Purpose -Sustainability is, in itself, the idea of a harmonic answer to the dual nature of the most pressing problem for global society. Most of the problems dealing with sustainability concern its dual and contradictory nature. That paradoxical reality is in no way a unique feature of sustainability; its universal pervasiveness is demonstrated by the attention that Western and Eastern philosophies have given to it. This paper seeks to describe paradoxes that arise in managerial and organizational learning processes and proposes a taxonomy. It pays special attention to the central paradox of "complexifying" and to reductionism-holism in science. Design/methodology/approach -The work is based on the theories of organizational learning and managerial cybernetics, under the paradox view of management. Findings -The study shows the relevance of the paradox view to management understanding of the complexity of sustainability, its controversial nature; and how the latter relates to epistemology and to the complementarity of analytical and synthetics methods in research and science. It also demonstrates that, at organizational levels, harnessing tensions that emerge from natural paradoxical situations enhances sustainable oriented decision-making.Research limitations/implications -The paper builds a bridge toward scientific communities that, working on sustainability and/or complexity, are unaware of the important contribution of cybernetics, especially Ashby's work and the VSM's relevance to the examination of complex societal issues. Practical implications -The paper provides a platform to enquire on the implications of societal learning on sustainability, and on de facto global digital networks emerging from over ideologized constituents that, in the name of the greenness of the environment and of a just society, fail to see how rapidly global society is positively changing after the dark years of the Cold War. Originality/value -The paper reviews current developments on the paradox view of management, and proposes a taxonomy of paradoxes based on managerial cybernetics and organizational learning.

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Background Higher hospital volume is associated with lower rates of adverse outcomes after revision total joint arthroplasty (TJA). Centralizing revision TJA care to higher-volume hospitals might reduce early complication and readmission rates after revision TJA; however, the effect of centralizing revision TJA care on patient populations who are more likely to experience challenges with access to care is unknown. Questions/purposes (1) Does a hypothetical policy of transferring patients undergoing revision TJA from lower-Each author certifies that there are no funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article related to the author or any immediate family members. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research® editors and board members are on file with the publication and can be viewed on request. Ethical approval for this study was waived by the University of Rochester Institutional Review Board.

Extracorporeal membrane oxygenation (ECMO) is a form of cardiopulmonary bypass that provides life-saving support to critically ill patients whose illness is progressing despite maximal conventional support. Use in adults is expanding, however neurological injuries are common. Currently, the existing brain imaging tools are a snapshot in time and require high-risk patient transport. Here we assess the feasibility of measuring diffuse correlation spectroscopy, transcranial Doppler ultrasound, electroencephalography, and auditory brainstem responses at the bedside, and developing a cerebral autoregulation metric. We report preliminary results from two patients, demonstrating feasibility and laying the foundation for future studies monitoring neurological health during ECMO.

Abstract:The non-invasive, in vivo measurement of microvascular blood flow has the potential to enhance breast cancer therapy monitoring. Here, longitudinal blood flow of 4T1 murine breast cancer (N=125) under chemotherapy was quantified with diffuse correlation spectroscopy based on layer models. Six different treatment regimens involving doxorubicin, cyclophosphamide, and paclitaxel at clinically relevant doses were investigated. Treatments with cyclophosphamide increased blood flow as early as 3 days after administration, whereas paclitaxel induced a transient blood flow decrease at 1 day after administration. Early blood flow changes correlated strongly with the treatment outcome and distinguished treated from untreated mice individually for effective treatments. characterization and therapeutic relevance," Int.