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Repositioning
Kinds of Repositioning Selected AbstractsPOST-MERGER PRODUCT REPOSITIONING,THE JOURNAL OF INDUSTRIAL ECONOMICS, Issue 1 2008AMIT GANDHI This paper analyzes the effects of mergers between firms competing by simultaneously choosing price and location. Products combined by a merger are repositioned away from each other to reduce cannibalization, and non-merging substitutes are, in response, repositioned between the merged products. This repositioning greatly reduces the merged firm's incentive to raise prices and thus substantially mitigates the anticompetitive effects of the merger. Computation of, and selection among, equilibria is done with a novel technique known as the stochastic response dynamic, which does not require the computation of first-order conditions. [source] Healing of 208 intraalveolar root fractures in patients aged 7,17 yearsDENTAL TRAUMATOLOGY, Issue 2 2001Miomir Cvek Abstract , This retrospective study consisted of 208 root-fractured, 168 splinted and 40 not splinted incisors in young individuals (aged 7,17 years) treated in the period 1959,1973 at the Pedodontic Department, Eastman Institute, Stockholm. Clinical and radiographic analyses showed that 69 teeth (33%) had developed hard tissue (fusion) healing of fragments. Interposition of periodontal ligament (PDL) and bone between the fragments was found in 17 teeth (8%). Interposition of PDL alone was found in 74 teeth (36%). Finally, non-healing with pulp necrosis and inflammatory changes between fragments was seen in 48 teeth (23%). Various clinical factors were analyzed for their relationship to the healing outcome with respect to healing/no healing and type of healing (hard tissue versus interposition of bone and/or PDL). Immature root and positive pulp sensitivity at time of injury was found to be significantly related to both pulp healing and hard tissue repair of the fracture. The same applied to concussion or subluxation of the coronal fragment compared to luxation with displacement (extrusive or lateral luxation). This relation was also represented by the variable millimeter diastasis between fragments before and after repositioning. Repositioning appeared to enhance the likelihood of both pulp healing and hard tissue repair. A positive effect of splinting, splinting methods (cap splints or orthodontic bands with an arch wire) or splinting periods could not be demonstrated on either pulp healing or type of healing (hard tissue versus interposition of bone and/or PDL). In conclusion, the findings from this retrospective study have cast doubts on the efficacy of long-term splinting and the types of splint used for root fracture healing. It is suggested that the role of splinting and splinting methods be examined in further studies. [source] Comments on the mechanism of attachment in species of the monogenean genus GyrodactylusINVERTEBRATE BIOLOGY, Issue 1 2003Andrew P. Shinn Abstract. In species of the monogenean helminth Gyrodactylus, the opisthaptor is the main organ of attachment to the host. The opisthaptor comprises two large centrally positioned hooks or hamuli and sixteen peripherally distributed marginal hooks. This paper describes the functional morphology and the mechanism and sequence of attachment in this species. Information on the attachment process was gathered from observations of live gyrodactylids, from transmission electron microscopy, from scanning electron microscopy of skeletal elements, and by histochemical and X-ray elemental analysis of hook chemical composition. The marginal hooks provide the principal force of attachment whilst the hamuli are not actively employed in the process of attachment. Instead, the hamuli provide a system preventing accidental dislodgement and assist the action of the marginal hooks. Attachment is achieved by the alternating action of two systems of muscles attached respectively to the hamuli and to the marginal hooks. Relaxation or contraction of the muscles connected to the hamuli manoeuvres the hamuli over the extremities of the accessory ventral bar and allows them to pivot around their longitudinal axis, effectively raising or lowering the opisthaptoral dome. Under reduced opisthaptoral tension, the independent gaffing activity of the marginal hooks ensures a secure attachment to the host's epidermis. Repositioning of the hamuli then raises the opisthaptoral dome to tension the peripheral marginal hooks. The sequence of attachment is complete when all the muscles associated with the hooks are in a state of relaxation but are held securely and under tension by the surrounding, stretched, opisthaptoral dome. [source] Surgical repositioning of a traumatically intruded permanent incisor in a patient with rheumatic fever: case reportDENTAL TRAUMATOLOGY, Issue 1 2009Rosana Sales Dias However, it is one of the most severe types of dentoalveolar trauma. By definition, intrusive luxation consists of the axial displacement of the tooth into the alveolar bone, accompanied by comminution or fracture of the alveolar bone. Here we report the treatment management of a traumatically intruded immature permanent central incisor by surgical repositioning undertaken in a 10-year-old child with rheumatic fever 10 days after sustaining a severe dentoalveolar trauma. The intraoral examination showed the complete intrusion of the permanent maxillary right central incisor and the radiographic examination revealed incomplete root formation. Prophylactic antibiotic therapy was prescribed and the intruded tooth was surgically repositioned and endodontically treated thereafter. The postoperative course was uneventful, with both clinically and radiographically sound conditions of the repositioned tooth up to 3 years and 2 months of follow-up. These outcomes suggest that surgical repositioning combined with proper antibiotic prophylaxis and adequate root canal therapy may be an effective treatment option in cases of severe intrusive luxations of permanent teeth with systemic involvement. [source] Rapidly progressive internal root resorption: a case reportDENTAL TRAUMATOLOGY, Issue 5 2008David Keinan Usually the process is asymptomatic and diagnosed upon routine radiographic examination. This case report presents a rapid progression of internal resorption related directly to traumatic injury. A 16-year-old female arrived at the emergency room after a mild extrusion of the mandibular incisors. The initial treatment included repositioning and splinting of the teeth. Radiographs performed at repositioning and splinting demonstrated normal configuration of the incisor's roots. Ten months later progressive internal resorption of the left mandibular first incisor was diagnosed. While treating this tooth similar process was detected in the right mandibular second incisor and in the mandibular left second incisor. The lower right first incisor reacted inconsistently to vitality test. As a result of the severe and rapidly progressive nature of the process, root canal treatments were performed in all lower incisors. The follow-up radiographs demonstrate arrest of the internal resorption process. [source] Dental trauma that require fixation in a children's hospitalDENTAL TRAUMATOLOGY, Issue 1 2008Timothy Bruns Complex injuries to permanent teeth and their periodontium require immediate repositioning and stabilization. Many of these emergencies are treated by pediatric dental residents at the Women and Children's Hospital of Buffalo, Buffalo, New York. The purpose of this study was to characterize these complex injuries of permanent teeth that require emergency treatment in a Children's Hospital. All of the cases of dental trauma which had involved permanent teeth and which had been treated with a splint in 2001 and 2002 were reviewed. There were 79 patients that were between 5 and 19 years of age with twice as many males (54) as females (25). The number of males increased from childhood (5,10 years) to early adolescence (11,15 years) and then decreased rapidly in late adolescence (16,19 years), whereas the number of females decreased steadily with age. Most of the incidents occurred during the summer months (72%), particularly in June and July (42%), and Fridays and Saturdays were the busiest days of the week. Most of the injuries were caused by organized and recreational sporting activities (39%) and accidental falls (33%), followed by interpersonal violence (15%) and a few motor vehicle accidents (7%). The 173 permanent tooth injuries were mostly luxations (62%) or avulsions (20%), with only a few fractures of the alveolar bone (5%) or tooth root (1%). Most of the displacements were lateral luxations (40%) or extrusions (18%) with only a few intrusions (3%). These injuries most commonly afflicted the maxillary central incisors (54%), followed by the maxillary laterals (18%) and mandibular centrals (17%). The emergency treatment that was provided at the Children's Hospital included replantation and repositioning, and the placement of a semi-rigid or flexible splint. [source] Immediate surgical repositioning following intrusive luxation: a case report and review of the literatureDENTAL TRAUMATOLOGY, Issue 6 2006H. Cem Güngör Abstract,,, This report presents a case of severe intrusive luxation of mature maxillary lateral incisor in a 10-year-old boy. The intruded tooth was immediately repositioned (surgical extrusion) and splinted within 2 h following injury. Tetracycline therapy was initiated at the time of repositioning and maintained for 10 days. Pulp removal and calcium hydroxide treatment of the root canal was carried out after repositioning. Splint was removed 1 month later. Definitive root canal treatment with gutta percha was accomplished at the second month recall. Clinical and radiographic examination 28 months after the surgical extrusion revealed satisfactory apical and periodontal healing. [source] Healing of 400 intra-alveolar root fractures.DENTAL TRAUMATOLOGY, Issue 4 2004Abstract,,, This is the second part of a retrospective study of 400 root-fractured permanent incisors. In this article, the effect of various treatment procedures is analyzed. Treatment delay, i.e. treatment later than 24 h after injury, did not change the root fracture healing pattern, healing with hard tissue between fragments (HH1), interposition of bone and/or periodontal ligament (PDL) or pulp necrosis (NEC). When initial displacement did not exceed 1 mm, optimal repositioning appeared to significantly enhance both the likelihood of pulpal healing and hard tissue repair (HH1). Significant differences in healing were found among the different splinting techniques. The lowest frequency of healing was found with cap splints and the highest with fiberglass or Kevlar® splints. The latter splinting procedure showed almost the same healing result as non-splinting. Comparison between non-splinting and splinting for non-displaced teeth was found to reveal no benefit from splinting. With respect to root fractures with displacement, too few cases were available for analysis. No beneficial effect of splinting periods greater than 4 weeks could be demonstrated. The administration of antibiotics had the paradoxical effect of promoting both HH1 and NEC. No explanation could be found. It was concluded that, optimal repositioning seems to favor healing. Furthermore, the chosen splinting method appears to be related to healing of root fractures, with a preference to pulp healing and healing fusion of fragments to a certain flexibility of the splint and possibly also non-traumatogenic splint application. Splinting for more than 4 weeks was not found to influence the healing pattern. A certain treatment delay (a few days) appears not to result in inferior healing. The role of antibiotics upon fracture healing is questionable. [source] Influence of surgical repositioning of mature permanent dog teeth following experimental intrusion: a histologic assessmentDENTAL TRAUMATOLOGY, Issue 6 2002R. F. Cunha Abstract,,, The aim of this study was to evaluate, through histologic examination, the effect of surgical repositioning of intruded dog teeth upon the pulpal and surrounding tissues. Thirty teeth in 10 adult dogs, aged 2,3 years, were used. Fifteen teeth were intruded, surgically repositioned and fixed using orthodontics wire, composite resin, and enamel acid conditioning. All these teeth served as the experimental group. The remaining intruded teeth were not treated (control group). The animals were sacrificed to allow observations at 7, 15, and 30 post-operative days. The maxillary and mandibular archs were removed and processed for histologic exam. Based on the methodology and observed results, we concluded that: pulpal necrosis, external root resorption and ankylosis were common sequelae to severe traumatic intrusion; a careful immediate surgical repositioning of severed intruded permanent tooth with complete root formation has many advantages with few disadvantages. [source] Conceptualizing Corporate Entrepreneurship StrategyENTREPRENEURSHIP THEORY AND PRACTICE, Issue 1 2009R. Duane Ireland Our knowledge of corporate entrepreneurship (CE) continues to expand. However, this knowledge remains quite fragmented and non-cumulative. Herein, we conceptualize CE strategy as a useful focal point for integrating and synthesizing key elements within CE's intellectual domain. The components of our CE strategy model include (1) the antecedents of CE strategy (i.e., individual entrepreneurial cognitions of the organization's members and external environmental conditions that invite entrepreneurial activity), (2) the elements of CE strategy (i.e., top management's entrepreneurial strategic vision for the firm, organizational architectures that encourage entrepreneurial processes and behavior, and the generic forms of entrepreneurial process that are reflected in entrepreneurial behavior), and (3) the outcomes of CE strategy (i.e., organizational outcomes resulting from entrepreneurial actions, including the development of competitive capability and strategic repositioning). We discuss how our model contributes to the CE literature, distinguish our model from prior models, and identify challenges future CE research should address. [source] Uterine torsion diagnosed in a mare at 515 days' gestationEQUINE VETERINARY EDUCATION, Issue 10 2010C. López Summary A pregnant mare with a history of prolonged gestation (,515 days) and suspected diagnosis of fetal mummification was examined. Rectal palpation revealed that the left broad ligament of the uterus was dorsal and medial to the right uterine ligament and it was not possible to observe the cervix during vaginal examination. Transabdominal ultrasound revealed fluid in the uterus, fetal membranes and the uterine walls defined and thickened. Free fluid was not seen in the peritoneal cavity. Laboratory tests (blood cell count and clinical chemistry) were normal. Based on clinical history, physical examination and ultrasound findings, a chronic uterine torsion with fetal death was diagnosed and the mare was subjected to exploratory celiotomy. The uterus was strongly adhered to the peritoneum of the ventral abdominal wall and there were multiple adhesions to the colon. Hysterotomy was performed to remove the fetus and to permit repositioning of the uterus. When the fetus was removed, a large devitalised grey tissue area of the right ventral uterine horn was observed. Multiple adhesions prevented a rescue hysterectomy and euthanasia of the patient was performed. During the necropsy, a 180° cranial cervix clockwise uterine torsion was observed. This rare case of uterine torsion appears to be the most chronic case reported in the equine literature. [source] Nuclear repositioning marks the selective exclusion of lineage-inappropriate transcription factor loci during T helper cell differentiationEUROPEAN JOURNAL OF IMMUNOLOGY, Issue 12 2004Susannah Abstract To address how heritable patterns of gene expression are acquired during the differentiation of Th1 and Th2 cells, we analyzed the nuclear position of lineage-restricted cytokine genes and their upstream regulators by 3-dimensional fluorescence in situ hybridization. During Th1 differentiation, GATA-3 and c-maf loci, which encode upstream regulators of Th2 cytokines, were progressively repositioned to centromeric heterochromatin as defined by a ,-satellite repeat probe and/or the nuclear periphery, compartments that have been associated with transcriptional repression. A third transcription factor locus, T-bet, which controls Th1-specific programs, was subject to de novo CpG methylation in a Th2 cell clone. In contrast, we did not find repositioning of the cytokine gene loci IL-2, IL-3, IL-4 or IFN-, during T helper cell differentiation. Instead, IFN-, was constitutively associated with the nuclear periphery, even when primed for expression in Th1 cells. Our results suggest that Th1/Th2 lineage commitment and differentiation involve repositioning of the regulators of cytokine expression, rather than the cytokine genes themselves. [source] A radialization factor in normal cortical plate restores disorganized radial glia and disrupted migration in a model of cortical dysplasiaEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 3 2003Thomas A. Hasling Abstract Treatment of pregnant ferrets on embryonic day 24 (E24) with the antimitotic methylazoxy methanol (MAM) leads to a specific constellation of effects in newborn kits, which include a very thin and poorly laminated neocortex, disruption of radial glial cell morphology with early differentiation into astrocytes, and abnormal positioning of Cajal,Retzius cells. We suggest that MAM treatment on E24 results in this model of cortical dysplasia by eliminating a population of cells that produce a factor capable of maintaining radial glia in their normal morphology. The abnormal radial glia, either alone or in combination with other abnormal features, are likely to prevent proper migration into the cortical plate. To test the possibility that normal cortex can provide the missing substance that influences radial glia, slices of E24 MAM-treated cortex were removed at postnatal day 0 (P0) and cultured adjacent to explants of P0 normal cortical plate. By labelling a small number of cells with injections of fluorescent dextrans into the cultured slices, we found that abnormal radial glia in MAM treated slices cocultured adjacent to normal cortical plate were restored toward normal, in comparison to E24 MAM treated slices cultured alone and in other control conditions. We also found that abnormally positioned Cajal,Retzius cells move into the marginal zone and that neurons are able to migrate into the cortical plate more effectively in the coculture condition. These data indicate that normal cortical plate of ferrets contains a factor causing radial glia to maintain their elongated morphology; the improved position of radial glia encourages repositioning of Cajal,Retzius cells and improved neuronal migration into the cortical plate. [source] Globalization and the transformation of the national political space: Six European countries comparedEUROPEAN JOURNAL OF POLITICAL RESEARCH, Issue 6 2006HANSPETER KRIESI The structural opposition between globalization ,winners' and ,losers' is expected to constitute potentials for political mobilization within national political contexts, the mobilization of which is expected to give rise to two intimately related dynamics: the transformation of the basic structure of the national political space and the strategic repositioning of the political parties within the transforming space. The article presents several hypotheses with regard to these two dynamics and tests them empirically on the basis of new data concerning the supply side of electoral politics from six Western European countries (Austria, Britain, France, Germany, the Netherlands and Switzerland). The results indicate that in all the countries, the new cleavage has become embedded into existing two-dimensional national political spaces, that the meaning of the original dimensions has been transformed, and that the configuration of the main parties has become triangular even in a country like France. [source] Deamidation of labile asparagine residues in the autoregulatory sequence of human phenylalanine hydroxylaseFEBS JOURNAL, Issue 5 2003Structural, functional implications Two dimensional electrophoresis has revealed a microheterogeneity in the recombinant human phenylalanine hydroxylase (hPAH) protomer, that is the result of spontaneous nonenzymatic deamidations of labile asparagine (Asn) residues [Solstad, T. and Flatmark, T. (2000) Eur. J. Biochem.267, 6302,6310]. Using of a computer algorithm, the relative deamidation rates of all Asn residues in hPAH have been predicted, and we here verify that Asn32, followed by a glycine residue, as well as Asn28 and Asn30 in a loop region of the N-terminal autoregulatory sequence (residues 19,33) of wt-hPAH, are among the susceptible residues. First, on MALDI-TOF mass spectrometry of the 24 h expressed enzyme, the E. coli 28-residue peptide, L15,K42 (containing three Asn residues), was recovered with four monoisotopic mass numbers (i.e., m/z of 3106.455, 3107.470, 3108.474 and 3109.476, of decreasing intensity) that differed by 1 Da. Secondly, by reverse-phase chromatography, isoaspartyl (isoAsp) was demonstrated in this 28-residue peptide by its methylation by protein- l -isoaspartic acid O -methyltransferase (PIMT; EC 2.1.1.77). Thirdly, on incubation at pH 7.0 and 37 °C of the phosphorylated form (at Ser16) of this 28-residue peptide, a time-dependent mobility shift from tR,,34 min to ,,31 min (i.e., to a more hydrophilic position) was observed on reverse-phase chromatography, and the recovery of the tR,,34 min species decreased with a biphasic time-course with t0.5 -values of 1.9 and 6.2 days. The fastest rate is compatible with the rate determined for the sequence-controlled deamidation of Asn32 (in a pentapeptide without 3D structural interference), i.e., a deamidation half-time of ,,1.5 days in 150 mm Tris/HCl, pH 7.0 at 37 °C. Asn32 is located in a cluster of three Asn residues (Asn28, Asn30 and Asn32) of a loop structure stabilized by a hydrogen-bond network. Deamidation of Asn32 introduces a negative charge and a partial ,-isomerization (isoAsp), which is predicted to result in a change in the backbone conformation of the loop structure and a repositioning of the autoregulatory sequence and thus affect its regulatory properties. The functional implications of this deamidation was further studied by site-directed mutagenesis, and the mutant form (Asn32,Asp) revealed a 1.7-fold increase in the catalytic efficiency, an increased affinity and positive cooperativity of L-Phe binding as well as substrate inhibition. [source] Surgical treatment of migraine headaches.HEADACHE, Issue 3 2003B Guyuron Plast Reconstr Surg. 2002 Jun;109(7):2183-2189 This prospective study was conducted to investigate the role of removal of corrugator supercilii muscles, transection of the zygomaticotemporal branch of the trigeminal nerve, and temple soft-tissue repositioning in the treatment of migraine headaches. Using the criteria set forth by the International Headache Society, the research team's neurologist evaluated patients with moderate to severe migraine headaches, to confirm the diagnosis. Subsequently, the patients completed a comprehensive migraine headaches questionnaire and the team's plastic surgeon injected 25 units of botulinum toxin type A (Botox) into each corrugator supercilii muscle. The patients were asked to maintain an accurate diary of their migraine headaches and to complete a monthly questionnaire documenting pertinent information related to their headaches. Patients in whom the injection of Botox resulted in complete elimination of the migraine headaches then underwent resection of the corrugator supercilii muscles. Those who experienced only significant improvement underwent transection of the zygomaticotemporal branch of the trigeminal nerve with repositioning of the temple soft tissues, in addition to removal of the corrugator supercilii muscles. Once again, patients kept a detailed postoperative record of their headaches. Of the 29 patients included in the study, 24 were women and five were men, with an average age of 44.9 years (range, 24 to 63 years). Twenty-four of 29 patients (82.8 percent, p < 0.001) reported a positive response to the injection of Botox, 16 (55.2 percent, p < 0.001) observed complete elimination, eight (27.6 percent, p < 0.04) experienced significant improvement (at least 50 percent reduction in intensity or severity), and five (17.2 percent, not significant) did not notice a change in their migraine headaches. Twenty-two of the 24 patients who had a favorable response to the injection of Botox underwent surgery, and 21 (95.5 percent, p < 0.001) observed a postoperative improvement. Ten patients (45.5 percent, p < 0.01) reported elimination of migraine headaches and 11 patients (50.0 percent, p < 0.004) noted a considerable improvement. For the entire surgical group, the average intensity of the migraine headaches reduced from 8.9 to 4.1 on an analogue scale of 1 to 10, and the frequency of migraine headaches changed from an average of 5.2 per month to an average of 0.8 per month. For the group who only experienced an improvement, the intensity fell from 9.0 to 7.5 and the frequency was reduced from 5.6 to 1.0 per month. Only one patient (4.5 percent, not significant) did not notice any change. The follow-up ranged from 222 to 494 days, the average being 347 days. In conclusion, this study confirms the value of surgical treatment of migraine headaches, inasmuch as 21 of 22 patients benefited significantly from the surgery. It is also evident that injection of Botox is an extremely reliable predictor of surgical outcome. Comment: Many small placebo-controlled studies and much anecdotal literature suggests that botulinum toxin may be effective in prevention of migraine, perhaps to the same extent as conventional prophylactic treatment. Larger, randomized clinical trials are underway to resolve this issue. In the meantime, those who believe in the effectiveness of botulinum toxin prophylaxis argue about how it works, that is whether its antinociceptive properties are due to peripheral effects, central or presynaptic effects, or both. Dr. Guyuron's group favors the idea that botulinum toxin interrupts a reflex arc between the central nervous system (CNS) and peripheral musculature, and that after establishing efficacy by low dose botulinum injection in the corrugator supercilii muscles, surgical resection of these muscles results in prolonged and effective prophylaxis. The idea is radical but intriguing and should not be dismissed out of hand. However, a trial is necessary in which both the botulinum toxin injections are blinded with vehicle, and the study of the surgery involves a sham surgery control group with extended long-term follow-up, before these forms of prophylaxis can be recommended to patients. SJT [source] A mesh adaptation framework for dealing with large deforming meshesINTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN ENGINEERING, Issue 7 2010Gaëtan Compère Abstract In this paper, we identify and propose solutions for several issues encountered when designing a mesh adaptation package, such as mesh-to-mesh projections and mesh database design, and we describe an algorithm to integrate a mesh adaptation procedure in a physics solver. The open-source MAdLib package is presented as an example of such a mesh adaptation library. A new technique combining global node repositioning and mesh optimization in order to perform arbitrarily large deformations is also proposed. We then present several test cases to evaluate the performances of the proposed techniques and to show their applicability to fluid,structure interaction problems with arbitrarily large deformations. Copyright © 2009 John Wiley & Sons, Ltd. [source] The development of pressure ulcers in patients with hip fractures: inadequate nursing documentation is still a problemJOURNAL OF ADVANCED NURSING, Issue 5 2000Lena Gunningberg MSC RN The aims of the study were to investigate, on a daily basis: (i] the development and progress of pressure ulcers, (ii) the documented nursing interventions for prevention and treatment of pressure ulcers, and (iii) when nursing interventions regarding prevention and treatment of pressure ulcers were documented, in relation to patient risk status and the development of pressure ulcers. The study design was prospective, comparative and descriptive. A total of 55 patients with hip fracture were included. To facilitate the nurse's assessment, a ,pressure ulcer card' was developed, consisting of the Modified Norton Scale (MNS) and descriptions of the four stages of pressure ulcers. The incidence of pressure ulcers was 55%. The mean rank of the lowest MNS score was significantly lower for patients who developed pressure ulcers than for patients without pressure ulcers. The majority of the pressure ulcers occurred between admission to the ward and the fourth day after surgery. Documented interventions regarding prevention and treatment were: repositioning, overlays, cushions, use of lotion and observation. The mean number of interventions per patient was 2·2 for patients who developed pressure ulcers during their hospital stay. The comprehensiveness and quality of the nursing record was unsatisfactory, and only three nursing records reached the level required by Swedish law. Preventive interventions such as repositioning were documented when the pressure ulcer had already occurred. The lack of nursing documentation regarding prevention and treatment of pressure ulcers may indicate that nurses did not identify pressure ulcers as a prioritized nursing problem for this patient group. The Modified Norton Scale could be a valuable tool for nurses, both identifying the patient at risk and acting as a guide for nursing interventions. The study was approved by the ethics committee of the Faculty of Medicine at Uppsala University. [source] Tissue alterations after tooth extraction with and without surgical trauma: a volumetric study in the beagle dogJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 4 2008Stefan Fickl Abstract Objectives: The aim of this study is to evaluate whether tooth extraction without the elevation of a muco-periosteal flap has advantageous effects on the resorption rate after tooth extraction. Material and Methods: In five beagle dogs polyether impressions were taken before the surgery. The roots of the first and second pre-molars (P1 and P2) were extracted and the sites were assigned to one of the following treatments: treatment group (Tx) 1, no treatment; Tx 2, surgical trauma (flap elevation and repositioning); Tx 3, the extraction socket was filled with BioOss Collagen® and closed with a free soft-tissue graft; Tx 4, after flap elevation and repositioning, the extraction socket was treated with BioOss Collagen® and a free soft-tissue graft. Impressions were taken 2 and 4 months after surgery. The casts were scanned, matched together with baseline casts and evaluated with digital image analysis. Results: The "flapless groups" demonstrated significant lower resorption rates both when using socket-preservation techniques and without. Furthermore, socket-preservation techniques yielded better results compared with not treating the socket. Conclusion: The results demonstrate that leaving the periosteum in place decreases the resorption rate of the extraction socket. Furthermore, the treatment of the extraction socket with BioOss Collagen® and a free gingival graft seems beneficial in limiting the resorption process after tooth extraction. [source] Assembling the "Empire of Morality": State Building Strategies in Catholic Ecuador, 1861,1875JOURNAL OF HISTORICAL SOCIOLOGY, Issue 2 2001Derek Williams This article studies the efforts of the Ecuadorian government between 1861 and 1875 to construct a "truly catholic nation". It examines the implementation and engagement of centralized initiatives of morality and religiosity, and reflects on its implications for the repositioning of state-society boundaries. Specifically, it considers the government's efforts after 1869 to centrally coordinate the institutions of municipal government and Church, and to redeploy them for national moralizing ends. It assesses the substantial achievements and limits of this model for strengthening state power and for disseminating "national" meanings of citizenship and progress. [source] Percutaneous Retrieval of a Wallstent from the Pulmonary Artery Following Stent Migration from the Iliac VeinJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 2 2002RAJIV M. ASHAR M.D. Wallstents are being used increasingly in conjunction with balloon dilatation for treatment of iliac vein stenosis. Stent misplacement or migration is a complication of the procedure, and may be symptomatic and warrant repositioning or removal. We report the case of a patient whose iliac vein stenosis was managed with two overlapping Wallstents and was complicated by embolization of one stent into the right ventricle (RV) and the other to the pulmonary artery (PA). This article illustrates percutaneous endovascular removal of a migrated stent from the PA using a jugular and femoral approach. [source] Conscious Sedation with Intermittent Midazolam and Fentanyl in Electrophysiology ProceduresJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 2 2001F.A.C.C., ROMAN T. PACHULSKI M.D. Objectives: To determine the safety and efficacy of intermittent midazolam and fentanyl conscious sedation for electrophysiology procedures (EP). Background: Intermittent midazolam and fentanyl conscious sedation was administered in 700 consecutive cases (175 radiofrequency ablations, 163 EP studies, 261 pacemakers, and 101 implantable cardioverter-defibrillators) for 471 patients (239 males, 51%) mean age 65 ± 15 years. The mean dose of midazolam was 0.063 mg/kg/hr and fentanyl was 0.591,g/kg/hr. Methods: Cardiac rate and rhythm were monitored continuously, while blood pressure and arterial oxygen saturation were noninvasively assessed evevy 5 minutes. Drugs were administered in aliquots of 0.5 to 2.0 mg of midazolam and 6.25 to 25 ,g of fentanyl as determined by clinical condition every 15 to 30 minutes. Results: There were no deaths. In no case was endotracheal intubation required. Mild hypoxemia (SaO2 > 80%, but < 90%) occurred in 17 cases (2.4%) and was easily reversed with verbal stimulation and oropharyngeal repositioning (12 cases, 1.7%), increased F1O2 (3 cases, 0.4%), or intravenous naloxone (2 cases, 0.3%). Reversible hypotension (systolic blood pressure < 90, but > 60 mmHg) occurred in 14 patients (2.0%) and was corrected with intravenous crystalloid bolus or flumazenil (10 cases, 1.4%) or inotrope infusion (4 cases, 0.6%). No patient stay was prolonged due to sedation. Only five patients (0.7%) had any recollection of the procedure, while two (0.3%) were aware of pain. All hypoxemic episodes occurred during the first hour, whereas 43% (6/14) of hypotensive episodes occurred after the first hour. Conclusion: Conscious sedation with intermittent midazolam and fentanyl is safe and eficacious for a broad range of EP procedures. (J Interven Cardiol 2001; 14:143,146) [source] Variation in identifying neonatal percutaneous central venous line positionJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 9-10 2004DE Odd Objective: The study objective was to obtain data on interpretation, including intra and interobserver variation and action taken for a given line tip location, for a series of radiographs demonstrating neonatal long lines. Methods: Nineteen radiographs taken to identify line tip position were digitized and published on an internet site. One film was included twice in order to assess intraobserver variation giving a total of 20 images. Fourteen used radio-opaque contrast and five no contrast. Australian and New Zealand Neonatal Network members and National Women's Hospital NICU staff were invited to participate in the study. For each radiograph, participants were asked to identify if long line tip could be identified, the likely anatomical position and desired action. Interobserver agreement was assessed by the maximum proportion of agreement per radiograph and by the number of different options selected. Intraobserver agreement was assessed by comparing the two reports from the duplicate radiograph. Results: Twenty-seven responses were received. Overall, 50% of the reports stated that the long line tips could be identified. The most commonly reported position was in the right atrium (31%) and most commonly reported action was to pull the line back (53%). The median agreement of whether the line was seen was 68%, agreement on position 62% and agreement on action 86%. On analysis of intraobserver variability, from the identical radiographs, 27% of respondents differed on whether the line tip could be visualized. Conclusion: Interobserver and intraobserver reliability was poor when using radiographs to assess long line tips. The major determinant of line repositioning was the perceived location. [source] Dextrose 5% in water: fluid medium for maintaining electrical stimulation of peripheral nerves during stimulating catheter placementACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 10 2005B. C. H. Tsui It is well documented that a higher electrical current is required to elicit a motor response following a normal saline (NS) injection during the placement of stimulating catheters for peripheral nerve block. We present three cases of continuous brachial plexus catheter placement in which Dextrose 5% in water (D5W) was used to dilate the perineural space instead of NS. Three brachial plexus blocks (two interscalene and one axillary) were performed in three different patients for pain relief. In each case, an insulated needle was advanced towards the brachial plexus. A corresponding motor response was elicited with a current less than 0.5 mA after needle repositioning. A stimulating catheter was advanced with ease after 3,5 ml of D5W was injected to dilate the perineural space. A corresponding motor response was maintained when the current applied to the stimulating catheter was less than 0.5 mA. Local anesthetic was then injected and the motor response immediately ceased. All blocks were successful and provided excellent pain relief with the continuous infusion of local anesthetics. [source] Visualization of active devices and automatic slice repositioning ("SnapTo") for MRI-guided interventionsMAGNETIC RESONANCE IN MEDICINE, Issue 4 2010Ashvin K. George Abstract The accurate visualization of interventional devices is crucial for the safety and effectiveness of MRI-guided interventional procedures. In this paper, we introduce an improvement to the visualization of active devices. The key component is a fast, robust method ("CurveFind") that reconstructs the three-dimensional trajectory of the device from projection images in a fraction of a second. CurveFind is an iterative prediction-correction algorithm that acts on a product of orthogonal projection images. By varying step size and search direction, it is robust to signal inhomogeneities. At the touch of a key, the imaged slice is repositioned to contain the relevant section of the device ("SnapTo"), the curve of the device is plotted in a three-dimensional display, and the point on a target slice, which the device will intersect, is displayed. These features have been incorporated into a real-time MRI system. Experiments in vitro and in vivo (in a pig) have produced successful results using a variety of single- and multichannel devices designed to produce both spatially continuous and discrete signals. CurveFind is typically able to reconstruct the device curve, with an average error of approximately 2 mm, even in the case of complex geometries. Magn Reson Med 63:1070,1079, 2010. © 2010 Wiley-Liss, Inc. [source] Business portfolio restructuring, prior diversification posture and investor reactionsMANAGERIAL AND DECISION ECONOMICS, Issue 8 2003Robin T. Byerly This study examined firm performance in market reaction to two types of business portfolio restructuring announcements: refocusing and repositioning. We predicted that market performance effects for these two types of strategic restructurers would be moderated by prior diversification posture. The theory behind these expectations was built on a general premise that restructuring strategy would be more favorably viewed by the market as performance enhancing when it offered greater potential for organizational transformation. Results showed strong support for our conclusion that prior diversification posture poses a significant contingency factor in restructuring firms' strategic choices. Further, the market tended to respond more favorably with this sample to repositioning restructuring choices. Copyright © 2003 John Wiley & Sons, Ltd. [source] Pacemaker Lead Prolapse through the Pulmonary Valve in ChildrenPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 10 2007CHARLES I. BERUL M.D. Background:Transvenous pacemaker leads in children are often placed with redundant lead length to allow for anticipated patient growth. This excess lead may rarely prolapse into the pulmonary artery and potentially interfere with valve function. We sought to determine the response to lead repositioning on pulmonary valve insufficiency. Methods:Retrospective reviews of demographics, lead type, implant duration, and radiography and echocardiography. Results:A total of 11 pediatric patients were identified with lead prolapse through the pulmonary valve, of which nine patients underwent procedures to retract and reposition the lead (age at implant 9 ± 4 years, age at revision 13 ± 4 years). The implant duration prior to revision was 4 ± 3 years. Two leads required radiofrequency extraction sheaths for removal, two pulled back using a snare, while five leads were simply retracted and repositioned. Tricuspid regurgitation was none/trivial (three), mild (four), or moderate (two) and only two improved with repositioning or replacement. Pulmonary regurgitation preoperatively was mild (three), mild-moderate (two), or moderate (four) compared with trivial (three), mild (four), and moderate (two) after revision. Patients with longer-term implanted leads had less improvement in pulmonary insufficiency. Two patients had mild pulmonary stenosis from lead-related obstruction. Conclusions:Prolapse of transvenous pacing leads into the pulmonary artery can occur when excess slack is left for growth. Leads can often be repositioned, but may require extraction and replacement, particularly if chronically implanted and adherent to valve apparatus. Lead revision does not always resolve pulmonary insufficiency, potentially leaving permanent valve damage. [source] Implant Experience with an Implantable Hemodynamic Monitor for the Management of Symptomatic Heart FailurePACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 8 2005DAVID STEINHAUS Introduction: Management of congestive heart failure is a serious public health problem. The use of implantable hemodynamic monitors (IHMs) may assist in this management by providing continuous ambulatory filling pressure status for optimal volume management. Methods and Results: The Chronicle® system includes an implanted monitor, a pressure sensor lead with passive fixation, an external pressure reference (EPR), and data retrieval and viewing components. The tip of the lead is placed near the right ventricular outflow tract to minimize risk of sensor tissue encapsulation. Implant technique and lead placement is similar to that of a permanent pacemaker. After the system had been successfully implanted in 148 patients, the type and frequency of implant-related adverse events were similar to a single-chamber pacemaker implant. R-wave amplitude was 15.2 ± 6.7 mV and the pressure waveform signal was acceptable in all but two patients in whom presence of artifacts required lead repositioning. Implant procedure time was not influenced by experience, remaining constant throughout the study. Conclusion: Based on this evaluation, permanent placement of an IHM in symptomatic heart failure patients is technically feasible. Further investigation is warranted to evaluate the use of the continuous hemodynamic data in management of heart failure patients. [source] POST-MERGER PRODUCT REPOSITIONING,THE JOURNAL OF INDUSTRIAL ECONOMICS, Issue 1 2008AMIT GANDHI This paper analyzes the effects of mergers between firms competing by simultaneously choosing price and location. Products combined by a merger are repositioned away from each other to reduce cannibalization, and non-merging substitutes are, in response, repositioned between the merged products. This repositioning greatly reduces the merged firm's incentive to raise prices and thus substantially mitigates the anticompetitive effects of the merger. Computation of, and selection among, equilibria is done with a novel technique known as the stochastic response dynamic, which does not require the computation of first-order conditions. [source] Networking as a Means to Strategy Change: The Case of Open Innovation in Mobile TelephonyTHE JOURNAL OF PRODUCT INNOVATION MANAGEMENT, Issue 6 2007Koen Dittrich The purpose of this article is to investigate how innovation networks can be used to deal with a changing technological environment. This study combines different concepts related to research and development (R&D) collaboration strategies of large firms and applies these concepts to R&D alliance projects undertaken by Nokia Corporation in the period 1985,2002. The research methodology is a combination of in-depth semistructured interviews and a large-scale quantitative analysis of alliance agreements. For the empirical analysis a distinction is made between exploration and exploitation in innovation networks in terms of three different measures. As a first measure, the difference between exploration and exploitation strategies by means of the observed capabilities of the partners of the contracting firms is investigated. The second measure is related to partner turnover. The present article argues that in exploration networks partner turnover will be higher than in exploitation networks. As a third measure, the type of alliance contract will be taken; exploration networks will make use of flexible legal organizational structures, whereas exploitation alliances are associated with legal structures that enable long-term collaboration. The case of Nokia has illustrated the importance of strategic technology networks for strategic repositioning under conditions of change. Nokia followed an exploitation strategy in the development of the first two generations of mobile telephony and an exploration strategy in the development of technologies for the third generation. Such interfirm networks seem to offer flexibility, speed, innovation, and the ability to adjust smoothly to changing market conditions and new strategic opportunities. These two different strategies have led to distinctly different international innovation networks, have helped the company in becoming a world leader in the mobile phone industry, and have enabled it to sustain that position in a radically changed technological environment. This study also illustrates that Nokia effectively uses an open innovation strategy in the development of new products and services and in setting technology standards for current and future use of mobile communication applications. This article presents one of the first longitudinal studies, which describes the use of innovation networks as a means to adapt swiftly to changing market conditions and strategic change. This study contributes to the emerging, but still inconsistent, literature on explorative and exploitative learning by means of strategic technology networks. [source] | ||||||||||||||||||||||||||||||||||