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Personal brand orientation has become a critical issue, enabling SMEs to gain a significant competitive advantage, particularly in markets where personalities influence followers’ actions on social media commerce. This study proposes and empirically validates a theoretically structured approach for assessing personal brand orientation, its antecedents, and implications for the performance of digital firms. The model distinguishes between personal characteristics of SMEs owners such as narcissism, vision, and educational background as antecedents of personal brand orientation and correlates them with the performance of digital firms in social commerce in Indonesia. A purposive sample of 355 respondents completed an online survey questionnaire, with each respondent representing one SME organization. Owner narcissism, owner vision, owner education background, personal brand orientation, and digital firm performance were all included in the questionnaire, which was adapted from previous studies. A five-point Likert scale was used to evaluate each item. To test the proposed research hypotheses, structural equation modeling (SEM) was used. Later confirmation of this study’s positive relationship between owner vision and owner education for personal brand orientation based on upper echelon theory. On the other hand, owner narcissism was found to have a detrimental effect on personal brand orientation. This study discovered a significant correlation between personal brand orientation and the performance of digital firms. This notion implies that SMEs that rely on their owner’s social media popularity can improve their performance by effectively communicating their vision to their team, leveraging the owner’s relevant education and expertise, and increasing personal brand-related strategies at the marketing level within the organization.

Background: Immunotherapy is a recently recognised FDA-approved treatment for R/M HNSCC. Our goal is to explore the safety profile and the efficacy of immunotherapy in the neoadjuvant setting before surgery in mucosal head and neck cancer., Methods: Three electronic databases had been systematically searched through March 2024. Demographic and tumour characteristics were extracted. Primary outcomes obtained were disease-free survival (DFS), progression-free survival (PFS), overall survival (OS), complete pathological response (cPR), which was defined as no residual tumour, and major pathological response (MPR), which as defined as <10% residual viable tumour. Safety outcomes examined were grade 3 and above adverse event, median time to surgery, delays to surgery, and death related to neoadjuvant treatment., Results: A total of 459 patients from 15 studies were included in the analysis. The pooled estimate of cPR for all the studies was 14.9% (95% confidence interval [CI] 8.0-26.2). Subgroup analysis showed chemoimmunotherapy had a higher cPR 30.1% (95% CI 22.8-38.62) compared with immunotherapy alone 1.4% (95% CI 0.3-5.2). There was no treatment-related death. Chemoimmunotherapy had a higher pooled estimate of adverse events 22.9% (95% CI 11.0-41.5) compared with immunotherapy alone 8.5% (95% CI 2.6-24.3). Subgroup analysis demonstrated that chemoimmunotherapy had a higher DFS compared with immunotherapy alone: 89.8% (95% CI 81.4-94.7) versus 80.44% (95% CI 73.9-85.7), respectively. Neoadjuvant immunoradiotherapy had conflicting results., Conclusions: Neoadjuvant immunotherapy was well tolerated. Neoadjuvant chemoimmunotherapy may be more effective in treating LAHNSCC over immunotherapy alone; however, TRAEs were higher., Competing Interests: Disclosure: The authors have no conflict of interest to declare., (© 2024. Society of Surgical Oncology.)

Introduction: De-escalated treatment of hemithyroidectomy without radioactive iodine (RAI) is now accepted for patients with low-risk, well-differentiated thyroid cancer (WDTC). The benefit of long-term follow-up care remains controversial. This study aims to describe parameters associated with less than total thyroidectomy, and discharge from specialist follow-up in patients with low-risk WDTC in Australia., Methods: An online survey was distributed to Australian members of Endocrine Society of Australia, Australian and New Zealand Endocrine Surgeons, and Australian Society of Otolaryngology, Head and Neck Surgery. Clinicians completed a survey of management and follow-up care preferences for four clinical vignettes (all low-risk WDTC)., Results: 119 clinicians (48% endocrinologists, 55% male) answered at least one question. The majority (59%) of respondents recommended less than total thyroidectomy and omission of RAI in patients with WDTC <2 cm. Most (62%) would discharge a patient with micropapillary thyroid cancer within 1 year following total thyroidectomy. In contrast, for WDTC 1-4 cm, >90% of clinicians would continue specialist follow-up for at least 5 years. The majority of clinicians felt that patients experienced disproportionate fear of recurrence and were reassured by follow-up. After multivariable analysis, clinicians who participated in multidisciplinary teams (MDTs) were more likely to choose de-escalated care for both initial treatment (p = .005) and follow-up care (>5 years, p = .05)., Conclusion: Clinician attitudes captured by this survey reflect recent changes in guidelines towards hemithyroidectomy for low-risk WDTC, particularly amongst MDT attendees. There is a need to further examine the impact of de-escalated care on fear of recurrence and quality of life in thyroid cancer survivors., (© 2023 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.)

Enhanced Recovery After Surgery (ERAS) protocols have been developed in several fields to reduce hospitalization lengths and overall costs. There have also been developments in multimodal analgesia methods to curtail opioid usage after surgery. Herein, we present the results of our initiation of an ERAS protocol for robotic-assisted laparoscopic partial and radical nephrectomies, employing a quadratus lumborum (QL) regional anesthetic block. We retrospectively reviewed 614 patients in our Institutional Review Board approved database who underwent robotic-assisted laparoscopic partial or radical nephrectomies from January 2017 to February 2020. An ERAS protocol utilizing multimodal analgesia (acetaminophen and gabapentin) and a QL block was developed and introduced in February 2019. We then compared the opioid consumption and perioperative outcomes of patients before and after ERAS protocol initiation. 192 ERAS patients (February 2019 to February 2020) were compared to 422 non-ERAS patients (January 2017 to January 2019). Baseline characteristics and the proportion of preoperative opioids users were similar between the two groups. There were no statistically significant differences in surgery length, hospitalization length, or complication rates. There were statistically significant differences in our primary endpoint, opioid consumption, on post-operative days 0 (p < 0.001), 1 (p < 0.001), and 2 (p < 0.001). The total opioid requirements over the course of admission were lower in the ERAS group compared to the non-ERAS group (p = 0.03). The initiation of an ERAS protocol employing multimodal analgesia and a QL block, for patients undergoing robotic-assisted laparoscopic partial or radical nephrectomies, can decrease opioid requirements without compromising perioperative outcomes., (© 2022. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)

The purpose of the study is to evaluate the impact of a multimodal Enhanced Recovery After Surgery (ERAS) protocol on perioperative opioid consumption and hospital length of stay (LOS) after robotic-assisted radical prostatectomy (RARP). We compared the first 176 patients enrolled in the protocol (ERAS group) with the previous 176 patients (non-ERAS group) at a single quaternary institution from December 2017 to June 2019. The ERAS protocol included a multimodal opioid-sparing regimen utilizing acetaminophen, gabapentin, celecoxib, and liposomal bupivacaine. Demographic data, co-morbidities, post-operative pain scores, post-operative opiate consumption measured by morphine milligram equivalents (MME), operating time, and LOS were collected. The two groups were compared using chi-squared, Fisher exact, or Student t tests as appropriate. Multivariable logistic regression analysis was performed to identify predictors of prolonged LOS (> 1 day). The ERAS and non-ERAS groups were equivalent in terms of baseline characteristics and pathological data. The ERAS group had lower post-operative pain scores, post-operative opiate consumption (MME 15 vs. 46, p < 0.01), and LOS (1.2 vs. 1.7 days, p < 0.01) compared to the non-ERAS group. Only 22% in the ERAS cohort had a prolonged LOS compared to 39% of the non-ERAS group (p < 0.01). The ERAS protocol was a negative predictor of prolonged LOS on multivariable logistic regression analysis (odds ratio 0.39, 95% confidence interval 0.22-0.70, p < 0.01). A limitation of this study is its single-center retrospective design. The implementation of a multimodal opioid-sparing ERAS protocol was associated with improved pain control, reduced perioperative opioid usage, and shorter LOS after RARP., (© 2021. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)

Background and Purpose: Although Thai Yoga (TY) is reported to improve health-related fitness for the elderly, no study has yet carried out the effect of TY Program on physical mobility and lower-limb muscle strength in overweight/obese older women., Materials and Methods: In a randomized controlled pilot design, twenty-two sedentary women with a BMI ≥ 23 kg/m 2 , aged 62 ± 1 years were randomly assigned to either a TY group for 60 min, 3 times a week or to a "no exercise" control (CON) group. Sit and reach (SRT), functional reach (FRT) and 30-s chair stand (CST-30), 8-foot up and go (8UGT), 6-min walk (6MWT)) and lower-limb muscle strength were measured at the beginning, 4, and 8 weeks., Results: At week 4, a significant between groups was obtained in CST-30, 8UGT, and 6MWT. At week 8, FRT, 8UGT, 6MWT and knee flexor and extensor muscle strength were improved in the TY over the CON. Significant improvement was found in all variables within the TY, but no change was observed in the CON., Conclusion: An 8-week TY program appears to provide beneficial improvements in physical mobility in overweight/obese older women., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Objectives: We implement a novel enhanced recovery after surgery (ERAS) protocol with pre-operative non-opioid loading, total intravenous anesthesia, multimodal peri-operative analgesia, and restricted red blood cell (pRBC) transfusions. 1) Compare differences in mean postoperative peak pain scores, opioid usage, and pRBC transfusions. 2) Examine changes in overall length of stay (LOS), intensive care unit LOS, complications, and 30-day readmissions., Methods: Retrospective cohort study comparing 132 ERAS vs. 66 non-ERAS patients after HNC tissue transfer reconstruction. Data was collected in a double-blind fashion by two teams., Results: Mean postoperative peak pain scores were lower in the ERAS group up to postoperative day (POD) 2. POD0: 4.6 ± 3.6 vs. 6.5 ± 3.5; P = .004) (POD1: 5.2 ± 3.5 vs. 7.3 ± 2.3; P = .002) (POD2: 4.1 ± 3.5 vs. 6.6 ± 2.8; P = .000). Opioid utilization, converted into morphine milligram equivalents, was decreased in the ERAS group (POD0: 6.0 ± 9.8 vs. 10.3 ± 10.8; P = .010) (POD1: 14.1 ± 22.1 vs. 34.2 ± 23.2; P = .000) (POD2: 11.4 ± 19.7 vs. 37.6 ± 31.7; P = .000) (POD3: 13.7 ± 20.5 vs. 37.9 ± 42.3; P = .000) (POD4: 11.7 ± 17.9 vs. 36.2 ± 39.2; P = .000) (POD5: 10.3 ± 17.9 vs. 35.4 ± 45.6; P = .000). Mean pRBC transfusion rate was lower in ERAS patients (2.1 vs. 3.1 units, P = .017). There were no differences between ERAS and non-ERAS patients in hospital LOS, ICU LOS, complication rates, and 30-day readmissions., Conclusion: Our ERAS pathway reduced postoperative pain, opioid usage, and pRBC transfusions after HNC reconstruction. These benefits were obtained without an increase in hospital or ICU LOS, complications, or readmission rates., Level of Evidence: 3 Laryngoscope, 131:E792-E799, 2021., (© 2020 The American Laryngological, Rhinological and Otological Society, Inc.)

Objective: Perioperative neurocognitive disorder (PND) is now recognized as the most common postoperative complication in older surgical patients. Current multidisciplinary guidelines recommend simple cognitive screening of older adults before surgery. Patients identified at risk should have input from an interprofessional team with expertise caring for older surgical patients. Data suggest these recommendations are infrequently met. We set out to test feasibility of routine cognitive screening in a busy preoperative assessment clinic and establish a perioperative pathway with multidisciplinary support for patients identified at risk., Methods: We undertook a prospective quality improvement study. A cohort of 1,803 older surgical patients scheduled for preoperative evaluation was screened with the Mini-Cog© test. As the project developed, we began confirmatory neurocognitive testing by occupational therapists for those patients flagged at risk. Patients confirmed at risk were referred for further evaluation by a geriatrician and geriatric pharmacist. Alerts were developed to flag patients at risk through their in-patient journey, and a multidisciplinary team developed a comprehensive care pathway., Results: We demonstrated that implementing routine cognitive screening can be done in a busy clinic, regardless of prior experience. The prevalence of preoperative cognitive impairment was 21% in our older patients undergoing inpatient surgery, rising to 36% in those older than 85 years. When the Mini-Cog results were not known to providers, they were unable to identify cognitive impairment in half of the patients, supporting the use of a validated screening test. We established an interprofessional team and pooled relevant recommendations into an age-friendly perioperative care pathway for patients at increased cognitive risk., Conclusion: Cognitive screening must be done to reliably identify older surgical patients at risk of PND. Demonstrating the prevalence of cognitive impairment in older surgical patients can provide impetus to develop a multidisciplinary team and care pathway with the aim of reducing the incidence of PNDs. J Am Geriatr Soc 68:2359-2364, 2020., (© 2020 The American Geriatrics Society.)

Ajjimaporn, A, Chaunchaiyakul, R, Pitsamai, S, and Widjaja, W. Effect of cold shower on recovery from high-intensity cycling in the heat. J Strength Cond Res 33(8): 2233-2240, 2019-Post-exercise cooling, e.g., cold water immersion has shown beneficial cardiovascular and hormonal effects during recovery from exercise in a hot environment. However, not much is known about the effects of a cold water shower (CWS) as a recovery intervention. This study examined the effects of a CWS on heart rate (HR), core temperature (Tc), salivary cortisol, and thermal comfort sensation (TCS) after exercise in the heat. Nine healthy male subjects (age, 21 ± 1 year) performed 45 minutes of cycling in a hot environment (35° C, 40-60% relative humidity) at 65% of peak oxygen uptake. Thereafter, subjects underwent the CWS condition (15 minutes, 15° C water shower) or control (SIT25; 15 minutes passive recovery in 25° C room) in a randomized crossover design. After each 15 minutes, subjects sat in a 25° C room for another 2-hour recovery. Heart rate, Tc, and TCS were recorded before and immediately after exercise, immediately after CWS or SIT25, and at 30 minutes, 1, and 2 hours during additional recovery. Salivary cortisol was collected at the same time points except at 30 minutes of the additional recovery period. Thermal comfort sensation was higher immediately after CWS (+4; very comfortable) than SIT25 (+1; just comfortable). The change of HR decreased faster with CWS (-18.3 ± 2.3%) than with SIT25 (-7.0 ± 4.6%) at the first 30-minute recovery time point (p < 0.01). No differences between recovery conditions were observed for the Tc or salivary cortisol at any time point during the 2-hour recovery period. The findings demonstrate that a 15-minute, 15° C CWS was not effective in reducing Tc or salivary cortisol during recovery from exercise in a hot environment. However, CWS can promote TCS by facilitating a faster HR recovery after 30-minute postintervention compared with passive recovery. The cooling benefits of a CWS could be only recommended to reduce cardiac stress after routine workout in a hot environment.

New Zealand blackcurrant (NZBC) extract affects cardiovascular and metabolic responses during rest and exercise in Caucasian men. Ethnicity and nutritional habits may affect responses to nutritional ergogenic aids. We examined the effects of NZBC extract on cardiovascular, metabolic, and physiological responses during seated rest and moderate-intensity exercise in Southeast Asian men. Seventeen healthy Thai men (age: 22 ± 3 years; body mass index (BMI): 21.8 ± 1.1 kg·m -2 ) participated. Resting metabolic equivalent (1-MET) was measured (Oxycon™ mobile, Germany), and an incremental walking protocol was completed to establish the relationship between walking speed and MET. In a double-blind, randomized, placebo-controlled, crossover design, cardiovascular (Physioflow, n = 12) and physiological responses (Oxycon, n = 17) were measured during both seated rest and a 30-min treadmill walk at five metabolic equivalent (5-MET), with either a seven-day intake of placebo (PL) or two capsules of NZBC extract (each 300 mg capsule contains 35% blackcurrant extract) with a 14-day washout. Paired t -tests were used with significance accepted at p < 0.05 and a trend for 0.05 > p ≤ 0.10. During 30 min of treadmill walking at 5-MET, no differences were observed for heart rate and substrate oxidation. With intake of NZBC during treadmill walking, there was a trend for increased stroke volume by 12% (PL: 83.2 ± 25.1; NZBC: 93.0 ± 24.3 mL; p = 0.072) and cardiac output increased by 12% (PL: 9.2 ± 2.6; NZBC: 10.3 ± 2.8 L·min -1 ; p = 0.057). Systemic vascular resistance decreased by 10% (PL: 779 ± 267; NZBC: 697 ± 245 dyn·s·cm -5 ; p = 0.048). NZBC extract had no effect on metabolic, physiological, and cardiovascular parameters during seated rest and exercise-induced fat oxidation in Thai men, in contrast to observations in Caucasian men. During treadmill walking, Thai men showed cardiovascular response, indicating vasodilatory effects during moderate-intensity exercise with the intake of NZBC extract. Our findings suggest that the ergogenic responses to anthocyanin intake from New Zealand blackcurrant may be ethnicity-dependent.

Background: The study aims to systematically examine the efficacy of dermal regeneration templates (DRTs) in comparison to split thickness skin grafting (STSG) in the management of acute burn injuries post-excision and debridement., Methods: Systematic literature search was conducted by two independent reviewers from the following databases: MEDLINE, EMBASE and Cochrane Library with selection criteria set a priori. Only randomized controlled trials (RCTs) were included. Main outcomes extracted were percent of STSG take, infection rate and scar quality., Results: Seven studies were included. Three of the seven studies reported no significant difference in STSG take between burn wounds treated with dermal substitute and or STSG only. Three of the seven studies reported either low rates of infection or no significant difference in infection rates between dermal substitute and control. Four of the seven studies reported no significant difference in scar quality. Statistical pooling of data was not performed due to heterogeneity of the studies., Conclusion: Current RCTs available are generally of small sample size with poor methodological reporting. Given the results of more recent RCTs, the risk associated with DRTs is low and it can be a useful alternative for immediate wound coverage post-burn excision. However, there is still no strong evidence to support that DRTs have significant impact on scaring., (© 2017 Royal Australasian College of Surgeons.)

Purpose: The purpose of this study was to assess the effects of 8 weeks of modified hatha yoga training on physical fitness and stress level in injured workers., Methods: Eighteen male and female injured workers, age between 18 and 55 years, participated in this study. They were divided into two groups: an additive hatha yoga training to routine industrial rehabilitation program group (HYG: n = 9) and a control group with no yoga training (CG: n = 9). A modified hatha yoga protocol was designed for this population by two certified yoga instructors, approved by a physical therapist, and conducted for 1 h, three times weekly for 8 weeks. Physical fitness variables including flexibility of lower back and hamstrings, hand grip strength and lung capacity and scores of sensitivity to stress were evaluated at the time of recruitment and after 8 weeks of intervention., Results: The values of all physical fitness variables and stress scores were no significant difference between the two groups at baseline. Significant post-yoga improvements for HYG group were noted in flexibility, hand grip strength, and vital capacity (p < 0.05). In contrast, there was no significant change in the CG group. Stress scores did not change as a result of hatha yoga training., Conclusion: An 8-week modified hatha yoga training experience exerted therapeutic effects on physical fitness variables including flexibility of lower back and hamstrings, hand grip strength and vital capacity, but not on stress level in injured workers. These findings indicate that hatha yoga can be a beneficial adjunct to routine physical therapy treatment in industrial rehabilitation programs.

The purpose of this study was to determine whether tissue oxygen indices (TOIs) in two muscle groups oscillated and were synchronized in repetition of impulse exercise with high intensity. Five impulse exercises of 400 watts for 10 s were repeated with intervals of 6 min. During this period, TOI was determined by near-infrared spectroscopy in the vastus lateralis and gastrocnemius muscles. TOIs in the two muscles oscillated at rest. The TOIs rapidly decreased during each impulse exercise and then recovered and overshot after each impulse. The TOIs oscillated during each interval period. During this test period, coherent and phase differences were determined. There was high coherence between TOIs in the two muscles with a peak value at 0.019 Hz. There was a phase difference of -45 ± 32.4 degrees between TOIs in the two muscles. This phase difference corresponded to about 6 s in time scale. It seemed from this time delay that impulse exercise was not a trigger factor for the starting point of TOIs in the two muscles. It has been concluded that TOIs oscillate and are synchronized between two muscles in repetition of impulse exercise with high intensity.

This paper reports on the effectiveness of an intervention designed to improve nursing students' conceptual understanding of decimal numbers. Results of recent intervention studies have indicated some success at improving nursing students' numeracy through practice in applying procedural rules for calculation and working in real or simulated practical contexts. However, in this we identified a fundamental problem: a significant minority of students had an inadequate understanding of decimal numbers. The intervention aimed to improve nursing students' basic understanding of the size of decimal numbers, so that, firstly, calculation rules are more meaningful, and secondly, students can interpret decimal numbers (whether digital output or results of calculations) sensibly. A well-researched, time-efficient diagnostic instrument was used to identify individuals with an inadequate understanding of decimal numbers. We describe a remedial intervention that resulted in significant improvement on a delayed post-intervention test. We conclude that nurse educators should consider diagnosing and, as necessary, plan for remediation of students' foundational understanding of decimal numbers before teaching procedural rules.

This study was designed to examine the effects of oestradiol (E2) on sperm transport in the swine uterus. The bicornuate swine uterus is optimal for the study of the uterine transport and peristalsis because the influence of various factors can be examined on each uterine horn independently. Forty swine uteri (with or without ovarectomy) were perfused for a period of up to 7 h. Two different E2 concentrations (3 or 30 pg/ml) in the perfusion medium were administered for 30 min unilaterally. Through an intracervical catheter 1 ml of a high concentrated dextran blue solution was administered directly in the upper part of the cervix. After bilateral perfusion of the swine uterus with a bolus of 0.3 IU oxytocin the distribution of coloured particles was assessed macroscopically before and after incision of the uterine horns. Coloration was evaluated by two observers blinded to the site-specific administration of E2. In the 10 ovarectomized uteri with the 3 pg/ml E2 concentration a unilateral distribution towards the side of oestradiol administration was observed in six uteri, in four it was a bilateral distribution. In the 10 non-ovarectomized uteri with the 3 pg/ml E2 concentration a uni- and ipsilateral coloration was observed in five uteri, in five it was a bilateral distribution. In the 20 uteri with 30 pg/ml E2, a unilateral coloration of the uterus horns was observed in all uteri. Oestradiol is one of the main factors, which influences the direction of the sperm transport in a dose-dependent manner, in the perfused swine uterus.

In the present study, the fixation system of a femoral medullary nail connection was investigated. In surgical treatment of fractured femurs, the fracture is bridged by a medullary nail that is fixed by interlocking screws in the bone. Bone failure around these screws is the most common complication associated with the treatment of fractures of osteoporotic bone. The present study analyses the stresses present in the region of the implant/bone system. Three-dimensional finite element models were generated, a nonlinear structure analysis performed, and the stresses at material interfaces investigated. The highest concentration of stresses is to be found in the middle of the interlocking screws and the holes drilled in the bone. This is in agreement with the results of experimental investigations.

Objective: A new design of intra-medullary nailing fixation is investigated in this study. The strength properties of the new design are compared to the standard fixation method., Design: The bone-implant-compound is examined by using experimental methods., Background: Failure of bone substance in the region of the interlocking screws is a complication in particular in treating fractures of osteoporotic bone. A new additional implant is investigated, which should improve the fracture fixation of the bone-implant-compound., Methods: The experiments were performed by using an universal testing machine. The bone-implant-compound was loaded by different compressive forces and the stiffness of the bone-implant-compound was measured. The maximum force to failure was also determined by a destructive test., Results: The experimental results indicate that the additional implant increases the stiffness of the bone-implant-compound. The highest stress concentrations occur at the drill holes of the interlocking screws. Failure of the bone-implant-compound occurs at higher maximum forces by using the additional implant., Conclusions: The additional implant improves the strength of the bone-implant-compound. In the case of osteoporotic bone, the use of the additional implant is recommended., Relevance: In surgical treatment of fractured femurs, the fracture is bridged by a medullary nail fixed with interlocking screws. Failure of bone substance in the region of the interlocking screws is the most common complication in the treatment of osteporotic bone. With the aim of preventing this complication, a new additional implant is developed and investigated.

In the surgical treatment of fractured femurs, the fracture is bridged by a medullary nail fixed in the bone with interlocking screws. Failure of bone substance in the region of the interlocking screws is the most common complication in the treatment of osteoporotic bone. With the aim of preventing this complication, an additional implant was developed. A finite element analysis of an ideal bone/implant system was carried out to investigate the role of the additional implant. Three defined finite element models were generated, and the associated stress situations compared. The first model is a standard fixation without the additional implant. In the second model, the additional implant is integrated within the bone/implant system. The third model uses a modified form of the additional implant. The results show that both additional implants reduce the stresses occurring, both in the bone substance and at the screws. The modified form of the additional implant proved to be the most favorable version. In the case of the original additional implant, the negative effect of the sharp edges of the thread was demonstrable.

A morphometric evaluation of number and grouping of megakaryocytes (MK) in five different groups of chronic myeloproliferative disorders (CMPD) was performed by counting 60 high power fields equaling approximately 14.28 mm2 of haematopoiesis in each case. Twenty-one up to 29 cases were evaluated for each of five categories of CMPD and one control group; a total of 132 cases of CMPD and 33 control cases were used. The mean number of MK per square millimetre was 15.54 +/- 1.53 in chronic myeloid leukaemia of common or granulocytic type (CML.CT), 69.91 +/- 5.85 in CML with megakaryocytic increase (CML.MI), 59.59 +/- 3.27 in polycythaemia vera (P. vera), 59.85 +/- 4.59 in primary thrombocythaemia (PTH), 67.58 +/- 4.11 in chronic megakaryocytic granulocytic myelosis (CMGM), and 19.7 +/- 3.07 in controls. The distinction between free or isolated MK, and between clustered or grouped MK corresponds to the total cell counts of MK in the various groups of CMPD. Clustering of MK was significantly higher in CMGM and PTH compared to other groups, but the difference between them was not statistically significant. Significant differences in the mean number of MK were obtained between controls and CML.CT on the one hand and all other groups of CMPD on the other. The results further support the histological sub-classification of CMPD according to the primary disorders of the Hannover classification (not advanced by sclerosis, fibrosis or excess of blasts, respectively).

This pilot study comprises quantitative ultrastructural investigations of the normal, non-leukemic granulopoiesis in the bone marrow of four patients suffering from heart diseases, compared with the granulopoiesis of four patients with different types of CMPD. By evaluation of the morphometric parameters it could be demonstrated that normal granulopoiesis is subject to a strong functional order of organelles in the course of maturation, aiming at the preparation of mitoses of immature cells and the production of functionally capable specific granules. Contrary to this, the studied cases of CMPD exhibited striking differences of morphometric parameters, which may be interpreted as functional deficiencies or defects of organelles involved in the production of specific granules, with the phenomenon of dissociation of nuclear and cytoplasmic maturation.

This was a study of the physical and mental health and lifestyle of elderly Balinese. Persons over 65 years of age (N = 45) in the village of Batur Utara were studied by structured interviews and quantitative psychological/psychiatric instruments. Prevalences of physical illness and mental disorders were obtained and compared with data available from other countries. The proportion of elderly in the total population was relatively low (4.1%). A high proportion (95.7%) were still working. We found relatively high prevalences of depression (14%) and anxiety (18%) and relatively low prevalences of dementia (7%) and obesity (0%).