Wednesday, February 13, 2013

Lady Gaga "You & I"-Video

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Source: www.youtube.com

BR-Promising Depression Therapy-Eng/Sp Version

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Promising Depression Therapy

By PAM BELLUCK



A type of brain stimulation caused by a mild electric current that appears to have minimal negative side effects is showing promise as a potential treatment for major depression, according to several studies.

The experimental therapy, known as transcranial direct current stimulation, or tDCS, involves a low-level charge about one-400th of that used in electroshock treatment. Unlike electroshock (also called electroconvulsive therapy or ECT), which is administered for a few seconds to patients under anesthesia, tDCS is given for 20 to 30 minutes continuously while patients are conscious.

While doctors do not see it replacing electroshock, considered the most effective approach for major depression that has been treatment-resistant and requires urgent attention, tDCS does not appear to cause memory loss as electroshock can. Because it is inexpensive and easily administered, scientists say it might become an alternative or additional treatment for people whose depression is not completely helped by medication.

“I think tDCS could be tried before ECT,” said Dr. Andre R. Brunoni, a psychiatrist at the University of São Paulo in Brazil and an author of a study published last week in The Journal of the American Medical Association-Psychiatry. Or, he said, it could be used “for avoiding drug treatment in patients that cannot use drugs.”

Researchers said Dr. Brunoni’s study is the largest to date of about half a dozen studies in recent years. It is the first comparing tDCS with another treatment — in this case, sertraline, or Zoloft. The study, involving 120 patients, found that tDCS appeared to work about as well as a low dose of Zoloft, and that combined with Zoloft, it worked better than the drug or the stimulation alone.

Zoloft and tDCS were equally safe. A few patients became manic, and some developed redness where electrodes were applied.

Researchers said much more study was needed, and that because the Zoloft dose was lower than what many patients use, it could not be concluded that tDCS works better than the drug.

But, Dr. Matthew V. Rudorfer, associate director for treatment research at the National Institute of Mental Health’s division of services and intervention research, said, “this report provides important further evidence for a possible therapeutic role of tDC stimulation in the treatment of depression.”

Another trial just starting at six sites in the United States and Australia is expected to provide further information on tDCS and depression.

Transcranial direct current stimulation was developed decades ago, but only recently have researchers begun testing it seriously for depression, said Dr. Colleen Loo, a psychiatry professor at the University of New South Wales in Sydney, who has led several tDCS studies and is the principal investigator for the new American-Australian trial.

She said the method, in which two electrodes, an anode and a cathode, are placed on the temples, provides “a mild form of brain stimulation that basically modulates the resting level of the nerve cells” in the brain. The current appears to make “the nerve cells communicate more effectively with other nerve cells” without giving the “strong stimulation that actually makes them fire off messages,” she said.

In her research, as with the newly-published Brazilian trial, patients received repeated treatments over several weeks, and there appeared to be cumulative effects. Dr. Loo also found indications that tDCS might have positive cognitive effects, appearing to enhance thinking speed in depressed people.

Dr. Sarah H. Lisanby, chairwoman of the psychiatry and behavioral sciences department at Duke University and an investigator in the American-Australian trial, sees tDCS as a potential treatment for patients who are not suicidal and whose depression has not responded to psychotherapy or antidepressants.

“TDCS as a technology is very safe — noninvasive, portable, cheap to make,” she said. “It runs on a battery, you can carry it around.” Unlike another relatively new noninvasive treatment, transcranial magnetic stimulation (TMS), now federally approved to treat depression in certain cases, tDCS does not have the rare but real risk of seizures, Dr. Lisanby said.

It is even conceivable tDCS could eventually be used at home, she and others said. But for now, doctors caution against using tDCS-type systems available online because patients would not know important information, like where to place electrodes or how much current to use.

Michael Donnelly, a 56-year-old biology teacher in Sydney participated in two trials led by Dr. Loo. He has suffered from depression for 30 years, he said, often taking two or three medications to control it. But in 2009, he plunged into a deep depression and “nothing, nothing was working,” he said.

In the first study, Mr. Donnelly said he received tDCS treatment five days a week for four weeks, followed by weekly and then biweekly treatments for several months. “Probably within a month, I was coming out of the depression,” he said.

Last year, as his mother was dying from cancer, Mr. Donnelly was concerned he might become suicidal, as he had when his father died in 2001. He participated in another study, where he received at least four weeks of tDCS. When his mother died during that period, “I didn’t crash — I was able to function,” he said. “If this was available as a regular treatment I’d probably go once a month for a charge.”

A version of this article appeared in print on 02/12/2013, on page D6 of the NewYork edition with the headline: New Therapy for Depression.


Source:www.nytimes.com



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Una nueva terapia sería positiva para la depresión mayor


La estimulación transcraneal muestra resultados prometedores, pero preliminares

Por Pam Belluck | The New York Times



NUEVA YORK.- Un tipo de estimulación cerebral producida por una suave corriente eléctrica que parece tener efectos colaterales mínimos está mostrando aspectos prometedores como tratamiento potencial para la depresión mayor, de acuerdo con diversos estudios.

La terapia experimental, conocida como estimulación transcraneal, utiliza alrededor de una cuatrocentésima parte de la carga empleada en los tratamientos de electroshock. Y a diferencia de estos últimos, que son administrados por unos pocos segundos a pacientes anestesiados, la terapia transcraneal se da en forma continua durante entre 20 y 30 minutos mientras los pacientes permanecen conscientes.

Los médicos no lo consideran un reemplazo del electroshock, considerado el enfoque más efectivo para la depresión mayor resistente al tratamiento y que requiere atención urgente. Pero la estimulación transcraneal no parece causar pérdida de memoria y es menos costosa y más fácil de aplicar, lo que podría convertirla en un tratamiento alternativo o adicional para personas cuya depresión no responde a la medicación.

"Creo que debería ser probada antes que el electroshock", dijo el doctor Andre R. Brunoni, psiquiatra de la Universidad de San Pablo, Brasil, y autor de un trabajo publicado la semana última en The Journal of the American Medical Association-Psychiatry. Agregó que podría aplicarse también para "evitar el tratamiento farmacológico en pacientes que no lo toleran".

Según los científicos, el estudio de Brunoni es el más grande realizado hasta la fecha. Es el primero que compara la estimulación transcraneal con otro tratamiento -en este caso, sertralina-. Involucró a 120 pacientes y obtuvo resultados similares a bajas dosis del medicamento. Combinada con el fármaco, mejoraba sus resultados.

Los científicos advierten que se necesitan todavía muchos estudios. Dado que se usó una dosis más baja del medicamento que la acostumbrada, no era lícito concluir que la estimulación transcraneal funciona mejor que la droga. Se espera que otro ensayo que está comenzando en seis sitios de EE.UU. y Australia ofrecerá más información.

Este método fue desarrollado hace décadas, pero sólo recientemente comenzó a ser investigado seriamente en depresión, dijo la doctora Colleen Loo, psiquiatra de la Universidad de Nueva Gales del Sur, en Sydney, e investigadora principal del nuevo ensayo.

Consiste en ubicar dos electrodos (un ánodo y un cátodo) en las sienes y ofrece "una suave estimulación que básicamente modula la actividad de las neuronas". La corriente parece hacer "que las células nerviosas se comuniquen más eficientemente entre sí", dijo.




Fuente: www.lanacion.com.ar


Nota: El tratamiento mencionado anteriormente se encuentra disponible también en Argentina.Para más datos enviar un email a: claramoras@gmail.com/Note: The above mentioned treatment is also available in Argentina.For more details, write to: claramoras@gmail.com

Tuesday, February 12, 2013

BR-Europe gives 2bn euros to science-Video & text

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Europe gives 2bn euros to science


By David Shukman

Science editor, BBC News


The project on graphene is one of two recipients of funding from the European Commission


Research projects investigating the "miracle material" graphene and the human brain have won unprecedented funding of up to 1bn euros each.

Under the European Commission's Future and Emerging Technologies programme, the backing is designed to give Europe an edge in key areas of research.

Graphene - a single-layer of carbon atoms - has extraordinary properties which give it immense potential.

Possible applications include flexible electronics and lighter aircraft.

The Human Brain Project will attempt to build a computer-based copy of a human brain to understand neurological disorders and the effects of drugs.

Both projects involve researchers in dozens of institutes across Europe and will receive the funding over a ten-year period. They include the scientists who first developed graphene at the University of Manchester, UK.

The two fields of novel materials and brain research are described as fulfilling the criteria for the funding by being "ambitious and risky" while promising large returns.

The backing is meant to answer the criticism that Europe lags behind more dynamic competitors such as the United States and China in economic growth and scientific research.

By focusing the funding on two key areas, the hope is that a "critical mass" can be achieved which will give Europe an edge in technologies vital to future economic development.

Patent race


Last month the BBC reported on the race to secure patents on graphene and how, despite the UK's early lead, China was now leading the field with the South Korean electronics giant Samsung holding nearly ten times more patents than Britain as a whole.

Graphene is far stronger than steel, more conductive than copper and more flexible than rubber so it could potentially open up entirely new avenues for manufacturing, consumer products and medical devices.

The material, so thin it effectively has just two dimensions, was first isolated by two Russian-born scientists, Andre Geim and Konstantin Novoselov, at the University of Manchester, work that earned them a Nobel Prize and knighthoods.

The European Commission vice-president Neelie Kroes, announcing the funding in Brussels today, said that it "rewards homegrown scientific breakthroughs".

"So, you've heard of Silicon Valley," she said.

"Where in Europe wants to be known as 'Graphene Valley'? That's the billion-euro question I am putting to you today."

The graphene funding will be spread across 126 academic and industrial research groups. It will be coordinated by Professor Jari Kinaret of Chalmers University of Technology at Gothenburg in Sweden who has stressed that it not attempt to match competitors in all areas.

"For example, we don't intend to compete with Korea on graphene screens," he said, a reference to Samsung's determined effort to lead the market in flexible electronic screens and e-paper. However graphene production - still not achieved on an affordable and industrial scale - is in the project's sights.

Profs Geim and Novoselov will play a leading role in guiding the collaborative effort.

Think big


Meanwhile the Human Brain Project will attempt to simulate the trillions of neural connections that make up a human brain in an effort to comprehend how the organ functions.

With an ageing European population, brain disorders, while becoming a more important feature of healthcare, remain poorly understood.

The Commission explains that the Human Brain Project will "collect the masses of clinical data available, mining for biological patterns, leading to new ways of diagnosing and classifying brain diseases."

The sheer volume of data involved in modelling the brain will itself lead to "radically new" IT with new computer technologies designed to manage the flow.

A further angle will be to explore how the brain manages such an intense workload with a relatively tiny power supply - "no more power than a light bulb". Understanding this could lead, it's hoped, to an entirely new way of powering energy-hungry supercomputer systems.

At a time of austerity across Europe and criticism of the European Commission's own budget, officials are emphasising the potential value of the funding for nurturing the kind of research that can produce an economic spin-off.

A key test will be how effectively the initial grants of 54m euros are handled. Beyond that, the precise level of future funding, which is meant to include contributions from industry, is still being negotiated.






Spanish version,also available at www.lanacion.com.ar/Source: www.bbc.co.uk

Sunday, February 10, 2013

"Supernatural" Pickpocketing-Video

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Source: www.youtube.com

Friday, February 8, 2013

Manchester-City: The Power of Online Video-Video

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Transcript: Russell Stopford Adam Burns, meettheboss.tv Manchester City football club is not just winning acclaim on the pitch... it’s approach to digital is also making headlines, and for all the right reasons. Manchester City football club’s digital team have been clearing up: best website, best use of technology, and much more. It’s Head of Digital, Russell Stopford is a man with clear ideas and a solid understanding of modern media – especially the power of video online. Russell Stopford, Head of Digital, Manchester City Football Club Well, I think what you’ve got to look at really with digital is that it’s not just a linear passive medium, but television is. Television is the preeminent force in advertising. It’s the dominant force. It’s the key _____, clearly. But I think if you look at the way the advertising spend is moving clearly, the direction in terms of growth, and _____ digital. And I think, obviously, the reason for that is the ability to tie it into _____ with your customers. So, I think in terms of measurability of ROI, that’s why digital is I think more important in most CMO’s marketing strategies. Adam Burns, meettheboss.tv What is the power of online video and how does it fit into your overall strategy moving forward? Russell Stopford, Head of Digital, Manchester City Football Club Well, I think the power of video is I would say it’s the most important asset in this sort of full range of digital media types and assets, and I think the key thing about video assets is its power to engage and create an emotional response, which I don’t think any of the other types of digital media really do at the same level. I think what’s interesting about for us the power of online video, if you look at something like the moment that Sergio scored the winning goal in the premier league, that clip you are seeing there, it’s almost like an icon of a season in many ways.More than just a photo, I think it’s you have to _____ build up on the emotional high its encapsulated within that whole few seconds of video and then his response afterwards. And I think for us, that’s – it’s an incredibly powerful story, and, obviously, with video, you get a story which is beyond what you may capture with a photo or a text, I suppose. Adam Burns, meettheboss.tv How are you dealing with the technical challenges of hosting, distributing, and publishing your online video content? Russell Stopford, Head of Digital, Manchester City Football Club Well, the technical challenge of hosting and distributing our content is managed in a number of different ways. Primarily, for our own sites, we have a relationship with Brightcove, and we distribute our content via their networks, which is what gives us a global presence, really, and a confidence that the content that we’re going to be distributing is going to get to an end viewer in this professional way. We also, obviously, work with YouTube, which gives us a fantastic presence worldwide. Adam Burns, meettheboss.tv For most marketers, television spend is still ten times that of digital. But not Russell. I asked him why... Russell Stopford, Head of Digital, Manchester City Football Club Video is an incredibly powerful sort of unit that we can use in a cross-platform or multi-channel video distribution _____. In terms of video being the most important element in a digital media strategy, the way they fit for us in terms of rest of the channels is that it’s really the essential and digital type highlight if you want, in a multi-channel for failure. So _____ to be on as many platforms on all of the app stores, and to be syndicated as widely as possible in order to be able to reach as many fans around the world as possible.At the same time, we want to create and continue to create content which are as fans who have been with us for many years through generations, get that deeper level of access to content _____. I think that’s what you need by _____, that level of engagement and level of access that we share with our fans, which separate us from what the other clubs are doing. Adam Burns, meettheboss.tv A lot of your fans are a broad diverse age range. Mobile, multi-screen content deliver must be vital, certainly, for your strategy, and being able to access those fans that are abroad and that are of different ages. Where are we on the creative ideas versus technology limitations like? Russell Stopford, Head of Digital, Manchester City Football Club Well, I think the two key _____ are mobile and social, and I think the technology limitation is irrelevant really, in terms of what’s possible there. I think most limitations I think come from say, ROI budget, against the creative ideas. So, really, it’s the creative idea that create the limit, and essentially are limitless depending on whatever ideas you have to be able to gauge your fan base. And particularly for football clubs _____ Manchester City and in an international setting.I think that one of the important aspects, and I think it’s evidenced by the fact that you’ve seen so many startups and new businesses in second screening and social TV is that extra layer of connectivity that you get from these second screen channels to a fan, and I think that’s where there’s a unique point – a unique place, really, for something like Manchester City to occupy with its relationships to its fan base. Adam Burns, meettheboss.tv How are you dealing with the technical challenges of hosting, distributing, and publishing your online video content? Russell Stopford, Head of Digital, Manchester City Football Club Well, the technical challenge of hosting and distributing our content is managed in a number of different ways. Primarily, for our own sites, we have a relationship with _____, and we distribute our content via their networks, which is what gives us a global presence, really, and a confidence that the content that we’re going to be distributing is going to get to an end viewer in this professional _____. We also, obviously, work with YouTube, which gives us a fantastic presence worldwide.And I think further down the line, we’ll be developing to the relationships with other technology partners with _____ channels, one of which we have some new services which we’ll be watching soon, and which _____. Adam Burns, meettheboss.tv To finish, I asked Russell about his equally award-winning approach to customer communications. In a recent survey of more than 1,000 consumers by Lithium and Red Shift Research, 25 percent of those questioned said they expect to hear back from a company when they Tweet about a brand or a product, but only 9 percent said that they have ever actually received a response. Is it because companies aren’t listening or don’t have the resources to respond? And what drives Manchester City’s differentiated approach? Russell Stopford, Head of Digital, Manchester City Football Club Well, I’m one of the nine percent that has received a response, and it created a very good feeling towards the brand when I received the sort of feedback. I think it’s true. I think companies don’t have the resources, and I think they also don’t understand what to do with it because I think it essentially a bunch of one-to-one conversations which are seen by a very big audience.So I think the most important thing is to engage with the discussion and actually go _____ and use it as a communications channel because those conversations are gonna happen whether or not you decide to take part. So I think it’s very important that brands understand the nature of social media and understand that the content is and they have to treat it as if it was essentially a broadcast medium as well as a communications channel. I think that’s the challenge for the brands. Source: www.meettheboss.tv

How McDonald´s is elevating its Digital Experience-Video

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Transcript: Pierre Woreczek Adam Burns – MeetTheBoss TV Hello and welcome to Meet The Boss TV. In this program, how McDonald’s is using digital to enhance the brand experience online – and in store. We’ve all seen McDonald’s redesigned restaurants – but how is this global giant embracing digital to shape a better experience, in store and online? To find out, Jonathan Spragg spoke with the company’s European Chief Brand & Strategy Officer – Pierre Woreczek. Jonathan Spragg – MeetTheBoss TV: What is the biggest sort of hurdle that you've had to overcome to really reap the benefits of digital marketing? Pierre Woreczek: Yeah, I mean, the hurdle is very simple. You have stores, many stores, and internally people feel that they have the connection with the customers. That they don’t need an extra link to be able to interact with customers because this company was so much focused on delivering the right experience in the store. So suddenly when you say, you know what, you need to invest in another kind of relationship, that is a little bit surprising, and the question immediately becomes what is the right return. Why shan’t – we should more focus on the stores, be even better on the stores? And they are right.

But the world is changing, and the issue is that when you go in the store you are on with the customers, but when they go out of the stores, you are off. And the question is why McDonald’s should be on and off and on and off. We should be on every time, in the store and outside the store. And this is what digital brings to us. It enable us to be on in the stores, on outside the stores, and to connect the physical experience and the virtual experience together. And that is new, and this is what the people inside the company has to understand. Jonathan Spragg: Has that been difficult for you to – I guess to evangelize the whole digital space within the McDonald’s Europe? Pierre Woreczek: Yes, you need to deep dive in this, and you have to make some business cases and explain why companies should move. But honestly, very rapidly, people live it, breathe it and understand it. I think the challenge is to put in place the right organization, to make it happen fast. That is the challenge. And some markets have been doing that very well in McDonald’s. If you take France, for example, they made a very conscious decision that digital should be led by an entire group representing the different function of the company.

So, suddenly, it becomes a key element that the company was pushing together and not, again, only one piece of the company. It becomes a company issue, not just a marketing issue or a communication issue. And all the different components that digital can impact was considered, prioritized, organized, and the vocabulary and all the language that goes with digital was shared inside the company. So I think this is, for me, a perfect example how a company should move, trying to incarnate at every level the digital revolution. I found a word I like very much. Somebody was talking about concierge brand. I like this word very much. Concierge brand, what a brand is doing to me. What a brand is doing to simplify my life. And digital is there for that, and that will go faster, faster and faster. And if you are not listening, if you are not watching how technology is changing to enable you to do this, how the different elements of accessibility are moving, if you stay behind, then suddenly you will stay out, you know. You can’t be behind. Behind means out.

 Jonathan Spragg: Are there any particular areas that you’re looking to focus on at McDonald’s with regards to using digital, something you are looking towards at the moment? Pierre Woreczek: Yeah, I mean, there are two big areas at the moment. The first one has to do with the stores, okay. We are a fast-moving company, and our goal is to provide the best food possible at the best price with the faster – with the best ______ possible. This is the expectations of people. So you need to be sure that you bring the right technology to get there.

So, for example, in stores, we have a kiosk to enable people to order what they want, at the speed they want. We have put in place, we are testing a mobile ordering, so people can also decide to order from outside the store. We’re also putting in place, thanks to these new technologies, new services, so when you go and order at the kiosk, you could decide to have the service at the table because thanks to the new technology, you can just send your new order, explain where you will sit, and somebody will bring the food to you. 

The second area in the store is the experience. We have created a new concept called spirit of family, where we put digital elements to entertain the family and to entertain the kids. So it’s not just about the food. It’s also about the pleasure and the fun that goes around. And the creators of McDonald’s ______ that we are not in the food business. We are in the entertainment business, and we need to leverage the digital assets to answer to this objective. And we have worked very hard to leverage iPad, to leverage magic table, to leverage new kind of projections, so the kids and the family can have a much bigger enjoyment when they go in the stores.

So all this store experience is a critical part of what we do, okay. And then you have a second key part, which is more related to the relationship we’ve created with consumers, either through our marketing, so through Facebook, through Twitter, through our websites, how we engage customers to have either more or either more understanding about what the brand stands for. And you know, some people said – I love this sentence – they said since digital exists, don’t do something that you will not be happy to hear on digital, and it’s right. Digital makes the brand totally transparent.

So how we make the relationship with McDonald’s outside the store as entertaining and pleasant than it could be inside the stores. And – for example, for the kids, we are creating a place called Happy Studio where the kids can come, no advertising, no push for anything, for food, for anything. It’s just about having the right fun and the right relationship inside the family between the parents and the kids. This is also a good example.

So these are the two areas that we’ve been focusing on quite a lot during the last months. Jonathan Spragg: Fantastic. I wanted to quote you on something that you said at the CMO World Tour that you were at a couple of months ago. You said that there are various differences between markets; however, curiously, digital itself is leveraging those differences between the markets. Can you expand on that a little bit? Pierre Woreczek: Yeah, it’s interesting. It’s always a paradox. You know, with digital, everything travels. So if you start to do something locally, you need to think that it will travel. And it has to have a global strength, okay, and you have to think about it. You can’t think that you are in a closed world anymore. And the local relevance has also to resonate with the rest of the world, okay. And what you do locally could be used or even expanded in the rest of the system or in the rest of your work, and you need to understand that, and you need to be ready for that. So it’s always this balance between glocal and local, that digital is rating even more than any other things before. Jonathan Spragg: You mentioned global, glocal. We have the local. We have national. I mean, how do you define which digital tools do you use for each of those three tiers, or do you try and use the same digital tool and the digital strategy across all three? Pierre Woreczek: You are asking probably one of the most challenging and complicated questions. And I think if you look around the different companies, you’ll see different models, different approaches, and you see the company that move from one and then to another and then back to the first one, so your question is very challenging, and I don’t know if there is a magic answer.

Today where we are in Europe and where we start to work at also the global level, first they are big, iconic moves that are shared by everyone. And I don’t see why this cannot be even handled more globally. Okay. After that, we can express them more locally, with more local relevance, but I don’t see why some big ideas can be defined and designed at a more global level. In the same way, creativity can happen everywhere, and this is the strengths of McDonald’s, the power of the countries and the creativity at the country level. And I can really imagine a great idea moving from a market and expanding to the system. And we need to keep that working, and the best example is Mein Burger approach in Germany, where they’ve been engaging the consumers to think and invent new burgers. These ideas have started to travel because it is potentially a global idea. So I think both are existing and should continue to exist.

The second thing is we need to be smart, and we need to partner when we can do economy of scale, okay. Why should we reinvent hardware, when we can have a common hardware? Why should we invent some software when we can have common software? So I think naturally there are areas where we can scale things to the benefit of the entire system. But when things have to stop is when it starts to impact negatively the relationship. And when you start to feel that you lose the proximity, that you try to find only the minimum common denominator, then you have to stop. You have to stop and try to keep the creativity and the power at the local level. Pierre Woreczek: I mean, you know our brand, especially in Europe, were sometimes a scapegoat for a lot of issues. And perception is reality, and we need to deal with this. So it has, in a certain extent, pushed us to be more transparent, more open and listening to what people were asking and telling us. Sometimes they didn’t know what the reality was. Sometimes they help us to progress. And that should continue. I don’t know if you heard about the experience Canada has put in place to explain how they do their product and how they do the business. I think it was amazing and so well received. So we also need to find the right vocabulary and the right approach to talk to people because sometimes we try to do this, and either they don’t listen to you or either they feel that you don’t listen to them. 
So how you manage the right bottom-up relationship and after that the right top-down relationship, that is a question, okay. And I think in the future, people should feel that they are part of the game, okay. There is not only the consumers here and the company here. They should feel they are a little bit part of the company because they bring ideas, because they propose solutions, because they criticize, and they feel and hear that you are taking into consideration what they express. You can’t do everything, of course, but they feel you try. And this is where we have to be.

 Source: www.meettheboss.tv

Lo que la escuela dejó de prometer: la movilidad social, por Gala Díaz Langou

The following information is used for educational purposes only. Lo que la escuela dejó de prometer: la movilidad social Las pruebas PISA ...