The process of creative construction: knowledge spillovers, entrepreneurship and economic growth

Questioning the underlying assumptions of the process of creative destruction, we conceptualize an alternative process of creative construction that may characterize the dynamics between entrants and incumbents. We discuss the underlying mechanism of knowledge spillover strategic entrepreneurship whereby knowledge investments by existing organizations, when coupled with entrepreneurial action by individuals embedded in their context, results in new venture creation, heterogeneity in performance and subsequent growth in industries, regions and economies. The framework has implications for future research in entrepreneurship, strategy and economic growth

A near miss case of placenta percreta in a patient with post myomectomy scar

The term placenta accreta or placenta accrete syndrome is used to describe a spectrum of an abnormal placental implantation and firm adherence which are classified according to the depth of invasion into the uterus. A 28-year-old elderly primigravida presented AIIMS OPD to for the 1st time at 13+2 weeks of gestation with brownish discharge per vaginum. Ultrasonography done showed 12 weeks single intrauterine pregnancy with subchorionic haemorrhage of 3.7×2.52 cm with placenta being fundoanterior. She underwent myomectomy 2 years back and during her antenatal care in 3rd trimester growth scan at 30+2 weeks of gestation placenta was fundoanterior with loss of retroplacental hypoechoic in the upper margin of placenta at the myomectomy scar site with small extra uterine collection seen measuring 7.6×2.3 cm and hence possibility of placenta accreta was suggestive by the above findings confirmed by MRI. Emergency cesarean section done at 36+6 weeks of gestation for leaking per vaginum. Manual removal of placenta was tried but it failed and soon atonic PPH developed. Seeing no response with uterotonics internal iliac artery ligation was also attempted but failed. Immediate decision for hysterectomy was taken as a life-saving method. On adhesiolysis in the fundal region placental tissue perforating uterine serosa was visible on the surface of uterus, hence diagnosis of placenta percreta was confirmed which was further confirmed on histopathological report. Currently hysterectomy or local resection is preferred over conservative management with methotrexate

Knowledge, attitude and practices towards medical research among resident doctors at a tertiary care hospital

Background: Research is a systematic process utilizing the scientific method for generating new knowledge that can be used to solve a problem or improving the existing status of a system. Human being is living a life of ease due to research in medical field. But it is important to know that whether those who are closest to society like resident doctors are involved in research process or not. Thus, the present study is planned to assess the knowledge, attitude and practice of resident doctors in a tertiary care hospital.Methods: This was the questionnaire-based study conducted among the resident doctors. Sample size calculated was 110 by open Epi software. A self-structured questionnaire was validated and distributed. Then we collected the data which was analysed using statistical analysis with MS excel and SPSS software version 21.Results: The 62% response rate was achieved. More than 50% of the resident doctors have the knowledge of p value and protocol writing. 63% students are strongly agreed that research in medical field is important while only 19% students are strongly disagreed that research increases burden over students 17% of the students have presented research paper. More than 75% student told that there are many barriers conducting research.Conclusions: This study demonstrates that more than 50% respondents have the basic knowledge about the medical research and they have the positive attitude too. But there is lack of the practices regarding research. Thus, there should be some efforts to improve practices of medical research among resident doctors

Recurrent hematometra with endometriosis in an adolescent girl: a case report

Hematometra is a collection or retention of blood in the uterine cavity. This condition is most commonly associated with congenital uterine anomalies that result from abnormal formation, fusion or resorption of Mullerian ducts during fetal life or may be due to prior surgical procedures, causing an obstruction of the genitourinary outflow tract. We report an unusual case of hematometra with endometriosis secondary to cervical stenosis. This is a rare and important case report due to the complexity of diagnosis as cervical stenosis was not presented as primary amenorrhoea as its usual presentation. This case was successfully managed by Hysteroscopic cervical dilatation under USG guidance followed by transcervical insertion of a catheter to prevent recurrent stenosis

Studies of structural, magnetic and dielectric properties of X-type Barium Zinc hexaferrite Ba2Zn2Fe28O46 powder prepared by combustion treatment method using ginger root extract as a green reducing agent

Various quantities of ginger (Zingiber officinale) root extract were used to prepare X-type Barium–Zinc hexaferrite with the chemical composition Ba2Zn2Fe28O46. The powders were prepared using a combustion treatment method, being pre-heated at 550 °C for 4 h with the ginger as a fuel, followed by final heating to 900 °C for 5 h and natural cooling to room temperature to obtain Ba2Zn2Fe28O46 hexagonal ferrite powder. The phase composition of heated powder samples was investigated by X-ray diffraction (XRD), indicating the formation of a mixture of X-type and hematite (α-Fe2O3). Up to 82.6%, X-ferrite was formed at 900 °C with 52.5 g of ginger root extract. Dielectric analysis of the prepared samples shows the frequency-dependent phenomena. All samples were hard magnets, with coercivity values (HC) between 262.2 and 318.3 kA m−1, and squareness ratios > 0.5. The sample prepared with 52.5 g ginger root extract possesses the highest value of saturation magnetisation (MS = 33.87 Am2 kg−1) in comparison with the other prepared samples. Therefore, ginger was shown to be a useful natural plant extract as a reducing fuel for the low-temperature synthesis of X-ferrites. The sample prepared with 35 g ginger root extract shows a broad loss tangent resonance peak between 10 kHz and 100 kHz, while other samples show loss tangent resonance peaks between 300 kHz and 2 MHz frequency range.publishe

Design and development of Ga-substituted Z-type hexaferrites for microwave absorber applications: mössbauer, static and dynamic properties

Gallium substituted Z-type Sr3GaxCo2-xFe24O41 (x = 0.0–2.0 in steps of 0.4) hexaferrites were synthesised by the sol-gel auto-combustion process, and sintered at 1150 °C. The structural, morphology, magnetic, Mössbauer, dielectric and microwave absorption properties were examined. XRD results of x = 0.0, 0.4, 0.8, and 1.2 samples show the formation of a single Z-type hexagonal phase. The samples x = 1.6 and 2.0 show the formation of Z and M phases. Hysteresis loops analysis suggest that samples x < 1.6 possess a soft magnetic nature, while the samples x = 1.6 and 2.0 show a hard ferrite characteristics. All samples possess multi-domain microstructures. The composition x = 0.4 [maximum MS = 97.94 Am2kg−1] was fitted with seven sextets (Fe3+) and a paramagnetic doublet-A (Fe3+), while beyond x ≥ 0.8 two more doublets (Fe2+) were observed along with seven sextets in Mössbauer spectra. The maximum values of Fe2+ ions (1.26%) and relative area of paramagnetic doublets (1.91%) were observed for x = 1.6 composition, which is also responsible for the lowest value of MS (69.99 Am2kg−1) for this composition. The average hyperfine magnetic field was found to decrease, whereas average quadrupole splitting was found to increase, with Ga-substitution. The substitution of Ga ions enhanced permeability, dielectric constant, magnetic loss and dielectric loss, in a non-linear fashion. The reflection loss was maximum at lower frequencies for samples x = 0.0 and 0.8, and decreases with frequency. Sample x = 0.8 has maximum reflection loss of −12.44 dB at 8 GHz, a measured thickness of 3 mm, and a bandwidth of −10 dB at 1.18 GHz. The observed absorption has been discussed with the help of the input impedance matching mechanism and quarter wavelength mechanism. The observed coercivity in different samples also influenced microwave absorption which demonstrated potenial in microwave absorber applications.publishe

Implications of Strategic Management Theory

Macroeconomic theory assumes that factors of production in the economy are homogeneous and fungible. As a result, it may be ill-suited for developing policy responses to the recent financial crisis. Theories of strategic management and organization, with their emphasis on heterogeneously distributed resources and capabilities, may be better positioned. Examples of where macroeconomic theory may lead policies astray, and where theories of strategic management may be more appropriate, are provided

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic