Management of ST-elevation myocardial infarction according to European and American guidelines.

AIMS To highlight differences between the most recent guidelines of the European Society of Cardiology (ESC) and the American College of Cardiology Foundation/American Heart Association (ACCF/AHA) on the management of ST-elevation myocardial infarction (STEMI). METHODS AND RESULTS ESC 2012 and ACCF/AHA 2013 guidelines on the management of STEMI were systematically reviewed for consistency. Recommendations were matched, directly compared in terms of class of recommendation and level of evidence, and classified as "identical", "overlapping", or "different". Out of 32 recommendations compared, 26 recommendations (81%) were classified as identical or overlapping, and six recommendations (19%) were classified as different. Most diverging recommendations were related to minor differences in class of recommendation between the two documents. This applies to recommendations for reperfusion therapy >12 hours after symptom onset, immediate transfer of all patients after fibrinolytic therapy, rescue PCI for patients with failed fibrinolysis, and intra-aortic balloon pump use in patients with cardiogenic shock. More substantial differences were observed with respect to the type of P2Y12 inhibitor and duration of dual antiplatelet therapy. CONCLUSIONS The majority of recommendations for the management of STEMI according to ESC and ACCF/AHA guidelines were identical or overlapping. Differences were explained by gaps in available evidence, in which case expert consensus differed between European and American guidelines due to divergence in interpretation, perception, and culture of medical practice. Systematic comparisons of European and American guidelines are valuable and indicate that interpretation of available evidence leads to agreement in the vast majority of topics. The latter is indirect support for the process of review and guideline preparation on both sides of the Atlantic.

Religion as Culture? How European and American High Courts Endorse Majority Religion

This paper examines a trend in European and American High Courts to endorse majority religion by transforming it into “culture”, and thus by secularizing it. To dissociate religion and state is the hallmark of the liberal state. However, no state has ever managed a perfect separation, not even the American. Under conditions of mounting religious pluralism and ongoing secularization, there is pressure on the state to live up to its “neutrality”. A main strategy to square the circle of neutrality and incomplete dissociation from religion is to declare it “culture”, which gives the state the license to associate or even identify with it (as guardian of nationhood). The paper compares recent American and European High Court rules on religious symbols (especially crucifixes) that exhibits this strategy, addressing similarities and differences as well as the limits and pitfalls of “culturalizing” religion.

European mink (Mustela lutreola) and American mink (Neovison vison) detection histories in Northern Spain between 2000 and 2011

Understanding changes over time in the distribution of interacting native and invasive species that may be symptomatic of competitive exclusion is critical to identify the need for and effectiveness of management interventions. Occupancy models greatly increase the robustness of inference that can be made from presence/absence data when species are imperfectly detected, and recent novel developments allow for the quantification of the strength of interaction between pairs of species. We used a two-species multi-season occupancy model to quantify the impact of the invasive American mink on the native European mink in Spain through the analysis of their co-occurrence pattern over twelve years (2000 - 2011) in the entire Spanish range of European mink distribution, where both species were detected by live trapping but American mink were culled. We detected a negative temporal trend in the rate of occupancy of European mink and a simultaneous positive trend in the occupancy of American mink. The species co-occurred less often than expected and the native mink was more likely to become extinct from sites occupied by the invasive species. Removal of American mink resulted in a high probability of local extinction where it co-occurred with the endemic mink, but the overall increase in the probability of occupancy over the last decade indicates that the ongoing management is failing to halt its spread. More intensive culling effort where both species co-exist as well as in adjacent areas where the invasive American mink is found at high densities is required in order to stop thedecline of European mink.

Latin American Agricultural Trade: The Role of the WTO in Sustainable Virtual Water Flows, European Association of Agricultural Economists

International agricultural trade has been growing significantly during the last decade. Many countries rely on imports to ensure adequate food supplies to the people. A few are becoming food baskets of the world. This process raises issues about the food security in depending countries and potentially unsustainable land and water use in exporting countries. In this paper, we analyse the impacts of amplified farm trade on natural resources, especially water. Farm exports and imports of five Latin America countries (Brazil, Argentina, Mexico, Peru and Chile) are examined carefully. A preliminary analysis indicates that virtual water imports can save valuable water resources in water-short countries, such as Mexico and Chile. Major exporting countries, including Brazil and Argentina, have become big exporters due to abundant natural resource endowments. The opportunity costs of agricultural production in those countries are identified as being low, because of the predominant green water use. It is concluded that virtual water trade can be a powerful tool to alleviate water stress in semi-arid countries. However, for exporting nations a sustainable water use can only be guaranteed if environmental production costs are fully reflected in the commodity prices. There is no basis for erecting environmental trade tariffs on exporters though. Setting up legal foundations for them in full compliance with WTOs processes would be a daunting task.

Low major histocompatibility complex class II diversity in European and North American moose.

Major histocompatibility complex (MHC) genes encode cell surface proteins whose function is to bind and present intracellularly processed peptides to T lymphocytes of the immune system. Extensive MHC diversity has been documented in many species and is maintained by some form of balancing selection. We report here that both European and North American populations of moose (Alces alces) exhibit very low levels of genetic diversity at an expressed MHC class II DRB locus. The observed polymorphism was restricted to six amino acid substitutions, all in the peptide binding site, and four of these were shared between continents. The data imply that the moose have lost MHC diversity in a population bottleneck, prior to the divergence of the Old and New World subspecies. Sequence analysis of mtDNA showed that the two subspecies diverged at least 100,000 years ago. Thus, viable moose populations with very restricted MHC diversity have been maintained for a long period of time. Both positive selection for polymorphism and intraexonic recombination have contributed to the generation of MHC diversity after the putative bottleneck.

European and North American Railway, New England and Eastern Canada, 1850 (Raster Image)

This layer is a georeferenced raster image of the historic paper map entitled: Map of the European and North American Railway : showing its connection with the railways of the United States & Canada, [by] A.C. Morton, engineer. It was published in 1850 by Bowen & Co. Scale [ca. 1:1,625,000]. Covers New England, eastern New York, and the Maritime Provinces. The image inside the map neatline is georeferenced to the surface of the earth and fit to the USA Contiguous Albers Equal Area Conic projection (Meters). All map collar and inset information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, or other information associated with the principal map. This map shows features such as completed, in progress, and proposed railroads, selected towns, drainage, state boundaries, and more. Includes inset: Map showing the plan for shortening the transit between New York & London. This layer is part of a selection of digitally scanned and georeferenced historic maps of New England from the Harvard Map Collection. These maps typically portray both natural and manmade features. The selection represents a range of regions, originators, ground condition dates, scales, and purposes.

European Union-Latin American relations in a turbulant era. Jean Monnet/Robert Schuman Paper Series Vol. 12, Special December 2012

From the Introduction. The mere mentioning of “the Trans-Atlantic Relationship” generates a standard interpretation. Customary understanding claims that it is supposed to deal with the links between Europe and the United States (moderately expanded to include Canada, a country taken for granted). This is a view shared both in Brussels and Washington. This geographical concept very rarely refers to include the role of Mexico, for example. This “relationship” is never understood as triangular, formed by three partners (United States/Canada, Europe and Latin America/Caribbean). A quadrangular format, including Africa, is contemplated only in a bilateral sense (usually when one of the important partners (the United States or Europe) is considered as a protagonist. In sum, “Atlantis” (as an entity shared by all) is as mysterious and difficult to grasp as the myth of antiquity, as a problem that this volume surely tries to grasp and analysis.