Combined Evaluation of ST-segment Elevation in lead AVR and ST-segment Depression in other Leads Enhances Prediction of in-hospital Cardiovascular Death in Patients with Non ST-segment Elevation Acute Coronary Syndrome

Objective: To investigate the prognostic significance of ST-segment elevation (STE) in aVR associated with ST-segment depression (STD) in other leads in patients with non-STE acute coronary syndrome (NSTE-ACS). Background: In NSTE-ACS patients, STD has been extensively associated with severe coronary lesions and poor outcomes. The prognostic role of STE in aVR is uncertain. Methods: We enrolled 888 consecutive patients with NSTE-ACS. They were divided into two groups according to the presence or not on admission ECG of aVR STE≥ 1mm and STD (defined as high risk ECG pattern). The primary and secondary endpoints were: in-hospital cardiovascular (CV) death and the rate of culprit left main disease (LMD). Results: Patients with high risk ECG pattern (n=121) disclosed a worse clinical profile compared to patients (n=575) without [median GRACE (Global-Registry-of-Acute-Coronary-Events) risk score =142 vs. 182, respectively]. A total of 75% of patients underwent coronary angiography. The rate of in-hospital CV death was 3.9%. On multivariable analysis patients who had the high risk ECG pattern showed an increased risk of CV death (OR=2.88, 95%CI 1.05-7.88) and culprit LMD (OR=4.67,95%CI 1.86-11.74) compared to patients who had not. The prognostic significance of the high risk ECG pattern was maintained even after adjustment for the GRACE risk score (OR = 2.28, 95%CI:1.06-4.93 and OR = 4.13, 95%CI:2.13-8.01, for primary and secondary endpoint, respectively). Conclusions: STE in aVR associated with STD in other leads predicts in-hospital CV death and culprit LMD. This pattern may add prognostic information in patients with NSTE-ACS on top of recommended scoring system.

Does improvisation lead to outcome deviation? A conceptual framework of improvisation, its antecedents and outcome deviation

Management and organization literature has extensively noticed the crucial role that improvisation assumes in organizations, both as a learning process (Miner, Bassoff & Moorman, 2001), a creative process (Fisher & Amabile, 2008), a capability (Vera & Crossan, 2005), and a personal disposition (Hmielesky & Corbett, 2006; 2008). My dissertation aims to contribute to the existing literature on improvisation, addressing two general research questions: 1) How does improvisation unfold at an individual level? 2) What are the potential antecedents and consequences of individual proclivity to improvise? This dissertation is based on a mixed methodology that allowed me to deal with these two general research questions and enabled a constant interaction between the theoretical framework and the empirical results. The selected empirical field is haute cuisine and the respondents are the executive chefs of the restaurants awarded by Michelin Guide in 2010 in Italy. The qualitative section of the dissertation is based on the analysis of 26 inductive case studies and offers a multifaceted contribution. First, I describe how improvisation works both as a learning and creative process. Second, I introduce a new categorization of individual improvisational scenarios (demanded creative improvisation, problem solving improvisation, and pure creative improvisation). Third, I describe the differences between improvisation and other creative processes detected in the field (experimentation, brainstorming, trial and error through analytical procedure, trial and error, and imagination). The quantitative inquiry is founded on a Structural Equation Model, which allowed me to test simultaneously the relationships between proclivity to improvise and its antecedents and consequences. In particular, using a newly developed scale to measure individual proclivity to improvise, I test the positive influence of industry experience, self-efficacy, and age on proclivity to improvise and the negative impact of proclivity to improvise on outcome deviation. Theoretical contributions and practical implications of the results are discussed.

Catalytic processes for the transformation of ethanol into acetonitrile

This thesis deals with the transformation of ethanol into acetonitrile. Two approaches are investigated: (a) the ammoxidation of ethanol to acetonitrile and (b) the amination of ethanol to acetonitrile. The reaction of ethanol ammoxidation to acetonitrile has been studied using several catalytic systems, such as vanadyl pyrophosphate, supported vanadium oxide, multimetal molibdates and antimonates. The main conclusions are: (I) The surface acidity must be very low, because acidity catalyzes several undesired reactions, such as the formation of ethylene, and of heavy compounds as well. (II) Supported vanadium oxide is the catalyst showing the best catalytic behaviour, but the role of the support is of crucial importance. (III) Both metal molybdates and antimonates show interesting catalytic behaviour, but are poorly active, and probably require harder conditions than those used with the V oxide-based catalysts. (IV) One key point in the reaction network is the rate of reaction between acetaldehyde (the first intermediate) and ammonia, compared to the parallel rates of acetaldehyde transformation into by-products (CO, CO2, HCN, heavy compounds). Concerning the non-oxidative process, two possible strategies are investigated: (a) the ethanol ammonolysis to ethylamine coupled with ethylamine dehydrogenation, and (b) the direct non-reductive amination of ethanol to acetonitrile. Despite the good results obtained in each single step, the former reaction does not lead to good results in terms of yield to acetonitrile. The direct amination can be catalyzed with good acetonitrile yield over catalyst based on supported metal oxides. Strategies aimed at limiting catalyst deactivation have also been investigated.

Rigorous results in Spin Glasses and Monomer-Dimer systems

In this work I reported recent results in the field of Statistical Mechanics of Equilibrium, and in particular in Spin Glass models and Monomer Dimer models . We start giving the mathematical background and the general formalism for Spin (Disordered) Models with some of their applications to physical and mathematical problems. Next we move on general aspects of the theory of spin glasses, in particular to the Sherrington-Kirkpatrick model which is of fundamental interest for the work. In Chapter 3, we introduce the Multi-species Sherrington-Kirkpatrick model (MSK), we prove the existence of the thermodynamical limit and the Guerra's Bound for the quenched pressure together with a detailed analysis of the annealed and the replica symmetric regime. The result is a multidimensional generalization of the Parisi's theory. Finally we brie y illustrate the strategy of the Panchenko's proof of the lower bound. In Chapter 4 we discuss the Aizenmann-Contucci and the Ghirlanda-Guerra identities for a wide class of Spin Glass models. As an example of application, we discuss the role of these identities in the proof of the lower bound. In Chapter 5 we introduce the basic mathematical formalism of Monomer Dimer models. We introduce a Gaussian representation of the partition function that will be fundamental in the rest of the work. In Chapter 6, we introduce an interacting Monomer-Dimer model. Its exact solution is derived and a detailed study of its analytical properties and related physical quantities is performed. In Chapter 7, we introduce a quenched randomness in the Monomer Dimer model and show that, under suitable conditions the pressure is a self averaging quantity. The main result is that, if we consider randomness only in the monomer activity, the model is exactly solvable.