Why Hispanic Women Wear What They Wear

This paper is an exploration of how Hispanic women communicate their identity through clothing and how cultural values affect how they shop for clothes. Based on in-depth interviews with Hispanic women in Florida, this study demonstrates that Latinas retain overtime a set of values characteristic of the traditional Hispanic culture. This study also reveals that Hispanic women are high self-monitors and enjoy the experience of discovery when they shop. Specific implications for marketers are offered

アートという遊び : 構成のたくらみと技巧の悪だくみ

東京藝術大学平成24年

Qualitative evaluation of the seismic vulnerability of school buildings in Mérida city

Este trabajo evalúa la vulnerabilidad sísmica, en términos cualitativos, de 65 edificaciones educativas del sector público, ubicadas a lo largo de la terraza de la ciudad de Mérida, para estimar un índice que permita conocer las condiciones que presenta la estructura ante la eventualidad de un sismo regional. La evaluación se hace en base a un formato que contempla el estudio de diferentes parámetros que se dividen en formularios que contienen preguntas donde se valoran, por ejemplo, el entorno y ubicación, suelos, seguridad y zonas de evacuación; edad de la edificación y número de pisos, cambio de uso y ampliaciones, posibilidad de golpeteo, estado y tipo de cubierta, aspectos geométricos, aspectos constructivos y grado de deterioro; estado de la estructura, muros y antepechos; así como, otros parámetros que evalúan requerimientos de la normativa sismorresistente. El grado de vulnerabilidad es el resultado de la ponderación, sobre las calificaciones asignadas a cada pregunta de cada formulario, en base a un porcentaje de incidencia distinto de acuerdo a la influencia de cada uno de los aspectos considerados en la vulnerabilidad de la edificación. Los resultados muestran que el 51% de los planteles evaluados tienen un índice de vulnerabilidad media. Sin embargo, cuando se evalúan individualmente algunos parámetros se obtienen índices de vulnerabilidad alto y muy alto. Uno de los mayores problemas, presente en el 81% del grupo analizado, lo constituye el grado de deterioro por presencia de fisuras, humedades y otros elementos que afectan la calidad de la estructura. Se hacen recomendaciones con la finalidad de corregir las condiciones físicas y estructurales que presentan un grupo de instalaciones educativas para mejorar la calidad y la seguridad de sus ocupantes.The qualitative seismic vulnerability of 65 public educational buildings, located in the city of Mérida, is evaluated in this paper. The evaluation is done, based on a format that studies different parameters, using forms that contain questions as, for example, the environment and location, soil types, security and zones of evacuation; age of the building, number of floors, change of use, possibility of collisions between structures, current state and type of ceiling, geometric aspects, constructive aspects and degree of deterioration; state of the structure and walls; as well as, other parameters. The degree of vulnerability is obtained through the qualification of each question, based on a different incidence percentage related to the importance of each aspect analyzed in the vulnerability of the building. The results show that 51% of the buildings evaluated have an intermediate degree of vulnerability. Nevertheless, when some parameters are individually evaluated, indexes of high and very high vulnerability are obtained. One of the greater problems, present in 81% of the group analyzed, is the deterioration shown by the presence of cracks, humidities and other elements that affect the quality of the structure. In order to improve the quality and the security of their occupants, we give some recommendations with the purpose of correcting the structural and physical conditions present in a group of educational installations

Procedural Characteristics and Outcomes of Transcatheter Interventions for Aortic Coarctation: A Report From the IMPACT Registry.

BACKGROUND: Although surgical repair was the traditional first-line treatment for native coarctation of the aorta (CoA), balloon angioplasty (BA) and stenting are now increasingly being performed. We aimed to determine the practice patterns and acute outcomes of transcatheter interventions for native coarctation in the largest multicenter registry for congenital catheterization. METHODS: CoA interventions from the IMPACT (IMproving Pediatric and Adult Congenital Treatment) National Cardiovascular Data Registry were analyzed. The procedure choice and acute outcomes were compared among patients with no prior interventions on the aortic isthmus (native CoA). Procedural success was defined as no major adverse events (MAEs) and a final peak gradient of <20 mm Hg and optimal outcome as no MAEs and a final gradient of <10 mm Hg. RESULTS: Over the 8-year study period, 5928 CoA procedures were performed, of which 1187 were performed in patients with native CoA. In this group, stenting was performed in more then half of children aged >1 year and >90% of those aged >8 years. Procedural success was achieved in >90% of stenting procedures but in only 69% of BAs. Stent implantation was associated with a higher likelihood of optimal gradient (<10 mm Hg) after adjustment for age and baseline characteristics. MAEs were most common in children aged <1 year (14%), occurred in 2% to 2.5% of those aged 1 to 18 years and in 6.6% of adults (P < .001), and were more likely after BA than after stenting (odds ratio, 0.5; 95% CI, 0.28-0.9; unadjusted P = .02). CONCLUSIONS: Catheter interventions for native coarctation are performed safely in older children and adults, with a high degree of immediate procedural success, particularly with stenting

Impact of Decision Aid on Decision-making of Patients With Severe Aortic Stenosis: Randomized Pilot Study.

BACKGROUND: Clinical guidelines recommend patients with aortic stenosis (AS) being considered for transcatheter aortic valve implantation or surgical aortic valve replacement to participate in shared decision-making (SDM) with a heart valve team (HVT). Data supporting these recommendations are limited. This project gathered data on feasibility and preliminary efficacy of a decision aid (DA) in decision-making for patients with severe AS deciding between transcatheter aortic valve implantation and surgical aortic valve replacement. METHODS: This institutional review board-approved randomized pilot trial assigned eligible patients to receive either the American College of Cardiologys DA for patients with AS or usual care. Patients were surveyed after their visit regarding knowledge, treatment-preference concordance, SDM (SDM process and CollaboRATE Scales), and decisional conflict. Patients were followed for 3 months to collect data on treatment received. RESULTS: Of 62 patients approached, 59 (95%) consented and participated. The average age of participants was 72 years, they were 100% white, and 32% of them were female. Intervention patients had higher knowledge scores (75.6 vs 65.5) and more frequently reported CollaboRATE top scores (67% vs 33%) than usual care patients. No other group comparisons reached significance. Patients who saw both members of the HVT before survey completion reported higher SDM process scores than those who saw only 1 specialist (3.1 vs 2.4). CONCLUSIONS: The study exceeded enrollment targets, indicating feasibility. Results suggest the American College of Cardiologys DA improved patient knowledge and communication scores. Patients who met with both members of the HVT reported higher SDM. These observations highlight the importance of SDM and multidisciplinary HVT assessment in the management of severe AS

Complicaciones Cardiovasculares asociadas a infección por SARS-CoV-2. Revisión Sistemática

El COVID-19 es una enfermedad que ha afectado a la población mundial, convirtiéndose en una de las peores pandemias de nuestra generación, representando un reto social y sanitario sin precedentes; afecta principalmente el sistema respiratorio, sin embargo, diversos estudios han demostrado el compromiso cardiovascular, generando preocupación, que se traduce en una mayor vulnerabilidad en los pacientes con patologías cardiovasculares subyacentes. Se ha establecido que la presencia de comorbilidades, como hipertensión, diabetes y enfermedad arterial coronaria, se asocian con tasas de mortalidad elevadas, afectando a pacientes cardiovasculares crónicos y causando alteraciones cardiovasculares en pacientes sin antecedentes, por lo cual es necesario el monitoreo de biomarcadores cardíacos para un mejor abordaje de la enfermedad. Estudios clínicos han evidenciado que la patología cardiovascular que principalmente se asocia al COVID-19 es la insuficiencia cardíaca (IC), que se manifiesta con un aumento en los niveles de troponina, miopericarditis, shock cardiogénico, lesión cardíaca aguda, trastornos de coagulación y trombosis, arritmias, además del síndrome coronario agudo y la enfermedad de Kawasaki. Este artículo es una revisión de las complicaciones cardíacas asociadas al COVID-19 y sus posibles mecanismos de acción, que permitan un mejor entendimiento por parte del personal médico y de salud (PROSPERO ID 316364

Environmental concentrations of fibers with fluoro-edenitic composition and population exposure in Biancavilla (Sicily, Italy)

Introduction. The town of Biancavilla (Sicily) was included in the National Priorities List of Contaminated Sites due to environmental dispersion of amphibole fibers owing to the extraction of materials from a local quarry. The present report summarizes results from several, hitherto unpublished, environmental surveys carried out in the area, as well as from published analyses of the chemistry and composition of fibers.Methods. Data included here comprises environmental fiber concentrations by scanning electron microscopy with energy dispersive spectroscopy (SEM-EDS) analysis in soil, indoor and outdoor air, personal monitoring, as well as a chemical characterization of the fibers.The full chemical structure and spectroscopic characterization of fibers were obtained through a multi-analytical approach: SEM-EDS, X-ray powder diffraction (XRPD), as well as Mössbauer (MS) and Fourier transform infrared (FT-IR) spectroscopies.Results. Data analyzed provided a spatial and temporal picture of fiber concentrations in Biancavilla, and a qualitative assessment of population exposure. Results suggest that until 2000, the population had been exposed to high levels of amphibole fibers. Mitigation measures adopted since 2001, gradually reduced exposure levels to about 0.1-0.4 ff/l. Previous studies on fibrous amphiboles from Biancavilla reported considerable chemical variability. Differences in composition, especially concerning the presence of Si, Ca, Fe, and Na, were found both within and between samples. Compared to the previously investigated prismatic fluoro-edenite, these fibrous fluorine amphiboles consistently showed higher average values of Si and Fe content, whereas Ca was significantly lower, which we consider a distinctive characteristic of the fluorine fibrous variety.Conclusions. The population of Biancavilla had been highly exposed to a suite of fibrous amphiboles for over 50 years. Dust mitigation measures have gradually reduced exposure, but continuous environmental follow-up is necessary in order to monitor exposurelevels and prevent adverse health effects for future generations

Content, mineral allocation and leaching behavior of heavy metals in urban PM2.5

This work provides a novel perspective in the field of urban airborne particle investigation that is not currently found in the literature. Four sampling campaigns were performed in the urban area of Rome (Central Italy) during the winter and summer seasons (February and July 2013 and 2014, respectively). The measured concentrations of the regulated 34 elements of As, Cd, Ni and Pb were consistent with those reported by the local Environmental Agency (ARPA Lazio), but non-regulated heavy metals, including Fe, Cu, Cr and Zn, were also found in PM2.5 and analyzed in detail. As an novelty, heavy metals were associated with the host-identified mineral phases, primarily oxides and alloys, and to a lesser extent, other minerals, such as sulfates, carbonates and silicates. Leaching tests of the collected samples were conducted in a buffered solution mimicking the bodily physiological environment. Despite the highest concentration of heavy metals found during the winter sampling period, all of the elements showed a leaching trend leading to major mobility during the summer period. To explain this result, an interesting comparative analysis between the leaching test behavior and innovative mineral allocation was conducted. Both the heavy metal content and mineral allocation in PM2.5 might contribute to the bioavailability of toxic elements in the pulmonary environment. Hence, for regulatory purposes, the non-linear dependency of heavy metal bioavailability on the total metal content should be taken into account

Outcomes of Transcatheter Aortic Valve Replacement Using Third-Generation Balloon-Expandable Versus Self-Expanding Valves: A Meta-analysis.

BACKGROUND: The choice of transcatheter aortic valve replacement (TAVR) prosthesis is crucial in optimizing short- and long-term outcomes. The objective of this study was to conduct a meta-analysis comparing outcomes of third-generation balloon-expandable valves (BEV) vs self-expanding valves (SEV). METHODS: Electronic databases were searched from inception to June 2023 for studies comparing third-generation BEV vs SEV. Primary outcome was all-cause mortality. Secondary outcomes included clinical and hemodynamic end points. Random-effects models were used to calculate pooled odds ratios (ORs) or weighted mean differences (WMDs). RESULTS: The meta-analysis included 16 studies and 10,174 patients (BEV, 5753 and SEV, 4421). There were no significant differences in 1-year all-cause mortality (OR, 1.15; 95% CI, 0.89-1.48) between third-generation BEV vs SEV. TAVR with third generation BEV was associated with a significantly lower risk of TIA/stroke (OR, 0.62; 95% CI, 0.44-0.87), permanent pacemaker implantation (OR, 0.55; 95% CI, 0.44-0.70), and ≥moderate paravalvular leak (PVL, OR, 0.43; 95% CI, 0.25-0.75), and higher risk of ≥moderate patient-prosthesis mismatch (OR, 3.76; 95% CI, 2.33-6.05), higher mean gradient (WMD, 4.35; 95% CI, 3.63-5.08), and smaller effective orifice area (WMD, -0.30; 95% CI, -0.37 to -0.23), compared with SEV. CONCLUSION: In this meta-analysis, TAVR with third-generation BEV vs SEV was associated with similar all-cause mortality, lower risk of TIA/stroke, permanent pacemaker implantation, and ≥moderate PVL, but higher risk of ≥moderate patient-prosthesis mismatch, higher mean gradient, and smaller effective orifice area. Large, adequately powered randomized trials are needed to evaluate long-term outcomes of TAVR with latest generations of BEV vs SEV