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This chapter seeks to investigate the nature of strategic capabilities required for Indian firms to successfully transcend domestic markets and venture abroad. The study is based on intensive case studies of four Indian firms in the manufacturing and services sectors. The findings indicates that the capabilities considered most important by the firm leaders for the internationalization of their activities were ability to develop resources internally, entrepreneurship, and ability to adjust to poor infrastructure need. Three interesting patterns also emerged in the way firms choose to expand their operations to other markets: capability complementing, capability augmenting, and new capability development. Overall, the study indicates that the competencies required to succeed are also significantly influenced by the industry type and prior history of internationalization by associated companies. To gain a better understanding of these issues it would be necessary to moderate for industry, size, and ownership effects.
Introduction: Abdominal pain is one of the most frequent reasons for an emergency department (ED) visit. Most cases are functional and no therapy has proven effective. Our objective was to determine if hyoscine butylbromide (HBB) (BuscopanTM) is effective for children who present to the ED with functional abdominal pain. Methods: We conducted a randomized, blinded, superiority trial comparing HBB 10 mg plus acetaminophen placebo to oral acetaminophen 15 mg/kg (max 975 mg) plus HBB placebo using a double-dummy approach. We included children 8-17 years presenting to the ED at London Health Sciences Centre with colicky abdominal pain rated >40 mm on a 100 mm visual analog scale (VAS). The primary outcome was VAS pain score at 80 minutes post-administration. Secondary outcomes included adverse effects; caregiver satisfaction with pain management using a five-item Likert scale; recidivism and missed surgical diagnoses within 24-hours of discharge. Analysis was based on intention to treat. Results: We analyzed 225 participants (112 acetaminophen; 113 HBB). The mean (SD) age was 12.4 (3.0) years and 148/225 (65.8%) were females. Prior to enrollment, the median (IQR) duration of pain prior was 2 (4.5) hours and analgesia was provided to 101/225 (44.9%) of participants. The mean (SD) pre-intervention pain scores in the acetaminophen and HBB groups were 62.7 (15.9) mm and 60.3 (17.3) mm, respectively. At 80 minutes, the mean (SD) pain scores in the acetaminophen and HBB groups were 30.1 (28.8) mm and 29.4 (26.4) mm, respectively and there were no significant differences adjusting for pre-intervention scores (p = 0.96). The median (IQR) caregiver satisfaction was high in the acetaminophen [5 (2)] and HBB [5 (1)] groups (p = 0.79). The median (IQR) length of stay between acetaminophen [235 (101)] and HBB [234 (103)] was not significantly different (p = 0.53). The proportion of participants with a return visit for abdominal pain was 4/112 (3.5%) in the acetaminophen group and 6/113 (5.3%) in the HBB group. The most common adverse effect was nausea (9% in each group) and there were no significant differences in adverse effects between acetaminophen (26/112, 23.2%) and HBB (31/113, 27.4%) (p = 0.52). There were no missed surgical diagnoses. Conclusion: For children with presumed functional abdominal pain who present to the ED, both acetaminophen and HBB produce a clinically important (VAS < 30 mm) reduction in pain and should be routinely considered in this clinical setting.
The present experiment was undertaken to validate a probiotic of canine origin for its potential use in dogs. A total of fifteen adult female Labrador dogs were allocated to three equal groups and fed a basal diet without probiotic (control) or with probiotic of either canine (Lactobacillus johnsonii CPN23; cPRO) or dairy (L. acidophilus NCDC 15; dPRO) origin for 9 weeks. The digestibility of most macronutrients remained similar among the groups; however, fibre digestibility was improved (P = 0·034) in dogs receiving cPRO. The faecal fermentative metabolites ammonia (P< 0·05) and lactate (P = 0·094) were altered favourably, indicating a positive influence of both probiotics. Faecal concentrations of acetate, propionate and butyrate were increased (P< 0·01) in both probiotic groups. However, improvements were higher in cPRO v. dPRO. The delayed-type hypersensitivity reaction to intradermal inoculation of phytohaemagglutinin-P was higher (P = 0·053) in cPRO as compared with control. The antibody response to sheep erythrocytes was, however, similar across the three groups. Overall, in dogs, the canine-origin probiotic was superior when compared with the dairy-origin probiotic.
The BiFeO3/BaTiO3 (BFO/BTO) multilayers were deposited on Pt/Ti/SiO2/Si substrates using sol-gel spin coating technique. The electric and magnetic studies on BFO/BTO multilayer structures were carried out for different number of layers. Enhancement in multiferroic properties were seen for all the prepared multilayers as compared to individual BTO and BFO thin films. Maximum value of ferroelectric polarization 71.18 µC/cm2 and saturation magnetization 69.85 emu/cm3 was obtained for multilayer structure having five layers. The observed enhancement in the multiferroic properties of the multilayer system is due to the increased interfacial stress and multiferroic coupling between the alternating layers.
Allergic rhinitis is associated with excess specific immunoglobulin E. Inner ear involvement (via both cellular and humoral immunity) is poorly understood, but appears to arise from the endolymphatic sac and duct.
To assess the otological and audiological status of patients with allergic rhinitis.
Thirty allergic rhinitis patients (14 men, 16 women; age 17–45 years, mean 31 years) and 20 controls (12 men, eight women; age 21–42 years, mean 27 years) underwent audiological investigation.
All study group patients had sensorineural (rather than conductive) hearing loss, worse at high frequencies. All had abnormal transient evoked otoacoustic emissions and 27 had abnormal distortion product otoacoustic emissions. All had a statistically significantly prolonged wave I latency, and shortened absolute wave I–III and I–V interpeak latencies, compared with controls.
Allergic rhinitis patients had a higher prevalence of hearing loss and otoacoustic emission abnormalities than controls. The endolymphatic sac can process antigens and produce its own local antibody response; the resulting inflammatory mediators and toxic products may interfere with hair cell function. Additional research is needed to determine the clinical value of audiometry and otoacoustic emission testing in allergic rhinitis.
Chemical Mechanical Planarization (CMP) has emerged as the central technology for polishing wafers in the semiconductor manufacturing industry to make integrated multi-level devices. Both chemical and mechanical processes work simultaneously to achieve local and global planarization. Although extensive research has been carried out to understand the various factors affecting the CMP process, many aspects remain unaddressed. One such aspect of CMP is the role of abrasives in the process of conditioning. Abrasives play an important role during conditioning to regenerate the clogged polishing pads. This research is focused on the study of abrasives in the process of conditioning with a focus on the size of abrasives. With diamond being widely used as an abrasive for conditioning the polishing pad, five different sizes of diamonds ranging from 0.25μm to 100μm were selected to condition the commercially available IC 1000 polishing pad. Properties like pad roughness and pad wear were measured to understand the effect of the abrasive size on the pad morphology and pad topography. In-situ ‘coefficient of friction’ was also monitored on the CETR bench top tester. The final impact was seen in the form of surface defects on the polished copper wafers using optical microscopy.
To meet the stringent requirements of device integration and manufacture, surface defects and mechanical stresses that arise during chemical mechanic planarization (CMP) must be reduced. Towards this end, we have synthesized multiple hybrid and composite particles on micron length scales consisting of siloxane co-polymers functionalized with inorganic nanoparticles. These particles can be easily tailored during synthesis, leading to softer or harder abrasion when desired. Upon using these particles for the planarization of silicon oxide wafers, we obtain smooth surfaces with reduced scratches and minimal particle deposition, which is an improvement from conventional abrasive materials like pure silica, ceria and alumina nanoparticle slurries. Tribological characteristics during polishing were examined using a bench top CMP tester to evaluate the in situ co-efficient of friction. Characterization of the hybrid and composite particles has been done using infrared spectroscopy, dynamic light scattering, and electron microscopy. Surface roughness of the wafers was examined using atomic force and optical microscopy while removal rate measurements were conducted using ellipsometry at multiple angles.
This chapter discusses the implications of oxidative stress (OS) on female reproduction and assisted reproductive technology (ART). Reactive oxygen species (ROS) such as superoxide, hydrogen peroxide, hydroxyl, and singlet oxygen radicals are capable of producing free radicals leading to OS. Various biomarkers of OS have been studied in the female reproductive tract. ROS is thought to play a regulatory role in oocyte maturation, folliculogenesis, ovarian steroidogenesis, and luteolysis. ROS may play a role in age-related decrease in estrogen production. Superoxide dismutase (SOD) and glutathione peroxidase expression decreases in the ovary from the premenopausal to menopausal period. The effects of follicular OS on oocyte maturation, fertilization, and pregnancy have also been studied. Follicular fluid ROS and lipid peroxidation levels may be markers for success with in vitro fertilization (IVF). Successful management of infertility in the ART scenario depends on overcoming OS in the in vitro conditions.
A case of idiopathic intracranial hypertension (IIH) with visual field loss was decompressed in the intracanalicular segment of the optic nerve transnasally under endoscopic control. Visual functions improved after surgery.
Treatment of auricular arteriovenous fistula (AVF) is a challenge with surgery being the preferred option until now. We present three cases of auricular AVFs who underwent pre-operative embolization and its outcome on surgery. Three patients were diagnosed to have auricular AVF by angiography. All three patients underwent pre-operative embolization with n-butyl 2-cyanoacrylate after which they underwent surgical resection of the AVF. Pre-operative embolization resulted in significant devascularization of the AVF thus leading to near bloodless and clean surgery. Pre-operative embolization of auricular AVFs is a good treatment option, leading to significantly reduced blood loss during surgical excision.
Since the introduction of clozapine, several novel antipsychotic agents have been introduced and more are in Phase II/III studies. Because these agents are used clinically as first-line treatment, we need to be more familiar with their side-effect profiles. This manuscript reviews the cardiovascular side effects of currently available novel antipsychotics. The medications reviewed include clozapine, risperidone, olanzapine, quetiapine, and ziprasidone. Guidelines are suggested for the use of these medications in clinical practice.
The lattice deformation caused by 100 MeV Ti7+ ion irradiation in Si (100) has been studied using X-ray topographic techniques. An important finding is the appearance of a strain field perpendicular to the ion beam direction in the irradiated region well separated from the projected range of implanted ions. This in-plane strain extends in the bulk of the sample and is not merely confined to the surface. The implanted region has been found to experience an out of plane strain which is expected to be tensile in nature.
1.1.1 The Faculty of Actuaries' Marketing Research Group was set up in May 1988 to research areas of interest to that new breed of Fellow, the “Marketing Actuary”.
In the initial meetings two general areas of interest were identified—namely the marketing of the actuarial profession, and the marketing of financial services products.
Whilst the group has spent time on both subjects this first paper is concerned with the marketing of the actuarial profession.
1.1.2 We felt that the starting point for a marketing audit of the profession was to conduct research amongst the members. In addition we have investigated the coverage achieved by the profession in the media, and looked into developments in North America, including a survey which ranked the actuarial profession against other forms of employment.
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