Detection of symptom-related coronary arteries in patients with coronary artery disease using real-time three-dimensional stress echocardiography with adenosine triphosphate

Aim 1) To develop normative values of global and regional left ventricular longitudinal deformation (LVLD) during real time three-dimensional stress echocardiography with adenosine triphosphate (ATP) and utilization of automated function imaging technology (4D Stress-Echo + LVLD with ATP); 2) to compare the effectiveness of detection of symptom-related coronary arteries during 4D Stress-Echo with ATP using: a) traditional visual assessment of regional myocardial contractility and b) step-by-step analysis of segmental LVLD.Material and Methods 15 healthy subjects and 32 patients with coronary artery disease (CAD) were examined after coronary angiography. All individuals underwent 4D Stress-Echo + LVLD with ATP (Vivid E95, General Electric).Results The normative values of global LVLD at three stages of the pharmacological stress-test (before, during and after ATP infusion) were –19.5 (95% CI: -20.4 – -19.0), –21.6 (95% CI: -22.8 – -20.4) and –19.5 (95% CI: -20.3 – -18.6), respectively; the values of LVLD in each of the 17 segments of left ventricular myocardium in healthy subjects were also determined. In patients with CAD visual control of contractility during stress test revealed dynamic decrease in local thickening of the myocardium, appearance of new zones of contractility disorders and expansion of previously noted in 31.2% of cases, while analysis of deformation detected the appearance of new zones of deformation disturbances and expansion of previously found – in 68.7% (р = 0.0055). Stress-induced worsening of myocardial deformation during ATP infusion in the zones of blood supply of left anterior descending coronary artery, circumflex artery and right coronary artery (with presence of hemodynamically significant stenoses and occlusions detected during coronary angiography) were found in 28.0, 77.7 and 65.2% respectively (р1-3 = 0.0194; р1-2 = 0.0019; р2-3 = 0.2864).Conclusion The normal values of global and segmental LVLD for each stage of 4D Stress-Echo + LVLD with ATP were determined. 4D Stress-Echo + LVLD with ATP can significantly increase the effectiveness of symptom-related coronary arteries identification in patients with CAD in comparison with traditional Stress-Echo with visual assessment of local myocardial contractility

High-Performance Work Systems and Organizational Performance in Emerging Economies: Evidence from MNEs in Turkey

This study examines the association between the usage of high-performance work systems (HPWS) by subsidiaries of multinational enterprises (MNEs) in Turkey and employee and subsidiary level outcomes. The study is based on a survey of 148 MNE subsidiaries operating in Turkey. The results show that the usage of HPWS has a significant positive impact on employee effectiveness. However, their impact on employee skills and development, and organizational financial performance are far less clear. Our findings highlight the extent to which HWPS need to be adapted to take account of context-specific institutional realities. © 2014 Springer-Verlag Berlin Heidelberg

ПЕРСПЕКТИВЫ ПРИМЕНЕНИЯ РАЗЛИЧНЫХ ПОЖАРОБЕЗОПАСНЫХ ГАЗОВЫХ СРЕД НА ГЕРМЕТИЗИРУЕМЫХ ОБИТАЕМЫХ ОБЪЕКТАХ ВОЕННО-МОРСКОГО ФЛОТА

Introduction. The need to ensure trouble-free operation of inhabited sealed objects of the Navy requires continuous improvement of technologies to increase their fire safety. Such technologies include the creation of hypoxic gas media at facilities that reduce the risk of fires and ensure the possibility of personnel staying in them. The purpose of the work is a comparative assessment of changes in the maximum human working capacity during continuous stay in various normobaric hypoxic environments, promising to increase the fire safety of sealed inhabited objects of the Navy. Materials and methods. In the 1st series of studies, 100 daily sealing of 6 male volunteers (28–53 years old) in controlled hypoxic environments was carried out: [O2] in the premises of permanent residence — 18–19%, periodic (4 hours per day) stay — 16–17%/ In the 2nd series of studies, 6 male volunteers (age 25–51 years) were continuously in argon-containing gas media with [O2]=13,5–14,5%, [Ar]=30–35% for 60 days. During the studies, the dynamics of the mental (operator) and maximum physical working capacity of the subjects were evaluated. Results. Stay in hypoxic environments was accompanied by a decrease in the working capacity of volunteers. The relative degree of negative changes in mental performance in group 1 did not exceed –7%, in group 2 — –10% of the initial level; the maximum decrease in physical performance in group 1 was on average about — –11%, in group 2 — –17% compared with the initial state, which does not go beyond the permissible limits. Conclusion. The introduction of tested gaseous media at naval facilities is promising. The choice of the composition of the gas mixture should be determined by the degree of risk of fires at a particular facility, the technical capabilities of creating and maintaining a hypoxic environment of optimal composition, the number and state of health of the crew.Введение. Необходимость обеспечения безаварийной эксплуатации герметизируемых обитаемых объектов Военно-Морского Флота предписывает постоянное совершенствование технологий повышения их пожаробезопасности. К таким технологиям относится создание на объектах гипоксических газовых сред, позволяющих снизить риск пожаров и обеспечить возможность пребывания в них персонала. Цель работы: сравнительная оценка изменений максимальной работоспособности человека при непрерывном пребывании в различных нормобарических гипоксических средах, перспективных для повышения пожаробезопасности герметизируемых обитаемых объектов ВМФ. Материалы и методы. В 1-й серии исследований проведена 100 суточная герметизация 6 добровольцев-мужчин (28–53 лет) в регулируемых гипоксических средах: [O2] в помещениях постоянного пребывания — 18–19%, периодического (4 часа в сутки) пребывания — 16–17%. Во 2-й серии исследований 6 добровольцев-мужчин (возраст 25–51 год) в течение 60 суток непрерывно находились в аргоносодержащих газовых средах с [O2]=13,5–14,5%, [Ar]=30–35%. В ходе исследований оценивали динамику умственной (операторской) и максимальной физической работоспособности испытуемых. Результаты исследований показали, что пребывание в гипоксических средах сопровождалось снижением работоспособности добровольцев. Относительная степень негативных сдвигов умственной работоспособности в 1-й группе не превышала 7%, во 2-й группе — 10% от исходного уровня; максимальное снижение физической работоспособности в 1-й группе составляло в среднем около –11%, во 2-й группе — –17% в сравнении с исходным состоянием, что не выходит за рамки допустимых пределов. Заключение. Внедрение испытанных газовых сред на объектах ВМФ является перспективным. Выбор состава газовой смеси должен определяться степенью риска возникновения пожаров на конкретном объекте, техническими возможностями создания и поддержания гипоксической среды оптимального состава, численностью и состоянием здоровья экипажа.</p

Determinants of the adoption of HRM practices in tourism SMEs in Spain: an exploratory study

Human resource management, Small and medium-sized enterprises, HRM practices, Spain, Catalonia, Tourism,