L’amiodarone en fibrillation auriculaire chez les patients avec et sans dysfonction ventriculaire gauche sévère : une étude combinée de AFFIRM et AF-CHF

Objectif: Déterminer si l’efficacité de l’amiodarone pour le maintien du rythme sinusal varie selon la fonction systolique ventriculaire gauche. Contexte: Malgré un profil de sécurité établi en insuffisance cardiaque, nous ignorons si l’efficacité de l’amiodarone et son impact sur différentes issues cardiovasculaires sont modulés par la fonction ventriculaire gauche. Méthode: Nous avons effectué une analyse combinée de 3307 patients (âgés de 68,0±0,9 ans ; 31,1% de femmes) recrutés dans les études AFFIRM et AF-CHF qui ont été randomisés au contrôle du rythme par l’amiodarone (N=1107) ou au contrôle de la fréquence cardiaque (N=2200). Résultats: Chez les patients sous amiodarone, la survie sans fibrillation auriculaire était de 84% et de 45% à 1 et 5 ans respectivement, sans égard à la fraction d’éjection ventriculaire gauche (P=0,8754, ajusté). De façon similaire, la proportion moyenne ajustée de temps en fibrillation auriculaire (15,0±1,8%) n’a pas été influencée par la fraction d’éjection (P=0,6094). Durant le suivi, 1963 patients (59,4%) ont requis au moins une hospitalisation, incluant 1401 (42,6%) patients hospitalisés pour cause cardiovasculaire. Les taux ajustés d’hospitalisation pour toutes causes et pour cause cardiovasculaire étaient similaires entre les patients sous amiodarone et ceux dans le groupe de contrôle de la fréquence dans l’ensemble de la population ainsi que dans les sous-groupes de patients avec et sans dysfonction ventriculaire gauche sévère. De façon similaire, les taux ajustés de mortalité globale et cardiovasculaire étaient similaires entre chez les patients sous amiodarone et ceux traités par le contrôle de la fréquence dans l’ensemble de la population ainsi que dans les sous-groupes de patients avec et sans dysfonction ventriculaire gauche sévère. Conclusions: L’efficacité de l’amiodarone pour le maintien du rythme sinusal n’est pas influencée par la fonction ventriculaire gauche. Le contrôle du rythme avec l’amiodarone s’associe à des taux de mortalité et d’hospitalisation comparables au contrôle de la fréquence à la fois chez les patients avec et sans dysfonction ventriculaire gauche sévère.

Posibilidades de aplicaci??n del Sistema Bliss en la rehabilitaci??n logop??dica de pacientes af??sicos globales adultos

Aplicaci??n del Sistema Bliss como medio de comunicaci??n en casos de afasias globales graves (adultos). Un caso (mujer). Protocolo de exploraci??n logop??dico, y psicol??gico. Tests de expresi??n oral y escrita. El estudio presentado supone un intento de esclarecer las posibilidades de la aplicaci??n de un sistema de comunicaci??n no-vocal (concretamente el sistema Bliss), en la rehabilitaci??n logop??dica de pacientes af??sicos adultos en los que las posibilidades de reestructurar la comunicaci??n oral hayan sido valoradas como m??nimas o inexistentes. Para comprender, aunque sea minimamente, lo que supone dicho cuadro af??sico, se necesitaba exponer algunas ideas claves sobre la relaci??n cerebro-lenguaje, siendo, como sabemos, el lenguaje de una capacidad espec??ficamente humana y una de las operaciones m??s complejas que realiza el cerebro del hombre. El cuadro af??sico global es consecuencia de lesiones masivas del hemisferio izquierdo (en sujetos manidiestros) estas lesiones por su amplitud afectan a las zonas corticales implicadas tanto en la decodificaci??n o comprensi??n del habla, como en su codificaci??n o expresi??n. Esto lleva a valorar en ocasiones como inviable una rehabilitaci??n encaminada a reestructurar la comunicaci??n oral del paciente, a utilizar en la rehabilitaci??n logop??dica las v??as auditiva y articulatoria. Cuando la valoraci??n de estas v??as es negativa, es imprescindible canalizar la comunicaci??n del paciente d??ndole un sistema alternativo al habla. Con este trabajo vemos viable la utilizaci??n del sistema de comunicaci??n no-vocal Bliss, como alternativa al habla en casos de afasias globales graves, ya que con ello, se est??n utilizando aquellas zonas cerebrales no da??adas (es decir el hemisferio derecho), y por tanto, aquellas capacidades cognitivas intactas o al menos suficientemente preservadas.

El Quijote : literatura e identidad

Resumen basado en el de la publicaci??n

A greve académica de 1907

Este artigo procura revisitar a greve académica de 1907 e integrá-la num cenário de declínio da Monarquia Constitucional e numa conjuntura promissora da nova ordem republicana. Num primeiro momento, aborda-se a origem, o desenvolvimento e as consequências desta rebelião estudantil, enfocando uma multiplicidade de olhares, coevos, de publicistas, escritores e políticos e dando igualmente voz a alguns estudantes que vivenciaram esses acontecimentos. Num segundo momento, procede-se à abordagem das intervenções parlamentares que esta questão académica despoletou na Câmara dos Deputados, com destaque para os discursos eloquentes de António José de Almeida, um dos grandes tribunos republicanos do seu tempo.

Impact of I/Q imbalance on the performance of two-way CSI-assisted AF relaying

In this paper, we investigate half-duplex two-way dual-hop channel state information (CSI)-assisted amplify-and-forward (AF) relaying in the presence of in-phase and quadrature-phase (I/Q) imbalance. A compensation approach for the I/Q imbalance is proposed, which employs the received signals together with their conjugations to detect the desired signal. We also derive the average symbol error probability of the considered half-duplex two-way dual-hop CSI-assisted AF relaying networks with and without compensation for I/Q imbalance in Rayleigh fading channels. Numerical results are provided and show that the proposed compensation method mitigates the impact of I/Q imbalance to a certain extent.

Performance analysis of AF cooperative systems with HPA nonlinearity in semi-blind relays

In this paper, dual-hop amplify-and-forward (AF) cooperative systems in the presence of high-power amplifier (HPA) nonlinearity at semi-blind relays, are investigated. Based on the modified AF cooperative system model taking into account the HPA nonlinearity, the expression for the output signal-to-noise ratio (SNR) at the destination node is derived, where the interference due to both the AF relaying mechanism and the HPA nonlinearity is characterized. The performance of the AF cooperative system under study is evaluated in terms of average symbol error probability (SEP), which is derived using the moment-generating function (MGF) approach, considering transmissions over Nakagami-m fading channels. Numerical results are provided and show the effects of some system parameters, such as the HPA parameters, numbers of relays, quadrature amplitude modulation (QAM) order, Nakagami parameters, on performance.

Flow synthesis using gaseous ammonia in a Teflon AF-2400 tube-in-tube reactor: Paal–Knorr pyrrole formation and gas concentration measurement by inline flow titration

Using a simple and accessible Teflon AF-2400 based tube-intube reactor, a series of pyrroles were synthesised in flow using the Paal–Knorr reaction of 1,4-diketones with gaseous ammonia. An inline flow titration technique allowed measurement of the ammonia concentration and its relationship to residence time and temperature.

Continuous-flow processing of gaseous ammonia using a Teflon AF-2400 tube-in-tube reactor: synthesis of thioureas and in-line titrations

A simple tube-in-tube reactor based on the gas-permeable membrane Teflon AF-2400 was used in the continuous flow reaction of gaseous ammonia with isothiocyanates and one isocyanate. A colourimetric in-line titration technique is also reported as a simple method to quantify the amount of ammonia taken up by the solvent in the system.

Foreign executive appointments: a multilevel examination

As multinational enterprises (MNE) expand, their attachment to the country of origin is challenged by the need to adapt to an increasingly diverse geographical posture. We examine how these countervailing forces affect top management team (TMT) composition and test a model that associates foreign executive appointments with individual- and firm-level antecedents. Using multilevel data comprising 1,446 TMT appointments at 360 large European firms between 2001 and 2005, we show that individual experiential characteristics, the type of TMT function, prior performance of the MNE, and the MNE’s overall degree of internationalization are associated with foreign TMT appointments. We discuss how our findings contribute to the international business literature and complement recent research on the internationalization of TMTs.

Regionalization strategy and performance: the moderating role of industry dynamism and top management team diversity

Purpose– This paper contributes to the debate about the performance implications of adopting a regional as opposed to a global strategic posture. The aim of this paper is to argue that the performance effects of a regionalization strategy vary based on the characteristics of the industry in which the MNE operates and the composition of its top management team (TMT). Design/methodology/approach– This analysis is based on a cross‐sectional dataset of 211 large European MNEs headquartered in four Western European economies at the end of 2005. Findings– Results show that firms adopting a regional orientation outperform MNEs with global strategic positioning. This positive relationship is less pronounced under conditions of industry dynamism and inter‐regional TMT diversity. Originality/value– The study contributes to our understanding of whether and under what conditions MNEs benefit from adopting a regional as opposed to a global strategic posture.

International experiential diversity and performance at project organizations: The case of national football teams

Purpose– The purpose of this paper is to shed new light on the link between diversity in project teams and team performance by examining the effects of players’ international career diversity on the performance of national football teams. Design/methodology/approach– The paper draws upon the literature on project organizations and experiential diversity in teams. Using data on players’ international career backgrounds and team performance from the FIFA World Cup 2006, the authors test two hypotheses linking experiential diversity in teams and a measure of relative team performance. The dataset includes detailed individual background profiles of the 736 participating players and performance data from the 64 games played at the tournament. Findings– The findings suggest that different types of experiential diversity have contrasting effects on team performance in a time‐limited project team setting. Research limitations/implications– These findings encourage team diversity researchers to further examine the impact of experiential diversity in teams on team process and performance outcomes in future research. Practical implications– The findings particularly highlight the need to carefully manage experiential diversity in project team settings in order to benefit from access to diverse tacit resources, while at the same time avoiding that the integrative capacities of teams becoming overstretched. Originality/value– The paper is a step towards a better understanding of how diversity of individual career backgrounds affects team performance outcomes in project teams.

Transcending borders with international top management teams: a study of European financial multinational corporations

This paper investigates how changes in firm degree of internationalization are associated with the configuration of top management teams (TMT) based on a dataset of 41 large European firms in the banking and insurance industry, including detailed career profiles of the 264 executives that were serving on the TMTs of these firms at year-end 2002. Our findings suggest firms tend to match top executive profiles to their strategies. Entry into new foreign markets and new cultural zones was found to be associated with higher levels of international capacity at TMT level, whereas changes in international posture per se are not related to TMT international capacity. We discuss the interplay between firm strategies and internal structures in the context of firm internationalization and suggest directions for future research on TMTs