Management: Leading & Collaborating in A Competitive World -9/E.

Leading & Collaborating in a Competitive World is a text with a fully modernized functional approach. This text is maintaining the four traditional functions of planning, organizing, leading, and controlling, while modernizing and re-visioning the concepts as delivering strategic value, building a dynamic organization, mobilizing people, and learning and changing. Bateman/Snell’ results-oriented approach is a unique hallmark of this textbook. In this ever more competitive environment there are five essential types of performance, on which the organization beats, equals, or loses to the competition which are cost, quality, speed, innovation and service. These five performance dimensions, when done well, deliver value to the customer and competitive advantage to you and your organization. Throughout the text Bateman & Snell remind students of these five dimensions and their impact on the “bottom line” with marginal icons contributing to the leadership and collaboration theme, which is the key to successful management. People working with one another, rather than against, is essential to competitive advantage

Aeolianite and barrier dune construction spanning the last two glacial-interglacial cycles from the southern Cape coast, South Africa

The southern Cape region of South Africa has extensive coastal aeolianites and barrier dunes. Whilst previously reported, limited knowledge of their age has precluded an understanding of their relationship with the climatic and sea-level fluctuations that have taken place during the Late Quaternary. Sedimentological and geomorphological studies combined with an optical dating programme reveal aeolianite development and barrier dune construction spanning at least the last two glacial–interglacial cycles. Aeolianite deposition has occurred on the southern Cape coast at ca 67–80, 88–90, 104–128, 160–189 and >200 ka before the present. Using this and other published data coupled with a better understanding of Late Quaternary sea-level fluctuations and palaeocoastline configurations, it is concluded that these depositional phases appear to be controlled by interglacial and subsequent interstadial sea-level high stands. These marine transgressions and regressions allowed onshore carbonate-rich sediment movement and subsequent aeolian reworking to occur at similar points in the landscape on a number of occasions. The lack of carbonates in more recent dunes (Oxygen Isotope Stages 1/2 and 4/5) is attributed not to leaching but to changes to carbonate production in the sediment source area caused by increased terrigenous material and/or changes in the balance between the warm Agulhas and nutrient-rich Benguela ocean current

Even perturbations of self-similar Vaidya space-time

We study even parity metric and matter perturbations of all angular modes in self-similar Vaidya space-time. We focus on the case where the background contains a naked singularity. Initial conditions are imposed describing a finite perturbation emerging from the portion of flat space-time preceding the matter-filled region of space-time. The most general perturbation satisfying the initial conditions is allowed impinge upon the Cauchy horizon (CH), whereat the perturbation remains finite: there is no ``blue-sheet'' instability. However when the perturbation evolves through the CH and onto the second future similarity horizon of the naked singularity, divergence necessarily occurs: this surface is found to be unstable. The analysis is based on the study of individual modes following a Mellin transform of the perturbation. We present an argument that the full perturbation remains finite after resummation of the (possibly infinite number of) modes.Comment: Accepted for publication in Physical Review D, 27 page

Tumour infiltrating lymphocytes correlate with improved survival in patients with oesophageal adenocarcinoma

BACKGROUND: Oesophageal adenocarcinoma (OAC) is increasingly common in the west, and survival remains poor at 10-15 % at 5 years. Immune responses are increasingly implicated as a determining factor of tumour progression. The ability of lymphocytes to recognise tumour antigens provides a mechanism for a host immune attack against cancer providing a potential treatment strategy.MATERIALS AND METHODS: Tumour infiltrating lymphocytes (TILs: CD3+, CD4+, CD8+ and FOXp3+) were assessed by immunohistochemistry using tissue microarrays in a contemporary and homogeneous cohort of OAC patients (n = 128) undergoing curative treatment.RESULTS: Multivariate analysis identified three independent prognostic factors for improved cancer-specific survival (CSS): increased CD8+ TILs (p = 0.003), completeness of resection (p < 0.0001) and lower pathological N stage (p < 0.0001). Independent prognostic factors for favourable disease-free survival included surgery-only treatment (p = 0.015), completeness of resection (p = 0.001), increased CD8+ TILs (p < 0.0001) and reduced pathological N stage (p < 0.0001). Higher levels of TILs in the pathological specimen were associated with significant pathological response to neoadjuvant chemotherapy (NAC). On multivariate analysis increased levels of CD4+ (p = 0.017) and CD8+ TILs (p = 0.005) were associated with significant local tumour regression and lymph node downstaging, respectively.DISCUSSION: Our results establish an association of TILs and survival in OAC, as seen in other solid tumours, and identify particular TIL subsets that are present at higher levels in patients who responded to NAC compared to non-responders. These findings highlight potential therapeutic strategies in EAC based on utilising the host immunological response and highlight the immune responses biomarker potential

Harmonic fields on the extended projective disc and a problem in optics

The Hodge equations for 1-forms are studied on Beltrami's projective disc model for hyperbolic space. Ideal points lying beyond projective infinity arise naturally in both the geometric and analytic arguments. An existence theorem for weakly harmonic 1-fields, changing type on the unit circle, is derived under Dirichlet conditions imposed on the non-characteristic portion of the boundary. A similar system arises in the analysis of wave motion near a caustic. A class of elliptic-hyperbolic boundary-value problems is formulated for those equations as well. For both classes of boundary-value problems, an arbitrarily small lower-order perturbation of the equations is shown to yield solutions which are strong in the sense of Friedrichs.Comment: 30 pages; Section 3.3 has been revise

Hospital usage of TOXBASE in Great Britain:Temporal trends in accesses 2008 to 2015

Aim: Examining temporal trends in accesses to the UK's National Poison Information Service's TOXBASE database in Britain. Methods: Generalised additive models were used to examine trends in daily numbers of accesses to TOXBASE from British emergency departments between January 2008 and December 2015. Day-of-the-week, seasonality and long term trends were analysed at national and regional levels (Wales, Scotland and the 9 English Government Office Regions). Results: The long-term trend in daily accesses increases from 2.8 (95% CI:2.6, 3.0) per user on 1st January 2008 to 4.6 (95% CI:4.3, 4.9) on 31st December 2015, with small but significant differences in population-corrected accesses by region (p<0.001). There are statistically significant seasonal and day of the week patterns (p<0.001) across all regions. Accesses are 18 % (95% CI:14%, 22%) higher in summer than in January and at the weekend compared to weekdays in all regions; there is a 7.5% (95% CI:6.1%, 8.9%) increase between Friday and Sunday. Conclusions: There are consistent in-year patterns in access to TOXBASE indicating potential seasonal patterns in poisonings in Britain, with location-dependant rates of usage. This novel descriptive work lays the basis for future work on the interaction of TOXBASE use with emergency admission of patients into hospital

D-Brane Propagation in Two-Dimensional Black Hole Geometries

We study propagation of D0-brane in two-dimensional Lorentzian black hole backgrounds by the method of boundary conformal field theory of SL(2,R)/U(1) supercoset at level k. Typically, such backgrounds arise as near-horizon geometries of k coincident non-extremal NS5-branes, where 1/k measures curvature of the backgrounds in string unit and hence size of string worldsheet effects. At classical level, string worldsheet effects are suppressed and D0-brane propagation in the Lorentzian black hole geometry is simply given by the Wick rotation of D1-brane contour in the Euclidean black hole geometry. Taking account of string worldsheet effects, boundary state of the Lorentzian D0-brane is formally constructible via Wick rotation from that of the Euclidean D1-brane. However, the construction is subject to ambiguities in boundary conditions. We propose exact boundary states describing the D0-brane, and clarify physical interpretations of various boundary states constructed from different boundary conditions. As it falls into the black hole, the D0-brane radiates off to the horizon and to the infinity. From the boundary states constructed, we compute physical observables of such radiative process. We find that part of the radiation to infinity is in effective thermal distribution at the Hawking temperature. We also find that part of the radiation to horizon is in the Hagedorn distribution, dominated by massive, highly non-relativistic closed string states, much like the tachyon matter. Remarkably, such distribution emerges only after string worldsheet effects are taken exactly into account. From these results, we observe that nature of the radiation distribution changes dramatically across the conifold geometry k=1 (k=3 for the bosonic case), exposing the `string - black hole transition' therein.Comment: 51 pages, 5 figures, v2: referece added, note added replying the comment made in hep-th/060206

Intermediate acting non-depolarizing neuromuscular blocking agents and risk of postoperative respiratory complications: prospective propensity score matched cohort study

Objective: To determine whether use of intermediate acting neuromuscular blocking agents during general anesthesia increases the incidence of postoperative respiratory complications. Design: Prospective, propensity score matched cohort study. Setting: General teaching hospital in Boston, Massachusetts, United States, 2006-10. Participants: 18 579 surgical patients who received intermediate acting neuromuscular blocking agents during surgery were matched by propensity score to 18 579 reference patients who did not receive such agents. Main outcome measures: The main outcome measures were oxygen desaturation after extubation (hemoglobin oxygen saturation 3%) and reintubations requiring unplanned admission to an intensive care unit within seven days of surgery. We also evaluated effects on these outcome variables of qualitative monitoring of neuromuscular transmission (train-of-four ratio) and reversal of neuromuscular blockade with neostigmine to prevent residual postoperative neuromuscular blockade. Results: The use of intermediate acting neuromuscular blocking agents was associated with an increased risk of postoperative desaturation less than 90% after extubation (odds ratio 1.36, 95% confidence interval 1.23 to 1.51) and reintubation requiring unplanned admission to an intensive care unit (1.40, 1.09 to 1.80). Qualitative monitoring of neuromuscular transmission did not decrease this risk and neostigmine reversal increased the risk of postoperative desaturation to values less than 90% (1.32, 1.20 to 1.46) and reintubation (1.76, 1.38 to 2.26). Conclusion: The use of intermediate acting neuromuscular blocking agents during anesthesia was associated with an increased risk of clinically meaningful respiratory complications. Our data suggest that the strategies used in our trial to prevent residual postoperative neuromuscular blockade should be revisited

Contribution of nitrification and denitrification to N2O emissions from urine patches

Urine deposition by grazing livestock causes an immediate increase in nitrous oxide (N2O) emissions, but the responsible mechanisms are not well understood. A nitrogen-15 (15N) labelling study was conducted in an organic grass-clover sward to examine the initial effect of urine on the rates and N2O loss ratio of nitrification (i.e. moles of N2O-N produced per moles of nitrate produced) and denitrification (i.e. moles of N2O produced per moles of N2O + N2 produced). The effect of artificial urine (52.9 g N m-2) and ammonium solution (52.9 g N m-2) was examined in separate experiments at 45 and 35% water-filled pore space (WFPS), respectively, and in each experiment a water control was included. The N2O loss derived from nitrification or denitrification was determined in the field immediately after application of 15N-labelled solutions. During the next 24 h, gross nitrification rates were measured in the field, whereas the denitrification rates were measured in soil cores in the laboratory. Compared with the water control, urine application increased the N2O emission from 3.9 to 42.3 μg N2O-N m-2 h-1, whereas application of ammonium increased the emission from 0.9 to 6.1 μg N2O-N m-2 h-1. In the urine-affected soil, nitrification and denitrification contributed equally to the N2O emission, and the increased N2O loss resulted from a combination of higher rates and higher N2O loss ratios of the processes. In the present study, an enhanced nitrification rate seemed to be the most important factor explaining the high initial N2O emission from urine patches deposited on well-aerated soils

Utilization and responsiveness of the asthma control test (ACT) at the initiation of therapy for patients with asthma: a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to assess the responsiveness of the asthma control test (ACT) to detect changes at the initiation of therapy and its utilization in the initiation of asthma treatment.</p> <p>Methods</p> <p>This study was designed as a randomized clinical trial conducted in a primary care setting. The subjects were asthma patients who had not received controller therapy for at least two months. The patients were randomized into two groups: The Saudi Initiative for Asthma (SINA) group and the Global Initiative for Asthma (GINA) group. Treatment in the SINA group was initiated at step1 when the ACT scores ≥ 20, step 2 when the score between16-19, and step 3 when the score < 16 began at step 3. The GINA group patients were started on step 2 when they had persistent asthma symptoms or step 3 when they had severely uncontrolled disease.</p> <p>Results</p> <p>Forty-five patients were analyzed in each group. The improvement in ACT score after treatment initiation was significantly higher when the SINA approach was used (2.9 in the SINA group compared to 1.7 in the GINA group (<it>p </it>= 0.04)). The improvement in FEV₁was 5.8% in the SINA group compared to 3.4% in the GINA group (<it>p </it>= 0.46). The number of patients who achieved asthma control at the follow-up visit and required no treatment adjustment was 33 (73.3%) in the SINA group and 27 (60%) in the GINA group (<it>p </it>= 0.0125).</p> <p>Conclusion</p> <p>The ACT was responsive to change at the initiation of asthma treatment and was useful for the initiation of asthma treatment.</p> <p>Trial Registration number</p> <p><a href="http://www.controlled-trials.com/ISRCTN31998214">ISRCTN31998214</a></p