Influence of socioeconomic factors on delays, management and outcome amongst patients with acute myocardial infarction undergoing primary percutaneous coronary intervention.

The outcome after primary percutaneous coronary intervention (pPCI) for ST-elevation myocardial infarction (STEMI) is strongly affected by time delays. In this study, we sought to identify the impact of specific socioeconomic factors on time delays, subsequent STEMI management and outcomes in STEMI patients undergoing pPCI, who came from a well-defined region of the French part of Switzerland. A total of 402 consecutive patients undergoing pPCI for STEMI in a large tertiary hospital were retrospectively studied. Symptom-to-first-medical-contact time was analysed for the following socioeconomic factors: level of education, origin and marital status. Main exclusion criteria were: time delay beyond 12 hours, previous treatment with fibrinolytic agents or patients immediately referred for coronary artery bypass graft surgery. Therefore, 222 patients were finally included. At 1 year, there was no difference in mortality between the different socioeconomic groups. Furthermore, there was no difference in management characteristics between them. Symptom-to-first-medical-contact time was significantly longer for patients with a low level of education, Swiss citizens and unmarried patients, with median differences of 23 minutes, 18 minutes and 13 minutes, respectively (p <0.05). Nevertheless, no difference was found regarding in-hospital management and clinical outcome. This study demonstrates that symptom-to-first-medical-contact time is longer amongst people with a lower educational level, Swiss citizens and unmarried people. Because of the low mortality rate in general, these differences in delays did not affect clinical outcomes. Still, tertiary prevention measures should particularly focus on these vulnerable populations.

European Cardiovascular Magnetic Resonance (EuroCMR) registry--multi national results from 57 centers in 15 countries.

BACKGROUND: The EuroCMR registry sought to evaluate indications, image quality, safety and impact on patient management of clinical routine CMR in a multi-national European setting. Furthermore, interim analysis of the specific protocols should underscore the prognostic potential of CMR. METHODS: Multi-center registry with consecutive enrolment of patients in 57 centers in 15 countries. More than 27000 consecutive patients were enrolled. RESULTS: The most important indications were risk stratification in suspected CAD/Ischemia (34.2%), workup of myocarditis/cardiomyopathies (32.2%), as well as assessment of viability (14.6%). Image quality was diagnostic in more than 98% of cases. Severe complications occurred in 0.026%, always associated with stress testing. No patient died during or due to CMR. In 61.8% CMR findings impacted on patient management. Importantly, in nearly 8.7% the final diagnosis based on CMR was different to the diagnosis before CMR, leading to a complete change in management. Interim analysis of suspected CAD and risk stratification in HCM specific protocols revealed a low rate of adverse events for suspected CAD patients with normal stress CMR (1.0% per year), and for HCM patients without LGE (2.7% per year). CONCLUSION: The most important indications in Europe are risk stratification in suspected CAD/Ischemia, work-up of myocarditis and cardiomyopathies, as well as assessment of viability. CMR imaging is a safe procedure, has diagnostic image quality in more than 98% of cases, and its results have strong impact on patient management. Interim analyses of the specific protocols underscore the prognostic value of clinical routine CMR in CAD and HCM.

Interventions hybrides et malformations cardiaques congénitales [Hybrid procedures in congenital heart disease]

La complexité croissante de la prise en charge des malformations cardiaques congénitales impose des interventions chirurgicales et des cathétérismes cardiaques interventionnels fréquents. Chacune de ces techniques a ces limitations propres. Les interventions hybrides associent les avantages de la chirurgie cardiaque et du cathétérisme interventionnel. Dans notre expérience, les thérapies hybrides permettent de diminuer le temps de circulation extracorporelle, de diminuer la morbidité des interventions chirurgicales, de raccourcir le séjour du patient aux soins intensifs. Pour certaines malformations cardiaques congénitales complexes pour lesquelles il n'existe pas de chirurgie ou de thérapie interventionnelle idéale, les interventions hybrides sont en train de s'imposer comme la prise en charge incontournable. Increasing complexity in management of congenital heart disease imposes more frequent surgeries and interventions. Each technique has its own limitations, which could impair the anticipated result. Hybrid procedures join the advantages of cardiac surgery and interventions, creating a synergy in the management of these patients with cardiac anomalies. In our experience, hybrid procedures shorten cardiopulmonary bypass, reduce morbidity of surgery and reduce duration of stay in the intensive care unit. For some complex congenital heart diseases for which there are no ideal surgical or interventional options, hybrid procedures are becoming increasingly important in their management. Finally hybrid procedures allow surgeons and cardiologist to achieve complex procedures that could not be possible in another way

The double-edged sword of social capital: Three essays on entrepreneurship in developing nations

ABSTRACT My study seeks to answer the main question: "how does entrepreneurs' social capital positively and negatively affect their resource mobilization efforts, and exploitation of entrepreneurial opportunity?" To answer this question, I develop a model for examining positive and negative effects of social capital on resource accumulation by entrepreneurs, and the subsequent effect of resource accumulation on the exploitation of entrepreneurial opportunity, and utilize data from Africa to ëmpirically test the relationships in this model. Developing nations are a suitable context because: a) They require entrepreneurship for economic development, b) They have received less attention in management and entrepreneurship research, c) Because of inadequately-developed institutions, entrepreneurs from developing nations face major resource mobilization challenges hence they often turn to their social ties for resources, and d) The communalistic and collectivistic nature of most developing nations -encouraging support and sharing of resources- may help us better understand how society's values and structures may contribute and also deduct firm resources. My study reveals that social capital contributes resources to entrepreneurs in developing nations at a cost that takes away resources, and that more resources but lower costs facilitate entrepreneurial opportunity exploitation. For entrepreneurs in developing nations, large networks, greater shared identity, and more trust are beneficial. To increase chances of raising more resources, entrepreneurs from communalistic societies should include network members from outside their communities. Besides providing financial support, policy-makers should develop training programs and advisory services on configuration of entrepreneurs' networks so as to achieve more resources at a low cost. My study insights can help improve entrepreneurs' resource accumulation efforts and the subsequent growth of their firms, leading to the overall economic growth of developing nations.

Enhancement of viability of radiosensitive (PBMC) and resistant (MDA-MB-231) clones in low-dose-rate cobalt-60 radiation therapy

AbstractObjective:In the present study, the authors investigated the in vitrobehavior of radio-resistant breast adenocarcinoma (MDA-MB-231) cells line and radiosensitive peripheral blood mononuclear cells (PBMC), as a function of different radiation doses, dose rates and postirradiation time kinetics, with a view to the interest of clinical radiotherapy.Materials and Methods:The cells were irradiated with Co-60, at 2 and 10 Gy and two different exposure rates, 339.56 cGy.min–1 and the other corresponding to one fourth of the standard dose rates, present over a 10-year period of cobalt therapy. Post-irradiation sampling was performed at pre-established kinetics of 24, 48 and 72 hours. The optical density response in viability assay was evaluated and a morphological analysis was performed.Results:Radiosensitive PBMC showed decrease in viability at 2 Gy, and a more significant decrease at 10 Gy for both dose rates. MDAMB- 231 cells presented viability decrease only at higher dose and dose rate. The results showed MDA-MB-231 clone expansion at low dose rate after 48–72 hours post-radiation.Conclusion:Low dose rate shows a possible potential clinical impact involving decrease in management of radio-resistant and radiosensitive tumor cell lines in cobalt therapy for breast cancer.

The long run development of Chile and the Natural Resources curse. Linkages, policy and growth, 1850-1950

This chapter analyses the effects of Natural Resources on the Chilean economy in the long run -1850-1950-. Specifically, the authors focus their attention on the mining cycles -nitrates and copper- and their impact on the mining activity. We also compare it with the evolution of the industry and whole economy, and how this has affected the economic growth of the country. In that sense, the industrial performance in Chile at the end of the 19th century until the Great Depression is still under debate. The optimistic view of Kirsch -1977- forehead the pessimistic view of Lagos -1966- and Palma -1979-. The new data and its analyses shows a neutral effect of the Natural Resources in the industrial development.

Low cost driver device for microclimate maintenance in the pre-milking of dairy cattle

Due to the importance of the environment on animal production and thus environmental control, the study aims to build a system for monitoring and control the meteorological variables, temperature and relative humidity, low cost, which can be associated with an evaporative cooling system (ECS). The system development included all the stages of assembly, test and laboratory calibration, and later the validation of the equipment carried in the field. The validation step showed results which allowed concluding that the system can be safely used in the monitoring of these variables. The controller was efficient in management of the microclimate in the waiting corral and allowed the maintenance of the air temperature within the comfort range for dairy cattle in pre-milking with averaged 25.09 ºC during the afternoon. The equipment showed the lower cost (R$ 325.76) when compared to other middle market (R$ 450.00).

Business intelligence and management control

The purpose of this study is to explore the possibilities of utilizing business intelligence (BI)systems in management control (MC). The topic of this study is explored trough four researchquestions. Firstly, what kind of management control systems (MCS) use or could use the data and information enabled by the BI system? Secondly, how the BI system is or could be utilized? Thirdly, has BI system enabled new forms of control or changed old ones? The fourth and final research question is whether the BI system supports some forms of control that the literature has not thought of, or is the BI system not used for some forms of control the literature suggests it should be used? The study is conducted as an extensive case study. Three different organizations were interviewed for the study. For the theoretical basis of the study, central theories in the field of management control are introduced. The term business intelligence is discussed in detail and the mechanisms for governance of business intelligence are presented. A literature analysis of the uses of BI for management control is introduced. The theoretical part of the study ends in the construction of a framework for business intelligence in management control. In the empirical part of the study the case organizations, their BI systems, and the ways they utilize these systems for management control are presented. The main findings of the study are that BI systems can be utilized in the fields suggested in the literature, namely in planning, cybernetic, reward, boundary, and interactive control. The systems are used both as the data or information feeders and directly as the tools. Using BI systems has also enabled entirely new forms of control in the studied organizations, most significantly in the area of interactive control. They have also changed the old control systems by making the information more readily available to the whole organization. No evidence of the BI systems being used for forms of control that the literature had not suggested was found. The systems were mostly used for cybernetic control and interactive control, whereas the support for other types of control was not as prevalent. The main contribution of the study to the existing literature is the insight provided into how BI systems, both theoretically and empirically, are used for management control. The framework for business intelligence in management control presented in the study can also be utilized in further studies about the subject.

Reputational Risk Management as a key element for business continuity and value maximization

This thesis reveals the topic of reputational risk management as a key element for business continuity and value maximization. The purpose of the work is to investigate reputational risk from the side of its definition, management (including legal requirements on this risk category) and measurement and to analyse reputational risk’s impact on business continuity and value maximization. To be able to do this, different respective articles, reports of financial institutions are gathered and constructive summaries and analysis are made. In order to deeply investigate the impact of reputational risk on business continuity and value maximization, it was chosen to study it from three aspects: 1) check the impact of stock valuation of 7 companies that experienced reputational catastrophe / risk, 2) analyse a case study on disagreements in management of reputational risk among case companies and impact on their respective performance, and 3) conduct a survey of financial sector companies in Liechtenstein to see how reputational risk management works in practice. The findings of the research showed a significant impact of reputation decadence on company’s value and trading volume, and showed crucial importance of post-crisis management for the company’s financial performance. The results of the qualitative research based on survey proved that companies consider reputational risk management as a one of the key elements for their business continuity and value maximization.

東園雜字Dong yuan za zi.

Même ouvrage, édition datant de Dao guang (1821-1850), sans localité.

A study of the thermal decomposition of allyl t-butyl peroxide and 3-hydroperoxy-1-propene (allyl hydroperoxide) in toluene /|nby Krishnankutty Nair V. G. -- 260 St. Catharines [Ont. : s. n.],

Kinetics and product studies of the decompositions of allyl-t-butyl peroxide and 3-hydroperoxy- l-propene (allyl hydroperoxide ) in tolune were investigated. Decompositions of allyl-t-butyl peroxide in toluene at 130-1600 followed first order kinetics with an activation energy of 32.8 K.cals/mol and a log A factor of 13.65. The rates of decomposition were lowered in presence of the radical trap~methyl styrene. By the radical trap method, the induced decomposition at 1300 is shown to be 12.5%. From the yield of 4-phenyl-l,2- epoxy butane the major path of induced decomposition is shown to be via an addition mechanism. On the other hand, di-t-butYl peroxyoxalate induced decomposition of this peroxide at 600 proceeded by an abstraction mechanism. Induced decomposition of peroxides and hydroperoxides containing the allyl system is proposed to occur mainly through an addition mechanism at these higher temperatures. Allyl hydroperoxide in toluene at 165-1850 decomposes following 3/2 order kinetics with an Ea of 30.2 K.cals per mole and log A of 10.6. Enormous production of radicals through chain branching may explain these relatively low values of E and log A. The complexity of the reaction is indicated a by the formation of various products of the decomposition. A study of the radical attack of the hydro peroxide at lower temperatures is suggested as a further work to throw more light on the nature of decomposition of this hydroperoxide.

Twenty-Third Annual Management Achievement Awards Luncheon Program 2003

A program for the Twenty-Third Annual Management Achievement Awards Luncheon on February 7th, 2003 at The Windsor. Mr. Ziraldo is to be presented an award for his achievement in Management during the luncheon ceremony. Also, listed are the names of recipients of the award for the past twenty three years.

An integrated assessment of resource use strategies in the Borana pastoral system of southern Ethiopia

In the pastoral production systems, mobility remains the main technique used to meet livestock’s fodder requirements. Currently, with growing challenges on the pastoral production systems, there is urgent need for an in-depth understanding of how pastoralists continue to manage their grazing resources and how they determine their mobility strategies. This study examined the Borana pastoralists’ regulation of access to grazing resources, mobility practices and cattle reproductive performances in three pastoral zones of Borana region of southern Ethiopia. The central objective of the study was to contribute to the understanding of pastoral land use strategies at a scale relevant to their management. The study applied a multi-scalar methodological approach that allowed zooming in from communal to individual herd level. Through participatory mapping that applied Google Earth image print out as visual aid, the study revealed that the Borana pastoralists conceptualized their grazing areas as distinctive grazing units with names, borders, and specific characteristics. This knowledge enables the herders to communicate the condition of grazing resources among themselves in a precise way which is important in management of livestock mobility. Analysis of grazing area use from the participatory maps showed that the Borana pastoralists apportion their grazing areas into categories that are accessed at different times of the year (temporal use areas). This re-organization is an attempt by the community to cope with the prevailing constraints which results in fodder shortages especially during the dry periods. The re-organization represents a shift in resource use system, as the previous mobility practice across the ecologically varied zones of the rangelands became severely restricted. Grazing itineraries of 91 cattle herds for over 16 months obtained using the seasonal calendar interviews indicated that in the areas with the severest mobility constraints, the herders spent most of their time in the year round use areas that are within close proximity to the settlements. A significant change in mobility strategy was the disallowing of foora practice by the communities in Dirre and Malbe zones in order to reduce competition. With the reduction in mobility practices, there is a general decline in cattle reproductive parameters with the areas experiencing the severest constraints showing the least favourable reproductive performances. The study concludes that the multi-scalar methodology was well suited to zoom into pastoral grazing management practices from communal to individual herd levels. Also the loss of mobility in the Borana pastoral system affects fulfilment of livestock feed requirements thus resulting in reduced reproductive performances and herd growth potentials. While reversal of the conditions of the situations in the Borana rangelands is practically unfeasible, the findings from this research underscore the need to protect the remaining pastoral lands since the pastoral production system remains the most important livelihood option for the majority of the Borana people. In this regards the study emphasises the need to adopt and domesticate regional and international policy frameworks such as that proposed by the African Union in 2010.

Sobrepeso en escolares : prevalencia, factores protectores y de riesgo en Bogotá

Objetivo: Calcular la prevalencia del sobrepeso en la población escolar de la ciudad de Bogotá en niños de 8 a 16 años determinando algunos de los factores protectores y/o de riesgo para desarrollar esta patología. Materiales y métodos: Se utilizaron los datos del estudio QAPACE de 1840 escolares de Bogotá, de 8 a 16 años, en el cual se les aplicó un cuestionario validado para poder determinar el gasto energético de cada individuo y se realizaron mediciones antropométricas y de cualidades físicas. Se clasificaron en casos según el IMC limites C.D.C e Indice Internacional y el porcentaje graso según ecuación de Siri. Se evaluó la relación con los posibles factores de riesgo y se calculó la concordancia entre las pruebas. Resultados: La prevalencia de sobrepeso según el CDC es del 7,5% y la obesidad del 1,63%; según el Índice Internacional se observaron valores de 7,61% y 0,6% respectivamente y por porcentaje graso fue de 3,86% y 1,79%. No se encontraron diferencias significativas por género. Los principales factores de riesgo significativos fueron el gasto energético bajo fuera del colegio, tener un test de leger menor a los limites saludables recomendados por fitnessgram y dormir un tiempo inferior a 7 horas. La concordancia entre los diferentes métodos diagnósticos es mayor del 92%. Conclusiones: La prevalencia del sobrepeso en la ciudad de Bogotá es mayor a la de bajo peso según CDC lo cual sugiere una transición nutricional en Bogotá. Existe una alta concordancia entre los diferentes métodos para evaluar el sobrepeso.

Diseño del sistema logístico de la cadena de abastecimiento del desperdicio y desecho del vidrio

En economías emergentes y tan volátiles, los mercados globales de productos tradicionales se han vuelto poco atractivos, razón por la cual se investigo y se trabajo en la creación y adecuación de una organización que concentra, genera valor agregado y distribuye material reciclado de vidrio a Chile. Bajo este esquema se propone trabajar en un proyecto para el Centro de reciclaje La Alquería, situado en la ciudad de Bogotá, con el fin de abrir nuevos canales y mercados para el sector del reciclaje, generando nuevas oportunidades, competencias y practicas más eficientes en la administración logística para que esta empresa perdure en el tiempo.