The Hunger Games: Katniss Everdeen\u27s Effort To Gain American Pragmatism Goals In Terms Of American Values

As one of a popular American novel which was published recently, The Hunger Games composed by Suzanne Collins, provides a significant description about the manifestation of American values portrayed by the main character, KatnissEverdeen.Katniss\u27 efforts in the novel are in line with the principle of American Pragmatism, which later on can be analyzed by its relation with the idea of American values, the grounding idea of the framing of this great American philosophy. By applying a sociological approach, this study discover the existence of the two roots of American culture known as American values and American Pragmatism, are still preserved. Katniss successfully manifests the goals of American Pragmatism that certainly taken from American values\u27 idea through her struggle told in the novel. This result leads to the comprehension of how American values influence American\u27s mind in fulfilling their goals or achievements

Factores de marketing que determinan el rendimiento internacional de las empresas exportadoras españolas : enfoque sobre las empresas born-global

El estudio de las nuevas empresas se ha convertido en una parte importante de la literatura sobre la creación de empresas internacionales y dentro de este campo las empresas que empiezan la actividad internacional a poco tiempo después de su creación, nombradas empresas born-global, en adelante BG*, empiezan a despertar el interés de los investigadores. En España, hasta la fecha el número de estudios, que han investigado las empresas BG, es limitado. El objetivo de la investigación es contribuir a explicar los factores claves, principalmente de marketing, que influyen sobre el rendimiento internacional de las empresas BG españolas y las empresas exportadoras tradicionales. En base a una revisión de la literatura específica, se desarrolla un modelo para explicar los factores determinantes del rendimiento internacional de este tipo de empresas, que es comprobado en una muestra de 29 empresas BG y 26 empresas exportadoras tradicionales. Los resultados demuestran que el modelo es significativo, los factores propuestos influyen sobre el rendimiento internacional de estas empresas. Sin embargo, sólo uno de los factores propuestos, la calidad del producto, es el factor clave que más determina el rendimiento internacional de las empresas BG, y para las empresas exportadoras tradicionales es otro factor distinto, la diferenciación del producto, lo que más determina el rendimiento internacional. Conclusiones y limitaciones del estudio son presentadas junto con indicaciones para futuras investigaciones

Arrhythmias and Conduction Disturbances in Patients with Systemic Sclerosis—A Systematic Literature Review

Systemic sclerosis (SSc) is an autoimmune disease characterized by skin and internal organ fibrosis and microvascular impairment, which can affect major organs, including the heart. Arrhythmias are responsible for approximately 6% of deaths in patients with SSc, and mainly occur due to myocardial fibrosis, which causes electrical inhomogeneity. The aim of this study was to determine the frequency of arrhythmias and conduction disturbances in SSc cohorts, and to identify the characteristics and risk factors associated with the occurrence of dysrhythmias in patients with SSc. A systematic literature review using PubMed, Embase, Web of Science and Scopus databases was performed. Full-text articles in English with arrhythmias as the main topic published until 21 April 2022 were included. Most prevalent arrhythmias were premature supraventricular and ventricular contractions, while the most frequent conduction disturbance was represented by right bundle branch block (RBBB). Elevated concentrations of N-terminal prohormones of brain natriuretic peptides (NT-pro BNP) were associated with numerous types of atrial and ventricular arrhythmias, and with the occurrence of RBBB. A lower value of the turbulence slope (TS) emerged as an independent predictor for ventricular arrhythmias. In conclusion, dysrhythmias are frequent in SSc cohorts. Paraclinical and laboratory parameters are useful instruments that could lead to early diagnosis in the course of the disease

Stratification in systemic sclerosis according to autoantibody status versus skin involvement: a study of the prospective EUSTAR cohort

Background: The current subclassification of systemic sclerosis into cutaneous subtypes does not fully capture the heterogeneity of the disease. We aimed to compare the performances of stratification into LeRoy's cutaneous subtypes versus stratification by autoantibody status in systemic sclerosis. Methods: For this cohort study, we assessed people with systemic sclerosis in the multicentre international European Scleroderma Trials and Research (EUSTAR) database. Individuals positive for systemic-sclerosis autoantibodies of two specificities were excluded, and remaining individuals were classified by cutaneous subtype, according to their systemic sclerosis-specific autoantibodies, or both. We assessed the performance of each model to predict overall survival, progression-free survival, disease progression, and different organ involvement. The three models were compared by use of the area under the curve (AUC) of the receiver operating characteristic and the net reclassification improvement (NRI). Missing data were imputed. Findings: We assessed the database on July 26, 2019. Of 16 939 patients assessed for eligibility, 10 711 patients were included: 1647 (15·4%) of 10 709 were male, 9062 (84·6%) were female, mean age was 54·4 (SD 13·8) years, and mean disease duration was 7·9 (SD 8·2) years. Information regarding cutaneous subtype was available for 10 176 participants and antibody data were available for 9643 participants. In the prognostic analysis, there was no difference in AUC for overall survival (0·82, 95% CI 0·81-0·84 for cutaneous only vs 0·84, 0·82-0·85 for antibody only vs 0·84, 0·83-0·86 for combined) or for progression-free survival (0·70, 0·69-0·71 vs 0·71, 0·70-0·72 vs 0·71, 0·70-0·72). However, at 4 years the NRI showed substantial improvement for the antibody-only model compared with the cutaneous-only model in prediction of overall survival (0·57, 0·46-0·71 for antibody only vs 0·29, 0·19-0·39 for cutaneous only) and disease progression (0·36, 0·29-0·46 vs 0·21, 0·14-0·28). The antibody-only model did better than the cutaneous-only model in predicting renal crisis (AUC 0·72, 0·70-0·74 for antibody only vs 0·66, 0·64-0·69 for cutaneous only) and lung fibrosis leading to restrictive lung function (AUC 0·76, 0·75-0·77 vs 0·71, 0·70-0·72). The combined model improved the prediction of digital ulcers and elevated systolic pulmonary artery pressure, but did poorly for cardiac involvement. Interpretation: The autoantibody-only model outperforms cutaneous-only subsetting for risk stratifying people with systemic sclerosis in the EUSTAR cohort. Physicians should be aware of these findings at the time of decision making for patient management. Funding: World Scleroderma Foundation

Racial differences in systemic sclerosis disease presentation: a European Scleroderma Trials and Research group study

Objectives. Racial factors play a significant role in SSc. We evaluated differences in SSc presentations between white patients (WP), Asian patients (AP) and black patients (BP) and analysed the effects of geographical locations.Methods. SSc characteristics of patients from the EUSTAR cohort were cross-sectionally compared across racial groups using survival and multiple logistic regression analyses.Results. The study included 9162 WP, 341 AP and 181 BP. AP developed the first non-RP feature faster than WP but slower than BP. AP were less frequently anti-centromere (ACA; odds ratio (OR) = 0.4, P < 0.001) and more frequently anti-topoisomerase-I autoantibodies (ATA) positive (OR = 1.2, P = 0.068), while BP were less likely to be ACA and ATA positive than were WP [OR(ACA) = 0.3, P < 0.001; OR(ATA) = 0.5, P = 0.020]. AP had less often (OR = 0.7, P = 0.06) and BP more often (OR = 2.7, P < 0.001) diffuse skin involvement than had WP.AP and BP were more likely to have pulmonary hypertension [OR(AP) = 2.6, P < 0.001; OR(BP) = 2.7, P = 0.03 vs WP] and a reduced forced vital capacity [OR(AP) = 2.5, P < 0.001; OR(BP) = 2.4, P < 0.004] than were WP. AP more often had an impaired diffusing capacity of the lung than had BP and WP [OR(AP vs BP) = 1.9, P = 0.038; OR(AP vs WP) = 2.4, P < 0.001]. After RP onset, AP and BP had a higher hazard to die than had WP [hazard ratio (HR) (AP) = 1.6, P = 0.011; HR(BP) = 2.1, P < 0.001].Conclusion. Compared with WP, and mostly independent of geographical location, AP have a faster and earlier disease onset with high prevalences of ATA, pulmonary hypertension and forced vital capacity impairment and higher mortality. BP had the fastest disease onset, a high prevalence of diffuse skin involvement and nominally the highest mortality

Factores de marketing que determinan el rendimiento internacional de las empresas exportadoras españolas: enfoque sobre las empresas born-global

El estudio de las nuevas empresas se ha convertido en una parte importante de la literatura sobre la creación de empresas internacionales y dentro de este campo las empresas que empiezan la actividad internacional a poco tiempo después de su creación, nombradas empresas born-global, en adelante BG*, empiezan a despertar el interés de los investigadores. En España, hasta la fecha el número de estudios, que han investigado las empresas BG, es limitado. El objetivo de la investigación es contribuir a explicar los factores claves, principalmente de marketing, que influyen sobre el rendimiento internacional de las empresas BG españolas y las empresas exportadoras tradicionales. En base a una revisión de la literatura específica, se desarrolla un modelo para explicar los factores determinantes del rendimiento internacional de este tipo de empresas, que es comprobado en una muestra de 29 empresas BG y 26 empresas exportadoras tradicionales. Los resultados demuestran que el modelo es significativo, los factores propuestos influyen sobre el rendimiento internacional de estas empresas. Sin embargo, sólo uno de los factores propuestos, la calidad del producto, es el factor clave que más determina el rendimiento internacional de las empresas BG, y para las empresas exportadoras tradicionales es otro factor distinto, la diferenciación del producto, lo que más determina el rendimiento internacional. Conclusiones y limitaciones del estudio son presentadas junto con indicaciones para futuras investigaciones

The Conflict between Economic Development and Planetary Ecosystem in the Context of Sustainable Development

The green area of economy is the key of healthy living. It is necessary to convene economic and ecologic framework to establish a market attentive to drastic reduction of emissions damaging our climate and landscapes in rural areas, to the protection of biological diversity of the planet, to stop producing nuclear waste, etc. This paper tries to demonstrate human concern for a waste recycling economy that will provide new jobs, will create economic and social stability and will ensure a healthier and cleaner environment. Green Economy and its support system (planetary ecosystem) won't be in conflict anymore. Green Economy will be able to support economic progress for future.

Direct, Rapid Detection of Pathogens from Urine Samples

The problem of rapidly detecting pathogens directly from clinical samples poses significant analytical challenges. Addressing this issue in relation to urinary tract infections, we propose an effective protocol and related immunomagnetic test kits enabling versatile screening for the presence of pathogenic bacteria in unprocessed urine samples. To achieve this, the components of a typical immunomagnetic separation protocol were optimized towards the sensitive assessment of the aggregates formed out of immunomagnetically tagged target pathogens collected from clinical samples. Specifically, a dedicated immunomagnetic material was developed via the functionalization of standardized, micron-sized magnetic beads with generic antibodies against gram-specific bacterial constituents with mannan binding lectin. As such, we demonstrate efficient procedures for achieving the enhanced, specific, and pathogen-mediated cluster formation of these tailored affinity-coated magnetic beads in complex samples. We further show how cluster analysis, in conjunction with the use of nonspecific, inexpensive fluorescent dye, allows for a straightforward optical assessment of the bacterial load directly from urine samples. The optimized sensing protocol and related kits provide, in less than 60 min, qualitative (positive/negative) information on the bacterial load with 85% specificity and 96% sensitivity, which is appropriate to empower clinical microscopy with a new analytic dimension. The procedure is prone to automation, can be conveniently used in clinical microbiology laboratories and, since it preserves the viability of the captured bacteria, can be interfaced with downstream analyses and antimicrobial susceptibility testing. Moreover, the study emphasizes a suite of practical validation assays that are useful for bringing the tool-box of immunomagnetic materials outside the academic laboratory and into real-life applications

RELEVANCE OF IRRIGATION IN CLEANING THE ROOT CANAL ISTHMUSES

The root canal irrigation going along with instrumentation is a mandatory attitude in current endodontic practice. To increase the evacuation efficacy of dental pulp remnants, dentin debris and bacterial biofilms from root canals and lateral irregularities including canal isthmuses, various procedures of irrigants activation were conceived. If not yet quite satisfactory, among various techniques of irrigant activation currently used the passive ultrasonic activation proved to be more efficient to achieving cleaning and disinfection of root canal isthmuses