Evaluation of DNA damage and lipoperoxidation of propofol in patients undergoing elective surgery

Inhaled anaesthetics have been studied regarding their genotoxic and mutagenic potential in vivo. Propofol differs from volatile anaesthetics because it does not show mutagenic effects and it has been reported to be an antioxidant. However, there are no studies with propofol and genotoxicity in vivo. The study aimed to evaluate the hypothesis that propofol is not genotoxic and it inhibits lipid peroxidation [malondialdehyde (MDA)] in patients undergoing propofol anaesthesia. ASA physical status I patients scheduled for elective surgery, lasting at least 90 min, were enrolled in this study. Initially, the estimated plasma concentration of propofol was targeted at 4 microg ml(-1) and then maintained at 2-4 microg ml(-1) until the end of surgery. Haemodynamic data were determined at baseline (before premedication) and in conjunction with target-controlled infusion of propofol: after tracheal intubation, 30, 60 and 90 min after anaesthesia induction and at the end of the surgery. Venous blood samples were collected at baseline, after tracheal intubation, at the end of the surgery and on the postoperative first day for evaluating DNA damage in white blood cells (WBCs), by comet assay, and MDA levels. Haemodynamic data did not differ among times. No statistically significant differences were observed for the levels of DNA damage in WBCs, nor in plasma MDA, among the four times. Propofol does not induce DNA damage in WBCs and does not alter MDA in plasma of patients.

Pituitary surgery for small prolactinomas as an alternative to treatment with dopamine agonists

Despite the fact that consensus guidelines recommend long-term dopamine agonist (DA) therapy as a first-line approach to the treatment of small prolactinoma, some patients continue to prefer a primary surgical approach. Concerns over potential adverse effects of long-term medical therapy and/or the desire to become pregnant and avoid long-term medication are often mentioned as reasons to pursue surgical removal. In this retrospective study, 34 consecutive patients (30 female, 4 male) preferably underwent primary pituitary surgery without prior DA treatment for small prolactinomas (microprolactinoma 1-10 mm, macroprolactinoma 11-20 mm) at the Department of Neurosurgery, University of Bern, Switzerland. At the time of diagnosis, 31 of 34 patients (91%) presented with symptoms. Patients with microprolactinomas had significantly lower preoperative prolactin (PRL) levels compared to patients with macroprolactinomas (median 143 μg/l vs. 340 μg/l). Ninety percent of symptomatic patients experienced significant improvement of their signs and symptoms upon surgery. The postoperative PRL levels (median 3.45 μg/l) returned to normal in 94% of patients with small prolactinomas. There was no mortality and no major morbidities. One patient suffered from hypogonadotropic hypogonadism after surgery despite postoperative normal PRL levels. Long-term remission was achieved in 22 of 24 patients (91%) with microprolactinomas, and in 8 of 10 patients (80%) with macroprolactinomas after a median follow-up period of 33.5 months. Patients with small prolactinomas can safely consider pituitary surgery in a specialized centre with good chance of long-term remission as an alternative to long-term DA therapy.

How did the crisis affect small and medium-sized enterprises? -- from a field study of the metal-working industry in Java

This paper focuses on the impact of Indonesia's economic crisis on small and medium-sized enterprises (SMEs). It shows how the performance of SMEs during the crisis varied widely even in the same industrial subsector, and found that the factors most affecting performance have been market orientation and the linkages that the SMEs have formed with the buyers of their products. Well-performing SMEs were found to have utilized putting-out linkages with wholesalers which enabled them to switch to products having better markets. On the other hand, the SMEs which had subcontracting linkages with assemblers or contracting linkages with user-factories (with the exception of SMEs having export-oriented linkages) suffered badly in the crisis because of specificity of products with little room for switching. The paper also found that exposure to debt due to borrowing for investment has been another factor affecting performance, but that enterprise size has had no linear correlation with performance.

Regional Cooperation of Small & Medium Firms in Japanese Industrial Clusters

This study examines the effects of intra-regional cooperation among firms and institutions on the growth of firms, using the unique data set of questionnaire survey collected in the three major industrial clusters in Japan. In contrast to the existing studies on regional innovations or agglomeration economies, this study explicitly focuses on the detailed contents of cooperative activities with two specific viewpoints: 1) the contents of regional cooperation in each of the three production stages of R&D, commercialization, and marketing, and 2) the detailed types of alliance partners. Our results demonstrate three points: 1) positive correlations are observed between the intensity of regional cooperation and the firm growth rate and R&D expenditure, 2) horizontal cooperation such as alliances with universities and cross-industry exchange organizations has positive significant effects on the growth rate of firms, which is in contrast with the previous studies that stressed only the role of vertically integrated inter-firm linkages in Japan, and 3) contents and partners of regional cooperation are different among the three clusters based on different dominant industries.

Unlocking the Potential of Zambian Micro, Small and Medium Enterprises "Learning from the international best practices - the Southeast Asian Experience"

This paper examines the SMEs performance in Zambia and attempts to identify some practical lessons that Zambia can learn from Southeast Asian countries (with reference to Malaysia) in order to facilitate industrial development through unlocking the potential of its SMEs sector. Malaysia and Zambia were at the same level of economic development as evidenced by similar per capita incomes but Zambia has remained behind economically and its manufacturing sector has stagnated as if both countries did not have similar initial endowments. It therefore, becomes imperative that Zambia learns from such countries on how they managed to take-off economically with a focus on SME development. Training (education), research & development, market availability and technological advancement through establishment of industrial linkages coupled with cluster formation were some of the outstanding strategies identified that Zambia could use as a “key” to unlock its SMEs’ potential as it strives to meet the UN MDGs in particular halving its poverty levels by 2015 and also realizing its vision of becoming a middle income earner by 2030.

How small and medium enterprises can begin their implementation of ITIL?

Sequencing of Information Technology Infrastructure Library (ITIL) processes related to their order of implementation is one of the pending issues in the ITIL handbooks. Other frameworks and process models related to service management (e.g., COBIT, COSO and CMMI-SVC) are quite well described in the literature and their handbooks. However, the identifi cation of the fi rst process to be implemented has not been deeply analysed in the previous frameworks and models, and it is also a complex question to answer for organizations, especially Small and Medium Enterprises (SMEs). Moreover, SMEs are the organizations that have the largest presence in the world economy; offi cial data of General Business Directory, show that their range of presence in different countries around the world is between 93% and 99%, and the average of employment contribution is around 60%. Consequently, the improvement of information technology service management is of vital importance to accomplish in this type of enterprises. This research has focused on two surveys that aim at helping SMEs to select the ITIL process by which starting the implementation of ITIL. In the fi rst survey, data were gathered through a questionnaire to SMEs registered in the region of Madrid. The second survey obtained data from experts and enterprises in countries as Spain, Ecuador, Chile, Luxembourg, Colombia, Norway, El Salvador, and Venezuela. Finally, the results of both surveys show that the tendency for starting an ITIL implementation in SMEs points to one of the processes included in the Service Operation.

The Vulnerability of Europe's Small and Medium-Sized Banks. Bruegel Working Paper 2015/07, 16 July 2015

We study the vulnerability of 130 banks directly supervised by the European Central Bank’s Single Supervisory Mechanism. Illustrative stress tests using banks’ balance sheet data reveal that significant stress prevails in the euro area’s smaller and medium-sized banks, many of them located in southern Europe. The banks we identify as stressed also have performed substantially worse on the stock market. The vulnerable banks are typically hobbled by non-performing loans to European businesses. Strengthening the banking system, therefore, is important to achieve sustainable recovery because it will revitalise credit to the healthier segments of the economy. But instead of emphasising bank recapitalisation, as in past years, we believe the task is to shrink the banking sector to a healthier core.

Examining the role of networking capability in small and medium firm internationalization

While research on SME internationalization has increased, there remains a lack of relevant theory on the SME internationalization process. The literature reports that small firms overcome their resource poverty-based constraints to internationalization by developing network relationships. Networking enables SMEs to acquire much needed internationalization process knowledge, and knowledge for the development of innovative products and services for this internationalization. However, networking activity has not yet been conceptualized and measured as a competitive capability in internationalization research. Drawing on the capability-based theory of competitive strategy, this paper conjectures that internationally entrepreneurial SMEs build and nurture distinctive networking capabilities, enabling them to acquire new knowledge. These learning capabilities enable them to pursue innovation thereby facilitating nternationalization. Data from Australian firms largely supports the conceptual framework. Implications for theory and practice are presented.

Creating innovation in small and medium-sized enterprises:evaluating the short-term effects of the creative credits pilot

This working paper looks at the short-term impact of the Creative Credits pilot scheme which operated in the Manchester City Region in the North West of England from September 2009 to September 2010, and was funded by NESTA, Manchester City Council, the North West Development Agency, the Economic and Social Research Council (ESRC) and the Arts and Humanities Research Council (AHRC). Creative Credits is a business-to-business (B2B) voucher mechanism designed to encourage small and medium-sized enterprises (SMEs) to work innovatively with creative companies. Businesses receive credits worth £4,000, which they must match with at least £1,000, to spend with creative firms on a variety of creative services.

Do social capital building strategies influence the financing behavior of Chinese private small and medium-sized enterprises?

Using data from 65,485 Chinese private small and medium-sized enterprises over the period 2000-2006, we examine the extent to which firms can improve access to debt by adopting strategies aimed at building social capital, namely entertaining and gift giving to others in their social network, and obtaining political affiliation. We find that although entertainment and gift-giving expenditure leads to higher levels of total and short-term debt, it does not enable firms to obtain greater long-term debt. In contrast, we demonstrate that obtaining political affiliation allows firms greater access to long-term debt.

An investigation into the adoption and implementation of electronic commerce in Saudi Arabian small and medium enterprises

Saudi Arabian Small and Medium Enterprises (SMEs) will face fierce competition from new entrants to local markets as a result of their accession to the Word Trade Organisation (WTO), and electronic commerce (e-commerce) technologies can reinforce SME’s competitive edge. This study investigates the state of e-commerce adoption and analyses the factors that determine the extent to which SMEs in Saudi Arabia are inclined towards deploying e-commerce technologies. This could assist future firms in designing effective implementation projects. Seven SMEs’ e-commerce adoption levels are studied as a case. The Technology-Organization-Environment (TOE) framework was used as the major source of inspiration in our analysis of e-commerce adoption amongst Saudi SMEs. In addition to advancing research on e-commerce in Saudi Arabia, this chapter also highlights several directions for future inquiry and implications for managers and policymakers.

Impacts of flood hazards on small and medium companies:strategies for property level protection and business continuity

Worldwide floods have become one of the costliest weather-related hazards, causing large-scale human, economic, and environmental damage during the recent past. Recent years have seen a large number of such flood events around the globe, with Europe and the United Kingdom being no exception. Currently, about one in six properties in England is at risk of flooding (EA, 2009), and the risk is expected to further increase in the future (Evans et al., 2004). Although public spending on community-level flood protection has increased and some properties are protected by such protection schemes, many properties at risk of flooding may still be left without adequate protection. As far as businesses are concerned, this has led to an increased need for implementing strategies for property-level flood protection and business continuity, in order to improve their capacity to survive a flood hazard. Small and medium-sized enterprises (SMEs) constitute a significant portion of the UK business community. In the United Kingdom, more than 99% of private sector enterprises fall within the category of SMEs (BERR, 2008). They account for more than half of employment creation (59%) and turnover generation (52%) (BERR, 2008), and are thus considered the backbone of the UK economy. However, they are often affected disproportionately by natural hazards when compared with their larger counterparts (Tierney and Dahlhamer, 1996; Webb, Tierney, and Dahlhamer, 2000; Alesch et al., 2001) due to their increased vulnerability. Previous research reveals that small businesses are not adequately prepared to cope with the risk of natural hazards and to recover following such events (Tierney and Dahlhamer, 1996; Alesch et al., 2001; Yoshida and Deyle, 2005; Crichton, 2006; Dlugolecki, 2008). For instance, 90% of small businesses do not have adequate insurance coverage for their property (AXA Insurance UK, 2008) and only about 30% have a business continuity plan (Woodman, 2008). Not being adequately protected by community-level flood protection measures as well as property- and business-level protection measures threatens the survival of SMEs, especially those located in flood risk areas. This chapter discusses the potential effects of flood hazards on SMEs and the coping strategies that the SMEs can undertake to ensure the continuity of their business activities amid flood events. It contextualizes this discussion within a survey conducted under the Engineering and Physical Sciences Research Council (EPSRC) funded research project entitled “Community Resilience to Extreme Weather — CREW”.

The Strategical Impact of Knowledge Markets and Knowledge Management for Small and Medium Enterprises

According to the rapidly changing environment small and medium enterprises constantly need to adapt their strategies and activities. The transition from the industrial economy to knowledge-based economy results in the increasing of the volume of the available information. Therefore knowledge markets are needed and innovation centers have to be developed. An effective knowledge management system helps small and medium enterprises to overcome their disadvantages and compete with big corporations. The review of current developments in the field of knowledge markets is also made.

An investigation into the adoption and implementation of electronic commerce in Saudi Arabian small and medium enterprises

Saudi Arabian Small and Medium Enterprises (SMEs) will face fierce competition from new entrants to local markets as a result of their accession to the Word Trade Organisation (WTO), and electronic commerce (e-commerce) technologies can reinforce SME's competitive edge. This study investigates the state of e-commerce adoption and analyses the factors that determine the extent to which SMEs in Saudi Arabia are inclined towards deploying e-commerce technologies. This could assist future firms in designing effective implementation projects. Seven SMEs' e-commerce adoption levels are studied as a case. The Technology-Organization-Environment (TOE) framework was used as the major source of inspiration in our analysis of e-commerce adoption amongst Saudi SMEs. In addition to advancing research on e-commerce in Saudi Arabia, this chapter also highlights several directions for future inquiry and implications for managers and policymakers.

A beszerzés helye és szerepe a kis és középvállalatok gyakorlatában = The role of purchasing in small and medium sized companies

A tanulmány a szakirodalom azon egyre szélesedő részéhez járul hozzá, amely a kis és középvállalatok gyakorlatával, sajátosságaik vizsgálatával foglalkozik. Egy speciális aspektust emel ki, mely a hazai nagyvállalati működésben jelentős fejlődésen ment keresztül azzal, hogy a KKV-k beszerzési sajátosságainak megismerését célozza meg. Az áttekintő kép kialakításához a nemzetközi szakirodalomban elérhető empirikus eredményeket és a BCE-n folyó Versenyképesség Kutatás kérdőíves adatbázisának válaszait dolgozza fel. Olyan kérdéseket emel ki, mint a beszerzés szerepe a KKV-k működésében és az azt befolyásoló tényezők illetve a beszerzési gyakorlat sajátosságai. _________ Small and medium sized enterprises play an important role in every economy. This article aims to contribute to the growing number of literature focusing on SMEs management practice. It highlights a management field, which has gone through a significant development in large companies’ practice as it investigates the purchasing and supplier management related issues. The overview is based on a review of literature and the analysis of the survey database of Competitiveness Research of CUB. It highlights such topics as the role of purchasing in SMEs, factors influencing the perceived importance and the purchasing practice of SME-s.