bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of organizational context and infrastructure practices in JIT implementation
Authors: Bayo‐Moriones Alberto , Bello‐Pintado Alejandro , Merino‐Díaz‐de‐Cerio Javier
Published: November 2008

Purpose

The purpose of this paper is to analyze which factors determine the use of just‐in‐time (JIT) in companies. More precisely, the paper aims to study the role played by two variables of organizational context (size and age) and three infrastructure practices (advanced manufacturing technologies – AMT, quality management, and work organization).

Design/methodology/approach

The hypotheses were tested using data collected from 203 manufacturing plants with at least 20 employees. Data were collected by means of personal interviews with plant managers. Regression analyses have been performed to test the hypotheses.

Findings

The results reveal the existence of diversity in the factors that affect the use of the different components of JIT. Infrastructure practices are shown to be more determining than contextual factors. This happens in particular with AMT, basic quality tools and the management of the relationships with suppliers and customers.

Research limitations/implications

The main limitations of the research are those derived from the cross‐sectional character of the data and from information coming from surveys, especially when the measures are subjective.

Practical implications

The paper stresses the need to develop adequate infrastructures in technology management, quality management and work organization to obtain all the benefits of JIT implementation.

Originality/value

The paper highlights the role of organizational context and, especially, infrastructure practices in the incidence of JIT in the manufacturing industry. Moreover, the identification of different dimensions of JIT systems makes it possible to conclude that the influence of the different factors considered is not uniform across all JIT elements.
Product development and innovation for developing countries
Authors: Chandra Mahesh , Neelankavil James P.
Published: November 2008

Purpose

Between the lack of incentives for larger international companies and the lack of resources of the local companies the majority of the people in less developed countries never benefit from new products. International companies generally offer modified product offerings to consumers in developing countries. To date, their attempts to penetrate the developing country markets have not been successful. The reasons for this failure in their attempts to succeed in these markets include the prohibitive cost of developing entirely new products for this market and the low‐income levels of the families in these countries. To succeed in developing countries, international companies have to observe and study their customers' needs and uncover the problem areas. There are many approaches available to accomplish this process including systematic innovation and the seven R's. Each approach focuses on the consumer and suggests a radical approach to developing new products. The purpose of this paper is to provide an introduction and overview of new product development in emerging countries.

Design/methodology/approach

Challenges, process, and success strategies are explored.

Findings

To succeed in developing countries, international companies have to observe and study their customers' needs and uncover the problem areas. The authors suggest an approach that focuses on the consumer and suggests a radical approach to developing new products – the limitations/constraints point of view. The single biggest constraint in developing products for less developed countries is affordability (price). Unlike the new product development process that is practiced in industrialized countries, international companies wanting to be successful in less developed countries should start with the customers' affordability and value‐added point of view and then work backwards to develop products/services for these countries.

Practical implications

International companies are provided with an approach to new product development in emerging countries.

Originality/value

New product development in emerging countries is likely to become increasingly important, and there is very little research on the topic. The value of this paper is in its overview of the challenges of new product development in emerging countries, and suggested solutions.
Exploring four generations' beliefs about career
Authors: Dries Nicky , Pepermans Roland , De Kerpel Evelien
Published: November 2008

Purpose

The purpose of this paper is to examine whether four different generations (Silent Generation, Baby Boomers, Generation X, and Generation Y) hold different beliefs about career. Career type, career success evaluation and importance attached to organizational security are to be scrutinized for each generation.

Design/methodology/approach

A total of 750 people completed a vignette task, rating the career success of 32 fictitious people. Each vignette contained a different combination of five career features (functional level, salary, number of promotions, promotion speed, and satisfaction) at two levels (low and high). Furthermore, several items were added in order to determine each participant's career type and the extent to which they attached importance to organizational security.

Findings

The majority of participants still had rather “traditional” careers, although younger generations seemed to exhibit larger discrepancies between career preferences and actual career situation. Overall, satisfaction appeared to be the overriding criterion used to evaluate other people's career success. No significant differences were found between generations. With regard to importance attached to organizational security, the Silent Generation and Generation Y scored significantly higher than the other generations.

Research limitations/implications

The convenience sampling strategy led to large differences in sample size per generation. Using a vignette design limited the amount and richness of information that could be offered to participants. Perhaps other criteria relevant to real‐life career success evaluation should have been incorporated in this study.

Originality/value

The study raises questions about the validity of career success operationalizations frequently used in research. It is the first study to examine career success evaluation by means of vignettes.
Social reporting, engagements, controversies and conflict in an arena context
Authors: Georgakopoulos Georgios , Thomson Ian
Published: November 2008

Purpose

The purpose of this paper is to empirically investigate relationships between engagement activities and social reporting practices in a controversial and environmentally sensitive industry. The interactions investigated were not restricted to stakeholder relationships but included other communications between different stakeholders.

Design/methodology/approach

This paper presents a case study approach framed within a contested political arena. Data were gathered using multiple methods including interviews with salmon farming organisations, stakeholders, rule‐enforcers, issue amplifiers and political institutions.

Findings

All arena participants used social reports in their interactions to communicate the social, environmental and economic consequences of salmon farming. Different social reporting practices appeared to be reflexively related to the competing motivations of different stakeholders. However, social reporting in Scottish salmon farming was fragmented, driven by many different factors and did not necessarily lead to a resolution of the conflicts within this arena.

Research limitations/implications

Researching social reporting should consider the co‐existence and co‐evolution of different social reports, competing motivations and engagement tactics of stakeholders. This paper identifies the construction of holistic reports from multiple reports and issue amplification as two research methods to engage in social and environmental policy debates.

Originality/value

This paper presents empirical evidence from an under‐researched industry, which has the potential to develop the theoretical understanding of social reporting. It also introduces the arena concept as a useful tool in further social reporting research.
The transition to financial capitalism and its implications for financial reporting
Authors: Arnold A.J. , McCartney S.
Published: November 2008

Purpose

There are two main alternative explanations in the literature for the patterns of financial reporting during the period of the British Industrial Revolution (BIR). Rob Bryer sees the new social relations of production in which manufacturing entrepreneurs strove to increase the productivity of wage‐labour as leading to a distinct capitalist “calculative mentality”, focused on the return on capital employed; Dick Edwards argues from agency precepts that financial reporting emerged with the transition from “industrial” to “financial capitalism”. This paper aims to reappraise these theorisations using new archival evidence.

Design/methodology/approach

Canals, the crucial transport network during the BIR, were owned by limited liability companies financed by outside investors, with clear separation of ownership and control, yet were not capitalist in Bryer's sense because their profits came from a form of rent (tolls on freight) not from the exploitation of wage‐labour. The paper reviews the financial statements of seven major English canals from the 1770s to the 1850s, and uses these findings as a basis for appraising the above‐mentioned theories.

Findings

The financial statements of English canal companies do not distinguish profit or enable users to calculate rates of return on capital employed and so assess the performance of management. This sharply conflicts with agency theory but is consistent with Bryer's thesis.

Originality/value

The paper contributes to the authors' understanding of how and why corporate financial reporting emerged, and the relationship between this process and the transition to the capitalist mode of production.
In brief: the National Retail Planning Forum Briefing Paper series
Authors: Findlay Anne , Sparks Leigh
Published: November 2008

Purpose

This paper seeks to make sense of recent developments in retail planning with reference to the changing agendas on retail planning, the disparate nature of participation in the retail planning debate and the diversity of literature on the subject.

Design/methodology/approach

The paper focuses on the work of the National Retail Planning Forum. Specifically, it examines the Briefing Paper Series using it as a way of seeing how the agenda has been changing and policy challenged.

Findings

The paper underlines the importance of distinguishing between evidence based research and rhetoric or advocacy in evaluating policy in retail planning.

Originality/value

The paper provides an accessible short tour of recent issues on the policy agenda whilst also counterpoising some of the underlying retail planning policy issues.
Prognosis and mitigation strategy for major landslide‐prone areas
Authors: Uniyal Aniruddh
Published: November 2008

Purpose

The aim of this paper is to present a discussion on prognosis and mitigation of major landslide zones in an attempt to minimize the impact of such disasters in future. A case study on the sequence of sliding events of Varunavat Parvat, Uttarkashi (India), response of masses and administration and causative factors of sliding events has been presented in detail for prognosis and mitigation of large slide zones.

Design/methodology/approach

The prognosis and mitigation strategy discussed is based on the monitoring of mass wasting zones through field investigations and satellite image analysis (of pre‐ and post‐landslide period images) and experiential learning and interaction with village elders in landslide hazard‐prone Himalayan terrain.

Findings

The paper finds that Himalayan habitations such as Uttarkashi (which is situated in an area of fragile rocks, complex tectonics, seismic activity and cloud burst‐prone unstable hill slopes with colluvium and old slide zones) should have minimum anthropogenic activity in the form of slope cutting for road or building construction.

Research limitations/implications

The paper reflects the author's individual understanding of causative factors and indications of landslides in Varunavat Parvat area in Uttarkashi township of Uttarakhand (India).

Originality/value

The paper calls for amalgamation of experience‐based local knowledge of villagers of landslide‐prone areas and modern scientific and technical know‐how and above all the coordinated efforts of community and authorities for prognosis and mitigation of large‐scale landslides in the inhabited areas. It has been further emphasized that sensitization and awareness programs and strict implementation of land‐use regulations are vital components of effective mitigation strategy.
Public relations before “public relations” in Spain: an early history (1881‐1960)
Authors: Rodríguez Salcedo Natalia
Published: November 2008

Purpose

This paper aims to contribute to a better understanding of the origins of Spanish public relations from the end of the nineteenth to the early twentieth century. Although the term “public relations” was an export to Europe by the end of the second world war (with some exceptions), its philosophy had already been practised in some countries, and countries not always under a democratic regime, as the Spanish case shows.

Design/methodology/approach

The approach taken is a literature review of the first Spanish communication journals, oral interviews with the pioneers in the field and documentary research of the unpublished professional archive of the first Spanish agency, established in 1960.

Findings

The first “public relations” campaigns did not appear until the very late 1950s. However, a closer look reveals the existence of precedents in the first half of the century though under other names such as “educational” and “prestige” advertising, or “propaganda” campaigns. Despite being considered as isolated experiences, they prove the phenomenon precedes the name of “public relations”.

Practical implications

This paper places special emphasis on two lines of emergence for public relations. First, the profession in Spain naturally evolved and stemmed from advertising and, due to historical reasons, it was also related to communicative initiatives known as “propaganda”. Second, once the practitioners heard about the American term “public relations”, the precedents seemed to be ignored and were replaced by the influence of other countries' experiences, thanks to the wide vision of the pioneers.

Originality/value

There is little research on the origins of public relations in Spain and none on the precedents. This paper fills in some of the gaps.
And did those feet? Getting medieval England “on‐message”
Authors: Croft Robin , Hartland Trevor , Skinner Heather
Published: November 2008

Purpose

This paper aims to gain an understanding of the nature and extent of the practice of “public relations” in history.

Design/methodology/approach

The paper uses an analysis of popular narratives (in particular rumour, legend and myth) to inform a detailed case study of Glastonbury abbey in the medieval period.

Findings

Glastonbury Abbey worked in partnership with the Crown to develop a detailed promotional campaign based on powerful narratives. As a consequence it was able to grow to become one of the wealthiest communities in the country. The Crown, meanwhile, consolidated its position by being able to engender a whole national “brand” around the mythical corpus.

Research limitations/implications

Methodologically, using folklore and other popular narrative material is useful as to an extent it is outside official control, but also provides information about the story tellers and the audiences.

Originality/value

The research builds on Watson's recent work on St Swithun and Winchester, taking the ideas forward several hundred years (and finding many of the same patterns). It finds new developments in terms of co‐branding and brand revivals.
First impressions: US media portrayals of public relations in the 1920s
Authors: Penning Timothy
Published: November 2008

Purpose

The paper traces negative and limiting media depictions of public relations (PR) to their origins in the 1920s in order to determine whether modern media characterizations of “public relations” are new or a legacy of the past.

Design/methodology/approach

A qualitative content analysis was used in order to look more deeply at media characterizations of public relations. The New York Times and Time magazine were chosen to sample because of their dominance and unique reflection of the era, respectively.

Findings

Reporting about “public relations” was primarily fair. Early practitioners were often quoted defining the profession, including “great men” of PR history and more common practitioners. These practitioners of PR are as much to blame for confounding the terms “public relations” and “press agent” as are the media of the 1920s.

Practical implications

This historical study sheds a light on and provides context for both the media and society's understanding of public relations today.

Originality/value

While much research has looked at media portrayals and public perceptions of the public relations field, few if any have traced attitudes about the profession to the decade when the term “public relations” was first popularized. The paper remedies this deficit.
The influence of extra projects on overall investment feasibility
Authors: Carmichael David G. , Balatbat Maria C.A.
Published: November 2008

Purpose

The paper looks at the influence of adding more projects on overall investment feasibility under conditions of uncertainty, and how far into the future the project cash flows should be relied upon, given that the project owner expects a reasonable level of feasibility attached to the investment.

Design/methodology/approach

The paper presents a formulation for the feasibility of the multi‐project case under uncertainty. A second order moment analysis method is adopted. Existing theory is extended to take into account the presence of multiple projects with a requirement imposed on feasibility by the project owner. In tandem with the theoretical development, example case study numerical results are presented.

Findings

With a conventional deterministic discounted cash flow analysis, the feasibility calculations change little in going from one to many projects. However with uncertainty attached, the feasibility calculations need to be reworked and become more complex, the issue of feasibility becomes less transparent on going from one to many projects, distinct feasibility transition points disappear, and feasibility is found to vary over the projects' time horizons.

Practical implications

The need for the analysis given in this paper resulted from an actual investment decision. The paper formulation provides interesting insight into feasibility calculations, and will be of use to practitioners engaged in front‐end project investment risk work.

Originality/value

The paper provides original commentary on the feasibility of multiple projects and the time‐variant nature of feasibility.
“Perfect storm” boding for the accounting and finance academic disciplines and professions
Authors: Pagani Marco , Turetsky Howard F.
Published: November 2008

Purpose

The purpose of this paper is to analyze the problems faced by Accounting and Finance (A&F) Departments concerning the hiring and retention of tenure/tenure‐track faculty members.

Design/methodology/approach

Analytic research.

Findings

Due to the rigorous Association to Advance Collegiate Schools of Business standards for “academically qualified” classification, increasing enrollment for A&F majors, and demographic trends of faculty members, it is becoming very challenging to hire and retain high‐quality academicians. This challenge is especially dire for public institutions of higher learning that are facing budget cuts and possible steep salary inversion. As an example, the average salary of US faculty members are compared to the salaries allowed under the California State University (CSU) collective bargaining agreement. The paper analytically argues that unless CSU A&F faculty members' salaries are allowed to reflect market conditions, severe negative externalities will impact the educational sector and A&F professionals.

Originality/value

Alumni, the A&F professionals, university administrators and other stakeholders must be made aware of the “perfect storm” on the horizon and the severe consequences that loom in its wake. It will take the collective “wisdom” to provide the necessary strength to resolve these critical issues. Hopefully, the distress siren will not only be heard, but listened to and addressed in a timely manner, so that rather solemn consequences can be avoided. The needs of the college communities at large should not be thwarted by existing inappropriate funding mechanisms.
Stock market liberalization, structural breaks and dynamic changes in emerging market volatility
Authors: Khuong Nguyen Duc , Bellalah Mondher
Published: November 2008

Purpose

This paper aims to empirically reexamine the dynamic changes in emerging market volatility around stock market liberalization.

Design/methodology/approach

First, a bivariate GARCH‐M model which counts for partial market integration is developed for modeling stock market volatility in emerging market countries. Second, the Bai and Perron stability test in a linear framework and a pooled time‐series cross‐section model were employed to examine the empirical relationship between stock market liberalization and volatility.

Findings

Structural breaks detected in emerging market volatility series did not take place at the time of official liberalization dates, but they rather coincide with alternative events of liberalization process. The effects of official liberalization on return volatility are on average insignificant. The stock return volatility is however lowered when the participation of the US investors becomes effective and important on emerging markets, and when emerging markets increase in size.

Research limitations/implications

The study assumes a static degree of market integration. Future research should extend our model by using a time‐varying measure of market integration.

Practical implications

Policymakers in frontier markets should open up local stock markets to attract foreign investments and to allow local firms to benefit from international risk sharing. Also, the gradual embankment of market‐liberalization is necessary to gain investors' confidence and to prevent the harmful effects of foreign capital flows.

Originality/value

The consideration of alternative events of liberalization process and the use of a powerful stability test to examine the time‐series properties of conditional volatilities.
Organisational behaviour associated with emotional contagion among direct selling members
Authors: Hashim Junaidah , Wok Saodah , Ghazali Ruziah
Published: November 2008

Purpose

This paper aims to examine organisational behaviour as a result of emotional contagion experienced by selected members in direct selling companies. Specifically, it seeks to investigate how members in a group are affected by the happiness of their high achievers, what factors influence the emotional contagion to occur, and what are the effects of emotional contagion on individual, group and organisation work outcomes.

Design/methodology/approach

The variables studied were emotional contagion, personal characteristics, group outcomes and organisational outcomes. Emotional contagion was measured by self‐report of impulsive acts; while personal characteristics were measured in terms of social desirability, extraversion, locus of control, live accomplishment, materialistic world, susceptibility to interpersonal influence, and self‐esteem. Organisational outcome variables were measured in terms of organisational commitment and organisational culture. Other variables studied were group behaviour, team player, demographic characteristics, and business organisational characteristics. A total of 276 respondents participated in this study.

Findings

It is found that emotional contagion is positively related with personal outcomes. Further findings reveal that emotional contagion has an impact on both the group and the team. The team, as a whole, is influenced not only by the emotional contagion but also by the personal characteristics of the respondents. Emotional contagion is also related to organisational outcomes. Both the group characteristics are positively related with organisational commitment. Emotional contagion is also positively related to organisational culture. Group characteristics are also positively related with organisational culture. It can be postulated that the following relationships exist between emotional contagion, personal outcomes, group outcomes, and organisational outcomes. It is also found that emotional contagion is a very important variable in the light of personal characteristics, group characteristics and organisational characteristics.

Originality/value

The paper focuses on a specific industry in Malaysia – direct selling – where no such study has been conducted in the past.
Desperately seeking serendipity
Authors: Gilinsky Armand , Santini Cristina , Lazzeretti Luciana , Eyler Robert
Published: November 2008

Purpose

The purpose of this paper is to investigate innovation practice of small family firms. Top management teams’ styles, their strategic orientations, and perceptions of external environment promote or deter innovation.

Design/methodology/approach

Ten Tuscan and ten Californian family wineries are investigated via questionnaire and in‐person interviews to develop longitudinal case studies describing barriers or incentives to innovate.

Findings

Changes in processes, products, or market orientations are subordinated to how top managers perceive internal and external pressure to implement innovation.

Originality/value

This exploratory research proposes a model depicting the extent to which location impacts the selected variables.
Consumer attitudes towards local wines in an emerging region: a segmentation approach
Authors: Kolyesnikova Natalia , Dodd Tim H. , Duhan Dale F.
Published: November 2008

Purpose

The current study is an initial attempt to segment the wine market in an emerging region and examine local residents’ attitudes towards local wines.

Design/methodology/approach

The study was conducted using data collected from US households through a telephone survey. Consumer attitudes towards local wines were operationalized through assessment of local wines; recommendation of local wines to others; and rating of quality of local wines. The K‐means clustering algorithm was applied to classify the respondents into clusters.

Findings

The developing wine market was segmented into four clusters: “local enthusiasts”, “local detractors”, “local advocates” and “local non‐advocates”. Socio‐demographic and wine consumption profiles for each segment are developed. Of particular interest was the difference in recommendation behavior between two of groups of consumers with similar relatively high‐quality ratings and assessments of the local wines. Despite the similarity in attitudes, local advocates are willing to recommend the regional wines to other people, whereas non‐advocates would not recommend them.

Practical implications

By better understanding how information is transferred from one person to the next will assist marketers in their efforts to establish new products or introduce new brands or regional wines.

Originality/value

The market segmentation approach taken in this study is based on local residents’ attitudes towards local wines. The study sets the starting point in investigating new markets consumer characteristics and reasons for their behavior. Of particular interest for future research is consumer recommendation behavior.
Living organisational values: the bridges value inculcation model
Authors: Speculand Robin , Chaudhary Ruchira
Published: November 2008

Purpose

Vision, Mission and Values are buzzwords that many leaders have grasped on to and attempted to adopt. Most, however, have failed to inculcate the values. What is missing is a model to translate values into actions and behviours.

Design/methodology/approach

The Value Inculcation Model introduces a four step approach that links Values to Organizational Performance. It is based on ten years research and work by Bridges Business Consultancy Int.

Findings

By identifying core values, changing attitudes and encouraging new behaviours, the organisation will start to transform.

Originality/value

Identifying the values for an organisation is only step one of a four step process. To successfully become a value‐driven organisation, leaders must translate core values into what it means to staff member's attitude and behaviours and then consider the overall impact to Organisational performance.
Oxidative stress and its determinants in the airways of children with asthma
Authors: Dut R. , Dizdar E. A. , Birben E. , Sackesen C. , Soyer O. U. , Besler T. , Kalayci O.
Published: November 2008

Background:  There is ample evidence for the existence of a systemic oxidative stress in childhood asthma but relatively little information on the oxidant stress in the airways.

Objective:  To determine the extent of oxidant/antioxidant imbalance and describe its determinants in the airways of asthmatic children including asthma severity and the genotype of the antioxidant enzymes.

Methods:  One hundred and ten children with mild asthma, 30 children with moderate asthma and 191 healthy controls were included in the study. Exhaled breath condensate (EBC) was collected from all children with EcoScreen®. Levels of malondialdehyde were measured as the indicator of oxidative stress, and of reduced glutathione as the indicator of antioxidant defense. Children were genotyped for the presence of null variants of glutathione S transferase (GST) T1 and GSTM1, and ile105val variant of GSTP1. Risk factors were analyzed with multivariate logistic regression.

Results:  EBC contained significantly higher levels of malondialdehyde and lower levels of reduced glutathione in asthmatic children compared with healthy controls (P < 0.001 for each), whereas there was no difference between mild and moderate asthmatics. Multivariate logistic regression identified asthma as the only independent factor contributing to oxidative stress. Genotypes of the antioxidant enzymes had no effect on the oxidative burden.

Conclusions:  Asthma is associated with an extremely powerful oxidative stress not only in the systemic circulation but also in the airways.
A Comparison of the Relative Efficacy of CAPD and Hernodialysis in the Control of Solute Concentration
Authors: Hiatt Mary P. , Pyle W. Keith , Moncrief Jack W. , Popovich Robert P.
Published: November 2008

Metabolite concentrations found in patients on both continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis are predicted by means of a theoretical transport model. Effects of variation in parameters such as generation rate, mass transfer coefficients and residual renal clearance are studied. The information obtained indicates that CAPD is as effective as hemodialysis in reducing the concentrations of low molecular weight metabolites occurring in the “average” ESRD patient. CAPD becomes increasingly more effective than hernodialysis as molecular weight increases.
Feasibility of Extracorporeal On‐Line Large‐Scale Plasma Adsorptions on Protein A‐Sepharose Columns in Cancer Patients
Authors: Wallmark Anders , Grubb Anders , Freiburghaus Christian , Flodgren Per , Husberg Bo , Lindholm Tore , Lindström Clas , Thysell Hans , Sjögren Hans O.
Published: November 2008

Abstract: The feasibility of extracorporeal adsorption of 1.5‐3 L plasma on protein A‐Sepharose was investigated in six patients with advanced cancer. Anticoagulation with heparin was associated with respiratory distress syndrome in two patients, most likely caused by complement activation as indicated by a transient leukopenia during plasma reinfusion and appearance of C3 degradation products in the extracorporeal circulation. Addition of citrate abolished the respiratory symptoms, C3 degradation, and leukopenia, and no adverse reactions were observed. No objective tumor regression was observed in any of the patients. Three patients progressed during therapy. In one of these, multifocal central tumor necrosis was observed as a possible, although unproven, therapeutic effect. Increased natural killer and/or killer cell activities were recorded in three patients and increased complement‐dependent serum cytotoxicity in one patient. The level of circulating immune complexes decreased significantly (18–28%) in three patients studied. It is concluded that extracorporeal plasma adsorption on protein A‐Sepharose is feasible when citrate is added to the extracorporeal system, but its therapeutic efficacy is uncertain.
Human Thoracic Anatomy Based on Computed Tomography for Development of a Totally Implantable Left Ventricular Assist System
Authors: Fujimoto Luiz K. , Jacobs Gordon , Przybysz Jeff , Collins Steven , Meaney Thomas , Smith William A. , Kiraly Raymond J. , Nosé Yukihiko
Published: November 2008

Abstract: Human thoracic anatomy was studied using computed tomography (CT) for the development of a totally implantable electrohydraulic left ventricular system [Nimbus, Inc., and The Cleveland Clinic Foundation (CCF)]. To obtain statistical dimensional information for the chest wall, apex of the heart, and aorta, routine calibrated CT scans of 18 men and 17 women were analyzed. A special radiopaque vest was worn by the patient just prior to the scanning and X‐ray procedures, so that each transverse scan could be assigned to a specific chest level after combination with a standard vertical referencing system set on the patient's radiogram. A polar coordinate system and direct measurement of transverse distances from the vertical column to points on the chest wall were employed to define collectively the shape and size of the intrathoracic surface of the chest wall. Locations of the aorta and apex were described by measuring their normalized distances from the midline and vertical column to the intrathoracic surface of the lateral and anterior chest wall. The radius of curvature of the intrathoracic wall lateral to the left ventricle was determined to be ˜ 10.4 cm for the average adult male chest. The present CCF intrathoracic pump with this curvature fits fairly well in both the average and individual thoraxes of these adult males. The location of the aorta, particularly of the descending aorta, was used to determine the optimal outlet design. The most critical anatomical area was the apex location. For adult males, an average distance of 2.8 cm from the apex to the internal chest wall was found. Because of this small dimension, careful design of the inflow port is being performed to avoid anatomical mismatch.
Adequacy of Dialysis: Marker Molecules and Kinetic Modeling
Authors: Farrell Peter C.
Published: November 2008

Abstract: The effective use of kinetic modeling to assess adequacy of dialysis, based upon marker molecules, is in its infancy. However, for the patient, perhaps the most identifiable benefit of modeling is that the technical parameters of the therapy are at least being measured and monitored. With regard to choice of marker molecules, the National Dialysis Cooperative Study (NCDS) group, in choosing urea as the reference molecule, has given a useful impetus to its wider use. Since urea is directly connected with dietary protein intake and its net generation is also directly correlated with that of other metabolites, its application as a marker molecule makes good sense. Analysis of the NCDS data has permitted identification of a very useful quantitative parameter of minimal dialysis therapy based on urea clearance and distribution volume and dialysis time. For thrice‐weekly dialysis, normalized whole body urea clearance (Kt/V) should be s ≥1.0 and less than ˜1.5. Although this alone does not guarantee adequate dialysis, it does alert the dialysis staff to the potential for both under‐and over‐dialysis. It would thus appear that currently the most reliable and useful means by which to apply modeling techniques to dialysis therapy is urea kinetics. In time, the application of more broad‐based modeling techniques to dialysis therapy will provide more clearly identifiable clinical benefits, as well as the already realizable economic benefits.
Newly Developed Circulating Blood Volume‐Monitoring System and Its Clinical Application for Measuring Changes in Blood Volume During Hemofiltration
Authors: Maeda Kenji , Shinzato Takahiro , Yoshida Fuminao , Tsuruta Yoshinari , Usuda Masatsune , Yamada Kazumasa , Ishihara Toshikazu , Inagaki Futoshi , Igarashi Isemi , Kitano Tomoyuki
Published: November 2008

Abstract: Blood and ultrafiltrate electrical resistivities were continuously monitored during hemofiltration. By substituting these values into a previously developed equation that was modified by the authors, the hematocrit value was determined; and blood volume change was obtained from the change in this value. The following facts were discovered as the result of monitoring the blood volume change during treatment: (a) When the body position was changed from the reclining to the sitting position, the blood volume decreased by 4.2 ± 0.3%. (b) With the body water removal rate kept constant, the body position recumbent, and the subject fasted, the blood volume gradually decreased. However, when the position was changed from reclining to sitting for food intake and once more returned to the supine position after the meal, the blood volume was greatly affected by the change in position and the food intake.
Endothelium: The Next Frontier in Biocompatibility
Authors: von Appen Kai , Ivanovich Peter , Mujais Salim , Klinkmann Horst
Published: November 2008

Abstract: Vascular endothelium plays a central role in two specific functional systems. It controls vascular tone, hemostasis, and substance transport. The endothelium is the “docking station” for trapping, deactivation, and re‐generation of activated blood compounds and provides the principal clearance mechanism for biologically active mediators released by different cell types. The second function is a regenerational one. During the period between insults (or between dialysis sessions), the endothelium has to restore the “first line of defense,” that is, to regenerate the injured athrombogenic surface of the vessel wall and its antioxidative potential, defoliate damaged endothelial cells, and interpolated new ones. These two important endothelial activities are required over and above its basic functions. Future research in artificial organs must take into account that continuous or intermittent blood‐membrane contact creates an altered endothelial response. These altered responses may result in adaptional reactions that may differ substantially in the acutely ill patient on continuous venovenous hemofiltration (CVVH) or in a stable patient on maintenance hemodialysis. By a reduction in such factors as immediate or delayed cell‐cell interactions (direct or indirect), it may be possible to influence the long‐term outcome of chronic hemodialysis patients. Other research should strive to enhance those factors of endothelial function that are essential in the defensive and restorative properties of endothelial tissue. This is especially important in such continuous therapies as CVVH, long‐term membrane oxygenation, and artificial heart and blood vessels. Currently, there are more unanswered questions than possible answers concerning endothelial functions in long‐term hemodialysis patients, but it is clear that excluding endothelial cell behavior from investigation of extracorporeal therapy in the future would be a substantial omission.
Muscle‐ and Pneumatic‐Powered Counterpulsating LVADs: A Pilot Study
Authors: Wilde J.C.H. , van Ioon J. , Bishop N.D. , Shelton A. Dehlavi , Marten C. , Kolff W.J. , Stephenson L. , Baciewicz F. , Nakajima H. , Thomas G. , Hammond B.
Published: November 2008

Abstract: There is a worldwide interest in supporting the failing heart with a skeletal muscle by either wrapping it around the natural heart (dynamic cardiomyoplasty) or by constructing a skeletal muscle ventricle (SMV) used for counterpulsation. Conventional cardiomyoplasty in many clinics carries an operative mortality rate of 15–20% partly because it requires 6 weeks to train the muscle to contract continually. A flexible, pear‐shaped blood pump with an inflatable air chamber was designed and made around which a muscle can be wrapped. The advantage of our design is that it can also be driven by pneumatic power, immediately supporting the circulation of a seriously ill patient while that patient is still on the operating table. After a period of time to allow for revascularization and the subsequent training of the muscle, the external pneumatic power can be gradually discontinued. Then the assisted patient becomes tether‐free. If, at any time, the muscle power fails, the pneumatic‐powered mechanism can be reactivated. In the preferred approach, the blood pump is connected to the aorta for diastolic counterpulsation. A muscle can either be wrapped around the blood pump directly, or around one of two separate muscle pouches connected to the blood pump. To facilitate surgery, a large pouch is inserted under the musculus latissimus dorsi, which is connected to a blood pump. When stimulated, the muscle will contract over the pouch compressing it and providing power to the blood pump. If it is found that the pressure generated in the pouch cannot meet the aortic blood pressure, it can be augmented by using a pressure amplifier. An amplifier has been designed and constructed that can be incorporated into the pouch under the musculus latissimus dorsi. Once again, an external pneumatic power source could be used to drive this system while the muscle is being trained. We can make our pouches and pumps available to surgeons for experimental work if they are willing to test them.
The Adequacy of Fragmin as a Single Bolus Dose with Reused Dialyzers
Authors: Kerr P.G. , Mattingly S. , Io A. , Atkins R.C.
Published: November 2008

Abstract: Thirty‐four hemodialysis patients were studied in a crossover fashion to compare the effectiveness of bolus‐dose Fragmin (a low molecular weight heparin) with regular heparin usage in hemodialysis. For each anticoagulant, 3 dialyzes were studied for each patient; the first sessions involved a new dialyzer, and the subsequent sessions involved dialyzers reprocessed with peracetic acid. To assess the effectiveness of the anticoagulation regimens, the following were measured: the dialyzer fiber bundle volume and the instantaneous dialyzer clearances for urea (1 h into the second session). In addition, factor Xa levels were measured in 5 patients during the first and second sessions at 0 min, 30 min, and 4 h. Fiber bundle volumes were (in ml) 75.4 ± 8.8, 73.0 ± 8.9, and 73.5 ± 7.6 on first, second, and third uses with Fragmin (p = ns); and 77.8 ± 9.0, 73.4 ± 8.1, and 73.8 ± 8.1 with heparin (p < 0.001 second and third vs. first). Thus, there were no significant differences between Fragmin and heparin. Instantaneous dialyzer clearances were 165.8 ± 12.6ml/min with Fragmin and 163.8 ± 9.8 with heparin (p = ns). Factor Xa levels were 0 predialysis, 0.81 ± 0.17 U/ml at 30 min on first use, and 0.92 ± 0.09 U/ml on second use (p = ns); they were 0.51 ± 0.21 U/ml at 4 h on first use and 0.61 ± 0.16 U/ml on second use (p = ns). Thus, bolus‐dose Fragmin provided similar results to constant infusion heparin and is not deleteriously influenced by reprocessing dialyzers with peracetic acid.
Comparison of Echocardiographic Changes Associated with Hemodialysis and Renal Transplantation
Authors: Lima José J.G. De , Abensur Henry , da Fonseca Jo˜o Américo , Krieger Eduardo M. , Pileggi Fúlvio
Published: November 2008

Abstract: Long‐term hemodialysis has been reported to cause progression of left ventricular (LV) hypertrophy with a tendency toward asymmetric septal hypertrophy. Renal transplantation is believed to reverse some of these changes. The aim of this prospective study was to compare the effects of long‐term hemodialysis and of successful renal transplantation on cardiac structure and function assessed by echocardiography. Fifty‐three patients were submitted to two echocardiographic evaluations separated by a 30 ± 8 month interval. At the first control, all patients were on hemodialysis; at the second, 36 patients remained on dialysis while 17 had been submitted to renal transplantation. Age (44 ± 13 vs. 40 ± 10 years), gender (male, 50% vs 53%), and duration of dialysis at the initiation of the study (43 ± 34 vs. 47 ± 32 months) were comparable in the 2 groups. The prevalences of LV hypertrophy were 83% (first control) and 69% (second control) in the dialysis group and 82% and 71% in the transplant group. Comparisons between the two periods within each group showed that hemodialysis was associated with a significant reduction of the E/A ratio (1.25 ± 0.4 vs. 1.02 ± 0.4, p < 0.001) and systolic (155 ± 28 vs. 137 ± 26 mm Hg, p < 0.001) and diastolic (94 ± 21 vs. 84 ± 16 mm Hg, p < 0.05) blood pressure, and no change in LV mass index (171 ± 51 vs. 156 ± 43 g/m2, NS). In the transplanted group, there were reductions in the E/A ratio (1.42 ± 0.6 vs. 1.10 ± 0.4, p < 0.05) and in LV diastolic dimension (50 ± 7 vs. 46 ± 5 mm, p < 0.05), but not in systolic (155 ± 27 vs. 152 ± 31 mm Hg, NS) or diastolic (97 ± 11 vs. 97 ± 20 mm Hg, NS) blood pressure. The LV mass index also did not change significantly (157 ± 51 vs. 133 ± 31 g/m2, NS). Left atrium dimension, LV posterior wall thickness, interventricular septum thickness, and fractional shortening were not significantly changed in either group. Asymmetric septal hypertrophy was not observed. It is concluded that patients treated by long‐term hemodialysis did not present progression in the degree and prevalence of LV hypertrophy over time while systolic function was preserved and diastolic function deteriorated. Contrary to previous reports, successful renal transplantation did not cause a reduction in LV hypertrophy and also failed to improve LV diastolic function.
Association of human NAD(P)H:quinone oxidoreductase 1 (NQO1) polymorphism with development of acute lung injury
Authors: Reddy Anita J. , Christie Jason D. , Aplenc Richard , Fuchs Barry , Lanken Paul N. , Kleeberger Steven R.
Published: November 2008

Acute lung injury (ALI) is a syndrome with significant morbidity and mortality, but its genetic susceptibility is not clearly understood. In the present study, we characterized functional promoter single nucleotide polymorphisms (SNPs) in the phase II antioxidant gene NQO1 (NAD(P)H:quinone oxidoreductase1) to evaluate its role in susceptibility to ALI. Three previously uncharacterized SNPs in the NQO1 promoter were selected for investigation. Luciferase assays were performed using constructs of each promoter polymorphism to evaluate function. Functional SNPs were genotyped in a prospective cohort of major trauma patients (N= 264) and assessed for association with development of ALI. The A/C SNP at −1221 decreased in vitro transcription of NQO1 at baseline and after exposure to hyperoxia and other oxidant stressors. Patients heterozygous for the −1221 C allele were at significantly lesser risk of ALI after major trauma compared with patients with wild‐type alleles, even after adjustment for APACHE III score, and mechanism of trauma [OR, 0.46 (95% CI 0.23, 0.90); P= 0.024]. This study demonstrated that the AC genotype at position −1221 in the NQO1 gene caused decreased transcription and was associated with a lower incidence of ALI following major trauma. These novel findings may have important implications in diseases with oxidant stress aetiologies.