The role of embeddedness for resource integration and value co-creation in service systems

Marketing theory and practice highlight the significance of co-creation among market actors (e.g. firms and/or consumers) for mutually beneficial valued outcomes. The essence of such collaborations is the social relationships that facilitate opportunities for resource exchange. The significance of social contexts for value creation is emphasized within the marketing literature. Despite its importance, the nature of social constellations—particularly the concept of embeddedness—is rarely discussed in the context of service-dominant (S-D) logic, the most influential school of thought in marketing.This significantly confines the extant understanding of factors that influence value co-creation amongst actors in service systems. Grounded in its sociological foundations, the concept of embeddedness has the potential to provide meaningful insights into the dynamics of value co-creation processes. Against this background, the present thesis develops a comprehensive conceptual framework to establish the importance of embeddedness as a powerful construct, and for understanding actors’ resource integration processes in service systems. This research develops a rich theoretical and empirical understanding of embeddedness by way of three dimensions (structural, relational and cultural), and investigates its implications for actors’ value co-creation behaviours and value-in-context outcomes. In addition, the research refines co-creation perspectives by examining a central boundary condition of co-creation processes. The data was collected in an online service environment and was analysed using structural equation modelling techniques. The findings support a significant impact of embeddedness on consumers’ co-creation behaviours and their value outcomes. Overall, the study contributes by foregrounding conceptual and empirical insights into embeddedness, and advances S-D logic research by clarifying how actors’ value perceptions are socially constructed, adapted and consumed to co-create meaningful service experiences

Ceftazidime-avibactam or best available therapy in patients with ceftazidime-resistant Enterobacteriaceae and Pseudomonas aeruginosa complicated urinary tract infections or complicated intra-abdominal infections (REPRISE): a randomised, pathogen-directed, phase 3 study

Background Carbapenems are frequently the last line of defence in serious infections due to multidrug-resistant Gram-negative bacteria, but their use is threatened by the growing prevalence of carbapenemase-producing pathogens. Ceftazidime-avibactam is a potential new agent for use in such infections. We aimed to assess the efficacy, safety, and tolerability of ceftazidime-avibactam compared with best available therapy in patients with complicated urinary tract infection or complicated intra-abdominal infection due to ceftazidime-resistant Gram-negative pathogens. Methods REPRISE was a pathogen-directed, international, randomised, open-label, phase 3 trial that recruited patients from hospitals across 16 countries worldwide. Eligible patients were aged 18–90 years with complicated urinary tract infection or complicated intra-abdominal infection caused by ceftazidime-resistant Enterobacteriaceae or Pseudomonas aeruginosa. Patients were randomised (1:1) to 5–21 days of treatment with either ceftazidime-avibactam (a combination of 2000 mg ceftazidime plus 500 mg avibactam, administered via a 2-h intravenous infusion every 8 h) or best available therapy. The primary endpoint was clinical response at the test-of-cure visit, 7–10 days after last infusion of study therapy, analysed in all patients who had at least one ceftazidime-resistant Gram-negative pathogen, as confirmed by the central laboratory, and who received at least one dose of study drug. Safety endpoints were assessed in all patients who received at least one dose of study drug. This study is registered with ClinicalTrials.gov, number NCT01644643. Findings Between Jan 7, 2013, and Aug 29, 2014, 333 patients were randomly assigned, 165 to ceftazidime-avibactam and 168 to best available therapy. Of these, 154 assigned to ceftazidime-avibactam (144 with complicated urinary tract infection and ten with complicated intra-abdominal infection) and 148 assigned to best available therapy (137 with complicated urinary tract infection and 11 with complicated intra-abdominal infection) were analysed for the primary outcome. 163 (97%) of 168 patients in the best available therapy group received a carbapenem, 161 (96%) as monotherapy. The overall proportions of patients with a clinical cure at the test-of-cure visit were similar with ceftazidime-avibactam (140 [91%; 95% CI 85·6–94·7] of 154 patients) and best available therapy (135 [91%; 85·9–95·0] of 148 patients). 51 (31%) of 164 patients in the ceftazidime-avibactam group and 66 (39%) of 168 in the best available therapy group had an adverse event, most of which were mild or moderate in intensity. Gastrointestinal disorders were the most frequently reported treatment-emergent adverse events with both ceftazidime-avibactam (21 [13%] of 164 patients) and best available therapy (30 [18%] of 168 patients). No new safety concerns were identified for ceftazidime-avibactam. Interpretation These results provide evidence of the efficacy of ceftazidime-avibactam as a potential alternative to carbapenems in patients with ceftazidime-resistant Enterobacteriaceae and P aeruginosa. Funding AstraZeneca

Analysis of environmental conditions and management in a compost-bedded pack barn with tunnel ventilation

Received: January 5th, 2021 ; Accepted: March 27th, 2021 ; Published: April 16th, 2021 ; Correspondence: [email protected] housing system based on compost-bedded pack for dairy cows is spreading rapidly in Brazil. Completely open buildings without curtains and simple roofs are usually provided. However, in the last years some new completely closed barns have been realized. This study aims to analyse one of these closed barns, located in the State of Minas Gerais. The two main sides of the facility are provided with polyethylene curtains of blue colour and five deflectors. The barn is equipped with an evaporative adiabatic cooling system, associated with the tunnel-style ventilation, realized with exhaust fans, continuously operating 24 hours a day. 85 lactating Holstein cows were housed in the barn during the trials carried out in the winter season 2019. Microclimatic data were collected continuously. Air speed, illuminance and bedding temperature were measured during the farm visits. Pack moisture was calculated. The results state the importance of bedding management and climatic conditions inside the barn. It emerges that the cows housed in this kind of closed barn, with forced ventilation, are in good thermal conditions, which are fairly constant. The average illumination of the barn can be considered acceptable (55.06 lx), even if some areas of the barn present values below the minimum ones reported in literature. The bedding temperature varies between a maximum of 36.33 °C and a minimum of 25.44 °C with an average of 31.26 °C. The values of bedding moisture are between a maximum of 64.36% and a minimum of 60.81% with an average of 62.48%

Match It or Die: Proving Integrity by Equality

Cryptographic hash functions are commonly used as modification detection codes. The goal is to provide message integrity assurance by comparing the digest of the original message with the hash of what is thought to be the intended message. This paper generalizes this idea by applying it to general expressions instead of just digests: success of an equality test between a tainted data and a trusted one can be seen as a proof of high-integrity for the first item. Secure usage of hash functions is also studied with respect to the confidentiality of digests by extending secret-sensitive noninterference of Demange and Sands

Cell-to-cell heterogeneity of EWSR1-FLI1 activity determines proliferation/migration choices in Ewing sarcoma cells

Animal science

Preponderance of the oncogenic V599E and V599K mutations in B-raf kinase domain is enhanced in melanoma cutaneous/subcutaneous metastases

BACKGROUND: Downstream of Ras, the serine/threonine kinase B-raf has been reported to be mutated, among other carcinomas, in a substantial subset of primary melanomas with a preponderance of mutations within the kinase domain including the activating V599E and V599K transitions. METHODS: We here investigated a representative series of 60 resection specimens of cutaneous and subcutaneous melanoma metastases for the presence of mutations within the activation segment (exon 15) of the B-raf kinase domain by polymerase chain reaction (PCR) and single-strand conformation polymorphism (SSCP) gel electrophoresis. RESULTS: Sequencing of cloned PCR-SSCP amplicons resulted in 24 (40%) samples harbouring somatic mutations which is not exceeding the mutation frequency in recently investigated primary melanomas. The activating mutation T1796A was present in 24/60 (40%) resection specimens, followed in frequency by the oncogenic g1795A mutation in 8/60 (13%) cases. As to the B-raf protein sequence, the acidic amino acid transitions V599E and V599K were predicted in 19/60 (32%) and 6/60 (10%) cases, resepectively, but were not associated with enhanced risk for subsequent metastasis in patients' follow up. In comparison to the primary melanomas that we recently investigated, the spectrum of predicted B-raf protein mutations narrowed significantly in the cutaneous/subcutaneous metastases. Unexpectedly, V599 and V599E mutations were absent in cutaneous/subcutaneous metastases derived from acrolentiginous melanomas as preceding primary tumours. CONCLUSION: During transition from primary melanomas towards cutaneous/subcutaneous metastases, the spectrum of predicted B-raf mutations narrows significantly. Focusing on the V599E and V599K, these oncogenic mutations are likely to affect melanocyte-specific pathways controlling proliferation and differentiation

The contribution of large genomic deletions at the CDKN2A locus to the burden of familial melanoma

Mutations in two genes encoding cell cycle regulatory proteins have been shown to cause familial cutaneous malignant melanoma (CMM). About 20% of melanoma-prone families bear a point mutation in the CDKN2A locus at 9p21, which encodes two unrelated proteins, p16INK4a and p14ARF. Rare mutations in CDK4 have also been linked to the disease. Although the CDKN2A gene has been shown to be the major melanoma predisposing gene, there remains a significant proportion of melanoma kindreds linked to 9p21 in which germline mutations of CDKN2A have not been identified through direct exon sequencing. The purpose of this study was to assess the contribution of large rearrangements in CDKN2A to the disease in melanoma-prone families using multiplex ligation-dependent probe amplification. We examined 214 patients from independent pedigrees with at least two CMM cases. All had been tested for CDKN2A and CDK4 point mutation, and 47 were found positive. Among the remaining 167 negative patients, one carried a novel genomic deletion of CDKN2A exon 2. Overall, genomic deletions represented 2.1% of total mutations in this series (1 of 48), confirming that they explain a very small proportion of CMM susceptibility. In addition, we excluded a new gene on 9p21, KLHL9, as being a major CMM gene

Plasma levels of leptin and mammographic density among postmenopausal women: a cross-sectional study

INTRODUCTION: Obesity has been linked to increased risk of breast cancer in postmenopausal women. Increased peripheral production of estrogens has been regarded as the main cause for this association, but other features of increased body fat mass may also play a part. Leptin is a protein produced mainly by adipose tissue and may represent a growth factor in cancer. We examined the association between leptin plasma levels and mammographic density, a biomarker for breast cancer risk. METHODS: We included data from postmenopausal women aged 55 and older, who participated in a cross-sectional mammography study in Tromsø, Norway. Mammograms, plasma leptin measurements as well as information on anthropometric and hormonal/reproductive factors were available from 967 women. We assessed mammographic density using a previously validated computer-assisted method. Multiple linear regression analysis was applied to investigate the association between mammographic density and quartiles of plasma leptin concentration. Because we hypothesized that the effect of leptin on mammographic density could vary depending on the amount of nondense or fat tissue in the breast, we also performed analyses on plasma leptin levels and mammographic density within tertiles of mammographic nondense area. RESULTS: After adjusting for age, postmenopausal hormone use, number of full-term pregnancies and age of first birth, there was an inverse association between leptin and absolute mammographic density (P(trend )= 0.001). When we additionally adjusted for body mass index and mammographic nondense area, no statistically significant association between plasma leptin and mammographic density was found (P(trend )= 0.16). Stratified analyses suggested that the association between plasma leptin and mammographic density could differ with the amount of nondense area of the mammogram, with the strongest association between leptin and mammographic absolute density in the stratum with the medium breast fat content (P(trend )= 0.003, P for interaction = 0.05). CONCLUSION: We found no overall consistent association between the plasma concentration of leptin and absolute mammographic density. Although weak, there was some suggestion that the association between leptin and mammographic density could differ with the amount of fat tissue in the breast