Effect of Segmental Bronchoalveolar Lavage on Quantitative Computed Tomography of the Lung

RATIONALE AND OBJECTIVES: With employment of both multi-detector computed tomography (MDCT) and endobronchial procedures in multi-center studies, effects of timing of endobronchial procedures on quantitative imaging (Q-MDCT) metrics is a question of increasing importance. MATERIALS AND METHODS: Six subjects were studied via MDCT at baseline, immediately following and at 4hrs and 24hrs post-BAL (right middle lobe (RML) and lingula). Through quantitative image analysis, non-air, or ‘tissue’ volume (TV) in each lung and lobe was recorded. Change in TV from baseline was used to infer retention and re-distribution of lavage fluid. RESULTS: Bronchoscopist reported unrecovered BAL volume correlated well with Q-MDCT for whole lung measures, but less well with individual lobes indicating redistribution. TV in all lobes except the RLL differed significantly (p<.05) from baseline immediately post lavage. At 24hrs, all lobes except the LLL (small 1% mean difference at 24hrs.) returned to baseline. CONCLUSIONS: These findings suggest fluid movement, effecting Q-MDCT metrics, between lobes and between lungs before eventual resolution, and preclude protocols involving the lavage of one lung and imaging of the other to avoid interactions. We demonstrate that Q-MDCT is sensitive to lavage fluid retention and re-distribution, and endobronchial procedures should not precede Q-MDCT imaging by less than 24hrs

A terminal assessment of stages theory : introducing a dynamic states approach to entrepreneurship

Stages of Growth models were the most frequent theoretical approach to understanding entrepreneurial business growth from 1962 to 2006; they built on the growth imperative and developmental models of that time. An analysis of the universe of such models (N=104) published in the management literature shows no consensus on basic constructs of the approach, nor is there any empirical confirmations of stages theory. However, by changing two propositions of the stages models, a new dynamic states approach is derived. The dynamic states approach has far greater explanatory power than its precursor, and is compatible with leading edge research in entrepreneurship

A Corporate Social Entrepreneurship Approach to Market-Based Poverty Reduction

In this article, we aim to conceptualize a market-based approach to poverty reduction from a corporate social entrepreneurship (CSE) perspective. Specifically, we describe some market-based initiatives at the base of the economic pyramid and relate them to the social entrepreneurship literature. We refer to the entrepreneurial activities of multinational corporations that create social value as CSE. We then conceptualize CSE according to the corporate entrepreneurship and social entrepreneurship domains and shed light on how corporations can implement CSE. Finally, by reviewing relevant literature, we propose some of the factors that can stimulate CSE in organizations and some of the benefits companies can gain by implementing CSE

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo