Associations between mood, anxiety or substance use disorders and inflammatory markers after adjustment for multiple covariates in a population-based study.

Inflammation is one possible mechanism underlying the associations between mental disorders and cardiovascular diseases (CVD). However, studies on mental disorders and inflammation have yielded inconsistent results and the majority did not adjust for potential confounding factors. We examined the associations of several pro-inflammatory cytokines (IL-1β, IL-6 and TNF-α) and high sensitive C-reactive protein (hsCRP) with lifetime and current mood, anxiety and substance use disorders (SUD), while adjusting for multiple covariates. The sample included 3719 subjects, randomly selected from the general population, who underwent thorough somatic and psychiatric evaluations. Psychiatric diagnoses were made with a semi-structured interview. Major depressive disorder was subtyped into "atypical", "melancholic", "combined atypical-melancholic" and "unspecified". Associations between inflammatory markers and psychiatric diagnoses were assessed using multiple linear and logistic regression models. Lifetime bipolar disorders and atypical depression were associated with increased levels of hsCRP, but not after multivariate adjustment. After multivariate adjustment, SUD remained associated with increased hsCRP levels in men (β = 0.13 (95% CI: 0.03,0.23)) but not in women. After multivariate adjustment, lifetime combined and unspecified depression were associated with decreased levels of IL-6 (β = -0.27 (-0.51,-0.02); β = -0.19 (-0.34,-0.05), respectively) and TNF-α (β = -0.16 (-0.30,-0.01); β = -0.10 (-0.19,-0.02), respectively), whereas current combined and unspecified depression were associated with decreased levels of hsCRP (β = -0.20 (-0.39,-0.02); β = -0.12 (-0.24,-0.01), respectively). Our data suggest that the significant associations between increased hsCRP levels and mood disorders are mainly attributable to the effects of comorbid disorders, medication as well as behavioral and physical CVRFs.

Feasibility of Therapeutic Drug Monitoring (TDM) for Imatinib: Preliminary considerations on the dosage adjustment approach for CML patients enrolled in the Imatinib Concentration Monitoring (I-COME) study

Background: As imatinib pharmacokinetics are highly variable, plasma levels differ largely between patients under the same dosage. Retrospective studies in chronic myeloid leukemia (CML) patients showed significant correlations between low levels and suboptimal response, and between high levels and poor tolerability. Monitoring of plasma levels is thus increasingly advised, targeting trough concentrations of 1000 μg/L and above. Objectives: Our study was launched to assess the clinical usefulness of systematic imatinib TDM in CML patients. The present preliminary evaluation questions the appropriateness of dosage adjustment following plasma level measurement to reach the recommended trough level, while allowing an interval of 4-24 h after last drug intake for blood sampling. Methods: Initial blood samples from the first 9 patients in the intervention arm were obtained 4-25 h after last dose. Trough levels in 7 patients were predicted to be significantly away from the target (6 <750 μg/L, and 1 >1500 μg/L with poor tolerance), based on a Bayesian approach using a population pharmacokinetic model. Individual dosage adjustments were taken up in 5 patients, who had a control measurement 1-4 weeks after dosage change. Predicted trough levels were confronted to anterior model-based extrapolations. Results: Before dosage adjustment, observed concentrations extrapolated at trough ranged from 359 to 1832 μg/L (median 710; mean 804, CV 53%) in the 9 patients. After dosage adjustment they were expected to target between 720 and 1090 μg/L (median 878; mean 872, CV 13%). Observed levels of the 5 recheck measurements extrapolated at trough actually ranged from 710 to 1069 μg/L (median 1015; mean 950, CV 16%) and had absolute differences of 21 to 241 μg/L to the model-based predictions (median 175; mean 157, CV 52%). Differences between observed and predicted trough levels were larger when intervals between last drug intake and sampling were very short (~4 h). Conclusion: These preliminary results suggest that TDM of imatinib using a Bayesian interpretation is able to bring trough levels closer to 1000 μg/L (with CV decreasing from 53% to 16%). While this may simplify blood collection in daily practice, as samples do not have to be drawn exactly at trough, the largest possible interval to last drug intake yet remains preferable. This encourages the evaluation of the clinical benefit of a routine TDM intervention in CML patients, which the randomized Swiss I-COME study aims to.

Workplace adjustment of an expatriate manager: identifying key components from a social capital perspective

Perustaen tutkimuksen kansainvälisen sopeutumisen teoreettiselle rungolle täydentäen sitä sosiaalisen pääoman teorialla, tämä tutkielma tutkii kuinka johtoasemassa oleva ulkosuomalainen luo hyvin toimivan sosiaalisen verkoston hong kongilaisella työpaikallansa. Tutkielma lähestyy aihetta Nahapietin ja Ghoshalin (1998) kehittämän sosiaalisen pääoman kolmen ulottuvuuden mallin avulla. Tutkielmassa kirjallisuudesta haettua teoriaa käytetään tutkimustavarten tehtyjen haastattelujen analysointiapuna. Tutkimalla sosiaalista pääomaa, kansainvälisen sopeutumisen kirjallisuutta, ekspatriootin perinteisiä menestystekijöitä ja guanxia (kiinalaisten henkilökohtaisia siteitä) tämän tutkimuksen teoriaosuus implikoi, että sosiaalisella pääomalla tulisi olla täydentävä rooli kansainvälisen sopeutumisen kirjallisuudessa. Sosiaalisen pääoman kolmen ulottuvuuden mallia käytetään pohjana empiirisen datan analysointiin. Tutkielman empiiriset tulokset osoittavat, että työpaikan sosiaaliseen verkostoon sopeutuminen liittyy exspatriootin kykyyn käsitellä estäviä ja mahdollistajia sosiaalisen pääoman luontiin vaikuttavia tekijöitä. Lisäksi sopeutuminen vaatii exspatriootin tunnistavan kohdemaalle tyypillisiä exspatriootin menestystekijöitä ja ekspatriootinomia tärkeitä henkilökohtaisia ominaisuuksia.

Significance of an isolated new right bundle branch block in a patient with chest pain.

Chest pain is a common presenting symptom in emergency departments, and a typical manifestation of acute myocardial infarction (AMI). Recognition of ECG changes in AMI is essential for timely diagnosis and treatment. Right bundle branch block (RBBB) may be an isolated sign of AMI, and was previously considered as a criterion for fibrinolytic therapy. Since the most recent European Society of Cardiology and American Heart Association guidelines in 2013, RBBB alone is no longer considered a diagnostic criterion of AMI, even if it occurs in the context of acute chest pain, as RBBB does not usually interfere with the interpretation of ST-segment alteration. Our case illustrates an acute septal myocardial infarction with an isolated RBBB, and thus the importance of recognising this pattern in order to permit timely diagnosis and treatment.

How Party Linkages Shape Austerity Politics: Clientelism and Fiscal Adjustment in Greece and Portugal during the Eurozone Crisis

Drawing on an analysis of austerity reforms in Greece and Portugal during the sovereign debt crisis from 2009 onwards, we show how the nature of the linkages between parties and citizens shapes party strategies of fiscal retrenchment. We argue that parties which rely to a greater extent on the selective distribution of state resources to mobilize electoral support (clientelistic linkages) are more reluctant to agree to fiscal retrenchment because their own electoral survival depends on their ability to control state budgets to reward clients. In Greece, where parties relied extensively on these clientelistic linkages, austerity reforms have been characterized by recurring conflicts and disagreements between the main parties, as well as a fundamental transformation of the party system. By contrast, in Portugal, where parties relied less on clientelistic strategies, austerity reforms have been more consensual because fiscal retrenchment challenged to a lesser extent the electoral base of the mainstream parties.

Numerical Investigation of Flow Past a Circular Cylinder and in a Staggered Tube Bundle Using Various Turbulence Models

Transitional flow past a three-dimensional circular cylinder is a widely studied phenomenon since this problem is of interest with respect to many technical applications. In the present work, the numerical simulation of flow past a circular cylinder, performed by using a commercial CFD code (ANSYS Fluent 12.1) with large eddy simulation (LES) and RANS (κ - ε and Shear-Stress Transport (SST) κ - ω! model) approaches. The turbulent flow for ReD = 1000 & 3900 is simulated to investigate the force coefficient, Strouhal number, flow separation angle, pressure distribution on cylinder and the complex three dimensional vortex shedding of the cylinder wake region. The numerical results extracted from these simulations have good agreement with the experimental data (Zdravkovich, 1997). Moreover, grid refinement and time-step influence have been examined. Numerical calculations of turbulent cross-flow in a staggered tube bundle continues to attract interest due to its importance in the engineering application as well as the fact that this complex flow represents a challenging problem for CFD. In the present work a time dependent simulation using κ – ε, κ - ω! and SST models are performed in two dimensional for a subcritical flow through a staggered tube bundle. The predicted turbulence statistics (mean and r.m.s velocities) have good agreement with the experimental data (S. Balabani, 1996). Turbulent quantities such as turbulent kinetic energy and dissipation rate are predicted using RANS models and compared with each other. The sensitivity of grid and time-step size have been analyzed. Model constants sensitivity study have been carried out by adopting κ – ε model. It has been observed that model constants are very sensitive to turbulence statistics and turbulent quantities.

Method adjustment and equation set of maximum rainfall intensity, duration and frequency in the Mato Grosso do Sul State

Due to the lack of information concerning maximum rainfall equations for most locations in Mato Grosso do Sul State, the alternative for carrying out hydraulic work projects has been information from meteorological stations closest to the location in which the project is carried out. Alternative methods, such as 24 hours rain disaggregation method from rainfall data due to greater availability of stations and longer observations can work. Based on this approach, the objective of this study was to estimate maximum rainfall equations for Mato Grosso do Sul State by adjusting the 24 hours rain disaggregation method, depending on data obtained from rain gauge stations from Dourado and Campo Grande. For this purpose, data consisting of 105 rainfall stations were used, which are available in the ANA (Water Resources Management National Agency) database. Based on the results we concluded: the intense rainfall equations obtained by pluviogram analysis showed determination coefficient above 99%; and the performance of 24 hours rain disaggregation method was classified as excellent, based on relative average error WILMOTT concordance index (1982).

The potential of social networking sites in inpatriate adjustment

People make up one of the most important resources for a corporation and therefore it has to continuously seek an ever more diverse and international workforce. Inpatriation is another way of utilizing foreign expertise in a corporation. An inpatriate refers to a person that is on an international assignment at the headquarters of a corporation, where they have been sent either from a subsidiary abroad or from a third country outside the corporation. Strengthening the social network of the inpatriate and their family contributes to the adjustment process and furthermore the success of the work assignment. As social networking sites are currently the fastest developing personal networking tools in the world, it is interesting to see how they can help in inpatriate adjustment. The objective of this thesis is to explore the potential of social networking sites (SNS) in inpatriate adjustment. The main objective can be divided into three sub objectives: 1. What is SNS used for during the inpatriate assignment? 2. What are the inpatriates’ motivations to use SNS? 3. Could the three facets of adjustment (work, interaction and general) be gained through SNS? This qualitative study utilizes the theme interview data collection method and the thematic analysis approach for analysing the interview data. From the interviews with five Indian inpatriates in Finland the most mentioned uses of SNS were related to participating (sharing opinions, recommendations and discussing things and connecting to friends, family and colleagues) and consuming (collecting information for work and free time), the least mentioned use of SNS was producing (posting videos, photos and updates). An interesting finding was that the five interviewees did not use SNS for purely entertainment motives at all during their assignment. This thesis found that all three facets of adjustment could potentially be gained through SNS.

Static pressure and wall shear stress distributions in air flow in a seven wire-wrapped rod bundle

An experimental investigation is performed in a turbulent flow in a seven wire-wrapped rod bundle, mounted in an open air facility. Static pressure distributions are measured on central and peripheral rods. By using a Preston tube, the wall shear stress profiles are experimentally obtained along the perimeter of the rods. The geometric parameters of the test section are P/D=1.20 and H/D=15. The measuring section is located at L/D=40 from the air inlet. It is observed that the dimensionless static pressure and wall shear stress profiles are nearly independent of the Reynolds number and strongly dependent of the wire-spacer position, with abrupt variations of the parameters in the neighborhood of the wires.

The adjustment from Russia to Finland for corporate repatriates: How the repatriation experience influences readjustment in the workplace

To manage foreign operations, companies must often send their employees on international assignments. Repatriating these expatriates can be difficult because they have been forgotten during their posting, and their new experiences are not utilised. In addition to the possible difficulties in organisational repatriation, the returnee can suffer from readjustment problems after a lengthy stay abroad has changed their habits and even identity. This thesis examines the repatriation experience of Finnish assignees returning from Russia. The purpose of the study is to understand how the repatriation experience influences their readjustment to work in Finland. This experience is influenced by many factors including personal and situational changes, the repatriation process, job and organisational factors, and individual’s motives. The theoretical background of the study is founded on two models of repatriation adjustment. A refined, holistic theoretical framework for the study is created. It describes the formation of the repatriation experience and its importance for readjustment to work and retention. The qualitative research approach is suitable for the thesis which examines the returnees’ personal experiences and feelings: a qualitative case study aims to explain the phenomenon in-depth and comprehensively. The data was collected in summer 2013 through semi-standardised interviews with eight Finnish repatriates. They had returned from Russia within the last two years. The data was analysed by structuring the interview transcripts using template analysis. The results supported earlier literature and suggest that the re-entry remains a challenging phase for both the individual and the company. For some, adjusting to a new job was difficult for various reasons. The repatriates underwent personal change and development and felt it was for the better. Many repatriates criticised the company’s repatriation process upon return. Finding a suitable return job was not clear. Instead, the returnees had to be active in finding a new position. Many assignees had only modest career-related motives regarding the assignment and they had realistic expectations about the return. Therefore they were not extremely surprised or dissatisfied when they were not actively offered positions or support by the company. The significance of motives stood out even more than the theory predicted. As predicted, they are linked to the expectations of employees. Moreover, if the employees are motivated to remain in the company, they can tolerate partly a negative repatriation experience. Despite the complexity of the return and readjustment, the assignment as a whole was seen as a rewarding experience by all participants.

Two-phase flow measurements with spacer grid in a rod bundle geometry

Heat transfer effectiveness in nuclear rod bundles is of great importance to nuclear reactor safety and economics. An important design parameter is the Critical Heat Flux (CHF), which limits the transferred heat from the fuel to the coolant. The CHF is determined by flow behaviour, especially the turbulence created inside the fuel rod bundle. Adiabatic experiments can be used to characterize the flow behaviour separately from the heat transfer phenomena in diabatic flow. To enhance the turbulence, mixing vanes are attached to spacer grids, which hold the rods in place. The vanes either make the flow swirl around a single sub-channel or induce cross-mixing between adjacent sub-channels. In adiabatic two-phase conditions an important phenomenon that can be investigated is the effect of the spacer on canceling the lift force, which collects the small bubbles to the rod surfaces leading to decreased CHF in diabatic conditions and thus limits the reactor power. Computational Fluid Dynamics (CFD) can be used to simulate the flow numerically and to test how different spacer configurations affect the flow. Experimental data is needed to validate and verify the used CFD models. Especially the modeling of turbulence is challenging even for single-phase flow inside the complex sub-channel geometry. In two-phase flow other factors such as bubble dynamics further complicate the modeling. To investigate the spacer grid effect on two-phase flow, and to provide further experimental data for CFD validation, a series of experiments was run on an adiabatic sub-channel flow loop using a duct-type spacer grid with different configurations. Utilizing the wire-mesh sensor technology, the facility gives high resolution experimental data in both time and space. The experimental results indicate that the duct-type spacer grid is less effective in canceling the lift force effect than the egg-crate type spacer tested earlier.