This study analyzes the strategy-structure fit and its effect on the economic performance of 144 US. manufacturing and service multinational corporations (MNCs). The results indicate that MNCs, irrespective of being services or manufacturing, choose their organization structure consistent with the theoretical fit prescription for the kind of strategy they are pursuing. However, the strategy-structure fit had no effect on service M N C economic performance. With manufacturing MNCs, mixed results regarding the fit-performance linkage were found. Based on the findings, implications and directions for future research are suggested.With the complexity and growth of international business, the study of multinational corporations (MNCs) has become extremely important. Most MNCs are operating in markets where the competition is intense and the competitors are large. To succeed in these markets, MNCs must successfully implement their strategies to provide them with a competitive advantage.Galbraith (1977) suggests that strategy implementation requires a 'fit' between strategy and organization design. Fit has been described by Miles and Snow as: a process as well as a state . . . . . . a dynamic search that seeks to align the organization with its environment and to arrange resources internally in support of that alignment. In practical terms, the basic alignment mechanism is strategy and the internal arrangements are organizational structure and management processes (Miles and Snow 1984: 11).At the corporate level, research has focused on the fit of the overall structure of the organization

We have investigated thyroid hormone-(T 3 ) induced liver cell hyperplasia in rats to explore the potential utility of primary mitogens within the clinical context of donor conditioning prior to living-related transplantation. A single injection of T 3 induced a semisynchronized proliferative response in hepatocytes, resulting at 10 days in a peak increase in liver mass, liver/body mass ratio, total DNA and total protein. Importantly, the hyperplastic liver induced by T 3 exhibits a commensurate increase in metabolic capacity, as assessed by enhanced galactose elimination capacity. Furthermore, when the liver mass had been increased by an injection of T 3 given 10 days previously and 70% partial hepatectomy performed, there was a larger remnant liver mass, liver/body mass ratio, total DNA and total protein content 24 h after surgery, compared with animals given a control injection. Interestingly, the regenerative response to surgery was the same in both groups, indicating that prior T 3 conditioning did not impair the regenerative response of the liver. Using more stringent conditions to test hepatic functional reserve, following 90% hepatectomy, there was a greater (57%) survival in animals pre-treated with T 3 compared to 14% in controls.

Several protective measures have been described to prevent contrast-induced nephropathy (CIN). This study is aimed to evaluate the effect of a high dose of N-acetylcysteine (NAC) plus hydration, a low dose of NAC plus ascorbic acid and hydration or hydration alone on the prevention of CIN in high-risk patients undergoing elective coronary artery intervention. We conducted a randomized, prospective, placebo-controlled trial of 105 high-risk patients undergoing elective cardiac catheterization. The patients were divided into three different groups: Group A (n=30), NAC 1200 mg orally before angiography and 1200 mg orally twice daily for three doses along with good hydration; Group B (n=30), NAC 600 mg before angiography and 600 mg orally twice daily for three doses plus ascorbic acid (3000 mg one dose) before angiography and 2000 mg two doses after angiography and good hydration; and Group C (n=45), hydration with 0.9% saline started just before contrast media injection and continued for 12 h at a rate 1.0 mL/kg//min after angiography or 0.5 mL/kg/h in cases with overt heart failure for 12 h. CIN was defined as an increase in serum creatinine of >25% of baseline or an absolute increase of 0.5 mg/dL above baseline after 48 h. The incidence of CIN was significantly lower in Group A (6.66%) compared with Group B (16.66%) or Group C (17.77%). The difference between Groups A and B and between Groups A and C was also highly significant (P=0.001). In contrast, the difference between Groups B and C was not statistically significant (P=0.37). Our study indicates that high doses of NAC plus hydration provide better protection against CIN than combination therapy of NAC and ascorbic acid plus hydration, or hydration alone.

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Objective: Percutaneous access for endovascular aneurysm repair (P-EVAR) is less invasive compared with surgical access (S-EVAR) and is associated with faster recovery and fewer wound complications. However, vascular closure devices (VCDs) are costly, and better understanding of the precise economic impact of P-EVAR has important implications for resource allocation. The objective was to determine the differences in cost between P-EVAR and S-EVAR.Methods: We used a decision tree to analyze costs from a payer's perspective during the course of the index hospitalization. Probabilities, relative risks, and mean difference summary measures were obtained from a systematic review and meta-analysis. We modeled differences in surgical site infection, lymphocele, and length of hospitalization. Cost parameters were derived from the 2014 U.S. National Inpatient Sample using International Classification of Diseases, Ninth Revision, Clinical Modification codes. Attributable costs were estimated using generalized linear models adjusted by age, sex, and comorbidities.Results: A total of 6876 abdominal and thoracic EVARs were identified. P-EVAR resulted in a cost saving of $751 per procedure. The costs were $1287 (95% confidence interval [CI], $884-$1835) for P-EVAR and $2038 (95% CI, $757-$4280) for S-EVAR. P-EVARs were converted to open repair in 4.3% of cases. P-EVAR patients had a difference of À1.4 days (95% CI, À0.12 to À2.68) in length of hospitalization at a cost of $1190/day (standard error, $298). The cost saving of P-EVAR was primarily driven by the cost difference in length of hospitalization. In the base case, four VCDs were used per P-EVAR at $200/device. In the two-way sensitivity analysis, P-EVAR was cost saving even when 1.5 times more VCDs were used per procedure and the cost of each VCD was 1.5 times greater (Fig). In our probabilistic sensitivity analysis, P-EVAR was the cost-saving strategy in 82.6% of 10,000 Monte Carlo simulations when simultaneously varying parameters across their uncertainty ranges.Conclusions: P-EVAR had lower costs compared with S-EVAR and is economically feasible.