Why do incumbents respond heterogeneously to disruptive innovations? The interplay of domain identity and role identity.

We adopt a multifaceted view of organizational identity to contribute to research on organizational identity and incumbent adaptations to disruptive innovations. Based on a qualitative, multi-case study on the responses of German publishing houses to the emergence of digitalization, we distill a novel and thus far disregarded facet of organizational identity: organizational role identity. We show how organizational role identity and organizational domain identity—the facet that has so far dominated research on identity and innovation—interactively determine how organizations interpret and respond to a disruptive innovation. In contrast to previous studies, we show that incumbents experience dysfunctional identity-driven struggles when one of the two identity facets is challenged by the disruptive innovation while the other is enhanced. We also induce that domain and role identities can jointly determine how quickly incumbents react to a disruption, whether they adopt that disruption, and the innovativeness of their responses

Why do incumbents respond heterogeneously to disruptive innovations? The interplay of domain identity and role identity.

We adopt a multifaceted view of organizational identity to contribute to research on organizational identity and incumbent adaptations to disruptive innovations. Based on a qualitative, multi-case study on the responses of German publishing houses to the emergence of digitalization, we distill a novel and thus far disregarded facet of organizational identity: organizational role identity. We show how organizational role identity and organizational domain identity—the facet that has so far dominated research on identity and innovation—interactively determine how organizations interpret and respond to a disruptive innovation. In contrast to previous studies, we show that incumbents experience dysfunctional identity-driven struggles when one of the two identity facets is challenged by the disruptive innovation while the other is enhanced. We also induce that domain and role identities can jointly determine how quickly incumbents react to a disruption, whether they adopt that disruption, and the innovativeness of their responses

Multitrophic diversity in a biodiverse forest is highly nonlinear across spatial scales

Date of Acceptance: 10/11/2015 Acknowledgements We thank the administration of the Gutianshan National Nature Reserve and members of the BEF-China consortium for support, the many people involved in the plant and arthropod censuses, and T. Fang, S. Chen, T. Li, M. Ohl and C.-D. Zhu for help with species identification. G. Seidler kindly calculated forest cover and T. Scholten and P. Kühn provided soil data. The study was funded by the German Research Foundation (DFG FOR 891/1, 891/2), the Sino-German Centre for Research Promotion (GZ 524, 592, 698, 699, 785 and 1020) and the National Science Foundation of China (NSFC 30710103907 and 30930005).Peer reviewedPublisher PD

Quantitative fluid overload in severe aortic stenosis refines cardiac damage and associates with worse outcomes

Aims: Cardiac decompensation in aortic stenosis (AS) involves extra-valvular cardiac damage and progressive fluid overload (FO). FO can be objectively quantified using bioimpedance spectroscopy. We aimed to assess the prognostic value of FO beyond established damage markers to guide risk stratification. Methods and results: Consecutive patients with severe AS scheduled for transcatheter aortic valve implantation (TAVI) underwent prospective risk assessment with bioimpedance spectroscopy (BIS) and echocardiography. FO by BIS was defined as ≥1.0 L (0.0 L = euvolaemia). The extent of cardiac damage was assessed by echocardiography according to an established staging classification. Right-sided cardiac damage (rCD) was defined as pulmonary vasculature/tricuspid/right ventricular damage. Hospitalization for heart failure (HHF) and/or death served as primary endpoint. In total, 880 patients (81 ± 7 years, 47% female) undergoing TAVI were included and 360 (41%) had FO. Clinical examination in patients with FO was unremarkable for congestion signs in >50%. A quarter had FO but no rCD (FO+/rCD−). FO+/rCD+ had the highest damage markers, including N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels. After 2.4 ± 1.0 years of follow-up, 236 patients (27%) had reached the primary endpoint (29 HHF, 194 deaths, 13 both). Quantitatively, every 1.0 L increase in bioimpedance was associated with a 13% increase in event hazard (adjusted hazard ratio 1.13, 95% confidence interval 1.06–1.22, p < 0.001). FO provided incremental prognostic value to traditional risk markers (NT-proBNP, EuroSCORE II, damage on echocardiography). Stratification according to FO and rCD yielded worse outcomes for FO+/rCD+ and FO+/rCD−, but not FO−/rCD+, compared to FO−/rCD−. Conclusion: Quantitative FO in patients with severe AS improves risk prediction of worse post-interventional outcomes compared to traditional risk assessment

Multitrophic diversity in a biodiverse forest is highly nonlinear across spatial scales

Subtropical and tropical forests are biodiversity hotspots, and untangling the spatial scaling of their diversity is fundamental for understanding global species richness and conserving biodiversity essential to human well-being. However, scale-dependent diversity distributions among coexisting taxa remain poorly understood for heterogeneous environments in biodiverse regions. We show that diversity relations among 43 taxa - including plants, arthropods and microorganisms - in a mountainous subtropical forest are highly nonlinear across spatial scales. Taxon-specific differences in β-diversity cause under- or overestimation of overall diversity by up to 50% when using surrogate taxa such as plants. Similar relationships may apply to half of all (sub)tropical forests - including major biodiversity hotspots - where high environmental heterogeneity causes high biodiversity and species turnover. Our study highlights that our general understanding of biodiversity patterns has to be improved - and that much larger areas will be required than in better-studied lowland forests - to reliably estimate biodiversity distributions and devise conservation strategies for the world's biodiverse regions

Evaluation of the 2021 ESC recommendations for family screening in hereditary transthyretin cardiac amyloidosis

AIMS: The 2021 European Society of Cardiology (ESC) screening recommendations for individuals carrying a pathogenic transthyretin amyloidosis variant (ATTRv) are based on expert opinion. We aimed to (i) determine the penetrance of ATTRv cardiomyopathy (ATTRv-CM) at baseline; (ii) examine the value of serial evaluation; and (iii) establish the yield of first-line diagnostic tests (i.e. electrocardiogram, echocardiogram, and laboratory tests) as per 2021 ESC position statement.METHODS AND RESULTS: We included 159 relatives (median age 55.6 [43.2-65.9] years, 52% male) at risk for ATTRv-CM from 10 centres. The primary endpoint, ATTRv-CM diagnosis, was defined as the presence of (i) cardiac tracer uptake in bone scintigraphy; or (ii) transthyretin-positive cardiac biopsy. The secondary endpoint was a composite of heart failure (New York Heart Association class ≥II) and pacemaker-requiring conduction disorders. At baseline, 40/159 (25%) relatives were diagnosed with ATTRv-CM. Of those, 20 (50%) met the secondary endpoint. Indication to screen (≤10 years prior to predicted disease onset and absence of extracardiac amyloidosis) had an excellent negative predictive value (97%). Other pre-screening predictors for ATTRv-CM were infrequently identified variants and male sex. Importantly, 13% of relatives with ATTRv-CM did not show any signs of cardiac involvement on first-line diagnostic tests. The yield of serial evaluation (n = 41 relatives; follow-up 3.1 [2.2-5.2] years) at 3-year interval was 9.4%.CONCLUSIONS: Screening according to the 2021 ESC position statement performs well in daily clinical practice. Clinicians should adhere to repeating bone scintigraphy after 3 years, as progressing to ATTRv-CM without signs of ATTRv-CM on first-line diagnostic tests or symptoms is common.</p

Evaluation of the 2021 ESC recommendations for family screening in hereditary transthyretin cardiac amyloidosis

AIMS: The 2021 European Society of Cardiology (ESC) screening recommendations for individuals carrying a pathogenic transthyretin amyloidosis variant (ATTRv) are based on expert opinion. We aimed to (i) determine the penetrance of ATTRv cardiomyopathy (ATTRv-CM) at baseline; (ii) examine the value of serial evaluation; and (iii) establish the yield of first-line diagnostic tests (i.e. electrocardiogram, echocardiogram, and laboratory tests) as per 2021 ESC position statement.METHODS AND RESULTS: We included 159 relatives (median age 55.6 [43.2-65.9] years, 52% male) at risk for ATTRv-CM from 10 centres. The primary endpoint, ATTRv-CM diagnosis, was defined as the presence of (i) cardiac tracer uptake in bone scintigraphy; or (ii) transthyretin-positive cardiac biopsy. The secondary endpoint was a composite of heart failure (New York Heart Association class ≥II) and pacemaker-requiring conduction disorders. At baseline, 40/159 (25%) relatives were diagnosed with ATTRv-CM. Of those, 20 (50%) met the secondary endpoint. Indication to screen (≤10 years prior to predicted disease onset and absence of extracardiac amyloidosis) had an excellent negative predictive value (97%). Other pre-screening predictors for ATTRv-CM were infrequently identified variants and male sex. Importantly, 13% of relatives with ATTRv-CM did not show any signs of cardiac involvement on first-line diagnostic tests. The yield of serial evaluation (n = 41 relatives; follow-up 3.1 [2.2-5.2] years) at 3-year interval was 9.4%.CONCLUSIONS: Screening according to the 2021 ESC position statement performs well in daily clinical practice. Clinicians should adhere to repeating bone scintigraphy after 3 years, as progressing to ATTRv-CM without signs of ATTRv-CM on first-line diagnostic tests or symptoms is common.</p