Gastroesophageal Reflux Disease Could Progress to Achalasia

Laura Bognar,Andras Vereczkei,Ors Peter Horvath 대한소화기 기능성질환∙운동학회 2017 Journal of Neurogastroenterology and Motility (JNM Vol.23 No.4

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Comparison of Linear Accelerator and Helical Tomotherapy Plans for Glioblastoma Multiforme Patients

Koca, Timur,Basaran, Hamit,Sezen, Duygu,Karaca, Sibel,Ors, Yasemin,Arslan, Deniz,Aydin, Aysen Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.18

Background: Despite advances in radiotherapy, overall survival of glioblastoma multiforme (GBM) patients is still poor. Moreover dosimetrical analyses with these newer treatment methods are insufficient. The current study is aimed to compare intensity modulated radiation therapy (IMRT) linear accelerator (linac) and helical tomotherapy (HT) treatment plans for patients with prognostic aggressive brain tumors. Material and Methods: A total of 20 GBM patient plans were prospectively evaluated in both linac and HT planning systems. Plans are compared with respect to homogenity index, conformity index and organs at risk (OAR) sparing effects of the treatments. Results: Both treatment plans provided good results that can be applied to GBM patients but it was concluded that if the critical organs with relatively lower dose constraints are closer to the target region, HT for radiotherapeutical application could be preferred. Conclusion: Tomotherapy plans were superior to linear accelerator plans from the aspect of OAR sparing with slightly broader low dose ranges over the healthy tissues. In case a clinic has both of these IMRT systems, employment of HT is recommended based on the observed results and future re-irradiation strategies must be considered.

WEBROOMING OR SHOWROOMING IN FASHION SHOPPING? A MATTER OF INVOLVEMENT

Carlos Flavián,Daniel Marín,Carlos Orús 글로벌지식마케팅경영학회 2017 Global Fashion Management Conference Vol.2017 No.07

Introduction Consumers can easily combine the online and physical channels in their shopping process. This new reality is changing the nature of the customer-firm interactions and is challenging retailers to effectively manage their customers. In this line, two antagonistic shopping patterns can be identified: showrooming (visiting physical retailers to check out products and then buy online) and webrooming (research products online before making the purchase offline). In this way, the fashion industry has been deeply affected by these cross-channel shopping behaviour (Lee and Kim, 2008; Cho and Workman, 2010). In this way, according to the Google Consumer Barometer 2015 (www.consumerbarometer.com), webrooming represents the dominant channel combination in fashion shopping around the globe. Cross-channel shopping patterns can threaten traditional retailers though, in the form of free-riding behaviors, such that consumers use one retailer’s channel to prepare, and then switch to another retailer’s channel to purchase (Chiou et al., 2012). Both showroomers and webroomers can free ride, yet the latter is less problematic, because online retailers’ costs are largely fixed (Van Baal and Dach 2005), and consumers often use multiple online sources to search for product information. In an omnichannel era, retailers must learn to integrate channels to offer seamless and unique experiences that retain consumers throughout their entire purchase experience (Verhoef et al, 2015). However, there is a lack of studies analysing the situational characteristics that lead consumers to adopt a specific combination of channels. Specialised literature has emphasised the role convenience (e.g. Verhoef et al., 2007), overlooking the impact of other relevant factors. This research examines the differences between webrooming and showrooming in terms of the degree of the consumer’s involvement with the purchase. Specifically, we examine the differences between webrooming and showrooming in terms of involvement, and how these differences translate into different preferences for the virtual and physical channels to search for information and carry out the purchase. Hypotheses Formulation The consumer’s cross-channel behavior is defined as the use of a combination of channels at different stages of the same shopping process (Dholakia et al., 2005). As previously stated, showrooming and webrooming are two antagonistic forms of cross-channel behavior. We propose that the degree of involvement will shape the consumer’s tendency to carry out one of the two cross-channel sequences. Involvement is defined as the individual’s degree of interest or relevance with a product or purchase situation (Zaichkowsky, 1985; Mittal, 1989). The fashion industry encompasses products whose characteristics prevent consumers from evaluating their quality without physical interaction (Weathers et al., 2007). Thus, they are sensitive to be acquired by means of a cross-channel process. However, when consumers are involved with the purchase of the product, their informational needs are increased (Brunelle, 2009), which lead them to carry out an exhaustive information search. Purchase involvement entails that the consumer is motivated to choose the best option. In this way, the Internet is widely acknowledged as the best channel to satisfy consumers’ need for an extensive information search (e.g. Ratchford et al. 2003), except for the physical inspection of the product (Citrin et al., 2003). This lack of complete knowledge leads them to carry out a webrooming purchase process. On the other hand, when consumers are not involved with the purchase of the product, they seek for convenience in their experiences and paying a low price (McGoldrick and Collins, 2007), which are the main defining factors of showrooming. Showroomers go the physical store to find the product they want to acquire and then take the advantage of the convenience and low prices of the Internet to buy the product. Therefore: H1: Purchase involvement is higher in webrooming than in showrooming. For showroomers, the use of the Internet is more limited to the search for lower prices and to carry out the purchase. In webrooming, consumers use the Internet to research about products and then go to the store with a higher knowledge of the product they want, to corroborate the information they have seen online, and to gain power in the interaction with the salesman (Orús, 2015). Webroomers value the information richness that the Internet offers. Therefore, the relevance of the Internet as channel to search for product information should be higher in webrooming experiences than in showrooming experiences H2: The preference for the Internet to search for information about the product is higher in Webrooming than in Showrooming. Finally, if involvement determines the differences between webrooming and showrooming, it should also explain the preferences for the purchase channel. Specifically, highly involved consumers will be more likely to use the physical store because they can have a physical interaction with the product and the sales personal, which helps them to take the shopping decision with a high degree of confidence (Flavián et al., 2016). Low involved consumers will purchase from the channel which allows them to pay a low price and to make the purchase in a convenient way (i.e. the Internet). Thus: H3: The degree of consumer’s involvement with the purchase mediates the effects of webrooming versus showrooming experiences on the preference for the purchase channel. Methodology Three studies were developed to test the hypotheses. The Study 1 consisted of an exploratory survey to identify and characterise different cross-channel shopping behaviours. In Study 2 we directly manipulate the degree of the participants’ involvement in order to examine their preference for the Internet as a channel for searching for information and their preference of the channel to carry out the purchase. Finally, Study 3 put participants into a webrooming or a showrooming shopping scenario and examines differences in the degree of involvement and purchase intentions. All the studies are carried out with samples of millennials or Generation Y (Parment, 2013) and focus on the purchase of clothing and accessories. Study 1 Participants were 192 millennials (60.9% female; between 18 and 35 years old). They were asked to think about a recent purchase experience of clothing or accessories in which they combined different channels during the purchase process. The participants reported the product purchased and the channels employed to search for information and buy the product. Finally, they indicated, on a 7-point scale (1 = not at all, 7 = extremely), to what extent the purchase of the product was (1) important, (2) interesting, (3) relevant, (4) meant a lot, (5) significant, to measure their degree of involvement (Zaichkowsky, 1985; Mittal, 1989; α = 0.89, 70.51% of variance explained). Due to space constraints, only a summary of results is presented. Out of the 192 participants, 109 (57%) reported a webrooming experience, whereas 28 (15%) recalled a showrooming experience. This result confirms that webrooming is a more extended behavior than showrooming. Moreover, purchase involvement for participants who recalled a webrooming experience (M = 5.56, SD = 0.86) was significantly higher than for those who recalled a showrooming experience (M = 4.33, SD = 1.46; U Mann-Whitney non-parametric test: p < 0.001). Evidence in favor of H1 was found. Study 2 This study consisted of an experimental design with one between-subjects factor with two levels. Specifically, participants (n = 68; 58% female; between 18 and 35 years old) were asked to think about the purchase of a clothing and fashion product with a cost of either €20 or less (low involvement condition) or €100 or more (high involvement condition). Among other measures, participants reported the probability of using the Internet to search for product information before purchase (from 1 = very unlikely, to 7 = very likely), and the preference for the channel to carry out the purchase (from 1 = definitely the Internet, to 7 = definitely the physical store). The participants also indicated their degree of involvement in the same way as in the previous study (α = 0.91, 75.41% of variance explained). In this way, the manipulation was successful since participants’ involvement with the purchase of the expensive product (M = 5.14, SD = 1.32) was significantly higher than with the purchase of the cheap product (M = 4.31, SD = 1.19; t(66) = 2.688, p < 0.01). The results of the analyses were consistent with our expectations. The probability of using the Internet for searching for product information was significantly higher for participants in the highly-involving purchase (M = 5.55, SD = 1.92) than for those in the low-involving purchase (M = 3.07, SD = 1.84; t(66) = 5.391, p < 0.001). In addition, participants’ preference for the purchase channel was also affected by the experimental treatment. In the purchase of the expensive product, participants indicated a higher preference for the physical store (M = 5.95, SD = 1.33), whereas for the cheap garment, participants were more indifferent, slightly leaned toward the Internet though (M = 3.87, SD = 1.68; t(66) = 5.701, p < 0.001). H2 is supported. In addition, two ANCOVAs were carried out to test the mediator effect of involvement. Involvement significantly influenced the preference for the Internet to search for information (F(1, 67) = 13.589, p < 0.001) and the purchase preference (F(1, 67) = 11.364, p < 0.001). The effect of the treatment was reduced in both cases, supporting partial mediation (H3). Study 3 The last study manipulated the type of information search sequence. Participants (n = 54; 53.7% female; between 17 and 24 years old) had an initial interaction with the product (a strap bag) and then changed the channel to have a cross-channel search experience with the same product. In this way, participants in the webrooming condition first had an online experience with the product and then had the opportunity to physically interact with it. Participants in the showrooming condition had the reverse sequence. After having both experiences with the product, the participants indicated the likelihood of purchasing the product in the channel where they had had the last experience (from 1 = very unlikely, to 7 = very likely). A set of additional measures were gathered. At the end of the questionnaire, participants indicated the degree of involvement with the experience (α = 0.86, 63.70 % of variance explained). The results of the analyses further confirmed H1. Participants in the webrooming scenario indicated a higher degree of involvement (M = 5.22, SD = 0.67) than participants in the showrooming scenario (M = 4.67, SD = 0.95; t(52) = 2.505, p < 0.05). Moreover, purchase intention at the physical store was higher for webroomers (M = 5.87, SD = 1.92) than purchase intentions in the online store for showroomers (M = 4.83, SD = 1.24; F(1, 53) = 11.789, p < 0.01). When involvement was included as a covariate in the analysis, it had a positive effect on purchase intentions (F(1, 53) = 13.591, p < 0.01), whereas the effect of the type of search sequence decreased (F(1, 53) = 5.785, p < 0.05). Again, we find support for H3, given that involvement partially explained the effect of webrooming on the preference for the physical store to purchase the product. Discussion and Conclusions Consistent with previous reports (Sevitt and Samuel, 2013; Google Consumer Barometer, 2015), the results of the first study confirmed that webrooming is a more frequent cross-channel shopping than showrooming. Thus, traditional retailers may take the advantages of the Internet to offer enhanced shopping experiences to customers, instead of fearing of a possible cannibalization of the online channel. Importantly, the results of the three studies show differences between webrooming and showrooming in terms of the involvement with the purchase situation. The first study measured the degree of consumers’ involvement depending on the type of cross-channel behavior, revealing that involvement was higher for webroomers than for showroomers. The second study directly manipulated the degree of involvement and demonstrated a clear preference for a webrooming experience when the purchase of the product entailed a higher degree of involvement. The third study showed that, depending on the type of search sequence (webrooming or showrooming) the involvement with the purchase experience was different. Furthermore, the level of purchase involvement determined the preference for the online and physical channels to search for information and purchasing the product. This finding entails important implications for both theory and practice. Nevertheless, this research has several limitations which open avenues for further research. Specifically, we only focused on a specific segment of the market and on a specific product category. Future studies should replicate these findings with more representative samples and a wider set of product categories, which have been found to determine multichannel behaviour to a great extent (Kushwaha and Shankar, 2013). Further research should also include convenience- and price-related variables which can explain the differences between webrooming and showrooming.

Retrorectal tumor: a single-center 10-years’ experience

Orçun Yalav,Uğur Topal,İsmail Cem Eray,Mehmet Ali Deveci,Eyüphan Gencel,Ahmet Rencuzogullari 대한외과학회 2020 Annals of Surgical Treatment and Research(ASRT) Vol.99 No.2

Purpose: Retrorectal tumors (RTs) are a rare incidence and recommendations on the ideal surgical approaches are lacking. This study aimed to evaluate outcomes and follow-up results of patients undergoing excision of RTs at our institution. Methods: A retrospective review was conducted for undergoing surgery for RT between January 2009 and January 2019. Demographic characteristics, presenting symptoms, preoperative diagnostic tests, surgical procedures, histopathological results, intraoperative and postoperative complications, postoperative hospital stay, postoperative 30-day mortality, 90-day unplanned readmission rate, and long-term outcomes were evaluated. Results: Twenty patients with a mean age of 48.3 ± 14.2 were analyzed. The most common presenting complaint was perineal pain (35.0%). Magnetic resonance imaging and computed tomography was preferred in 18 and 2 patients, respectively. Tumor localization was below the level of the third sacral vertebrae in 14 patients for whom the posterior surgical approach was used. No postoperative mortality was recorded at the end of follow-up of 53.8 ± 40 months. Mean length of postoperative hospital stay was 8.6 ± 9.4 days. Ten percent of the patients had unplanned hospital readmission within 90 days after discharge. Recurrence developed in 1 patient, for whom pathology were reported as chordoma. Conclusion: RT should be managed by a multidisciplinary team given the complexity and heterogeneity of these tumors despite the fact that the majority are benign. A good understanding of pelvic anatomy and characterization of lesions through detailed radiological imaging is crucial to optimize surgical planning. Complete surgical resection is key for prolonged disease-free and overall survival of patients diagnosed with RTs.

Operation of ULCS - real life

Jasna Prpić-Oršić,Joško Parunov,Igor Šikić 대한조선학회 2014 International Journal of Naval Architecture and Oc Vol.6 No.4

In this paper the real life operation of ULCS (Ultra Large Container Ships) is presented from the point ofview of shipmasters. The paper provides interpretation of results of questionnaire filled by masters of large containerships during Tools for Ultra Large Container Ships (TULC) EUI FP7 project. This is done in a way that results ofquestionnaire are further reviewed and commented by experienced master of ULCS. Following phenomena are subjectof questionnaire and further discussed in the paper: parametric rolling, slamming, whipping, springing, green waterand rogue waves. Special attention is given to the definition of rough sea states as well as to measures that ship masterstake to avoid them as well as to the manoeuvring in heavy seas. The role of the wave forecast and weather routingsoftware is also discussed.

Endoscopic Ultrasound in the Diagnosis of Pancreatoduodenal Groove Pathology: Report of Three Cases and Brief Review of the Literature

Inés C. Oría,Juan E. Pizzala,Augusto M. Villaverde,Juan C. Spina,Analía V. Pasqua,Julio C. Lazarte,Oscar M. Mazza,Mariano M. Marcolongo 대한소화기내시경학회 2019 Clinical Endoscopy Vol.52 No.2

The pancreatoduodenal groove is a small area where pathologic processes involving the distal bile duct, duodenum, pancreatic head,ampulla of Vater, and retroperitoneum converge. Despite great advances in imaging techniques, a definitive preoperative diagnosis ischallenging because of the complex anatomy of this area. Therefore, surgical intervention is frequently required because of the inabilityto completely exclude malignancy. We report 3 cases of patients with different groove pathologies but similar clinical and imaging presentation, and show the essential roleof endoscopic ultrasound (EUS) in making a specific preoperative diagnosis, excluding malignancy in the first case, changing diagnosisin the second case, and confirming malignancy in the third case. EUS was a fundamental tool in this cohort of patients, not onlybecause of its ability to provide superior visualization of a diffcult anatomical region, but because of the ability to guide precise, realtimeprocedures, such as fine-needle aspiration.

Smoking and Associated Factors Among the Population Aged 40-64 in Shahroud, Iran

Hamrah, Mohammad Shoaib,Harun-Or-Rashid, Md.,Hirosawa, Tomoya,Sakamoto, Junichi,Hashemi, Hassan,Emamian, Mohammad Hassan,Shariati, Mohammad,Fotouhi, Akbar Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.3

Background: Smoking is known as a major risk factor for different types of cancer, as well as cardiovascular disease. Its prevalence is increasing in developing countries. The aims of this study were to determine the prevalence of smoking and its associated factors among the population aged 40-64 years in the city of Shahroud which is a representative urban population in Iran. Materials and Methods: A cross-sectional population-based study with stratified random cluster sampling was conducted in 2009 as the first phase of Shahroud Eye Cohort Study. Of 6,311 people, 5,190 participated (82.2%). Information about smoking habit was obtained by face-to-face interview. Results: The overall prevalence of current tobacco smoking was 11.3% (95%CI: 10.5-12.3). It was significantly higher among males than females (25.7% and 0.71%, P<0.001). The prevalence of current cigarette smoking was 10.8% and 1.75% were past smokers. The smoking rate of water-pipe was 0.67%. Unemployed people smoked more than employed (OR=2.66, 95%CI: 1.38-5.14). Conclusions: The prevalence of smoking is low in Shahroud compared with other parts of Iran and other countries. Age, sex, job and marital status were associated with smoking. The low smoking rate among women may be attributed to cultural and social reasons.

Comparative analysis of physicochemical properties of root perforation sealer materials

Maura Cristiane Gonçales Orçati Dorileo,Fábio Luis Miranda Pedro,Matheus Coelho Bandeca,Orlando Aguirre Guedes,Ricardo Dalla Villa,Alvaro Henrique Borges 대한치과보존학회 2014 Restorative Dentistry & Endodontics Vol.39 No.3

Objectives: This study evaluated the solubility, dimensional alteration, pH, electrical conductivity, and radiopacity of root perforation sealer materials. Materials and Methods: For the pH test, the samples were immersed in distilled water for different periods of time. Then, the samples were retained in plastic recipients, and the electrical conductivity of the solution was measured. The solubility, dimensional alteration, and radiopacity properties were evaluated according to Specification No. 57 of the American National Standards Institute/American Dental Association (ANSI/ ADA). Statistical analyses were carried out using analysis of variance (ANOVA) and Tukey’s test at a significance level of 5%. When the sample distribution was not normal, a nonparametric ANOVA was performed with a Kruskal-Wallis test (α = 0.05). Results: The results showed that white structural Portland cement (PC) had the highest solubility, while mineral trioxide aggregate (MTA)-based cements, ProRoot MTA (Dentsply-Tulsa Dental) and MTA BIO (Ângelus Ind. Prod.), had the lowest values. MTA BIO showed the lowest dimensional alteration values and white PC presented the highest values. No differences among the tested materials were observed in the the pH and electrical conductivity analyses. Only the MTA-based cements met the ANSI/ADA recommendations regarding radiopacity, overcoming the three steps of the aluminum step wedge. Conclusions: On the basis of these results, we concluded that the values of solubility and dimensional alteration of the materials were in accordance with the ANSI/ADA specifications. PCs did not fulfill the ANSI/ADA requirements regarding radiopacity. No differences were observed among the materials with respect to the pH and electrical conductivity analyses.

Image-Based Markers Predict Dynamic Instability in Lumbar Degenerative Spondylolisthesis

William Slikker III,Alejandro A. Espinoza Orías,Grant D. Shifflett,Joe Y.B. Lee,Krzysztof Siemionow,Sapan Gandhi,Louis Fogg,Dino Samartzis,Nozomu Inoue,Howard S. An 대한척추신경외과학회 2020 Neurospine Vol.17 No.1

Objective: To identify possible radiographic predictors markers of dynamic instability including disc height (DH), disc degeneration, and spondylosis in the setting of degenerative spondylolisthesis (DS). Methods: A retrospective review with prospectively collected data was performed on 125 patients with L4–5 DS who underwent decompression and fusion. Patients were divided into groups with dynamic instability and those without. Radiographs of the lumbar spine in neutral, flexion, and extension were used to determine degree of slip, DH, translational motion, angular motion, spondylotic changes, and lumbar lordosis. Magnetic resonance imaging (MRI) scans were reviewed to assess disc degeneration. Results: Thirty-one percent of the patients met criteria for dynamic instability. Significant correlations (p<0.05) were found between preserved DH and dynamic instability; increased spondylotic changes and decreased translational motion; as well as advanced MRI-based disc degeneration scores with decreased angular motion, respectively. Six radiographic parameters were utilized to create a predictive model for dynamic instability, and a receiver operating characteristic curve was able to validate the predictive model (area=0.891, standard error=0.034, p<0.001). Conclusion: In DS patients, preserved DH was significantly related to dynamic instability. This finding may represent a greater potential for slip progression over time in these patients. In contrast, disc degeneration on MRI, and spondylotic changes were inversely related to dynamic instability and may represent restabilization mechanisms that decrease the chance of future slip progression in DS.

Morphological Variation of the Sea Silverside Odontesthes regia in Regions with Dissimilar Upwelling Intensity along the Humboldt Current System

Diego Deville,Gustavo Sanchez,Sergio Barahona,Carmen Yamashiro,Daniel Oré-Chávez,Roger Quiroz Bazán,Tetsuya Umino 한국해양과학기술원 2020 Ocean science journal Vol.55 No.1

We evaluated the influence of areas with dissimilar upwelling intensity along the Humboldt Current System on the morphological variation of the economically important sea silverside Odontesthes regia by using geometric morphometric (GM) and meristic data of populations sampled off Northern Peru, Central Peru, Southern Peru-Northern Chile, and Central-Southern Chile (CSCH). Multivariate analyses of variance, a UPGMA tree, and discriminant analyses of meristic counts separated CSCH individuals, which had slightly higher numbers of gill rakers and radius of the anal fin. Permutation tests and canonical variate analyses of GM data distinguished all populations and highlighted deformations in the head and fins. Variations in GM and meristic analyses were significantly correlated with values of the sea surface temperature and surface chlorophyll-a concentrations. Morphological differences among populations might be associated with the spatial coastal upwelling dynamic of the Humboldt Current System, which highlights the role that this system plays in relation to the phenotypic variation of fish.