The GTN patch: a simple and effective new approach to cardioprotection?

This is a post-peer-review, pre-copyedit version of an article published in Basic Research in Cardiology . The final authenticated version is available online at: https://doi.org/10.1007/s00395-018-0681-2There remains a significant un-met need to reduce the extent of myocardial injury caused by ischaemia and reperfusion injury in patients experiencing an ST-elevation MI. Although nitric oxide is central to many cardioprotective strategies currently undergoing investigation, cardioprotection from the delivery of nitrates/nitrites has been inconsistently observed. The route of administration appears to be a critical variable. The glyceryl trinitrate (GTN) patch is commonly used as a simple and practical means of delivering nitric oxide to patients with ischaemic heart disease, but whether acute cardioprotection can be achieved by application of a GTN patch has not been investigated before. Here, we use a mouse model to demonstrate that a GTN patch is highly cardioprotective when applied immediately prior to 40 min occlusion of the left anterior coronary artery followed by 2 h reperfusion, reducing infarct size from 54 ± 4% in control mice, to 28 ± 4% (P < 0.001, N = 7). The degree of protection was similar to that achieved with a standard remote ischaemic preconditioning protocol. Furthermore, and of greater potential clinical relevance, a GTN patch was also protective when applied well after the initiation of ischaemia and 15 min prior to reperfusion (28 ± 4 vs 59 ± 4%; P < 0.01, N = 5). Confirmatory experiments verified the expected effect increase in plasma nitrite levels and decrease in blood pressure. The simplicity and rapidity of GTN patch application (easily applied in an ambulance or cardiac catheterization laboratory), and low cost (potentially relevant to low-income countries), make it attractive for further investigation.NIHR Biomedical Research Council (SD), British Heart Foundation PG/15/52/31598 (SD, DH) and the The Hatter Foundation

Storytelling and Corporate Social Responsibility Reporting: A Review of BHP 1992–2017

The aim of this study is to critically examine the development of corporate social responsibility (CSR) reporting through storytelling and institutionalism to understand how BHP Billiton Ltd. (BHP) has shaped stakeholders’ sensemaking of CSR and its CSR performance. To explore this, the study focuses on how the narrative themes in CSR reports by BHP corroborate with newspaper articles published by the Sydney Morning Herald (SMH) from 1992 until 2017. Results have identified instances where BHP used CSR storytelling to manage negative impressions of its CSR conduct, restore trust and re-establish legitimacy. This reinforces literature that identifies how companies use organisational storytelling to shape stakeholders understanding of social responsibility and manage impressions about CSR conduct