Short Message Discussions: On The Conversational Nature Of Microblogging In A Large Consultancy Organisation

With the rise of Twitter Microblogging as a phenomenon has gained widespread popularity. As with other social software (e.g. Wikis), organisations have begun experimenting with the application of Microblogging for facilitating internal communication and group processes. However, research on the topic is still in its infancy. In this paper we explore how Yammer, a Twitter-like platform, has been adopted within Capgemini, a large, globally operating consultancy business. In contrast to existing findings on Twitter usage and other Enterprise Microblogging (EMB) cases, we find that EMB in our case is a predominantly conversational medium, where people interact with each other explicitly. Rather than using the platform to inform others about themselves (Twitter) or, about their immediate task/team context as has been described in other EMB cases, the Yammer users in this case are expressing views, discussing opinion and responding to each other. We discuss these results in light of the particular organisational context of the case and the emergent nature of communication technologies. We further demonstrate how the interactive and conversational nature of short message communications has led us to investigate the classification of Microblogging according to the context of its use. We conclude that the appropriation of Enterprise Microblogging is shaped largely by the characteristics of the organisational context in which it is used and propose a model that supports this

Tweet Talking - Exploring The Nature Of Microblogging at Capgemini Yammer

Microblogging has gained widespread popularity with the emergence of Twitter. While Twitter has shaped public perceptions of Microblogging, organisations have begun experimenting with Microblogging ‘behind the firewall’, for facilitating communication and group processes. However, research is still in its infancy. In this paper we explore how Yammer has been adopted within Capgemini, a large, globally operating consultancy business. In contrast to existing findings on Twitter usage, we find that Enterprise Microblogging (EMB) in our case is a predominantly conversational medium, where people interact and discuss, rather than only inform others about themselves (Twitter) or about their immediate task/team context, as has also been described in other EMB cases. We discuss our results in light of the particular organisational context of Capgemini and the general open nature of communication technologies. We conclude that appropriation of Enterprise Microblogging happens largely in accordance with the organisational context in which it is set. Microblogging is a diverse phenomenon, which is not sufficiently defined via the underlying technology characteristics

Induced fibrillation is equally effective as crystalloid cardioplegia in the protection of fetal myocardial function

AbstractBackgroundFetal cardiac intervention represents a potential advance in the treatment of congenital cardiac lesions that increase in complexity during development. Prenatal repair of a primary defect might prevent pathologic blood-flow patterns that can result in hypoplasia of a cardiac chamber or great vessel. However, strategies to optimize fetal myocardial protection have not been studied. A biventricular working fetal heart preparation was used to evaluate the cardioprotective properties of induced fibrillation and crystalloid cardioplegia.MethodsHearts from 16 fetal lambs at 115 to 125 days’ gestation were harvested and perfused with Krebs-Henseleit solution. The descending aorta was ligated distal to the ductal insertion and the branch pulmonary arteries were ligated to simulate the parallel circulation of the fetus. Hearts were arrested with normothermic fibrillation (n = 8) or hypothermic crystalloid cardioplegia (n = 8) before reperfusion with Krebs-Henseleit solution. Baseline and postarrest myocardial function measurements were obtained from analysis of pressure-dimension relationships.ResultsFibrillatory and cardioplegic arrest were equally effective at preserving postarrest systolic function (left ventricle, 70% ± 5% vs 68% ± 15%, P = .52; right ventricle, 68% ± 4.5% vs 65% ± 4.5%, P = .26) and preventing increased diastolic stiffness (left ventricle, 32% ± 5.3% vs 38% ± 11%, P = .24; right ventricle, 25% ± 3.3% vs 27% ± 2.1%, P = .46). Myocardial water content was unchanged in hearts arrested with fibrillation and cardioplegia (84% ± 1.5% vs 83.7% ± 0.9%, P = .71).ConclusionsNormothermic fibrillation and hypothermic crystalloid cardioplegia provide equal protection of the fetal myocardium. In the setting of diminished fetal myocardial reserve and because of the limited ability to manipulate the surrounding temperature in the fetus, normothermic fibrillation may be preferable for in utero repairs of selected congenital heart defects

Impact of the COVID-19 pandemic on implementation of novel guideline-directed medical therapies for heart failure in Germany: a nationwide retrospective analysis

Background Guideline-directed medical therapy (GDMT) is the cornerstone in the treatment of patients with heart failure and reduced ejection fraction (HFrEF) and novel substances such as sacubitril/valsartan (S/V) and sodium-glucose co-transporter-2 inhibitors (SGLT2i) have demonstrated marked clinical benefits. We investigated their implementation into real-world HF care in Germany before, during, and after the COVID-19 pandemic period. Methods The IQVIA LRx data set is based on ∼80% of 73 million people covered by the German statutory health insurance. Prescriptions of S/V were used as a proxy for HFrEF. Time trends were analysed between Q1/2016 and Q2/2023 for prescriptions for S/V alone and in combination therapy with SGLT2i. Findings The number of patients treated with S/V increased from 5260 in Q1/2016 to 351,262 in Q2/2023. The share of patients with combination therapy grew from 0.6% (29 of 5260) to 14.2% (31,128 of 219,762) in Q2/2021, and then showed a steep surge up to 54.8% (192,429 of 351,262) in Q2/2023, coinciding with the release of the European Society of Cardiology (ESC) guidelines for HF in Q3/2021. Women and patients aged >80 years were treated less often with combined therapy than men and younger patients. With the start of the COVID-19 pandemic, the number of patients with new S/V prescriptions dropped by 17.5% within one quarter, i.e., from 26,855 in Q1/2020 to 22,145 in Q2/2020, and returned to pre-pandemic levels only in Q1/2021. Interpretation The COVID-19 pandemic was associated with a 12-month deceleration of S/V uptake in Germany. Following the release of the ESC HF guidelines, the combined prescription of S/V and SGLT2i was readily adopted. Further efforts are needed to fully implement GDMT and strengthen the resilience of healthcare systems during public health crises

A high abdominal aortic calcification score by dual X-ray absorptiometry is associated with cardiovascular events after kidney transplantation

Background: Aortic calcification is associated with an increased risk for cardiovascular events in renal transplant recipients. This study focused on the association of abdominal aortic calcification (AAC) and cardiovascular events assessed using a dual-energy X-ray absorptiometry (DXA) scoring methodology for AAC. Methods: From 2008 to 2014, renal transplant recipients referred for a DXA procedure within 6 months after transplantation were included in a retrospective, single-centre study. The primary endpoint was the occurrence of cardiovascular events, defined as myocardial infarction, cerebrovascular accident or transient ischaemic attack, after transplantation. AAC was quantified using an 8-point scoring system and patients were divided into three groups; a control group (AAC = 0), a low AAC group (AAC = 1-3) and a high AAC group (AAC = 4-8). Results: We evaluated 701 patients, 267 (38.1%) had detectable calcifications (low AAC 190 patients, high AAC 77 patients) and 434 (61.9%) had no calcifications. Cardiovascular events were seen in 37 (8.5%) patients in the control group, in 18 (9.5%) in the low AAC group and in 20 (26.0%) in the high AAC group. Univariate Cox proportional hazards analysis of the high AAC score showed a hazard ratio (HR) of 4.23 [95% confidence interval (CI) 2.44-7.33; P < 0.01] for cardiovascular events, while results were not significant for the low AAC score. Multivariate analysis showed an independent significant association between a high AAC score and cardiovascular events [HR 2.78 (95% CI 1.05-7.64); P = 0.04]. Assessment of the continuous net reclassification index (NRI), comparing the combined clinical variables with a model of both AAC scoring and clinical variables, showed an NRI of 0.76 (95% CI 0.65-0.86; P < 0.01). Conclusions: An independent association between a high AAC score, assessed by DXA, and cardiovascular events was identified and provides an opportunity for early cardiovascular risk stratification in renal transplant recipients

Catechol-O-methyltransferase (COMT) Genotype Affects Age-Related Changes in Plasticity in Working Memory: A Pilot Study

Objectives. Recent work suggests that a genetic variation associated with increased dopamine metabolism in the prefrontal cortex (catechol-O-methyltransferase Val158Met; COMT) amplifies age-related changes in working memory performance. Research on younger adults indicates that the influence of dopamine-related genetic polymorphisms on working memory performance increases when testing the cognitive limits through training. To date, this has not been studied in older adults.Method. Here we investigate the effect of COMT genotype on plasticity in working memory in a sample of 14 younger (aged 24-30 years) and 25 older (aged 60-75 years) healthy adults. Participants underwent adaptive training in the -back working memory task over 12 sessions under increasing difficulty conditions. Results. Both younger and older adults exhibited sizeable behavioral plasticity through training ( &lt; .001), which was larger in younger as compared to older adults ( &lt; .001). Age-related differences were qualified by an interaction with COMT genotype ( &lt; .001), and this interaction was due to decreased behavioral plasticity in older adults carrying the Val/Val genotype, while there was no effect of genotype in younger adults.Discussion. Our findings indicate that age-related changes in plasticity in working memory are critically affected by genetic variation in prefrontal dopamine metabolism

Bone Mineral Density and Aortic Calcification: Evidence for a Bone-Vascular Axis After Kidney Transplantation

BACKGROUND: Chronic kidney disease mineral and bone disorders (CKD-MBD) and vascular calcification are often seen in kidney transplantation recipients (KTR). This study focused on the bone-vascular axis hypothesis, the pathophysiological mechanisms driving both bone loss and vascular calcification, supported by an association between lower bone mineral density (BMD) and higher risk of vascular calcification. METHODS: KTR referred for a dual-energy X-ray absorptiometry procedure within 6 mo after transplantation were included in a cross-sectional study (2004-2014). Areal BMD was measured at the proximal femur, and abdominal aortic calcification (AAC) was quantified (8-points score) from lateral single-energy images of the lumbar spine. Patients were divided into 3 AAC categories (negative-AAC: AAC 0; low-AAC: AAC 1-3; and high-AAC: AAC 4-8). Multivariable-adjusted multinomial logistic regression models were performed to study the association between BMD and AAC. RESULTS: We included 678 KTR (51 ± 13 y old, 58% males), 366 (54%) had BMD disorders, and 266 (39%) had detectable calcification. High-AAC was observed in 9%, 11%, and 25% of KTR with normal BMD, osteopenia, and osteoporosis, respectively (P &lt; 0.001). Higher BMD (T-score, continuous) was associated with a lower risk of high-AAC (odds ratio 0.61, 95% confidence interval 0.42-0.88; P = 0.008), independent of age, sex, body mass index, estimated glomerular filtration rate, and immunosuppressive therapy. KTR with normal BMD were less likely to have high-AAC (odds ratio 0.24, 95% confidence interval 0.08-0.72; P = 0.01). CONCLUSIONS: BMD disorders are highly prevalent in KTR. The independent inverse association between BMD and AAC may provide evidence to point toward the existence, while highlighting the clinical and epidemiological relevance, of a bone-vascular axis after kidney transplantation.</p

Predictors of early scaffold thrombosis: results from the multicenter prospective German-Austrian ABSORB RegIstRy

Background: In randomized clinical trials, the risk of thrombotic events with the absorb bioresorbable vascular scaffold (BVS) was significantly higher than with metallic drug-eluting stents. We evaluated predictors of scaffold thrombosis in the large-scale, multicenter German-Austrian ABSORB RegIstRy.Methods and Results: 3178 patients with treatment of 4252 lesions using 5020 scaffolds were included. Follow-up rate at 6 months was 97.4%. Forty-five (1.42%) patients experienced definite/probable scaffold thrombosis during follow-up. Multiple regression analysis showed implantation of absorb BVS in bifurcation lesions [odds ratio (OR): 4.43;95% confidence interval (CI): 1.69-11.59;P=0.0024] or treatment in the years 2013/2014 (OR: 1.88;95% CI: 1.02-3.47;P=0.04) to be significant predictors of scaffold thrombosis. Excluding bifurcation lesions, the incidence of definite/probable scaffold thrombosis decreased from 1.8% (95% CI: 1.17-2.64%) in 2013/2014 to 0.89% (95% CI: 0.5-1.46%) in 2015/2016. In the latter period, absorb BVS were implanted more often in younger patients with less complex de novo lesions, and debulking devices and postdilatation were used more frequently. Between the two treatment periods, there was a significant reduction in myocardial infarction (2.73-1.24%, P<0.01;OR: 0.45;95% CI: 0.26-0.77), definite/probable scaffold thrombosis (1.79-0.88%, P<0.05;OR: 0.49;95% CI: 0.26-0.93), and target lesion failure and revascularization during follow-up.Conclusion: Improved procedural technique and more strict patient selection may explain a significant decrease in the absorb BVS thrombosis rates during the recruitment period of the large-scale German-Austrian ABSORB RegIstRy. In addition, treatment of bifurcation lesions was identified as an independent predictor of definite/probable scaffold thrombosis

Plasma cadmium is associated with increased risk of long-term kidney graft failure

The kidney is one of the most sensitive organs to cadmium-induced toxicity, particularly in conditions of long-term oxidative stress. We hypothesized that, in kidney transplant recipients, nephrotoxic exposure to cadmium represents an overlooked hazard for optimal graft function. To test this, we performed a prospective cohort study and included 672 outpatient kidney transplant recipients with a functioning graft of beyond one year. The median plasma cadmium was 58 ng/L. During a median 4.9 years of follow-up, 78 kidney transplant recipients developed graft failure with a significantly different distribution across tertiles of plasma cadmium (13, 26, and 39 events, respectively). Plasma cadmium was associated with an increased risk of graft failure (hazard ratio 1.96, 95% confidence interval 1.56-2.47 per log(2) ng/L). Similarly, a dose-response relationship was observed over increasing tertiles of plasma cadmium, after adjustments for potential confounders (donor, recipient, transplant and lifestyle characteristics), robust in both competing risk and sensitivity analyses. These findings were also consistent for kidney function decline (graft failure or doubling of serum creatinine). Thus, plasma cadmium is independently associated with an increased risk of long-term kidney graft failure and decline in kidney function. Further studies are needed to investigate whether exposure to cadmium represents an otherwise overlooked modifiable risk factor for adverse long-term graft outcomes in different populations