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Background: The Americas Hepato-Pancreato-Biliary Association (AHPBA) Education and Training Committee standardized a Hepatopancreatobiliary (HPB) Surgery Fellowship certification process in 2010. Several classes of fellows have since graduated from HPB, combined Society of Surgical Oncology/AHPBA, and combined American Society of Transplant Surgeons/AHPBA fellowships, but there is little information on their career outcomes. We seek to offer long-term data on the careers of HPB fellowship graduates.Methods: A 26-question anonymous survey was distributed among graduates of accredited programs for the last 10 years. We generated descriptive statistics from the responses.Results: The respondents were evenly distributed in terms of graduation years between 2010 and 2019. Fifty-eight percent of fellows had completed a prior fellowship, 82% received 1 to 3 job offers during the fellowship, and 75% of respondents were still at their first job. The majority of graduates (>60%) were able to secure a job with a >50% HPB practice and >40 HPB cases per year within 3 years of graduation. Overall, >90% candidates rated their satisfaction with fellowship training greater than 8 out of 10.Discussion: This survey helps shed light on the early formative years in the practices of HPB fellowship graduates. These data show that HPB fellowship training is essential and effective in providing job security and helps fellowship graduates develop a gratifying practice. [ABSTRACT FROM AUTHOR]

Results of a cross-cultural empirical study investigating differences of managers' attitudes towards ethical 'grey areas' and their influence on managers' decision making are reported. Findings reveal that the perceived behavior of managers'collegues is especially important, indicating that companies should place more emphasis on intervening in peer dynamics rather than trying to legislate conduct.

Maxadilan is a potent vasodilator suggested to share pharmacological and immunological properties with the calcitonin gene-related peptide. Exposure of vessels from isolated rabbit thoracic and abdominal aorta, carotid artery and iliac artery caused dose-dependent and endothelium-independent arterial relaxation. Pharmacological probes revealed that maxadilan-mediated arterial relaxation involved the activation of adenosine 3',5'-cyclic monophosphate but was inhibited by protein kinase A inhibitor H-89.

Militancy is a continuing process in many developing regions where entrepreneurial activities in the informal economy have the potential to transform lives leading to sustainable development through local initiatives. Often militancy originates in protest against global encroachment and defending the livelihoods of local communities. Yet this leads to detrimental effects on such initiatives. The study focuses on small and medium-sized enterprises (SMEs) in the Niger Delta in Nigeria and looks at how the lessons learned may be used in other developing regions facing similar issues. Findings suggest how violent conflict resulting in an adverse impact on enterprise development can be mediated by collective actions. [ABSTRACT FROM AUTHOR]

China's international engagement is changing geopolitical dynamics to an extent that Western governments appear concerned. Negative reports of this engagement in Africa abound, not least in the area of employment relations and human resource management. Yet currently there is a lack of serious management research and theory development in this area, leaving international HR managers to rely on anecdotal information. The way Chinese management engages with African workforces may be quite different from Western managers'. The current work suggests that understanding this engagement should be informed by China's recent anti-imperialist involvement in Africa, its commercial motivation coupled with its political-seeking motive, the values such as paternalism that modify Western influences on Chinese HRM that are brought to Africa, and possible synergies with African values. Yet the current work identifies from the current published evidence a disparity between China's professed strategic level of engagement and what happens at the organizational level, indicating that many Chinese organizations may be contributing to employment, but not to upskilling of workers, mutual learning, or engagement with local communities. © 2014 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Several pathophysiologic changes after the Whipple procedure have been well described, but anemia has not. Post-surgical changes can impede micronutrient absorption. We hypothesize that patients post-pancreatoduodenectomy suffer from iron deficiency anemia. Patients who underwent a pancreatoduodenectomy from 2016 to 2018 were retrospectively evaluated. Preoperative, intraoperative, and postoperative data, including hemoglobin (Hb) levels and mean corpuscular volume (MCV) as well as therapies with chemoradiation, iron, and/or B12 were collected at 1-, 3-, 6-, and 12-months after surgery. The dataset included 74 patients (median age: 64 years). Mean preoperative Hb and MCV were 11.7 ± 1.9 g/dl and 90.1 ± 7.3 fl, respectively. Significant changes in Hb were noted at 1 and 6 months (11.7 vs 10.9, p = 0.01 and 11.7 vs 11.3, p = 0.003, respectively), and in MCV were noted at 6 and 12 months (90.1 vs 94.6, p = 0.008 and 90.1 vs. 93.7, p = 0.02, respectively). All patients remained anemic after pancreatoduodenectomy. This was not linked to chemotherapy. Iron and vitamin B12 supplementation, given in a minority, did not ameliorate the anemia. Future studies should investigate this lack of aid, as nutrient supplementation may be an important change in the standard of care of these patients. [ABSTRACT FROM AUTHOR]

The cultural perception that human beings are a resource to be used in the pursuit of shareholder value may be challenged by a view that people have a value in their own right. The two classic world systems of management, American and Japanese, may provide the archetypal distinction between two ways of valuing people in organizations and the basis of the ideal types which are referred to in the international management literature as Western and the converse non-Western management practices. There is a growing interest in the relationship between indigenous and Western cultures in the practice and development of management and organization internationally. If organizations are regarded as fulfilling collective social needs such as providing full employment, or serving the needs of people as part of a collective in-group, this may be reflected in the level to which organizations are seen to be fulfilling the needs of their people. Going against this type of view within individualistic societies may be a belief that the corporation has only a contractual obligation to its employees. In a society with collectivistic socio-cultural values, individuals may be valued as part of the wider collective.

There is currently a lack of empirical work on cross-cultural differences in ethical attitudes towards day-to-day management decision-making in organizations. Work that currently exists in the area of management ethics also lacks cultural explanations of differences. The present study tries to overcome these deficiencies by providing a model of ethical decision-making that is based on cultural antecedents, which may explain differences in judgements of ethicality, and consequential ethical attitudes or professed behaviour. This article reports a 10-nation empirical study that focuses on ethical `grey areas' that form part of the day-to-day decision-making in organizations across the globe. Countries were selected to represent variation along two cultural dimensions of `collectivism-individualism', and `uncertainty avoidance'. These dimensions were then used to explain national cultural differences in judgements of ethicality of decision items concerned with relations with external stakeholders, with the corporation and with the group. Results generally confirm that these dimensions, once elaborated to consider more recent detailed research, provide explanations for differences in ethical attitudes among national groups. This study points the way to further investigations based on cultural explanations of differences in managers' ethical attitudes and behaviour. KEYWORDS cross-cultural * ethics * international * management * values

Despite increasing Chinese MNE activity in emerging countries, there is a paucity of studies and critical analysis of expatriate management in Emerging Market Multinational Enterprises (EMMNEs). This article provides a needed critical evaluation of the literature and research, and identifies an agenda for research. Chinese firms' expatriation policies and practices should be viewed differently to those of Western firms. This has implications for policy regarding state MNEs in African countries, and individual Chinese MNE expatriation policies. There are potential synergies between Chinese and African cultural values, moderated by a low importance of the knowledge transfer role of Chinese expatriates. This may be moderated by the relational nature of career development including expatriate selection and a low emphasis on predeparture training. The main contribution of this work is to inform empirical research at organizational level by making explicit differences in Chinese MNE engagement in Africa to Western MNEs, how this may influence differences in expatriate policy and practices, and why this may contribute a different perspective to the extant expatriation literature. [ABSTRACT FROM AUTHOR]

The article presents the U.S. is faced with a severe projected shortage of physicians and surgeons in this environment, we believe that increasing specialty and subspecialty training is further widening the supply and demand gap. Topics include creating a culture where a patient with a pancreatic mass, and the paraesophageal hernia can only be taken care of if a surgical oncologist or hepatobiliary surgeon is available with a foregut or thoracic surgeon.

Background Electromagnetic navigational bronchoscopy (ENB) is a commonly used technique to obtain biopsies of peripheral pulmonary lesions. Little is known about risk factors for complications with this procedure. The aim of this study was to assess the complication rate associated with ENB and the relationship of complications to patient- and procedure-related factors. Methods Consecutive ENB procedures at an academic medical center between May 11, 2011, and September 11, 2015, were reviewed retrospectively. Preoperative characteristics, including pulmonary function, procedure characteristics, and the occurrence of complications, were recorded. Results In all, 361 procedures were performed on 341 patients. Complications occurred in 30 of 361 (8.3%), the most common of which was pneumothorax (27, 7.5%). Complications were not related to age, sex, American Society of Anesthesiologists grade, or pulmonary function test result. Patients with complications had longer procedure times (50 versus 73 minutes, p = 0.03), and had more interventional modalities used (2.4 versus 3.2, p = 0.001). Multiple logistic regression demonstrated that bronchoalveolar lavage was significantly associated with complications (odds ratio 6.40; 95% confidence interval: 1.68 to 24.3, p = 0.006). Conclusions Electromagnetic navigational bronchoscopy is safe, and the rate of complications is not elevated among patients with poor lung function. Bronchoalveolar lavage performed during ENB was associated with elevated risk of complications and should be studied further. [ABSTRACT FROM AUTHOR]

Background. Bile contamination from the digestive tract is a well-known risk factor for postoperative complications. Despite the literature concerning prevalence of bacterobilia and fungobilia in patients with biliary pathologies, there are no specific recommendations for perioperative antimicrobial coverage for biliary/pancreatic procedures. We evaluated the effect of at least 72 hours of perioperative broad spectrum antibiotic coverage on outcomes of pancreaticoduodenectomy (PD). Materials and Methods. A retrospective review of all patients at Case Medical Center of Case Western Reserve University undergoing PD procedure, from 2006 to 2011, was performed (n=122). Perioperative data including demographics, comorbidities, biliary instrumentation, antibiotic coverage, culture results, and postoperative outcomes were analyzed. Propensity score matching method was used to match the patients according to duration of antibiotic coverage into two groups: 72 hours (A72) and 24 hours (A24). Results. Longer broad spectrum antibiotic coverage in group A72 resulted in significantly less surgical site infections after PD, compared to routine 24 hours of perioperative antibiotics in group A24. This study did not reveal a statistically significant decrease in postoperative fungal infections in patients receiving preoperative antifungals. Conclusion. Prolonged perioperative antibiotic therapy in conjunction with intraoperative bile cultures decreases the short-term infectious complications of PD, with no significant increase in Clostridium difficile colitis incidence. [ABSTRACT FROM AUTHOR]

Future liver remnant (FLR) is the most important deciding factor in planning for liver resection. Portal vein embolization (PVE) was first introduced in the 1980s to induce liver hypertrophy, enabling removal of multiple/bilobar tumors. PVE was later combined with sequential hepatectomies with the aim of allowing the liver remnant to hypertrophy (15-20%) between procedures. However, the interval between the two procedures (3-8 weeks) put patients at risk for disease progression. With portal vein ligation alone or when combined with sequential hepatectomy, there is also a risk for inadequate liver hypertrophy because of intrahepatic portal collaterals leading to a high (19-30%) dropout rate. The ALPPS procedure (associating liver partition and portal vein ligation for staged hepatectomy) was recently developed as a feasible means to perform extensive/bilobar liver resections. It produces rapid, enormous hypertrophy of the remnant, making previously unresectable lesions resectable. Indications for ALPPS include any extensive liver resection with inadequate FLR. Here we present a novel indication for ALPPS as a rescue when inadequate FLR was faced intraoperatively, during a simultaneous resection of rectal primary and liver metastasis. [ABSTRACT FROM AUTHOR]

The presence of China in Africa has introduced a new geopolitical dynamic that should be incorporated into the way international human resource management (HRM) is studied cross-culturally. Despite a growing literature on China's international relations with and investment in Africa, little previous study has been undertaken at organizational level. We review relevant literature, together with that on management and organization in Africa and China, to develop a conceptual framework that incorporates critiques of North–South interactions including Dependency Theories that posit First World development is based on Third World underdevelopment, and Postcolonial Theory that posits the South's knowledge dependency on the North. We consider how a growing South–South dynamic may be integrated into a consideration of power dynamics and cultural crossvergence, and construct organizational and management ‘ideal types’ to enable us to frame a research agenda in this area. This is important, as it is difficult to sustain cross-cultural scholarship merely on cultural comparisons. By providing a way of studying cultural hybrid forms of organization, or cultural ‘third spaces’, it is hoped this will contribute to understanding the implications to people management practice in South–South partnerships, not only in Chinese organizations in Africa, and contribute theoretically to the development of cross-cultural management studies and its application to international HRM. [ABSTRACT FROM PUBLISHER]

An introduction is presented in which the editor discusses various reports within the issue on topics including cross-cultural management, worker participation and rights, and paternalistic styles.

The informal economy has grown in importance within sub-Saharan Africa, yet there are debates about its role within national economies that appear not to take cognizance of the interests and the weak power base of those working within the informal economy. The current article argues that a cross-cultural perspective should be taken in understanding the geopolitical context of informal organizations, the power relationships involved and how the contributions and future of skills development, employment and organization within the informal and wider economies can be better understood and researched. It initially alludes to the informal sector being closer to local communities, and more appropriate to developments in Africa, but draws on postcolonial theory to better understand the nature and role of such organization within an interface of structural and phenomenological influences that question the nature of the ‘indigenous’ as an artefact. Some of the parameters of research in this area are drawn within this work while recognizing that further development is needed in both theory and methods. This article thus attempts to lay the foundations for a cross-cultural conceptual framework leading to a methodology that can inform both practice and policy in this neglected but important area. [ABSTRACT FROM PUBLISHER]

Non-profit organisations (NPOs) are being pushed to become 'more business-like', reflecting global discourse on 'aid effectiveness', which is underpinned by managerialist modes of thinking that may be inappropriate to local contexts. We examined the nature of the tendency towards institutional isomorphism empirically investigating this with 14 NPOs in South Africa's Eastern Cape, using a conceptual framework derived from institutional theory. This suggests that institutional isomorphism is shaping management in NPOs. However, this theory seems inadequate in explaining resistance to these forces. We go on to explain the limitations of using a purely institutionalist lens and suggest how the integration of postcolonial theory may benefit further research. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

China’s presence in Africa appears to be part of a new geopolitical dynamic that may be affecting the way management and organizational knowledge from the South should be conceptualized and studied. The purpose of this article is to interrogate the adequacy of emerging critical management theories premised on challenging the West’s modernization projects, particularly Postcolonial and Dependency Theories, in the light of a changing geopolitical dynamic. It discusses the need for a new theoretical lens through which to understand and research China’s presence in Africa at organizational and community levels. It points to the lack of empirical knowledge at these levels, and proposes a research agenda based on an interrogation of China’s previous anti-colonial relationship with African countries and the way its present-day motives are played out at organizational level, and with an aim to understanding the extent to which China’s engagement is given voice to African management and organizational knowledge. [ABSTRACT FROM PUBLISHER]

Purpose: The purpose of this paper is to report the findings of a broad-based study that initially investigated a possible gap in global inputs into the fight against HIV/AIDS and TB co-infection, and outputs in terms of results achieved. It is proposed that such a gap may be hypothesized to be due, at least in part, to inappropriate management regimes within the global health governance structure. The research does not simply question the effectiveness of the management of programs and projects, but rather the inappropriateness resulting from the lack of addressing cross-cultural issues. Design/methodology/approach: The factors facilitating or hampering project service delivery were examined, by looking at 12 case studies in Botswana and South Africa. These data were complemented with seven semi-structured interviews with donor organizations and NGOs, conducted in the North. Cultural interactions were investigated by using the concept of "interfaces". Findings: The results suggest that there is a disjuncture between the global and local level that affects project delivery. The main issues hampering project outcomes can be summarized as systemic, structural and cultural. Originality/value: The article's main contributions are both theoretical, looking at global project delivery from a cross-cultural management perspective, as well as to development praxis by highlighting the need to focus more critically on cross-cultural management issues within the global health governance structure, and indeed within international development as a whole. [ABSTRACT FROM AUTHOR]