Future treatment strategies in ST-segment elevation myocardial infarction

Over the past five decades, management of acute ST-segment elevation myocardial infarction (STEMI) has evolved substantially. Current treatment encompasses a systematic chain of network activation, antithrombotic drugs, and rapid instigation of mechanical reperfusion, although pharmacoinvasive strategies remain relevant. Secondary prevention with drugs and lifestyle modifications completes the contemporary management package. Despite a tangible improvement in outcomes, STEMI remains a frequent cause of morbidity and mortality, justifying the quest to find new therapeutic avenues. Ways to reduce delays in doing coronary angioplasty after STEMI onset include early recognition of symptoms by patients and prehospital diagnosis by paramedics so that the emergency room can be bypassed in favour of direct admission to the catheterisation laboratory. Mechanical reperfusion can be optimised by improvements to stent design, whereas visualisation of infarct size has been improved by developments in cardiac MRI. Novel treatments to modulate the inflammatory component of atherosclerosis and the vulnerable plaque include use of bioresorbable vascular scaffolds and anti-proliferative drugs. Translational efforts to improve patients' outcomes after STEMI in relation to cardioprotection, cardiac remodelling, and regeneration are also being realised. This is the third in a Series of three papers about ST-segment elevation myocardial infarction.

Social relationship correlates of major depressive disorder and depressive symptoms in Switzerland: nationally representative cross sectional study

BACKGROUND The quality and quantity of social relationships are associated with depression but there is less evidence regarding which aspects of social relationship are most predictive. We evaluated the relative magnitude and independence of the association of four social relationship domains with major depressive disorder and depressive symptoms. METHODS We analyzed a cross-sectional telephone interview and postal survey of a probability sample of adults living in Switzerland (N = 12,286). Twelve-month major depressive disorder was assessed via structured interview over the telephone using the Composite International Diagnostic Interview (CIDI). The postal survey assessed depressive symptoms as well as variables representing emotional support, tangible support, social integration, and loneliness. RESULTS Each individual social relationship domain was associated with both outcome measures, but in multivariate models being lonely and perceiving unmet emotional support had the largest and most consistent associations across depression outcomes (incidence rate ratios ranging from 1.55-9.97 for loneliness and from 1.23-1.40 for unmet support, p's < 0.05). All social relationship domains except marital status were independently associated with depressive symptoms whereas only loneliness and unmet support were associated with depressive disorder. CONCLUSIONS Perceived quality and frequency of social relationships are associated with clinical depression and depressive symptoms across a wide adult age spectrum. This study extends prior work linking loneliness to depression by showing that a broad range of social relationship domains are associated with psychological well-being.

Trade Governance in the Digital Age (Preface)

The development of new digital technologies has resulted in significant transformations in daily life, from the arrival of online shopping to more fundamental changes in the ways we work and communicate. Many of these changes raise questions that transcend market access and liberalisation and demand cooperation and coherent regulatory design. International trade regulation has hitherto not reacted in a forward-looking manner to the digital revolution; particularly at the multilateral level, legal engineering has yielded few tangible results. This book examines whether WTO laws possess the necessary flexibility and resilience to accommodate the changes brought about by burgeoning digital trade. By revealing both the potential and the limitations of the WTO framework, it provides a broad picture of the interaction between digital technologies and trade regulation, links the often disconnected discourses of international trade law, intellectual property and cyberlaw, and explores discrete problems in different domains of global trade regulation.

Introduction XXIX European Seminar in Ethnomusicology: Cultural Mapping and Musical Diversity

«Cultural mapping» has become a central keyword in the UNESCO strategy to protect world cultural and natural heritage. It can be described as a tool to increase the awareness of cultural diversity. As Crawhall (2009) pointed out, cultural mapping was initially considered to represent the «landscapes in two or three dimensions from the perspectives of indigenous and local peoples». It thus transforms the intangible cultural heritage to visible items by establishing profiles of cultures and communities, including music traditions. Cultural mapping is used as a resource for a variety of purposes as broad as peace building, adaptation to climate change, sustainability management, heritage debate and management, but can also become highly useful in the analysis of conflict points. Music plays a significant role in each of these aspects. This year’s symposium invites to highlight, yet also to critically reassess this topic from the following ethnomusicological perspectives: - The method of cultural mapping in ethnomusicology What approaches and research techniques have been used so far to establish musical maps in this context? What kinds of maps have been developed (and, for example, how far do these relate to indigenous mental maps that have only been transmitted orally)? How far do these modern approaches deviate from the earlier cultural mapping approaches of the cultural area approaches that were still evident with Alan P. Merriam and in Alan Lomax` Cantometrics? In how far are the methods of cultural mapping and of ethnomusicological fieldwork different and how can they benefit from each other? - Intangible cultural heritage and musical diversity As the 2003 UNESCO Convention for the Safeguarding of the Intangible Cultural Heritage pointed out in Article 12, each state signing the declaration «shall draw up, in a manner geared to its own situation, one or more inventories of the intangible cultural heritage, present in its territory and monitor these.» This symposium calls for a critical re-assessment of the hitherto established UNESCO intangible cultural heritage lists. The idea is to highlight the sensitive nature and the effects of the various heritage representations. «Heritage» is understood here as a selection from a selection – a small subset of history that relates to a given group of people in a particular place, at a specific time (Dann and Seaton 2001:26). This can include presentations of case studies, yet also a critical re-analysis of the selection process, e.g. who was included – or even excluded (and why)? Who were the decision makers? How can the role of ethnomusicology be described here? Where are the (existent and possible) conflict points (politically, socially, legally, etc.)? What kinds of solution strategies are available to us? How is the issue of diversity – that has been so strongly emphasized in the UNESCO declarations – reflected in the approaches? How might diversity be represented in future approaches? How does the selection process affect musical canonization (and exclusion)? What is the role of archives in this process? - Cultural landscape and music As defined by the World Heritage Committee, cultural landscapes can be understood as a distinct geographical area representing the «combined work of nature and man» (http://whc.unesco.org/en/culturallandscape/). This sub-topic calls for a more detailed – and general – exploration of the exact relation between nature/landscape (and definition of such) and music/sound. How exactly is landscape interrelated with music – and identified (and vice versa)? How is this interrelation being applied and exploited in a (inter-)national context?

Removal of fractured endodontic instruments using an Nd:YAG laser.

OBJECTIVE Fractured endodontic instruments inhibit optimal cleaning and filling of dental root canals, which may result in a less favorable prognosis for the tooth. Several techniques are available to remove fractured instruments; however, healthy tooth substance often must be destroyed in the process. This study was intended to evaluate Nd:YAG laser treatment as a method to remove fractured stainless steel instruments without destroying healthy tooth substance. METHOD AND MATERIALS Stainless steel endodontic instruments were fractured in 33 unprocessed root canals of mandibular central and lateral incisors and premolars in vitro. A brass tube charged with solder was placed at the coronal end of the fractured instrument and laser energy was used to melt the solder, connecting the fractured instrument with the brass tube. The success rates of connecting and removal of fractured instruments from the root channel were recorded for each case. RESULTS Connecting was achieved in every case in which more than 1.5 mm of the fractured instrument was tangible (22 out of 22). In cases where less than 1.5 mm was tangible, the rate for successful connection decreased to 4 out of 11 (36.4%). Fractured endodontic instruments were removed successfully in 17 out of 22 cases (77.3%) in which more than 1.5 mm was tangible. If less than 1.5 mm was tangible, the removal success rate decreased to 3 out of 11 cases (27.3%). CONCLUSION Our data support Nd:YAG laser-mediated connecting of a brass tube to a fractured endodontic instrument as a feasible and tissue conserving removal approach when more than 1.5 mm of the instrument is tangible.

Preinterventional screening of the TAVI patient: how to choose the suitable patient and the best procedure.

Transcatheter aortic valve implantation (TAVI) is a novel therapy, which has transformed the management of inoperable patients presenting with symptomatic severe aortic stenosis (AS). It is also a proven and less invasive alternative therapeutic option for high-risk symptomatic patients presenting with severe AS who are otherwise eligible for surgical aortic valve replacement. Patient age is not strictly a limitation for TAVI but since this procedure is currently restricted to high-risk and inoperable patients, it follows that most patients selected for TAVI are at an advanced age. Patient frailty and co-morbidities need to be assessed and a clinical judgment made on whether the patient will gain a measureable improvement in their quality of life. Risk stratification has assumed a central role in selecting suitable patients and surgical risk algorithms have proven helpful in this regard. However, limitations exist with these risk models, which must be understood in the context of TAVI. When making final treatment decisions, it is essential that a collaborative multidisciplinary "heart team" be involved and this is stressed in the most recent guidelines of the European Society of Cardiology. Choosing the best procedure is contingent upon anatomical feasibility, and multimodality imaging has emerged as an integral component of the pre-interventional screening process in this regard. The transfemoral route is now considered the default approach although vascular complications remain a concern. A minimal vessel diameter of 6 mm is required for currently commercial available vascular introducer sheaths. Several alternative access routes are available to choose from when confronted with difficult iliofemoral anatomy such as severe peripheral vascular disease or diffuse circumferential vessel calcification. The degree of aortic valve leaflet and annular calcification also needs to be assessed as the latter is a risk factor for post-procedural paravalvular aortic regurgitation. The ultimate goal of patient selection is to achieve the highest procedural success rate while minimizing complications and to choose patients most likely to derive tangible benefit from this procedure.

Verfassung des Großherzogthums Luxemburg: Wir, Wilhelm II., von Gottes Gnaden, König der Niederlande, Prinz von Oranien-Nassau, Großherzog von Luxemburg ...

Welsch (Projektbearbeiter): Veröffentlichung der - zweiten - parlamentarischen Verfassung Luxemburgs. "La constitution ... a consacré[e] et coulé[e] dans les textes les grands principes modernes sur la séparation des pouvoirs, l'inamovibilité des juges, les libertés constituant les droits de l'homme et du citoyen. Elle n'a jamais été abolie et est restée, dans son cadre général, intangible ..." [Molitor, V.; aus: Muller, P.: Tatsachen aus d. Gesch. d. Luxemb. Landes]. Des weiteren: Herabsetzung des Wahlzensus auf 10 Francs, Abschaffung der Stempelsteuer, Inaussichtstellung eines Konkordates. Nebst Protokoll der Eidesleistung Wilhelms II. auf die Verfassung (10. Juli 1848)

A focused ethnographic study of community social capital

Social capital, a relatively new public health concept, represents the intangible resources embedded in social relationships that facilitate collective action. Current interest in the concept stems from empirical studies linking social capital with health outcomes. However, in order for social capital to function as a meaningful research variable, conceptual development aimed at refining the domains, attributes, and boundaries of the concept are needed. An existing framework of social capital (Uphoff, 2000), developed from studies in India, was selected for congruence with the inductive analysis of pilot data from a community that was unsuccessful at mobilizing collective action. This framework provided the underpinnings for a formal ethnographic research study designed to examine the components of social capital in a community that had successfully mobilized collective action. The specific aim of the ethnographic study was to examine the fittingness of Uphoff's framework in the contrasting American community. A contrasting context was purposefully selected to distinguish essential attributes of social capital from those that were specific to one community. Ethnographic data collection methods included participant observation, formal interviews, and public documents. Data was originally analyzed according to codes developed from Uphoff's theoretical framework. The results from this analysis were only partially satisfactory, indicating that the theoretical framework required refinement. The refinement of the coding system resulted in the emergence of an explanatory theory of social capital that was tested with the data collected from formal fieldwork. Although Uphoff's framework was useful, the refinement of the framework revealed, (1) trust as the dominant attribute of social capital, (2) efficacy of mutually beneficial collective action as the outcome indicator, (3) cognitive and structural domains more appropriately defined as the cultural norms of the community and group, and (4) a definition of social capital as the combination of the cognitive norms of the community and the structural norms of the group that are either constructive or destructive to the development of trust and the efficacy of mutually beneficial collective action. This explanatory framework holds increased pragmatic utility for public health practice and research. ^

From Concrete to Abstract: Teaching for Transfer of Learning when Using Manipulatives

One of the most important uses of manipulatives in a classroom is to aid a learner to make connection from tangible concrete object to its abstraction. In this paper we discuss how teacher educators can foster deeper understanding of how manipulatives facilitate student learning of math concepts by emphasizing the connection between concrete objects and math symbolization with, preservice elementary teachers, the future implementers of knowledge. We provide an example and a model, with specific steps of how teacher educators can effectively demonstrate connections between concrete objects and abstract math concepts.

MMM2- Turismo patrimonial: la Arquitectura del Movimiento Moderno en Misiones.16H374

Luego de una primera etapa de investigación concluida, que durante tres años nos llevó a investigar interdisciplinariamente turismo y arquitectura, el mismo equipo de investigación que llevara adelante el proyecto Patrimonio, turismo y educación: la arquitectura del Movimiento Moderno de Misiones 16H313 2010/12, Facultad de Humanidades y Ciencias Sociales (F.H.y C.S.) Universidad Nacional de Misiones (U.Na.M.), se propone un segundo estamento de investigación. Este equipo interdisciplinario de investigación en producción continua desde 2001 donde a partir del patrimonio jesuítico y el concepto de territorio museo abierto, luego con la inclusión de otras fundamentaciones como el aportado recientemente por ICOMOS de espíritu del lugar. Utilizado desde la antigüedad por el hombre el espíritu del lugar le ha servido para acordar con sus dioses antes del asentamiento de un poblado/castro/chester/burgo/burger/borgo/burg, entre ellos el de locus genius que los campamentos de centuriones romanos utilizaban para denominar al espíritu dueño de ese espacio, que en general tenía alguna caracterización particular y diferente del resto. En este nuevo ciclo nuestro equipo se plantea la cuestion en tres escalas de trabajo: La escala Macro/Territorial: el antiguo Territorio Nacional devenido con la presidencia de Juan Domingo Perón mediante, en provincia de Misiones en diciembre de 1953 en una escala macro; en La escala Media/Urbana: la influencia que algunas obras tuvieron en el devenir de sus poblados y las que no lo hicieron. La escala Micro/Arquitectónica: en la que se estudiará detenidamente la Escuela Normal de Alem, declarada recientemente Monumento Historico Nacional mediante decreto N°1934/12 del Poder Ejecutivo Nacional con la firma de la presidenta Cristina Fernández de Kirchner, y otros. La utilización de la información de este modo producida tendrá como resultado más tangible la formulación en la provincia de un Circuito Turístico de la Modernidad que utilice como antecedente el producido, puesto en marcha y analizado en MMM1, sin perjuicio de una profundización del análisis de dicho modelo en MMM2

Responsabilidad social

El presente trabajo trata de realizar un acercamiento al concepto de Responsabilidad Social Empresaria, desde las normas ISO (en especial a la Norma 26000 publicada el primero de noviembre del año 2010), hasta su aplicación en la realidad actual, abarcando un panorama global y desagregándolo para ver y comprobar su aplicabilidad en nuestra sociedad. La elección del tema surgió debido a que en el segundo semestre del año 2010 se presentó la oportunidad de participar de un intercambio estudiantil con la Universidad Nacional del Comahue, y acceder, en calidad de alumno regular, al cursado de la materia Fundamentos de Responsabilidad Social. Durante el desarrollo del cursado se alcanzaron conceptos que si bien en cada materia de la currícula de la carrera Licenciatura en Administración (de la Universidad Nacional de Cuyo) se desarrollan, no logran ahondar en el concepto de Responsabilidad Social Empresaria (de ahora en adelante RSE), sólo logran exponerse temas bajo un punto de vista de ética y compromiso asociado al contenido específico de cada materia. Este hecho motivó el desarrollo de un informe que permitiera conocer el tema como un concepto individual y con fuerza propia, independiente, pero a la vez intrínsecamente relacionado con cada aspecto de la vida, tanto profesional como personal de cada individuo en particular. La responsabilidad como un valor intangible, individual, y colectivo al momento de integrarse a la estrategia empresarial.

La escasez impuesta : el software libre y el status económico de los bienes inmateriales

Ante el despliegue de posibilidades para crear, reproducir y compartir contenidos que la informática proporciona, surgieron incesantes debates sobre su estatuto económico. Las leyes de propiedad intelectual promulgan medidas cada vez más restrictivas para consumidores y productores, lo que erige barreras a la cultura y favorece monopolios sobredimensionados. Frente a esta situación emergen voces disidentes como el movimiento del software libre. En este artículo, haremos un análisis del debate de los bienes inmateriales, el papel de las leyes de propiedad intelectual y las reivindicaciones del los partidarios del software libre.

El Paisaje como Servicio Ambiental que otorgan las zonas agrícolas de la provincia de Mendoza, Argentina

Los ecosistemas proveen de servicios ambientales necesarios para la satisfacción de las necesidades tanto materiales, como no materiales de los seres humanos. Aportan al crecimiento económico y también a otros aspectos intangibles, que hacen al bienestar humano. Este flujo de bienes y servicios es vital para la economía. Los ecosistemas rurales, satisfacen las necesidades humanas y generan bienestar, incidiendo directamente sobre calidad de vida de las personas. En Argentina, existen conflictos sociales, económicos y ecológicos estrechamente relacionados. Por ello, no es correcto separar la sociedad de la naturaleza y tratar los problemas como si existieran escindidos. Por este motivo se recurre a la valoración de los ecosistemas y del medio ambiente, como instrumento preventivo ante posibles amenazas que vienen alterando el funcionamiento y la estructura de los ecosistemas rurales, por medio de estrategias y políticas sostenidas para el tratamiento y corrección de esta situación. Mendoza es considerada actualmente en un lugar destacado a nivel turístico. Teniendo en cuenta los caminos del vino y la Fiesta Nacional de la Vendimia. Actividades distintivas de la identidad provincial y de sus pobladores. En la última década, el departamento de Maipú ha sufrido una notoria pérdida de tierras agrícolas que se destinaron a la urbanización. Los problemas típicos de la ciudad ya han alcanzado a las zonas rurales. La inseguridad alcanzada, es un claro ejemplo de ésta situación. La elección del territorio de estudio, surgió al analizar el avance urbano en los censos 2001 y 2010, en zonas agrícolas representativas de Mendoza. Se observó que el departamento de Maipú obtuvo un incremento poblacional del 93%. Siendo el mismo, el departamento del Gran Mendoza, con mayor crecimiento de la última década. Además se tuvo en cuenta que Maipú es uno de los departamentos más importantes en el aspecto agrícola de la provincia, conocido como la cuna del vino y del olivo. Se toma como referencia la opinión de habitantes de un departamento que ha sufrido este cambio más recientemente para calificar el avance urbano y pérdida de servicios ambientales en zonas agrícolas de toda la provincia de Mendoza. La presente investigación se centra en el estudio de la provisión de servicios ambientales, por parte de los ecosistemas rurales de la provincia de Mendoza, Argentina. Se estudia la valoración social de los beneficios ambientales y sociales que la sociedad maipucina, le otorga a las zonas agrícolas de Mendoza. Se realiza a través de entrevistas enmarcadas en una técnica de Valoración Contingente en la que se obtienen resultados para el análisis de la Valoración Social de los servicios ambientales, sin llegar al análisis de una Valoración Económica. Los resultados obtenidos muestran que existe una preferencia de los habitantes de Maipú hacia paisajes naturales y agrícolas. Se sienten beneficiados y atraídos por la sensación de bienestar, otorgándoles valor social de existencia. Sin embrago, se percibe que están siendo afectados por problemas típicos de un paisaje urbanizado como lo son la contaminación visual, sonora y la pérdida de servicios ambientales como lo son la belleza escénica y la cultura mendocina. Los datos obtenidos de las encuestas quedan a disposición como herramienta para la toma de decisiones y para la correcta aplicación de la Ley 8051 de Ordenamiento Territorial y Uso del Suelo en Mendoza.

Redes personales digitales y contexto escolar : estudio de un grupo de adolescentes de Mendoza (Argentina)

Este artículo se centra en el análisis de redes personales digitales de un grupo de adolescentes del último año de una escuela secundaria de gestión privada en Mendoza, Argentina. Se escogió Facebook porque es la red más difundida entre ellos. El objetivo de este estudio fue analizar las redes de Facebook de adolescentes de una escuela con una fuerte implementación de las TIC y comprender las percepciones que tienen sobre sus vinculaciones digitales. La recolección de los datos fueron tres momentos (administración de TouchGraph sobre Facebook, entrevista individual y Focus Group). El análisis de los datos fue cuantitativo, de análisis de grafos y cualitativo. Con respecto a los resultados se observaron que los varones tuvieron redes con mayor dispersión en cuanto al número de miembros y las mujeres mayor homogeneidad (menor número de subgrupos). En los grafos se observó que la familia tuvo una baja importancia (está aislada, es pequeña y con baja relación o no está). El análisis cualitativo, reveló un acercamiento crítico a Facebook y que la protección de la privacidad obstaculiza la relación a través de esta red con la escuela y los padres. Finalmente las redes personales digitales brindan apoyo afectivo, informacional, tangible y axiológico.

La economía del conocimiento : perspectivas urbano - regionales

El conocimiento y su aplicación en la economía, ha sido siempre un factor importante del desarrollo socio-económico. El conocimiento toma relevancia en la economía contemporánea al invertirse la jerarquización de los factores del desarrollo, cobrando mayor importancia los factores intangibles, como el conocimiento, el cual se convierte en el recurso fundamental para los procesos productivos. En este contexto, surgieron los estudios relacionados con la Economía Regional del Conocimiento (ERC) así como los estudios relativos al Desarrollo basado en el Conocimiento (DBC). Ambas perspectivas teóricas han establecido indicadores para explicar el fenómeno de la economía del conocimiento desde su base territorial, sea a nivel regional (ERC) o desde la ciudad (DBC). A manera exploratoria consideramos que los indicadores de los sistemas regionales de innovación pueden complementarse con los indicadores del desarrollo basado en el conocimiento, sobre todo por la dimensión meta-cultural a la que hacen referencia estos estudios.