity goal but combining them in manageable and cost-effective way remains a challenge. The options, opportunities, and challenges encountered by Cape Verde are applicable to other countries, especially small island developing states and archipelagos around the world.

In our experience, clotted angiographic catheters pulled back to near the puncture site and severed near the skin will spontaneously clear, facilitating insertion of a guidewire and catheter exchange without repuncture or other manipulation.

tional management (NIM). We hypothesize that there will be a significant difference between the rate of infections dependent on management pathway. Materials: We conducted a retrospective review of all 1,101 splenic injuries at our institution from 2005 to 2010. Criteria for inclusion included age greater than 6, documented visit within our health system more than 30 days from injury, and a completed dataset. Infections, as determined by ICD9 code, were included if they occurred more than 5 days from the injury and was related to encapsulated bacteria, other bacterial infection, bacterial syndrome (e.g., pneumonia), or systemic inflammatory response syndrome. Groups were compared by a binary logistic regression analysis that included splenic injury grade, injury severity scale (ISS), Glasgow Coma Scale (GCS) at presentation, and age at the time of injury to control for potential confounders. Results: Six hundred thirty seven cases were included in the final analysis. Infection rates for splenectomy and IR were similar at 28.5% and 27.5%, respectively, and both significantly higher than NIM at 10.8% (OR ¼ 2.51, 95% CI 1.38-4.59 and OR ¼ 2.70, 95% CI 1.25-5.79). Multivariate logistic regression demonstrated management pathway (p ¼ 0.004), age (p ¼ 0.024), ISS (p ¼ 0.004), and GCS (p o 0.001) as independent predictors for infection. Conclusions: Management pathway is an independent predictor for future infections with both splenectomy and IR having a higher rate of infection compared to NIM when controlling for potential confounders. Vaccination may be indicated in IR patients after embolization.