Cardiac Imaging in the Diagnosis of Coronary Artery Disease: The Value of Quantitative Imaging of Myocardial Perfusion and Deformation

Atherosclerosis is a chronic and progressive disease of the vasculature. Increasing coronary atherosclerosis can lead to obstructive coronary artery disease (CAD) or myocardial infarction. Computed tomography angiography (CTA) allows noninvasive assessment of coronary anatomy and quantitation of atherosclerotic burden. Myocardial blood flow (MBF) can be accurately measured in absolute terms (mL/g/min) by positron emission tomography (PET) with [15O] H O as a radiotracer. We studied the coronary microvascular dysfunction as a risk factor for future coronary calcification in healthy young men by measuring the coronary flow reserve (CFR) which is the ratio between resting and hyperemic MBF. Impaired vasodilator function was not linked with accelerated atherosclerosis 11 years later. Currently, there is a global interest in quantitative PET perfusion imaging. We established optimal thresholds of [15O] H O PET perfusion for diagnosis of CAD (hyperemic MBF of 2.3 mL/g/min and CFR of 2.5) in the first multicenter study of this type (Turku, Amsterdam and Uppsala). In myocardial bridging a segment of the coronary artery travels inside the myocardium and can be seen as intramural course (CTA) or systolic compression (invasive coronary angiography). Myocardial bridging is frequently linked with proximal atherosclerotic plaques. We used quantitative [15O] H O PET perfusion to evaluate the hemodynamic effects of myocardial bridging. Myocardial bridging was not associated with decreased absolute MBF or increased atherosclerotic burden. Speckle tracking allows quantitative echocardiographic imaging of myocardial deformation. Speckle tracking during dobutamine stress echocardiography was feasible and comparable to subjective wall motion analysis in the diagnosis of CAD. In addition, it correctly risk stratified patients with multivessel disease and extensive ischemia.

EU Strategy for the Baltic Sea Region: its added value in environmental social and economic dimensions

The European Council has invited the European Commission to present the first macro-regional strategy – the EU Strategy for the Baltic Sea Region (EUSBSR) on the 14th of December 2007, primarily to address collective challenges and opportunities of the Region and also to engender cohesion in support of an European integration policy. However, macro-regional strategies conceived to aid European integration and territorial cohesion were viewed by academics with skepticism, obscuring the strategies’ potential impact. This thesis intends to investigate and measure the added value of the EUSBSR in order to analyze its impact on regional development and its feasibility as a guide for future programs intending to strengthen European cohesion and integration. To determine the added value of the EUSBSR the thesis is organized into three sections, so as to address environmental, social, and economic concerns, respectively. The first case examines EU-Russia cooperation in an environmental context to investigate how environmental cooperation with an external neighbor could forge increased cohesion in a macro-regional setting. To figure the added cooperation that academic cooperation among universities would contribute to social dimension, the work has chosen several study results. Lastly, to measure out the added value for the economic strategy objective, the study employs the project for Improved Global Competitiveness in an example of ‘A Baltic Sea Region Program for Innovation, Cluster and SME-Networks’ as an economic plan.

Developing Global Sourcing

Global Sourcing has gained popularity among Multinational Corporations as a method to achieve competitive advantage in increasingly competitive international environment. However, the companies pursuing coordinated global sourcing strategies in many cases tend to overlook many potential synergies from global sourcing. The objective of this research is to identify development areas in which the case company can further improve its conduct regarding global sourcing. This thesis was done as a case study for a MNC with business units across the world. The data used to analyse the case company is based on personal observations of the researcher, company’s material regarding its global sourcing, and on themed interviews and discussions with the company’s purchasing personnel. The analyses of this research are qualitative in nature, relying on subjective observations of the researcher. The research revealed that the case company has room for improvement in many of the identified success factors of global sourcing. One main recommendation of the thesis is to introduce portfolio-tool to identify synergy areas from global sourcing in a more systematic manner. In addition, the thesis proposes that information-processing framework can help the case company design more effective integration mechanisms that are required to process complex information emerging when sourcing globally.

Cultural and linguistic context and lexical inferencing in English language learning: A case study

In an increasingly multilingual world, English language has kept a marked predominance as a global language. In many countries, English is the primary choice for foreign language learning. There is a long history of research in English language learning. The same applies for research in reading. A main interest since the 1970s has been the reading strategy defined as inferencing or guessing the meaning of unknown words from context. Inferencing has ben widely researched, however, the results and conclusions seem to be mixed. While some agree that inferencing is a useful strategy, others doubt its usefulness. Nevertheless, most of the research seem to agree that the cultural background affects comprehension and inferencing. While most of these studies have been done with texts and contexts created by the researches, little has been done using natural prose. The present study will attempt to further clarify the process of inferencing and the effects of the text’s cultural context and the linguistic background of the reader using a text that has not been created by the researcher. The participants of the study are 40 international students from Turku, Finland. Their linguistic background was obtained through a questionnaire and proved to be diverse. Think aloud protocols were performed to investigate their inferencing process and find connections between their inferences, comments, the text, and their linguistic background. The results show that: some inferences were made based on the participants’ world knowledge, experience, other languages, and English language knowledge; other inferences and comments were made based on the text, its use of language and vocabulary, and few cues provided by the author. The results from the present study and previous research seem to show that: 1) linguistic background is a source of information for inferencing but is not a major source; 2) the cultural context of the text affected the inferences made by the participants according to their closeness or distance from it.