Addressing Grand Challenges Collectively: A brief introduction to Impact-oriented Networks

This paper aims to provide a brief introduction to networks from the perspective of philanthropy and social impact. Acknowledging the depth and breadth of the discourse around networks and its terminology, we focus on a particular type of networks – impact-oriented networks – and discuss their key characteristics, value creation and, briefly, their potential role in the philanthropic toolkit

Serial Assessment of Right Ventricular Deformation in Patients With Hypoplastic Left Heart Syndrome: A Cardiovascular Magnetic Resonance Feature Tracking Study

Background As right ventricular dysfunction is a major cause of adverse outcome in patients with hypoplastic left heart syndrome, the aim was to assess right ventricular function and deformation after Fontan completion by performing 2-dimensional cardiovascular magnetic resonance feature tracking in serial cardiovascular magnetic resonance studies. Methods and Results Cardiovascular magnetic resonance examinations of 108 patients with hypoplastic left heart syndrome (female: 31) were analyzed. Short-axis cine images were used for right ventricular volumetry. Two-dimensional cardiovascular magnetic resonance feature tracking was performed using long-axis and short-axis cine images to measure myocardial global longitudinal, circumferential, and radial strain. All patients had at least 2 cardiovascular magnetic resonance examinations after Fontan completion and 41 patients had 3 examinations. Global strain values and right ventricular ejection fraction decreased from the first to the third examination with a significant decline in global longitudinal strain from the first examination to the second examination (median, first, and third quartile: -18.8%, [-20.5;-16.5] versus -16.9%, [-19.3;-14.7]) and from the first to the third examination in 41 patients (-18.6%, [-20.9;-15.7] versus -15.8%, [-18.7;-12.6]; P-values <0.004). Right ventricular ejection fraction decreased significantly from the first to the third examination (55.4%, [49.8;59.3] versus 50.2%, [45.0;55.9]; P<0.002) and from the second to the third examination (53.8%, [47.2;58.7] versus 50.2%, [45.0;55.9]; P<0.0002). The significant reduction in global longitudinal strain between the first 2 examinations with non-significant changes in right ventricular ejection fraction suggest that global longitudinal strain measured by 2-dimensional cardiovascular magnetic resonance feature tracking might be a superior technique for the detection of changes in myocardial function

Factors influencing preoperative stress response in coronary artery bypass graft patients

BACKGROUND: In many studies investigating measures to attenuate the hemodynamic and humoral stress response during induction of anaesthesia, primary attention was paid to the period of endotracheal intubation since it has been shown that even short-lasting sympathetic cardiovascular stimulation may have detrimental effects on patients with coronary artery disease. The aim of this analysis was, however, to identify the influencing factors on high catecholamine levels before induction of anaesthesia. METHODS: Various potential risk factors that could impact the humoral stress response before induction of anaesthesia were recorded in 84 males undergoing coronary aortic bypass surgery, and were entered into a stepwise linear regression analysis. The plasma level of norepinephrine measured immediately after radial artery canulation was chosen as a surrogate marker for the humoral stress response, and it was used as the dependent variable in the regression model. Accordingly, the mean arterial blood pressure, heart rate and the calculated pressure-rate product were taken as parameters of the hemodynamic situation. RESULTS: Stepwise regression analysis revealed that the oral administration of low-dose clonidine (mean dose 1.75 μg·kg(-1)) on the morning of surgery was the only significant predictor (p = 0.004) of the high variation in preoperative norepinephrine plasma levels. This intervention decreased norepinephrine levels by more than 40% compared to no clonidine administration, from 1.26 to 0.75 nmol·l(-1). There was no evidence for dose-responsiveness of clonidine. All other potential predictors were removed from the model as insignificant (p > 0.05). The use of beta-blocker, ace-inhibitors, ejection fraction, and body mass index were significant determinants for the hemodynamic situation (heart rate, mean arterial pressure, pressure rate product) of the patient during the pre-induction period. CONCLUSION: The oral administration of clonidine is the only significant predictor for the observed variation of norepinephrine levels during the preoperative period. Lack of significant dose responsiveness suggests that even a low dose of the drug can attenuate the preoperative stress response and thus is recommended in cardiovascular high risk patients

Supporting Social Entrepreneurs - The effects of organizational maturity and business model on perceived support needs

Social Entrepreneurs tend to be characterized as "unusually resourceful in being relatively undaunted by scarce assets in pursuing their social venture" (Peredo/McLean 2006: 64) or "acting boldly without being limited by resources currently in hand" (Dees 2001: 4). Still, social entrepreneurs do not operate in a vacuum. They depend on various forms of support and resources to establish and grow their ventures and impact. Hence, the question of how to support social entrepreneurs and their initiatives becomes of increasing relevance (Lyon/Sepulveda 2009). In spite of the growing call for measures to enable social entrepreneurship on a broad scale (e.g. by the World Economic Forum, Skoll Foundation and others) and increasing political support for the topic, little is known about the actual activities and resources required for incubating and sustaining social ventures. As of now, the support needs of social entrepreneurs have received limited attention in organizational and entrepreneurship research. Studies that touch upon the topic are mostly of qualitative or narrative nature (Thompson 2002: 429). Also, while it is a common understanding that "there is no one type of social entrepreneur" (Barendsen/Gardner 2004: 47), current perspectives rarely take into consideration that the needs of social entrepreneurs may be heterogeneous and vary over time. The approach of value creation can create different support demands, depending on the business model and the scale and scope of the intended impact (e.g. Zahra et al. 2009). Distinctive research still remains to be conducted in order to answer where, when, whom and how to best support within the social entrepreneurship spectrum. Against this background, this paper is guided by the following research questions: (1) What are the support needs of social entrepreneurs? (2) How are these support needs influenced by (a) organizational maturity and (b) the way, value is created by the organization. In an attempt to answer these questions this paper presents an explorative empirical investigation of these the support needs of a heterogeneous sample in seven countries. Our focus is firstly set on conceptualizing relevant support needs. Based on a literature review and 22 semi-structured interviews, seventeen support needs are identified with regards to the individual development (Thompson et al. 2000: 337), organizational resources (Austin et al. 2006: 13), the entrepreneurial process (Sharir/Lerner 2006: 15) and the environment (CASE 2008: 14). Moreover, two potential determinants of support needs are being dentified: varying stages of organizational maturity (herein referred to as "stages") as well as different business and income models ("models"). The levels of these support needs and the influence of stages and models are then tested among 112 social entrepreneurs in seven countries

Behandlung des Hypoplastischen Linksherz Syndroms: eine Bilanz über 12 Jahre

Analyse des dreistufigen operativen Behandlungskonzeptes bei Patienten mit Hypoplastischen Linksherz Syndrom

Transcatheter mitral valve implantation: different fixation techniques

Transcatheter mitral valve implantation provides an off-pump treatment option for mitral valve regurgitation, especially for secondary mitral regurgitation. It offers an opportunity for the treatment of a large cohort of patients not referred for conventional surgery. One of the biggest challenges is the development of a valved stent that suits the complex anatomy of the native mitral valve. Furthermore, secure anchorage of the device is difficult in the mitral area without clearly defined structures. In the last few years, various new self-expanding nitinol valved stents for transapical implantation in the beating heart have been developed. Different design iterations were conducted to improve fixation and overall stent performance. The risk of paravalvular leakage was decreased and reproducibility enhanced. This article reviews the major achievements in the development process of our apically fixed mitral valved stent over the last few years, with prototypes that provide secure stent deployment, high reproducibility and low paravalvular leakage rates

Right ventricular outflow tract reconstruction with the Labcor® stentless valved pulmonary conduit

OBJECTIVES The right ventricular outflow tract reconstruction is a common necessity in congenital cardiac surgery. As homograft availability is limited, alternatives need to be evaluated. The Labcor® conduit consists of a porcine tricomposite valve assembled inside a bovine pericardium tube. This study presents intermediate-term results for its utilization for right ventricular outflow tract reconstruction. METHODS Labcor conduits were implanted in 53 patients (February 2009-July 2016). We analysed perioperative data, freedom from conduit failure and risk factors for conduit dysfunction. RESULTS The most common diagnosis was Tetralogy of Fallot (n = 20, 37.7%). The median age at surgery was 10.0 [interquartile range (IQR) 4.9-14.3] years. Pulmonary artery plasty (n = 37, 69.8%) and augmentation of the right ventricular outflow tract (n = 16, 30.2%) were often part of the procedure. The median conduit size was 21 (range 11-25) mm. There was no in-hospital death. The median follow-up after surgery was 4.6 (IQR 3.4-5.6) years. Fourteen patients (27.5%) developed conduit failure with stenosis being the main cause. Freedom from conduit failure was 98.0% at 2 and 80.5% at 5 years. The median longevity of the conduit was 7.4 years (95% confidence interval 5.1-9.8 years). Younger age and smaller conduit size were related to conduit failure. CONCLUSIONS Utilization of the Labcor conduit revealed acceptable intermediate-term results. The conduit appeared to be functioning sufficiently well within the first 5 years in the majority of patients. The higher rate of failure concerning smaller conduits might be associated with somatic outgrowth; however, conduit degeneration as common and long-term outcome still needs to be evaluated

How can networks help encourage the development and professionalisation of innovative early STEM Education in a changing world?

Maailma muuttuu monimutkaisemmaksi ja vaatii muun muassa STEM*-osaamista ja lukutaitoa oppijoilta, yhteisön jäseniltä ja yhteiskunnilta. Siksi laadukkaalle varhaiselle STEM-koulutukselle tarvitaan laajaa puolustamista. Tässä artikkelissa hahmotellaan, kuinka vaikutusverkostot (joita on muodostettu käsittelemään monimutkaisia sosiaalisia tai ympäristökysymyksiä) voivat edistää varhaisen STEM-koulutuksen kehittämistä ja ammattimaistumista. Sen tavoitteena on tukea alaa kehittäviä oppilaitoksia lisäämään työnsä vaikutusta paremman ja helposti saavutettavan koulutuksen puolesta maailmanlaajuisesti. Tutkittuaan varhaisen STEM-koulutuksen suunniteltuja vaikutuksia nykyisessä kontekstissa esitellään erilaisia verkostotyyppejä ja arvioidaan koulutusorganisaatioiden ja niiden verkostokumppaneiden verkostomaisia lähestymistapoja useissa maissa. Se pohtii verkostojen eri toimintoja ja menestystekijöitä suhteessa kirjoittajien kuuden organisaation verkostoihin omissa maissaan ja analysoi verkostoja mahdollisuuksien ja haasteiden mukaan. Paperi argumentoi verkostoyhteistyön merkityksellisyyden ja verkostojen potentiaalin muutoksen vaikuttajina osoittaen niiden vaikutusta STEM-koulutuksen parantamiseen muuttuvassa maailmassa. Lyhenne "STEM" LUMAa vastaava kansainvälinen lyhenne, joka tarkoittaa tiedettä, teknologiaa, tekniikkaa, tietotekniikkaa ja matematiikkaa. Artikkelissa STEM Education määritellään koulutukseksi, jossa yhdistyvät tieteen, teknologian, (tieto)tekniikan ja matematiikan käsitteet ja menetelmät integroidulla tieteenaloja muuttavalla tavalla.The world is becoming more complex and requires, among other skills, STEM1knowledge and literacy of its learners, community members, and societies alike. Thus, an extensive advocacy for quality early STEM Education is needed. This paper outlines how impact networks (formed to address complex social or environmental issues) can promote the development and professionalisation of early STEM Education. It aims to support field-developing institutions to increase the impact of their work for a better and easily accessible education worldwide. After reviewing the intended impact of early STEM Education in the present context, the paper presentsvarious network types and then assesses the network approaches of educational organisations and their network partners in multiple countries. It reflects on the various functions and success factors of networks in relation to the authors’ six organisations’ networks in their respective countries and analyses the networks according to opportunities and challenges. The paper argues for the relevance of network collaborations and for the potential of networks as agents of change, exemplifying their impact on improving STEM Education in a changing world. The abbreviation “STEM” stands for science, technology, (information) engineering/computer science, and mathematics. We define STEM Education as an education combining science, technology, (information) engineering, and math concepts and methods in an integrated way that transforms the discipline of science.nonPeerReviewe

Tissue Engineered Transcatheter Pulmonary Valved Stent Implantation: Current State and Future Prospect

Patients with the complex congenital heart disease (CHD) are usually associated with right ventricular outflow tract dysfunction and typically require multiple surgical interventions during their lives to relieve the right ventricular outflow tract abnormality. Transcatheter pulmonary valve replacement was used as a non-surgical, less invasive alternative treatment for right ventricular outflow tract dysfunction and has been rapidly developing over the past years. Despite the current favorable results of transcatheter pulmonary valve replacement, many patients eligible for pulmonary valve replacement are still not candidates for transcatheter pulmonary valve replacement. Therefore, one of the significant future challenges is to expand transcatheter pulmonary valve replacement to a broader patient population. This review describes the limitations and problems of existing techniques and focuses on decellularized tissue engineering for pulmonary valve stenting.Other UBCNon UBCReviewedFacultyResearcherOthe