bluuebunny/crossref_metadata_2025 huggingface dataset:
Creating a Quality Culture through Organizational Change: A Case Analysis
Authors: Handfield Robert , Ghosh Soumen
Published: November 2018

Previous works on the implementation of strategic objectives have neglected to consider the critical role of quality management. Beginning with the assumption that the role of quality is instrumental to the successful implementation of any form of generic strategy, a conceptual model of quality management is developed through a set of case studies with 13 North American and European Fortune 500 companies. The results suggest that firms that have experienced greater global competition in earlier years have implemented Total Quality Management (TQM) initiatives earlier, and their programs are subsequently more advanced. Firms with advanced TQM implementation have made significant infrastructural changes within their organizations, and have also embraced the principles of continuous improvement as a critical component of their corporate culture. Moreover, quality has developed into a cultural artifact with an associated language and history that provides an integrating mechanism linking a firm's value-adding activities.
International Advertising Standardization: What do the Multinationals Actually Standardize?
Authors: Harris Greg
Published: November 2018

This article reports on a study of the international advertising practices of a sample of major United States and European multinationals in the EC. The objective of the study was to investigate the detailed forms of international advertising standardization actually practiced by the sampled companies and establish how widely spread they were across the standardization spectrum in terms of the extent of standardization practiced. Many permutations were found in terms of which executional elements were standardized, the extent to which these elements were standardized and how these practices varied by market. These findings indicate that standardization is a flexible and adaptive policy that can take many forms and that to use the term “modified” to describe the practices of all those companies who neither totally adapt, nor totally standardize, is of limited descriptive value. In other words, these companies should not be categorized as a homogenous group. These findings are important because the rationales behind the practices of these companies are likely to vary as much as the practices themselves. The implications of these findings regarding analysis relating to the benefits of advertising standardization are then discussed.
Executive Insights: Guiding Companies to Successful Exporting in an Interactive Group Format—Lessons from a Collaborative Project
Authors: Miller Myron M. , Zischke David
Published: November 2018

Guiding small and mid-sized companies to internationalization can be problematic due to a number of unique characteristics of these firms. The authors describe a unique and successful process for ensuring continued success in foreign markets through a program they have developed in partnership with a local utility company. The Export Success Program provides the client companies with a structured approach in an interactive group format, thus allowing much more opportunity to create the culture shift necessary to successfully enter foreign markets.
Country-of-Origin Effects on Sellers’ Price Premiums in Competitive Philippine Markets
Authors: Hulland John , Todiño Honorio S. , Lecraw Donald J.
Published: November 2018

Data collected from highly competitive markets in the Philippines were used to investigate how country-of-origin (CO) information influenced the prices set for a wide range of products. The data permitted direct comparisons between prices for the same product produced by the same company, but in different countries, and sold in adjacent markets. Imported products produced in more industrialized countries were found to command price premiums over the same product, produced by the same company in less industrialized countries. However, imports from all countries commanded significant price premiums over domestically produced products. Consistent with previous research, branding was found to moderate the effect of CO information on price. Finally, CO information had a stronger impact on price when product risk was high than when it was low.
NATID: The Development and Application of a National Identity Measure for Use in International Marketing
Authors: Keillor Bruce D. , Hult G. Tomas M. , Erffmeyer Robert C. , Babakus Emin
Published: November 2018

The international marketing literature abounds with studies outlining the various similarities and differences that exist across cultural and national boundaries (e.g. Hofstede 1980 ). Unfortunately, many of these studies have focused on descriptive comparisons between cultures and nations.

This article develops a measurement instrument designed to explicate the degree to which national identity can be specified and the differences between that national identity and other nations. Utilizing Churchill's (1979) , and Anderson and Gerbing's (1988) guidelines for scale construction and application, this article develops an instrument to measure national identity and establishes norms for its usage, using samples from the United States, Japan, and Sweden. The overall objective of this study is threefold: 1) to develop an empirically sound instrument for measuring national identity; 2) to explore the importance placed on a unique national identity in the three nations comprising the sample; and 3) to consider differences in the underlying dimensions comprising these countries’ national identity and their impact on marketing strategy. The development of such a measurement instrument should provide a means by which the results of cross-cultural and cross-national research can be empirically tested and on which more rigorous theory building can be based.
Executive Insights: Researching Markets in Japan—A Methodological Case Study
Authors: Williams S.C.
Published: November 2018

Foreigners studying markets in Japan face different sets of problems from those encountered in their own, familiar, domestic markets. They have to cope with the nuances of a different language, alien perceptions, different role expectations, and personal inexperience in business and social etiquette. There are unexpected difficulties with access to both published information and target respondents, and some may find they are on the receiving end of a program of deliberate disinformation. This case history is based on the author's recent decade of experiences in studying food markets in Japan. Attention is focused on some difficult methodological problems, and strategies and approaches are offered to maximize the quality of information obtained.
Educator Insights: Strategic Partnerships for Global Education—Linkages with Overseas Institutions
Authors: Green Robert T. , Gerber Linda V.
Published: November 2018

The globalization of business education involves much more than the inclusion of more international business courses in the curriculum and the infusion of more international materials into all business courses. Like their corporate counterparts, business schools themselves need to become global institutions with operations in various parts of the world to enable faculty, students, and executive clients to gain international expertise and to provide regular and diverse global inputs into the educational process. Since most schools lack the resources to achieve a global reach by themselves, the best course generally involves the establishment of strategic alliances with foreign business schools. This article examines the nature of these alliances and suggests the many joint activities in which alliance partners can engage.
A Framework for Analysis of Strategy Development in Globalizing Markets
Authors: Solberg Carl Arthur
Published: November 2018

This article describes the development of an analytical framework of strategic behavior in globalizing markets, based on different strands of literature (internationalization process, strategic groups, intra-industry trade, and global management). The framework consists of a three-by-three matrix with the following dimensions: the global structure of the industry (industry globality) and the firm's preparedness for internationalization. In each of the nine resulting cells (“The Nine Strategic Windows”) the author discusses consequences for strategic behavior of the firm. The author makes concrete suggestions on company strategy, varying from “stay at home” to “strengthen your global position.” In order to illustrate the framework, the study of a Norwegian ship equipment manufacturer is briefly discussed.
Executive Insights: How does this Firm Make Money? Understanding your Overseas Partner1
Authors: Ataç Osman A.
Published: November 2018

It is common knowledge that the health of any relationship depends on the degree to which parties “understand” the needs of each other. Businesses are exchange organizations created to make money. Therefore, in an international business relationship what the parties “need” seems obvious and many would not belabor this issue. Although it is true that all businesses intend to make money, it is not true that they all make money the same way. One of the misconceptions of developed country executives going into international partnerships is that their foreign partners make their money the same way they do. Understanding the sources of profits of prospective foreign partners is important as they will determine whether there will be a partnership, and also whether a partnership will last.
Executive Insights: Managing the Transnational Value Chain—Strategies for Firms from Emerging Markets
Authors: Craig C. Samuel , Douglas Susan P.
Published: November 2018

To compete successfully in world markets, firms from emerging market and newly industrialized economies need to develop strategies to participate more broadly in the transnational value chain. More specifically, they need to move beyond cost-oriented commodity approaches that rely on low-cost labor and other resources to value-creating strategies that capture a greater share of the transnational value chain. This article presents six generic strategies appropriate for emerging market firms: low cost commodity, component manufacturing, private label manufacturing, low-cost leader, first generation technology, and specialized niche. The advantages and limitations of each of these strategies are discussed, as well as general guidelines for extending the firm's participation in the transnational value chain.
Russia's Transition to a Market Economy: Learning about Business
Authors: Czinkota Michael R.
Published: November 2018

Russia's business leaders and employees find themselves in a new environment of competition, efficiency, and innovation, without the training and skills to adjust to these new realities. A field study investigated the business education needs in Russia. Four focus group sessions were conducted and interviews were held with 68 individuals.

Distinct attitudes held by Russians toward business learning were national pride, anger with the seeming disrespect of outsiders for indigenous accomplishments, and a fear of the unknown, coupled with suspicion toward new practices. There was concern about the lack of relevance of the education offered, and about the linkage between knowledge, learning, and actual change, and the longevity of such change.

A rank order of business education priorities identified issues requiring learning and areas in need of behavioral change. Marketing, strategic planning, international business, and business law were the four key learning issues while problem solving, decision making, customer orientation, team building and communications abilities were rated highest in terms of the need for behavioral change.

Overall, many similarities between Russian and Western managers were found. However, Russian managers approach problems in a different fashion, need to be taught in different ways, and have different expectations of learning content. In order to be accepted and useful, business education efforts must consider the specifics of the Russian situation and focus both on the teaching of knowledge and skills as well as on the change of attitudes and behavior.
Internationalization of Service SMEs: An Integrated Perspective from the Engineering Consulting Sector
Authors: Coviello Nicole E. , Martin Kristina A.-M.
Published: November 2018

Internationalization traditionally has been examined using a single theoretical framework in the context of large manufacturing firms. The authors argue that it is more relevant to examine foreign direct investment (FDI) theory (including transaction cost analysis), the stage models of internationalization, or network theory in an integrated and holistic manner. Using case studies of four New Zealand-based engineering consulting firms classified as small or medium-sized enterprises (SMEs), the study identifies and analyzes patterns and influences related to the smaller service firm's decision to internationalize, subsequent internationalization, market selection, and mode of entry. The findings show that SME internationalization in the engineering consulting sector is a complex process, and concepts inherent in FDI theory, the stage models, and the network perspective are all evident. These results support the argument that service internationalization is too broad a concept to be defined exclusively or examined by any one theoretical framework. Implications are drawn for research and practice.
The Importance of Cultural Factors in R&D Intensity
Authors: Lorca Pedro , de Andrés Javier
Published: November 2018

Research and development (R&D) investments are a key issue for companies. In an increasingly competitive economy, R&D can be a source of competitive advantage. Therefore, a profuse research line on the reasons that can motivate firms for R&D investment has emerged. Theoretical frameworks include the resource-based theory, the creative destruction model, the domestic competitive pressure model, and the exposure to international competition model, among others. However, the culture of the country is not widely used as an explanatory variable. Therefore, in this article we will test the extent to which R&D intensity in European countries may be explained by cultural dimensions. Our study included observations from 6,919 firm-year data from 1,517 firms in a sample of 13 European countries. The results support the idea that culture influences R&D intensity.
Struggling and Overcoming Daily Life Barriers Among Children With Congenital Heart Disease and Their Parents in the West Bank, Palestine
Authors: Elissa Kawther , Sparud-Lundin Carina , Axelsson Åsa B. , Khatib Salam , Bratt Ewa-Lena
Published: November 2018

Advances in early diagnosis, treatment, and postoperative care have resulted in increased survival rates among children with congenital heart disease (CHD). Research focus has shifted from survival to long-term follow-up, well-being, daily life experiences, and psychosocial consequences. This study explored the everyday experiences of children with CHD and of their parents living in the Palestinian West Bank. Interviews with nine children aged 8 to 18 years with CHD and nine parents were analyzed using content analysis. The overall theme that emerged was facing and managing challenges, consisting of four themes: sociocultural burden and finding comfort, physical and external limitations, self-perception and concerns about not standing out, and limitations in access to health care due to the political situation. To provide optimum care for children with CHD and their parents, health care providers and policy makers must understand the negative consequences associated with sociocultural conditions and beliefs about chronic illness.
Cusp bifurcation of slightly curved tensioned pipe conveying hot pressurized fluid
Authors: Orolu Kehinde O. , Fashanu Theophilus A. , Oyediran Ayo A.
Published: November 2018

In the course of operation of pipes conveying high temperature-high pressure fluid, unexpected behaviors leading to catastrophic failures have been observed. These have been attributed to uncertainties arising from issues not adequately addressed in the design. Sources of such uncertainties include geometric imperfection of the pipe and temperature variation. The perfectly straight pipe is assumed in most designs, but it is an idealization that does not exist in practice. In a bid to reduce the number of uncertainties in design and operation, a model governing nonlinear vibration of tensioned pipes conveying hot pressurized fluid that accounts for the geometric imperfection of the pipe is developed in this work. Coupled nonlinear equations of motion in both axial and transverse directions are obtained and solved using the eigenfunction expansion method. The influence of initial curvature, temperature, and the longitudinal vibration on the pipe are investigated. The results obtained show that a pipe with geometric imperfection exhibits cusp bifurcation and not supercritical pitchfork bifurcation.
Implementing value assessment in oncology practice: A single-center experience
Authors: Saunders Katherine , Mably Mary S , Shull Sara S , Jones Heather , Leal Ticiana A , Bergsbaken Jason J
Published: November 2018

Cancer treatment costs in the United States are rising. Evidence suggests that increased costs do not always correlate with improved outcomes. Several organizations have developed tools and frameworks to assess cancer treatment value; however, many centers have reported difficulty in implementing these tools and effectively incorporating value-based decision making into clinical practice. After evaluating existing frameworks, the Carbone Cancer Center at UW Health set out to create a value-based tool that could be used to inform the decisions of clinicians and patients. This tool was piloted in metastatic or advanced non-small cell lung cancer, specifically in the second-line setting to assess the value of immune checkpoint inhibitors nivolumab, atezolizumab, and pembrolizumab. The results of the pilot suggest that atezolizumab is the best value of the three agents in this patient population. Challenges and opportunities for improvement that were identified during the pilot process have helped refine the tool for use in a variety of disease states within oncology.
Norm transformation and the institutionalization of targeted killing in the US
Authors: Pratt Simon Frankel
Published: November 2018

This article explains the emergence and institutionalization of the US’s targeted killing practices as a case of norm transformation. I argue that international and domestic US prohibitions on assassination have not disappeared, but have changed as a result of practitioner-led changes in the conventions, technologies, and bureaucratic structures governing the use of force in counterterrorism activities. After discussing the limits of alternative explanations, and drawing inspiration from practice theory, pragmatist social theory, and relational sociology, I posit three causal mechanisms as responsible for the transformation: convention reorientation, which was the redefinition of targeted killing to distinguish it from assassination; technological revision, which was the development and use of unmanned aerial vehicles (“drones”) to bypass normative and strategic concerns over precision; and network synthesis, which was the support of the Bush administration and especially of the Obama administration, overruling dissenters from within the Central Intelligence Agency (who were often very highly placed). I trace the processes by which these mechanisms operated and interacted in simultaneous and mutually reinforcing ways from the start of the millennium until now. Finally, I discuss some of the ways in which this contributes to institutional analysis and the study of norm change more generally, and, in particular, how it considers the role of technology and the reciprocity of means and ends.
(Re)imagining the ‘Backstreet’: Anti-abortion Campaigning against Decriminalisation in the UK
Authors: Lowe Pam
Published: November 2018

The risk of death or serious injury from ‘backstreet abortions’ was an important narrative in the 20th century campaign to liberalise abortion in the UK. Since then, clinical developments have reduced the overall health risks of abortion, and international health organisations have been set up to provide cross-border, medically safe abortions to places where it is unlawful, offering advice and, where possible, supplying abortion pills. These changes mean that pro-choice campaigns in Europe have often moved away from the risks of ‘backstreet abortions’ as a central narrative when campaigning for abortion liberalisation. In contrast, in the UK, anti-abortion activists are increasingly using ideas about ‘backstreet abortions’ to resist further liberalisation. These claims can be seen to fit within a broader shift from morals to risk within moral regulation campaigns and build on anti-abortion messages framed as being ‘pro-women’, with anti-abortion activists claiming to be the ‘savers’ of women. Using a parliamentary debate as a case study, this article will illustrate these trends and show how the ‘backstreet’ metaphor within anti-abortion campaigns builds on three interconnected themes of ‘abortion-as-harmful’, ‘abortion industry’, and ‘abortion culture’. This article will argue that the anti-abortion movement’s adoption of risk-based narratives contains unresolved contradictions due to the underlying moral basis of their position. These are exacerbated by the need, in this case, to defend legislation that they fundamentally disagree with. Moreover, their attempts to construct identifiable ‘harms’ and vulnerable ‘victims’, which are components of moral regulation campaigns, are unlikely to be convincing in the context of widespread public support for abortion.
Homophobia in Health Professionals in Ankara, Turkey: Developing a Scale
Authors: Yertutanol Fatma Duygu Kaya , Candansayar Selçuk , Seydaoğlu Gülşah
Published: November 2018

The aims of this study were to develop a sexual orientation attitude scale and use it to investigate the attitudes of psychiatrists, other physicians and first year medical students toward homosexuals and homosexuality in Ankara, Turkey. A cross-sectional study was performed with three groups including psychiatrists (n = 147), non-psychiatric physicians (n = 224) and first year medical students (n  =  280). A scale with 43 items consisting of four subscales (heterosexism, homophobia, homonegativity, neutrality) was developed which showed high internal consistency, validity and reliability in this sample of Turkish individuals. The internal consistency coefficients (Cronbach's alpha) for the subscales were 0.85-0.86, 0.95-0.95, 0.95-0.95, and 0.85-0.86, respectively. Being male, single, a graduate of a religious (Imam Hatip) or vocational high school, of rural origin, a student, more religious, heterosexual and studying at university hospitals were found to be related to higher scores (indicating more negative attitudes) on all subscales and the total scale and these differences were significant. Students had the highest scores and psychiatrists had the lowest scores in all subscales and the total scale. The results of this study indicate that physicians and medical students have negative attitudes toward homosexuals and that medical training on sexual health issues should be improved in Turkey.
Acoustic characteristics of a ported shroud turbocompressor operating at design conditions
Authors: Sharma Sidharath , Broatch Alberto , García-Tíscar Jorge , Allport John M , Nickson Ambrose K
Published: November 2018

In this article, the acoustic characterisation of a turbocharger compressor with ported shroud design is carried out through the numerical simulation of the system operating under design conditions of maximum isentropic efficiency. While ported shroud compressors have been proposed as a way to control the flow near unstable conditions in order to obtain a more stable operation and enhance deep surge margin, it is often assumed that the behaviour under stable design conditions is characterised by a smooth, non-detached flow that matches an equivalent standard compressor. Furthermore, research is scarce regarding the acoustic effects of the ported shroud addition, especially under the design conditions. To analyse the flow field evolution and its relation with the noise generation, spectral signatures using statistical and scale-resolving turbulence modelling methods are obtained after successfully validating the performance and acoustic predictions of the numerical model with experimental measurements. Propagation of the frequency content through the ducts has been estimated with the aid of pressure decomposition methods to enhance the content coming from the compressor. Expected acoustic phenomena such as ‘buzz-saw’ tones, blade passing peaks and broadband noise are correctly identified in the modelled spectrum. Analysis of the flow behaviour in the ported shroud shows rotating structures through the slot that may impact the acoustic and vibration response. Further inspection of the pressure field through modal decomposition confirms the influence of the ported shroud cavity in noise generation and propagation, especially at lower frequencies, suggesting that further research should be carried out on the impact these flow enhancement solutions have on the noise emission of the turbocharger.
The perceived and observed needs of patients with dementia admitted to acute medical wards
Authors: Scerri Anthony , Scerri Charles , Innes Anthea
Published: November 2018

It is acknowledged that the needs of persons living with dementia admitted in acute hospitals are not always met. Previous studies have focused on the perceived needs of professional caregivers or family members whilst the voices of patients with dementia in acute hospitals have not been extensively reported. This may have contributed to the under-recognition of the needs of persons living with dementia. The aim of this study was to categorise the perceived and observed needs of persons with dementia admitted in acute medical wards and to explore whether these needs are being or have been met. Thirteen people with dementia in three medical wards, who could verbally communicate with the researcher, were purposively selected as research participants. Semi-structured interviews were conducted to elicit each participant’s experiences of their hospital stay and whether their needs were perceived to have been/are being met. Moreover, routine care with the same participants was observed using Dementia Care Mapping. Maslow’s Hierarchy of Needs was used as a framework to categorise care needs. Our findings demonstrate that basic needs such as toileting, feeding, drinking, continence and comfort were not always met. Moreover, the largest gap between met and unmet needs was found in patients who were either under constant observation or unable to communicate. Too much emphasis was perceived and observed to be given on what staff considered as safety needs at the expense of other needs. The patients’ need for social contact and self-esteem such as dignity and respect were often ignored and this led to patients feeling devalued. Hospital staff have to be more aware of the holistic needs of patients with dementia in acute settings and the way care is delivered in order to make up for these unmet needs, thus facilitating person-centred care.
Facilitators and barriers to optimizing eating performance among cognitively impaired older adults: A qualitative study of nursing assistants’ perspectives
Authors: Liu Wen , Tripp-Reimer Toni , Williams Kristine , Shaw Claire
Published: November 2018

Background and Objectives

Cognitively impaired individuals are at increased risk for functional and behavioral difficulties at mealtimes, leading to compromised eating performance, low food and fluid intake, and negative functional and nutritional outcomes. Nursing assistants are the most critical front-line care staff and best positioned to manage the personal and environmental factors that influence resident eating performance. Identifying nursing assistants’ perceptions of barriers and facilitators to engaging residents in eating will provide important experientially based foundation for developing and testing evidence-driven interventions to promote mealtime care.

Methods

A qualitative descriptive study was conducted in three sites: two nursing homes and one hospital gero-psychiatric inpatient unit. Six focus groups were conducted with a purposive sample of 23 nursing assistants who regularly provided mealtime care to residents with cognitive impairment. Interview questions addressed barriers and facilitators at resident, caregiver, environmental (facility), and policy levels in optimizing mealtime care. Audio recordings of focus groups were transcribed and analyzed using qualitative descriptive content analysis. Both barriers and facilitators were organized into a hierarchical taxonomy based on similarities and differences framed by the Social Ecological Model.

Results

The majority of barriers and facilitators were at the caregiver level. Caregiver-level barriers included lack of preparation and training, competing work demands, time pressure, and frustration. Caregiver-level facilitators included caregiver preparation and motivational, technical, informational, and instrumental assistance. Environmental-level barriers and facilitators related to the physical, social, and cultural environment and facility practices. Only barriers to optimizing mealtime care were identified at resident and policy levels.

Conclusions

Nursing assistants identified multilevel barriers as well as a wide range of caregiver and environmental facilitators to optimizing dementia mealtime care. Findings can inform the development and implementation of multifaceted innovative mealtime assistance and staff training programs to promote resident eating performance while fostering person-centered individualized mealtime care practice.
Review and historical overview of experimental facilities used in hull coating hydrodynamic tests
Authors: Yeginbayeva Irma Amangeldykyzy , Granhag Lena , Chernoray Valery
Published: November 2018

The prediction of hydrodynamic performance of hull coatings with different surface conditions is a challenging task. Moreover, with the emergence of new prototype coatings that are relatively smooth in terms of roughness characteristics, the accurate estimation of their drag is particularly important, as this will enable a good grading of drag reducing benefits of coatings. In the context of coating studies, the experimental methods are considered as the backbone and results obtained from experimental facilities with the required performance will enable accurate scaling of test results to full-scale ship results. Although numerical simulations like computational fluid dynamics have acquired the level of accuracy good enough to replace some of the systematic model testing used for ship design optimization, it is still not evident whether the simulations will be able to replicate the physical reality such as coating type, its roughness and biofilms accurate enough to enable predictions of the power requirements for ships. Therefore, this article gives insight into various coating hydrodynamic testing facilities and methods that are capable of measuring drag characteristics of coatings. The work highlights the details of each method and identifies the concepts and parameters needed to describe, implement and analyze hydrodynamic coating drag measurements. This article also summarizes the merits and demerits of each type of facility based on reports and studies reported in open literature. Finally, the authors propose a recommendation that can be incorporated into the design of the new hydrodynamic facility.
Stent Frame Movement Following Endovascular Aneurysm Sealing in the Abdominal Aorta
Authors: Yafawi Asma , McWilliams Richard G. , Fisher Robert K. , England Andrew , Karouki Maria , Torella Francesco
Published: November 2018

Purpose: To investigate the incidence and extent of stent frame movement after endovascular aneurysm sealing (EVAS) in the abdominal aorta and its relationships to aneurysm growth and the instructions for use (IFU) of the Nellix endograft. Methods: A retrospective single-center study was conducted to review the clinical data and computed tomography (CT) images of 75 patients (mean age 76±7.6 years; 57 men) who underwent infrarenal EVAS and had a minimum 1-year follow-up. The first postoperative CT scan at 1 month and the subsequent scans were used to measure the distances between the proximal end of the stent frames and a reference visceral vessel using a previously validated technique. Device migration was based on the Society of Vascular Surgery definition of >10-mm downward movement of either Nellix stent frame in the proximal landing zone; a more conservative proximal displacement measure (downward movement ⩾4 mm) was also recorded. Patients were categorized according to adherence to the old (2013) or new (2016) Nellix IFU. Aneurysm diameter was measured for each scan; a change ⩾5 mm was deemed indicative of aneurysm growth. Results: Over a median follow-up of 24 months (range 12–48), proximal displacement ⩾4 mm occurred in 42 (56%) patients and migration >10 mm in 16 (21%), with similar incidences in the right and left stent frames. Proximal displacement was significantly more frequent among patients whose anatomy did not conform to any IFU (p=0.025). Presence of aneurysm growth ⩾5 mm was observed in 14 (19%) patients and was significantly associated with proximal displacement ⩾4 mm (p=0.03). Conclusion: Infrarenal EVAS may be complicated by proximal displacement and migration, particularly when performed outside the IFU. The definition of migration used for endovascular aneurysm repair may be inappropriate for EVAS; a new consensus on definition and measurement technique is necessary.
SLC25A22 Promotes Proliferation and Metastasis of Osteosarcoma Cells via the PTEN Signaling Pathway
Authors: Chen Ming-Wei , Wu Xue-jian
Published: November 2018

Osteosarcoma is a highly malignant bone tumor. However, due to the high complexity of the occurrence and metastasis of osteosarcoma, the exact mechanism promoting its development and progression remains to be elucidated. This study highlights the causal link between solute carrier family 25 member 22 (SLC25A22) and the development, progression, and metastasis of osteosarcoma. SLC25A22 is upregulated in human osteosarcoma and predicts a poor prognosis. The upregulation of SLC25A22 in osteosarcoma tissues was significantly associated with cell proliferation, invasion, and metastasis. Studies of functional gain (overexpression) and loss (knockdown) showed that SLC25A22 significantly increases the ability of osteosarcoma cells to proliferate, as well as invade and metastasize in vitro. At the same time, the expression of SLC25A22 promoted the progression of the cellcycle of osteosarcoma cell lines and inhibited the apoptosis of osteosarcoma cells. Analysis using a mouse xenograft model showed that xenografts of SLC25A22 stable overexpressing osteosarcoma cells had a significant increase in tumor volume and weight compared to the control group. Lung metastasis models in mice showed that expression of SLC25A22 promoted lung metastasis of osteosarcoma in vivo. Furthermore, SLC25A22 inhibited phosphatase and tensin homolog expression and increased phosphorylation of protein kinase b (Akt) and Focal Adhesion Kinase (FAK) in the phosphatase and tensin homolog signaling pathway. In summary, SLC25A22 is highly expressed in osteosarcoma, promoting osteosarcoma cell proliferation and invasion by inhibiting the phosphatase and tensin homolog signaling pathway.
Forecasting violent events in the Middle East and North Africa using the Hidden Markov Model and regularized autoregressive models
Authors: Hossain KSM Tozammel , Gao Shuyang , Kennedy Brendan , Galstyan Aram , Natarajan Prem
Published: November 2018

This paper focuses on forecasting Military Action-type events by both state and non-state actors. Here we demonstrate that the dynamics of these types of events can be adequately described by a Hidden Markov Model (HMM) where the hidden states correspond to different operational regimes of an actor, and observations correspond to event frequency—and the HMM effectively predicts events with different lead times. We also demonstrate that one can enrich statistical time series-based methods that work only on historical data by exploiting predictive signals in real-time external data streams. We demonstrate the superior predictive power of the proposed models with evaluation of recent data capturing activities over two groups, ISIS and the Syrian Arab Military, two countries, Syria and Iraq, and two cities, Aleppo and Mosul. We also present an approach to converting predictions of the proposed models to real-world warnings.
A Multimodality Navigation System for Endoscopic Fetal Surgery: A Phantom Case Study for Congenital Diaphragmatic Hernia
Authors: Elangovan Hariprashanth , Yao Wei , Nicolaides Kypros
Published: November 2018

This article presents a multi-modality tracking and navigation system achieved by merging optical tracking and ultrasound imaging into a novel navigation software to help in surgical pre-planning and real-time target setting and guidance. Fetal surgeries require extensive experience in coordination of hand-eye-ultrasound-surgical equipment, knowledge, and precise assessment of relative anatomy. While there are navigation systems available for similar constrained working spaces in arthroscopic and cardiovascular procedures, fetal minimally invasive surgery does not yet have a dedicated navigation platform capable of supporting robotic instruments that can be adapted to the set of unique procedures. This article discusses the testing of the novel multi-modality navigation system in a phantom environment developed for this purpose. The outcomes suggest that the subjects demonstrated an increase in average reaching accuracy by about 60% and an overall reduction in time taken by 33.6%. They also showed higher levels of confidence in reaching the targets, which was visualised from the pattern of trajectory of movements during the procedure. To evaluate the navigation system, a phantom surgical environment was found necessary. Therefore, the article also discusses the details of the development of a fetal phantom environment for congenital diaphragmatic hernia for surgical testing, evaluation, and training. A surgical procedure was conducted on the phantom using the proposed tracking navigation system and using only ultrasound.
Consulting in the Clinical Skills Assessment
Authors: Williams Nicki
Published: November 2018

The aim of the Clinical Skills Assessment (CSA) is to test a doctor’s ability to gather information, apply learned understanding of disease processes, and offer appropriate person-centred care. Effective integration of these skills is a key element in the exam, and not commonly tested in other disciplines. The CSA is a type of Objective Structured Clinical Examination (OSCE). Most medical OSCEs have stations each relating to one skill set, such as ‘communication’ or ‘physical examination’. Although that may be more relevant in secondary care, where patients arrive already partly sifted, the primary care doctor is faced daily with undifferentiated, often multiple, problems experienced by patients who vary as much as their symptoms. The GP’s task is complex, and best considered as an integration of skill sets. The CSA is an exit exam, testing for evidence of competence of independent practice as a family doctor; hence, we use the entire consultation as our unit of testing. In this article I set out to demystify consulting in the CSA. Throughout, I offer practical tips; these are marked *. I end with a list of suggestions to better prepare candidates for what we all hope will be a good experience.
Accessing Green Spaces Within a Healthcare Setting: A Mixed Studies Review of Barriers and Facilitators
Authors: Weerasuriya Rona , Henderson-Wilson Claire , Townsend Mardie
Published: November 2018

This review describes the facilitators and barriers impacting on passive access to green spaces within healthcare settings. A systematic mixed-studies review was undertaken to review the quantitative and qualitative evidence on access to green spaces within healthcare settings, as well as to review the methodological quality of the studies eligible for inclusion. A total of 24 articles met the inclusion criteria and were included in the review. The barriers to access were grouped into three themes: “awareness,” “accessibility,” and “comfort.” The facilitators were grouped into 13 themes: “flora and foliage,” “views,” “water features,” “sun, rain, fresh air, wind,” “animal life,” “diverse textures, heights, shapes,” “lawn,” “natural versus artificial material,” “rest areas,” “shade,” “private areas,” “play equipment,” and “safety.” These findings can be explained through multiple lenses, using existing theories on contact with nature and supportive garden design. In an era of elevated stress, patient admissions, and staff turnover in hospitals, and rising costs of providing healthcare services, the creation of settings conducive to health promotion, stress reduction, and faster recovery is relevant and timely. This article, which has collated over three decades of research evidence, is invaluable in addressing this issue.
Prevalence and Risk Factors of Chronic Rhinosinusitis in the Elderly Population of Korea
Authors: Hwang Chi Sang , Lee Hye Sun , Kim Si Nae , Kim Ji Hyung , Park Dong-Joon , Kim Kyung-Su
Published: November 2018

Background

Although a significant number of the clinical features and pathophysiologic mechanisms of chronic rhinosinusitis (CRS) have been described, only a few studies have been published on characterization of CRS in the field of aging.

Objective

We investigated the prevalence and risk factors of CRS in elderly (≥65 years old) Koreans using large-scale nationwide epidemiological data and compared the risk factors of elderly with those of younger adult participants (19–64 years old).

Methods

Data from 25 529 participants who completed the 2008–2012 Korean National Health and Nutrition Examination Survey were analyzed. Diagnosis of CRS was done according to the EP3OS 2012 guideline for epidemiologic study. Risk factors of CRS were compared in the aspects of sociodemographics, general health behaviors, clinical characteristics, and comorbidities of participants.

Results

The prevalence of CRS was significantly higher in 5590 elderly than in 19 939 younger adults (6.55% vs 5.69%; P = .016. Some variables of socioeconomic status and mental health in the adult group were associated with increased risk of CRS but did not show association in the elderly group. We observed a significant association between CRS prevalence and comorbid allergic rhinitis, asthma, and atopic dermatitis in both groups ( P < .05). However, in the elderly group, the associations were significantly weaker with regard to allergic rhinitis ( P-interaction = .03) and asthma ( P-interaction = .002).

Conclusion

These results suggest that elderly populations have distinct pathophysiology and clinical presentations from adult CRS, and management for elderly patients with CRS may require different or additional therapeutic approaches.
Endoscopic and Radiologic Findings in Failed Dacryocystorhinostomy: Teaching Pearls for Success
Authors: Herzallah Islam R. , Marglani Osama A. , Muathen Sumaiya H. , Obaid Arwa A.
Published: November 2018

Background

Although several studies have commented on causes of dacryocystorhinostomy (DCR) failure, detailed description of anatomical findings in such cases remains insufficient.

Objective

Our objective was primarily to analyze radiologic, endoscopic, and intraoperative findings in patients presenting with failed DCR and secondarily to assess the outcome of revision endoscopic DCR (endo-DCR) carried out at our institution.

Methods

Twenty-four failed DCRs presenting to our tertiary care center were retrospectively analyzed. Data collection included patients’ history, diagnostic, and management data, as well as thorough analysis of sinonasal CT scans, along with endoscopic and intraoperative findings. Outcome was also assessed in 21 cases with revision endo-DCR performed.

Results

The anterior part of uncinate process was not previously removed in 15 sides (62.5%), with unopened agger nasi in 13 sides (54.2%). The lacrimal bone was detected covering the posterior sac despite removal of the anterior ascending process of maxilla in 9 sides (37.5%). Rhinostoma was anterior to lacrimal sac in 2 sides (8.3%) and was below the sac in 7 sides (29.2%). Fibrous membrane covered the rhinostoma despite removal of all sac-overlying bones in 6 sides (25%). Other findings included intranasal adhesions, septal deviation, lateralized middle turbinate, granulation tissue, foreign body reaction, and chronic sinusitis. Nineteen of the 21 revision endo-DCRs were successful (90.5%).

Conclusion

This study provides a precise anatomical description of findings in cases of failed DCR. Such information is paramount in helping surgeons enhance their learning curve, refine the surgical technique, and improve patients’ outcome.
Treatment of chronic post-herpetic neuralgia with autologous fat grafts: a first-in-the-world case report
Authors: Sollie Martin , Sørensen Jens Ahm
Published: November 2018

A 60-year-old woman suffering from severe chronic post-herpetic neuralgia (PHN) was treated with simple autologous fat grafting to the affected area of skin. Post-operatively, she reported a great improvement in her symptoms. The effect was stable throughout the 3-month follow-up period. This case report presents a first-in-the-world case of using fat grafting to treat chronic post-herpetic neuralgia and discusses the future potential of this as a primary treatment of this syndrome. This report presents partial data of a pilot study registered at clinicaltrials.org ( ClinicalTrials.gov Identifier: NCT03584061).
Remembering the voice: Exploring information and sentiment in voicemail archival practices
Authors: LeFebvre Leah E. , Haggadone Brad A.
Published: November 2018

This study examines preservation of voicemail artifacts. Applying an exploratory approach through grounded theory, participants ( N = 52) from Amazon’s Mechanical Turk provided common reasons for retaining voicemail artifacts. Results highlighted why participants retained or deleted general and specific voicemails. Five categories,  past-focused, important, future-focused, sentimental, and neglectful, represented retaining reasons. The oldest and most important artifacts represented sentimental messages. Three categories, past-focused, technological affordance, and unremarkable or undesirable calls, represented reasons for deletion. Voicemails are paralleled to mass and interpersonal communication and implications make connections between information retention, temporality, and interpersonal memorialization. Findings indicate that asynchronous communication exchanges and relics, such as voicemails, offer linkages to and reverberations of old and emerging technologies.
Smartphone and self-extension: Functionally, anthropomorphically, and ontologically extending self via the smartphone
Authors: Park Chang Sup , Kaye Barbara K.
Published: November 2018

This paper focuses on the blurring boundary between the “human self” and the smartphone, using interviews with 60 heavy smartphone users. The interview responses reveal three types of self-extension via the smartphone— functional extension, anthropomorphic extension, and ontological extension. Smartphone users assert that their phone has become an indispensable part of their self and thus influences their identity and sense of being in both positive and negative ways.