Repositioning template for mandibular reconstruction with fibular free flap: an alternative technique to pre-plating and virtual surgical planning

Oral malignancies involving the mandibular bone require a complex reconstructive plan. Mandibular reconstruction with a fibular free flap is currently considered the best choice for functional and aesthetic rehabilitation after oncological surgery. This flap can be modelled with multiple osteotomies and can provide bone, muscle and skin for composite reconstruction. One of the most delicate aspects of mandibular reconstruction is the technique of bone modelling; the risk of prolonging the period of ischaemia and not restoring the correct maxillomandibular and occlusal relationships can ultimately lead to a higher rate of complications as well as poor aesthetic and functional results. Recently, there has been rising interest in virtual surgical planning and computer-assisted mandibular reconstruction in pre-operative planning; however, this is not always possible because of the costs involved and the set-up time for the entire procedure. In this paper, we present a simple and inexpensive technique for fibular free flap modelling and repositioning after segmental resection of the mandible; the technique entails the pre-operative preparation of a resin repositioning template on a stereolithographic model. This technique has been successfully applied in four cases: two cases underwent resection involving only the mandibular body, one case involving the mandibular body and symphysis and one case in which a ramus to ramus resection was performed. In this preliminary report, we show that the resin repositioning template is an easy, safe and useful tool for mandibular reconstruction with a fibular free flap

The Impact of Symbolic and Substantive Actions on Environmental Legitimacy

Drawing on institutional theory and insights from stakeholder theory and impression management, we empirically analyze the impact of both environmental symbolic polices (participation in voluntary environmental programs, green trademarks, environmental-dedicated board committees, environmental pay policies and community communication) and substantive actions (environmental patents and pollution prevention practices) on environmental legitimacy. We show that (1) symbolic actions have a weaker positive effect on legitimacy than substantive actions, (2) that the impact of symbolic actions is greater when they are combined with substantive actions, (3) that this impact is only short-term while substantive actions have both short- and long-term effects

‘Better late than never’: the interplay between green technology and age for firm growth

This paper investigates the relationship between green/non-green technologies and firm growth. By combining the literature on eco-innovations, industrial organisation and entrepreneurial studies, we examine the dependence of this relationship on the pace at which firms grow and the age of the firm. From a dataset of 5498 manufacturing firms in Italy for the period of 2000–2008, longitudinal fixed effects quantile models are estimated, in which the firm’s age is set to moderate the effects of green and non-green patents on employment growth. We find that the positive effect of green technologies on growth is greater than that of non-green technologies. However, this result does not apply to struggling and rapidly growing firms. With fast-growing (above the median) firms, age moderates the growth effect of green technologies. Inconsistent with the extant literature, this moderation effect is positive: firm experience appears important for the growth benefits of green technologies, possibly relative to the complexity of their management

Family involvement and firms’ establishment mode choice in foreign markets

Extant literature on foreign entry increasingly recognizes firms’ heterogeneity as a potential reason for inconsistency in results on the establishment mode choice, i.e. whether and under which conditions firms should choose to enter a new country through a greenfield investment or an acquisition. Our study contributes to this debate by identifying family ownership and family involvement in management as potential powerful sources of such heterogeneity. Integrating international business studies with both corporate finance literature on family firms and recent contributions from the Socio Emotional Wealth perspective on family ownership, we claim that, due to greater risk aversion and lower access to information, the family involvement either in the firm ownership and management leads to a higher propensity towards greenfield initiatives (vs. acquisitions). However, we also find that such a propensity decreases with international experience especially in family-owned firms given the greater ability of professionalized management to overcome family-related concerns on making acquisitions. Our analysis on 1,045 foreign initiatives undertaken by 311 Italian family and non-family firms between 2003 and 2013 confirms our expectations – indicating family ownership as a significant driver of international business choices

Corporate ethical identity as a determinant of firm performance : a test of the mediating role of stakeholder satisfaction

In this article, we empirically assess the impact of corporate ethical identity (CEI) on a firm’s financial performance. Drawing on formulations of normative and instrumental stakeholder theory, we argue that firms with a strong ethical identity achieve a greater degree of stakeholder satisfaction (SS), which, in turn, positively influences a firm’s financial performance. We analyze two dimensions of the CEI of firms: corporate revealed ethics and corporate applied ethics. Our results indicate that revealed ethics has informational worth and enhances shareholder value, whereas applied ethics has a positive impact through the improvement of SS. However, revealed ethics by itself (i.e. decoupled from ethical initiatives) is not sufficient to boost economic performance.Publicad

Born to be green: new insights into the economics and management of green entrepreneurship

While the number of green start-ups has steadily increased around the world in response to the environmental problems demanding immediate solutions, there are several unresolved questions on the behaviour and performance of such ventures. The papers in this special issue shed light on these issues by underscoring the role of several factors, such as industry life cycles, knowledge spillovers, institutions, and availability of external finance, in shaping decision-making and firm behaviour in green start-ups. This paper highlights the state-of-the art developments in the literature, discusses the key contributions of the papers put together in this special issue and presents a future research agenda for scholars interested in green entrepreneurship

Complicanze sinusali monolaterali da patologia o trattamenti dentali: quando la chirurgia endoscopica endonasale necessita un approccio intraorale?

L'utilizzo diffuso degli impianti dentali e delle procedure ricostruttive per il loro posizionamento ha portato un aumento delle complicanze sinusali da patologia o trattamenti dentali (SCDDT). La diagnosi richiede una valutazione dentale e rinologica accurata, compresa la tomografia computerizzata (TC). Lo scopo di questo studio è stato quello di considerare un approccio multidisciplinare per il trattamento delle SCDDT, combinando la chirurgia endoscopica endonasale (EES) e l'approccio intraorale sulla base di un sistema di classificazione preliminare già proposto da altri autori. Inoltre, gli autori hanno analizzato la percentuale di sinusite mascellare a eziologica odontogena che si estende a interessare i seni etmoidali anteriori come anche i batteri coinvolti nella patogenesi delle SCDDT. Tra il gennaio 2012 e agosto 2015, nella nostra casistica di 31 pazienti, 16/31 pazienti (51,6%) sono stati trattati con approccio EES, 3/31 pazienti (9,7%) con approccio intraorale, e 12/31 pazienti (38,7%) con approccio combinato. Tutti i pazienti hanno riferito un miglioramento dei sintomi della rinosinusite, confermato attraverso i risultati degli esami clinici e della TC di controllo. Non è stata osservata nessuna complicanza significativa, né si è ricorsi a una revisione chirurgica. Infine, i risultati di questo studio preliminare suggeriscono che un approccio multidisciplinare delle SCDDT dalla diagnosi alla terapia permette una diagnosi più precisa e una terapia più esauriente, così da ottenere un rapido recupero, riducendo al minimo il rischio di recidiva

Fibular osteofasciocutaneous flap in computer-assisted mandibular reconstruction: technical aspects in oral malignancies

Lutilizzo della pianificazione virtuale in chirurgia testa e collo è in forte crescita. In letteratura, la validità del metodo dal punto di vista dellacuratezza e lutilità clinica sono stati ampiamente documentati, in modo particolare per il rimodellamento osseo del lembo. Al giorno doggi, laumentato utilizzo della programmazione virtuale in chirurgia oncologica testa-collo e, conseguentemente, la maggiore necessità di ricostruzioni sia ossee che dei tessuti molli, rendono importante realizzare il programma virtuale considerando non solo la ricostruzione ossea, ma anche tutti gli aspetti relativi alla ricostruzione dei tessuti molli con lembi compositi. Descriviamo nel seguente articolo il nostro approccio alla pianificazione virtuale nel caso di lembi compositi. Lo studio riporta sei pazienti consecutivi con malattia maligna programmati mediante ricostruzione mandibolare computer assistita e lembi osteo-fascio-cutanei di perone. In tutti i sei pazienti, la resezione e la ricostruzione sono state progettate concentrandosi sulla posizione dei vasi perforanti cutanei, al fine di programmare la posizione più corretta delle guide di taglio a livello del perone in funzione della posizione dei vasi perforanti stessi. La tecnica descritta ci ha permesso di programmare lembi osteo-fascio-cutanei di perone nella ricostruzione mandibolare computer assistita, con buona precisione della posizione del segmento osseo rispetto alla padella cutanea, importante per la ricostruzione dei tessuti molli. Nonostante il numero limitato di casi, i risultati preliminari dello studio suggeriscono che questo protocollo è utile nella programmazione virtuale. Sono necessarie ulteriori indagini

Assessing managerial power theory: A meta-analytic approach to understanding the determinants of CEO compensation

Although studies about the determinants of CEO compensation are ubiquitous, the balance of evidence for one of the more controversial theoretical approaches, managerial power theory, remains inconclusive. The authors provide a meta-analysis of 219 U.S.-based studies, focusing on the relationships between indicators of managerial power and levels of CEO compensation and CEO pay-performance sensitivities. The results indicate that managerial power theory is well equipped for predicting core compensation variables such as total cash and total compensation but less so for predicting the sensitivity of pay to performance. In most situations where CEOs are expected to have power over the pay setting process, they receive significantly higher levels of total cash and total compensation. In contrast, where boards are expected to have more power, CEOs receive lower total cash and total compensation. In addition, powerful directors also appear to be able to establish tighter links between CEO compensation and firm performance and can accomplish this even in the face of powerful CEOs. The authors discuss the implications for theory and research regarding the determinants of executive compensation