Managing the Lean–Agile Paradox in Complex Environments

The decision to incrementally improve existing processes and products or introduce breakthrough innovations depends on the context a company is facing. In situations where problems are known, it is better to incrementally improve, while in complex situations where problems are not known, a probe-sense-respond approach based on experimentation and the exploration of new solutions is preferable. Lean management adapts well to the first type of context, while agile management fits the second type of context. However, organizations must increasingly consider both approaches and become ambidextrous by introducing incremental improvements and breakthrough innovations simultaneously. This requires embracing the paradox between exploiting and exploring, adopting a new leadership mindset, and dual strategic, organizational, and behavioral models. This paper proposed a framework to implement lean and agile approaches simultaneously using the paradox theory to justify and manage this co-existence. This framework is threefold. First, managers need to differentiate between lean and agile, finding ways of keeping the two approaches separated. Second, lean and agile should be integrated so that synergies between the two approaches can be generated. Finally, managers need to achieve a dynamic equilibrium over time between lean and agile. Contributions to the theory and practice of this approach were discussed

The ionization potential of NF 3 : a G3 computational study on the thermochemical properties of NF x and NF ϩ x x 1-3

Abstract The adiabatic ionization potential (IP) of NF x x 1-3 and the enthalpies of formation of NF x and NF ϩ x have been computed using the Gaussian-3 (G3) theory. The obtained values are generally found in very good agreement with the experimental ones. However, the G3 enthalpy of formation of N

Long COVID in Children and Adolescents

Severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) has caused significant mortality and morbidity worldwide. In children, the acute SARS-CoV-2 infection is often asymptomatic or paucisymptomatic, and life-threatening complications are rare. Nevertheless, there are two long-term consequences of SARS-CoV-2 infection in children that raise concern: multisystem inflammatory syndrome in children (MIS-C) and long COVID. While the understanding and the experience regarding the acute phase of SARS-CoV-2 infection have remarkably increased over time, scientific and clinical research is still exploring the long-term effects of COVID-19. In children, data on long COVID are scant. Reports are conflicting regarding its prevalence, duration and impact on daily life. This narrative review explored the latest literature regarding long COVID-19 in the pediatric population. We showed that long COVID in children might be a relevant clinical problem. In most cases, the prognosis is good, but some children may develop long-term symptoms with a significant impact on their daily life. The paucity of studies on long COVID, including a control group of children not infected by SARS-CoV-2, prevents us from drawing firm conclusions. Whether the neuropsychiatric symptoms widely observed in children and adolescents with long COVID are the consequence of SARS-CoV-2 infection or are due to the tremendous stress resulting from the restrictions and the pandemics is still not clear. In both cases, psychological support can play a fundamental role in managing COVID pandemics in children. More knowledge is needed to share a standardized definition of the syndrome and improve its management and treatment

Alignment of the high beta magnets in the RHIC interaction regions

The betatron functions inside the triplet quadrupoles in the Relativistic Heavy Ion Collider-RHIC are of the order of 1,500 m, necessitating additional attention in the alignment procedure. On each side of the interaction regions eight cryogenic elements (six quadrupoles and two horizontal bending dipoles) are placed inside large cryostats. The quadrupole magnetic centers are obtained by antenna measurements with an accuracy of {+-} 60 {micro}m. The signals from the antenna were cross calibrated with the colloidal cell measurements of the same magnet. The positions of the fiducials are related to the magnet centers during the antenna measurements. Elements are positioned warm inside the cryostats, with offsets to account for shrinkage during the cool down. The supports at the middle of the two central quadrupoles are fixed, while every other element slides longitudinally inside the cryostat during cool down or warm up

Right ventricular strain in Fabry disease: prognostic implications

IntroductionLeft ventricular (LV) hypertrophy is the main feature of cardiac involvement in Anderson-Fabry disease (FD), but the right ventricle (RV) is also frequently affected. Previous studies failed to demonstrate an independent association between conventional parameters of RV performance and outcomes in FD. Nevertheless, if RV free wall strain (RV-FWS), assessed by 2D speckle tracking analysis, may provide a better prognostication is currently unknown.MethodsWe retrospectively evaluated the association between RV-FWS and the occurrence of cardiovascular events in a cohort of 56 patients with FD. The study endpoint comprises cardiovascular mortality, severe heart failure symptoms, new-onset atrial fibrillation and major arrhythmias requiring device implantation.ResultsReduced RV-FWS, defined by values lower than 23%, was found in 25 (45%) patients. During a median follow-up of 47 months, 16 (29%) patients met the study endpoint. A ROC-curve analysis confirmed the threshold of reduced RV-FWS (Cox regression analysis, RV-FWS, expressed as continuous variable, was significantly associated with the study endpoint (HR: 0.795, 95% CI: 0.710–0.889, p p = 0.340 and p = 0.289 respectively).ConclusionsRV-FWS was not independently associated with the occurrence of cardiovascular events in FD, confirming previous observations that prognosis is mainly driven by the severity of LV cardiomyopathy.Cardiolog

Gender Differences and Psychopathological Features Associated With Addictive Behaviors in Adolescents.

BACKGROUND: The aims of the study were to assess prevalence and gender differences of addictive behaviors (substance- and non-substance-related) in an adolescent population, and their association with psychopathological features and academic performance. MATERIAL AND METHODS: A sample of high school Italian students (n\u2009=\u2009996; M\u2009=\u2009240, F\u2009=\u2009756) was examined using a self-report survey concerning sociodemographic characteristics, cigarette smoking, alcohol and substance use, perceived academic performance, activities, and behaviors (Internet use, gambling, and physical exercising). The Internet Addiction Test, the South Oaks Gambling Screen-revised Adolescent, and the Exercise Addiction Inventory-Short Form were administered to identify problematic behaviors. The Barratt Impulsiveness Scale for Adolescent, the Snaith-Hamilton Pleasure Scale, the Dissociative Experience Scale for Adolescent, and the Toronto Alexithymia Scale were used to investigate psychopathological dimensions. RESULTS: Frequent alcohol intake and lifetime substances consumption were more common among males. The occurrence of other addictive behaviors was 22.1% for problematic Internet use (M\u2009=\u2009F), 9.7% for at-risk/problematic gambling (M\u2009>\u2009F), and 6.2% for maladaptive physical exercise (M\u2009=\u2009F). We also found an association between substance-/non-substance-related addictive behaviors and psychopathological dimensions. Addictive behaviors were more frequent among students reporting poor school performance. CONCLUSION: Our study showed a relevant prevalence of addictive behaviors in a sample of Italian high school students, with specific gender differences. We underlined the cooccurrence of substance and non-substance-related addictive behaviors, and their association with worse school performance. Dissociative proneness, anhedonia, alexithymia, and impulsivity were associated with addictive behaviors in adolescents and might represent vulnerability factors for the development of psychiatric disorders in adulthood. A better understanding of psychopathological features associated with addictive behaviors might be useful for the prevention/early intervention

Optical investigation of action potential and calcium handling maturation of hiPSC-cardiomyocytes on biomimetic substrates

Cardiomyocytes from human induced pluripotent stem cells (hiPSC-CMs) are the most promising human source with preserved genetic background of healthy individuals or patients. This study aimed to establish a systematic procedure for exploring development of hiPSC-CM functional output to predict genetic cardiomyopathy outcomes and identify molecular targets for therapy. Biomimetic substrates with microtopography and physiological stiffness can overcome the immaturity of hiPSC-CM function. We have developed a custom-made apparatus for simultaneous optical measurements of hiPSC-CM action potential and calcium transients to correlate these parameters at specific time points (day 60, 75 and 90 post differentiation) and under inotropic interventions. In later-stages, single hiPSC-CMs revealed prolonged action potential duration, increased calcium transient amplitude and shorter duration that closely resembled those of human adult cardiomyocytes from fresh ventricular tissue of patients. Thus, the major contribution of sarcoplasmic reticulum and positive inotropic response to \u3b2-adrenergic stimulation are time-dependent events underlying excitation contraction coupling (ECC) maturation of hiPSC-CM; biomimetic substrates can promote calcium-handling regulation towards adult-like kinetics. Simultaneous optical recordings of long-term cultured hiPSC-CMs on biomimetic substrates favor high-throughput electrophysiological analysis aimed at testing (mechanistic hypothesis on) disease progression and pharmacological interventions in patient-derived hiPSC-CMs