Background: Obesity is a risk factor for airway-related incidents during anaesthesia. High-flow nasal oxygen has been advocated to improve safety in high-risk groups, but its effectiveness in the obese population is uncertain. This study compared the effect of high-flow nasal oxygen and low-flow facemask oxygen delivery on duration of apnoea in morbidly obese patients. Methods: Morbidly obese patients undergoing bariatric surgery were randomly allocated to receive either high-flow nasal (70 L min À1 ) or facemask (15 L min À1 ) oxygen. After induction of anaesthesia, the patients were apnoeic for 18 min or until peripheral oxygen saturation decreased to 92%. Results: Eighty patients were studied (41 High-Flow Nasal Oxygen, 39 Facemask). The median apnoea time was 18 min in both the High-Flow Nasal Oxygen (IQR 18e18 min) and the Facemask (inter-quartile range [IQR], 4.1e18 min) groups. Five patients in the High-Flow Nasal Oxygen group and 14 patients in the Facemask group desaturated to 92% within 18 min. The risk of desaturation was significantly lower in the High-Flow Nasal Oxygen group (hazard ratio¼0.27; 95% confidence interval [CI], 0.11e0.65; P¼0.007). Conclusions: In experienced hands, apnoeic oxygenation is possible in morbidly obese patients, and oxygen desaturation did not occur for 18 min in the majority of patients, whether oxygen delivery was high-flow nasal or low-flow facemask. High-flow nasal oxygen may reduce desaturation risk compared with facemask oxygen. Desaturation risk is a more clinically relevant outcome than duration of apnoea. Individual physiological factors are likely to be the primary determinant of risk rather than method of oxygen delivery. Clinical trial registration: NCT03428256.

Purpose – Small and medium-sized exporters (SMEs) are driven to develop a network entry strategy to tap into a new foreign market. The purpose of this paper is to draw on the network perspective to evaluate how a network gatekeeper facilitates a foreign SME exporter’s entry into local business networks in China. Design/methodology/approach – The single case study method was adopted. The Ule New Zealand Mall, an online shopping platform that sells New Zealand products in China, was selected in this case study. The authors applied the critical incident technique to evaluate the position of New Zealand Post (as a home country-based network gatekeeper), the roles within the position, and the key outcome of the network gatekeeping. Findings – The study discovers two key roles of network gatekeepers: bridging the gap in trust between outsider networks and insider networks; and reducing the costs of experiential learning for SME exporters. Finally, this study concludes that the “brokered insidership” position acquired by SME exporters is the key outcome of network gatekeeping in foreign market entry. Originality/value – This study advances the understanding of theories of structural holes, business network and gatekeeping. The authors articulate the critical position assumed by a network gatekeeper in bridging two otherwise disconnected business networks, and their key roles in networking. The study also proposes a new network concept – “brokered insidership”.

A large number of case-control studies have investigated the association of apolipoprotein E (APOE) polymorphisms with Parkinson disease (PD) and Parkinson disease dementia (PDD), with inconsistent results. This meta-analysis aimed to evaluate the relationship between APOE polymorphisms and PD/PDD risk. We searched for published studies in PubMed, Web of Science, WanFang Data (in Chinese), and CNKI (in Chinese) from inception to June 2017. Case-control studies reporting part or complete APOE genotype and allele frequency data were included. Pooled odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated using RevMan 5.3 software. A total of 39 studies involving 6453 cases with PD, with 461 cases with PDD, and 6855 controls were included in this meta-analysis. The results showed that the APOE E3 allele was a protective factor for PD (OR ¼ 0.90, 95% CI: 0.81-0.99; P ¼ .04), whereas no significant differences in PD risk among all cases compared to controls were found for APOE E2 and E4. In Asian subgroups, the APOE E4 allele was shown to be a risk factor for PD (

Assembly is an essential part of the product life cycle. Inefficient assembly has a direct impact on the effectiveness and quality of the product. One of the main problems of current on-site assembly operations is clear and efficient guidance, which consists of two aspects: the lack of efficient reuse of existing data and confusion in the form of presentation. In order to reduce errors and the time required to perform assembly tasks, we aim to propose an integrated lightweight 3D interactive method to guidance in assembly process. It enables the reuse of previous process design and simulation stages, which can reduce the duplication of content and enhance the content preparation efficiency. At the same time, the method is platform-independent, does not rely on high-performance workstations and can be presented on mobile, cross-platform. One case of disassembly the graphic card in the computer is presented to verify the method.

<p>For SME exporters, developing an effective value co-creation strategy appears to be a good way to overcome resource constraints and other market structural barriers in internationalisation. As an emerging topic in the marketing literature, value co-creation is mainly studied in B2C markets, and the understandings of value co-creation are still quite fragmented and abstract with limited empirical investigations. Inspired by the recent development of the business network theory and S-D logic, my thesis presents a new theoretical framework for value co-creation in cross-border business relationships. Through an in-depth case study, this research confirms ten propositions in relation to the theoretical framework and identifies the most important motives, attributes and outcomes of value co-creation. Some insights in the case are unique to value co-creation, such as hierarchical resource integration. The findings in this research indicate that the co-creation of symbolic value and the emerging value co-creation network will benefit participating firms and also attract more firms to join. Compared with other types of business relationships, the uniqueness of value co-creation is the significant interplay of trust and resource integration. More importantly, this study shows the creation of a novel network, including both B2C and B2B markets, which is wider than the integration of the prior individual networks. Overall, this new value co-creation network is competitive and viable for SME exporters to overcome internationalisation barriers. It also shifts the network position from being ‘one of them’ to becoming ‘one of us’ in the eyes of local network incumbents in the export markets. This is the fundamental goal that a SME exporter may achieve in the export market, for the benefit of long-term survival and growth.</p>