The effects of a firm’s internationalization, age, and environmental turbulence on the capabilities that comprise strategic agility

This study investigates a largely unexplored area by examining how internationalization, firm age, and environmental turbulence influence the key components of strategic agility, namely strategic sensitivity, leadership unity, and resource fluidity. Although these factors have been identified as potential catalysts for strategic agility, their specific impacts on strategic agility’s core capabilities have yet to be thoroughly explored. Our research aims to bridge this gap, providing a nuanced understanding of how each of these variables shapes the strategic agility of a firm. The study uses the empirical research of 220 Spanish firms in the service sector and then adopts partial least squares structural equation modeling to analyze the data. Our findings indicate that internationalization has a dual effect on strategic agility: internationalization enhances strategic sensitivity, reflecting improved environmental awareness, but it diminishes leadership unity, illustrating the complexities of global leadership alignment. Additionally, an increase in firm age is associated with a decrease in all the aspects of strategic agility. By contrast, environmental turbulence positively impacts each dimension of strategic agility, suggesting that turbulent conditions can indeed promote the adaptability and responsiveness of a firm

Endothelial PlexinD1 signaling instructs spinal cord vascularization and motor neuron development

How the vascular and neural compartment cooperate to achieve such a complex and highly specialized structure as the central nervous system is still unclear. Here, we reveal a crosstalk between motor neurons (MNs) and endothelial cells (ECs), necessary for the coordinated development of MNs. By analyzing cell-to-cell interaction profiles of the mouse developing spinal cord, we uncovered semaphorin 3C (Sema3C) and PlexinD1 as a communication axis between MNs and ECs. Using cell-specific knockout mice and in vitro assays, we demonstrate that removal of Sema3C in MNs, or its receptor PlexinD1 in ECs, results in premature and aberrant vascularization of MN columns. Those vascular defects impair MN axon exit from the spinal cord. Impaired PlexinD1 signaling in ECs also causes MN maturation defects at later stages. This study highlights the importance of a timely and spatially controlled communication between MNs and ECs for proper spinal cord development

The psychological impact of the COVID-19 pandemic on physicians in Puerto Rico: a cross-sectional study after the second wave in 2021

IntroductionHealth care providers faced a challenge with the emergence of COVID-19 and its rapid spread. Early studies measuring the psychological impact of COVID-19 on the general population found high levels of anxiety and sleep disorders. The primary goal of this project was to assess the psychological impact of COVID-19 on physicians in Puerto Rico.Materials and methodsA cross-sectional study of physicians in Puerto Rico was conducted anonymously and electronically from February 2021 through April 2021. The electronic survey included socio-demographic data and 4 self-administered assessment tools (Generalized Anxiety Disorder-7, Perceived Stress Scale-10, Pittsburgh Sleep Quality Index and COVID-19 Organizational Support) for anxiety, perceived stress, sleep disturbances, and organizational support during the COVID-19 pandemic.ResultsA total of 145 physicians completed the survey, with a female predominance of 53.5% and a majority practicing in the San Juan metropolitan area (50.3%). Mild anxiety symptoms were reported in 26.9% of physicians, and 33.8% had moderate to severe anxiety symptoms. Moderate to high perceived stress was found in 69.9% of participants, and women reported statistically significantly higher levels of anxiety symptoms (8.84 ± 5.99; p = 0.037) and stress (19.0 ± 6.94, p = 0.001). The Pittsburgh Sleep Quality Index reported 67.9% of physicians with global scores associated with poor sleep quality. Assessment of perceived organizational support found a high perception of work support (65.7%) but low perception of personal support (43.4%) and risk support (30.3%). A correlation analysis found a negative correlation for work and personal support, but a positive correlation for risk support, all statistically significant.ConclusionCOVID-19 had a lasting psychological impact in health care providers in Puerto Rico a year after the beginning of the pandemic. Our data supports the importance of organizational support and its correlation with the development of anxiety. It is thus essential to develop strategies to identify individuals at risk of experiencing psychological disturbances and to provide effective support for medical professionals during medical emergencies for their well-being and optimal delivery of patient care

La estructura sísmica de la corteza de la Zona de Ossa Morena y su interpretación geológica

El experimento de sísmica de reflexión profunda IBERSEIS ha proporcionado una imagen de la corteza del Orógeno Varisco en el sudoeste de Iberia. Este artículo se centra en la descripción de la corteza de la Zona de Ossa Morena (OMZ), que está claramente dividida en una corteza superior, con reflectividad de buzamiento al NE, y una corteza inferior de pobre reflectividad. Las estructuras geológicas cartografiadas en superficie se correlacionan bien con la reflectividad de la corteza superior, y en la imagen sísmica se ven enraizar en la corteza media. Ésta está constituida por un cuerpo muy reflectivo, interpretado como una gran intrusión de rocas básicas. La imagen de las suturas que limitan la OMZ muestra el carácter fuertemente transpresivo de la colisión orogénica varisca registrada en el sudoeste de Iberia. La Moho actual es plana y, en consecuencia, no se observa la raíz del orógeno

Dissecting the role of the NADPH oxidase NOX4 in TGF-beta signaling in hepatocellular carcinoma

The NADPH oxidase NOX4 has been proposed as necessary for the apoptosis induced by the Transforming Growth Factor-beta (TGF-I3) in hepatocytes and hepatocellular carcinoma (HCC) cells. However, whether NOX4 is required for TGF-I3-induced canonical (SMADs) or non-canonical signals is not fully understood yet, neither its potential involvement in other parallel actions induced by TGF-I3. In this work we have used CRISPR Cas9 technology to stable attenuate NOX4 expression in HCC cells. Results have indicated that NOX4 is required for an efficient SMAD2/3 phosphorylation in response to TGF-I3, whereas non-canonical signals, such as the phos-phorylation of the Epidermal Growth Receptor or AKT, are higher in NOX4 silenced cells. TGF-I3-mediated in-hibition of cell proliferation and viability is attenuated in NOX4 silenced cells, correlating with decreased response in terms of apoptosis, and maintenance of high expression of MYC and CYCLIN D1. These results would indicate that NOX4 is required for all the tumor suppressor actions of TGF-I3 in HCC. However, analysis in human HCC tumors has revealed a worse prognosis for patients showing high expression of TGF-I31-related genes concomitant with high expression of NOX4. Deepening into other tumorigenic actions of TGF-I3 that may contribute to tumor progression, we found that NOX4 is also required for TGF-I3-induced migratory effects. The Epithelial-Mesenchymal transition (EMT) program does not appear to be affected by attenuation of NOX4 levels. However, TGF-I3-mediated regulation of cytoskeleton dynamics and focal adhesions require NOX4, which is necessary for TGF-I3-induced increase in the chaperone Hsp27 and correct subcellular localization of Hic-5 within focal adhesions, as well for upregulation of the metalloprotease MMP9. All these results together point to NOX4 as a key element in the whole TGF-I3 signaling in HCC cells, revealing an unknown role for NOX4 as tumor promoter in HCC patients presenting activation of the TGF-I3 pathway

Firm-specific, country-specific and region-specific competitive advantages: the case of emerging economy MNEs - Thailand

Increasing levels of regional economic integration have created a new source of international competitiveness for MNEs from an emerging economy, Thailand, in the context of ASEAN economic integration. Building on the theoretical framework of firm-specific advantages (FSAs) and country-specific advantages (CSAs) grounded in internalization theory, we introduce region-specific advantages (RSAs) and advance a novel regional dual-double-diamond model to analyse regional competitiveness. Using both primary and secondary data we find that most Thai firms derive their international competitiveness from CSAs rather than FSAs, and will benefit from ASEAN RSAs. Our study significantly advances the literature on international competitiveness of emerging-economy MNEs

Clostridium difficile infection among hospitalized HIV-infected individuals: epidemiology and risk factors: results from a case-control study (2002-2013).

BACKGROUND: HIV infection is a risk factor for Clostridium difficile infection (CDI) yet the immune deficiency predisposing to CDI is not well understood, despite an increasing incidence of CDI among such individuals. We aimed to estimate the incidence and to evaluate the risk factors of CDI among an HIV cohort in Italy. METHODS: We conducted a retrospective case-control (1:2) study. Clinical records of HIV inpatients admitted to the National Institute for Infectious Disease "L. Spallanzani", Rome, were reviewed (2002-2013). CASES: HIV inpatients with HO-HCFA CDI, and controls: HIV inpatients without CDI, were matched by gender and age. Logistic regression was used to identify risk factors associated with CDI. RESULTS: We found 79 CDI episodes (5.1 per 1000 HIV hospital admissions, 3.4 per 10000 HIV patient-days). The mean age of cases was 46 years. At univariate analysis factors associated with CDI included: antimycobacterial drug exposure, treatment for Pneumocystis pneumonia, acid suppressant exposure, previous hospitalization, antibiotic exposure, low CD4 cell count, high Charlson score, low creatinine, low albumin and low gammaglobulin level. Using multivariate analysis, lower gammaglobulin level and low serum albumin at admission were independently associated with CDI among HIV-infected patients. CONCLUSIONS: Low gammaglobulin and low albumin levels at admission are associated with an increased risk of developing CDI. A deficiency in humoral immunity appears to play a major role in the development of CDI. The potential protective role of albumin warrants further investigation

Risk and protective factors for anxiety and obsessive-compulsive disorders: an umbrella review of systematic reviews and meta-analyses

A multitude of risk/protective factors for anxiety and obsessive-compulsive disorders have been proposed. We conducted an umbrella review to summarize the evidence of the associations between risk/protective factors and each of the following disorders: specific phobia, social anxiety disorder, generalized anxiety disorder, panic disorder, and obsessive-compulsive disorder, and to assess the strength of this evidence whilst controlling for several biases.Publication databases were searched for systematic reviews and meta-analyses examining associations between potential risk/protective factors and each of the disorders investigated. The evidence of the association between each factor and disorder was graded into convincing, highly suggestive, suggestive, weak, or non-significant according to a standardized classification based on: number of cases (>1000), random-effects p-values, 95% prediction intervals, confidence interval of the largest study, heterogeneity between studies, study effects, and excess of significance.Nineteen systematic reviews and meta-analyses were included, corresponding to 216 individual studies covering 427 potential risk/protective factors. Only one factor association (early physical trauma as a risk factor for social anxiety disorder, OR 2.59, 95% CI 2.17-3.1) met all the criteria for convincing evidence. When excluding the requirement for more than 1000 cases, five factor associations met the other criteria for convincing evidence and 22 met the remaining criteria for highly suggestive evidence.Although the amount and quality of the evidence for most risk/protective factors for anxiety and obsessive-compulsive disorders is limited, a number of factors significantly increase the risk for these disorders, may have potential prognostic ability and inform prevention