The Quest for Competitive Sustainability: From Technology Sourcing to Knowledge Management

This study undertakes an analysis of external sourcing of knowledge by biotechnology companies. It suggests that biotechnology companies need to be more realistic about R&D operational models in a context where technological changes are only incremental and companies based solely on single technology platforms are highly inefficient. It is argued that in order to build, preserve or enhance their knowledge creation capabilities in a fast changing environment, firms increasingly combine internal ‘‘core’’ capabilities with externally acquired ‘‘complementary’’ ones. Knowledge creation requires in reaching the right balance between exploration and exploitation. It consists of activities within the firm in order to create knowledge from its own experience and from the experience of other firms, and on the exploitation of that knowledge to fulfill the mission of the firm. Thus, a biotechnology company’s ability to choose technologies wisely will have a large impact on the performance of its R&D organization in terms of time to market, productivity, and product quality.This study undertakes an analysis of external sourcing of knowledge by biotechnology companies. It suggests that biotechnology companies need to be more realistic about R&D operational models in a context where technological changes are only incremental and companies based solely on single technology platforms are highly inefficient. It is argued that in order to build, preserve or enhance their knowledge creation capabilities in a fast changing environment, firms increasingly combine internal ‘‘core’’ capabilities with externally acquired ‘‘complementary’’ ones. Knowledge creation requires in reaching the right balance between exploration and exploitation. It consists of activities within the firm in order to create knowledge from its own experience and from the experience of other firms, and on the exploitation of that knowledge to fulfill the mission of the firm. Thus, a biotechnology company’s ability to choose technologies wisely will have a large impact on the performance of its R&D organization in terms of time to market, productivity, and product quality.This study undertakes an analysis of external sourcing of knowledge by biotechnology companies. It suggests that biotechnology companies need to be more realistic about R&D operational models in a context where technological changes are only incremental and companies based solely on single technology platforms are highly inefficient. It is argued that in order to build, preserve or enhance their knowledge creation capabilities in a fast changing environment, firms increasingly combine internal ‘‘core’’ capabilities with externally acquired ‘‘complementary’’ ones. Knowledge creation requires in reaching the right balance between exploration and exploitation. It consists of activities within the firm in order to create knowledge from its own experience and from the experience of other firms, and on the exploitation of that knowledge to fulfill the mission of the firm. Thus, a biotechnology company’s ability to choose technologies wisely will have a large impact on the performance of its R&D organization in terms of time to market, productivity, and product quality

Diffuse Fragmented QRS as an Index of Extensive Myocardial Scar

A 70-year-old man with history of previous myocardial infarction was referred for cardiac resynchronization therapy (CRT) implantation. Echocardiography showed global wall motion abnormality and non-viable myocardium with ejection fraction of 15% and large apical aneurysm. Electrocardiography (ECG) revealed sinus rhythm with wide QRS (200 ms). Of note is the finding of marked fragmentation of QRS in limb leads and V4 - V6

Management of anxiety and depression in post coronary artery bypass graft surgery

Depression and anxiety are common events in 30-40 percent of post coronary artery bypass graft (CABG) surgery patients. Depression symptoms in patients with CAD are expected to be significantly more, comparing the public incidence rate. Impaired remedy after coronary artery events may partly be attributed to depression and anxiety. If anxiety continues, it may lead to elevate metabolism and oxygen consuming. High level of anxiety increases the pain sensation in post CABG patients. This paper aimed to review results and findings of previous studies in the field of anxiety and depression management of post coronary artery bypass graft surgery. Up to 78 credited studies collected and compared in this review. Findings revealed that depression and anxiety could more complicate medical post CABG remedy. In addition, preoperative depression and anxiety symptoms would be persisted in post CABG recovery. Therefore, prior patients training about depression and anxiety symptoms would be wise strategy to help them describe their psychological mood before and after surgery. Findings also suggest that anxiety amplified depression prevalence in post CABG patients. Among the other methods, Benson relaxation is the best complementary medicine to mitigate pre-CABG anxiety. In addition, massage and music therapy could influence on post CABG anxiety and depression. There are also some robust evidences, indicating that perceived social support could influence post CABG anxiety and depression. Furthermore, sedative (such as propofol) and opioid and non-opioid analgesics, which used in post CABG pain management, could directly reduce anxiety level. Antidepressants sertraline and citalopram are the best studied post CABG pharmacological treatments which influence on post CABG remedy and hospitalization. The results suggest that treatment for anxiety is essential for alleviating patient suffering. In addition, anxiety treatment could protect patient against depression before and after CABG surgery

Clinical Results of Platelet-Rich Plasma in Frozen Shoulder

Background: Frozen shoulder is a common cause of shoulder pain and disability. Several treatments are utilized to reduce patients' pain and improve range of motion (ROM). Recent researches have been conducted on Platelet-rich plasma (PRP) injection. In this study, the clinical results of PRP injection for patients with frozen shoulder was assessed. Materials and Methods: Forty-four patients in phases I or II of frozen shoulder were treated with PRP. During the first session, two syringes of PRP were injected in the subacromial bursa and intra-articular space; this process was repeated after four weeks. In the second stage, PRP was injected only in the glenohumeral joint. Results: The average pre-treatment flexion was about 65°; abduction was 70°while external rotation was 22°. Also, baseline scores for VAS, DASH, and SF-12 Health Survey questionnaire were 8.4, 65.9 and 26, respectively. After 25 weeks follow-up, all patients showed significant improvement in shoulder ROM, pain, and function (p˂0.001). Patients reported 66.7% improvement in pain, 51.6% in DASH score, and 100% in SF-12 Health Survey questionnaire. They were also 65% satisfied with the treatment protocol. Conclusion: This case series study demonstrated clinically and statistically significant improvement in patients' pain and disability outcomes following PRP injection. These results provide support for PRP as a safe treatment protocol that decreases pain and increases upper limb function. In addition, it can also improve shoulder range of motion

$ Canadian: an exception

Dollar, Canadian ; Dollar, American ; Monetary theory ; Balance of payments ; Canada ; Purchasing power parity

Nosocomial Infections Caused by Drug-Resistant Bacteria in a Referral University Hospital, Tehran, Iran

Background: The emergence of antimicrobial-resistant pathogens associated with hospital-acquired infections (HAIs) is a major public health problem worldwide. Although being drug resistance is common in some countries and rare in others, the extent of this condition is not precisely known in most parts of Iran.Materials and Methods: Clinical specimens from patients who had been in the hospital for at least 48 hours were included in this study. The pattern of antibiotic resistance was determined by disk diffusion method as recommended by the Clinical Laboratory and Standards Institute (CLSI).Results: Of 11164 patients that were investigated, 369 (3.3%) had nosocomial infections. The most frequently isolated organisms from all sites of infections were Acinetobacter species (14.2%), Escherichia coli (13.7%) and Pseudomonas aeruginosa (9.9%). Among the Gram-negative bacilli, Acinetobacter spp was mostly resistant to ciprofloxacin, ceftriaxon, co-trimoxazole and centamicin, while P. aeruginosa was frequently resistant to ampicillin/sulbactam (87%). Imipenem and piperacillin/tazobactam were the most active antimicrobials against gram-negative microorganisms whereas vancomycin was the antimicrobial agent most consistently active against the Gram-positive cocci.Conclusions: This study highlights the importance of antimicrobial-resistant pathogens associated with nosocomial infection in Tehran, Iran. Using proper diagnostic criteria as well as administering more effective treatment may limit the frequency of drug-resistant bacteria associated with HAIs.

Hairpin structures formed by alpha satellite DNA of human centromeres are cleaved by human topoisomerase IIα

Although centromere function has been conserved through evolution, apparently no interspecies consensus DNA sequence exists. Instead, centromere DNA may be interconnected through the formation of certain DNA structures creating topological binding sites for centromeric proteins. DNA topoisomerase II is a protein, which is located at centromeres, and enzymatic topoisomerase II activity correlates with centromere activity in human cells. It is therefore possible that topoisomerase II recognizes and interacts with the alpha satellite DNA of human centromeres through an interaction with potential DNA structures formed solely at active centromeres. In the present study, human topoisomerase IIα-mediated cleavage at centromeric DNA sequences was examined in vitro. The investigation has revealed that the enzyme recognizes and cleaves a specific hairpin structure formed by alpha satellite DNA. The topoisomerase introduces a single-stranded break at the hairpin loop in a reaction, where DNA ligation is partly uncoupled from the cleavage reaction. A mutational analysis has revealed, which features of the hairpin are required for topoisomerease IIα-mediated cleavage. Based on this a model is discussed, where topoisomerase II interacts with two hairpins as a mediator of centromere cohesion