Safety and outcome of coronary interventions with special reference to anticoagulation and stent type

University of Turku, Faculty of Medicine, Department of Cardiology and Cardiovascular Medicine, Doctoral Programme of Clinical Investigation, Heart Center, Turku University Hospital, Turku, Finland Division of Internal Medicine, Department of Cardiology, Seinäjoki Central Hospital, Seinäjoki, Finland Heart Center, Satakunta Central Hospital, Pori, Finland Annales Universitatis Turkuensis Painosalama Oy, Turku, Finland 2015 Antithrombotic therapy during and after coronary procedures always entails the challenging establishment of a balance between bleeding and thrombotic complications. It has been generally recommended to patients on long-term warfarin therapy to discontinue warfarin a few days prior to elective coronary angiography or intervention to prevent bleeding complications. Bridging therapy with heparin is recommended for patients at an increased risk of thromboembolism who require the interruption of anticoagulation for elective surgery or an invasive procedure. In study I, consecutive patients on warfarin therapy referred for diagnostic coronary angiography were compared to control patients with a similar disease presentation without warfarin. The strategy of performing coronary angiography during uninterrupted therapeutic warfarin anticoagulation appeared to be a relatively safe alternative to bridging therapy, if the international normalized ratio level was not on a supratherapeutic level. In-stent restenosis remains an important reason for failure of long-term success after a percutaneous coronary intervention (PCI). Drug-eluting stents (DES) reduce the problem of restenosis inherent to bare metal stents (BMS). However, a longer delay in arterial healing may extend the risk of stent thrombosis (ST) far beyond 30 days after the DES implantation. Early discontinuation of antiplatelet therapy has been the most important predisposing factor for ST. In study II, patients on long-term oral anticoagulant (OAC) underwent DES or BMS stenting with a median of 3.5 years’follow-up. The selective use of DESs with a short triple therapy seemed to be safe in OAC patients, since late STs were rare even without long clopidogrel treatment. Major bleeding and cardiac events were common in this patient group irrespective of stent type. In order to help to predict the bleeding risk in patients on OAC, several different bleeding risk scorings have been developed. Risk scoring systems have also been used also in the setting of patients undergoing a PCI. In study III, the predictive value of an outpatient bleeding risk index (OBRI) to identify patients at high risk of bleeding was analysed. The bleeding risk seemed not to modify periprocedural or long-term treatment choices in patients on OAC after a percutaneous coronary intervention. Patients with a high OBRI often had major bleeding episodes, and the OBRI may be suitable for risk evaluation in this patient group. Optical coherence tomography (OCT) is a novel technology for imaging intravascular coronary arteries. OCT is a light-based imaging modality that enables a 12–18 µm tissue axial resolution to visualize plaques in the vessel, possible dissections and thrombi as well as, stent strut appositions and coverage, and to measure the vessel lumen and lesions. In study IV, 30 days after titanium-nitride-oxide (TITANOX)-coated stent implantation, the binary stent strut coverage was satisfactory and the prevalence of malapposed struts was low as evaluated by OCT. Long-term clinical events in patients treated with (TITANOX)-coated bio-active stents (BAS) and paclitaxel-eluting stents (PES) in routine clinical practice were examined in study V. At the 3-year follow-up, BAS resulted in better long-term outcome when compared with PES with an infrequent need for target vessel revascularization. Keywords: anticoagulation, restenosis, thrombosis, bleeding, optical coherence tomography, titanium

Catching up with competitiveness in emerging markets – An analysis of the role of the firm’s technology management strategies

Emerging markets have experienced rapid economic growth, and manufacturing firms have had to face the effects of globalisation. Some of the major emerging economies have been able to create a supportive business environment that fosters innovation, and China is a good example of a country that has been able to increase value-added investments. Conversely, when we look at Russia, another big emerging market, we witness a situation in which domestic firms struggle more with global competitiveness. Innovation has proven to be one of the most essential ingredients for firms aiming to grow and become more competitive. In emerging markets, the business environment sets many constraints for innovation. However, open strategic choices in new product development enable companies in emerging markets to expand their resource base and capability building. Networking and close inter-firm cooperation are essential in this regard. In this dissertation, I argue that technology transfer is one of the key tools for these companies to become internationally networked and to improve their competitiveness. It forces companies to reach outside the company and national borders, which in many cases, is a major challenge for firms in emerging markets. This dissertation focuses on how companies can catch up with competitiveness in emerging markets. The empirical studies included in the dissertation are based on analyses of survey data mainly of firms and their strategies in the Russian manufacturing industry. The dissertation contributes to the current strategic management literature by further investigating technology management strategies in manufacturing firms in emerging markets and the benefits of more open approaches to new product development and innovation.

The impact of meaningfulness of and responsibility for work on the relationships among work values, organizational commitment, and job satisfaction for part- time faculty in a community college

One hundred and thirty four subjects participated in this survey. Quantitative data were obtained and correlational analyses were used to test a model to study the relationships among the achievement of work values and organizational commitment and job satisfaction and to identify the moderating effects of the meaningfulness of work and responsibility for work on these relationships. Part-time faculty in the Faculty of Continuing Education of a community college were mailed a questionnaire on all the variables of the model. Several reliable, valid instruments were used to test the variables. Data analysis through Pearson correlation and stepwise multiple regression analyses revealed that the achievement of the work values of recognition and satisfaction with promotions did predict organizational commitment and job satisfaction, although the moderating effects of the meaningfulness of work and responsibility for work was not supported in this study. This study suggests that the revised model may be used for determining the relationships between the achievement of work values and organizational commitment and job satisfaction in a community college setting.

CEO Compensation, Compensation Risk, and Corporate Governance: Evidence from Technology Firms

Literature suggests that CEOs of technology firms earn higher pay than CEOs of non-technology firms. I investigate whether compensation risk explains the difference in compensation between technology firms and non-technology firms. Controlling for firm size and performance, I find that CEOs in technology firms have higher pay, but also have much higher compensation risk compared to non-technology firms. Compensation risk explains the major part of the difference in CEO pay. My study is consistent with the labor market economics view that CEOs earn competitive risk-adjusted total compensation.

Social Media Use in Medical and Health Professional Education: Role of the Librarian on a Faculty Steering Committee

Objective: An interprofessional steering committee was created at Université de Montréal’s Faculty of Medicine to examine how social media are integrated in medical and health professional education in universities across the globe, and to propose a strategic plan for integrating social media in the Faculty’s various curricula. This presentation will summarize the steering committee’s work and describe the librarian’s contribution. Methods: The Committee’s project leader first conducted a literature search on best practices of social media in medical and health professional curricula. A reference website was then created (mse.med.umontreal.ca) to provide easy access to a large number of the articles and resources reviewed. A steering committee was constituted and 11 meetings were held over a 9-month period. The Committee comprised 18 members and included assistant deans, academic program directors, professors, communication advisors, undergraduate and graduate students and a librarian. An online survey on social media use by students and professors of the Faculty was conducted, ten pilot projects were put forward and a three-year strategic plan was proposed. Results: A total of 1508 students and 565 professors participated in the survey. Results showed that both groups had a strong interest in learning how social media could be integrated in academic and professional activities. Participants reported concern with risks associated with social media use and expressed the need for a Faculty policy and guidelines. The librarian’s contribution to the steering committee included: writing posts on the website’s internal blog, assisting in the design of the survey questionnaires and writing the final report’s survey results chapter. She also proposed two pilot projects: creating a social media learning portal and an altmetrics workshop. Conclusions: Based on the literature review and the survey results, the Committee affirmed the importance of integrating social media in the various study programs of the Faculty of Medicine. Despite the restricted timeline, this interprofessional steering committee was able to carry out its mandate because of the leadership and expertise of each of its members. As the librarian had the most experience with the use of social media in a professional context, her knowledge was instrumental in assisting the project leader in a group mainly composed of social media non-users.

Studies on the Antiulcerogenic and Antihepatotoxic Potential of Chitosan and Glucosamine in Experimental Rats

The present study examined the antiulcer effect of glucosamine on mucosal antioxidant defense system in ibuprofen-induced peptic ulcer in male albino rats. The results of the present study indicate that the pre-oral administration of chitosan and glucosamine maintain near to the normal status the activities of the mucosal antioxidant enzymes and the level of GSH (Glutathione), which protect mucosa against oxidative damage by decreasing the lipid peroxidation and strengthening the mucosal barrier, and which are the first line of defense against exogenous ulcerogenic agents. In this study indicate that the oral pre-treatment of chitosan and glucosamine can prevent ibuprofen-induced peptic ulcer in rats.This study can be concluded that co-administration of chitsosan and glucosamine can effectively prevent the isonized and rifampicin induced hepatotoxicity in rats.Comparatively, chitosan was found to have better results than glucosamine in alleviating the hepatic disorders.

Characteristics of near surface crustal deformation associated with shield seismicity

The purpose of the present study is to understand the surface deformation associated with the Killari and Wadakkancheri earthquake and to examine if there are any evidence of occurrence of paleo-earthquakes in this region or its vicinity. The present study is an attempt to characterize active tectonic structures from two areas within penisular India: the sites of 1993 Killari (Latur) (Mb 6.3) and 1994 Wadakkancheri (M 4.3) earthquakes in the Precambrian shield. The main objectives of the study are to isolate structures related to active tectonism, constraint the style of near – surface deformation and identify previous events by interpreting the deformational features. The study indicates the existence of a NW-SE trending pre-existing fault, passing through the epicentral area of the 1993 Killari earthquake. It presents the salient features obtained during the field investigations in and around the rupture zone. Details of mapping of the scrap, trenching, and shallow drilling are discussed here. It presents the geologic and tectonic settings of the Wadakkancheri area and the local seismicity; interpretation of remote sensing data and a detailed geomorphic analysis. Quantitative geomorphic analysis around the epicenter of the Wadakkancheri earthquake indicates suitable neotectonic rejuvenation. Evaluation of remote sensing data shows distinct linear features including the presence of potentially active WNW-ESE trending fault within the Precambrian shear zone. The study concludes that the earthquakes in the shield area are mostly associated with discrete faults that are developed in association with the preexisting shear zones or structurally weak zones

Studies on the Synthesis and Transformations of a Few Dibenzoylalkene-type Systems

The aim of the study is to synthesise several dibenzoylakene-type systems such as acenaphthenone-2-ylidene ketones 47 and phenanthrenone-9-ylidene ketones 48 by the condensation reaction of acenaphthenequinone and phenanthrenequinone with methyl ketones. Here studies the thermal and photochemical transformations of acenaphthaenone-2-ylidene ketones 3a-c.These acenaphthenone –2-ylidene ketones underwent extensive decomposition on heating. The objectives of present study is to synthesise acenaphthenone-2-ylidene ketones by the Claisen-Schmidt condensation of acenaphthenequinone and methyl ketones, it is to synthesise phenanthrenone –9-ylidene ketones by the Claisen-Schmidt condensation of phenanthrequinone and methyl ketones, thermal studies on acenaphthenone-2-ylidene ketones and phenanthrenone-9-ylidene ketones, photochemical studies on acenaphthenone-2-ylidene ketones and phenanthrenone –9-ylidene ketones to establish the generality of dibenzoyalkene rearrangement. Cyclic voltammetric studies on these dibezoyalkenes to compare their redox behaviour with that of the cis and trans isomers of dibenzoyl-ethylene, dibenzoylstilbene. These results should provide some information about their reactivity, and to assess and exploit the potential of these systems as quinonemethides. This study conclude that a number of new dibenzolalkene-type systems have been synthesized by the Claisen-Schmidt condensation of 1,2-diketones such as phenanthequinone and acenaphthenequinone with methyl ketones. Some of these compounds have been shown to undergo interesting photochemical transformations. Based on the results it is conclude that phenanthjrenone-9-ylidene ketones are excellent Michael acceptors. Methanol adds to these to yield the corresponding furanols. These furanols are unstable and are slowly converted to phenanthro-2 (3H)-furanones

Tunable diode Laser Absorption Spectroscopy ,Nir Overtone and Life Studies of Some Organic Compound

The present work is mainly concentrated on setting up a NIR tunable diode laser absorption (TDLA) spectrometer for high-resolution molecular spectroscopic studies. For successfully recording the high-resolution tunable diode laser spectrum, various experimental considerations are to be taken into account like the setup should be free from mechanical vibrations, sample should be kept at a low pressure, laser should be in a single mode operation etc. The present experimental set up considers all these factors. It is to be mentioned here that the setting up of a high resolution NIR TDLA spectrometer is a novel experiment requiring much effort and patience. The analysis of near infrared (NIR) vibrational overtone spectra of some substituted benzene compounds using local mode model forms another part of the present work. An attempt is made to record the pulsed laser induced fluorescence/Raman spectra of some organic compounds. A Q-switched Nd:YAG laser is used as the excitation source. A TRIAX monochromator and CCD detector is used for the spectral recording. The observed fluorescence emission for carbon disulphide is centered at 680 nm; this is assigned as due to the n, p* transition. Aniline also shows a broad fluorescence emission centered at 725 nm, which is due to the p,p* transition. The pulsed laser Raman spectra of some organic compounds are also recorded using the same experimental setup. The calibration of the set up is done using the laser Raman spectra of carbon tetrachloride and carbon disulphide. The observed laser Raman spectra for aniline, o-chloroaniline and m-chlorotoluene show peaks characteristics of the aromatic ring in common and the characteristics peaks due to the substitutuent groups. Some new peaks corresponding to low-lying vibrations of these molecules are also assigned

Characterization of Probability Distributions Using the Residual Entropy Function

The present study on the characterization of probability distributions using the residual entropy function. The concept of entropy is extensively used in literature as a quantitative measure of uncertainty associated with a random phenomenon. The commonly used life time models in reliability Theory are exponential distribution, Pareto distribution, Beta distribution, Weibull distribution and gamma distribution. Several characterization theorems are obtained for the above models using reliability concepts such as failure rate, mean residual life function, vitality function, variance residual life function etc. Most of the works on characterization of distributions in the reliability context centers around the failure rate or the residual life function. The important aspect of interest in the study of entropy is that of locating distributions for which the shannon’s entropy is maximum subject to certain restrictions on the underlying random variable. The geometric vitality function and examine its properties. It is established that the geometric vitality function determines the distribution uniquely. The problem of averaging the residual entropy function is examined, and also the truncated form version of entropies of higher order are defined. In this study it is established that the residual entropy function determines the distribution uniquely and that the constancy of the same is characteristics to the geometric distribution

Studies om the Antiulcerogenic and Antihepatotoxic Potential of Chitosan and Glucosamine in Eeperimental Rats

The present study examined the antiulcer effect of glucosamine on mucosal antioxidant defense system in ibuprofen-induced peptic ulcer in male albino rats. The results of the present study indicate that the pre-oral administration of chitosan and glucosamine maintain near to the normal status the activities of the mucosal antioxidant enzymes and the level of GSH (Glutathione), which protect mucosa against oxidative damage by decreasing the lipid peroxidation and strengthening the mucosal barrier, and which are the first line of defense against exogenous ulcerogenic agents. In this study indicate that the oral pre-treatment of chitosan and glucosamine can prevent ibuprofen-induced peptic ulcer in rats.This study can be concluded that co-administration of chitsosan and glucosamine can effectively prevent the isonized and rifampicin induced hepatotoxicity in rats.Comparatively, chitosan was found to have better results than glucosamine in alleviating the hepatic disorders