Configurations of Learning in Global Work

Abstract Introduction Early detection of affected family relatives of patients with dilated cardiomyopathy (DCM) is essential in order to guide follow up, outcomes and initiate early treatment. Myocardial work analysis is a novel method which integrated strain imaging and blood pressure and has the potential to identify patients with subclinical disease. Purpose We analysed myocardial work in family relatives of DCM patients with positive genotype but negative phenotype in order to identify whether myocardial work can identify early changes. Methods Seventy-four family relatives of DCM patients attending for screening were examined. All individuals were asymptomatic with either positive (45/74, G+) or negative (29/74, G-) genotype and no echocardiographic evidence of left ventricular dilatation or systolic impairment. Non-invasive myocardial work analysis using two-dimensional (2D) speckle tracking echocardiography was analysed. Global longitudinal strain (GLS) was measured by the same vendor specific software used for myocardial work analysis. Left ventricular (LV) ejection fraction (EF) was measured with the Simpson's biplane method. The peak systolic arm cuff blood pressure (BP) measurement at the time of echocardiography was used for the myocardial work study. Results In total we included 74 individuals (37±15 years old, 50.7% women) with mean systolic and diastolic BP of 121.3±14 and 73.2±10 mmHg respectively, mean EF was 58±5% and mean GLS at 18.4±2.5%. G+ individuals had pathogenic and very likely pathogenic mutations in 8 different genes (TTN, BAG3, DSP, FLNC, LMNA, DMD, RBM20, TPM1). There was no difference in age, systemic hypertension, diabetes or medical treatment between the 2 groups. No significant difference was found among G+ and G- individuals in mean systolic and diastolic BP (121.2±14.7 vs 121.2±15.2 mmHg), mean EF (57.3±5 vs 59.1±4%), GLS (−18.2±1.5 vs −18.6±2.9%), mean global work index (1818±403 vs 1928±295 mmHg%) and global constructive work (2192±464 vs 2260±318 mmHg%). However, we found significant reduction of the global work efficiency (GWE) with a GWE of 94.4±2.7% in the G+ versus 95.9±1.6% in the G- individuals (p 0.02). Moreover, the global wasted work (GWW) was increased in the G+ with a GWW of 111±58 mmHg% versus 82±41 mmHg% in the G- individuals (p 0.03). Conclusion DCM gene carriers show, early on, decreased myocardial work efficiency and increased wasted work compared to unaffected family members, which appears to be earlier than other parameters such as EF and GLS. Myocardial work analysis could potentially recognize individuals showing early cardiac involvement and guide closer follow up and early initiation of treatment. Funding Acknowledgement Type of funding source: None

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Myocardial work: a new way to predict fibrosis in patients with hypertrophic cardiomyopathy

European Heart Journal ◽

10.1093/ehjci/ehaa946.0089 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

A Valentim Goncalves ◽

S Aguiar Rosa ◽

L Moura Branco ◽

A Galrinho ◽

A Fiarresga ◽

...

Keyword(s):

Hypertrophic Cardiomyopathy ◽

Global Longitudinal Strain ◽

Left Ventricular Pressure ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Prognostic Information ◽

Ventricular Ejection Fraction ◽

Significant Fibrosis ◽

Constructive Work ◽

Global Work

Abstract Aims Late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) adds prognostic information in patients with hypertrophic cardiomyopathy (HCM). Whether Myocardial work (MW), a new parameter on transthoracic echocardiographic (TTE), can predict significant fibrosis in HCM patients is unknown. Methods Single-centre evaluation of consecutively recruited HCM patients in which TTE and CMR were performed. MW and related indices were calculated from global longitudinal strain (GLS) and from estimated left ventricular pressure curves. The extent of LGE was quantitatively assessed. LGE ≥15% was chosen to define significant fibrosis. Logistic regression analysis was used to find the variables associated with LGE ≥15% and cut-off values were determined. Results Among the thirty-two patients analysed mean age was 57±16 years, 18 (56%) were male patients and the mean left ventricular ejection fraction by TTE was 67±8%. Global constructive work (GCW), global work index and GLS were significant predictors of LGE ≥15%. A cut-off ≤1550 mmHg% of GCW was able to predict significant fibrosis with a sensitivity of 92% and a specificity of 79%, while the best cut-off for GLS (>−15%) had a sensitivity of 86% and a specificity of 72%. Conclusion GCW was the best parameter to predict significant left ventricular myocardial fibrosis in CMR, suggesting its utility in patients who may not be able to have a CMR study. Myocardial Work and LGE in CMR in HCM Funding Acknowledgement Type of funding source: None

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Myocardial work in Stage 1 and 2 hypertensive patients

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeab043 ◽

2021 ◽

Author(s):

Akshar Jaglan ◽

Sarah Roemer ◽

Ana Cristina Perez Moreno ◽

Bijoy K Khandheria

Keyword(s):

Ejection Fraction ◽

Longitudinal Strain ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Hypertensive Patients ◽

Non Invasive ◽

Significant Difference ◽

Lv Ejection Fraction ◽

Global Work ◽

Stage 1

Abstract Aims Myocardial work (MW) is a novel parameter that can be used in a clinical setting to assess left ventricular (LV) pressures and deformation. We sought to distinguish patterns of global MW index in hypertensive vs. non-hypertensive patients and to look at differences between categories of hypertension. Methods and results Sixty-five hypertensive patients (mean age 65 ± 13 years; 30 male) and 15 controls (mean age 38 ± 12 years; 7 male) underwent transthoracic echocardiography at rest. Hypertensive patients were subdivided into Stage 1 (n = 32) and Stage 2 (n = 33) hypertension based on 2017 American College of Cardiology guidelines. Exclusion criteria were suboptimal image quality for myocardial deformation analysis, reduced ejection fraction, valvular heart disease, intracardiac shunt, and arrhythmia. Global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency were estimated from LV pressure–strain loops utilizing proprietary software from speckle-tracking echocardiography. LV systolic and diastolic pressures were estimated using non-invasive brachial artery cuff pressure. Global longitudinal strain and LV ejection fraction were preserved between the groups with no statistically significant difference, whereas there was a statically significant difference between the control and two hypertension groups in GWI (P = 0.01), GCW (P < 0.001), and GWW (P < 0.001). Conclusion Non-invasive MW analysis allows better understanding of LV response under conditions of increased afterload. MW is an advanced assessment of LV systolic function in hypertension patients, giving a closer look at the relationship between LV pressure and contractility in settings of increased load dependency than LV ejection fraction and global longitudinal strain.

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To Make the Wounded Whole

10.5149/northcarolina/9781469661339.001.0001 ◽

2020 ◽

Author(s):

Dan Royles

Keyword(s):

African American ◽

Drug Users ◽

Medical Professionals ◽

Nation Of Islam ◽

Black America ◽

Black Feminists ◽

Aids Activism ◽

History Of ◽

Global Work ◽

Hiv Aids

In the decades since it was identified in 1981, HIV/AIDS has devastated African American communities. Members of those communities mobilized to fight the epidemic and its consequences from the beginning of the AIDS activist movement. They struggled not only to overcome the stigma and denial surrounding a “white gay disease” in Black America, but also to bring resources to struggling communities that were often dismissed as too “hard to reach.” To Make the Wounded Whole offers the first history of African American AIDS activism in all of its depth and breadth. Dan Royles introduces a diverse constellation of activists, including medical professionals, Black gay intellectuals, church pastors, Nation of Islam leaders, recovering drug users, and Black feminists who pursued a wide array of grassroots approaches to slow the epidemic's spread and address its impacts. Through interlinked stories from Philadelphia and Atlanta to South Africa and back again, Royles documents the diverse, creative, and global work of African American activists in the decades-long battle against HIV/AIDS.

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Abstract 14432: Myocardial Work in Stage I and II Hypertensive Patients

Circulation ◽

10.1161/circ.142.suppl_3.14432 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Akshar Jaglan ◽

Sarah Roemer ◽

Ana C Perez Moreno ◽

Bijoy K Khandheria

Keyword(s):

Systolic Function ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Deformation Analysis ◽

Hypertensive Patients ◽

Reduced Ejection Fraction ◽

Work Index ◽

Significant Difference ◽

Global Work ◽

Lv Systolic Function

Introduction: Myocardial work is a novel parameter that can be used in a clinic setting to assess left ventricular (LV) pressures and deformation. This study sought to distinguish patterns of global myocardial work index in hypertensive vs. non-hypertensive patients. Methods: Fifty (25 male, mean age 60±14 years) hypertensive patients and 15 (7 male, mean age 38±12 years) control patients underwent transthoracic echocardiography at rest. Hypertensive patients were divided into stage 1 (26 patients) and stage 2 (24 patients) based on the 2017 American College of Cardiology guidelines. We excluded patients with suboptimal image quality for myocardial deformation analysis, reduced ejection fraction (EF), valvular heart disease, and arrhythmia. Global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE) were estimated from LV pressure strain loops utilizing proprietary software from speckle-tracking echocardiography. LV systolic and diastolic pressures were estimated using a noninvasive brachial artery cuff. Results: Global longitudinal strain (GLS) and EF were preserved between the two groups with no statistically significant difference whereas there was a statistically significant difference in the GWI (p<0.01), GCW (p=0.03), GWW (p<0.01), and GWE (p=0.03) (Figure and Table). Conclusions: Myocardial work gives us a closer look at the relationship between LV pressure and contractility in settings of increased load dependency whereas LVEF and GLS cannot. We show how myocardial work is an advanced assessment of LV systolic function in hypertensive patients.

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Global Work Culture and Global Identity, as a Platform for a Shared Understanding in Multicultural Teams

Research on Managing Groups and Teams - National Culture and Groups ◽

10.1016/s1534-0856(06)09013-x ◽

2006 ◽

pp. 325-352 ◽

Cited By ~ 24

Author(s):

Efrat Shokef ◽

Miriam Erez

Keyword(s):

Shared Understanding ◽

Work Culture ◽

Multicultural Teams ◽

Global Identity ◽

Global Work

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Actors, Structure, and Processes: A Review and Conceptualization of Global Work Integrating IB and HRM Research

Journal of Management ◽

10.1177/0149206318808885 ◽

2018 ◽

Vol 45 (2) ◽

pp. 359-383 ◽

Cited By ~ 7

Author(s):

B. Sebastian Reiche ◽

Yih-teen Lee ◽

David G. Allen

Keyword(s):

Human Resource ◽

International Business ◽

Scientific Community ◽

Multinational Enterprise ◽

Future Research ◽

Special Issue ◽

Global Work ◽

Work Done ◽

Advance Knowledge ◽

Cross Fertilization

As organizations increasingly fulfill their customer needs by getting their work done globally, there is a pressing need for the scientific community to further advance knowledge on global work, especially in terms of how to better conceptualize and integrate it. A particular opportunity for such development involves the cross-fertilization between the international business (IB) and human resource management (HRM) literatures, which serve as the focal domains to study global work phenomena but have treated global work largely as separate research streams. We therefore edited a special issue to contribute to a more integrative understanding of various aspects of global work across both domains. In this opening article, we review existing research on global work in the multinational enterprise from both IB and HRM perspectives. Subsequently, we present a shared conceptualization of global work that helps integrate theoretical and empirical research in both fields. We then introduce the articles in this special issue, before developing an integrative agenda for future research on global work.

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Can myocardial work indices contribute to the exploration of patients with cardiac amyloidosis?

Open Heart ◽

10.1136/openhrt-2020-001346 ◽

2020 ◽

Vol 7 (2) ◽

pp. e001346

Author(s):

Aénora Roger-Rollé ◽

Eve Cariou ◽

Khailène Rguez ◽

Pauline Fournier ◽

Yoan Lavie-Badie ◽

...

Keyword(s):

Cardiac Amyloidosis ◽

Characteristic Curve ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Peak Oxygen Consumption ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

Echocardiographic Parameters ◽

Global Work ◽

Better Than

BackgroundCardiac amyloidosis (CA) is a life-threatening restrictive cardiomyopathy. Identifying patients with a poor prognosis is essential to ensure appropriate care. The aim of this study was to compare myocardial work (MW) indices with standard echocardiographic parameters in predicting mortality among patients with CA.MethodsClinical, biological and transthoracic echocardiographic parameters were retrospectively compared among 118 patients with CA. Global work index (GWI) was calculated as the area of left ventricular pressure–strain loop. Global work efficiency (GWE) was defined as percentage ratio of constructive work to sum of constructive and wasted works. Sixty-one (52%) patients performed a cardiopulmonary exercise.ResultsGWI, GWE, global longitudinal strain (GLS), left ventricular ejection fraction (LVEF) and myocardial contraction fraction (MCF) were correlated with N-terminal prohormone brain natriuretic peptide (R=−0.518, R=−0.383, R=−0.553, R=−0.382 and R=−0.336, respectively; p<0.001). GWI and GLS were correlated with peak oxygen consumption (R=0.359 and R=0.313, respectively; p<0.05). Twenty-eight (24%) patients died during a median follow-up of 11 (4–19) months. The best cut-off values to predict all-cause mortality for GWI, GWE, GLS, LVEF and MCF were 937 mm Hg/%, 89%, 10%, 52% and 15%, respectively. The area under the receiver operator characteristic curve of GWE, GLS, GWI, LVEF and MCF were 0.689, 0.631, 0.626, 0.511 and 0.504, respectively.ConclusionIn CA population, MW indices are well correlated with known prognosis markers and are better than LVEF and MCF in predicting mortality. However, MW does not perform better than GLS.

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From Amate Paper Making to Global Work

Latin American Perspectives ◽

10.1177/0094582x13519426 ◽

2014 ◽

Vol 41 (3) ◽

pp. 118-136 ◽

Cited By ~ 1

Author(s):

María Eugenia D’Aubeterre Buznego ◽

María Leticia Rivermar Pérez

Keyword(s):

Paper Making ◽

Global Work

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