Downside-Upside Duality: The Role of Ambidexterity in Enterprise Risk Management

Enterprise risk management (ERM) is a widely studied management control process, representing an important advancement from the traditional methods by which firms control the risks they face. This study steps back from attempts to quantify the relationship between ERM and firm performance. Instead, it explores how non-financial institutions with significant time and resource commitments to ERM configure those resources to effectuate a downside-upside duality as ERM is adopted, using for the first time in ERM research the theoretical lens of ambidexterity as a dynamic capability. This duality is the simultaneous engagement in mitigating existing and emerging risks while pursuing new value contributions from risk management processes. Empirical evidence indicates that the downside-upside duality is asymmetric, and challenges exist in quantifying the upside. The upside value component is most closely associated with raising the level of the risk discourse in firms. This is accomplished structurally by establishing new ERM-focused organizational subunits, and contextually by stretching capabilities. Dynamic capabilities emerge as firms sense, seize and reconfigure resources in the operationalization of ERM to supplant core competencies associated with traditional modes of risk management. Practitioners will gain from this research a richer understanding of the fit, form and function of ERM informed by empirical data and extrinsic theory

The increasing temperature as driving force for spatial distribution patterns of Parapenaeus longirostris (Lucas 1846) in the Strait of Sicily (Central Mediterranean Sea)

The deep-water rose shrimp Parapenaeus longirostris (DPS), a demersal decapod representing the most important component of crustacean landings in the Mediterranean Sea, has been suggested as a species that may exhibit temperature-driven changes in the spatio-temporal dynamics. Considering that Mediterranean waters are warming up faster than oceans, understanding the relationships of DPS populations with temperature variations and the related changes in spatial patterns is absolutely key for its management. Using a long-term dataset covering 13-years from scientific surveys (International Bottom Trawl-Surveys in the Mediterranean, MEDITS; Italian national trawl surveys, GRUND) in the Strait of Sicily (central Mediterranean Sea), the annual DPS spatial patches and the depth distribution were investigated using geostatistical and quotient analyses. The patches dimension and depth range occupation were then related to sea temperature by using linear regression analysis. Results showed that both the dimension of DPS spatial patches and the depth distribution range occupied increased concurrently with temperature. Our findings corroborate that the ongoing sea warming widen areas suitable for this species and in which it can expand its spatial distribution

Letter to the editor : management of patients with Ebola virus disease in Europe : high-level isolation units should have a key role

In the past, the rare imported cases of Ebola and Marburg in western European countries and the United States were managed in high-level isolation units (HLIUs). Subsequently, reported experiences indicate that strict contact-droplet isolation is enough for preventing transmission. From this hypothesis, the idea may derive that HLIUs are not strictly necessary for the management of EVD patients, who may be safely managed in non-specialised hospitals, as suggested by some international recommendations elaborated during the current Ebola outbreak in West Africa. Even if we concur that strict contact-droplet isolation is enough to prevent transmission during routine care, we believe that HLIUs should have a key role in EVD containment in countries where such facilities are available. An HLIU is a healthcare facility specifically designed to provide safe, secure, high-quality, and appropriate care, with optimal infection containment and infection prevention and control procedures, for a single patient or a small number of patients who have, or who may have, a highly infectious disease.peer-reviewe

Cold Atmospheric Pressure Plasmas for Food Applications

Successfully distributing shelf food requires treatment to eliminate microorganisms. Current chemical methods, such as chlorine wash, can alter food quality while only being effective for a limited time. Cold atmospheric pressure plasmas (CAPs) can eradicate the microorganisms responsible for food spoilage and foodborne illness. Optimizing CAP treatments requires understanding the reactive species generated and relating them to eradication efficiency. Recent studies have used optical emission spectroscopy (OES) to determine the species generated in a sealed package that would hold food. In this study,we supplement the OES results with optical absorption spectroscopy (OAS) using the same gases (helium, nitrogen, compressed air, humid air) to elucidate plasma chemistry and temperature. We first reproduce previous results using a new setup while assessing the impact of the package and surrounding box on the plasma spectrum. A UV-Vis light lightsource is emitted through a series of lenses placed next to the plasma. Analysis using SpecAir software allows the identification of absorbed peaks and the calculation of rotational, vibrational, and electron temperatures. Results show that the air plasma produces a primary absorbance peak at a wavelength of ~260 nm, demonstrating the diagnostic capability of this technique . Species generation declined dramatically during the first two minutes of treatment with the effect leveling off thereafter. These findings elucidate reactive species generation within the plasma to optimize CAP systems for microorganism decontamination

The diagnostic criteria for small fibre neuropathy: from symptoms to neuropathology

Small fibre neuropathy (SFN), a condition dominated by neuropathic pain, is frequently encountered in clinical practise either as prevalent manifestation of more diffuse neuropathy or distinct nosologic entity. Aetiology of SFN includes pre-diabetes status and immune-mediated diseases, though it remains frequently unknown. Due to their physiologic characteristics, small nerve fibres cannot be investigated by routine electrophysiological tests, making the diagnosis particularly difficult. Quantitative sensory testing (QST) to assess the psychophysical thresholds for cold and warm sensations and skin biopsy with quantification of somatic intraepidermal nerve fibres (IENF) have been used to determine the damage to small nerve fibres. Nevertheless, the diagnostic criteria for SFN have not been defined yet and a ‘gold standard’ for clinical practise and research is not available. We screened 486 patients referred to our institutions and collected 124 patients with sensory neuropathy. Among them, we identified 67 patients with pure SFN using a new diagnostic ‘gold standard’, based on the presence of at least two abnormal results at clinical, QST and skin biopsy examination. The diagnosis of SFN was achieved by abnormal clinical and skin biopsy findings in 43.3% of patients, abnormal skin biopsy and QST findings in 37.3% of patients, abnormal clinical and QST findings in 11.9% of patients, whereas 7.5% patients had abnormal results at all the examinations. Skin biopsy showed a diagnostic efficiency of 88.4%, clinical examination of 54.6% and QST of 46.9%. Receiver operating characteristic curve analysis confirmed the significantly higher performance of skin biopsy comparing with QST. However, we found a significant inverse correlation between IENF density and both cold and warm thresholds at the leg. Clinical examination revealed pinprick and thermal hypoesthesia in about 50% patients, and signs of peripheral vascular autonomic dysfunction in about 70% of patients. Spontaneous pain dominated the clinical picture in most SFN patients. Neuropathic pain intensity was more severe in patients with SFN than in patients with large or mixed fibre neuropathy, but there was no significant correlation with IENF density. The aetiology of SFN was initially unknown in 41.8% of patients and at 2-year follow-up a potential cause could be determined in 25% of them. Over the same period, 13% of SFN patients showed the involvement of large nerve fibres, whereas in 45.6% of them the clinical picture did not change. Spontaneous remission of neuropathic pain occurred in 10.9% of SFN patients, while it worsened in 30.4% of them

Management of chronic lymphocytic leukemia: practice guidelines from the Italian Society of Hematology, the Italian Society of Experimental Hematology and the Italian Group for Bone Marrow Transplantation.

The Italian Society of Hematology (SIE) and two affiliate societies (SIES and GITMO) commissioned a project to develop clinical practice guidelines for the treatment of chronic lymphocytic leukemia (CLL). METHODS: Key questions in the management of patients with CLL were formulated by an Advisory Committee and approved by an Expert Panel of eight senior hematologists. After a systematic review of the literature, recommendations for disease-specific and supportive therapies were formulated and graded according to the supporting evidence. Explicit consensus methods were used for providing recommendations for questions with incomplete or potentially biased evidence. RESULTS: It is recommended that therapy is commenced in patients with CLL when at least one of the following are present: B-symptoms, progressive/obstructive lymphadenopathy or organomegaly, rapid lymphocyte doubling time, anemia or thrombocytopenia (of new onset, worsening or steroid-resistant). It is recommended that patients without co-morbidity should receive fludarabine plus cyclophosphamide, whereas elderly patients with co-morbidity should receive oral chlorambucil. Younger patients with unfavorable biological risk factors should be considered for high-dose chemotherapy and autologous or allogeneic stem cell transplantation within approved clinical trials. Patients either relapsing rapidly after, or non-responsive to, first-line chlorambucil should receive fludarabine-containing regimens. Patients either relapsing soon after or not responding to fludarabine-based chemotherapy should be considered for schedules including non-cross-reactive agents, such as alemtuzumab, possibly followed by high-dose chemotherapy and autologous transplantation in the context of a clinical trial or by allogeneic stem cell transplantation. CONCLUSIONS: We describe the results of a systematic literature review and an explicit approach to consensus techniques which resulted in recommendations for the key therapeutic decisions in patients with CLL