Modelling the Value Adding Attributes of Real Estate to the Wealth Maximization of the Firm

Firms develop strategies to help them achieve their primary goal of maximizing the wealth of the shareholders. These strategies should define the supporting role corporate real estate management plays; however current theory and practice do not adequately identify the direct and indirect methods by which corporate real estate management (CREM) adds value to the firm. We develop a model of how real estate adds value to the firm to help fill this void. This model can be then used to develop more precise and complete metrics to measure the value real estate adds to the firm.

Elinkeinopoliittinen tilannekuva, kevät 2019 TEM:n hallinnonalan näkemyksiä

Elinkeinopoliittinen tilannekuva perustuu työ- ja elinkeinoministeriön toteuttamaan kyselyyn, joka on kohdistettu kahdeksalle ministeriön ohjaamalle organisaatiolle (Business Finland, Energiavirasto, Finnvera, Geologian tutkimuskeskus, Kilpailu- ja kuluttajavirasto, Patentti- ja rekisterihallitus, Suomen Teollisuussijoitus Oy ja Teknologian tutkimuskeskus VTT Oy). Kysely toteutetaan kaksi kertaa vuodessa. Kyselyllä kartoitetaan ministeriön ohjaamien organisaatioiden näkemyksiä toimintaympäristön dynamiikasta ja sen muutoksista viime puolen vuoden aikana sekä lähitulevaisuudessa. Raportti auttaa tarkentamaan kokonaiskuvaa talouden suunnasta sekä tukee ministeriön politiikkavalmistelua ja omistajaohjausta. Talouden kasvuvauhti on vuonna 2019 yhä kohtuullinen, n. 1,5 %. Ennustelaitosten arvioita tälle vuodelle on kuitenkin korjattu viime syksyltä keskimäärin puoli prosenttiyksikköä alaspäin. Kotimaassa investointihaluttomuus sekä osaajapula (työntekijöiden määrä) ja osaamispula (työntekijöiden taidot) ovat keskeisiä kasvun hidasteita. Maailmantalous kasvaa ainakin parin seuraavan vuoden aikana yli kolmen prosentin vuosivauhtia. Monista poliittisista ja taloudellisista riskeistä johtuen mahdollisuus niin talouden kuin ulkomaankaupan odotettua heikommalle kehitykselle on kuitenkin melko suuri. Tilannekuvassa nousevia muita teemoja ovat mm. ilmastonmuutoksen laajeneva huomioon ottaminen poliittisessa keskustelussa ja taloudessa, t&k-toiminnan voimavarojen kehitykseen liittyvät epävarmuudet, geoalan kasvunäkymät esimerkiksi akkuteollisuuden kasvuun liittyen sekä kotimaisten markkinoiden toimivuuden parantaminen ja kilpailullisuuden lisääminen. Aikaisen kasvuvaiheen pääomasijoitusmarkkinoista on laadittu erillinen katsaus. Yritysrahoituksen saatavuus on Suomessa yleisesti ottaen varsin hyvällä tasolla. Vaihtoehtojen lisääntymisestä huolimatta pk-sektorin rahoitus on vielä pitkälti pankkien varassa. Erityisesti nopeasti kasvavat ja kansainvälistyvät pk-yritykset voivat vaihtelevista syistä jäädä ilman kaipaamaansa pankkirahoitusta. Tällöin pääomasijoitus tai muu vaihtoehtoinen rahoitusmuoto saattaa olla sopivampi ratkaisu. Suomen pääomasijoitusmarkkina on kehittynyt viime vuosina varsin suotuisasti. Oman pääoman ehtoisten startup-sijoitusten määrä on lähes nelinkertaistunut vuosina 2010–2018. Yritysten kannalta positiivista on ollut useiden kokonaan uusien rahastojen ja pääomasijoittajatiimien synty. Vuonna 2018 pääomasijoittajien sijoitusaktiivisuus oli huipputasolla. Kai Husso puh. 029 506 3683, Olli Koski puh. 029 504 7174 / TEM, Innovaatiot ja yritysrahoitus

Gastrointestinal Symptoms and Dopamine Transporter Asymmetry in Early Parkinson's Disease

Background The neurophysiological correlates of gastrointestinal symptoms (GISs) in Parkinson's disease (PD) are not well understood. It has been proposed that in patients with a gastrointestinal origin of PD dopaminergic neurodegeneration would be more symmetric. Objectives The aim is to assess the associations between GISs and asymmetry of nigrostriatal dopaminergic neurodegeneration in PD. Methods Ninety PD patients were assessed using motor and GIS scales and I-123-FP-CIT SPECT. We calculated the asymmetry index and the predominant side of motor symptoms and dopamine transporter (DAT) imaging defect and assessed their association with GISs. Results There were no significant differences in GISs between symmetric and asymmetric dopaminergic defect. Left predominant defect was related to more GIS and higher constipation scores. Conclusions GISs were associated with left predominant reduction in putaminal DAT binding but not asymmetry per se. It remains open whether left-sided DAT deficit is related to more pronounced GI involvement or symptom perception in PD. (c) 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson Movement Disorder Society.Peer reviewe

Sex correction improves the accuracy of clinical dopamine transporter imaging

Background In clinical diagnostic imaging, dopamine transporter (DAT) SPECT scans are commonly evaluated using automated semiquantitative analysis software. Age correction is routinely implemented, but usually no sex correction of DAT binding is performed. Since there are sex differences in presynaptic dopaminergic function, we investigated the effect of DAT sex correction in a sample of healthy volunteers who underwent brain [I-123]-FP-CIT SPECT. Methods Forty healthy elderly individuals (21 men and 19 women) underwent brain [I-123]-FP-CIT SPECT, and each subject was examined clinically for motor and non-motor parkinsonian symptoms and signs. Regional specific DAT binding ratios (SBR = [ROI-occ]/occ) were calculated using age correction, and the results were compared to those in normal databases with and without sex correction. The level of regional abnormality was set at 2 standard deviations below the mean values of the reference databases. Results In the analysis without sex correction, compared to the mean ratio of the reference database, ten healthy individuals (8 men and 2 women) had abnormally low DAT binding ratios, and four individuals (3 men and 1 woman) had borderline low DAT binding ratios in at least one striatal region. When sex correction was implemented, the ratio of one individual was abnormal, and the ratio of one individual was borderline (both males). There were no clinically significant differences in motor or non-motor symptoms between healthy volunteers with abnormal and normal binding. Conclusions A considerable number of elderly healthy male subjects can be interpreted to be dopaminergically abnormal if no sex correction of DAT binding is performed. Sex differences in striatal dopaminergic function should be taken into account when DAT imaging is used to assist clinical diagnostics in patients with suspected neurological disorders.</p

Diagnostic accuracy of glabellar tap sign for Parkinson's disease

Glabellar tap or reflex (GR) is an old bedside clinical test used in the diagnostics of Parkinson's disease (PD), but its diagnostic value is unclear. This study examines the diagnostic validity and reliability of GR in PD in relation to brain dopaminergic activity. GR was performed on 161 patients with PD, 47 patients with essential tremor (ET) and 40 healthy controls immediately prior to dopamine transporter (DAT) [I-123]FP-CIT SPECT scanning. The binding ratios were investigated with consideration of the GR result (normal/abnormal). In addition, the consistency of the GR was investigated with 89 patients after a mean follow-up of 2.2 years. PD and ET patients had higher GR scores than healthy controls (p 0.36). Over follow-up, the GR changed from abnormal to normal in 20% of PD patients despite the presence of clinically typical disease. The sensitivity and specificity of GR for differentiating PD from ET were 78.3% and 36.2%, respectively. Although GR has been used by clinicians in the diagnostics of PD, it does not separate PD from ET. It also shows considerable inconsistency over time, and abnormal GR has no relationship with dopamine loss. Its usefulness should be tested for other clinical diagnostic purposes.Peer reviewe

Diagnostic value of micrographia in Parkinson's disease : a study with [I-123]FP-CIT SPECT

Micrographia is a common symptom of Parkinson's disease (PD), and it may precede other motor symptoms. Despite the high prevalence of micrographia in PD, its neurobiological mechanisms are not known. Given that levodopa may alleviate consistent micrographia and that nondopaminergic essential tremor (ET) is not associated with micrographia, micrographia could possibly be used as an ancillary diagnostic method that reflects nigrostriatal dopamine function. We evaluated the usefulness of micrographia as a simple one-sentence writing test in differentiating PD from ET. A total of 146 PD patients, 42 ET patients and 38 healthy controls provided writing samples and were scanned with brain [I-123]FP-CIT dopamine transporter (DAT) SPECT imaging with ROI-based and voxelwise analyses. The diagnostic accuracy of micrographia was evaluated and compared to that of DAT binding. Compared to ET and healthy controls, PD patients showed micrographia (consistent, 25.6% smaller area of handwriting sample in PD compared to ET, p = 0.002, and 27.2% smaller area of handwriting compared to healthy controls, p = 0.004). PD patients showed 133% more severe progressive micrographia compared with ET patients (median b = - 0.14 in PD, b = - 0.06 in ET, p = 0.021). In early unmedicated cognitively normal patients, consistent micrographia showed 71.2% specificity and 87.5% sensitivity in PD versus ET differentiation, but micrographia had no correlation with striatal or extrastriatal [I-123]FP-CIT binding in patients with PD. The one-sentence micrographia test shows moderately good accuracy in PD versus ET differentiation. The severity of micrographia has no relationship with DAT binding, suggesting nondopaminergic mechanism of micrographia in PD. ClinicalTrials.gov identifier: NCT02650843 (NMDAT study).Peer reviewe

Changing epidemiology of methicillin-resistant Staphylococcus aureus in a low endemicity area- new challenges for MRSA control

The incidence of methicillin-resistant Staphylococcus aureus (MRSA) has increased sharply in Hospital District of Southwest Finland (HD). To understand reasons behind this, a retrospective, population-based study covering 10 years was conducted. All new 983 MRSA cases in HD from January 2007 to December 2016 were analysed. Several data sources were used to gather background information on the cases. MRSA cases were classified as healthcare-associated (HA-MRSA), community-associated (CA-MRSA), and livestock contact was determined (livestock-associated MRSA, LA-MRSA). Spa typing was performed to all available strains. The incidence of MRSA doubled from 12.4 to 24.9 cases/100000 persons/year. The proportion of clinical infections increased from 25 to 32% in the 5-year periods, respectively, (p </p

Adrenomedullin : a marker of impaired hemodynamics, organ dysfunction, and poor prognosis in cardiogenic shock

Background: The clinical CardShock risk score, including baseline lactate levels, was recently shown to facilitate risk stratification in patients with cardiogenic shock (CS). As based on baseline parameters, however, it may not reflect the change in mortality risk in response to initial therapies. Adrenomedullin is a prognostic biomarker in several cardiovascular diseases and was recently shown to associate with hemodynamic instability in patients with septic shock. The aim of our study was to evaluate the prognostic value and association with hemodynamic parameters of bioactive adrenomedullin (bio-ADM) in patients with CS. Methods: CardShock was a prospective, observational, European multinational cohort study of CS. In this sub-analysis, serial plasma bio-ADM and arterial blood lactate measurements were collected from 178 patients during the first 10 days after detection of CS. Results: Both bio-ADM and lactate were higher in 90-day non-survivors compared to survivors at all time points (P <0.05 for all). Lactate showed good prognostic value during the initial 24 h (AUC 0.78 at admission and 0.76 at 24 h). Subsequently, lactate returned normal ( 55.7 pg/mL) at 48 h compared to those with low bio-ADM levels (49.1 vs. 22.6%, P = 0.001). High levels of bio-ADM were associated with impaired cardiac index, mean arterial pressure, central venous pressure, and systolic pulmonary artery pressure during the study period. Furthermore, high levels of bio-ADM at 48 to 96 h were related to persistently impaired cardiac and end-organ function. Conclusions: Bio-ADM is a valuable prognosticator and marker of impaired hemodynamics in CS patients. High levels of bio-ADM may show shock refractoriness and developing end-organ dysfunction and thus help to guide therapeutic approach in patients with CS.Peer reviewe