Corporate venture (CV) units constitute vehicles through which firms may act ambidextrously, thereby increasing their longevity, but they suffer from a high failure rate. The authors examine why and ...how some CV units last significantly longer than others. They argue that CV units endure by developing an ambidextrous orientation themselves—they build new capabilities for the parent firm while simultaneously leveraging its existing strengths. They argue that CV units become ambidextrous by nurturing a supportive relational context, defined by the strength of their relationships with three different sets of actors—parent firm executives, business unit managers, and members of the venture capital community. Using primary data collected from 95 CV units over a three-year period, the authors test and find support for these arguments.
The results of large clinical trials have led physicians and patients to question the safety of hormone therapy for menopause. In the past, physicians prescribed hormone therapy to improve overall ...health and prevent cardiac disease, as well as for symptoms of menopause. Combined estrogen/progestogen therapy, but not estrogen alone, increases the risk of breast cancer when used for more than three to five years. Therefore, in women with a uterus, it is recommended that physicians prescribe combination therapy only to treat menopausal symptoms such as vasomotor symptoms (hot flashes) and vaginal atrophy, using the smallest effective dosage for the shortest possible duration. Although estrogen is the most effective treatment for hot flashes, nonhormonal alternatives such as low-dose paroxetine, venlafaxine, and gabapentin are effective alternatives. Women with a uterus who are using estrogen should also take a progestogen to reduce the risk of endometrial cancer. Women who cannot tolerate adverse effects of progestogens may benefit from a combined formulation of estrogen and the selective estrogen receptor modulator bazedoxifene. There is no highquality, consistent evidence that yoga, paced respiration, acupuncture, exercise, stress reduction, relaxation therapy, and alternative therapies such as black cohosh, botanical products, omega-3 fatty acid supplements, and dietary Chinese herbs benefit patients more than placebo. One systematic review suggests modest improvement in hot flashes and vaginal dryness with soy products, and small studies suggest that clinical hypnosis significantly reduces hot flashes. Patients with genitourinary syndrome of menopause may benefit from vaginal estrogen, nonhormonal vaginal moisturizers, or ospemifene (the only nonhormonal treatment approved by the U.S. Food and Drug Administration for dyspareunia due to menopausal atrophy). The decision to use hormone therapy depends on clinical presentation, a thorough evaluation of the risks and benefits, and an informed discussion with the patient.
Research on the microfoundations of ambidexterity has identified a number of drivers that shape the ability of individuals to overcome exploration-exploitation tensions. However, little is known ...about how these drivers interact and whether they act as complements or substitutes. In a two-stage survey of small and medium-sized enterprises, we find that formal structural drivers and informal contextual drivers of ambidexterity do not demonstrate complementarity, as generally assumed, but rather act at cross-purposes with each other. Furthermore, we find that behaviorally complex executives (those with the ability to think and act ambidextrously) appear to render the effects of the other two drivers relatively unimportant, and are only ever associated with moderate levels of ambidexterity. These findings permit the development of important theoretical insights for ambidexterity research from a microfoundations perspective.
We develop a typology of corporate venture units, based on their strategic role in the corporation, and specifically on (a) their relative emphasis on exploration versus exploitation and (b) the ...internal versus external locus of opportunity they pursue. Following configurations logic, we argue that the structures and systems used by venture units will be a function of their strategic role, and that their performance will be higher when internal elements are aligned. We also argue that exploitation-oriented units will survive for longer than exploration-oriented units. Using primary data collected on 95 venture units during 2001–2003, we use configurational analyses to test and find support for our hypotheses.
Children with chronic intestinal failure (IF) treated with long-term parenteral nutrition (PN) may present with low bone mineral density (BMD). The cause may reflect small body size or suboptimal ...bone mineralization.
We assessed growth and bone health in children with severe IF.
Height, weight, and fracture history were recorded. The lumbar spine bone mass was measured in 45 consecutive patients (24 male subjects) aged 5-17 y receiving PN for a median of 5 y. BMD and bone mineral apparent density (BMAD) ie, adjusted-for-height SD scores (SDSs) were calculated.
Diagnoses were short bowel syndrome in 12 patients (27%), intestinal enteropathy in 20 patients (44%), and motility disorder in 13 patients (29%). Mean (±SD) weight, height, and body mass index SDSs were -0.8 ± 1.3, -1.80 ± 1.5, and 0.4 ± 1.3, respectively. The height SDS was less than -2 in 23 children (50%). Patients with enteropathy or intestinal mucosal inflammation (associated with dysmotility or short bowel) were significantly shorter than patients without enteropathy (P = 0.007). The BMD SDS was -1.7 ± 1.6, and the BMAD SDS was -1.4 ± 1.5, independent of primary diagnosis or mucosal inflammation. Nineteen patients (42%) had low BMD (SDS less than -2.0), and 14 patients (31%) had low BMAD. In 25 patients studied at 1-2-y intervals, the BMD SDS fell significantly with time, whereas BMAD declined less, which suggested that a poor bone mineral accretion reflected poor growth. A total of 11 of 37 patients (24%) had nonpathologic fractures (P = 0.3 compared with the general population).
Approximately 50% of children were short, and one-third of children had low BMD and BMAD. Children with enteropathy or intestinal mucosal inflammation are at greatest risk of growth failure. Close nutritional monitoring and bespoke PN should maximize the potential for growth and bone mass.
Background
Continuous glucose monitoring systems have been validated for eu‐ and hyperglycemic cats. The FreeStyle Libre 2 (FSL2) is sufficiently accurate in people during hypoglycemia to guide ...critical treatment decisions without confirmation of blood glucose concentration (BG).
Objectives
Assess FSL2 accuracy in cats with hypoglycemia.
Animals
Nine healthy, purpose‐bred cats.
Methods
Hyperinsulinemic‐hypoglycemic clamps were performed by IV infusion of regular insulin (constant rate) and glucose (variable rate). Interstitial glucose concentration (IG), measured by FSL2, was compared to BG measured by AlphaTrak2. Data were analyzed for all paired measurements (n = 364) and separately during stable BG (≤1 mg/dL/min change over 10 minutes). Pearson's r test, Bland‐Altman test, and Parkes Error Grid analysis respectively were used to determine correlation, bias, and clinical accuracy (P < .05 considered significant).
Results
Overall, BG and IG correlated strongly (r = 0.83, P < .0001) in stable glycemia and moderately at all rates of change (r = 0.69, P < .0001). Interstitial glucose concentration underestimated BG in euglycemia, but the BG‐IG difference was progressively smaller as BG decreased (12.9 ± 12.2, 8.8 ± 11.2, −3.2 ± 7.4, and −7.8 ± 5.2 mg/dL in the ranges of 80‐120 n = 64, 60‐79 n = 29, 50‐59 n = 71, and 29‐49 mg/dL n = 53, respectively).
Conclusions
Although IG underestimates BG throughout most of the hypo‐euglycemic range, IG generally overestimates BG in marked hypoglycemia (<60 mg/dL). It is therefore imperative to evaluate FSL2 results in this critical range with caution.
To review the outcome of children with severe neurological impairment (NI) and intestinal failure (IF) referred to our specialist multidisciplinary IF rehabilitation service and to discuss ...implications.
Case report series, descriptive analysis.
IF rehabilitation programme at a tertiary children's hospital in the UK.
Children with severe NI referred to our IF rehabilitation programme from 2009 to 2019.
Demographic and social data, diagnosis, clinical condition, use of home parenteral nutrition (HPN), complications, ethics review outcome and advance care plans.
Six patients with severe NI were referred to our IF rehabilitation service. Consent for publication was obtained from five families. After thorough medical review and clinical ethics committee assessment, three children started HPN, one had intravenous fluids in addition to enteral feed as tolerated and one intravenous fluids only. The HPN children survived 3-7.08 years (median 4.42 years) on treatment. Objective gastrointestinal signs, for example, bleeding improved without excessive HPN-related complications. Symptomatic improvement was less clear. Analgesia was reduced in three of the five children. All cases had detailed symptom management and advance care plans regularly updated.
HPN can play a role in relieving gastrointestinal signs/symptoms in children with severe NI and IF. HPN can be conceptualised as part of good palliative care if judged to be in the child's best interests. However, given its risks and that HPN has the potential to become inappropriately life-sustaining, a thorough ethics review and evaluation should be performed before it is initiated, withheld or withdrawn in children with severe NI.
Reading difficulties have been associated with limited academic success and related social-emotional outcomes including anxiety and low motivation. Recent research on the educational impact of the ...COVID-19 pandemic indicates that children with poor reading skills were disproportionally disadvantaged. This growing number of students experiencing reading difficulties will require effective implementation of strategies to prevent long-term disadvantage, including in the challenging context of secondary schools where teachers are unfamiliar with reading instruction and constrained by timetabling of subjects and teachers. This research examined whether a Direct Instruction programme could be implemented with fidelity in the real world of a secondary school over a sustained period. Reading progress was monitored using a standardised assessment. Programme implementation was monitored via interviews with staff, classroom observations, and field notes. These data revealed that, whilst fidelity of programme implementation was challenging, programme delivery and student ability and confidence in reading improved over the three years.
In this paper we report on a study of the implementation of handheld game consoles (HGCs) in 10 Year four/five classrooms to develop student automaticity of mathematical calculations. The ...automaticity of mathematical calculations was compared for those students using the HGC and those being taught using traditional teaching methods. Over a school term, students (n=236) who used the HGCs and Dr Kawashima's Brain Training showed significant improvement in both the speed and accuracy of their mathematical calculations. Data collected in interviews during the intervention period from students, staff and parents were analysed to provide further information on the implementation and efficacy of this approach. This exploration identified that the HGCs contributed to positive learning, motivational, and efficiency outcomes. These findings highlight opportunities for using commercially available digital games to achieve classroom objectives. Author abstract
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