Improving coronary artery bypass graft durability: use of the external saphenous vein graft support.

Coronary bypass grafting remains the best option for patients suffering from multivessel coronary artery disease, and the saphenous vein is used as an additional conduit for multiple complete revascularizations. However, the long-term vein graft durability is poor, with almost 75% of occluded grafts after 10 years. To improve the durability, the concept of an external supportive structure was successfully developed during the last years: the eSVS Mesh device (Kips Bay Medical) is an external support for vein graft made of weft-knitted nitinol wire into a tubular form with an approximate length of 24 cm and available in three diameters (3.5, 4.0 and 4.5 mm). The device is placed over the outer wall of the vein and carefully deployed to cover the full length of the graft. The mesh is flexible for full adaptability to the heart anatomy and is intended to prevent kinking and dilatation of the vein in addition to suppressing the intima hyperplasia induced by the systemic blood pressure. The device is designed to reduce the vein diameter of about 15-20% at most to prevent the vein radial expansion induced by the arterial blood pressure, and the intima hyperplasia leading to the graft failure. We describe the surgical technique for preparing the vein graft with the external saphenous vein graft support (eSVS Mesh) and we share our preliminary clinical results.

Improving treatment satisfaction to increase adherence.

Poor adherence to treatment is a major issue for the management of hypertension and other chronic conditions. Although it is common among hypertensive patients and a cause of uncontrolled hypertension, poor adherence remains very difficult to diagnose in clinical practice. Moreover, it is unclear how to improve adherence. Hence, identifying potentially modifiable factors that are associated with treatment adherence among hypertensive patients is of high clinical interest. Treatment satisfaction is usually defined 'as the individual's rating of important attributes of the process and outcomes of his/her treatment experience'. Treatment satisfaction is conceptually difficult to define as it can encompass the entire treatment experience, going from the satisfaction with the medication to the satisfaction with health-care delivery system. Nevertheless, it represents an interesting patient reported outcome potentially useful to understand patient's perspectives and to evaluate some elements of the quality of care. Maintaining a long-term high treatment satisfaction is a serious challenge in patients having to take drugs for chronic conditions, such as hypertension.

Monitoring of the training load and recovery parameters in competitive swimmers

Nombreux sont les groupes de recherche qui se sont intéressés, ces dernières années, à la manière de monitorer l'entraînement des sportifs de haut niveau afin d'optimaliser le rendement de ce dernier tout en préservant la santé des athlètes. Un des problèmes cardinaux d'un entraînement sportif mal conduit est le syndrome du surentraînement. La définition du syndrome susmentionné proposée par Kreider et al. est celle qui est actuellement acceptée par le « European College of Sport Science » ainsi que par le « American College of Sports Medicine», à savoir : « An accumulation of training and/or non-training stress resulting in long-term decrement in performance capacity with or without related physiological and psychological signs and symptoms of maladaptation in which restoration of performance capacity may take several weeks or months. » « Une accumulation de stress lié, ou non, à l'entraînement, résultant en une diminution à long terme de la capacité de performance. Cette dernière est associée ou non avec des signes et des symptômes physiologiques et psychologiques d'inadaptation de l'athlète à l'entraînement. La restauration de ladite capacité de performance peut prendre plusieurs semaines ou mois. » Les recommandations actuelles, concernant le monitoring de l'entraînement et la détection précoce du syndrome du surentrainement, préconisent, entre autre, un suivi psychologique à l'aide de questionnaires (tel que le Profile of Mood State (POMS)), un suivi de la charge d'entraînement perçue par l'athlète (p.ex. avec la session rating of perceived exertion (RPE) method selon C. Foster), un suivi des performances des athlètes et des charges d'entraînement effectuées ainsi qu'un suivi des problèmes de santé (blessures et maladies). Le suivi de paramètres sanguins et hormonaux n'est pas recommandé d'une part pour des questions de coût et de faisabilité, d'autre part car la littérature scientifique n'a, jusqu'ici, pas été en mesure de dégager des évidences à ce sujet. A ce jour, peu d'études ont suivi ces paramètres de manière rigoureuse, sur une longue période et chez un nombre d'athlète important. Ceci est précisément le but de notre étude.

Innovative milieu, micro firms and local development in Barcelona

Peer-reviewed

Yrityksen toiminnan tehostaminen tilaus-toimitusprosessia kehittämällä

Tämän tutkimuksen päätavoitteena on selvittää, miten tilaus-toimitusprosessia kehittämällä voi tehostaa yrityksen toimintaa. Tutkimuksen alatavoitteina ovat tilaus-toimitusprosessin merkitystä ja kehittämistä koskevat kysymykset. Lisäksi tutkimuksessa selvitetään, voivatko tilaus-toimitusprosessi ja logistinen osaaminen olla kilpailuedun perustana. Työn näkökulma on asiakasnäkökulma. Tutkimuksessa on piirteitä toiminta-analyyttisestä ja konstruktiivisesta tutkimuksesta. Tutkimuksen viitekehys rakentuu tilaus-toimitusprosessin kehittämisen ja kilpailuedun muodostumisen kautta. Tilaus-toimitusprosessin kehittämiseksi tutkimuksessa paneudutaan prosessin kehittämisen yleisen mallin ja ABC-analyysin teorioiden kautta. Lopuksi tutkimuksessa etsitään vastaukset, voiko tilaus-toimitusprosessi olla kilpailuedun perusta. Aiempien tutkimuksien avulla selvitetään, millaisia hyötyjä logistisen prosessin avulla muodostetusta kilpailuedusta on yrityksen muihin osa-alueisiin. Tutkimuksen case-yrityksen, valmistavan teollisuusyrityksen, tilaus-toimitusprosessi on kehityskohde. Case-yrityksen tilaus-toimitusprosessia tarkastellaan yleisen prosessin kehittämisen mallin ja ABC-analyysin teorioiden kautta. Työn tulokset osoittavat, että kehittämällä tilaus-toimitusprosessia voidaan tehostaa yrityksen toimintaa. Tilaus-toimitusprosessin asiakasrajapinnan vuoksi hyvin onnistunut tilaus-toimitusprosessi vaikuttaa asiakastyytyväisyyteen. Tutkitut kehitysmallit vaikuttavat positiivisesti tilaus-toimitusprosessin onnistumiseen. Tilaus-toimitusprosessin positiivinen vaikutus kilpailuedun muodostumiseen osoitetaan myös tutkimuksessa.

O efeito do ultra-som em reações químicas

Unusual chemical phenomenon associated with ultrasound is on account of cavitation effect. The ultrasound increase the rate and yield of chemical reaction on account of its ability to emulsify liquids. When the ultrasound is used in metallic catalyst reaction the activity of catalyst is increased because the ultrasound clean the surface of catalyst. Sonogels have a fine porosity and large specific surface improving different properties. This paper deals with ultrasound phenomenon and gives some examples of reactions and properties where this radiation takes an important role.

Improving the effectiveness of supply chain development work – an expert role perspective

This study focuses to the intersection of three sets of activities in a company: expert work, development work and supply chain management, SCM. Experts and expert work represent a set of individuals whose efficiency and impact this study is intended to improve, while development work defines the set of organizational activities to focus on. SCM as an expertise area acts as the platform on which this study is built. The study has two aims. Firstly, it aims to derive a model helping an SCM expert to increase the effectiveness of expert work in development tasks by understanding the encountered organizational situations and processes better, reflecting his/her past and future actions to organizational processes and selecting and adjusting the processes and contents of his/her work accordingly. Secondly, it aims to develop applicable approaches and methods to understand, evaluate and manage the organizational processes and situations in development work. The integrative model on approaches and methods to improve the effectiveness of development processes is split to two aggregate dimensions: technical performance of the developed solution and consumption of resources of the development process. Six potential approaches and methods aiming at helping in the management of organizational dimensions are presented in enclosed publications. The approaches focus on three subtasks of development work: decision making, implementation and change, and knowledge accumulation. The approaches and methods have been tested in case studies representing typical development processes in the area of supply chain management. As a result, four suggestions are presented. Firstly, SCM experts are advised to consider the SCM development work to be consisting of development processes. Secondly, inside these processes they should identify and evaluate the risk of difficult decision-making related to organizational factors. Thirdly, they are prompted for an active role in implementation and change, supporting the implementation through whole process. Finally, the development should be seen in a holistic view, taking into account the stage of knowledge and organizational issues related to it, and adopt a knowledge development strategy.

Creating Global Competitive Advantage by Global Product Technology Transfers

Globalization is the trend which is realized in all areas in today’s business world. Pressure for cost reduction, changes in market situation and available scale economies have changed business environment more global than ever. To respond to new situation, companies are establishing global strategies. In this thesis, available global competitive advantages in electrical machine industry are studied in context of gaining them by global technology transfers. In theory part, establishing global strategy and competitive advantage is considered with connection to global sourcing and supply chain management. Additionally, market development in 21st century and its impact on global strategies is studied. In practice, global manufacturing is enabled by technology transfer projects. Smooth and fast project implementation enables faster and more flexible production ramp up. By starting the production available competitive advantages can be realized. In this thesis the present situation of technology transfer projects and the risks and advantages related to global manufacturing are analyzed. The analysis of implemented technology transfer projects indicates that project implementation is in good level. For further development of project execution 10 minor suggestions could be presented with two major ones: higher level standardization and development of product information model to support better global manufacturing.