Idea Generation and the Quality of the Best Idea

In a wide variety of settings, organizations generate a number of possible solutions to a problem—ideas—and then select a few for further development. We examine the effectiveness of two group structures for such tasks—the team structure, in which the group works together in time and space, and the hybrid structure, in which individuals first work independently and then work together. We define the performance of a group as the quality of the best ideas identified. Prior research has defined performance as the average quality of ideas or the number of ideas generated, ignoring what most organizations seek, a few great ideas. We build a theory that relates organizational phenomena to four different variables that govern the quality of the best ideas identified: (1) the average quality of ideas generated, (2) the number of ideas generated, (3) the variance in the quality of ideas generated, and (4) the ability of the group to discern the quality of the ideas. We test this theory with an experiment. We find that groups organized in the hybrid structure are able to generate more ideas, to generate better ideas, and to better discern the quality of the ideas they generate. Moreover, we find that the frequently recommended brainstorming technique of building on others\u27 ideas is counterproductive; teams exhibiting such buildup neither create more ideas, nor are the ideas that build on previous ideas better

Levodopa Responsive Parkinsonism in Patients with Hemochromatosis: Case Presentation and Literature Review

Hemochromatosis is an autosomal recessive disorder which leads to abnormal iron deposition in the parenchyma of multiple organs causing tissue damage. Accumulation of iron in the brain has been postulated to be associated with several neurodegenerative diseases including Parkinson\u27s disease. The excess iron promotes Parkin and α-synuclein aggregation in the neurons. Excess iron has also been noted in substantia nigra on MRI especially using susceptibility weighted imaging in patients with Parkinson\u27s disease. We present a case of a young male with alleles for both C282Y and H63D who presented with signs of Parkinsonism and demonstrated significant improvement with levodopa treatment

Evaluation of effectiveness of Ponseti's method in the clubfoot management under 1-year children: a prospective study

Background: Congenital talipes equino Varus is common congenital orthopedic foot deformity in children characterized by hindfootequinus, hind foot varus, midfoot cavus, and forefoot adduction deformities. There is a necessity to analyze the number of casts employed in the treatment, compliance of bracing, relapse pattern and percentages of surgical referral under 1 year of age for clear understanding and better practice to achieve successful outcomes. This study aimed to judge the effectiveness of Ponseti in the treatment of clubfoot under 1-year old children.  Methods: The patients were selected in the OPD and evaluated for virgin idiopathic clubfoot under 1-year age. Serial casting done weekly by Ponseti method after assessing Pirani and Demeglio score before every cast.Results: In our study all 29 clubfeet that were treated by Ponseti method showed complete correction. Minimum cast being 5 and maximum being 10 casts. Corrected feet were supple, plantigrade and painless of which 1 foot had relapse<3weeks due to ill-fitting shoes. Which was subsequently corrected with repeat tenotomy and cast application.Conclusions: The Ponseti method is a safe, effective, cheap and reproducible method for correction of CTEV which significantly reduces the rate of extensive corrective surgeries for correction of clubfoot under 1-year age. For successful outcome and to prevent relapse, this technique must be applied strictly in accordance to the protocol and parents must be taught the importance of full compliance with bracing. Our series has a short follow up. Longer follow-up is needed for further evaluation of effectiveness of Ponseti method.

Arthroscopic repair of rotator cuff tears: analysis and functional outcome

Background: Rotator cuff injuries are common injuries occurring around the shoulder with an incidence ranging from 5 to 39%. Rotator cuff tears can be either partial thickness or full thickness. If remains untreated, may lead to persistent shoulder pain, functional limitation and decreased quality of life. In the present study, we assess the functional outcome following arthroscopic repair of rotator cuff tears. We also assess the various parameters affecting the functional outcome following repair.Methods: 15 patients with rotator cuff tears were subjected to this study. Preoperative evaluation of the American Shoulder and Elbow Surgeons (ASES) shoulder score and University of California and Los Angeles (UCLA) shoulder score was done. Arthroscopic rotator cuff repair using single row repair with suture anchors was done. The patients were followed up at 6 weeks, 3 months and 6 months where ASES score and UCLA score were assessed.Results: Of the 15 patients, 14 had supraspinatus tear, 2 patients had infraspinatus tear and 2 patients had subscapularis tear. According to UCLA scoring system 22% patients had excellent, 43% patients had good results, 23% patients had fair results and 12% patients had poor results. ASES score also showed progressive improvement at subsequent follow ups at 3 and 6 months.Conclusions: From our present study we conclude that arthroscopic rotator cuff repair is a good modality showing excellent functional outcome with less morbidity, minimal postoperative pain, better cosmesis and early resumption of daily routine activities.

Deciphering Metabolic Regulation of Hematopoietic Stem Cell Fate

Hematopoietic stem cells (HSCs) are responsible for life-long production of all mature blood cells. This unique characteristic makes them an ideal candidate for cell-based therapies to treat various hematological malignancies. Their extensive use in the clinic is often hampered due to insufficient number of cells obtained from donors. Countless attempts to expand HSCs in vitro have failed, primarily due to our inability to recapitulate key features of the native bone marrow microenvironment, termed niche, in a dish. The absence of important niche signals in vitro results in rapid proliferation of HSCs with a concomitant loss of their long-term multi lineage blood reconstitution potential. The niche in the bone marrow involves a highly complex network of physical and biochemical signals that, in concert with cell-intrinsic mechanisms, is believed to control HSC fate choices. Moreover, the hypoxic conditions in the niche presents an extreme metabolic environment, imposing HSCs to attain a distinct metabolic identity as compared to their differentiated progeny. However, despite decades of research it is currently very poorly understood how HSCs take the decision to either undergo self-renewal or differentiation. Insights into the mechanisms regulating HSC fate choices are key to design better strategies for HSC maintenance and expansion in vitro for use in clinical transplantations. The overall goal of this thesis is to employ innovative experimental tools to explore the role of metabolism in regulating HSC fate choices. In the first part of this thesis a versatile cell-tracking assay was developed to follow HSC divisions in vitro. A combination of cell tracking and immunostaining was used to systematically map phenotypic changes in HSCs up to four divisions, under defined culture conditions imposing specific fates. We found that the proportion of cells maintaining an HSC phenotype decreased with increasing number of cell divisions, supporting the notion that faster cycling results in HSC exhaustion. In the second part of this thesis, we for the first time identify a link between mitochondrial metabolism and HSC fate decision. Using flow cytometry and long-term blood reconstitution assays low mitochondrial activity was established as a reliable marker of functional HSCs, independent of their cell cycle state. Consequently, we could use this marker to reliable identify self-renewing HSCs from heterogeneous in vitro cultures. Strikingly, we found that HSC fate could be altered by artificially modulating their mitochondrial activity in vitro. These results suggest that mitochondrial activity is a determinant of HSC fate. The last part of this thesis describes an experimental paradigm to analyze in vivo niche-instructed fate choices in paired HSC daughter cells. Live single cell imaging revealed a significant increase in asynchronous divisions in niche activated HSCs compared to control cells, suggesting a possible involvement of niche-instructed asymmetric cell division program. Indeed, a significantly higher level of asymmetric gene expression was found in paired daughter cells arising from niche-instructed HSCs. This analysis led to the identification of 12 asymmetrically expressed genes, among them were key enzymes belonging to glycolytic and mitochondrial TCA cycle metabolic pathways. Altogether, this thesis successfully employed unique experimental strategies to provide an intriguing link between metabolism and HSC fate choices

Effects of acupuncture in neck pain patients: A comparison of real and sham acupuncture

Master'sMASTER OF SCIENCE (CLINICAL SCIENCE

Early coronary angiography and survival after out-of-hospital cardiac arrest: a systematic review and meta-analysis

Background: Although acute myocardial infarction is a common cause of out-of-hospital cardiac arrest (OHCA), the role of early coronary angiography in OHCA remains uncertain. We conducted a meta-analysis of observational studies to determine the association of early coronary angiography with survival in OHCA. Methods: We searched multiple electronic databases for published studies on early coronary angiography in OHCA between 1 January 1990 and 18 January 2017. Studies were included if (1) restricted to only OHCA, (2) included an exposure group that underwent early coronary angiography within 1  day of arrest onset and a concurrent control group that did not undergo early coronary angiography, and (3) reported survival outcomes. We used a random-effects model to obtain pooled OR. I2 statistics and Cochran's Q test were used to determine between-study heterogeneity. Results: A total of 17 studies with 14 972 patients were included, of whom 6424 (44%) received early coronary angiography. Early coronary angiography was associated with higher odds of survival (pooled OR 2.54 (95% CI 1.94 to 3.33)) and survival with favourable neurological outcome (pooled OR 2.37 (95%  CI 1.71 to 3.28)). However, there was substantial heterogeneity in our pooled estimate (I2=88%  and p value for Cochran's test <0.0001 for both outcomes). The large heterogeneity in pooled estimates was reduced after including adjusted estimates when available, and was explained by differences in methodological rigour and characteristics of included studies. Conclusion: Among patients resuscitated from OHCA, early coronary angiography is associated with increased survival to discharge and favourable neurological outcome

Demographic profile and functional outcome following fixation of malleolar fractures in adults

Background: Malleolus are important structures which forms part of ankle mortise and provide stability to it. This article underlines the current demographic profile of patients sustaining malleolar fractures in adults. It also discusses the modalities of treatment and functional outcomes following open reduction and internal fixation of these fractures as well as the improvement in functional outcome following early mobilization.Methods: 30 patients sustaining malleolar fractures who attended the Department of Orthopedics were included in the study. The patients were operated as and when the soft tissue condition permitted and were followed up in outpatient department at 6 weeks, 3 months and 6 months where functional outcome based on Baird and Jackson scoring system was assessed.Results: In this study, the average age of patients was 43.8 years with a male preponderance. Supination-external rotation was the most common mechanism of injury following a slip or twisting injury. According to Baird and Jackson scoring system 20% patients had excellent, 50% patients had good results, 20% patients had fair results and 10% patients had poor results.Conclusions: 70% patients had excellent to good results following fixation of malleolar fractures. Early mobilization was started in 5 patients with 80% patients showing excellent results. Open reduction and Internal fixation proved to be an excellent procedure leading to union in all cases, less complication and early resumption of routine activities.