Knowledge management as intellectual property: Evidence from Mexican manufacturing SMEs

© 2016, © Emerald Group Publishing Limited. Purpose: The purpose of this paper is to explore the relationship between knowledge management and creation of intellectual property within the context of small and medium size manufacturing enterprises. Design/methodology/approach: A hypothesis was formulated and tested using structural equation modelling. Data were collected through an instrument that was developed based on key constructs adapted from the literature and that was first validated using Confirmatory Factor Analysis. A Cronbach’s alpha test was also conducted and the Composite Reliability Index was calculated to ensure reliability of the theoretical model. The instrument was distributed among manufacturing small and medium enterprises (SMEs) in the Aguascalientes region of Mexico, from were 125 valid responses were obtained. Findings: In general, the results indicate that knowledge management has positive effects on the creation of intellectual property in manufacturing SMEs. This suggests that SMEs can create more intellectual property if they dedicate more efforts to the management of knowledge. Practical implications: The implication of this research and its findings may inform the strategies formulated by policy makers, and the managerial practices that manufacturing SMEs can adopt to protect their knowledge. Originality/value: Evidence suggests that studies focused on investigating the relationship between knowledge and intellectual property are limited. This paper provides a refined understanding of the relationship between knowledge management and intellectual property creation

Cardiovascular disease in women: Do we need new diagnostic and therapeutic strategies?

Cardiovascular disease (CVD) is the leading cause of death worldwide affecting both genders equally. However, in comparison to men, in women it often is underrecognized and undertreated in both the primary and secondary prevention settings. It is clear, that in the healthy population, there are profound differences both anatomically and biochemically between woman and men and this may impact how both groups present when they become ill. Therefore, there are some diseases that affect more frequently in women than in men such us myocardial ischemia or infarction without obstructive coronary disease, Tako-subo syndrome, some atrial arrhythmias or the appearance of heart failure with preserved ejection fraction. Therefore, the diagnostic and therapeutic strategies that have been established based largely on clinical studies with a predominant male population must be adapted before being applied to women. There is a paucity of data regarding cardiovascular disease in women. It is inadequate to only perform a subgroup analysis evaluating a specific treatment or invasive technique, when women constitute fifty percent of the population. In this regard, this may affect the time of clinical diagnosis and severity assessments of some valvulopathies. In this review, we will focus on the differences in the diagnosis, management, and outcomes of woman with the most frequent cardiovascular pathologies including coronary artery disease, arrythmias, heart failure and valvopathies. In addition, we will describe diseases that exclusively affect to women related with the pregnancy some of them are life treating. Although the lack of research in women plays a role in the poorer outcomes in women specially in ischemic heart disease the results of some techniques such as transcathether aortic valve implantation and transcatheter edge to edge therapy seem to have better outcome in women

Differential effects of conditioned taste aversion on sucrose and stevia intake / Efectos diferenciales del condicionamiento aversivo a sabores sobre la ingesta de sacarosa y estevia

Abstract The association between a food stimulus and a feeling of discomfort produces a food aversion; this procedure is called aversive taste conditioning (ATC). Since there is no clear evidence about the effects of this procedure on the consumption of sweeteners, the purpose of this study was to examine the effectiveness of ATC to decrease the consumption of two natural sweeteners. Thirty Wistar rats were divided into three groups. In phase 1 all groups were exposed to free food access and each group to a different solution: water + sucrose (G1), water + stevia (G2) and unsweetened water (CG). In phase 2 the experimental groups received an intraperitoneal injection of lithium chloride. In phase 3 the groups returned to the conditions of the first phase. After the ATC, the G1 and G2 significantly decreased their beverage consumption, although it was higher than the consumption of CG. The results are discussed in terms of the association between flavor and energy content, which allows establishing new guidelines in the study of the consumption of sweeteners. It is concluded that procedures such as ATC are effective in the control of some disordered eating behaviors. Resumen La asociación entre un estímulo alimentario y una sensación de malestar produce una aversión alimentaria, procedimiento denominado condicionamiento aversivo a sabores (CAS). Dado que no existen evidencias claras acerca de los efectos de este procedimiento sobre el consumo de endulzantes, el propósito de este estudio fue examinar la efectividad del CAS para disminuir el consumo de dos endulzantes naturales. Se trabajó con 30 ratas Wistar, distribuidas en tres grupos. En la fase 1 los grupos fueron expuestos a alimento y cada uno a una solución distinta: agua + sacarosa (G1), agua + estevia (G2) y agua sin endulzar (GC). En la fase 2 los grupos experimentales recibieron una inyección intraperitoneal de cloruro de litio. En la fase 3 los grupos retornaron a las condiciones de la primera fase. Después del CAS, G1 y G2 disminuyeron significativamente su consumo de bebida, sin embargo fue mayor al registrado en GC. Los resultados se discuten en función de la asociación entre el sabor y el contenido energético, lo que permite establecer nuevas directrices en el estudio del consumo de endulzantes. Se concluye que los procedimientos que producen aversión condicionada podrían resultar eficaces en el control de algunas conductas alimentarias alteradas.

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Use of Thermally Modified Jarosite for the Removal of Hexavalent Chromium by Adsorption

Jarosites are residues generated during the purification of zinc and are composed mainly of iron sulfates ((Na, K)Fe3(SO4)2(OH)6). Due to the large volume of jarosite generated during the process, these residues tend to be deposited in large land areas and are not used. In the present work, jarosite was used without heat treatment (JST) as an adsorbent of hexavalent chromium contained in a sample of wastewater from a chrome plating industry under the following conditions: C0 = 200 mg/L of Cr, T = 25 °C, and pH = 3. It was only possible to remove 34% of Cr (VI). Subsequently, a thermal treatment of a jarosite sample (JTT) was carried out at 600 °C. The heat-treated sample was later used as an adsorbent in the same conditions as those for JST. The maximum chromium removal was 53%, and the adsorption capacity was 10.99 mg/g. The experimental data were fitted to the Langmuir model and to the pseudo-second-order kinetic model. It was determined that the adsorption process involved electrostatic attractions between the surface of the positively charged adsorbent and the chromium anions contained in industrial wastewater

Diabetes risk detection study in primary care according to FINDRISC questionnaire in the Municipality of Gral. Pueyrredón (DR. Diap study)

Conocer la magnitud del riesgo de padecer diabetes mellitus 2 (DM2) en la población del Municipio de Gral. Pueyrredón que concurre a los Centros Asistenciales de Atención Primaria. Materiales y métodos: estudio observacional para determinar el riesgo de padecer DM2 mediante una entrevista donde se indagaron sobre las ocho preguntas del cuestionario FINDRISC. Resultados: la muestra del estudio estuvo constituida por 2.784 pacientes, el 54% conformada por mujeres. La edad fue agrupada en menos de 45 años el 47,5% (1.323), de 45 a 54 años el 20,9% (582), de 55 a 64 años el 18,3% (510) y más de 64 años el 13,2% (368). El 20% de la población presentó una puntuación de la escala de riesgo del cuestionario FINDRISC igual o mayor a 15, alto riesgo a muy alto riesgo de padecer diabetes en los próximos 10 años. El 43,38% presentó un IMC>30 y el 25,97% declaró recibir medicación para la hipertensión arterial. El 55,37% refería actividad física baja, el 50,79% no ingería verduras y frutas en forma diaria y el 17,98% declaró cifras de glucemias elevadas. Las variables que con mayor frecuencia se asociaron a una escala de riesgo >15 fueron: sedentarismo (80,9%), cintura >102/88 (65,7/77,2%), antecedente de hiperglucemia (64,0%), alimentación no saludable (61,9%) e IMC>30 (61,8%). El riesgo >15 según IMC fue: IMC 30 el 45,4%. Conclusiones: el 20% de la población encuestada está en alto riesgo de padecer diabetes. Una de cada dos o tres personas sin diabetes que asisten a un centro de Atención Primaria tiene un FINDRISC >15. Esta escala de riesgo es una herramienta simple, económica, de rápida confección, no invasiva y segura para detectar individuos con alto riesgo de padecer diabetes tipo 2. También puede usarse para identificar DM2 no detectada y factores de riesgo de enfermedad cardiovascular.Objective: to determine the size of the population at risk of developing diabetes mellitus in the population of the municipality of Gral. Pueyrredón who go-attend to Health Centers for Primary Care. Materials y methods: observational study to determine the risk of developing DM2, through an interview where questions were asked about the 8 questions Questionnaire FINDRISC. Results: the study sample consisted of 2.784 patients, 54% were women. Age was grouped in less than 45 years old 47.5 % (1.323) from 45 to 54 years old 20.9% (582) from 55 to 64 years old 18.3% (510), and over 64 years old 13.2% (368). 20% of the population has a score of the risk scale questionnaire FINDRISC greater than or equal to 15, high risk to very high risk of developing diabetes in the next 10 years. The 43,38% showed a BMI >30 and 25.97% was currently receiving medication for high blood pressure. The 55.37% reported low physical activity, 50.79% do not eat vegetables and fruits on a daily basis and 17.98% declared high blood glucose. The variables most commonly associated with a risk score >15 were: sedentary lifestyle (80.9%), waist >102/88 (65.7/77.2%), history of hyperglycemia (64.0%), unhealthy diet (61.9%) and BMI>30 (61.8%). The risk >15 according to BMI was: BMI 30 45.4%. Conclusions: 20% of the surveyed population is at high risk for diabetes. One of every 2 or 3 non-diabetic patients attending to a primary care center have a FINDRISC >15. This diabetes risk scale is a simple, inexpensive tool, making quick, noninvasive and safe exploration to identify individuals at high risk of developing type 2 diabetes. It also can be used to identify undetected DM2 and risk factors for cardio vascular disease.Fil: Guzmán Rodríguez, Segundo. Hospital Transito Caceres de Allende ; Gobierno de la Provincia de Cordoba; ArgentinaFil: Faingold, María Cristina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Ciencia y Tecnología "Dr. César Milstein". Fundación Pablo Cassará. Instituto de Ciencia y Tecnología "Dr. César Milstein"; ArgentinaFil: Suarez, Raúl Oscar. Universidad Nacional de Mar del Plata; ArgentinaFil: Guzmán Rodríguez, Sofía. Centro de Especialidades Médicas Ambulatorias; ArgentinaFil: López Priori, Mariel. Centro de Especialidades Médicas Ambulatorias; ArgentinaFil: Martinez Arca, Jorge. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones en Ciencia y Tecnología de Materiales. Universidad Nacional de Mar del Plata. Facultad de Ingeniería. Instituto de Investigaciones en Ciencia y Tecnología de Materiales; ArgentinaFil: Lalli, Alejandra. Universidad del Cema; ArgentinaFil: Bonanno, Anastasia. Universidad del Cema; ArgentinaFil: Bozzone, Griselda. Universidad del Cema; ArgentinaFil: Pagani, Gabriela. Universidad del Cema; ArgentinaFil: Dottavio, Esteban. No especifica;Fil: Orosco, Laura Mabel. No especifica;Fil: Alzueta, Guillermo. No especifica;Fil: Scandurra, Adriana. Universidad Nacional de Mar del Plata; ArgentinaFil: Passoni, Lucía Isabel. Universidad Nacional de Mar del Plata; ArgentinaFil: Ciccioli, Carlos. No especifica;Fil: Leoni, Leandro. Universidad del Cema; ArgentinaFil: Zantleifer, Débora. Universidad del Cema; ArgentinaFil: Ruiz, María Laura. Universidad del Cema; ArgentinaFil: Rodríguez, Manuela. Universidad del Cema; Argentin

Comparing the evolutionary dynamics of predominant SARS-CoV-2 virus lineages co-circulating in Mexico

Over 200 different SARS-CoV-2 lineages have been observed in Mexico by November 2021. To investigate lineage replacement dynamics, we applied a phylodynamic approach and explored the evolutionary trajectories of five dominant lineages that circulated during the first year of local transmission. For most lineages, peaks in sampling frequencies coincided with different epidemiological waves of infection in Mexico. Lineages B.1.1.222 and B.1.1.519 exhibited similar dynamics, constituting clades that likely originated in Mexico and persisted for &gt;12 months. Lineages B.1.1.7, P.1 and B.1.617.2 also displayed similar dynamics, characterized by multiple introduction events leading to a few successful extended local transmission chains that persisted for several months. For the largest B.1.617.2 clades, we further explored viral lineage movements across Mexico. Many clades were located within the south region of the country, suggesting that this area played a key role in the spread of SARS-CoV-2 in Mexico

Early diagnostic indicators of dengue versus other febrile illnesses in Asia and Latin America (IDAMS study): a multicentre, prospective, observational study

BACKGROUND: Improvements in the early diagnosis of dengue are urgently needed, especially in resource-limited settings where the distinction between dengue and other febrile illnesses is crucial for patient management. METHODS: In this prospective, observational study (IDAMS), we included patients aged 5 years and older with undifferentiated fever at presentation from 26 outpatient facilities in eight countries (Bangladesh, Brazil, Cambodia, El Salvador, Indonesia, Malaysia, Venezuela, and Viet Nam). We used multivariable logistic regression to investigate the association between clinical symptoms and laboratory tests with dengue versus other febrile illnesses between day 2 and day 5 after onset of fever (ie, illness days). We built a set of candidate regression models including clinical and laboratory variables to reflect the need of a comprehensive versus parsimonious approach. We assessed performance of these models via standard measures of diagnostic values. FINDINGS: Between Oct 18, 2011, and Aug 4, 2016, we recruited 7428 patients, of whom 2694 (36%) were diagnosed with laboratory-confirmed dengue and 2495 (34%) with (non-dengue) other febrile illnesses and met inclusion criteria, and were included in the analysis. 2703 (52%) of 5189 included patients were younger than 15 years, 2486 (48%) were aged 15 years or older, 2179 (42%) were female and 3010 (58%) were male. Platelet count, white blood cell count, and the change in these variables from the previous day of illness had a strong association with dengue. Cough and rhinitis had strong associations with other febrile illnesses, whereas bleeding, anorexia, and skin flush were generally associated with dengue. Model performance increased between day 2 and 5 of illness. The comprehensive model (18 clinical and laboratory predictors) had sensitivities of 0·80 to 0·87 and specificities of 0·80 to 0·91, whereas the parsimonious model (eight clinical and laboratory predictors) had sensitivities of 0·80 to 0·88 and specificities of 0·81 to 0·89. A model that includes laboratory markers that are easy to measure (eg, platelet count or white blood cell count) outperformed the models based on clinical variables only. INTERPRETATION: Our results confirm the important role of platelet and white blood cell counts in diagnosing dengue, and the importance of serial measurements over subsequent days. We successfully quantified the performance of clinical and laboratory markers covering the early period of dengue. Resulting algorithms performed better than published schemes for distinction of dengue from other febrile illnesses, and take into account the dynamic changes over time. Our results provide crucial information needed for the update of guidelines, including the Integrated Management of Childhood Illness handbook. FUNDING: EU's Seventh Framework Programme. TRANSLATIONS: For the Bangla, Bahasa Indonesia, Portuguese, Khmer, Spanish and Vietnamese translations of the abstract see Supplementary Materials section

Status quo of pain-related patient reported outcomes and perioperative pain management in 10 415 patients from 10 countries: analysis of registry data

Postoperative pain is common at the global level, despite considerable attempts for improvement, reflecting the complexity of offering effective pain relief. In this study, clinicians from Mexico, China, and eight European countries evaluated perioperative pain practices and patient-reported outcomes (PROs) in their hospitals as a basis for carrying out quality improvement (QI) projects in each country