Validation of Two US Risk Scores for Percutaneous Coronary Intervention in a Single-Center Portuguese Population of Patients with Acute Coronary Syndrome

INTRODUCTION: New scores have been developed and validated in the US for in-hospital mortality risk stratification in patients undergoing coronary angioplasty: the National Cardiovascular Data Registry (NCDR) risk score and the Mayo Clinic Risk Score (MCRS). We sought to validate these scores in a European population with acute coronary syndrome (ACS) and to compare their predictive accuracy with that of the GRACE risk score. METHODS: In a single-center ACS registry of patients undergoing coronary angioplasty, we used the area under the receiver operating characteristic curve (AUC), a graphical representation of observed vs. expected mortality, and net reclassification improvement (NRI)/integrated discrimination improvement (IDI) analysis to compare the scores. RESULTS: A total of 2148 consecutive patients were included, mean age 63 years (SD 13), 74% male and 71% with ST-segment elevation ACS. In-hospital mortality was 4.5%. The GRACE score showed the best AUC (0.94, 95% CI 0.91-0.96) compared with NCDR (0.87, 95% CI 0.83-0.91, p=0.0003) and MCRS (0.85, 95% CI 0.81-0.90, p=0.0003). In model calibration analysis, GRACE showed the best predictive power. With GRACE, patients were more often correctly classified than with MCRS (NRI 78.7, 95% CI 59.6-97.7; IDI 0.136, 95% CI 0.073-0.199) or NCDR (NRI 79.2, 95% CI 60.2-98.2; IDI 0.148, 95% CI 0.087-0.209). CONCLUSION: The NCDR and Mayo Clinic risk scores are useful for risk stratification of in-hospital mortality in a European population of patients with ACS undergoing coronary angioplasty. However, the GRACE score is still to be preferred.

Young adults' preferences and satisfaction levels in Duty-free shopping in airports

This study aims to explore and understand what young adults’ duty free shoppers (18-26 years old) want and are getting from travel retail shopping on airport environments and to evaluate their satisfaction levels with the service. It has important managerial contributions since it is an important target in a fast growing market. An online survey was conducted with 188 young adults and its results show that young adults’ are somewhat satisfied with the overall service on duty free stores mainly in what concerns quality of the products and physical evidence of the stores. Results also show that the majority of buyers within this segment are price driven and strongly influenced by promotions associated with price reductions, and do not seem very satisfied with respect to that. Keywords: Young

US fiscal dynamics in political perspective

Given the importance of fiscal balance for ensuring a sustainable fiscal policy, we conduct an empirical examination of fiscal dynamics in the United States in response to unsustainable budget deviations. We concentrate on the role of political factors, namely the Republican - Democrat presidential divide, in determining the fiscal response to budget disequilibria. Making use of an asymmetric cointegration framework, we explore politically motivated fiscal asymmetries in the US, from Eisenhower to Obama. We conclude that political factors such as the government’s political quadrant and the timing of elections are important determinants of the fiscal response to unsustainable budget deviations.

The global shopper & brands communication at airports

This project aims to illuminate two perspectives on travel retail. On the one hand, it describes the main character of the shopping scenario at airports, namely the Global Shopper. It covers the entire profile of the referred character, the main nationalities that represent him and the current shopping trends of the passenger. Also estimates of the booming nationalities and the future purchasing trends are accurately presented. On the other hand, the travel retail market is analyzed from the airport brands’ perspective. It is described what is currently done in terms of brands communication in the top ten airports around the world and the expected future market retail trends. To accurately explore the Global Shopper behavior and purchasing preferences, a market research was conducted with a sample of 128 respondents, male and female, from different nationalities, age groups, occupation and education backgrounds. The essay tests hypothesis regarding the relevance of several variables in the purchasing process of the Global Shopper in order to understand the most pleasant way to approach consumers in travel retail. The main variables studied concern the reasons to shop at airports, to whom the passenger shops, the preferred category and brand of purchase, feelings while shopping abroad, impulsive buying behavior, brand loyalty, the use of mobile devices in the shopping process, brands communication at airports, pre-ordering online and the attitude towards self-service stores. Some findings were in accordance with expectations, while others were a surprise and may produce valuable recommendations for future travel retail practices. 4 The main relevant results concern two areas, namely pre-ordering online and self-service stores. Results showed a certain stress about not having enough time to choose between the various offerings in travel retail, as well as difficulty in dealing with crowed stores. However, pre-ordering online was not common, which would be an initiative that could solve the discomfort at airport’s stores. Moreover, self-service would promote efficiency in stores allowing passengers to save time if they already know how to go through the shopping process by themselves. Another possible recommendation concerns differentiating the strategy in travel retail for the two genders. Some differences were found in the categories bought by male and female, as well as to how brands should shape their approach concerning the demands of each gender.

Welle tecnologia laser internationalization analysis US market

Welle Laser is a Brazilian company that manufactures marking and engraving machines mainly for large-scale industry segments providing solutions that help increase productivity. Welle laser has 60% market share in Brazil and decided to go internationally in 2015, mainly to increase revenues and diversify business risks. Welle opened an office in Switzerland and celebrated a contract with a Mexican company to distribute their machines in Mexico. The next step for Welle is expanding its operation to USA. In my project I accessed the viability and reasons to enter the US market, the region where Welle should start its operation, and the best entry mode strategy.

Creation of an Age-Adjusted, Dual-Energy X-ray Absorptiometry-Derived Trabecular Bone Score Curve for the Lumbar Spine in Non-Hispanic US White Women.

The trabecular bone score (TBS, Med-Imaps, Pessac, France) is an index of bone microarchitecture texture extracted from anteroposterior dual-energy X-ray absorptiometry images of the spine. Previous studies have documented the ability of TBS of the spine to differentiate between women with and without fractures among age- and areal bone mineral density (aBMD)-matched controls, as well as to predict future fractures. In this cross-sectional analysis of data collected from 3 geographically dispersed facilities in the United States, we investigated age-related changes in the microarchitecture of lumbar vertebrae as assessed by TBS in a cohort of non-Hispanic US white American women. All subjects were 30 yr of age and older and had an L1-L4aBMDZ-score within ±2 SD of the population mean. Individuals were excluded if they had fractures, were on any osteoporosis treatment, or had any illness that would be expected to impact bone metabolism. All data were extracted from Prodigy dual-energy X-ray absorptiometry devices (GE-Lunar, Madison, WI). Cross-calibrations between the 3 participating centers were performed for TBS and aBMD. aBMD and TBS were evaluated for spine L1-L4 but also for all other possible vertebral combinations. To validate the cohort, a comparison between the aBMD normative data of our cohort and US non-Hispanic white Lunar data provided by the manufacturer was performed. A database of 619 non-Hispanic US white women, ages 30-90 yr, was created. aBMD normative data obtained from this cohort were not statistically different from the non-Hispanic US white Lunar normative data provided by the manufacturer (p = 0.30). This outcome thereby indirectly validates our cohort. TBS values at L1-L4 were weakly inversely correlated with body mass index (r = -0.17) and weight (r = -0.16) and not correlated with height. TBS values for all lumbar vertebral combinations decreased significantly with age. There was a linear decrease of 16.0% (-2.47 T-score) in TBS at L1-L4 between 45 and 90 yr of age (vs. -2.34 for aBMD). Microarchitectural loss rate increased after age 65 by 50% (-0.004 to -0.006). Similar results were obtained for other combinations of lumbar vertebra. TBS, an index of bone microarchitectural texture, decreases with advancing age in non-Hispanic US white women. Little change in TBS is observed between ages 30 and 45. Thereafter, a progressive decrease is observed with advancing age. The changes we observed in these American women are similar to that previously reported for a French population of white women (r(2) > 0.99). This reference database will facilitate the use of TBS to assess bone microarchitectural deterioration in clinical practice.

Le New Mexico [cuirassé de l'US Navy à bord duquel le prince de Galles fut invité le 7/4/1920] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 59165

Anvers, course par équipe [4x100 m] US gagnant [avec les coureurs] Paddock, Scholz, Murchison, Kirksey [Jeux olympiques, 22/8/20] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 60699

“Illegal Aliens” and the Inconspicuous Geographies of US Immigration and Border Policing within 100 Miles of the US-Canada Border

Legal provisions in the US have extended the idea of the border to the inside of US territory. Border Patrol Agents confront people in different spaces to inquire about their status. I examine border policing along the northern border of the United States through textual and discourse analysis. This thesis asks: How do border agents exercise power and control the movement of people within 100 miles of the border? In whose interest is the border, the “nation,” secured? The spaces in which these mobile borders are practiced become the sites where “citizens” and “aliens” are produced, reproduced and contested. These border policing practices create the illusion of a “nation” that is secured for “our” interests. However, the interests of these vulnerable groups are not reflected in the immigration policy and along the “border. Therefore the very existence of immigrants and their basic right to be in the US is undermined.

Educating for Community Resilience: How the Work of Thomas Homer-Dixon and JohnDewey's Pattern of Inquiry Can Help Us Prepare for the Ecological and Social Challenges of the 21st Century

Scientists have overwhelmingly concluded that global warming occurs as a consequence of human activities and that climate change, combined with the depletion of resources, could have catastrophic consequences for the human civilization later this century. However, in political circles and in the public sphere these conclusions are not taken seriously, or they are laid aside for future generations to deal with; at the same time, significant efforts are being deployed to discredit the scientific evidence. In this thesis I have studied the positions of climate scientists as well as those of climate change deniers, and I also examined how their points of view are likely to impact the interests and habits of corporations and citizens. The work of Thomas Homer-Dixon was used as an important source for analyzing the complex interaction between our natural, economic, and social systems, and John Dewey's pattern of inquiry provided the theoretical foundation for an analysis of the current crisis and its possible solutions. No concerted action to deal with climate change has yet been taken by the leaders of the Western world; I corroborated data from four reliable sources (Hansen, 2009; IPCC, 2007; Lynas, 2007; Steffen, 2011) regarding several development scenarios and their likely consequences on greenhouse gas emissions, and I concluded that a future temperature increase of more than 2°C appears now as unavoidable. In the light of this conclusion I argue that education for increasing the resilience of smaller communities is a realistic alternative that can offer some hope in dealing with the challenges ahead.

The Association of Sleep Disorder, Obesity Status, and Diabetes Mellitus among US Adults—The NHANES 2009-2010 Survey Results

To examine the association between sleep disorders, obesity status, and the risk of diabetes in adults, a total of 3668 individuals aged 40+ years fromtheNHANES 2009-2010 withoutmissing information on sleep-related questions,measurements related to diabetes, and BMI were included in this analysis. Subjects were categorized into three sleep groups based on two sleep questions: (a) no sleep problems; (b) sleep disturbance; and (c) sleep disorder. Diabetes was defined as having one of a diagnosis from a physician; an overnight fasting glucose > 125 mg/dL; Glycohemoglobin > 6.4%; or an oral glucose tolerance test > 199mg/dL. Overall, 19% of subjects were diabetics, 37% were obese, and 32% had either sleep disturbance or sleep disorder. Using multiple logistic regression models adjusting for covariates without including BMI, the odds ratios (OR, (95% CI)) of diabetes were 1.40 (1.06, 1.84) and 2.04 (1.40, 2.95) for those with sleep disturbance and with sleep disorder, respectively. When further adjusting for BMI, the ORs were similar for those with sleep disturbance 1.36 (1.06, 1.73) but greatly attenuated for those with sleep disorders (1.38 [0.95, 2.00]). In conclusion, the impact of sleep disorders on diabetes may be explained through the individuals’ obesity status.

Letter written by Mahlon Taylor to Samuel Clarke commenting on US troops during Fort George occupation, July 26, 1813

Fort George, situated on the west side of the Niagara River in Niagara-on-the-Lake, served as the headquarters for the Centre Division of the British Army during the War of 1812. On May 25, 1813, the Americans launched an artillery attack on the Fort, destroying most of the buildings. Two days later, the Americans invaded the Town of Niagara and occupied Fort George. They remained in the Fort for almost seven months, but suffered defeats at the Battle of Stoney Creek and Beaver Dams. Only a small number of militia remained stationed at the Fort. Fearing an attack by the British, the Americans retreated back across the Niagara River in December, 1813. The Fort remained in British possession for the rest of the War.

Letter written by Mahlon Taylor to Samuel Clarke commenting on US troops during Fort George occupation - July 26, 1813

A letter written by Mahlon Taylor to his uncle, Samuel Clarke, dated at Marcellus [New York], July 26, 1813. Mahlon Taylor writes that he believes the mail he has sent out is not making it past Princeton, as he has not had a reply to any of his sent correspondence. He also writes that he has heard there are 3500 men at Fort George, 1000 are unfit for duty, and that there is skirmishing daily. He comments that the general opinion is that the troops will withdraw from Canada entirely. The letter is signed Mahlon C Taylor and is addressed to Mr. Samuel Clarke, no. 227 South Front Street, Philadelphia.

One of Us or One of Them: A Generic Qualitative Study on the Efficacy of the Funds of Knowledge Strategy to Reduce Teacher Ethnocentrism

The purpose of this study was to examine whether English a Second Language (ESL) instructors’ ethnocentrism could be reduced using multicultural education (MCE) principles. There were three focus group discussions and a Likert scale questionnaire. The findings demonstrated that while ESL instructors were conscious of systemic barriers, media stereotypes, and bullying, more diversity training is required in order to improve teachers’ attitudes, responses, and instructional strategies regarding integration issues due to the increasing diversity of learners present in classrooms today. The findings of the study also demonstrated that MCE principles could be used to effectively raise the awareness of ESL instructors when dealing with integration and assimilation issues. When immigration, human rights, and multicultural policies were examined critically, ESL instructors were able to improve their cross-cultural skills in the classroom to be more inclusive towards diverse ethnic groups by giving learners greater opportunities to express themselves. As a result, learners’ knowledge, experience, and skills were validated in the classroom leading to a more meaningful learning experience.

"They're trying to trick us!": Making sense of anti-oppressive children's literature in the elementary school classroom

This study examines how children make sense of “anti-oppressive” children’s literature in the classroom, specifically, books that integrate and promote positive portrayals of gender non-conformity and sexual diversity. Through a feminist poststructural lens, I conducted ethnographic observations and reading groups with twenty students in a grade one/two classroom to explore how children engage with these storybooks. I further explored how the use of these books in the classroom might help to mediate and negotiate existing gendered and heteronormative beliefs and practices within educational settings. The books used in this study challenge oppressive gender and sexuality regimes within mainstream children’s literature that have traditionally served to marginalize and silence gender non-conforming and LGBTQ individuals. Responses from participants in this study aid in questioning how dominant discourses of gender and sexuality are produced and reinforced, as well as where we may find opportunities for change and reform within the elementary school classroom.