Does hand grip strength decrease in chronic obstructive pulmonary disease exacerbation? A cross-sectional study

Background/aim: Respiratory and peripheral muscle strength are reduced in chronic obstructive pulmonary disease (COPD). There is a well-known correlation between handgrip strength (HGS) and strenght extremity muscles. Our aim in this study was to measure HGS and investigate the related factors in COPD patients with exacerbation. Materials and methods: Subjects with COPD exacerbation (n = 101) and stable COPD (n = 22), and subjects without COPD (n = 201), were enrolled in this study. Age, sex, and body mass index were similar. HGS was measured using a Vigorimeter. Pulmonary function tests and 6-min walk tests were performed. Results: The mean HGS was significantly lower in subjects with COPD exacerbation than those with stable COPD and subjects without COPD. The mean HGS was similar between stable COPD and non-COPD subjects. The mean 6-min walk distance (6MWD) was significantly lower in subjects with COPD exacerbation than stable COPD. There was a significant correlation between HGS and 6MWD but no correlation between HGS and pulmonary function tests. Conclusion: In subjects with COPD exacerbation, the HGS was lower than that of stable COPD patients, and this difference was not explained by age, comorbidities, severity of obstruction, or smoking. Physical inactivity and steroid use during exacerbation might be possible factors affecting HGS. HGS was moderately correlated with 6MWD in cases of exacerbation. It may be used as a measure of muscle performance in COPD exacerbation, especially when the 6-min walk test cannot be performed.

Intraoperative neurophysiological monitoring during surgery for tethered cord syndrome.

AIM: The tethered cord syndrome refers to a variety of lesions that can cause the conus medullaris to be low-lying or incapable of movement within the spinal canal. Permanent or temporary neurological complications were reported following surgical release. In this report, peri- and postoperative results in cases with tethered cord syndrome that were followed by multimodal intraoperative neurophysiological monitoring (MIONM) methods are presented. MATERIAL AND METHODS: An IONM system (Nicolet CR Endeavor) was used for monitoring during tethered cord surgery. Somatosensory evoked potentials (SEPs), motor evoked potentials (MEPs), direct nerve root/rootlet stimulation, free-run electromyography (EMG) and F-waves were used during tethered cord surgery of 10 cases to prevent possible nerve injuries. RESULTS: MEP and SEP recordings did not change in any of the cases during surgery. The nervous tissue was identified and differentiated from connective tissue in three cases when motor responses were elicited with direct stimulation of nerve roots. None of the cases had neurological deficits following the operation. CONCLUSION: Direct nerve root/rootlet stimulation should be one of the components of MIONM during surgery for tethered cord syndrome to prevent postoperative neurological deficits.

The publishing and patenting strategies of successful university spinoffs in the biopharmaceutical industry.

Firms in the biopharmaceutical industry send signals to investors about the value of their knowledge by disclosing it in the form of patents and publications. In this way, they can gain reputation even before having products on the market. This paper compares the patenting and publishing activities of university spinoffs with other biopharmaceutical firms. The findings suggest that successful university spinoffs and successful other firms (not university spinoffs) tend to follow different knowledge disclosure strategies. Whereas successful university spinoffs tend to emphasize the scientific value of their knowledge and gain reputation through their high-quality publications, other successful firms tend to emphasize the commercial value of their knowledge and gain reputation through high-quality patents.

Rethinking leadership in drug discovery projects.

Great efforts have been dedicated to rebuilding the engine of pharmaceutical R&D. However, one potential area of improvement has received limited attention in the literature and in practice: namely, leadership. In this article, we enrich the traditional views of leadership, which consider leadership a responsibility of a few centrally placed authorities, with the concept of distributed leadership. Distributed leadership reflects a group-based capability driven by everyday activities and the key scientific questions at hand. We identify three leadership challenges faced by R&D teams that could be addressed by implementing distributed leadership. Furthermore, we provide some suggestions as to how to foster distributed leadership in drug discovery projects.

Clusters in the biopharmaceutical industry: toward a new method of analysis.

Clusters are groups of co-located and interconnected firms and institutions linked by commonalities in their strategies and complementarities in their activities and resources. There are several reasons for the geographical clustering of firms in the biopharmaceutical industry. This review unpacks some advantages and disadvantages of cluster participation, and proposes a new method to enable managers and researchers to identify clusters in the biopharmaceutical industry.

Strategic groups in the biopharmaceutical industry: implications for performance.

The biopharmaceutical industry is characterized by intense competition, high uncertainty, and strong dependence on scientific knowledge. We show that in order to succeed in this industry, firms need to be positioned along three strategic dimensions: the level of inter-firm R&D partnering, the level of diversification, and the size of the firm. Prior research has revealed that a firm's membership in so-called 'strategic groups' impacts strongly on its performance. This study analyzes strategic groups in the biopharmaceutical industry along the strategic dimensions listed. The performance of the groups differs significantly. The best performing groups are the ones that consist of large firms with a high level of in-house diversification across therapeutic areas and the medium-sized firms that pursue partnership with other companies.