LAS RELACIONES ECONÓMICAS INTERNACIONALES Y LOS PAÍSES EN DESARROLLO: EL RECURSO A UNA RACIONALIDAD ACOTADA / INTERNATIONAL ECONOMIC RELATIONS AND DEVELOPING COUNTRIES: THE SEARCH FOR A BOUNDED RATIONALITY

Para el análisis fructífero de las relaciones económicas internacionales parece indispensable reconocer que las condiciones de producción en el capitalismo tardío o economía globalizada carecen de una racionalidad que las sostenga. Esta falta de racionalidad explica, por un lado las dificultades de predicción y, por otro lado, la pérdida de orientación simbólica en el imaginario colectivo. Tales dificultades se relacionan en la práctica de los negocios con la imposibilidad de garantizar la continuidad de posiciones dominantes. Y en la teoría permiten descartar las visiones conspirativas que durante varias décadas simplificaron las explicaciones acerca del poder económico. En este marco los Estados nacionales y los actores privados se ven obligados a perseverar en un sistema de negociación permanente. A fin de responder a semejante desafío debe pulirse al máximo la capacidad para identificar prioridades nacionales y aplicar estrategias de negociación, aspectos que precisamente constituyen debilidades sintomáticas de los países en desarrollo. A propósito de dichas necesidades aparecen los denominados “acuerdos de libre comercio” (ALC), cuya progresiva difusión se debe precisamente a que promueven ámbitos de racionalidad o previsibilidad ajustada al objetivo de preservar y profundizar los nexos de interdependencia comercial y económica entre pares o grupos de países, contrarrestando así la incertidumbre prevaleciente a escala global. AbstractFor the successful analysis of international economic relations seems essential to recognize that the conditions of production in late capitalism lack of a global rationality that sustains it. This lack of rationality explains the difficulties in predicting affairs and also allow us to understand the symbolic loss of orientation in the collective imagination. The difficulties in predicting and hence related to planning in business practice are bond with the impossibility of ensuring continuity of dominant positions. And in theory those difficulties aid to preclude the conspiratorial visions which for decades ordered and simplified explanations about economic power. Within this framework national governments and private actors are forced to persevere in a system of continuous negotiations. To meet such a challenge must be polished to the maximum the ability to identify national priorities and negotiating strategies, aspects that are just sign of weakness in developing countries. On the occasion of these needs have emerged so-called “free trade agreements” (FTA), whose progressive spread is precisely to promote an adjusted predictability and by this way preserving and deepening the ties of trade and economic interdependence between pairs or groups of countries, thus counteracting the prevailing global uncertaint

ALBA and GRUPO DE PUEBLA: “true” Latin America integration or a repeated collective fantasy

En este documento se revisa una iniciativa de integración económica (ALBA) desplegada desde comienzos del siglo XXI en América Latina. Este proyecto fue promovido como la mejor opción (“verdadera” integración) a modo de réplica frente a otros formatos adaptados al proceso de internacionalización de los mercados internos. Considerando que dicha internacionalización de mercados constituía ya por entonces una imposición propia de una fase expansiva del sistema económico internacional, el principal problema que afrontaron los impulsores del ALBA fue de naturaleza ideológica: cómo seducir. Por lo tanto, el autor entiende que el ALBA debe ser objeto de apreciación ya no por sus logros funcionales –que por otro lado son imperceptibles- sino por la influencia ejercida por su narrativa destinada a diferentes sectores de la opinión pública latinoamericana. El discurso identificado con el ALBA se sustenta en dos guías argumentales. Por un lado, lucen las construcciones mitológicas sobre culturas ancestrales precolombinas y el ensalzamiento de gestas libertadoras que condujeron a la independencia política de los Estados de la región en el siglo XIX. Por el otro, se refuerzan imágenes y símbolos evocadores de un enemigo externo dotado de poderes omnímodos: el capitalismo imperialista. Una vez agotados los recursos financieros que hacían posible la difusión de su narrativa, el formato ALBA tendió a ser sustituido en la práctica por un foro en cuyo marco se reagruparon sus fundadores: el Grupo de Puebla. A partir de esta instancia las propuestas de integración pasaron a segundo plano, desplazadas por los llamados a conquistar o preservar –según cada caso- el poder político de los líderes presuntamente progresistas y cuyos mensajes continúan inspirando las mismas reivindicaciones y construcciones retóricas.This paper reviews an economic integration initiative (ALBA) deployed during the early 21 st. century in Latin América. This initiative was promoted as the best option (“true integration”) in opposition to the process of internationalization of domestic markets.Taking into account that this internationalization of markets is an imposition proper to the expansion phase of the international economic system, ALBA´s main problem was ideological: how to seduce. Therefore, ALBA should be appreciated not for its functional achievements –which are unnoticed- but for the influence of its narrative aimed at different sectors of Latin American public opinion. The speech at ALBA is supported by two discursive guidelines. The first is the appeal to a mythological reconstruction related to ancestral indigenous cultures and the struggles for political independence. As a second plot support, the images and symbols of an all-powerful external enemy are shaken: imperialist capitalism. Without the resources to finance this narrative, the ALBA format is practically replaced by the Puebla Group. Then the integration proposals go to the background displaced by the calls for the conquest or maintenance –depending on the case- of political power by the presumably progressive leaders who inspire that same preaching

Anticoagulant selection in relation to the SAMe-TT₂R₂ score in patients with atrial fibrillation:The GLORIA-AF registry

Aim: The SAMe-TT2R2 score helps identify patients with atrial fibrillation (AF) likely to have poor anticoagulation control during anticoagulation with vitamin K antagonists (VKA) and those with scores &gt;2 might be better managed with a target-specific oral anticoagulant (NOAC). We hypothesized that in clinical practice, VKAs may be prescribed less frequently to patients with AF and SAMe-TT2R2 scores &gt;2 than to patients with lower scores. Methods and results: We analyzed the Phase III dataset of the Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF), a large, global, prospective global registry of patients with newly diagnosed AF and ≥1 stroke risk factor. We compared baseline clinical characteristics and antithrombotic prescriptions to determine the probability of the VKA prescription among anticoagulated patients with the baseline SAMe-TT2R2 score &gt;2 and ≤ 2. Among 17,465 anticoagulated patients with AF, 4,828 (27.6%) patients were prescribed VKA and 12,637 (72.4%) patients an NOAC: 11,884 (68.0%) patients had SAMe-TT2R2 scores 0-2 and 5,581 (32.0%) patients had scores &gt;2. The proportion of patients prescribed VKA was 28.0% among patients with SAMe-TT2R2 scores &gt;2 and 27.5% in those with scores ≤2. Conclusions: The lack of a clear association between the SAMe-TT2R2 score and anticoagulant selection may be attributed to the relative efficacy and safety profiles between NOACs and VKAs as well as to the absence of trial evidence that an SAMe-TT2R2-guided strategy for the selection of the type of anticoagulation in NVAF patients has an impact on clinical outcomes of efficacy and safety. The latter hypothesis is currently being tested in a randomized controlled trial. Clinical trial registration: URL: https://www.clinicaltrials.gov//Unique identifier: NCT01937377, NCT01468701, and NCT01671007.</p

Radiation-induced changes in serum lipidome of head and neck cancer patients

Cancer radiotherapy (RT) induces response of the whole patient’s body that could be detected at the blood level. We aimed to identify changes induced in serum lipidome during RT and characterize their association with doses and volumes of irradiated tissue. Sixty-six patients treated with conformal RT because of head and neck cancer were enrolled in the study. Blood samples were collected before, during and about one month after the end of RT. Lipid extracts were analyzed using MALDI-oa-ToF mass spectrometry in positive ionization mode. The major changes were observed when pre-treatment and within-treatment samples were compared. Levels of several identified phosphatidylcholines, including (PC34), (PC36) and (PC38) variants, and lysophosphatidylcholines, including (LPC16) and (LPC18) variants, were first significantly decreased and then increased in post-treatment samples. Intensities of changes were correlated with doses of radiation received by patients. Of note, such correlations were more frequent when low-to-medium doses of radiation delivered during conformal RT to large volumes of normal tissues were analyzed. Additionally, some radiation-induced changes in serum lipidome were associated with toxicity of the treatment. Obtained results indicated the involvement of choline-related signaling and potential biological importance of exposure to clinically low/medium doses of radiation in patient’s body response to radiation

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase&nbsp;1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation&nbsp;disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age&nbsp; 6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score&nbsp; 652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc&nbsp;= 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N&nbsp;= 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in&nbsp;Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in&nbsp;Asia&nbsp;and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

I Diretrizes do Grupo de Estudos em Cardiogeriatria da Sociedade Brasileira de Cardiologia

O idoso apresenta características próprias na manifestação das doenças, na resposta à terapêutica e no efeito colateral dos medicamentos. Constitui um grupo de maior risco para o aparecimento das doenças degenerativas, em geral, e cardiovasculares, em particular, além de apresentar maior número de comorbidades

counteracting asymmetries in free trade agreements between countries with different development levels

En principio el trabajo se basa en observaciones metodológicas efectuadas a propósito de las tratativas que distintos países latinoamericanos y caribeños han venido realizando para formalizar acuerdos de libre comercio de última generación con países desarrollados y, en especial, con la Unión Europea. En tal sentido, resalta el tipo de intervención tanto de los equipos técnicos como de los negociadores que, abocados a la difícil tarea de concertar cláusulas destinadas a reducir asimetrías, suelen incurrir en prejuzgamientos y consiguientes planteos que, por su rigidez, terminan siendo contraproducentes para los intereses legítimos que intentan sostener. El documento puntualiza distintas disposiciones que, a juicio del autor, deberían ser incluidas en dichos acuerdos a fin de conciliar los términos de reciprocidad con las condiciones y necesidades propias de los países en desarrollo, incorporando a la normativa un trato especial y diferenciado que, en diferentes áreas, permita un mejor aprovechamiento de la materia negociadaWithin the framework of negotiations to conclude free trade agreements with more developedcountries, both technical teams and negotiators from Latin American and Caribbean countries try tocounteract asymmetries on the basis of criteria that are not usually appropriate due its lack offlexibility.This document raises the desirability of adopting proposals to reconcile the terms of reciprocity withthe need to effectively reduce asymmetries and take advantage of the obtained concessions. In thissense, the author suggests to take into account the special and differential treatment for the lessdeveloped economies including comprehensive clauses about the various negotiated issues

Datos personales: seguridad nacional y concertación internacional. La disyuntiva latinoamericana

The restrictions adopted by the US government shocked the international press, first to prevent government purchases (National Defense Authorization Act for Fiscal Year 2019 (NDAA) Sec.889), and more recently to prevent the updating of telecommunication equipment operating systems produced by Chinese companies (Executive Order issued by President Trump on May 16, 2019). But it was quickly noticed that the latest measures could be not only ineffective but, worse still, would lead to adverse effects. The threat posed by the development of high-speed networks and systems for the manipulation of data and, by extension, for the national security of the United States (USA), could no longer be neutralized by trade measures or by intellectual property rules. In this sense, the open source modality in the patents of operating systems for electronic devices, shows that the intellectual property statutes are becoming more flexible and adapting to very fast technological substitutions which, in the information &amp; technology sector, point to capture and manipulate personal data with un-precedent voracity. In this context and due to the electronic flow of personal data from the European Union (EU) to the USA and faced with the difficulty for a regulatory convergence, a “Privacy Shield” was set up in order to guarantee the rights of the users and make the activity of companies compatible with the principles of public interest on both sides of the Atlantic. This could be a valuable precedent for the design of an international agreement of a multilateral nature aimed at regulating global connectivity.Conmovieron a la prensa internacional las restricciones adoptadas por el gobierno estadounidense, primero para impedir compras gubernamentales (Ley de Autorización de Defensa Nacional 2019) y, más recientemente, para evitar la actualización de sistemas operativos de equipos de telecomunicaciones suministrados por empresas chinas (Orden Ejecutiva del Presidente, del 16 de mayo de 2019). Pero rápidamente se advirtió que las últimas medidas podían resultar no sólo ineficaces sino, peor aún, producirían efectos adversos. La amenaza que representa el desarrollo de redes y sistemas de alta velocidad para la manipulación de datos y, por extensión, para la seguridad nacional de Estados Unidos (EUA), ya no podría neutralizarse con medidas comerciales ni mediante las reglas de propiedad intelectual. En este sentido, la modalidad de código abierto en las patentes de sistemas operativos para dispositivos electrónicos, pone en evidencia que los estatutos de propiedad intelectual están flexibilizándose y adaptándose a muy aceleradas sustituciones tecnológicas, las cuales, en el sector de las tecnologías de la información y las comunicaciones (TIC) apuntan a la captura y manipulación de datos personales con una voracidad inédita. En este contexto y con motivo del flujo electrónico de datos personales desde la Unión Europea (UE) hacia EUA y ante la dificultad para armonizar sus normas, en los últimos años se habilitó un “Escudo de Privacidad” con el objeto de garantizar los derechos de los usuarios y compatibilizar la actividad de empresas tecnológicas con los principios de interés público en ambos lados del Atlántico. Este régimen podría ser un valioso antecedente en el diseño de un acuerdo internacional de carácter multilateral destinado a reglar la conectividad global

MERCOSUR: ALGUNOS INDICADORES DE INVIABILIDAD

No será materia de mi análisis el MERCOSUR en tanto objeto político-ideológico. Es decir, no examinaré la potencialidad del concepto MERCOSUR en tanto sugestión colectiva (o aporte al “imaginario colectivo”), ya sea desde el punto de vista de una posible manipulación política o ideológica ni desde el punto de vista de una (también posible) necesidad de pertenencia geopolítica (el MERCOSUR como “bloque”). Tampoco me detendré en apreciaciones teóricas acerca de la supuesta conveniencia de asumir los costos de la integración en aras de una (también supuesta) “inserción” en el mundo En cambio, exploraré algunos posibles indicadores de la inviabilidad del MERCOSUR en tanto esquema de integración económica. Al efecto doy por supuesta la vigencia de un orden jurídico de alcance multilateral (encarnado por la OMC), dentro del cual los procesos de integración, para merecer un reconocimiento de legitimidad han de cumplir determinados estatutos. Estas reglas figuran en el GATT (artículo XXIV) con respecto a las “zonas de libre comercio” y “uniones aduaneras”; en el GATS (artículo V) con respecto a los esquemas de integración de servicios; y en la Cláusula de Habilitación (Decisión de las Partes Contratantes dada en las postrimerías de la Ronda Tokio, en el año 1979) para los acuerdos de preferencias entre países en desarrollo y menos adelantado