The importance of optical coherence tomography examination of normal fellow eyes in neovascular age-related macular degeneration monitoring clinics

Purpose: To demonstrate the importance of OCT examination of fellow, normal eyes in unilateral nAMD follow up clinics. Methods: The authors present three cases of unilateral nAMD who were undergoing treatment with ranibizumab, in whom OCT evaluation of the previously unaffected, asymptomatic fellow eye allowed early diagnosis, treatment and preservation of vision. Fundus examination had previously failed to demonstrate abnormality. Results: Intravitreal anti-VEGF treatment for nAMD has caused a sharp increase in the number of subjects attending macular clinics, frequently overburdening the system. It may sometimes be tempting for hospitals to reduce the workload by for example, concentrating only on OCT examination of the affected eye in cases of unilateral nAMD. The three reported cases demonstrate that OCT scanning of the fellow, previously unaffected eye is essential in detecting asymptomatic nAMD, which gives a better chance of preservation of vision. Conclusions: Patients with unilateral neovascular AMD undergoing review in macular clinics should always undergo OCT scanning of normal, fellow eyes, as otherwise asymptomatic, “invisible” choroidal neovascular membranes may be missed.

Beyond theory:an examination of lean new product introduction practices in the UK

Interest is growing around the application of lean techniques to new product introduction (NPI). Although a relatively emergent topic compared with the application of ‘lean’ within the factory, since 2000 there has been an exponential rise in the literature on this subject. However, much of this work focuses on describing and extolling the virtues of the ‘Toyota approach’ to design. Therefore, by way of a stock take for the UK, the present authors' research has set out to understand how well lean product design practices have been adopted by leading manufacturers. This has been achieved by carrying out in-depth case studies with three carefully selected manufacturers of complex engineered products. This paper describes these studies, the detailed results and subsequent findings, and concludes that both the awareness and adoption of practices is generally embryonic and far removed from the theory advocated in the literature.

An examination of standards of functional requirements, performance and finish in housing

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An examination of moderator effects in the four-stage loyalty model

Oliver’s 1997 four-stage loyalty model proposes that loyalty consists of belief, affect, intention, and action. Although this loyalty model has recently been subject to empirical examination, the issue of moderator variables has been largely neglected. This article fills that void by analyzing the moderating effects of selected personal and situational characteristics, using a sample of 888 customers of a large do-it-yourself retailer. The results of multi-group causal analysis suggest that these moderators exert an influence on the development of the different stages of the loyalty sequence. Specifically, age, income, education and expertise, price orientation, critical incident recovery, and loyalty card membership are found to be important moderators of the links in the four-stage loyalty model. Limitations of the study are outlined, and implications for both research and managerial practice are discussed.

An examination of the calcium and strontium site distribution in bioactive glasses through isomorphic neutron diffraction, X-ray diffraction, EXAFS and multinuclear solid state NMR.

Strontium has been substituted for calcium in the glass series (SiO2)49.46(Na2O)26.38(P2O5)1.07(CaO)23.08x(SrO)x (where x = 0, 11.54, 23.08) to elucidate their underlying atomic-scale structural characteristics as a basis for understanding features related to the bioactivity. These bioactive glasses have been investigated using isomorphic neutron and X-ray diffraction, Sr K-edge EXAFS and solid state 17O, 23Na, 29Si, 31P and 43Ca magic-angle-spinning (MAS) NMR. An effective isomorphic substitution first-order difference function has been applied to the neutron diffraction data, confirming that Ca and Sr behave in a similar manner within the glass network, with residual differences attributed to solely the variation in ionic radius between the two species. The diffraction data provides the first direct experimental evidence of split Ca–O nearest-neighbour correlations in these melt quench bioactive glasses, together with an analogous splitting of the Sr–O correlations; the correlations are attributed to the metal ions correlated either to bridging or to non-bridging oxygen atoms. Triple quantum (3Q) 43Ca MAS NMR corroborates the split Ca–O correlations. Successful simplification of the 2 < r (A) < 3 region via the difference method has also revealed two distinct Na environments. These environments are attributed to sodium correlated either to bridging or to nonbridging oxygen atoms. Complementary multinuclear MAS NMR, Sr K-edge EXAFS and X-ray diffraction data supports the structural model presented. The structural sites present will be intimately related to their release properties in physiological fluids such as plasma and saliva, and hence the bioactivity of the material. Detailed structural knowledge is therefore a prerequisite for optimising material design.

An examination of the Prandtl mechanism in large dimension slope failures

An alternative explanation for the modes of failure of large scale failures of open pit walls to those of classical slope stability theory is proposed that makes use of the concept of a transition zone, which is described by a modified Prandtls prism.

A simultaneous examination of the effects of salesperson relationship-building activities and marketing activities on retail buyers' purchase decisions

Firms’ contemporary selling practices often not only demand that salespeople meet sales quotas, but also that they build strong, profitable relationships with customers. Given the belief that relationship-building activities can develop closer customer ties and improve sales performance, scholars have increasingly studied salesperson behaviors aimed at nurturing buyer-salesperson relations. However, while previous sales research has investigated the effects of a number of relational activities on performance outcomes in isolation, knowledge about their effectiveness in comparison to other important performance drivers is virtually absent. The present study provides some first theoretical and empirical insights into this research gap by simultaneously examining the role of specific salesperson relationship-building activities, and product-focused variables, in retail buyers’ new product purchase decisions. Following an extensive literature review, a two-part qualitative field study was conducted to explore salesperson relationship-building activities that are regarded as important by retail buyers. Two key relational behaviors were suggested by the customer-centric and retail industry-specific data; salesperson consultation (communication-based) and salesperson helping behavior (action-based). Drawing on this as well as extant literature, a conceptual framework was developed concerning the influences of these relationship-building activities and other product-focused factors on retail buyers’ new product acceptance. The study’s quantitative component contained a mail and web survey of U.S. retail buyers, resulting in a total dataset of 192 responses. After a comprehensive measure validation process, the theoretical hypotheses were tested using logistic regression analysis. Contrary to existing assertions, the results suggest that salesperson relationship-building activities themselves do not directly and/or indirectly influence purchase decisions, but instead can moderate the effects of product-focused determinants on retail buyers’ new product selections. Data on actual purchase decisions provide a high level of external validity to the findings. The study closes with a concluding discussion, including theoretical and managerial implications of the findings, limitations of the research, and directions for future inquiry.

Examination of the predictive value of structural magnetic resonance scans in bipolar disorder:a pattern classification approach

Background - Bipolar disorder (BD) is one of the leading causes of disability worldwide. Patients are further disadvantaged by delays in accurate diagnosis ranging between 5 and 10 years. We applied Gaussian process classifiers (GPCs) to structural magnetic resonance imaging (sMRI) data to evaluate the feasibility of using pattern recognition techniques for the diagnostic classification of patients with BD. Method - GPCs were applied to gray (GM) and white matter (WM) sMRI data derived from two independent samples of patients with BD (cohort 1: n = 26; cohort 2: n = 14). Within each cohort patients were matched on age, sex and IQ to an equal number of healthy controls. Results - The diagnostic accuracy of the GPC for GM was 73% in cohort 1 and 72% in cohort 2; the sensitivity and specificity of the GM classification were respectively 69% and 77% in cohort 1 and 64% and 99% in cohort 2. The diagnostic accuracy of the GPC for WM was 69% in cohort 1 and 78% in cohort 2; the sensitivity and specificity of the WM classification were both 69% in cohort 1 and 71% and 86% respectively in cohort 2. In both samples, GM and WM clusters discriminating between patients and controls were localized within cortical and subcortical structures implicated in BD. Conclusions - Our results demonstrate the predictive value of neuroanatomical data in discriminating patients with BD from healthy individuals. The overlap between discriminative networks and regions implicated in the pathophysiology of BD supports the biological plausibility of the classifiers.

An examination of the development of LTL hub-and-spoke freight distribution systems

Over recent years, hub-and-spoke distribution techniques have attracted widespread research attention. Despite there being a growing body of literature in this area there is less focus on the spoke-terminal element of the hub-and-spoke system as being a key component in the overall service received by the end-user. Current literature is highly geared towards discussing bulk optimization of freight units rather than to the more discrete and individualistic profile characteristics of shared-user Less-than-truckload (LTL) freight. In this paper, a literature review is presented to review the role hub-and-spoke systems play in meeting multi-profile customer demands, particularly in developing sectors with more sophisticated needs, such as retail. The paper also looks at the use of simulation technology as a suitable tool for analyzing spoke-terminal operations within developing hub-and spoke systems.

What does "good" look like? A three-country examination of marketing practice

Grounded in configuration theory, this study investigates the notion of co-alignment of business orientation, marketing assets and marketing capabilities, and their relationships to performance. Using these criteria, profiles of high performing businesses were derived and assessed against a three country sample of Brazil, China and the UK. Findings are consistent, statistically significant and invariant across the sample. They show that businesses with ideal profiles significantly outperform competitors in terms of market-based performance, customer satisfaction, and financial performance. Furthermore, profiles of top performing organizations are similar across countries with respect to their orientations, assets, and capabilities. Only customer-based assets, network capabilities, and customer and shareholder orientations were different. Implications and future research directions are subsequently addressed.

An examination of the comprehensiveness of corporate Internet reporting provided by London-listed companies

Recent changes in the regulatory environment of the London Stock Exchange are aimed at prohibiting selective disclosure and enhancing the credibility of reporting. Using an innovative 143-item disclosure checklist, we examine corporate Internet reporting (CIR) comprehensiveness and its determinants within this new regulatory environment. We also extend the literature linking corporate governance measures to CIR. Our findings indicate that despite this new regulatory environment, there is considerable room for improvement in CIR by London-listed companies. For example, our sample companies provide only 58 percent and 70 percent, respectively, of the credibility and usability items assessed by our comprehensiveness index. After controlling for size, profitability, industry, and high growth/ intangibles, we find the CIR comprehensiveness of London-listed companies is associated with analyst following, director holding, director independence, and CEO duality. Because prior research indicates the U.K. leads Europe in Internet reporting, our results may shed light on how CIR will evolve throughout Europe.

An examination of policies and issues relating to the management of industrial land in core and peripheral urban areas

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An examination of courses conducted by South Birmingham Technical College for the training officers

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