Instrumental stakeholder theory considers the performance consequences for firms of highly ethical relationships with stakeholders, characterized by high levels of trust, cooperation, and information ...sharing. While research suggests performance benefits, an obvious question remains: If instrumental stakeholder theory–based stakeholder treatment is so valuable, why isn’t it the dominant mode of relating to stakeholders? We argue that the existing instrumental stakeholder theory literature has three shortcomings that limit its ability to explain variance in performance. (1) Little theory exists around how instrumental stakeholder theory–based stakeholder management could provide sustainable competitive advantage. (2) The literature has largely neglected the potential downsides (i.e., costs) associated with pursuing these sorts of stakeholder relationships. (3) There is a paucity of theory on the contexts in which the incremental benefits of instrumental stakeholder theory–based stakeholder relationships are most likely to exceed the costs. As our primary contribution, we develop a theoretical path from a communal sharing relational ethics strategy—characterized by an intention to rely on relational contracts, joint wealth creation, high levels of mutual trust and cooperation, and communal sharing of property—to a close relationship capability, which we argue is valuable, rare, and difficult to imitate and, thus, a potential source of sustainable competitive advantage. We also consider the potential costs of achieving this capability and identify contexts in which the resulting relationships are likely to have the greatest net value.
Hepatitis delta virus (HDV) infection of humans was first reported in 1977, and now it is now estimated that 15–20 million people are infected worldwide. Infection with HDV can be an acute or chronic ...process that occurs only in patients with an hepatitis B virus infection. Chronic HDV infection commonly results in the most rapidly progressive form of viral hepatitis; it is the chronic viral infection that is most likely to lead to cirrhosis, and it is associated with an increased risk of hepatocellular carcinoma. HDV infection is the only chronic human hepatitis virus infection without a therapy approved by the US Food and Drug Administration. Peginterferon alfa is the only recommended therapy, but it produces unsatisfactory results. We review therapeutic agents in development, designed to disrupt the HDV life cycle, that might benefit patients with this devastating disease.
Heparin-induced thrombocytopenia (HIT) is a life and limb-threatening complication of heparin exposure. Here, we review the pathogenesis, incidence, diagnosis, and management of HIT. The first step ...in thwarting devastating complications from this entity is to maintain a high index of clinical suspicion, followed by an accurate clinical scoring assessment using the 4Ts. Next, appropriate stepwise laboratory testing must be undertaken in order to rule out HIT or establish the diagnosis. In the interim, all heparin must be stopped immediately, and the patient administered alternative anticoagulation. Here we review alternative anticoagulation choice, therapy alternatives in the difficult-to-manage patient with HIT, and the problem of overdiagnosis.
This book explores concepts of Cultural genocide, its definitions, place in international law, the systems and methods that contribute to its manifestations, and its occurrences. Through a systematic ...approach and comprehensive analysis, international and interdisciplinary contributors from the fields of genocide studies, legal studies, criminology, sociology, archaeology, human rights, colonial studies, and anthropology examine the legal, structural, and political issues associated with cultural genocide. This includes a series of geographically representative case studies from the USA, Brazil, Australia, West Papua, Iraq, Palestine, Iran, and Canada.This volume is unique in its interdisciplinarity, regional coverage, and the various methods of cultural genocide represented, and will be of interest to scholars of genocide studies, cultural studies and human rights, international law, international relations, indigenous studies, anthropology, and history.
The increased prevalence of obesity in recent decades is a topic of great scientific and medical interest, but despite many advances, the causes of this increase have not been adequately identified. ...In this context, two conflicting models for obesity—the carbohydrate-insulin model (CIM) and the energy balance model (EBM)—are being vigorously debated by distinct cohorts of experts in the field. The goal of this perspective is to assess this “conflict of models” from a neutral perspective. I conclude that although both models have produced useful insights, they differ fundamentally in what they seek to explain, and neither has yet provided a validated mechanistic account for the rising obesity prevalence in some but not all members of the population. Rather than engaging in such debates over competing models, the field should be more focused on establishing specific mechanistic insights in identified patient groups and, eventually, actionable interventions based on them.
The debate between the carbohydrate-insulin and energy balance models of obesity is assessed from a neutral perspective. I conclude that both are useful, but neither has yet adequately explained why obesity prevalence has increased within the population.
Maternally derived antibodies are a key element of neonatal immunity. Understanding the dynamics of maternal antibody responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ...infection during pregnancy and subsequent transplacental antibody transfer can inform neonatal management as well as maternal vaccination strategies.
To assess the association between maternal and neonatal SARS-CoV-2-specific antibody concentrations.
This cohort study took place at Pennsylvania Hospital in Philadelphia, Pennsylvania. A total of 1714 women delivered at the study site between April 9 and August 8, 2020. Maternal and cord blood sera were available for antibody measurement for 1471 mother/newborn dyads.
SARS-CoV-2.
IgG and IgM antibodies to the receptor-binding domain of the SARS-CoV-2 spike protein were measured by enzyme-linked immunosorbent assay. Antibody concentrations and transplacental transfer ratios were analyzed in combination with demographic and clinical data.
The study cohort consisted of 1714 parturient women, with median (interquartile range) age of 32 (28-35) years, of whom 450 (26.3%) identified as Black/non-Hispanic, 879 (51.3%) as White/non-Hispanic, 203 (11.8%) as Hispanic, 126 (7.3%) as Asian, and 56 (3.3%) as other race/ethnicity. Among 1471 mother/newborn dyads for which matched sera were available, SARS-CoV-2 IgG and/or IgM antibodies were detected in 83 of 1471 women (6%; 95% CI, 5%-7%) at the time of delivery, and IgG was detected in cord blood from 72 of 83 newborns (87%; 95% CI, 78%-93%). IgM was not detected in any cord blood specimen, and antibodies were not detected in any infant born to a seronegative mother. Eleven infants born to seropositive mothers were seronegative: 5 of 11 (45%) were born to mothers with IgM antibody only, and 6 of 11 (55%) were born to mothers with significantly lower IgG concentrations compared with those found among mothers of seropositive infants. Cord blood IgG concentrations were positively correlated with maternal IgG concentrations (r = 0.886; P < .001). Placental transfer ratios more than 1.0 were observed among women with asymptomatic SARS-CoV-2 infections as well as those with mild, moderate, and severe coronavirus disease 2019. Transfer ratios increased with increasing time between onset of maternal infection and delivery.
In this cohort study, maternal IgG antibodies to SARS-CoV-2 were transferred across the placenta after asymptomatic as well as symptomatic infection during pregnancy. Cord blood antibody concentrations correlated with maternal antibody concentrations and with duration between onset of infection and delivery. Our findings demonstrate the potential for maternally derived SARS-CoV-2 specific antibodies to provide neonatal protection from coronavirus disease 2019.
Duchenne muscular dystrophy (DMD) has been a major target for gene therapy development for nearly 30 years. DMD is among the most common genetic diseases, and isolation of the defective gene (DMD, or ...dystrophin) was a landmark discovery, as it was the first time a human disease gene had been cloned without knowledge of the protein product. Despite tremendous obstacles, including the enormous size of the gene and the large volume of muscle tissue in the human body, efforts to devise a treatment based on gene replacement have advanced steadily through the combined efforts of dozens of labs and patient advocacy groups. Progress in the development of DMD gene therapy has been well documented in Molecular Therapy over the past 20 years and will be reviewed here to highlight prospects for success in the imminent human clinical trials planned by several groups.
Duchenne muscular dystrophy (DMD) is one of the most common human genetic disorders. Cloning of the DMD gene preceded the human genome project and established DMD as an early gene therapy target. We summarize progress using AAV vectors for bodywide dystrophin gene delivery, an approach rapidly moving into clinical trials.
Monoclonal antibodies directed against the immune checkpoint protein cytotoxic T-lymphocyte antigen-4 (CTLA-4; CD152)-ipilimumab and tremelimumab-have been investigated in metastatic melanoma and ...other cancers and have shown promising results. Recently, ipilimumab was approved by the US Food and Drug Administration for the treatment of metastatic melanoma. We review the literature on managing the adverse effects and kinetics of tumor regression with ipilimumab and provide guidelines on their management. During treatment with these antibodies, a unique set of adverse effects may occur, called immune-related adverse events (irAEs). These include rashes, which may rarely progress to life-threatening toxic epidermal necrolysis, and colitis, characterized by a mild to moderate, but occasionally also severe and persistent diarrhea. Hypophysitis, hepatitis, pancreatitis, iridocyclitis, lymphadenopathy, neuropathies, and nephritis have also been reported with ipilimumab. Early recognition of irAEs and initiation of treatment are critical to reduce the risk of sequelae. Interestingly, irAEs correlated with treatment response in some studies. Unique kinetics of response have been observed with CTLA-4 blockade with at least four patterns: (1) response in baseline lesions by week 12, with no new lesions seen; (2) stable disease, followed by a slow, steady decline in total tumor burden; (3) regression of tumor after initial increase in total tumor burden; and (4) reduction in total tumor burden during or after the appearance of new lesion(s) after week 12. We provide a detailed description of irAEs and recommendations for practicing oncologists who are managing them, along with the unusual kinetics of response associated with ipilimumab therapy.
This paper examines dark tourism consumption motivations. Using a qualitative and interpretative mixed-method approach, this study traces the dark tourism motivations related to “blackpackers” and ...fans of the musical performance art known as black metal. Steeped in anti-Christian motifs and themes, with a history of past violence, black metal is a long-existing and still burgeoning art form that is growing in popularity throughout Europe and the United States. Through examination that involved participant observation, nethnography and content analysis, simulation, coupled with the emotional contagion were found to be key motivating aspects of this dark tourism related to black metal. Additionally, it was found, that similar to media tourists, many black metal fans seek tourism activity to reconcile comparisons between imaged landscapes and topographical reality. In addition to discussing specific aspects of the blackpacking phenomenon, larger theoretical implications related to the greater realm of dark tourism motivations are discussed.
► Dark Tourism can be motivated by processes related to simulation and the emotional contagion. ► Dark Tourism, similar to media tourism can be motivated by a desire to make comparisons between real and imagined landscapes. ► Dark Tourism can closely relate to affect and feed from it.
To realistically simulate climate feedbacks from the land surface to the atmosphere, models must replicate the responses of plants to environmental changes. Several processes, operating at various ...scales, cause the responses of photosynthesis and plant respiration to temperature and CO2 to change over time of exposure to new or changing environmental conditions. Here, we review the latest empirical evidence that short‐term responses of plant carbon exchange rates to temperature and CO2 are modified by plant photosynthetic and respiratory acclimation as well as biogeochemical feedbacks. We assess the frequency with which these responses have been incorporated into vegetation models, and highlight recently designed algorithms that can facilitate their incorporation. Few models currently include representations of the long‐term plant responses that have been recorded by empirical studies, likely because these responses are still poorly understood at scales relevant for models. Studies show that, at a regional scale, simulated carbon flux between the atmosphere and vegetation can dramatically differ between versions of models that do and do not include acclimation. However, the realism of these results is difficult to evaluate, as algorithm development is still in an early stage, and a limited number of data are available. We provide a series of recommendations that suggest how a combination of empirical and modeling studies can produce mechanistic algorithms that will realistically simulate longer term responses within global‐scale models.
PDF
