A Novel Country Classification System for Choosing International Business Locations

This paper introduces a novel country classification system that rates the political economy risks of countries for the purpose of conducting international business. It is intended to provide investors, multinational companies, and business researchers a quick and efficient way of gauging the extent of political, economic, and legal risks associated with doing business in different countries. The study covers over 170 countries and identifies 24 country types. At the extremes are Type 1 countries (least risky) and Type 24 countries (most risky). Overall, the new classification system suggests that political economy risks associated with doing international business are relatively mild in Type 1, Type 3, and Type 4 countries. However, international businesses should temper their investment decisions with caution in Type 19, Type 20, Type 22, Type 23, and Type 24 countries due to high political, economic, and legal risks, especially Types 23 and 24 where these risks are excessive. At the same time, international businesses may want to refocus their attention to Type 11 countries who are now havens for international investments due to drastic reduction in political, economic, and legal risks associated with doing business. The twenty-four country types identified in this new classification system are time-invariant. Thus, countries may move up or down due to improvements or deteriorations in certain aspects of their political economy.

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Cheek Dimpleplasty: A New Classification of Described Procedures

The American Journal of Cosmetic Surgery ◽

10.1177/0748806819898061 ◽

2020 ◽

Vol 37 (3) ◽

pp. 131-137

Author(s):

Jude L. Opoku-Agyeman ◽

Jamee E. Simone

Keyword(s):

Classification System ◽

Cosmetic Surgery ◽

English Language ◽

Cochrane Library ◽

New Classification ◽

Systematic Classification ◽

Advantages And Disadvantages ◽

Buccinator Muscle ◽

Type 3

Cheek dimpleplasty has become a popular request amongst patients requesting cosmetic surgery. Since the first reported dimpleplasty in 1962, there have been many reported procedures in the literature for cheek dimple creation. Some of the procedures described by various authors as “novel” are actually similar if not identical to existing procedures. This study reviews the different procedures of cheek dimple creation and provides the first ever systematic classification for these techniques. EMBASE, Cochrane library, Ovid medicine, and PubMed databases were searched from its inception to June of 2019. We included all studies describing the surgical creation of cheek dimples. The studies were reviewed, and the different procedures were cataloged. We then proposed a new classification system for these procedures based on their common characteristics. The study included 12 articles published in the English language that provided a descriptive procedure for cheek dimple creation. We classified the procedures into 3 broad categories and subcategories. Type 1 procedures are nonexcisional myocutaneous dimpleplasties. In these procedures, the buccinator muscle is not excised. In type 1A, the suture used to create the adhesion traverses the epidermis. In type 1B, the suture does not traverse the epidermis, rather, the suture travels up into the dermis and returned back to the mucosa. Type 2 procedures are excisional dimpleplasties. In these procedures, the buccinator muscle is excised with (open) or without (closed) the excision of the mucosa. Type 3 procedures are incisional dimpleplasty. In these procedures, the muscle is incised and fixed to the dermis. Each of these groups of procedures has potential unique advantages and disadvantages. There are multiple procedures reported in the English language literature for the creation of cheek dimples. Most of the procedures are based on similar concept with minor variations. Our classification system, the Opoku-Simone Classification, will help facilitate communication when describing the different configurations of these procedures. Procedure within each group has similar potential advantages and disadvantages.

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Surgical Configurations of the Pectoralis Major flap for Reconstruction of Sternoclavicular Defects: A Systematic Review and New Classification of Described Techniques

10.21203/rs.2.11054/v1 ◽

2019 ◽

Author(s):

Jude Opoku-Agyeman ◽

David Matera ◽

Jamee Simone

Keyword(s):

Classification System ◽

English Language ◽

Pectoralis Major ◽

Cochrane Library ◽

New Classification ◽

Pectoralis Major Flap ◽

Defect Reconstruction ◽

Type 3

Abstract Objectives The pectoralis major flap has been considered the workhorse flap for chest and sternoclavicular defect reconstruction. There have been many configurations of the pectoralis major flap reported in the literature for use in reconstruction sternoclavicular defects either involving bone, soft tissue elements, or both. This study reviews the different configurations of the pectoralis major flap for sternoclavicular defect reconstruction and provides the first ever classification for these techniques. Methods EMBASE, Cochrane library, Ovid medicine and PubMed databases were searched from its inception to November of 2018. We included all studies describing surgical management of sternoclavicular defects. The studies were reviewed, and the different configurations of the pectoralis major flap used for sternoclavicular defect reconstruction were cataloged. We then proposed a new classification system for these procedures. Results The study included 5 articles published in the English language that provided a descriptive procedure for the use of pectoralis major flap in the reconstruction of sternoclavicular defects. The procedures were classified into three broad categories. In Type 1, the whole pectoris muscle is used. In Type 2, the pectoralis muscle is split and either advanced medially (type 2a) or rotated (type 2b) to fill the defect. In type 3, the clavicular portion of the pectoralis is islandized on a pedicle, either the TAA (type 3a) or the deltoid branch of the TAA (type 3b). Conclusion There are multiple configurations of the pectoralis flap reported in the English language literature for the reconstruction of sternoclavicular defects. Our classification system will help facilitate communication when describing the different configurations of the pectoralis major flap for reconstruction of sternoclavicular joint defects.

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Proposal of Venous Drainage–Based Classification System for Carotid Cavernous Fistulae With Validity Assessment in a Multicenter Cohort

Neurosurgery ◽

10.1227/neu.0000000000000829 ◽

2015 ◽

Vol 77 (3) ◽

pp. 380-385 ◽

Cited By ~ 13

Author(s):

Ajith J. Thomas ◽

Michelle Chua ◽

Matthew Fusco ◽

Christopher S. Ogilvy ◽

R. Shane Tubbs ◽

...

Keyword(s):

Endovascular Treatment ◽

Classification System ◽

Internal Carotid ◽

Treatment Approach ◽

Venous Drainage ◽

Validity Assessment ◽

Drainage Channels ◽

Type 3

Abstract BACKGROUND: Carotid cavernous fistulae (CCFs) are most commonly classified based on arterial supply. Symptomatology and treatment approach, however, are largely influenced by venous drainage. OBJECTIVE: To propose an updated classification system using venous drainage. METHODS: CCFs with posterior/inferior drainage only, posterior/inferior and anterior drainage, anterior drainage only, and retrograde drainage into cortical veins with/without other drainage channels were designated as types 1, 2, 3, and 4, respectively. CCFs involving a direct connection between the internal carotid artery and cavernous sinus were designated as type 5. This system was retrospectively applied to 29 CCF patients. RESULTS: Our proposed classification was significantly associated with symptomatology (P.001). Type 2 was significantly associated with coexisting ocular/orbital and cavernous symptoms only (P.001), type 3 with ocular/orbital symptoms only (P.01), and type 4 demonstrated cortical symptoms with/without ocular/orbital and cavernous symptoms (P.01), respectively. There was a significant association of our classification system with the endovascular treatment approach (P.001). Types 1 and 2 were significantly associated with endovascular treatment through the inferior petrosal sinus (P.01). Type 3 was significantly associated with endovascular treatment through the ophthalmic vein (P.01) and type 5 with transarterial approach (P.01), respectively. Types 2 (27.6%) and 3 (34.5%) were most prevalent in this series, whereas type 1 was rare (6.9%), suggesting that some degree of thrombosis is present, with implications for spontaneous resolution. Type 2 CCFs demonstrated a trend toward partial resolution after endovascular treatment (P = .07). CONCLUSION: Our proposed classification system is easily applicable in clinical practice and demonstrates correlation with symptomatology, treatment approach, and outcome.

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Quantifying the potential scale of mitigation deterrence from greenhouse gas removal techniques

Climatic Change ◽

10.1007/s10584-020-02732-3 ◽

2020 ◽

Vol 162 (4) ◽

pp. 2411-2428 ◽

Cited By ~ 3

Author(s):

Duncan McLaren

Keyword(s):

Greenhouse Gas ◽

Oil Recovery ◽

Emissions Reduction ◽

Gas Removal ◽

Political Economic ◽

Type 3 ◽

Global Carbon ◽

Greenhouse Gas Removal

Abstract Greenhouse gas removal (GGR) techniques appear to offer hopes of balancing limited global carbon budgets by removing substantial amounts of greenhouse gases from the atmosphere later this century. This hope rests on an assumption that GGR will largely supplement emissions reduction. The paper reviews the expectations of GGR implied by integrated assessment modelling, categorizes ways in which delivery or promises of GGR might instead deter or delay emissions reduction, and offers a preliminary estimate of the possible extent of three such forms of ‘mitigation deterrence’. Type 1 is described as ‘substitution and failure’: an estimated 50–229 Gt-C (or 70% of expected GGR) may substitute for emissions otherwise reduced, yet may not be delivered (as a result of political, economic or technical shortcomings, or subsequent leakage or diversion of captured carbon into short-term utilization). Type 2, described as ‘rebounds’, encompasses rebounds, multipliers, and side-effects, such as those arising from land-use change, or use of captured CO2 in enhanced oil recovery. A partial estimate suggests that this could add 25–134 Gt-C to unabated emissions. Type 3, described as ‘imagined offsets’, is estimated to affect 17–27% of the emissions reductions required, reducing abatement by a further 182–297 Gt-C. The combined effect of these unanticipated net additions of CO2 to the atmosphere is equivalent to an additional temperature rise of up to 1.4 °C. The paper concludes that such a risk merits further deeper analysis and serious consideration of measures which might limit the occurrence and extent of mitigation deterrence.

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A novel classification for medial malleolar fracture based on the 3-D reconstruction CT

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02688-9 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Fangke Hu ◽

Guoyun Bu ◽

Jun Liang ◽

Haijing Huang ◽

Jinquan He

Keyword(s):

Medial Malleolus ◽

The Novel ◽

New Classification ◽

Surgical Decision ◽

Posterior Malleolus ◽

Type 3 ◽

Surgical Decision Making

Abstract Background Fracture of the medial malleolus is one of the most frequent injuries treated surgically; however, the classification of the fracture has not attracted much attention and a good classification system is still lacking. Methods Consecutive cases of medial malleolus fractures were prospectively enrolled. Based on the 3-D reconstruction CT morphology and centered on the posterior colliculus of the medial malleolus, we classified the fractures into 4 types: type 1 with no involvement of the posterior colliculus, type 2 with partial involvement of posterior colliculus, type 3 with the entire involvement of posterior colliculus, and type 4 with the fracture line 4 vertically extended from the intercollicular groove to the comminuted fracture of the posterior malleolus. Statistical analyses were performed to evaluate the clinical significance of the classification. Results There were 273 cases prospectively enrolled. The distribution of the cases was type 1 of 12.1%, type 2 of 41.0%, type 3 of 30.0%, and type 4 of 16.8%. Statistics showed that the new classification had significant associations but did not totally depend on the classical ankle fracture classifications. Results showed that the new classification had implications in the severity of ankle fractures. From type 1 to type 4, the ankle joint was more and more unstable. Furthermore, comminuted medial malleolar fractures could be subdivided, and the new classification could provide useful information for surgical decision-making. Conclusions The novel classification was a useful system to describe the 3-D geometry of the fractured medial malleolus.

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External validation of a new classification of spinal lipomas based on embryonic stage

Journal of Neurosurgery Pediatrics ◽

10.3171/2019.11.peds19575 ◽

2020 ◽

Vol 25 (4) ◽

pp. 394-401 ◽

Cited By ~ 1

Author(s):

Steven Tominey ◽

Chandrasekaran Kaliaperumal ◽

Pasquale Gallo

Keyword(s):

External Validation ◽

Radical Resection ◽

Classification Systems ◽

New Classification ◽

Improve Patient Selection ◽

Patient Representatives ◽

Type 3

OBJECTIVEContention exists regarding appropriate classification and management of spinal lipomas (SLs). Given the heterogeneity of SLs, omissions and overlap between surgically incomparable groups exist in conventional classification systems. The new classification of spinal lipoma (NCSL) recently proposed by Morota et al. delineates morphology by embryological pathogenesis and the resultant operative difficulty. Here, the authors aimed to validate the NCSL by applying it to patients who had been operated on at their institution.METHODSAll children who had undergone resection for SL between 2014 and 2018 were included in this analysis. MRI studies were independently reviewed and classified by three adjudicators. Baseline characteristics, inter-adjudicator agreement, coexisting anomalies and/or malformations, and postoperative outcomes and complications were analyzed.RESULTSThirty-six patients underwent surgical untethering for SL: NCSL type 1 in 5 patients (14%), type 2 in 14 patients (39%), type 3 in 4 patients (11%), and type 4 in 13 patients (36%). All classification was agreed on first assignment by the adjudicators. Radical or near-radical resection, which was attempted in all patients, was always possible in those with type 1 and 4 SL, but never in those with type 2 and 3 SL. Neurological stabilization and/or improvement were observed in all patients at the last follow-up.CONCLUSIONSThe NCSL was found to be a logical and reproducible system to apply in this SL population. All cases were successfully classified with a high degree of inter-assessor agreement. Widespread establishment of a commonly adopted and clinically useful classification system will enable clinicians to improve patient selection as well as discussion with patient representatives during the decision-making process.

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SUPERNUMERARY FLEXOR CARPI ULNARIS — CASE REPORT AND REVIEW

Hand Surgery ◽

10.1142/s0218810413720222 ◽

2013 ◽

Vol 18 (03) ◽

pp. 393-397 ◽

Cited By ~ 4

Author(s):

Praveen Bhardwaj ◽

Laxminarayan Bhandari ◽

S. Raja Sabapathy

Keyword(s):

Index Finger ◽

New Classification ◽

Clinical Appearance ◽

Anomalous Muscle ◽

Finger Flexion ◽

Flexor Carpi Ulnaris ◽

Combined Features ◽

Type 3

Anomalies of Flexor carpi ulnaris (FCU) are uncommon and predominantly consist of abnormal insertion or extra tendinous bands. The presence of two separate bellies of FCU muscle with separate tendons has been termed as Digastric FCU. It is a very rare anomaly with only six previously reported cases and no report of clinical use of such anomalous muscle. We describe a case of anomalous FCU found incidentally in a patient operated for complex Post Volkmann's ischemic contracture deficits. On table each head of FCU was found to form separate belly and tendon. One tendon was used for the thumb opposition while the other for index finger flexion. Postoperatively, the patient had independent movement of thumb and index finger. This is the first reported case of clinical application of digastric FCU. We reviewed the literature for supernumerary FCU in general and digastric FCU in particular. We propose a new classification for supernumerary FCUs based on the clinical appearance and the probable embryological basis of the anomaly: Type 1 (Split tendons) — single muscle with two tendons; Type 2 (Digastric FCU) — for each head of FCU forming separate muscle bellies and tendons; and Type 3 (Accessory FCU) — abnormal muscle adjacent to normal FCU with combined features of FCU and Palmaris longus.

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New classification of spinal lipomas based on embryonic stage

Journal of Neurosurgery Pediatrics ◽

10.3171/2016.10.peds16247 ◽

2017 ◽

Vol 19 (4) ◽

pp. 428-439 ◽

Cited By ~ 24

Author(s):

Nobuhito Morota ◽

Satoshi Ihara ◽

Hideki Ogiwara

Keyword(s):

Clinical Utility ◽

Radical Resection ◽

Embryonic Stage ◽

New Classification ◽

Failure Type ◽

Secondary Neurulation ◽

Type 3

OBJECTIVE Spinal lipomas are generally thought to occur as a result of failed primary neurulation. However, some clinical features cannot be explained by this theory. The authors propose a novel classification of spinal lipomas based on embryonic changes seen during primary and secondary neurulation. METHODS A total of 677 patients with occult spinal dysraphism underwent 699 surgeries between August 2002 and May 2015 at the National Center for Child Health and Development and Tokyo Metropolitan Children's Medical Center. This group of patients had 378 spinal lipomas, including 119 conus spinal lipomas, 27 lipomyelomeningoceles, and 232 filum lipomas, which the authors classified into 4 types based on neural tube formation during embryonic development. Type 1 is defined as pure primary neurulation failure; Type 2 ranges from primary to secondary neurulation failure; Type 3 consists of secondary neurulation failure (early phase); and Type 4 is defined as secondary neurulation failure (late phase). The authors also review embryogenesis in secondary neurulation and analyze the clinical utility of the new classification. RESULTS There were 55 Type 1 spinal lipomas, 29 Type 2, 62 Type 3, and 232 Type 4. All filum lipomas fell into the Type 4 spinal lipoma category. Association with anorectal and/or sacral anomalies was seen in none of the Type 1 cases, 15 (52%) of Type 2, 35 (56%) of Type 3, and 31 (13%) of Type 4. Urogenital anomalies were observed in none of the Type 1 or Type 2 cases, 1 (2%) of Type 3, and 28 (12%) of Type 4. Anomaly syndromes were present in none of the Type 1 cases, 6 (21%) of Type 2, 3 (5%) of Type 3, and 16 (7%) of Type 4. Associated anomalies or anomaly syndromes were clearly observed only for Type 2–4 spinal lipomas encompassing failed secondary neurulation. Radical resection was feasible for Type 1 spinal lipomas. CONCLUSIONS Secondary neurulation of the spinal cord gives rise to the conus medullaris and filum terminale, which are often involved in spinal lipomas. Formation of spinal lipomas seems to be a continuous process overlapping primary and secondary neurulation in some cases. Association with other anomalies was higher in Type 2–4 spinal lipomas, which included failed secondary neurulation, than in Type 1 lipomas, with failed primary neurulation. On the other hand, radical resection was indicated for Type 1, but not for Type 2, spinal lipomas. The new classification of spinal lipomas based on embryonic stage has the potential for clinical use and agrees well with both clinical and surgical findings. The classification proposed here is still preliminary. Further studies and verification are necessary to establish its clinical utility.

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Gummy Smile: Mercado-Rosso Classification System and Dynamic Restructuring with Hyaluronic Acid

Aesthetic Plastic Surgery ◽

10.1007/s00266-021-02169-8 ◽

2021 ◽

Author(s):

Jorge Mercado-García ◽

Paula Rosso ◽

Mar Gonzalvez-García ◽

Jesús Colina ◽

José Manuel Fernández

Keyword(s):

Hyaluronic Acid ◽

Classification System ◽

Therapeutic Approach ◽

Gingival Tissue ◽

Level Of Evidence ◽

Functional Aspects ◽

Molar Teeth ◽

Type 3 ◽

Gummy Smile

Abstract Background Gummy smile (GS) is a nonpathological condition causing esthetic disharmony in which an excessive amount of gingival tissue is exposed when smiling. Nowadays, there is not unanimous agreement regarding both classification and management of GS. This study aimed to present an organized and comprehensive clinical classification of the GS, as well as to discuss a therapeutic approach, with hyaluronic acid dermal fillers. Methods This study is presenting the clinical experience of the authors regarding GS. Results The Mercado-Rosso GS classification has into account aesthetic aspects, etiopathogenetic criteria, and functional aspects of the smile. According to Mercado-Rosso GS-classification-system, GS is divided into 3-types: Type 1, characterized by a lack of support and/or a lack of projection of the upper maxilla; Type 2, due to an imbalance between the strength (excess) and the resistance (defect) of the levator muscles; and Type 3, defined by an excessive strength of the zygomatic muscles, which causes a wide smile and an excessive visualization of the molar teeth. Conclusions The Mercado-Rosso GS classification system is a tool that facilitates the diagnostic and therapeutic approach to the gummy smile. RD Dynamic Restructuring® constitutes a comprehensive therapeutic approach that makes reference to both the effect of the HA filler on the muscle movement and the balance between the muscle strength and the resistance of the soft tissue to be folded in different facial structures). Level of evidence: Level V.

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