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Dorothy must die
\"I didn't ask for any of this. I didn't ask to be some kind of hero. But when your whole life gets swept up by a tornado -- taking you with it -- you have no choice but to go along, you know? Sure, I've read the books. I've seen the movies. I know the song about the rainbow and the happy little blue birds. But I never expected Oz to look like this. To be a place where Good Witches can't be trusted, Wicked Witches may just be the good guys, and winged monkeys can be executed for acts of rebellion. There's still the yellow brick road, though -- but even that's crumbling. What happened? Dorothy. They say she found a way to come back to Oz. They say she seized power and the power went to her head. And now no one is safe. My name is Amy Gumm -- and I'm the other girl from Kansas. I've been recruited by the Revolutionary Order of the Wicked. I've been trained to fight. And I have a mission: remove the Tin Woodman's heart, steal the Scarecrow's brain, take the Lion's courage. Then and only then -- Dorothy must die\"-- Jacket.
Book
Not if, but when we need resilience in the workplace
Workplace resilience is a necessity for organizations and employees given it assists them in overcoming adversity and ultimately succeeding. However, organizational scholars have largely overlooked this construct. In this Incubator, we briefly summarize extant research on workplace resilience to highlight opportunities for theory building and advancement of empirical research.
Journal Article
Organizing Ecologies of Complex Innovation
For many sectors like health care, financial services, or renewable energy, new products and services are generated by an ecology of business firms, nonprofit foundations, public institutions, and other agents. Knowledge to innovate is dispersed across ecologies, so no single firm or small group of firms can innovate alone. Moreover, many new products and services in ecologies such as health care or energy are complex or comprise many parts with unknown interactions. New products, knowledge, business models, and applications all emerge unpredictably over considerable time periods, as various agents in the ecologies of innovation interact with and react to the actions of others. However, the existing organizing structure in these ecologies stifles emergence and precludes much innovation, simply because theory and practice do not adequately address how to organize for complex innovation. We develop a preliminary model for organizing ecologies of complex innovation. We suggest that innovations can continually emerge productively if people work locally in ecologies to set and solve problems of orchestrating knowledge capabilities across the ecology, strategizing across the ecology to create new businesses and applications, and developing public policies to embrace ambiguity. Using examples from biopharmaceuticals and alternative energy, we develop specific organizing ideas that can be examined and elaborated upon. This new direction for organization science integrates existing ideas around a new kind of organizing and shows how organization science can add real value in addressing major challenges of public welfare and safety in the 21st century.
Journal Article
Lumbosacral Discitis and Osteomyelitis after Sacrocolpopexy: A Case Series and Review of Management
Introduction and Hypothesis
Lumbosacral discitis and osteomyelitis constitute a rare but devastating complication after mesh sacrocolpopexy for pelvic organ prolapse.
Methods
We present a case series of 3 patients at a single institution and a literature review of 30 patients suffering from this complication along with presenting symptoms, evaluation with laboratory and imaging findings, and management.
Results
Lumbosacral discitis can present after sacrocolpopexy of any route (abdominal, laparoscopic, and robotic) and with various suture types and tacking devices. Patients presented with lower back pain at varying time frames and with elevated inflammatory markers, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP).
Conclusion
The majority of cases required both excision of pelvic mesh via laparotomy or laparoscopy in combination with an extended course of intravenous (IV) antibiotics.
Journal Article
In vivo three-photon imaging of activity of GCaMP6-labeled neurons deep in intact mouse brain
Ouzounov
et al
. report calcium imaging with three-photon microscopy in the mouse brain. The approach enabled noninvasive recording of activity with high spatial and temporal resolution from GCaMP6-labeled neurons located as deep as the hippocampus.
High-resolution optical imaging is critical to understanding brain function. We demonstrate that three-photon microscopy at 1,300-nm excitation enables functional imaging of GCaMP6s-labeled neurons beyond the depth limit of two-photon microscopy. We record spontaneous activity from up to 150 neurons in the hippocampal stratum pyramidale at ∼1-mm depth within an intact mouse brain. Our method creates opportunities for noninvasive recording of neuronal activity with high spatial and temporal resolution deep within scattering brain tissues.
Journal Article
Sensorimotor and Pain Modulation Brain Abnormalities in Trigeminal Neuralgia: A Paroxysmal, Sensory-Triggered Neuropathic Pain
Idiopathic trigeminal neuralgia (TN) is characterized by paroxysms of severe facial pain but without the major sensory loss that commonly accompanies neuropathic pain. Since neurovascular compression of the trigeminal nerve root entry zone does not fully explain the pathogenesis of TN, we determined whether there were brain gray matter abnormalities in a cohort of idiopathic TN patients. We used structural MRI to test the hypothesis that TN is associated with altered gray matter (GM) in brain areas involved in the sensory and affective aspects of pain, pain modulation, and motor function. We further determined the contribution of long-term TN on GM plasticity.
Cortical thickness and subcortical GM volume were measured from high-resolution 3T T1-weighted MRI scans in 24 patients with right-sided TN and 24 healthy control participants.
TN patients had increased GM volume in the sensory thalamus, amygdala, periaqueductal gray, and basal ganglia (putamen, caudate, nucleus accumbens) compared to healthy controls. The patients also had greater cortical thickness in the contralateral primary somatosensory cortex and frontal pole compared to controls. In contrast, patients had thinner cortex in the pregenual anterior cingulate cortex, the insula and the orbitofrontal cortex. No relationship was observed between GM abnormalities and TN pain duration.
TN is associated with GM abnormalities in areas involved in pain perception, pain modulation and motor function. These findings may reflect increased nociceptive input to the brain, an impaired descending modulation system that does not adequately inhibit pain, and increased motor output to control facial movements to limit pain attacks.
Journal Article
Navigating the Workplace: The Costs and Benefits of Shifting Identities at Work among Early Career U.S. Black Women
Although much progress has been made in race relations in the United States, discrimination still persists in the workplace. As a result, Black women, among individuals from other underrepresented groups, develop coping strategies, such as identity shifting, to diminish the negative consequences of discrimination. We used the phenomenological variant of ecological systems theory to examine shifting racial, gender, and class identities among early career (recent college graduates) U.S. Black women working in predominantly White environments. Drawing on ten semi-structured interviews with college-educated Black women, data were analyzed with an interpretative phenomenological analysis. The results revealed two major themes: (a) benefits of identity shifting and (b) the costs of identity shifting, the latter with five subthemes: (a) managing interpersonal rejection: frozen effect, (b) assimilation to the dominant culture and inauthenticity, (c) confronting and dismantling stereotypes, (d) model Black citizen, and (c) mixed feelings toward identity shifting. The findings indicate that Black women vacillate between the benefits and costs of identity shifting, altering their dialect and behavior to meet social norms. Our study’s implications suggest the necessity of a multicultural approach by employers to affirm their workers’ social identities, strengthen employee relationships, and lessen the need for shifting identities.
Journal Article
Advances in the management of haemophilia: emerging treatments and their mechanisms
Mainstay haemophilia treatment, namely intravenous factor replacement, poses several clinical challenges including frequent injections due to the short half-life of recombinant factors, intravenous administration (which is particularly challenging in those with difficult venous access), and the risk of inhibitor development. These impact negatively upon quality of life and treatment compliance, highlighting the need for improved therapies. Several novel pharmacological therapies developed for haemophilia aim to rebalance the clotting cascade and potentially circumvent the aforementioned challenges. These therapies utilise a range of different mechanisms, namely: the extension of the circulating half-life of standard recombinant factors; the mimicking of factor VIII cofactor activity; rebalancing of coagulation through targeting of natural anticoagulants such as antithrombin and tissue factor pathway inhibitor; and inducing the production of endogenous factors with gene therapy. These therapies carry the potential of revolutionising haemophilia treatment by alleviating the current challenges presented by mainstay factor replacement. This review will provide an overview of the key trial findings related to novel therapies based on the mechanisms described above.
Journal Article
Developing Topics
Repetitive brain stimulation (rTMS) has been FDA-cleared for major depressive disorder (MDD) since 2008 with recent work focusing on personalized treatments. In one approach, resting-state functional MRI (fMRI) has been used to increase the effectiveness of TMS in MDD by identifying personalized targets. In addition, rTMS has shown promise as a safe and effective intervention for improving cognition in individuals with Alzheimer's disease (AD); however, previous clinical trials often excluded participants with MDD or other psychiatric comorbidities. Given the co-occurrence of AD and MDD is common, with pooled prevalence estimates of around 38%, there is a critical need to investigate personalized therapeutic strategies that address both conditions.
We describe the case of an 88-year-old woman with AD presenting to our outpatient psychiatry clinic with complaints of depression and anxiety. Her medical history noted mood and cognitive decline starting five and two years prior to presentation, respectively. At baseline, the patient had severe cognitive impairment with a Montreal Cognitive Assessment (MoCA) score of 8. We delivered an accelerated iTBS protocol (10 sessions/day, 1,800 pulses/session, over five days) targeted a left dorsolateral prefrontal cortex site anti-correlated with the sgACC, identified by resting-state fMRI. Due to residual anxiety and insomnia, a second accelerated course (26 sessions over five days) targeted a right prefrontal site anti-correlated with the ventral striatum. Regular follow-ups were scheduled to track status for 14 months.
Post-treatment mood symptoms were assessed by Clinical Global Impressions-Improvement (CGI-I) to be a score of 2, sustained for 14 months. Post-treatment MoCA score increased to 16. Collateral data from the patient's son and medical decisionmaker noted remarkable improvements in both mood and cognition, \"it's like she's my mom again.\"
This case supports the feasibility of using personalized resting-state fMRI-guided rTMS protocols to manage symptoms in individuals with AD with psychiatric comorbidities, including MDD and anxiety. Future research on larger samples is warranted to evaluate the efficacy of this approach and disentangle the complex interplay of symptoms related to each condition.
Journal Article
Determinants of temperature sensitivity of soil respiration with the decline of a foundation species
The eastern hemlock (Tsuga canadensis) is an important foundation species that is currently declining throughout eastern U.S. forests due to the exotic pests hemlock woolly adelgid (Adelges tsugae) and elongate hemlock scale (Fiorinia externa). Hemlock is often replaced by deciduous tree species, such as black birch (Betula lenta), and has been shown to have large consequences for carbon dynamics due to a substantial loss of soil organic layer carbon storage in hemlock forests when replaced by birch and higher decomposition found in black birch stands. Soil carbon is one of the most important components of the global carbon cycle and has high potential to feedback to climate change when large portions of stored carbon are lost to the atmosphere. There is a general consensus that soil respiration increases with temperature, but there has yet to be a consensus on how temperature sensitivity of soil respiration is affected by various biotic and abiotic factors, such as soil moisture and substrate quality. In this study, the effects of soil temperature and soil moisture on soil respiration (Rs), the temperature sensitivity of soil respiration (Q10), and soil basal respiration (R10) were investigated for hemlock, young birch, and mature birch forest types annually for three years. The Rs values of the three forest types were primarily driven by soil temperature rather than by soil moisture across all years. Soil respiration data collected from hemlock, young birch, and mature birch stands were used to determine annual Q10 and R10 values. The Q10 and R10 values were not significantly different between forest stands, but they were significantly different over the three years. Determinants of Q10 and R10 differed between forest type, with soil moisture primarily influencing Q10 in hemlock and mature birch stands and soil temperature primarily influencing R10 in mature birch stands. The results suggest a complex interaction of soil moisture and soil temperature, and potentially substrate quality and quantity, as determinants of temperature sensitivities in eastern U.S. forests that have transitioned from hemlock-dominated to black birch-dominated forests.
Journal Article