One of the big changes from Trials past is that there's now a story, of sorts, populated by a colourful cast of characters in a dusty frontier town. You've wound up there after an opening level cave-in - sadly, not the last time the game forces failure on you to move its tale forwards - and since the townsfolk have been ripped off by a rival biker, you're recruited to save the day.

Africa is mainly represented by its frontiers of the south with the British colonial expansion into modern day South Africa. There are also excellent clusters of material relating to the exploration of West Africa and the colonial administration of Lagos.


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The beginnings of European Australia and New Zealand are covered by British government documents, starting with Arthur Phillip and the penal colony at Sydney. The frontiers of other parts of Australia are also covered by documents from the UK National Archives and some material from Australian archives.

Recurrent GBM is an aggressive and difficult to treat cancer with no standard treatment considered by medical professionals as best practice. Some patients may be eligible for investigational treatment options in clinical trials.

This thesis explores the story of the Frontier Nursing Service (FNS), a rural health care delivery system established in Hyden, Kentucky in 1925. It is particularly concerned with examining the colonial construction of the organization created by the founder, Mary Breckinridge. This construction created a conceptual framework for the technological infrastructure of the FNS, and influenced interactions of FNS employees and the Appalachians who lived in the area served by them. A case study concerning the clinical trials of the birth control pi11, Enovid, is used to highlight in influence of colonial constructions and mentalities in convincing the trial's investigators that the FNS was a suitable place for them to be conducted. And finally, this thesis critiques two theoretical models of colonialism of by scholars in Appalachian Studies and Science and Technology Studies, and suggests new directions which might be undertaken this area.

Percutaneous coronary intervention (PCI) has become a key modality of therapy of patients with coronary artery disease. However, with the exception of acute coronary syndromes, there is as yet no conclusive evidence from randomized controlled trials that PCI improves survival and outcome compared with optimal medical therapy. Randomized trials comparing PCI and coronary artery bypass grafting in patients with stable coronary artery disease conducted before stenting showed superiority of the surgical approach. Early results from stent trials continue to indicate better symptom relief and less need for repeat intervention with the surgical approach, although myocardial infarction and mortality are similar with the 2 revascularization modalities. In the setting of acute coronary syndromes, however, recent trials suggest superiority of an aggressive approach, including PCI, compared with a conservative strategy of medical therapy only. This benefit extends to patients with acute ST-elevation myocardial infarction, including those with shock. In the latter setting, mortality remains high and novel approaches to protect myocardial metabolism and improve perfusion will be needed to further improve survival. The role of revascularization in patients with completed myocardial infarction and persistently occluded arteries is much less clear. Although the late open artery hypothesis is widely accepted and interventional cardiologists routinely open late infarct-related coronary occlusions, the available evidence to justify this strategy is weak. New devices, such as thrombectomy devices in thrombus-laden lesions and drug-eluting stents, offer promise, although all lack the degree of proof of benefit and safety typically required of new pharmaceutical agents. As new technologies and therapies with the potential to improve outcomes and decelerate the atherosclerotic process are developed, it will be important for investigators and industry to collaborate in incorporating these advances into ongoing and new trials testing the efficacy of PCI in all settings. ff782bc1db

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