English as a second language. Teacher's book : IGCSE.

Recurso que proporciona al profesor orientación y apoyo práctico para preparar a los alumnos de IGCSE inglés como segundo idioma. Tiene como objetivo ayudarlos a mejorar sus respuestas de examen y la calificación global. Las explicaciones y ejemplos hacen que también sea muy útil para estudiantes que se preparan para otros exámenes avanzados. Ofrece respuestas y asesoramiento acerca de las actividades en cada una de las unidades del curso.

English as a second language. Coursebook 1 : IGCSE.

Recurso para estudiantes del International General Certificate of Secondary Education (IGCSE) inglés como segundo idioma. Tiene como objetivo ayudar a mejorar las respuestas de examen y la calificación global. Las explicaciones y ejemplos hacen que también sea muy útil para alumnos que se preparan para otros exámenes avanzados. Cubre todos los aspectos de la prueba y está estructurado en dieciocho unidades agrupadas en dos en partes temáticas: el mundo que nos rodea; la actividad humana, para practicar lectura, escritura y escucha. Tiene un apéndice con transcripciones del CD audio.

English as a second language. Workbook 1 : IGCSE.

Recurso para estudiantes del International General Certificate of Secondary Education (IGCSE) inglés como segundo idioma. Tiene como objetivo ayudar a mejorar las respuestas de examen y la calificación global. Las explicaciones y ejemplos hacen que también sea muy útil para alumnos que se preparan para otros exámenes avanzados. Cubre todos los aspectos de la prueba y está estructurado en dieciocho unidades agrupadas en dos en partes temáticas: el mundo que nos rodea; la actividad humana, para practicar lectura, escritura y escucha. Tiene un apéndice con transcripciones del CD audio.

Temporal regulation of expression of immediate early and second phase transcripts by endothelin-1 in cardiomyocytes

Background: Endothelin-1 stimulates Gq protein-coupled receptors to promote proliferation in dividing cells or hypertrophy in terminally differentiated cardiomyocytes. In cardiomyocytes, endothelin-1 rapidly (within minutes) stimulates protein kinase signaling, including extracellular-signal regulated kinases 1/2 (ERK1/2; though not ERK5), with phenotypic/physiological changes developing from approximately 12 h. Hypertrophy is associated with changes in mRNA/protein expression, presumably consequent to protein kinase signaling, but the connections between early, transient signaling events and developed hypertrophy are unknown. Results: Using microarrays, we defined the early transcriptional responses of neonatal rat cardiomyocytes to endothelin-1 over 4 h, differentiating between immediate early gene (IEG) and second phase RNAs with cycloheximide. IEGs exhibited differential temporal and transient regulation, with expression of second phase RNAs within 1 h. Of transcripts upregulated at 30 minutes encoding established proteins, 28 were inhibited >50% by U0126 (which inhibits ERK1/2/5 signaling), with 9 inhibited 25-50%. Expression of only four transcripts was not inhibited. At 1 h, most RNAs (approximately 67%) were equally changed in total and polysomal RNA with approximately 17% of transcripts increased to a greater extent in polysomes. Thus, changes in expression of most protein-coding RNAs should be reflected in protein synthesis. However, approximately 16% of transcripts were essentially excluded from the polysomes, including some protein-coding mRNAs, presumably inefficiently translated. Conclusion: The phasic, temporal regulation of early transcriptional responses induced by endothelin-1 in cardiomyocytes indicates that, even in terminally differentiated cells, signals are propagated beyond the primary signaling pathways through transcriptional networks leading to phenotypic changes (that is, hypertrophy). Furthermore, ERK1/2 signaling plays a major role in this response.

Public policy and foreign-based enterprises in Britain prior to the Second World War

This article examines the early evolution of British policy, prior to the Second World War. The British government adopted an ‘open’ policy towards foreign direct investment (FDI), despite periodic fears that some foreign acquisitions of UK firms in key sectors might be detrimental to the national interest, and a few ad hoc attempts to deal with particular instances of this kind. During the 1930s, when the inflow of foreign firms accelerated following Britain's adoption of general tariff protection, the government developed a sophisticated admissions policy, based on an assessment of the likely net benefit of each applicant to the British economy. Its limited regulatory powers were used to maximize the potential of immigrant firms for technology transfer, enhanced competition, industrial diversification, and employment creation (particularly in the depressed regions), while protecting British industries suffering from excess capacity.

Fundamentos da filosofia moral de Peter Singer

This research aims to reconstruct and explain the argument proposed by Peter Singer to justify the principle of equal consideration of interests (PECI). The PECI is the basic normative principle according to people should consider the interests of all sentient beings affected when somebody taking a moral decision. It is the join that Singer proposes between universalizability and the principle of equal consideration of interests that constitutes a compelling reason to justify it. The universalizability requires to disregard the numerical differences, putting yourself in other people s shoes, and to consider preferences, interests, desires and ideals of those affected. Singer joins universalizability to normative principle and molds the form and content of his theory. The first chapter introduces the discussion will be developed in this essay. The second chapter deals the historical and philosophical viewpoint from which Singer starts his studies. The third chapter is about the Singer s critiques of naturalism, intuitionism, relativism, simple subjectivism and emotivism. The fourth chapter exposes the design of universal prescriptivism proposed by R. M. Hare. The universal prescriptivism indicates, in the Singer s viewpoint, a consistent way to create the join between the universalizability and PECI. It highlights also the criticism designed by J. L. Mackie and Singer himself to universal prescriptivism. The second part of this chapter shows briefly some of the main points of the classical conception of utilitarianism and its possible relationship with the theory of Singer. The fifth chapter introduces the Singer s thesis about the origin of ethics and the universalizability as a feature necessary to the point of view of ethic, and the way which this argument is developed to form the PECI. The sixth chapter exposes the main distinctions that characterize the PECI. Finally the seventh chapter provides a discussion about the reasons highlighted by Singer for one who wants orient his life according to the standpoint of ethics. This structure allows explaining the main ideas of the author concerning the theoretical foundations of his moral philosophy

The causal effect of switching to second-line ART in programmes without access to routine viral load monitoring

We examined the effect of switching to second-line antiretroviral therapy (ART) on mortality in patients who experienced immunological failure in ART programmes without access to routine viral load monitoring in sub-Saharan Africa.

Second valve implantation for the treatment of a malpositioned transcatheter aortic valve

Unfavorable immediate or delayed results after transcatheter aortic valve implantation (TAVI) may be a consequence of bioprosthesis malfunctioning, malpositioning, embolization, or degeneration. Deployment of a second valve within the first one implanted (TAVI-in-TAV) may be a potentially helpful therapeutic strategy.

Percutaneous aortic valve replacement for severe aortic stenosis in high-risk patients using the second- and current third-generation self-expanding CoreValve prosthesis: device success and 30-day clinical outcome

OBJECTIVES: We sought to determine both the procedural performance and safety of percutaneous implantation of the second (21-French [F])- and third (18-F)-generation CoreValve aortic valve prosthesis (CoreValve Inc., Irvine, California). BACKGROUND: Percutaneous aortic valve replacement represents an emerging alternative therapy for high-risk and inoperable patients with severe symptomatic aortic valve stenosis. METHODS: Patients with: 1) symptomatic, severe aortic valve stenosis (area <1 cm2); 2) age > or =80 years with a logistic EuroSCORE > or =20% (21-F group) or age > or =75 years with a logistic EuroSCORE > or =15% (18-F group); or 3) age > or =65 years plus additional prespecified risk factors were included. Introduction of the 18-F device enabled the transition from a multidisciplinary approach involving general anesthesia, surgical cut-down, and cardiopulmonary bypass to a truly percutaneous approach under local anesthesia without hemodynamic support. RESULTS: A total of 86 patients (21-F, n = 50; 18-F, n = 36) with a mean valve area of 0.66 +/- 0.19 cm2 (21-F) and 0.54 +/- 0.15 cm2 (18-F), a mean age of 81.3 +/- 5.2 years (21-F) and 83.4 +/- 6.7 years (18-F), and a mean logistic EuroSCORE of 23.4 +/- 13.5% (21-F) and 19.1 +/- 11.1% (18-F) were recruited. Acute device success was 88%. Successful device implantation resulted in a marked reduction of aortic transvalvular gradients (mean pre 43.7 mm Hg vs. post 9.0 mm Hg, p < 0.001) with aortic regurgitation grade remaining unchanged. Acute procedural success rate was 74% (21-F: 78%; 18-F: 69%). Procedural mortality was 6%. Overall 30-day mortality rate was 12%; the combined rate of death, stroke, and myocardial infarction was 22%. CONCLUSIONS: Treatment of severe aortic valve stenosis in high-risk patients with percutaneous implantation of the CoreValve prosthesis is feasible and associated with a lower mortality rate than predicted by risk algorithms.

Second Annual Kansas State–Nebraska Biochemical Engineering Symposium (April 29, 1972)

This booklet contains abstracts of papers presented at a biochemical engineering symposium conducted at the University of Nebraska-Lincoln on April 29, 1972. This was the second annual symposium on this subject, the first having been held at Kansas State University on June 4, 1971. It is expected that future symposia will alternate between the two campuses. ContentsS.H. Lin, Kansas State University, "Enzyme Reaction in a Tubular Reactor with Laminar Flow" Gregory C. Martin, University of Nebraska, "Estimation of Parameters in Population Models for Schizosaccharomyces pombe from Chemostat Data" Jaiprakash S. Shastry and Prakash N. Mishra, Kansas State University, "Immobilized Enzymes: Analysis of Ultrafiltration Reactors" Mark D. Young, University of Nebraska, "Modelling Unsteady-State Two-Species Data Using Ramkrishna's Staling Model" G.C.Y. Chu, Kansas State University, "Optimization of Step Aeration Waste Treatment Systems Using EVOP" Shinji Goto, University of Nebraska, "Growth of the Blue-Green Alga Microcytis aeruginosa under Defined Conditions" Prakash N. Mishra and Thomas M.C. Kuo, Kansas State University, "Digital Computer Simulation of the Activated Sludge System: Effect of Primary Clarifier on System Performance" Mark D. Young, University of Nebraska, "Aerobic Fermentation of Paunch Liquor"

Accelerated partial breast irradiation with interstitial brachytherapy as second conservative treatment for ipsilateral breast tumour recurrence: multicentric study of the GEC-ESTRO Breast Cancer Working Group

PURPOSE To analyse the clinical outcome after salvage lumpectomy and multi-catheter brachytherapy (MCB) for ipsilateral breast tumour recurrence (IBTR). MATERIAL AND METHODS Between 09/00 and 09/10, 217 patients presenting an IBTR underwent lumpectomy and MCB (low, pulsed, or high-dose rate). Survival rates without second local recurrence (2nd LR), distant metastasis (DM), and overall survival (OS) were analysed as well as late effects and cosmetic results. Univariate and multivariate analyses (MVA) based on IBTR data were performed to find prognostic factors for 2nd LR, DM, and OS. RESULTS Median follow-up after the IBTR was 3.9 years [range: 1.1-10.3]. Five and 10-year actuarial 2nd LR rates were 5.6% [range: 1.5-9.5] and 7.2% [range: 2.1-12.1], respectively. Five and 10-year actuarial DM rates were 9.6% [range: 5.7-15.2] and 19.1% [range: 7.8-28.3], respectively. Five and 10-year actuarial OS rates were 88.7% [range: 83.1-94.8] and 76.4% [range: 66.9-87.3], respectively. In MVA, histological grade was prognostic factor for 2nd LR (p=0.008) and OS (p=0.02); while tumour size was prognostic factor for DM (p=0.03). G3-4 complication rate was 11%. Excellent/good cosmetic result was achieved in 85%. CONCLUSION This study suggests that in case of IBTR, lumpectomy plus MCB is feasible and effective in preventing 2nd LR with an OS rate at least equivalent to those achieved with salvage mastectomy.

Transapical transcatheter aortic valve implantation using the second-generation self-expanding Symetis ACURATE TA valve

Transapical transcatheter aortic valve implantation (TA-TAVI) is the recognized first choice surgical TAVI access. Expansion of this well-established treatment modality with subsequent broader patient inclusion has accelerated development of second-generation TA-TAVI devices. The Swiss ACURATE TA Symetis valve allows for excellent anatomical positioning, resulting in a very low incidence of paravalvular leaks. The self-expanding stent features an hourglass shape to wedge the native aortic valve annulus. A specially designed delivery system facilitates controlled release aided by tactile operator feedback. The ACURATE TA valve made of three native porcine non-coronary leaflets has received CE approval in September 2011. Since then, this valve is the third most frequently implanted TAVI device with over 1200 implants in Europe and South America. Results from the Symetis ACURATE TA™ Valve Implantation ('SAVI') Registry showed a procedural success rate of 98.0% and a survival rate of 93.2% at 30 days. This presentation provides technical considerations and detailed procedural aspects of device implantation.

The Effect of 6 versus 9 Years of Zoledronic Acid Treatment in Osteoporosis: A Randomized Second Extension to the HORIZON-Pivotal Fracture Trial (PFT).

While bisphosphonates reduce fracture risk over 3 to 5 years, the optimal duration of treatment is uncertain. In a randomized extension study (E1) of the Health Outcomes and Reduced Incidence with Zoledronic Acid Once Yearly - Pivotal Fracture Trial (HORIZON-PFT), zoledronic acid (ZOL) 5 mg annually for 6 years showed maintenance of bone mineral density (BMD), decrease in morphometric vertebral fractures, and a modest reduction in bone turnover markers (BTMs) compared with discontinuation after 3 years. To investigate the longer-term efficacy and safety of ZOL, a second extension (E2) was conducted to 9 years in which women on ZOL for 6 years in E1 were randomized to either ZOL (Z9) or placebo (Z6P3) for 3 additional years. In this multicenter, randomized, double-blind study, 190 women were randomized to Z9 (n=95) and Z6P3 (n=95). The primary endpoint was change in total hip BMD at year 9 vs. year 6 in Z9 compared with Z6P3. Other secondary endpoints included fractures, BTMs, and safety. From year 6 to 9, the mean change in total hip BMD was -0.54% in Z9 vs. -1.31% in Z6P3 (difference 0.78%; 95% confidence interval [CI]: -0.37%, 1.93%; p=0.183). BTMs showed small, non-significant increases in those who discontinued after 6 years compared with those who continued for 9 years. The number of fractures was low and did not significantly differ by treatment. While generally safe, there was a small increase in cardiac arrhythmias (combined serious and non-serious) in the Z9 group but no significant imbalance in other safety parameters. The results suggest almost all patients who have received six annual ZOL infusions can stop medication for up to 3 years with apparent maintenance of benefits. This article is protected by copyright. All rights reserved.