Predictive nomograms of repeat intrahepatic recurrence and overall survival after radiofrequency ablation of recurrent colorectal liver metastases.

OBJECTIVES: This study was conducted to develop nomograms for predicting repeat intrahepatic recurrence (rIHR) and overall survival (OS), after radiofrequency ablation (RFA), treatment in patients with recurrent colorectal liver metastases (CLMs) after hepatectomy based on clinicopathologic features. METHODS: A total of 160 consecutive patients with recurrent CLMs after hepatectomy who were treated with ultrasound-guided percutaneous RFA from 2012 to 2022 were retrospectively included. Patients were randomly divided into a training cohort and a validation cohort, with a ratio of 8:2. Potential prognostic factors associated with rIHR and OS, after RFA, were identified by using the competing-risks and Cox proportional hazard models, respectively, and were used to construct the nomogram. The nomogram was evaluated by Harrell's C-index and a calibration curve. RESULTS: The 1-, 2-, and 3-year rIHR rates after RFA were 58.8%, 70.2%, and 74.2%, respectively. The 1-, 3- and 5-year OS rates were 96.3%, 60.4%, and 38.5%, respectively. In the multivariate analysis, mutant RAS, interval from hepatectomy to intrahepatic recurrence ≤ 12 months, CEA level >5 ng/ml, and ablation margin <5 mm were the independent predictive factors for rIHR. Mutant RAS, largest CLM at hepatectomy >3 cm, CEA level >5 ng/ml, and extrahepatic disease were independent predictors of poor OS. Two nomograms for rIHR and OS were constructed using the respective significant variables. In both cohorts, the nomogram demonstrated good discrimination and calibration. CONCLUSIONS: The established nomograms can predict individual risk of rIHR and OS after RFA for recurrent CLMs and contribute to improving individualized management.

Evaluation of the Time Difference Method in Identifying Hepatocellular Carcinoma in Current CEUS LR-M Category Nodules.

OBJECTIVE: The aim of the work described here was to explore a potential method for improving the diagnostic detection of hepatocellular carcinoma (HCC) based on the contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS) Version 2017. METHODS: We retrospectively evaluated 585 liver nodules in 427 patients at risk for HCC from December 2020 to March 2023. The nodules were categorized as LR-1 to LR-M based on CEUS LI-RADS Version 2017 and were randomly subclassified into a developmental cohort (DC) and a validation cohort (VC) at 3:1. In the DC, the cutoff value of the time difference (∆T) for differentiating HCC from other malignancies by LR-M was calculated and used to reclassify nodules in the VC. The diagnostic effect on HCC detection before and after reclassification was further assessed. RESULTS: According to the current CEUS LI-RADS, 140 of 426 (32.9%) confirmed HCC nodules were misclassified as LR-M. In the DC (439 nodules), the receiver operating characteristic (ROC) curve revealed that the cutoff value of ∆T (wash-out onset time minus contrast arrival time) recommended for HCC diagnosis was greater than 21 s. In the VC (146 nodules), 34 HCCs were correctly categorized as LR-5 according to the cutoff value, and after reclassification, LR-5 had higher accuracy (67.1% vs. 89.0%, p < 0.001) and sensitivity (56.0% vs. 87.2%, p < 0.001) for HCC diagnosis with high specificity (100% vs. 94.6%, p = 0.500). CONCLUSION: Using the time difference method could identify HCC nodules misdiagnosed as LR-M and improve the diagnostic performance of current CEUS LI-RADS.

Chitosan combined with intrauterine device prevents intrauterine adhesions after hysteroscopic adhesiolysis: A target trial emulation study.

AIM: To compare the efficacy of chitosan and intrauterine device (IUD) combination with an IUD alone in patients with intrauterine adhesions (IUAs) who underwent hysteroscopic adhesiolysis. METHODS: This retrospective study assessed 303 patients with moderate-to-severe IUA (American Fertility Society [AFS] score ≥5) who underwent hysteroscopic adhesiolysis between January 2018 and December 2020. Using observational data under a cohort design, we emulated a target trial with two treatment arms: chitosan plus IUD and IUD alone groups. Second-look hysteroscopy was performed in all patients 3 months after the initial hysteroscopy. The primary outcome was improved adhesion assessed using the AFS scoring system. RESULTS: The baseline characteristics were balanced between the two groups. The second hysteroscopy revealed significantly better AFS scores in group A than in group B (values: 3 [1-4] vs. 4 [2-6], p < 0.001; change: 63% [50%-80%] vs. 44% [33%-67%], p < 0.001, respectively). Significantly better menstruation conditions (improved rate: 66% vs. 49%, p = 0.004) and endometrial thickness (mean: 7.0 mm vs. 6.0 mm, p < 0.001) were also observed in group A than in group B. Moreover, group A showed a significantly higher 1-year clinical pregnancy rate (40% vs. 28%, p = 0.037) and better quality of life (p < 0.001) than group B. CONCLUSIONS: Chitosan and IUD combination showed better efficacy in reducing adhesions and improving clinical outcomes in patients with moderate-to-severe IUA after hysteroscopic adhesiolysis.

How do MNEs shape their international strategic alliances to facilitate higher alliance performance? Absorptive capacity as an antecedent.

The international strategic alliance in international marketing is international social network to realize superior performance. This requires firms to increasingly consolidate international relationship with foreign partners. Knowledge acquisition and integration by absorptive capacity (AC) as an antecedent for international strategic alliance is understudied. This study aims to explore the relationship between AC and international strategic alliance, and their impact on the international performance of multinational enterprises (MNEs). This study empirically verifies the research framework from 223 Taiwanese MNEs. In terms of structural model, researchers conduct PLS-SEM to verify the hypotheses in this study. The results confirm previous studies that indicate a positive relationship among AC, international strategic alliance, and international performance. The results also indicate that international explorative and exploitative alliance fits mediate the relationship between AC and international performance.

Psychological Contract, Self-Efficacy, Job Stress, and Turnover Intention: A View of Job Demand-Control-Support Model.

The outbreak of Coronavirus disease 2019 (COVID-19) has caused enterprises to face more challenges, such as operational management, production and sales management, and human resource management, among other issues. In the context of the global knowledge economy, employees with high knowledge and skills have become an important source of corporate growth and breakthroughs. However, employees may intend to transfer to other companies due to the pressure of the external and internal environments, so the main topic explored by this paper will be the change of employees' turnover intention. The purpose of this study was to explore the influence mechanism that propels the employees' self-efficacy, job stress, and turnover intention, and the moderating effect of transformational leadership. A total of 553 valid responses from several information service companies in China are collected via purposive sampling and used in the data analysis. This study conducts partial least squares structural equation modeling partial least squares structural equation modeling (PLS-SEM) to analyze collected data. The results of the path analysis with structural equation modeling show that employees' psychological contracts have a positive impact on the self-efficacy and a negative impact on the job stress. Employees' self-efficacy has a negative impact on job stress and turnover intention; transformational leadership plays a significant moderator in the research framework. Based on research findings, the theoretical and managerial implications are presented.

How Do Determiners of Job Performance Matter During COVID-19? The Conservation of Resource Theory.

During the COVID-19 pandemic, business managers are facing many challenges from a severe challenge. Many organizations have changed their original management mode and organizational behavior to improve employees' organizational citizenship behavior, thus reducing their sense of anxiety and incapability. Thereinto, job performance of the employees also affects the growth and development of the organization. To explore how to fragment employees' positive psychology and job performance, this study discusses the influence on employees' subjective wellbeing and job performance from relevant factors at the organizational and individual levels. Also, to explore the influence of organizational support and occupation self-efficacy on job performance and the mediating role of subjective wellbeing during COVID-19, a total of 618 valid questionnaires were collected from all walks of life in 2020. Hypotheses were tested by structural equation modeling and Bootstrap technology. The results show that: (1) Professional self-efficacy and subjective wellbeing have a significant positive impact on job performance; (2) Subjective wellbeing plays a complete mediating role between organizational support and job performance, and subjective wellbeing plays a partial mediating role between professional self-efficacy and job performance; (3) Compared with the sense of organizational support, the positive effect of self-efficacy on job performance is more significant.

Ambidexterity in Social Capital, Dynamic Capability, and SMEs' Performance: Quadratic Effect of Dynamic Capability and Moderating Role of Market Orientation.

The importance of organizational ambidexterity was stressed in different fields of management. This study was using a distinct method to measure the differences in the degree of ambidexterity to bridge the gap with the previous studies and to provide more insights in the successful management of exploitation and exploration. This study surveyed Taiwanese small and medium-sized enterprises (SMEs) to test the hypotheses. We issued 1000 questionnaires in total and received 234 valid ones. Results indicate exploitative and explorative capabilities exerting non-linear effect on performance. Likewise, ambidexterity and its interaction with market orientation have positive influence on firm performance. This study used structural equation modeling to analyze data, as this approach is known to be particularly advantageous for the exploratory nature of this study. We also used hierarchical regression analysis to test interaction and moderating effects. The study contributes to the literature in two ways. First, we offer a clearer understanding of the complete concept of social capital, including inter-firm and intra-firm social capital, and how contributes to improving and extending existing exploitative capabilities. Second, this study outlines how market orientation can have different effects on an ambidextrous strategy that is adopted to improve Taiwanese SMEs performance.