AgBiome co-founders, Scott Uknes and Eric Ward,were admirers of self-managed organizations and commitment culture, approaches to organizational structure and process that encouraged openness and collaboration. Accordingly, they built AgBiome to operate without supervisory relationships, job titles, formal performance evaluations, and individual performance bonuses. Instead, AgBiome relied on a committee structure that encouraged people with the greatest expertise to make decisions on matters within their ambit.By 2017, AgBiome employed 80 people and was projecting further expansion. But observers wondered, could a company, which worked on the basis of commitment and without a hierarchy, scale?

41 What drugs cause Budd-Chiari syndrome?

42 I recently saw a patient with pyrexia of unknown origin (PUO). He was not particularly unwell and not jaundiced. But 1 week later he was found to have a liver abscess on ultrasound. How can one make the diagnosis earlier?

43 What is the most recent management of HCC (hepatocellular carcinoma)? What is radiofrequency ablation? What is its role in the management of HCC and its prognosis?

44 How do you differentiate haemorrhagic ascitic fluid due to malignancy and accidental rupture of blood vessel while withdrawing the fluid?

45 Is there any place for the medical treatment of gallstones with ursodeoxycholic acid?

46 In a case of common bile duct stones, where it is acknowledged that spontaneous passage within 24 hours is observed in approximately 50% of patients provided the stone is small, and that in these cases there is no need for a sphincterotomy, is the use of antispasmodics, e.g. Buscopan (active ingredient hyoscine-N-butylbromide), recommended? Surely these will reduce the pain and improve the chance of a spontaneous release of obstruction without surgical procedure?

47 What is sphincter of Oddi dysfunction?

48 I would like to know: what is the role of lysosomal hydrolases (cathepsin B) in the pathogenesis of acute pancreatitis?

49 What is the role of octreotide in management of acute pancreatitis?

50 Why does paralytic ileus occur in pancreatitis?