What are the success factors for Spanish textile firms? An exploratory multiple-case study

The objective of this article is to identify differential traits of successful SMEs in comparison to average SME firms in the textile and clothing sector. The method used is the multiple case-study of 12 firms based on qualitative and quantitative data obtained by means of in-depth interviews. Building on recent academic literature, we use four main dimensions that may explain success: i) knowledge generation (R&D) and acquisition; ii) innovation activity; iii) product and market characteristics and iv) strategic characteristics. Our results indicate that a higher R&D intensity and knowledge acquisition do not explain success. The main differential characteristic is that successful firms have a higher level of innovation activity, since innovation is their strategic priority, being a result of perceiving the key success factors of their markets differently. From the analysis it also follows that the prevalent strategy of successful firms is the niche strategy, with a demand pull focus, and a high proximity to the customer

Characterizing the vulnerability of frequent emergency department users by applying a conceptual framework: a controlled, cross-sectional study.

BACKGROUND: Frequent emergency department (ED) users meet several of the criteria of vulnerability, but this needs to be further examined taking into consideration all vulnerability's different dimensions. This study aimed to characterize frequent ED users and to define risk factors of frequent ED use within a universal health care coverage system, applying a conceptual framework of vulnerability. METHODS: A controlled, cross-sectional study comparing frequent ED users to a control group of non-frequent users was conducted at the Lausanne University Hospital, Switzerland. Frequent users were defined as patients with five or more visits to the ED in the previous 12 months. The two groups were compared using validated scales for each one of the five dimensions of an innovative conceptual framework: socio-demographic characteristics; somatic, mental, and risk-behavior indicators; and use of health care services. Independent t-tests, Wilcoxon rank-sum tests, Pearson's Chi-squared test and Fisher's exact test were used for the comparison. To examine the -related to vulnerability- risk factors for being a frequent ED user, univariate and multivariate logistic regression models were used. RESULTS: We compared 226 frequent users and 173 controls. Frequent users had more vulnerabilities in all five dimensions of the conceptual framework. They were younger, and more often immigrants from low/middle-income countries or unemployed, had more somatic and psychiatric comorbidities, were more often tobacco users, and had more primary care physician (PCP) visits. The most significant frequent ED use risk factors were a history of more than three hospital admissions in the previous 12 months (adj OR:23.2, 95%CI = 9.1-59.2), the absence of a PCP (adj OR:8.4, 95%CI = 2.1-32.7), living less than 5 km from an ED (adj OR:4.4, 95%CI = 2.1-9.0), and household income lower than USD 2,800/month (adj OR:4.3, 95%CI = 2.0-9.2). CONCLUSIONS: Frequent ED users within a universal health coverage system form a highly vulnerable population, when taking into account all five dimensions of a conceptual framework of vulnerability. The predictive factors identified could be useful in the early detection of future frequent users, in order to address their specific needs and decrease vulnerability, a key priority for health care policy makers. Application of the conceptual framework in future research is warranted.

The role of renal biopsy in small renal masses.

Renal biopsy is being increasingly proposed as a diagnostic tool to characterize small renal masses (SRM). Indeed, the wide adoption of imaging in the diagnostic workup of many diseases had led to a substantial increased incidence of SRM (diameter ≤4 cm). While modern ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) techniques have high sensitivity for detecting SRM, none is able to accurately and reliably characterize them in terms of histological features. This is currently of key importance in guiding clinical decision-making in some situations, and in these cases renal biopsy should be considered. In this review, we aim to summarize the technique, diagnostic performance, and predicting factors of nondiagnostic biopsy, as well as the future perspectives.

Patients' Needs for Care in Public Mental Health: Unity and Diversity of Self-Assessed Needs for Care.

PURPOSE: Needs assessment is recognized to be a key element of mental health care. Patients tend to present heterogeneous profiles of needs. However, there is no consensus in previous research about how patients' needs are organized. This study investigates both general and specific dimensions of patients' needs for care. METHODS: Patients' needs were assessed with ELADEB, an 18-domain self-report scale. The use of a self-assessment scale represents a unique way of obtaining patients' perceptions. A patient-centered psychiatric practice facilitates empowerment as it is based on the patients' personal motivations, needs, and wants. Four seventy-one patients' profiles were analyzed through exploratory factor analysis. RESULTS: A four-factor bifactor model, including one general factor and three specific factors of needs, was most adequate. Specific factors were (a) "finances" and "administrative tasks"; (b) "transports," "public places," "self-care," "housework," and "food"; and (c) "family," "children," "intimate relationships," and "friendship." CONCLUSION: As revealed by the general factor, patients expressing urgent needs in some domains are also more susceptible to report urgent needs in several other domains. This general factor relates to high versus low utilizers of public mental healthcare. Patients also present specific needs in life domains, which are organized in three dimensions: management, functional disabilities, and familial and interpersonal relationships. These dimensions relate to the different types of existing social support described in the literature.

Définition et prise en charge de l'échec d'une première injection de toxine botulique Botox(®) 200 U pour hyperactivité détrusorienne neurogène : résultats de l'enquête DETOX [Definition of botulinum toxin failure in neurogenic detrusor overactivity: Preliminary results of the DETOX survey].

OBJECTIVE: There is currently no guideline regarding the management of neurogenic detrusor overactivity (NDO) refractory to intra-detrusor botulinum toxin injections. The primary objective of the present study was to find a consensus definition of failure of botulinum toxin intra-detrusor injections for NDO. The secondary objective was to report current trends in the managment of NDO refractory to botulinum toxin. METHODS: A survey was created, based on data drawn from current literature, and sent via e-mail to all the experts form the Group for research in neurourology in french language (GENULF) and from the comittee of neurourology of the French urological association (AFU). The experts who did not answer to the first e-mail were contacted again twice. Main results from the survey are presented and expressed as numbers and proportions. RESULTS: Out of the 42 experts contacted, 21 responded to the survey. Nineteen participants considered that the definition of failure should be a combination of clinical and urodynamics criteria. Among the urodynamics criteria, the persistence of a maximum detrusor pressure>40cm H2O was the most supported by the experts (18/21, 85%). According to the vast majority of participants (19/21, 90.5%), the impact of injections on urinary incontinence should be included in the definition of failure. Regarding the management, most experts considered that the first line treatment in case of failure of a first intra-detrusor injection of Botox(®) 200 U should be a repeat injection of Botox(®) at a higher dosage (300 U) (15/20, 75%), regardless of the presence or not of urodynamics risk factors of upper tract damage (16/20, 80%). CONCLUSION: This work has provided a first overview of the definition of failure of intra-detrusor injections of botulinum toxin in the management of NDO. For 90.5% of the experts involved, the definition of failure should be clinical and urodynamic and most participants (75%) considered that, in case of failure of a first injection of Botox(®) 200 U, repeat injection of Botox(®) 300 U should be the first line treatment. Level of proof 4.

PK-YRITYKSET INNOVAATTOREINA : Satunnaisista parannuksista kohti innovaatioiden virtaa. Yhteenveto tutkimusraportista, 3/2009

Tämän tutkimuksen tarkoituksena oli selvittää, minkälaisia innovaatioita eri toimialojen pienissä yrityksissä on kehitetty ja minkälaisia kyvykkyyksiä se on edellyttänyt. Lisäksi tavoitteena oli selvittää, kuinka suotuisana ympäristönä yritykset kokivat oman alueensa ja miten alueiden kehittämistyö on vaikuttanut yritysten kykyyn kilpailla. Teoreettiset oletukset perustuvat aikaisempiin tutkimuksiin innovaatiojohtamisen, yrittäjyyden ja pk-yritysten liiketoiminnan kehittämisen alueilta. Empiirinen aineisto on kerätty sähköpostikyselyllä tuottaen 733 kriteerit täyttävää vastausta. Kyselytutkimusta edelsi neljän alueen tapaustutkimus, jonka aikana luotiin teoreettinen rakennelma pienten yritysten innovaatiokyvykkyyden arvioimiseksi. Tämän tutkimuksen aineisto ei tue yleistä väitettä, jonka mukaan innovaatiotoiminta olisi harvinaisempaa tai vähäisempää kooltaan pienemmissä yrityksissä. Kokoa enemmän näyttäisi vaikuttavan innovaatiotoiminnan luonne ja siihen kytkeytyvä kyvykkyys. Yritysten innovaatio-toiminnan luonteen ja laajuuden perusteella tuloksista nousee neljä erilaista innovaattoriprofiilia: satunnainen parantaja, jatkuva parantaja, radikaali uudistaja ja monipuolinen kehittäjä. Innovaatiokyvykkyyttä tutkittiin seitsemän eri osatekijän suhteen. Eri profiilit omaavien yritysten kyvykkyyden tasot erosivat toisistaan merkittävästi. Tulokset vahvistavat käsityksiä siitä, että yksittäisen kyvykkyystekijän sijaan kyvykkyyskombinaatio vaikuttaa enemmän innovatiotoiminnan monipuolisuuteen. Innovaatiotoiminnan lisääntyessä ja monipuolistuessa, yritysten kyvykkyys-vaatimukset kasvavat kaikkien osatekijöiden suhteen. Yritykset ovat tiedostaneet innovaatio-kyvykkyyden kehittämisen tarpeet. Kyvykkyys on ajuri, jonka kyydissä pienet ja suuret innovaatiot syntyvät. Tämä tutkimus suosittelee, että innovaatiokyvykkyyden kehittäminen nostetaan näkyväm-mäksi tavoitteeksi. Pienissä yrityksissä luontevin tapa vahvistaa kyvykkyyksiä on integroida se yrityksen kehittämistoimintaan johtaen itse itseään ruokkivaksi prosessiksi. Haasteelliset kehittämis-tavoitteet edellyttävät monipuolista kyvykkyyksien vahvistamista ja vahvistuneet kyvykkyydet mahdollistavat entistä haastavampien kehittämistavoitteiden asettamisen. Parhaimmillaan tämä prosessi johtaa pienelle yritykselle soveltuvaan onnistumisen spiraaliin, joka samanaikaisesti kiihdyttää sekä kyvykkyyksien että innovaatioiden kehittämistä - tuotoksena jatkuva ja monipuolinen innovaatioiden virta. Tulokset vahvistavat ensimmäisessa vaiheessa toteutetun tapaustutkimuksen havaintoja siitä, että alueiden kehittämistyöstä hyötyvät yritykset, joiden kyvykkyystekijät ovat entuudestaan korkeaa tasoa. Pitkälle tuotteistetut julkiset palvelut soveltuvat parhaiten suuremmille yrityksille, joissa kehittämistoiminta on projektoitu ja kehittämistyö tehdään erillisten resurssien turvin. Sitä vastoin, valtaosassa pieniä yrityksiä kehittämistyö tapahtuu tavanomaisen liiketoiminnan ohessa ja samoilla resursseilla. Alueet tarjoavat varsin runsaasti luonteeltaan epäjatkuvia palveluja kohdistuen yksittäisten kyvykkyystekijöiden parantamiseen tai prosessin yksittäiseen vaiheeseen, usein innovaatioprosessin alkupäähän radikaalin innovaation kehittämiseksi. Tämän kyselyn tulokset suosittelevat myös toista reittiä: vahvistetaan ensin yritysten innovaatiokyvykkyyttä jatkuvaan pieniä askelia ottavaan innovaatiotoimintaan, josta matka jatkuu radikaalien uudistusten kautta moni-puoliseksi kehittämiseksi.

Cloud point extraction for the determination of copper in environmental samples by flame atomic absorption spectrometry

A simple cloud point extraction procedure is presented for the preconcentration of copper in various samples. After complexation by 4-hydroxy-2-mercapto-6-propylpyrimidine (PTU), copper ions are quantitatively extracted into the phase rich in Triton X-114 after centrifugation. Methanol acidified with 0.5 mol L-1 HNO3 was added to the surfactant-rich phase prior to its analysis by flame atomic absorption spectrometry (FAAS). Analytical parameters including concentrations for PTU, Triton X-114 and HNO3, bath temperature, centrifugation rate and time were optimized. The influences of the matrix ions on the recoveries of copper ions were investigated. The detection limits (3SDb/m, n=4) of 1.6 ng mL-1 along with enrichment factors of 30 for Cu were achieved. The proposed procedure was applied to the analysis of environmental samples.

Dispersive liquid-liquid microextraction based on solidification of floating organic drop for simultaneous separation/preconcentration of nickel, cobalt and copper prior to determination by electrothermal atomic absorption spectrometry

A dispersive liquid-liquid microextraction based on solidification of floating organic drop for simultaneous extraction of trace amounts of nickel, cobalt and copper followed by their determination with electrothermal atomic absorption spectrometry was developed. 300 µL of acetone and 1-undecanol was injected into an aqueous sample containing diethyldithiocarbamate complexes of metal ions. For a sample volume of 10 mL, enrichment factors of 277, 270 and 300 and detection limits of 1.2, 1.1 and 1 ng L-1 for nickel, cobalt and copper were obtained, respectively. The method was applied to the extraction and determination of these metals in different water samples.

Magnetic sputtering of complex oxides

HTSC materials are relevant in modern microelectronics, because of their transformation from the normal state to the superconducting. That is why the idea of producing HTSC in industrial amounts is actual nowadays. To decrease cost of their production it is important to use magnetron sputtering systems which give the best results for essential parameters. Modeling is the simplest and the fastest way to determine optimum sputtering condition. This thesis concentrates on determination the phases of the whole sputtering process and to find out basic factors of each phase using the modeling. It was find out, that the main factors which influence on the mode of occurrence of the initial stages are the current density of the magnetron discharge and the pressure of sputtering gas. With the modeling also velocity dependences were obtained for YBCO and SmFeAsO. These were compared and difference between them was examined. To support represented model comparison was made with experimental results. This showed that the model gives good results, very similar to the experimental ones. The results of this work were published in annual conference of the finnish physical society.

Role of oxidation-reduction cycle of iron in direct leaching of zinc concentrate

Direct leaching is an alternative to conventional roast-leach-electrowin (RLE) zinc production method. The basic reaction of direct leach method is the oxidation of sphalerite concentrate in acidic liquid by ferric iron. The reaction mechanism and kinetics, mass transfer and current modifications of zinc concentrate direct leaching process are considered. Particular attention is paid to the oxidation-reduction cycle of iron and its role in direct leaching of zinc concentrate, since it can be one of the limiting factors of the leaching process under certain conditions. The oxidation-reduction cycle of iron was experimentally studied with goal of gaining new knowledge for developing the direct leaching of zinc concentrate. In order to obtain this aim, ferrous iron oxidation experiments were carried out. Affect of such parameters as temperature, pressure, sulfuric acid concentration, ferrous iron and copper concentrations was studied. Based on the experimental results, mathematical model of the ferrous iron oxidation rate was developed. According to results obtained during the study, the reaction rate orders for ferrous iron concentration, oxygen concentration and copper concentration are 0.777, 0.652 and 0.0951 respectively. Values predicted by model were in good concordance with the experimental results. The reliability of estimated parameters was evaluated by MCMC analysis which showed good parameters reliability.

Berry polyphenol absorption and the effect of northern berries on metabolism, ectopic fat accumulation, and associated diseases

The prevalence of obesity and type 2 diabetes has increased at an alarming rate in developed countries. It seems in the light of current knowledge that metabolic syndrome may not develop at all without NAFLD, and NAFLD is estimated to be as common as metabolic syndrome in western population (23 % occurrence). Fat in the liver is called ectopic fat, which is triacylglycerols within the cells of non-adipose tissue. Serum alanine aminotransferase (ALT) values correlate positively with liver fat proportions, and increased activity of ALT predicts type 2 diabetes independently from obesity. Berries, high in natural bioactive compounds, have indicated the potential to reduce the risk of obesity-related diseases. Ectopic fat induces common endocrine excretion of adipose tissue resulting in the overproduction of inflammatory markers, which further induce insulin resistance by multiple mechanisms. Insulin resistance inducing hyperinsulinemia and lipolysis in adipocytes increases the concentration of free fatty acids and consequently causes further fat accumulation in hepatocytes. Polyphenolic fractions of berries have been shown to reverse inflammatory reaction cascades in in vitro and animal studies, and moreover to decrease ectopic fat accumulation. The aim of this thesis was to explore the role of northern berries in obesity-related diseases. The absorption and metabolism of selected berry polyphenols, flavonol glycosides and anthocyanins, was investigated in humans, and metabolites of the studied compounds were identified in plasma and urine samples (I, II). Further, the effects of berries on the risk factors of metabolic syndrome were studied in clinical intervention trials (III, IV), and the different fractions of sea buckthorn berry were tested for their ability to reduce postprandial glycemia and insulinemia after high-glucose meal in a postprandial study with humans (V). The marked impact of mixed berries on plasma ALT values (III), as well as indications of the positive effects of sea buckthorn, its fractions and bilberry on omental adiposity and adhesion molecules (IV) were observed. In study V, sea buckthorn and its polyphenol fractions had a promising effect on potprandial metabolism after high-glucose meal. In the literature review, the possible mechanisms behind the observed effects have been discussed with a special emphasis on ectopic fat accumulation. The literature review indicated that especially tannins and flavonoids have shown potential in suppressing diverse reaction cascades related to systemic inflammation, ectopic fat accumulation and insulin resistance development.

Regulation of B Cell Gene Expression and Function by Ikaros, Helios and Bcl6

B lymphocytes constitute a key branch of adaptive immunity by providing specificity to recognize a vast variety of antigens by B cell antigen receptors (BCR) and secreted antibodies. Antigen recognition activates the cells and can produce antibody secreting plasma cells via germinal center reaction that leads to the maturation of antigen recognition affinity and switching of antibody effector class. The specificity of antigen recognition is achieved through a multistep developmental pathway that is organized by interplay of transcription factors and signals through BCR. Lymphoid malignancies arise from different stages of development in abnormal function of transcriptional regulation. To understand the B cell development and the function of B cells, a thorough understanding of the regulation of gene expression is important. The transcription factors of the Ikaros family and Bcl6 are frequently associated with lymphoma generation. The aim of this study was to reveal the targets of Ikaros, Helios and Bcl6 mediated gene regulation and to find out the function of Ikaros and Helios in B cells. This study uses gene targeted DT40 B cell lines and establishes a role for Ikaros family factors Ikaros and Helios in the regulation of BCR signaling that is important at developmental checkpoints, for cell survival and in activation. Ikaros and Helios had opposing roles in the regulation of BCR signals. Ikaros was found to directly repress the SHIP gene that encodes a signaling lipid-metabolizing enzyme, whereas Helios had activating effect on SHIP expression. The findings demonstrate a balancing function for these two Ikaros family transcription factors in the regulation of BCR signaling as well as in the regulation of gene expression. Bcl6 was found to repress plasma cell gene expression program while maintaining gene expression profile of B cells. Analysis of direct Bcl6 target genes suggested novel mechanisms for Bcl6-mediated suppression of plasma cell differentiation and promoting germinal center phenotype.

Terveyskaupan erikoisliikkeen menestystarina: strategia ja houkuttelevuus yritysostajan perspektiivistä

Tutkielman tavoitteena on tiivistetysti edesauttaa Lappeenrannan Lifeterveyskaupan yritysmyyntiprosessia kuvailemalla kohdeyrityksen strategiaa, menestystekijöitä ja houkuttelevuutta yritysostajan näkökulma huomioiden siten, että niiden hahmottaminen ja omaksuminen helpottuu yritysostajalle. Tutkielman sisältöä voidaan hyödyntää yritysmyyntiprosessissa sellaisenaan tai tarpeen mukaan muunneltuna. Tutkielma on kvalitatiivinen tapaustutkimus, joka sisältää piirteitä käsite- ja toiminta-analyyttisestä sekä osin nomoteettisesta tutkimusotteesta. Aineisto kerättiin puolistrukturoiduilla teemahaastatteluilla. Kohdeyrityksen strategia on asiakaslähtöinen. Perusstrategia kohdeyrityksessä on riippuvainen kilpailijakontekstista, mutta useimmissa tapauksissa kilpailuetu perustuu differointiin. Suurena terveyskaupan erikoisliikkeenä voidaan hyödyntää myös suuruuden ekonomiaa. Yrityksen toiminta on alalle fokusoitua. Life-terveyskauppaketjuun kuuluminen ja erinomainen liiketilan sijainti ovat olleet tärkeitä tekijöitä menestyksessä. Runsas mainonta, suuri neuvotteluvoima toimittajiin nähden, tuoteportfolion hallinta, osaava henkilöstö ja hyvät sopimusehdot ovat edesauttaneet menestystä. Venäjä-potentiaali Lappeenrannassa on suuri. Markkina-asema on talousaseman ohella erinomainen ja hyödyksi sekä yritykselle että yritysostajalle.

Outcomes of cervical human papillomavirus (HPV) infections among mothers in the Finnish Family HPV Study

To understand the natural history of cervical human papillomavirus (HPV)-infections, more information is needed on their genotype-specific prevalence, acquisition, clearance, persistence and progression. This thesis is part of the prospective Finnish Family HPV study. 329 pregnant women (mean age 25.5 years) were recruited during the third trimester of pregnancy and were followed up for 6 years. The outcomes of cervical HPV infections were evaluated among all the mothers participating in the study. Generalized estimating equation (GEE)-models and Poisson regression were used to estimate the risk factors of type-specific acquisition, clearance, persistence and progression of Species 7 and 9 HPV-genotypes. Independent protective factors against incident infections were higher number of life-time sexual partners, initiation of oral contraceptive use after age 20 years and becoming pregnant during FU. Older age and negative oral HR-HPV DNA status at baseline were associated with increased clearance, whereas higher number of current sexual partners decreased the probability of clearance. Early onset of smoking, practicing oral sex and older age increased the risk of type-specific persistence, while key predictors of CIN/SIL were persistent HR-HPV, abnormal Pap smear and new sexual partners. HPV16, together with multiple-type infections were the most frequent incident genotypes, most likely to remain persistent and least likely to clear. Collectively, LR-HPV types showed shorter incidence and clearance times than HR-HPV types. In multivariate models, different predictors were associated with these main viral outcomes, and there is some tentative evidence to suggest that oral mucosa might play a role in controlling some of these outcomes.

Prevalence of Anxiety and Depression among Medical Students

ABSTRACT Background Medical students are a vulnerable population to develop depression and anxiety disorders. Objective To estimate the prevalence and associated factors of anxiety and depression among medical students. Methods A cross-sectional study with a random sample (n = 346) of medical students at a Brazilian university was performed. The Beck Depression Anxiety Inventory was used to measure anxiety and depression levels. Crude and adjusted analyses were performed using Poisson regression. Results The prevalence of anxiety was 35.5% and depression was 32.8%. The prevalence of anxiety and depression was 14% higher and 16% higher among women (p = 0.025 and p = 0.006, respectively). Students whose parents were not physicians reported 23% higher prevalence of anxiety (p = 0.006), and those who had physician parents reported 29% higher prevalence of depression (p = 0.034). Those who always or often felt pushed by their parents showed 22% higher prevalence of anxiety (p =.006) and 19% higher depression (p = 0.016). Students who had concerns over the future had 15% higher prevalence of depression (p = 0.017). Conclusion The prevalence of anxiety and depressive symptoms was higher than the average found in the general population.