Disruptive technology and hemophilia care : the multiple impacts of emicizumab

Emicizumab, a bispecific antibody mimicking the action of factor VIII (FVIII), is currently the first and only approved and increasingly accessible disruptive treatment option for hemophilia A, a disease so far mainly treated with frequent intravenous infusions of FVIII concentrates or bypassing agents in case of inhibitor development. Other disruptive treatments are expected to follow, such as agents that rebalance coagulation and gene therapy with the ambition of curing hemophilia. While these treatment options represent major achievements or expectations, their adoption and implementation should consider their multiple direct and indirect, immediate or delayed, consequences on hemophilia care globally. It is these multiple changes, present and future, already visible or hypothetical, that this article intends to review and explore

Design thinking for pre-empting digital disruption

Digital disruption is the phenomenon when established businesses succumb to new business models that exploit emerging technologies. Futurists often make dire predictions when discussing the impact of digital disruption, for instance that 40% of the Fortune 500 companies will disappear within the next decade. The digital disruption phenomenon was already studied two decades ago when Clayton Christensen developed a Theory of Disruptive Innovation, which is a popular theory for describing and explaining disruption due to technology developments that had occurred in the past. However it is still problematic to understand what is necessary to avoid disruption, especially within the context of a sustainable society in the 21st century. A key aspect we identified is the behavior of non-mainstream customers of an emerging technology, which is difficult to predict, especially when an organization is operating in an existing solution space. In this position paper we propose complementing the Theory of Disruptive Innovation with design thinking in order to identify the performance attributes that encourage the unpredictable and unforeseen customer behavior that is a cause for disruption. We employ case-based scenario analysis of higher education as evaluation mechanism for our extended disruptive innovation theory. Our position is that a better understanding of the implicit and unpredictable customer behavior that cause disruption due to additional performance attributes (using design thinking) could assist organizations to pre-empt digital disruption and adapt to support the additional functionality.http://link.springer.combookseries/558hj2020Informatic

Hyporheic Zone Microbiome Assembly Is Linked to Dynamic Water Mixing Patterns in Snowmelt-Dominated Headwater Catchments

Terrestrial and aquatic elemental cycles are tightly linked in upland fluvial networks. Biotic and abiotic mineral weathering, microbially mediated degradation of organic matter, and anthropogenic influences all result in the movement of solutes (e.g., carbon, metals, and nutrients) through these catchments, with implications for downstream water quality. Within the river channel, the region of hyporheic mixing represents a hot spot of microbial activity, exerting significant control over solute cycling. To investigate how snowmelt-driven seasonal changes in river discharge affect microbial community assembly and carbon biogeochemistry, depth-resolved pore water samples were recovered from multiple locations around a representative meander on the East River near Crested Butte, CO, USA. Vertical temperature sensor arrays were also installed in the streambed to enable seepage flux estimates. Snowmelt-driven high river discharge led to an expanding zone of vertical hyporheic mixing and introduced dissolved oxygen into the streambed that stimulated aerobic microbial respiration. These physicochemical processes contributed to microbial communities undergoing homogenizing selection, in contrast to other ecosystems where lower permeability may limit the extent of mixing. Conversely, lower river discharge conditions led to a greater influence of upwelling groundwater within the streambed and a decrease in microbial respiration rates. Associated with these processes, microbial communities throughout the streambed exhibited increasing dissimilarity between each other, suggesting that the earlier onset of snowmelt and longer periods of base flow may lead to changes in the composition (and associated function) of streambed microbiomes, with consequent implications for the processing and export of solutes from upland catchments

An appropriate tool for entrepreneurial learning in SMEs? The case of the 20Twenty Leadership Programme

The 20Twenty Leadership Programme was developed by Cardiff Metropolitan University as an executive education programme to be delivered within South Wales to small businesses. It is funded by the European Social Fund (ESF) and administered by the Welsh European Funding Office and has the key aim of developing SME’s growth potential via a range of leadership and management skills, including a focus on ‘soft’ skills. The focus of this paper is to place the 20Twenty Leadership Programme within the wider context of entrepreneurship policy and SME training initiatives in particular, and then to examine the rationale and delivery methods of the Programme in relation to these. It also reflects on the Programme’s success (or otherwise) to date where possible. Finally, the paper seeks to suggest fruitful areas of further research both in terms of the 20Twenty Leadership Programme itself, but also with regard to evaluation in relation to other parallel programmes, and to SME training initiatives more generally

Radiation reaction and energy-momentum conservation

We discuss subtle points of the momentum balance for radiating particles in flat and curved space-time. An instantaneous balance is obscured by the presence of the Schott term which is a finite part of the bound field momentum. To establish the balance one has to take into account the initial and final conditions for acceleration, or to apply averaging. In curved space-time an additional contribution arises from the tidal deformation of the bound field. This force is shown to be the finite remnant from the mass renormalization and it is different both form the radiation recoil force and the Schott force. For radiation of non-gravitational nature from point particles in curved space-time the reaction force can be computed substituting the retarded field directly to the equations of motion. Similar procedure is applicable to gravitational radiation in vacuum space-time, but fails in the non-vacuum case. The existence of the gravitational quasilocal reaction force in this general case seems implausible, though it still exists in the non-relativistic approximation. We also explain the putative antidamping effect for gravitational radiation under non-geodesic motion and derive the non-relativistic gravitational quadrupole Schott term. Radiation reaction in curved space of dimension other than four is also discussedComment: Lecture given at the C.N.R.S. School "Mass and Motion in General Relativity", Orleans, France, 200

The liminality of trajectory shifts in institutional entrepreneurship

In this paper, we develop a process model of trajectory shifts in institutional entrepreneurship. We focus on the liminal periods experienced by institutional entrepreneurs when they, unlike the rest of the organization, recognize limits in the present and seek to shift a familiar past into an unfamiliar and uncertain future. Such periods involve a situation where the new possible future, not yet fully formed, exists side-by-side with established innovation trajectories. Trajectory shifts are moments of truth for institutional entrepreneurs, but little is known about the underlying mechanisms of how entrepreneurs reflectively deal with liminality to conceive and bring forth new innovation trajectories. Our in-depth case study research at CarCorp traces three such mechanisms (reflective dissension, imaginative projection, and eliminatory exploration) and builds the basis for understanding the liminality of trajectory shifts. The paper offers theoretical implications for the institutional entrepreneurship literature

Bayesian Conditioning, the Reflection Principle, and Quantum Decoherence

The probabilities a Bayesian agent assigns to a set of events typically change with time, for instance when the agent updates them in the light of new data. In this paper we address the question of how an agent's probabilities at different times are constrained by Dutch-book coherence. We review and attempt to clarify the argument that, although an agent is not forced by coherence to use the usual Bayesian conditioning rule to update his probabilities, coherence does require the agent's probabilities to satisfy van Fraassen's [1984] reflection principle (which entails a related constraint pointed out by Goldstein [1983]). We then exhibit the specialized assumption needed to recover Bayesian conditioning from an analogous reflection-style consideration. Bringing the argument to the context of quantum measurement theory, we show that "quantum decoherence" can be understood in purely personalist terms---quantum decoherence (as supposed in a von Neumann chain) is not a physical process at all, but an application of the reflection principle. From this point of view, the decoherence theory of Zeh, Zurek, and others as a story of quantum measurement has the plot turned exactly backward.Comment: 14 pages, written in memory of Itamar Pitowsk