Association Between Preexisting Versus Newly Identified Atrial Fibrillation and Outcomes of Patients With Acute Pulmonary Embolism

Background Atrial fibrillation (AF) may exist before or occur early in the course of pulmonary embolism (PE). We determined the PE outcomes based on the presence and timing of AF. Methods and Results Using the data from a multicenter PE registry, we identified 3 groups: (1) those with preexisting AF, (2) patients with new AF within 2 days from acute PE (incident AF), and (3) patients without AF. We assessed the 90-day and 1-year risk of mortality and stroke in patients with AF, compared with those without AF (reference group). Among 16 497 patients with PE, 792 had preexisting AF. These patients had increased odds of 90-day all-cause (odds ratio [OR], 2.81; 95% CI, 2.33-3.38) and PE-related mortality (OR, 2.38; 95% CI, 1.37-4.14) and increased 1-year hazard for ischemic stroke (hazard ratio, 5.48; 95% CI, 3.10-9.69) compared with those without AF. After multivariable adjustment, preexisting AF was associated with significantly increased odds of all-cause mortality (OR, 1.91; 95% CI, 1.57-2.32) but not PE-related mortality (OR, 1.50; 95% CI, 0.85-2.66). Among 16 497 patients with PE, 445 developed new incident AF within 2 days of acute PE. Incident AF was associated with increased odds of 90-day all-cause (OR, 2.28; 95% CI, 1.75-2.97) and PE-related (OR, 3.64; 95% CI, 2.01-6.59) mortality but not stroke. Findings were similar in multivariable analyses. Conclusions In patients with acute symptomatic PE, both preexisting AF and incident AF predict adverse clinical outcomes. The type of adverse outcomes may differ depending on the timing of AF onset.info:eu-repo/semantics/publishedVersio

Estrategias del sector máquina-herramienta en España: aplicación de un enfoque de economía industrial

Tesis doctoral inédita. Universidad Autónoma de Madrid, Facultad de Ciencias Económicas y Empresariales, Departamento de Administración de Empresas, 198

El cluster del conocimiento en gestión empresarial en el País Vasco: aplicación de la metodología de M. Porter a su definición, análisis y potencial diagnóstico

Este artículo analiza el Cluster del Conocimiento en Gestión Empresarial en el País Vasco, para avanzar en el diseño de una metodología de estudio de su realidad económica e institucional, en la forma de evaluación de sus principales fortalezas y debilidades, y en la identificación del grado de avance experimentado con respecto al diagnóstico que para él inicialmente se realizó en 1996. Para ello se aplica de modo estricto la metodología porteriana de análisis cluster. Las principales conclusiones de todo ello son que para comprender la realidad económica e institucional del Cluster del Conocimiento en Gestión es preciso estudiar un Cluster más amplio: el Cluster de Educación y Creación de Conocimiento; que las fortalezas y debilidades de aquel se encuentran relacionadas con las del sistema de innovación con el que está interconectado, cuestión que se ilustra a través del estudio del sector universitario en la CAPV; y que la mejora de dicho cluster requiere trascender el análisis estricto de sus componentes e interrelaciones, ampliar el ámbito de análisis a los dos niveles anteriores y abordar de forma consistente nuevos niveles de diálogo e interacción

Towards a dynamic model of organisational flexibility

Organisational flexibility, as the ability to adapt quickly to new or changing environments, has received growing attention from both researchers and managers as a key driver for companies to survive and prosper in turbulent and unpredictable environments. Although many scholars have studied the complex nature and multidimensional structure of this construct, research on a comprehensive model, which explains the relationships between its key variables and consequent side effects of such iterations, remains a challenge. We explore these interactions and the dynamic adaptation processes applying system dynamics modelling to develop a more robust organisational flexibility theory. The objective of this paper is twofold, to provide dynamic propositions related to several strategies along different enterprise lifecycle stages and to complement the transition guidelines proposed by the organizational flexibility framework. The results suggest that decision concerning flexible capabilities management and organizational responsiveness can be improved if organizational flexibility is analysed and evaluated incorporating the time-varying dimension. The analysis help to test and expand current theory, envisage new theoretical propositions and provide new alternatives for empirical results about the complex construct of organizational flexibility