Innovating resilience: How avoiding reducing innovation through cost-cutting can boost performance in a crisis

Purpose:: This paper aims to review the latest management developments across the globe and pinpoint practical implications from cutting-edge research and case studies. Design:: This briefing is prepared by an independent writer who adds their own impartial comments and places the articles in context. Findings:: Organizational areas which deal with innovation are often the first to see costs cut when an economic crisis emerges. Yet this can actually have a dramatic negative effect on recovery after a crisis, compared to cutting costs elsewhere. Originality:: The briefing saves busy executives, strategists and researchers hours of reading time by selecting only the very best, most pertinent information and presenting it in a condensed and easy-to-digest format. © 2021, Emerald Publishing Limited.

Epithelial overexpression of human ACE2 in mice as a model for studying renal disease

Background: ACE2 is an integral part of the renin angiotensin system (RAS) and is highly expressed at the brush border of epithelial cells of the renal proximal tubule. Within the lumen, ACE2 is poised to metabolize angiotensin II and extinguish its effects as part of the counter-regulatory arm of the RAS. Use of transgenic mouse models has been essential in exploring the cardiovascular and renal functions of ACE2. Limitations in using mouse models for SARS was overcome by generation of mice expressing human ACE2 (hACE2) downstream of the keratin 18 promoter (K18-hACE2) by McCray et al 2007. K18-hACE2 mice express hACE2 in epithelial cells throughout the body and have proved valuable for the study of SARS-CoV and CoV2 viral infectivity and pathogenesis. Here, we investigate whether K18-hACE2 mice might serve as a unique tool with which to study the role of ACE2 in the intra-renal RAS. Methods: We assessed ACE2 activity in urine collected from K18-hACE2 mice (obtained from Jax and bred in our own colony) and their wildtype littermates. Urine was collected over 24 hours in individual metabolic cages, and enzymatic activity was determined using an ACE2 activity assay. Duplicate samples tested for each animal. Results: Our lab has a longstanding interest in the role of ACE2 in the kidney and our preliminary experiments demonstrate that K18-hACE2 mice have significantly increased ACE2 enzymatic activity in the urine compared to wildtype littermates (1597.0±379.74 vs 396.0±143.92, p=0.013). Conclusions: The increased urinary ACE2 activity suggests that there are elevated levels of ACE2 reaching the kidney. While this seems most likely due to increased expression of renal epithelial ACE2, soluble ACE2 derived elsewhere and able to reach the lumen of the nephron must also be considered. Thus, K18-hACE2 mice with increased urinary ACE2 activity can serve as a model to examine the effect of ACE2 and the RAS on kidney diseases such as hypertension and acute renal injury.

Risk and Assessment of COVID-19 in a Retina Ophthalmologic Setting

Purpose : To evaluate the risks and impact of COVID-19, SARS-CoV-2, on a private ophthalmology practice in Ohio and analyze the fluctuation in patient visits and surgeries before and during the COVID-19 pandemic. Methods : A retrospective analysis was performed using outpatient clinic logs for patients seen during the first 10 weeks of 2020 and compared to outpatient clinic logs for 10 weeks during the COVID-19 pandemic. During the twenty-week period, the number of appointments, intravitreal injections, and surgeries, most commonly retinal detachments, epiretinal membrane (ERM), and vitreous hemorrhages, were compared. Additionally, consideration was given to potential measures to reduce the spread and maintain prepandemic clinical care levels. The number of appointments, injections administered, and surgeries completed or postponed were analyzed before and during the COVID-19 pandemic. The practice implemented additional precautions for patients and staff. These included, but were not limited to, temperature checks, hand sanitizer availability, required use of face masks, and asking patients to come alone to appointments;with the exception of patients that were wheelchair bound, suffered from dementia, were under the age of 18, or required a translator. Results : During the first 10 weeks of 2020, the practice saw an average of 2,205 visits a week. In week one of the pandemic, the average was 1,147 patients per week, a 54% drop. An overall 40% drop was seen in surgical cases;vitreous hemorrhage surgeries decreased by 35%, retinal detachment surgeries decreased 25%, and ERM peels reduced by 60%. The drop in ERM's were mostly due to rescheduling. Intravitreal injections during the first 10 weeks averaged 1,025 (SD±112) per week. During the start of the 10 COVID-19 weeks, intravitreal injections averaged 852 (SD±122) per week and by the last weeks injections averaged 972 (SD±142) per week. Conclusions : In the early stages, the initial number of outpatient visits declined by 54%, the average number of intravitreal injections did not change in a similar pattern. This represents the importance of patients' triage and prioritizing urgent cases.