224 research outputs found
Using the enneagram for market segmentation
Session 6.4 New Products IISegmentation and positioning constitute the crux of marketing strategy. Over the past two decades, lifestyle and psychographics have been increasingly used as a basis for market segmentation. This paper illustrates how the ancient and mystical technique of the Enneagram can be effectively used as a base for psychographic segmentation. With the Enneagram finding ever-increasing applications in strategic management and human resource development, it is only fitting that scholars in marketing harness the diagnostic and predictive power of the Enneagram. However, adoption of the Enneagram for marketing purposes will require further conceptual development and empirical analysis.Rajeev Kamineni and Sudhir Kal
Posterior interosseous nerve localization within the proximal forearm - a patient normalized parameter
AIM
To provide a “patient-normalized” parameter in the proximal forearm.
METHODS
Sixty-three cadaveric upper extremities from thirty-five cadavers were studied. A muscle splitting approach was utilized to locate the posterior interosseous nerve (PIN) at the point where it emerges from beneath the supinator. The supinator was carefully incised to expose the midpoint length of the nerve as it passes into the forearm while preserving the associated fascial connections, thereby preserving the relationship of the nerve with the muscle. We measured the transepicondylar distance (TED), PIN distance in the forearm’s neutral rotation position, pronation position, supination position, and the nerve width. Two individuals performed measurements using a digital caliper with inter-observer and intra-observer blinding. The results were analyzed with the Wilcoxon-Mann-Whitney test for paired samples.
RESULTS
In pronation, the PIN was within two confidence intervals of 1.0 TED in 95% of cases (range 0.7-1.3 TED); in neutral, within two confidence intervals of 0.84 TED in 95% of cases (range 0.5-1.1 TED); in supination, within two confidence intervals of 0.72 TED in 95% of cases (range 0.5-0.9 TED). The mean PIN distance from the lateral epicondyle was 100% of TED in a pronated forearm, 84% in neutral, and 72% in supination. Predictive accuracy was highest in supination; in all cases the majority of specimens (90.47%-95.23%) are within 2 cm of the forearm position-specific percentage of TED. When comparing right to left sides for TEDs with the signed Wilcoxon-Mann-Whitney test for paired samples as well as a significance test (with normal distribution), the P-value was 0.0357 (significance - 0.05) indicating a significant difference between the two sides.
CONCLUSION
This “patient normalized” parameter localizes the PIN crossing a line drawn between the lateral epicondyle and the radial styloid. Accurate PIN localization will aid in diagnosis, injections, and surgical approaches
Marketing of religion in cyberspace
The Internet has begun to play a significant role in people’s lives, albeit in the lives of people living on the ‘right’ side of the digital divide. Yet, the nexus between religion and the Internet has seldom been discussed in the marketing context. This paper investigates the effect of the Internet on how people use the new technology to fulfill their spiritual and religious needs. The marketing implications of this nascent but widely spreading phenomenon are discussed since this trend has a significant impact on the providers of spiritual and religious services.Sudhir Kale, Rajeev Kaminen
Assimilation of IRS-P4 (MSMR) meteorological data in the NCMRWF global data assimilation system
Oceansat-1 was successfully launched by India in 1999, with two payloads, namely Multi-frequency Scanning Microwave Radiometer (MSMR) and Ocean Color Monitor (OCM) to study the biological and physical parameters of the ocean. The MSMR sensor is configured as an eight-channel radiometer using four frequencies with dual polarization. The MSMR data at 75 km resolution from the Oceansat-I have been assimilated in the National Centre for Medium Range Weather Forecasting (NCMRWF) data assimilation forecast system. The operational analysis and forecast system at NCMRWF is based on a T80L18 global spectral model and Spectral Statistical Interpolation (SSI) scheme for data analysis. The impact of the MSMR data is seen globally, however it is significant over the oceanic region where conventional data are rare. The dry-nature of the control analyses have been removed by utilizing the MSMR data. Therefore, the total precipitable water data from MSMR has been identified as a very crucial parameter in this study. The impact of surface wind speed from MSMR is to increase easterlies over the tropical Indian Ocean. Shifting of the positions of westerly troughs and ridges in the south Indian Ocean has contributed to reduction of temperature to around 30‡S
Impact of CAMEX-4 Data Sets for Hurricane Forecasts using a Global Model
This study explores the impact on hurricane data assimilation and forecasts from the use of dropsondes and remote-sensed moisture profiles from the airborne Lidar Atmospheric Sensing Experiment (LASE) system. We show that the use of these additional data sets, above those from the conventional world weather watch, has a positive impact on hurricane predictions. The forecast tracks and intensity from the experiments show a marked improvement compared to the control experiment where such data sets were excluded. A study of the moisture budget in these hurricanes showed enhanced evaporation and precipitation over the storm area. This resulted in these data sets making a large impact on the estimate of mass convergence and moisture fluxes, which were much smaller in the control runs. Overall this study points to the importance of high vertical resolution humidity data sets for improved model results. We note that the forecast impact from the moisture profiling data sets for some of the storms is even larger than the impact from the use of dropwindsonde based winds
Effects of Transitioning From Conventional Methods to Liquid Based Methods on Unsatisfactory Pap Tests: Results from a Multicenter U.S. Study (poster)
Background: Pap testing has transitioned from conventional preparations (CP) to liquid based preparations (LBP) due to perceived superiority of LBPs. Many studies conclude LBPs reduce unsatisfactory (UNSAT) tests however some believe the evidence to substantiate this claim is weak. We studied the effect of the transition from CPs to LBPs on the proportion of UNSAT Pap tests (PT) in four health care systems in the United States participating in the NIH-funded SEARCH project.
Methods: Our study cohort consisted of 548,174 women with 1,443,725 total PTs, ages 21-65 years, between 2000 and 2010. We used segmented regression analysis to estimate the effect of adopting LBPs on the proportion of UNSAT PTs after adjusting for age.
Results: Three sites implementing SurePath LBP experienced significant reductions in UNSAT PTs (Site 1 estimated effect: -2.46% [95% CI: -1.47%, -3.45%], Site 2: -1.78% [95% CI: -1.54%, -2.02%], Site 3: -8.25% [95% CI: -7.33%, -9.17%]. The fourth site implementing ThinPrep LBP did not experience a reduction in UNSAT studies. The relative risk of an UNSAT PT in women \u3e 50 increased after the transition to LBPs (SurePath: RR 2.1 [95% CI: 1.9, 2.2] and ThinPrep: RR 1.7 [95% CI: 1.5, 2.0]).
Conclusions: The observed changes in the proportion of UNSAT PTs varied across the participating sites and it was dependent on the type of LBP technology, age of women and the rates prior to the implementation of this technology
Total Elbow Arthroplasty
Total elbow arthroplasty has continued to evolve over time. Elbow implants may be linked or unlinked. Unlinked implants are attractive for patients with relatively well preserved bone stock and ligaments, but many favor linked implants, since they prevent instability and allow replacement for a wider spectrum of indications. Inflammatory arthropathies such as rheumatoid arthritis represent the classic indication for elbow arthroplasty. Indications have been expanded to include posttraumatic osteoarthritis, acute distal humerus fractures, distal humerus nonunions and reconstruction after tumor resection. Elbow arthroplasty is very successful in terms of pain relief, motion and function. However, its complication rate remains higher than arthroplasty of other joints. The overall success rate is best for patients with inflammatory arthritis and elderly patients with acute distal humerus fractures, worse for patients with posttraumatic osteoarthritis. The most common complications of elbow arthroplasty include infection, loosening, wear, triceps weakness and ulnar neuropathy. When revision surgery becomes necessary, bone augmentation techniques provide a reasonable outcome
Provider beliefs in effectiveness and recommendations for primary HPV testing in 3 health-care systems
In 2018, the US Preventive Services Task Force endorsed primary human papillomavirus testing (pHPV) for cervical cancer screening. We aimed to describe providers\u27 beliefs about pHPV testing effectiveness and which screening approach they regularly recommend. We invited providers who performed 10 or more cervical cancer screens in 2019 in 3 healthcare systems that had not adopted pHPV testing: Kaiser Permanente Washington, Mass General Brigham, and Parkland Health; 53.7% (501/933) completed the survey between October and December 2020. Response distributions varied across modalities (P \u3c .001), with cytology alone or cotesting being more often viewed as somewhat or very effective for 30- to 65-year-olds compared with pHPV (cytology alone 94.1%, cotesting 96.1%, pHPV 66.0%). In 21- to 29-year-olds, the pattern was similar (cytology alone 92.2%, 64.7% cotesting, 50.8% pHPV). Most providers were either incorrect or unsure of the guideline-recommended screening interval for pHPV. Educational efforts are needed about the relative effectiveness and recommended use of pHPV to promote guideline-concordant care
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Hemoglobin A1c and Arterial and Ventricular Stiffness in Older Adults
Objective: Arterial and ventricular stiffening are characteristics of diabetes and aging which confer significant morbidity and mortality; advanced glycation endproducts (AGE) are implicated in this stiffening pathophysiology. We examined the association between HbA1c, an AGE, with arterial and ventricular stiffness measures in older individuals without diabetes. Research Design & Methods: Baseline HbA1c was measured in 830 participants free of diabetes defined by fasting glucose or medication use in the Cardiovascular Health Study, a population-based cohort study of adults aged ≥65 years. We performed cross-sectional analyses using baseline exam data including echocardiography, ankle and brachial blood pressure measurement, and carotid ultrasonography. We examined the adjusted associations between HbA1c and multiple arterial and ventricular stiffness measures by linear regression models and compared these results to the association of fasting glucose (FG) with like measures. Results: HbA1c was correlated with fasting and 2-hour postload glucose levels (r = 0.21; p<0.001 for both) and positively associated with greater body-mass index and black race. In adjusted models, HbA1c was not associated with any measure of arterial or ventricular stiffness, including pulse pressure (PP), carotid intima-media thickness, ankle-brachial index, end-arterial elastance, or left ventricular mass (LVM). FG levels were positively associated with systolic, diastolic and PP and LVM. Conclusions: In this sample of older adults without diabetes, HbA1c was not associated with arterial or ventricular stiffness measures, whereas FG levels were. The role of AGE in arterial and ventricular stiffness in older adults may be better assessed using alternate AGE markers
Spontaneous coronary artery dissection presenting as an ischaemic stroke in a middle-aged man with anti-cardiolipin antibodies: a case report
<p>Abstract</p> <p>Introduction</p> <p>Cerebrovascular disease is a major cause of mortality and morbidity worldwide. Ischemic stroke is the most common manifestation, encompassing a wide variety of causative mechanisms. We present the case of a middle-aged male patient with spontaneous coronary artery dissection in the presence of anti-cardiolipin antibodies, leading to left ventricular thrombus and presenting with stroke.</p> <p>Case presentation</p> <p>A 56-year-old Caucasian man presented with dysarthria and right-sided weakness. There was a history of chest pain with autonomic symptoms four days earlier. Examination revealed right-sided hemiparesis. Electrocardiogram showed sinus rhythm with anterior Q waves. Magnetic resonance imaging of the brain showed large left parietal and smaller multiple cerebral infarcts. Echocardiogram showed anterior wall and apical akinesis with a large mural thrombus. Anti-cardiolipin antibodies immunoglobulin G and immunoglobulin M were strongly positive. Coronary angiography showed dissection of the mid left anterior descending artery with normal flow down the distal vessel. He was treated conservatively with anticoagulation and secondary prevention. He was in good health when seen in clinic four months later.</p> <p>Conclusion</p> <p>We highlight the importance of a comprehensive approach at obtaining the correct diagnosis, input of different specialities and the fact that the presence of anti-cardiolipin antibodies is associated with coronary artery dissection in a middle-aged male patient whose presentation was stroke.</p
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