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Firms require demand forecasts at different levels of aggregation to support a variety of resource allocation decisions. For example, a retailer needs store-level forecasts to manage inventory at the store, but also requires a regionally aggregated forecast for managing inventory at a distribution center. In generating an aggregate forecast, a firm can choose to make the forecast directly based on the aggregated data or indirectly by summing lower-level forecasts (i.e., bottom up). Our study investigates the relative performance of such hierarchical forecasting processes through a behavioral lens. We identify two judgment biases that affect the relative performance of direct and indirect forecasting approaches: a propensity for random judgment errors and a failure to benefit from the informational value that is embedded in the correlation structure between lower-level demands. Based on these biases, we characterize demand environments where one hierarchical process results in more accurate forecasts than the other. This paper was accepted by Martin Lariviere, operations management .

During surgery for elbow fracture, wires and screws crossing the elbow from posterior to anterior place the brachial and ulnar arteries at risk for inadvertent penetration. The authors’ goal was to define the sagittal proximity of the brachial and ulnar arteries to the proximal ulna throughout an arc of elbow motion using dynamic fluoroscopy. The brachial artery was injected with barium in 10 fresh-frozen cadaveric elbows. Sagittal fluoroscopic images were obtained at elbow flexion angles of 0°, 30°, 60°, 90°, and 120°. Two measurements were obtained at each flexion angle: (1) the distance between the coronoid tip and the brachial artery and (2) the distance between the coronoid base and the ulnar artery. One-way analysis of variance was used to compare mean distances for each flexion angle within each measurement group. A coronal image identified the mediolateral course of the brachial artery. The distance from the coronoid tip to the brachial artery significantly increased with increasing flexion from 0° to 60° (During surgery for elbow fracture, wires and screws crossing the elbow from posterior to anterior place the brachial and ulnar arteries at risk for inadvertent penetration. The authors’ goal was to define the sagittal proximity of the brachial and ulnar arteries to the proximal ulna throughout an arc of elbow motion using dynamic fluoroscopy. The brachial artery was injected with barium in 10 fresh-frozen cadaveric elbows. Sagittal fluoroscopic images were obtained at elbow flexion angles of 0°, 30°, 60°, 90°, and 120°. Two measurements were obtained at each flexion angle: (1) the distance between the coronoid tip and the brachial artery and (2) the distance between the coronoid base and the ulnar artery. One-way analysis of variance was used to compare mean distances for each flexion angle within each measurement group. A coronal image identified the mediolateral course of the brachial artery. The distance from the coronoid tip to the brachial artery significantly increased with increasing flexion from 0° to 60° ( P <.001). The distance from the ulnar artery to the coronoid base significantly increased with increasing flexion from 0° to 120° ( P <.002). The brachial artery traversed lateral to the coronoid in 9 of 10 specimens. The brachial and ulnar arteries are located further from the coronoid with increasing elbow flexion to at least 60°, and the brachial artery is typically located lateral to the coronoid in the coronal plane. These measurements can be used as surgical guides to reduce the risk of arterial injury during olecranon fracture surgery. [ Orthopedics. 2015; 38(4):e253–e256.]

Correspondence to George C Balazs, Investigation Performed at Naval Medical Center Portsmouth, 620 John Paul Jones Cir, Portsmouth, VA 23708, USA; gcbalazs@gmail.com Orthopaedic surgeons are the third highest opioid prescribing speciality in the USA. 1 Studies have consistently shown that most postoperative opioids go unused, 2–5 and that there is a direct relationship between the quantity of opioids prescribed and the likelihood of prolonged use/misuse of opioids following surgery. 6 Currently published guidelines place a strong emphasis on managing patient expectations for postoperative analgesia, but no study has reported actual patient expectations for opioid management following orthopaedic surgery. Following Institutional Review Board approval, a three-question anonymous survey was provided to all patients seen for any reason in our multi-subspeciality orthopaedic surgery clinic in May 2018. Upwards of 20% of the patients engage in ‘doctor shopping’ for additional opioid prescriptions after traumatic orthopaedic injuries. 7 8 In a study of 207 patients with trauma, Gangavalli et al reported that 19% felt their pain medication was under-prescribed, 12% admitted to taking more than the prescribed dosage and 9% admitted to obtaining opioids from other sources than their physician.

ObjectiveWe hypothesize that cut screws will deform in a manner that increases the core and outer diameters of the screw hole compared to uncut controls, and effects will be more pronounced in titanium screws.Materials and methodsWe used biomechanical polyurethane foam blocks to simulate cortical bone. We organized four groups of stainless steel and titanium cut and uncut screws. Blocks were fitted with a jig to ensure perpendicular screw insertion. We imaged the blocks using digital mammography and measured them using PACS software. Power analysis determined a power of 0.95 and an alpha error of 0.05.ResultsHighly statistically significant differences in core diameter were found after cutting stainless steel and titanium screws. Cutting stainless steel screws increased core diameter by 0.30 mm (95% CI, 0.16 to 0.45; p < .001). Titanium screws’ core diameter increased by 0.45 mm (95% CI, 0.30 to 0.61; p < .001). No significant differences were found in the outer diameters of stainless steel and titanium screws after cutting.ConclusionTitanium and stainless steel screw tracts demonstrated screw core diameter and screw thread pattern deformation after cutting. Titanium screws demonstrated more significant effects.

The relationship between the degree to which total quality management practices were adopted within organizations and the corresponding competitive advantages achieved are explored. Relatively strong support for this relationship is found. In addition, data showed some support for the moderating influence of organizational structure of TQM implementation effectiveness. Specifically, 2 measures of organizational structure, labeled \"control\" and \"exploration\", were found to offer independence and interdependent influences on the financial performance of firms implementing TQM programs.

Companies have increasingly turned to the use of optimization to create value and drive efficiencies in their supply chains. However, this practice also exposes the firm to increased levels of risk stemming from supply chain disruptions which can be quite costly relative to both short- and long-term performance. In response, companies need to build and maintain resilience to combat these disruptive events. Yet managers struggle with how to build resilience and where to focus resiliency enhancements. This article proposes a versatile optimization approach, READI—Resiliency Enhancement Analysis via Deletion (of key supply chain node, flow, or activity) and Insertion (of mitigation strategy), and demonstrates this approach on the supply chain of a major consumer products company. READI can be enlightening relative to both descriptive insights, such as the criticality of supply chain nodes and current levels of network resilience, and prescriptive insights, such as where to implement resiliency enhancements.

This study examines the drivers of competitive advantage within the hospital industry. Specifically, we examine both the direct and joint effects of market structure, firm-level competencies, and interorganizational relationships on organizational performance. The results of this approach indicated that managers, through their strategic actions related to the capabilities and relationships they develop and deploy, can establish advantageous competitive positions and influence the negative effects of market structure by developing important strategic competencies.

This article uses the Deming management model developed by Anderson et al. (1994b) as an initial template to analyze total quality in services. While the literatures addressing quality management have developed separately for products and services, the founders of total quality portrayed this management philosophy as universally oriented. Our study first replicates two earlier studies that tested the Deming management model in manufacturing industries. Using hospitals as our unit of analysis, we realized findings similar to the earlier manufacturing studies. Next, we used contributions from the MBNQA literature to test an enhanced model. Our subsequent findings support the MBNQA concept that “leadership drives the system that creates results” and provides evidence of the ubiquitous importance of leadership for ensuring the success of a quality improvement program. Finally, an anomaly of this study and those published earlier is the inability to find support for the relationship between continuous improvement and customer satisfaction. Integrating the substantial work in the service quality literature focused on customer satisfaction measurement is recommended to future researchers to help resolve this issue and further enhance the model.

The majority of reverse auctions for procurement use a single-attribute (price) format while providing constraints on nonprice attributes such as quality and lead time. Alternatively, a buyer could choose to conduct a multiattribute auction where bidders can specify both a price and levels of nonprice attributes. While such an auction may provide higher theoretical utility to the buyer, it is not clear that this theoretical improvement will be realized given the increased complexity of the auction. In this research, we present an ascending auction mechanism for a buyer whose utility function is known and dependent on three attributes. Motivated by a supply chain procurement problem setting, we consider quality and lead time for the two attributes in addition to price. The auction mechanism provides the bidders with restricted feedback regarding the buyer’s utility function. We explore, experimentally, the performance of this multiattribute auction mechanism as compared to a price-only auction mechanism. Compared with the price-only auction, we find that our mechanism design is effective in increasing both buyer utility and bidder (supplier) profits.