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Megalencephaly-capillary malformation-polymicrogyria syndrome (MCAP) is a rare genetic disorder characterized by megalencephaly, polymicrogyria, body overgrowth, and cutaneous capillary malformations. It has been reported recently that MCAP is related to a somatic mosaic mutation in the phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) gene. We report a case of hemimegalencephaly with polymicrogyria and cutaneous capillary malformations diagnosed by genetic evaluation of MCAP in the neonatal period. The PIK3CA mutation [c.1635G>T (p. Glu545Asp)] was determined by Sanger sequencing. The patient was treated with a ventriculoperitoneal shunt for progressive hydrocephalus. Because of the dynamic, progressive clinical manifestations and tumor-prone traits of MCAP, early diagnosis is important. Moreover, since the phosphoinositide 3-kinase (PI3K)-specific inhibitor, a targeted therapy for the PI3K/AKT/mTOR signaling pathway is emerging as a new therapy, early genetic diagnosis is becoming increasingly important.

The purpose of the current research is to examine the effect of repetition upon recall and attitudes when a list of ads includes (vs. does not include) creative ads. We found significant context effects, as the presence of creative ads in a list decreased recall of, and attitudes towards, regular ads. The effects of repetition upon recall for regular ads decreased by 30% when those ads were shown alongside creative ads. When creative (vs. regular) ads were repeated, recall for non-repeated regular ads dropped by 70%. Furthermore, the current research found that regular ads were judged less favorably when a list of ads included creative ads. Overall, ad attitudes for the same regular ads were 10% lower when shown in the presence of creative ads. In order to avoid such impairment effects, the current research demonstrates why advertisers need to develop creative advertising.

Lumbar transforaminal epidural injection (TFEI) effectively decreases low back pain and radicular pain in herniated intervertebral disc (HIVD) and spinal stenosis (SS). The precise delivery of drugs to the target is important for pain control and minimizing complications.We aimed to evaluate the efficacy and complications of the subpedicular (SP) and retrodiscal (RD) approaches by analysis of contrast spread patterns into the pathologic target on the basis of a newly established specific criterion. We also investigated whether the severity of patients' spinal disease influenced this pattern.A prospective, randomized, observational study.Interventional pain management center at a university-affiliated hospital.Among patients who showed lumbar spinal stenosis or HIVD at the L4/5 level, participants were randomly assigned to undergo TFEI with the SP approach (SP group) or RD approach (RD group). Pain relief in terms of the visual analog scale (VAS) score and complications such as intravascular or intradiscal uptake were also analyzed. The contrast image was analyzed as the contrast media was injected, starting from 0.5 mL up to 3.0 mL. The spread patterns of contrast media were graded into 4 categories, which were newly defined in this study.Both groups demonstrated a significant decrease in pain relief (P value0.01) at 2 and 4 weeks after the procedures, but no significant difference was found between the 2 groups. In the intergroup analysis between the RD and SP groups, with a 1.5-mL contrast media injection, more patients in the RD group (17.2%) showed a grade 3 spread than those in the SP group (8.2%). In the subgroup analysis, the RD group showed superior spread (more grade 3 and 4) with 1.5-, 2-, and 2.5-mL contrast media injections (P values = 0.02, 0.03, and 0.04) in severe central stenosis, and 1.5- and 2-mL contrast media injections (P values = 0.01, 0.02) in severe foraminal stenosis.The follow-up period was only 4 weeks after TFESI, and higher contrast injection was used for procedures.The RD approach for TFEI showed a better contrast spreading pattern than the SP approach, especially in patients with severe central and foraminal spinal stenosis. The RD approach might be more beneficial for patients with severe central and foraminal spinal stenosis in the short-term follow-up.

Previous literature on sponsorship-linked marketing have shown that articulation messages lead to more favorable attitudes toward the sponsor brand. However, results from some studies do not entirely support this finding, suggesting that important variables affecting the sponsorship articulation–fit relationship may have been overlooked. Addressing this gap in the literature, the authors show that consumer responses to sponsorship articulation are moderated by the fan’s level of identification with a sports team. That is, fans high in team identification respond differently to various types of articulation messages whereas fans with lower team identification levels do not. Furthermore, the authors demonstrate that messages highlighting how fans and sports team benefit from the sponsorship deal elicit thoughts of sincerity which in turn evokes reciprocity and more favorable attitudes from highly identified fans.

The present research builds upon the touch literature to show that the salience of haptic product attributes related to product surface texture (smooth, rough) and weight (light weight, heavy weight) influence consumer product impressions. We propose that haptic cue congruity across texture and weight drive consumer product impressions depending on a consumer's need for touch (NFT). We show that high autotelic-NFT consumers who touch for sensory pleasure enjoyed the incongruity between smooth texture and heavy weight haptic cues, and consequently showed favorable evaluations towards exciting brands. In contrast, low autotelic-NFT consumers prefer the anticipated match between smooth texture and light weight haptic cues, which conformed to their expectation about the nature of a sophisticated brand personality. Further, we show how the interactive effect of haptic attributes and a consumer's autotelic-NFT on willingness to purchase is mediated by product personality. Implications for theory and practice are discussed.

This research note investigates how consumers’ individual differences are associated with their attitude towards trip advice that has been curated by artificial intelligence (AI). Individual difference factors (anthropomorphic tendency, need for cognition, disillusionment toward marketing, life satisfaction) and variables such as smart phone usage were correlated with attitude towards AI-curated reviews (AAICR). A survey of 212 individuals from Taizhou, China found that anthropomorphic tendency, need for cognition, and smart phone usage were positively associated with AAICR. When controlling for the effect of need for cognition and smart phone usage, the effect of anthropomorphism on attitudes was still robust. Disillusionment toward marketing and life satisfaction were not associated with AAICR. The results contribute to the tourism literature by showing the effect of anthropomorphism on AAICR. Tourism practitioners who wish to inspire consumers with AI-curated destination reviews should target consumers with a high anthropomorphic tendency

Firms are deploying chatbots to automate customer service. However, miscommunication is a frequent occurrence in human-chatbot interaction. This study investigates the relationship between miscommunication and adoption for customer service chatbots. Anthropomorphism is tested as an account for the relationship. Two experiments compare the perceived humanness and adoption scores for (a) an error-free chatbot, (b) a chatbot seeking clarification regarding a consumer input and (c) a chatbot which fails to discern context. The results suggest that unresolved errors are sufficient to reduce anthropomorphism and adoption intent. However, there is no perceptual difference between an error-free chatbot and one which seeks clarification. The ability to resolve miscommunication (clarification) appears as effective as avoiding it (error-free). Furthermore, the higher a consumer’s need for human interaction, the stronger the anthropomorphism - adoption relationship. Thus, anthropomorphic chatbots may satisfy the social desires of consumers high in need for human interaction.

Despite the proliferation of gamification in the workplace, little is known about the contextual factors that contribute to its efficacy and impact on employee engagement and organizational productivity. Employing self-determination theory, this research investigates the impact of extrinsic motivation, such as social pressure or internalized guilt, on employees' psychological needs satisfaction and behavioral intention. A survey (n = 291) across multiple industries shows extrinsic motivation can decrease employees' autonomy and competence needs satisfaction, but when extrinsic motivation is internalized (such as through perceived personal value) it can support needs satisfaction, intrinsic motivation, and behavioral intention. For managers, these results indicate that beyond being enjoyable, sustainable gamification design should provide benefits that are meaningful to and valued by employees. While it is acknowledged that further research is required, this study provides a basis for deeper understanding of how gamification works as the first to empirically examine the role of extrinsic motivation.

Statistical and analytical methods using artificial intelligence approaches such as machine learning (ML) are increasingly being applied to the field of pediatrics, particularly to neonatology. This study compared the representative ML analysis and the logistic regression (LR), which is a traditional statistical analysis method, using them to predict the mortality of very low birth weight infants (VLBWI). We included 7,472 VLBWI data of a nationwide Korean neonatal network. Eleven predictor variables (neonatal factors: male sex, gestational age, 5min Apgar scores, body temperature, and resuscitation at birth; maternal factors: diabetes mellitus, hypertension, chorioamnionitis, premature rupture of membranes, antenatal steroid, and cesarean delivery) were selected based on clinical impact and statistical analysis. We compared the predicted mortality between ML methods, such as artificial neural network (ANN), random forest (RF), and support vector machine (SVM), and LR with randomly selected training set (80%) and test set (20%). The model performances of area under the receiver operating curve (95% confidence interval) equaled LR 0.841 (0.811–0.872), ANN 0.845 (0.815–0.875), and RF 0.826 (0.795–0.858), except SVM 0.631 (0.578–0.683), respectively. No statistically significant differences were observed between the performances of LR, ANN, and RF (i.e., P > 0.05). However, the SVM model was lower (P < 0.01). We suggest that VLBWI mortality prediction using ML methods would yield the same prediction rate as the traditional statistical LR method and may be suitable for predicting mortality. However, low prediction rates are observed in certain ML methods; hence, further research is needed on these limitations and selecting an appropriate method

Chronic health conditions have necessitated the need for behavioral interventions (such as exercise programs) outside of clinical contexts, increasingly managed through technology such as mobile health (mHealth) services. Gamification has emerged as a promising tool to facilitate greater engagement in these services; however, no studies investigate the links between specific game design elements (GDEs) and psychological or behavioral outcomes within a health context. This domain is motivationally complex and has shown resistance to the satisfaction of social (relatedness) needs, presenting a challenge to the design of gamification products for health promotion. Drawing on self-determination theory, this research demonstrates the strengths of a taxonomy based upon structural features of GDEs (such as social, narrative or reward elements) rather than the design intent definitions of these elements used in previous studies. This taxonomy is then used to assess the relationship between GDEs and psychological needs satisfaction in a survey (N = 236) of gamified exercise/fitness application users. Further qualitative interviews (N = 20) were conducted to clarify survey findings. This research demonstrates the positive association between control and presentation elements and autonomy satisfaction, and control and reward elements and competency satisfaction. However, it also suggests that player type and context may limit the ability for GDEs alone to support relatedness satisfaction in mHealth services. Implications for managers and researchers are discussed, particularly the strengths and weaknesses of using structural taxonomies in gamification assessment.Gamification, which is the use of game design elements (GDEs) such as points, badges and avatars in nongame contexts, has emerged as a promising tool for health promotion. However, while past studies demonstrate the capacity for gamification to deliver positive outcomes in health contexts, there is still limited understanding of what contributes to the success or failure of these health campaigns. This study consists of a quantitative online survey of 236 users of exercise/fitness gamification products, as well as qualitative interviews with an additional 20 users, to investigate the relationship between specific GDEs (such as social elements or control elements) and the satisfaction of users’ psychological needs. This study found that control and presentation elements had a positive relationship with feelings of user agency, while control and reward elements had a positive relationship with feelings of mastery. However, no specific GDEs supported feelings of connection with other users, with the interviews suggesting this may be due to differences in the types of players and the desire for interaction with others outside (rather than inside) the gamification service.

Purpose The creativity-based facilitation effect, well documented by previous research, shows that creative advertisements (ads) are more memorable than regular (or less creative) ads, that is, creativity facilitates memory. This current research aims to extend our understanding by investigating the impact of creativity on regular ads and competitive advertising. It examines whether creative ads impair the memorability of regular ads to determine whether a “creativity-based impairment effect” exists. Design/methodology/approach Three experiments were conducted. Experiment 1 tested creativity-based impairment effects in brand recall. Experiment 2 replicated and validated the impairment effect in recall, using a different presentation order of ads. In Experiment 3, effects of creative ads on competing vs non-competing brands were examined. Findings Results found that creative ads impaired the brand recall of regular ads, creative ads impaired the recall of competing brands more than non-competing brands and creative ads were recalled earlier in top-of-mind recall positions. Research limitations/implications Future research may look at whether different memory measures (e.g. recognition), different proportions of creative ads, and ads of familiar vs unfamiliar brands produce differential impairment effects. Practical implications One suggestion from this research could be to not only copy-test your own brand’s advertising, but also test the advertising of other brands so that the target ad’s relative levels of creativity can be assessed before media buying. As a result of this testing, when the brand identifies any potential impairment effects, the identified creative ads could then be tracked in terms of media placement, providing a guide of where “not to schedule” advertising. Originality/value This research makes an important theoretical contribution as the first to explore impairment effects in the context of creative advertising. In doing so, it offers important managerial insights for regular and competitive advertising.

This article examines why consumers choose to research their ancestry using commercial available products. Prior research suggests this is a voyage of personal discovery. We take this voyage and review consumer interest in ancestral products (e.g., DNA services) that is driven by a consumer’s uncertainty about their sense of self. Focusing on uncertainty-identity theory, the findings from a study with a sample of adult Australian consumers show that people who want to reduce uncertainty about their sense of self respond favourably to a genealogical product that offers insight into a person’s ancestry. Finding support the proposition that the need for closure moderates this effect. Consumers who are high in need for closure respond to self-uncertainty through an interest in commercial genealogical products. The study results show that curiosity underlies the effects in several ways; the desire to gain new knowledge about self, a curiosity to understand the past and the desire to reduce self uncertainty about the past. Research implications for the study of consumer self-identity and uncertainty are presented, how consumers respond to this through the use of genealogical products examined. Managerial implications for the marketing of genealogical products are discussed, and recommendations for future research made.

This research examined the relationship between different measures of narcissism and a range of consumption behaviors. Measures of individual, communal, and collective narcissism were correlated with three sets of consumption behaviors termed vanity, self-improvement, and prosocial consumption behavior. Based on a sample of 552 MTurk users, it was found that all narcissism measures were positively associated with vanity behaviors. However, differences amongst narcissism measures emerged for self-improvement behaviors and prosocial behaviors. The admiration scale of the NARQ was positively associated with self-improvement and prosocial behaviors, whereas the rivalry scale of the NARQ was negatively associated with prosocial behaviors. The communal and collective narcissism scales were also positively associated with prosocial consumption behaviors. The results contribute to the narcissism literature by showing (1) which narcissism measures are most strongly related to consumption behaviors (2) that certain measures of narcissism are positively associated with some prosocial consumption behaviors, and (3) that individual, communal and collective narcissism are not strongly correlated with each other.

This research examines the impact of Chinese tourists' level of entitlement (i.e., a belief they deserve more than others) on their responses to testimonials for a missed benefit. Missed benefits are destination activities which are no longer available (e.g., an annual festival). Two experiments compare how Chinese tourists react to a testimonial for a missed benefit from a satisfied tourist (vs. a local citizen). Results show that entitled tourists dislike testimonials from tourists. Non-entitled tourists have a similar preference for either endorser. The results provide important theoretical implications. First, the research introduces a new area of study to tourism researchers: missed benefits. Second, the results show how tourist entitlement negatively influences testimonial responses. Third, the malicious envy entitled tourists feel towards the tourists in the testimonial drives their negative responses. Managerial implications include showing destination marketers that Chinese tourists can have an entitled mindset. This mindset can result in envy felt toward other tourists which can explain their negative responses to marketing messages about destination activities.

This study assessed consumers’ initial reactions to in‐feed native ads appearing as news content. In particular, it focuses on consumers’ recognition of advertising when they realize that content they had thought were news stories had in fact been advertising. Recognition of advertising made consumers infer that advertisers had deliberately manipulated them. Consequently, consumers engaged less with the message, had less positive attitudes toward the brand, and were less likely to purchase and share. The results demonstrated the mechanisms through which the two mediators, manipulative intent and message engagement, lowered brand attitude, purchase intention, and sharing intention. In addition, ad disclosure made more people recognize the ad when they were exposed to it than when it was not disclosed as an ad.

This research investigates the interaction between ego depletion (a state of reduced self-regulatory resources) and different types of charitable message appeals upon subsequent charitable support. Three experiments compare the time donation intent and actual monetary donations of depleted (vs. non-depleted) individuals who have been exposed to either a self-benefit message, highlighting the gains to be accrued to donors themselves, or an other-benefit message which focuses on the welfare of beneficiaries. The results show that when people are depleted, self-benefit messages are more effective than other-benefit messages in generating charitable support. When people are not depleted, the opposite pattern is observed. It appears that generosity among depleted people is self-seeking. As a processing mechanism, we show that depleted individuals perceive self-benefit messages as more appealing than the other-benefit messages. This research demonstrates that charities can maximize donations by advertising other-benefit messages in the morning and then self-benefit messages in the evening, given that depletion occurs naturally over the course of the day.

This paper explores three omnichannel retailing models—that is, a Buy-Online, Pick-Up In-Store (BOPS) model, a Showroom model, and an Interactive model (a model that combines the characteristics of BOPS and Showroom)—under which the retailer offers coupons online and invests in service efforts offline. For each omnichannel retailing model, three coupon distribution scenarios (i.e. no coupon, coupon with a common value, and coupon with a different value) are discussed to investigate coupon promotion policies and omnichannel operation strategies. Profits in the omnichannel system and under each model are compared by deriving three decision values: price, coupon value, and service effort. The key findings show that the retailer achieves profit improvement when the incremental purchasing reaches a large value. In addition, a great service effort coefficient leads to a high price, service effort, and retailer profit. The service effort and coupon value in the Showroom model are the largest among the three omnichannel models, while its profit is the lowest. Conversely, although the retailer invests less in service effort, and the price and coupon value are not too large in the BOPS model, the retailer still gains the highest profit. Additionally, in the BOPS model, it is profitable for the retailer to distinguish the coupon value for the online-only and BOPS channels when consumers are less sensitive to the online-only channel’s coupon. However, in the Interactive model, the retailer derives increasing profit by providing coupons with a common value for the online-only and BOPS channels.

This study investigates how a consumer’s view of the brand personality of a holiday destination influences their destination attitude. While brand personality and brand attitudes have been well studied, destination personality and destination attitude are relatively new. The effect of brand trust as a mediator in this context is also new. Result show that destination personality and destination attitude are partially related. The analysis reveals the mediating role of brand trust in this relation.

This research examined how individual differences in anthropomorphic tendency (the tendency to humanize non-human agents/objects) influence how people respond to destination marketing communications. Specifically, this study examined whether individual-level anthropomorphic tendency and text-personification of destination marketing communications interact to influence destination attitude and travel intentions. Results from a study involving 210 Australian participants revealed that destination attitude and travel intentions were most favorable for people with high levels of anthropomorphic tendency and who were exposed to personified tourism messages. These findings indicate that text-personification represents a new communication tactic for tourism – particularly for target consumers who are high in anthropomorphic tendency – and one that can humanize the destination leading to more favorable attitudes and higher intentions to travel. This effect is mediated by positive emotions. People with high anthropomorphic tendency who are exposed to a personified advertisement feel more positive emotions, which lead to positive tourism outcomes.

This study assessed how and to what extent self-regulation of online behavioral advertising (OBA) is executed on participating companies' websites. Based on the principles of OBA, as outlined by the Digital Advertising Alliance and Federal Trade Commission, we analyzed the format of OBA notices, explanation of OBA notices, opt-out options, transparency, and use of unacceptable notices. A series of content analyses was done in the years 2013 and 2015. Our results indicated slight improvements over the years, but the specific details of the implementation continued to fall short of the standards. In terms of accessibility and visibility, many websites demonstrated problematic presentations or lack of the components necessary to increase consumers' understanding and control over the practice of OBA.

This paper explores an omnichannel retail system under which the retailer offers coupons via online channels for market share and profit. It investigates the action mechanism of coupon promotion on omnichannel price and operational decisions by employing a theoretical model. Three coupon distribution modes are investigated; a scenario in which the omnichannel retailer does not offer coupons, offers coupons with a common face value, or offers coupons with a different face value. The results show that the distribution of coupons does not always lead to increased market share. Rather, market volume may be reduced if the competition between different channels is intense. When conducting a coupon promotion, the retailer always charges a higher price, but if the negative effects of coupon promotion for the competitive channel are relatively large, the retailer will reduce their price. Larger cross-selling revenue comes from ‘Buy Online, Pick Up in Store’ channel, indicating a stronger willingness to offer coupons and higher profits for the retailer. If the retailer takes the channel characteristics and consumers' channel preferences into consideration and offers different coupon face values across channels, they will derive higher profits.

Objectives A double-blind randomised study to evaluate the opioid sparing effect and safety of nefopam when administered via intravenous patient controlled analgesia (PCA) with fentanyl. Methods Patients planned for elective open laparotomy, were randomly assigned to receive into fentanyl 25 µg/ml (SF group) or nefopam 2.4 mg/ml plus fentanyl 25 µg/ml (NF group). Patients were assessed before surgery and for 24 h postoperatively. Results Total PCA fentanyl consumption was significantly lower in the NF group ( n = 35) than the SF group ( n = 36). Pain scores were significantly lower and patients’ satisfaction with treatment significantly better in the NF group than the SF group. Dry mouth and dizziness were significantly more frequent in the NF group than the SF group. There were no other statistically significant between-group differences in the incidence of adverse events. Conclusions Intravenous PCA using nefopam + fentanyl following laparotomy has an opioid sparing effect and is associated with a low incidence of some of the typical opioid related adverse events. Trial registry Clinicaltrials.gov Registration No: NCT02596269

This research examines how a tourist’s degree of psychological entitlement (sense of deservingness) influences their responses to hotels that differ in cultural distance. Using a visit to China by Western tourists as a context, an experiment shows that entitled tourists respond more negatively to high cultural distance hotel environments compared with low cultural distance environments. Results are mediated by tourist irritation. Research contributions include demonstrating how entitlement moderates cultural distance effects, revealing tourist irritation as a mechanism that explains these effects, and showing how psychological entitlement influences how tourists react to hotel environments when visiting a foreign destination.

Background and Objectives Lidocaine infusion therapy (LIT) is an effective treatment for relieving neuropathic pain (NeP). However, it remains unclear whether pain relief can be sustained through repeated lidocaine infusions. This study aimed to determine whether repeated intravenous administration of low-dose lidocaine could provide prolonged pain relief in patients with specific NeP conditions. Methods This is a prospective, randomized, double-blind, placebo-controlled, parallel study. We compared the efficacy and safety of lidocaine infusions (3 mg/kg) in the LIT group and normal saline infusions in the control group once a week for 4 consecutive weeks in patients with postherpetic neuralgia or complex regional pain syndrome type II. The primary outcome was the difference in the percentage change in the 11-point numerical rating scale (NRS) pain score from baseline to after the final infusion. Secondary outcomes included pain scores during 4 weeks of follow-up and any complications. Results Forty-two patients completed this study protocol. The percentage reduction in NRS pain scores after the final infusion was significantly greater in the LIT group compared with the control group (P = 0.011). However, this pain reduction was not detectable at the 4-week follow-up. The difference in the percentage change in NRS pain scores was especially prominent in the LIT group after the third and fourth infusions. None of the study participants experienced serious complications from the treatment. Conclusions Lidocaine infusion therapy (3 mg/kg of lidocaine administered over 1 hour) provided effective short-term pain relief, which was substantially prominent after repeated infusions were administered to patients with refractory NeP. Clinical Trial Registration This study was registered at ClinicalTrials.gov, identifier NCT02597257.

Background: Radiofrequency thermocoagulation (RFT) has been widely used to manage trigeminal neuralgia (TN) refractory to oral medication. Careful selection of patients for managing TN with RFT can decrease morbidity and improve treatment efficacy. Objectives: The goal of this study was to determine clinical variables related to the treatment outcome in patients with TN undergoing RFT. Study Design: Retrospective analysis. Setting: University hospital in Korea. Methods: Demographic and clinical data were garnered by billing records for patients with TN who received RFT by one pain physician between January 2005 and August 2014. A successful outcome was pre-defined as at least 50% pain relief on a 0 – 10 NRS pain score for longer than 6 months after RFT. Variables evaluated for their association with outcome included age, gender, baseline pain score, etiology, type of pain, co-existing psychopathology, and history of previous intervention. Results: Among 90 patients who underwent RFT for managing TN, 75 patients (83.3%) reported a successful outcome (> 50% pain relief at 6 months after RFT procedure). Pain characteristics was the most significant predictor associated with successful outcomes of RFT in both univariate and multivariate logistic analysis; odds ratio of provoked paroxysmal pain was 131.516 and mixed type of pain was 20.602 in multivariate analysis. Limitations: Prospective studies are recommended to confirm our findings and ascertain which additional variables can be taken into account to improve the likelihood of a successful outcome for RFT in patients with TN. Conclusion: A provoked paroxysmal pain or mixed pain condition was associated with a positive outcome for RFT in patients with TN. In addition, bilateral TN, high baseline NRS pain score, or co-morbid psychiatric condition was related with negative outcomes in univariate analysis. Pain clinicians should consider these findings when selecting patients for managing TN to increase the efficacy of RFT. Key words: Facial pain, outcome assessment, predictive value, radiofrequency thermocoagulation, trigeminal neuralgia

Facet joint synovial cysts are usually associated with osteoarthritis of the adjacent facet joint and/or spondylolisthesis. In between the conservative and operative ends of the treatment spectrum lie minimally invasive techniques such as cyst rupture using epiduroscopy. In this report, we describe an 82-year-old male patient presenting with low back pain radiating to his lower left extremity and associated paresthesia. Magnetic resonance imaging of the lumbar spine revealed a synovial cyst at left L4/5 facet joint. Using epiduroscopy, the cyst was mechanically ruptured by popping it with the tip of the scope. The patient remained symptom-free at his successive visits until 12 months after the procedure, and was opened for desired follow up.

This study examined factors (e.g., ad values and social networking advertising characteristics) influencing consumers' attitudes and behavioural intention towards three types of social networking advertising (SNA) on Facebook – home page ad, social impression ad, and organic impression ad. Findings demonstrate that peer influence had the most significant impacts on attitude and behavioural intention across all types of SNA. The significant interaction term of invasiveness and privacy concern indicates that both attitude and behavioural intention were diminished, particularly when perceived invasiveness and privacy concern were high simultaneously. In addition, results suggest that attitudes towards the ad played a mediating role between SNA characteristics and behavioural intention. Lastly, among the types of SNA, consumers preferred organic impression ads that featured friends' names on their newsfeed more than paid ads located on the sidebar of their Facebook pages.

This study examines whether memory of antidepressant direct-to-consumer (DTC) prescription drug advertising is associated with the public stigma attached to depression. Results indicate that those who better remember antidepressant DTC ads tend to have a higher perceived prevalence of depression (i.e., more people suffer from depression). And, the perceived prevalence of depression is inversely associated with the public stigma toward depression. That is, those who have a higher perceived prevalence of depression report that they are more supportive of and comfortable with people who have depression. The results suggest that the perceived prevalence of depression is a mediating variable that accounts for the relationship between memory of antidepressant DTC ads and the public stigma toward depression. The implications and limitations of the study, as an exploratory investigation, are discussed.

This study examined whether children recognized advergames as a type of advertising and the efficacy of an advertising literacy program. Results indicated that without the advertising literacy education, about three-quarters of the children did not recognize advergames as a type of advertising. However, those with advertising literacy education showed a significantly enhanced understanding. Also, a series of mediation tests showed that recognition of advertising was an indirect-only mediator between the advertising literacy and skeptical attitudes toward advertising. Only those who viewed the advergame as a type of advertising demonstrated more skeptical attitudes toward it.

Destination image has consistently been a popular theme in the tourism literature. This is due to the important role the construct can play in the intangible nature of consumers’ travel decisions. However, one temporal aspect, of how destination image might change over time, has attracted little academic research attention. This manuscript attempts to make a contribution to this gap in the literature by reporting key findings from an investigation into perceptions held of one of New Zealand’s most popular resort destinations, Rotorua, at three points in time over two decades. The research is narrowly focused on the perceptions of consumers in Rotorua’s largest domestic market, Auckland, and for a specific travel situation, which is short break holidays by car. The research design is based on Fishbein’s multi-attribute theory and Kelly’s personal construct theory. The key finding was minimal changes in Rotorua’s perceived strengths and weaknesses, relative to four competing destinations, in the target market, over the 20 year time period. We propose the theoretical foundations of the research design, and the efficacy of the data analysis, provide DMOs with a valid and reliable means to monitor the strengths and weaknesses of their destination over time.

Despite the wide array of contemporary advertising formats and media, television advertising remains the most dominant form to which typical consumers are exposed. Research on attitudes toward advertising in general (Att-AiG) implicitly assumes that the Att-AiG measure represents advertising as a whole. A major finding of the current research is that consumers tend to have a mental representation, or exemplar, of the most typical type of advertising—television advertising—when they report their Att-AiG. Therefore, in reality, Att-AiG primarily reflects attitudes toward television advertising. In addition, the results of our experiments indicate that television ad exemplars generate temporal changes in consumers’ reported Att-AiG and attitudes toward television advertising. Theoretical and practical implications are discussed.

Background Faced with extremely low fertility rates and increasing numbers of low-birthweight births in Korea, we examined the factors affecting the mortality of very-low-birthweight (VLBW) infants in Korea. Methods A survey was conducted in 91 of 93 hospitals providing neonatal intensive care in Korea in 2009. Data included information on number of neonatal intensive care unit (NICU) beds, medical workforce, resources in the NICU, birth and death. Results There was approximately one NICU per 4888 births, one NICU bed per 355 births, one mechanical ventilator per 739 births, one incubator per 327 births and one board-certified neonatologist per 4683 births. Regional disparity existed in neonatal care resources and consequently in mortality rates. VLBW infants’ mortality was related to the NICU facility level, volume of VLBW infants and geographic regions. The capital city, Seoul, has the best NICU facilities and workforce, and the least mortality. Overall mortality rates before hospital discharge for

Background An anesthesia information management system (AIMS), although not widely used in Korea, will eventually replace handwritten records. This hospital began using AIMS in April 2010. The purpose of this study was to evaluate users' attitudes concerning AIMS and to compare them with manual documentation in the operating room (OR). Methods A structured questionnaire focused on satisfaction with electronic anesthetic records and comparison with handwritten anesthesia records was administered to anesthesiologists, trainees, and nurses during February 2011 and the responses were collected anonymously during March 2011. Results A total of 28 anesthesiologists, 27 trainees, and 47 nurses responded to this survey. Most participants involved in this survey were satisfied with AIMS (96.3%, 82.2%, and 89.3% of trainees, anesthesiologists, and nurses, respectively) and preferred AIMS over handwritten anesthesia records in 96.3%, 71.4%, and 97.9% of trainees, anesthesiologists, and nurses, respectively. However, there were also criticisms of AIMS related to user-discomfort during short, simple or emergency surgeries, doubtful legal status, and inconvenient placement of the system. Conclusions Overall, most of the anesthetic practitioners in this hospital quickly accepted and prefer AIMS over the handwritten anesthetic records in the OR.

Background Surgical stress can induce postoperative systemic leukocytic alterations, including leukocytosis, neutrophilia, or lymphopenia. The present study investigated whether the anesthetic technique could affect the leukocytic alterations, including neutrophil-to-lymphocyte (N/L) ratio, after gynecologic laparoscopy. Methods Forty patients scheduled for laparoscopy-assisted vaginal hysterectomy were randomly assigned into two groups: PR group, which received total intravenous anesthesia with propofol and remifentanil, and S group, which received inhalational anesthesia with sevoflurane. Differential counts of leukocytes with N/L ratio of peripheral blood were obtained just before induction (T1), at the end of surgery (T2), 2 hours after surgery (T3), and 24 hours (T4) after surgery. Results Significant increase in total leukocytic count, neutrophil count, and N/L ratio, and decrease in lymphocytic count were observed at all time points after surgery in both groups. N/L ratio was significantly lower in group PR compared with group S at T3. The increase of N/L ratio in contrast to the value at T1 was significantly lower at T2 and T3 in group PR compared with that of group S. Conclusion Total intravenous anesthesia with propofol and remifentanil resulted in transient but salient leukocytic alterations in the peripheral blood in terms of N/L ratio compared with inhalational anesthesia with sevoflurane in laparoscopy-assisted vaginal hysterectomy.

PURPOSE To evaluate whether changes in outcome prediction scores during the first 72 hours after admission to a pediatric intensive care unit (PICU) are more predictive of outcome than single assessments at admission in pediatric oncology patients requiring mechanical ventilatory support for more than 3 days. PATIENTS AND METHODS The medical records of 54 consecutive pediatric oncology patients requiring mechanical ventilation over 72 hours in the PICU of the Asan Medical Center, Seoul, Korea, between January 2006 and December 2008, were retrospectively reviewed. RESULTS Although both initial Sequential Organ Failure Assessment (SOFA) score and change in SOFA score (Δ-SOFA) correlated well with mortality, Δ-SOFA score showed a significantly stronger correlation (P