Amplifon in the US: A Story of Customer-Centric International Growth

Amplifon is a multinational corporation, headquartered in Milan, that operates in the retail hearing aids sector. The company has an extensive network of shops, and it specializes in customizing and fitting hearing aids and in distributing an extensive range of accessories to solve problems related to the loss of hearing. Since 2001, Amplifon has been listed on the Italian Stock Exchange. It joined the STAR segment in 2008, the FTSE-MIB Index in 2018, the Stoxx Europe 600 in 2019, and the MSCI Global Standard index in 2020. Amplifon is expected to have close to €2 billion in sales in 2021. It operates in 27 countries, and it has around 18,000 employees in a network of 11,500 points of sale. Amplifon competes in the hearing aid retail market, an industry that is highly fragmented at the global level. Amplifon is the global leader, with almost twice the market share of its largest competitor, but its worldwide share is just over 11%. The major players in the industry compete fiercely to lead the consolidation of the space. The sector is undergoing rapid development, thanks in part to the modernization impulse given by Amplifon in recent years. Hearing devices are highly technological products with continuous innovation, and distribution models are now experimenting with digitalization opportunities. Moreover, renewed interest in consumer hearing devices like Apple AirPods is bringing new products and technologies to market. The challenges facing competitors are diverse and complex. The market that best exemplifies the size and the depth of the challenges in the US market where Amplifon has been present since the early 1990s. Giulio Pizzini (Chief Strategy & Business Development Officer at Amplifon) explained the company’s challenges in the US market: “In the US we are the leader in the premium market, but we want to further increase our market share and consolidate our competitive position. Leadership in the US is fundamental not only because it is the largest retail market, covering around 40% of the world market, but also because this is the most innovative market where new technologies and innovation in retail tend to emerge first.

Internationalisation, cultural distance and country characteristics: a Bayesian analysis of SME's financial performance

Relying on the accounting data of a panel of 403 Italian manufacturing SMEs collected over a period of 5 years, we find results suggesting that multinationality per se does not impact on the economic performance of international small and medium sized firms. It is the characteristics of the country selected i.e. the political hazard, the financial stability and the economic performance that significantly influence SMEs financial performance. The management implication for small and medium sized firms selecting and entering new geographic markets is significant, since our results show that for SMEs it is the market selection process that really matters and not the degree of multinationality

MAR-Mediated transgene integration into permissive chromatin and increased expression by recombination pathway engineering.

Untargeted plasmid integration into mammalian cell genomes remains a poorly understood and inefficient process. The formation of plasmid concatemers and their genomic integration has been ascribed either to non-homologous end-joining (NHEJ) or homologous recombination (HR) DNA repair pathways. However, a direct involvement of these pathways has remained unclear. Here, we show that the silencing of many HR factors enhanced plasmid concatemer formation and stable expression of the gene of interest in Chinese hamster ovary (CHO) cells, while the inhibition of NHEJ had no effect. However, genomic integration was decreased by the silencing of specific HR components, such as Rad51, and DNA synthesis-dependent microhomology-mediated end-joining (SD-MMEJ) activities. Genome-wide analysis of the integration loci and junction sequences validated the prevalent use of the SD-MMEJ pathway for transgene integration close to cellular genes, an effect shared with matrix attachment region (MAR) DNA elements that stimulate plasmid integration and expression. Overall, we conclude that SD-MMEJ is the main mechanism driving the illegitimate genomic integration of foreign DNA in CHO cells, and we provide a recombination engineering approach that increases transgene integration and recombinant protein expression in these cells. Biotechnol. Bioeng. 2017;114: 384-396. © 2016 The Authors. Biotechnology and Bioengineering published by Wiley Periodicals, Inc

Acute outcome after a single cryoballoon ablation: Comparison between Arctic Front Advance and Arctic Front Advance PRO

BACKGROUND: The novel fourth-generation cryoballoon (CB4) potentially allows for enhanced catheter maneuverability and more frequent capture of pulmonary vein (PV) potentials which can be used to monitor real-time PV isolation (PVI). The aim of our study is to compare the acute procedural endpoints between the CB4 and second-generation cryoballoon (CB2). METHODS: A single-center retrospective chart review was used to examine 50 consecutive patients with drug-refractory atrial fibrillation undergoing CB4-based PVI. Procedural data and acute success of these patients were compared to 50 propensity-matched controls who underwent cryoballoon ablation procedure using CB2. RESULTS: Procedures performed with the CB4 showed significant shorter fluoroscopy time (14.8 \ub1 5.5 vs 18.0 \ub1 6.5 minutes, P = .04), shorter procedure time (58.3 \ub1 15.7 vs 65.3 \ub1 21 minutes, P = .13), and shorter total ablation time (10.8 \ub1 1.5 vs 13.8 \ub1 1.9 minutes, P = .42). The real-time PVI visualization rate was 33.3% in the CB2 group and 74.7% in the CB4 group (P < .001). CB4 was correlated to significant increase of acute real-time recordings with regard to all the single PV (left superior PV: 58% vs 84%, P = .02; left inferior PV: 26% vs 71%, P = .001; right superior PV 29% vs 61%, P = .01; and right inferior PV 19% vs 58%, P = .002). CONCLUSION: The CB4 was more often able to capture real-time recordings of PV potentials and the subsequent acute PV isolation

Franchise Business Development Model: Theoretical Considerations

Franchising is not a popular business development form in Lithuania. Only 0.02% of all Lithuanian companies use franchising for business development, while in most of the developed countries franchise is recognized as a convenient business expansion form. So, what factors determine such differences in the use of franchising? Analysis of related literature showed, that mainly researchers analyse some aspects of franchising, however there is no systematized analysis which covers all the main franchise development elements. Therefore, the aim of this article is to systematize franchise business development phases, main elements and factors, influencing this process and to propose a theoretical franchise system development model. Thus, theoretical considerations about the main phases and elements of franchise system development as well as advantages and disadvantages of the system are analysed in the article. These theoretical considerations are generalized in theoretical franchise system development model, which shows, that development of franchise business consists of particular steps, starting from favourable conditions for the system to emerge; intention and ability of franchisor to form franchise based on his business; the establishment and initial development of franchise system; and its further functioning. The article does not test the model and even does not discuss the operationalization of it. Operationalization of the model as well as empirical evidence is presented by the authors in the forthcoming articles

International trade and domestic competition: Evidence from Belgium

We investigate the effect of domestic market competition on firm-level export intensity. We employ a comprehensive dataset of Belgian firms from 2005–2008, when the fall in the number of firms engaged in trade was accompanied by a growing amount of transactions. The resulting increase in the domestic concentration of Belgian firms has sparked numerous debates, since the direction of causality between domestic market structure and export performance is unclear. We apply the fractional logit estimator and control for both self-selection and simultaneity bias. We find that a positive linkage exists between the level of competition and export intensity

Cryoballoon pulmonary vein ablation and left atrialappendage closure combined procedure: A long-termfollow-up analysis

BACKGROUND: The combined left atrial appendage closure (LAAC) and cryoenergy pulmonary vein isolation (PVI) procedure has been proven safe and effective in managing stroke in patients with nonvalvular atrial fibrillation (AF), although most data refer to procedures performed using radiofrequency as the main energy source. OBJECTIVE: The purpose of this study was to evaluate long-term follow-up of patients with AF undergoing concomitant LAAC and cryoenergy PVI. METHODS: Patients undergoing LAAC and cryoballoon PVI at our institution were enrolled. At 3, 6, and 24 months from the index procedure, we determined the atrial arrhythmia recurrence rate, the extent of LAAC, and the rate of cerebrovascular/bleeding events. RESULTS: Forty-nine patients (mean age 69 \ub1 8 years; 67% men; CHA2DS2-VASc score 2.8 \ub1 1.2; HAS-BLED score 3 \ub1 1) with a guideline LAAC indication were included. Acute PVI and complete LAAC were achieved in 100% of patients. All patients completed at least 24 months of follow-up. At 8 weeks and 6 months, complete or satisfactory (<5 mm leak) LAAC rates were achieved in 82% and 18% and in 86% and 14% of patients, respectively. The overall freedom from atrial arrhythmia rate at 24 months was 60%, and 92% of patients were off antithrombotic drugs. The observed annualized stroke and bleeding rates were 1% and 2%, respectively, a 71% and 60% risk reduction in comparison to event rates predicted from CHA2DS2-VASc and HAS-BLED scores. CONCLUSION: Concomitant cryoballoon ablation and LAAC procedures appear safe and effective at long-term follow-up, with high antithrombotic drug withdrawal rates at 24 months

Prevalence and clinical significance of collateral findings detected by chest computed tomography in patients undergoing atrial fibrillation ablation

Aims Chest computed tomography (CT) scanning is increasingly used as an imaging technique in patients undergoing atrial fibrillation (AF) catheter ablation. Chest CT scans visualize organs other than the heart and collateral findings may be identified incidentally. Our study aims to assess the prevalence and clinical relevance of such collateral findings in patients undergoing AF ablation. Methods and results One hundred and seventy-three patients (127 males, age 59 +/- 10 years) underwent chest CT scan for image integration in AF ablation. Collateral findings from visualized thoracic and upper abdominal organs were collected. Findings that required further investigations or treatment according to current guidelines were considered as clinically significant. A total of 164 collateral findings were identified in 97 (56%) patients, and most patients showed abnormalities of the lungs (67 patients, 39%). Forty-nine (28%) patients had clinically significant findings needing further investigation and 17 (10%) of them required specific treatments, including three cases (1.7%) of lung malignancy. Conclusions Chest CT images acquired for integration in AF ablation should be read thoroughly as they may serve as a screening tool for otherwise unrecognized clinically significant conditions of the heart, lungs, or other visualized organs

Ketahanan Sumberdaya Genetik Jagung Sulawesi Tenggara terhadap Cekaman Kekeringan pada Berbagai Fase Vegetatif

Maize crops experiencing water stress can experience cell damage, loss of turgor, closed stomata, plant leaf roll then wilt. Germination and vegetative growth are thought to be a very sensitive phases in relation to the availability of water, because it can influence subsequent growth processes. This study aimed to determine the potential tolerance of Southeast Sulawesi\u27s maize genotypes to drought stress at different vegetative growth phases. This study was based on completely randomized design (CRD) with factorial pattern consisting of two factors: the first factor composed of 9 local maize genotypes of Southeast Sulawesi and 1 national variety (cv. Arjuna), while the second factor was drought stress at different vegetative growth phases, consisting of four levels ie: C0 = plants irrigated with 100 % water availability during the growth phase, C1 = Stress for 5 days , at 21-26 days old (vegetative phase), C2 = Stress for 5 days starting at panicle emergence (early flowering stage), and C3 = Stress for 5 days starting 2 weeks after silking. Research results showed that Genotype (G) treatment significantly influenced all observed growth variables (at age 21 and 42 days after planting, DAP), except for the variable of number of leaf, age 21 DAP. However, water stress treatment (C) only significantly affected plant height variable, at the age of 42 DAP. In general, G6 and G7 genotypes tended to have a higher crop and trunk diameter than the other genotypes. Contrary, G3 genotype tended to have shorter crop and smaller stem diameter than the other genotypes. There are indications that the drought stress treatment (C) significantly inhibited the growth of maize crops