Estudio de la interrelación entre el eco-diseño y la eco-innovación e identificación de aspectos clave en la innovación sostenible en un sector industrial: aplicación al sector del automóvil

El respeto al medioambiente está calando en la sociedad moderna a todos los niveles. Los ciudadanos, las instituciones públicas y también las empresas son conscientes del papel que desempeñan en la protección del entorno. Este trabajo busca profundizar en los conceptos relacionados con el medioambiente que afectan a las decisiones que las empresas toman en el día a día. Por la relación de la autora con el sector del automóvil, en el que he desarrollado mi actividad profesional desde el año 1999, la aplicación empírica se ha realizado en esta industria, con el objetivo principal de identificar los aspectos sobre los que se debe indicir para potenciar las actuaciones mediomentalmente proactivas. Como actividades clave para el sector se ha analizado en profundidad el diseño y la innovación, que, al incluir el enfoque sostenible, se estudian en la tesis como ecodiseño y ecoinnovación. Así, en primer lugar se realiza una revision bibliográfica sobre el ecodiseño, los beneficios que se derivan para las empresas al considerar la mejora medioambiental a través del mismo, los que se derivan de la actitud proactiva y de su implementación también se identifican, como, por ejemplo, la mejora de la posición competitiva, la reducción de costes, la mejora de la imagen de la empresa o el desarrollo de nuevos productos En esta primera parte se identifica también el principal obstáculo que las empresas encuentran, que se resume en la falta de incentivos y de apoyo para que las empresas puedan potenciar e implementar las actuaciones de ecodiseño. En el segundo estudio, se analizaron las acciones concretas que una empresa automotriz líder como Faurecia ha desarrollado en los últimos años. A través del estudio de este caso de manera profunda, se presenta la información recogida mediante entrevistas con expertos en ecodiseño del grupo Faurecia. Los resultados observados a nivel particular en Faurecia se refuerzan por los resultados empíricos realizados sobre empresas pertenecientes al sector que muestran que la orientación ambiental está influenciada, principalmente, por las características de la empresa. Para las empresas de automoción españolas, el estudio detectó que la proactividad ambiental al innovar viene determinada, principalmente, por el tamaño de las empresas, medido por las variables: ingreso total, inversión total, cantidad de inversión en I+D y el número deempleados en I+D y también, aunque menos, por la actividad formal en I+D (número de patentes) y la orientación de exportadora de la empresa. Así, las grandes empresas con mayor número de patentes y con presencia internacional son más propensas a ser medioambientalmente activas en actividades de ecodiseño y ecoinnovación y que son este tipo de empresas las que lideran la actividad y la orientación medioambiental en el sector del automóvil español. Por otra parte, aunque la reducción en el uso de la energía y de material también se han relacionado con la ecoinnovación ambiental, están muy influenciados por otras variables como el rendimiento económico, la estructura de costes o su situación financiera, por lo que no se pudo concluir nada al respecto. La investigación prosiguió explorando las características específicas de la industria automotriz frente al eco diseño y otras cuestiones ambientales relacionadas. Así, el siguiente artículo que conforma esta tesis doctoral, se planteó con el propósito de identificar los impulsores de la orientación ambiental de las empresas del sector del automóvil. En concreto, se analizó la importancia de la tipología de las fuentes de información procedentes del entorno (denominadas ¿de mercado¿; proveedores, clientes, competidores y consultores externos) para orientar eficazmente mejoras de productos y procesos como factores claves para determinar la orientación ambiental de las empresas del sector. Utilizando el paquete de software SmartPLS 2.0, el modelo de medición fue confirmado con suficiente fiabilidad y validez para todas las hipótesis. Además, el modelo estructural demostró que todos los coeficientes de la ruta fueron estadísticamente significativos. Los resultados de nuestro estudio, consistentes con trabajos previos, destacan cómo las actividades de eco-innovación están positivamente relacionadas con la innovación. Las empresas que se centran en productos y procesos cuando innovan son más eco-innovadoras que el resto. La consistencia de los resultados sugiere que las compañías que buscan, por una parte, una mayor flexibilidad operativa, aumentar la capacidad de producción, reducir los costes laborales unitarios o reducir el consumo energético por unidad cuando están buscando innovaciones están también más dispuestas a adoptar una orientación ambiental y, por otra, las empresas que se centran en el desarrollo de nuevos productos, en aumentar o sustituir la gama de productos, en aumentar la calidad del producto o en alcanzar una mayor cuota de mercado o nuevos mercados, son también más propensas a ser medioambientalmente más proactivas.Paya Martinez, A. (2013). Estudio de la interrelación entre el eco-diseño y la eco-innovación e identificación de aspectos clave en la innovación sostenible en un sector industrial: aplicación al sector del automóvil [Tesis doctoral no publicada]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/32830TESI

A Review Of The Literature On Eco-Design In Manufacturing Industry: Are The Institutions Focusing On The Key Aspects?

[EN] The aim of this paper is to review the most important literature in relation to the special characteristics of the eco design as part of the innovation portfolio of companies. Eco design is a methodology that takes into account the environmental condition of products from conception. More than a half of the impacts can be prevented from the design process so that throughout their life circle are less harmful to the environment. As a methodology that integrates environmental criteria in the design of products and services, managing the environmental innovation through eco-design has to be considered as part of the strategic definition of both, companies and Public Agencies. We pretend to analyze literature related to eco-design in companies and the way policy makers are pretending to reinforce sustainable attitude at the industrial sector. The main objective of this paper is to uncover if there is any relation between what literature indicates companies are doing and what public administration are pretending with its industrial policies, to see if institutions are focusing on their industrial policies and check if they are covering the key.The authors acknowledge the financial aid received from the Spanish Ministry of Science and Innovation through project reference no. EC02008-05895-C02-01/ECON and from the PAID-06-2011 of the Universidad Politécnica the Valencia, that also funded a sabbatical research 2011-2012 course of M. Segarra.Segarra Oña, MDV.; De-Miguel-Molina, M.; Paya Martinez, A. (2011). A Review Of The Literature On Eco-Design In Manufacturing Industry: Are The Institutions Focusing On The Key Aspects?. Review of Business Information Systems. 15(5):61-68. doi:10.19030/rbis.v15i5.6028S616815

Evidence for classification of c.1852_1853AA>GC in MLH1 as a neutral variant for Lynch syndrome

Background: Lynch syndrome (LS) is an autosomal dominant inherited cancer syndrome characterized by early onset cancers of the colorectum, endometrium and other tumours. A significant proportion of DNA variants in LS patients are unclassified. Reports on the pathogenicity of the c.1852_1853AA>GC (p.Lys618Ala) variant of the MLH1 gene are conflicting. In this study, we provide new evidence indicating that this variant has no significant implications for LS. Methods: The following approach was used to assess the clinical significance of the p.Lys618Ala variant: frequency in a control population, case-control comparison, co-occurrence of the p.Lys618Ala variant with a pathogenic mutation, co-segregation with the disease and microsatellite instability in tumours from carriers of the variant. We genotyped p.Lys618Ala in 1034 individuals (373 sporadic colorectal cancer [CRC] patients, 250 index subjects from families suspected of having LS [revised Bethesda guidelines] and 411 controls). Three well-characterized LS families that fulfilled the Amsterdam II Criteria and consisted of members with the p.Lys618Ala variant were included to assess co-occurrence and co-segregation. A subset of colorectal tumour DNA samples from 17 patients carrying the p.Lys618Ala variant was screened for microsatellite instability using five mononucleotide markers. Results: Twenty-seven individuals were heterozygous for the p.Lys618Ala variant; nine had sporadic CRC (2.41%), seven were suspected of having hereditary CRC (2.8%) and 11 were controls (2.68%). There were no significant associations in the case-control and case-case studies. The p.Lys618Ala variant was co-existent with pathogenic mutations in two unrelated LS families. In one family, the allele distribution of the pathogenic and unclassified variant was in trans, in the other family the pathogenic variant was detected in the MSH6 gene and only the deleterious variant co-segregated with the disease in both families. Only two positive cases of microsatellite instability (2/17, 11.8%) were detected in tumours from p.Lys618Ala carriers, indicating that this variant does not play a role in functional inactivation of MLH1 in CRC patients. Conclusions: The p.Lys618Ala variant should be considered a neutral variant for LS. These findings have implications for the clinical management of CRC probands and their relatives.Generalitat Valenciana in Spain (AP140/08) and the Biomedical Research Foundation from the Hospital of Elche, Spain (FIBElx0902). Conselleria de Educació (Generalitat Valenciana); Fundacion Juan Peran-Pikolinos; Fundacion Carolina-BBVA and Fondo Investigación Sanitaria (FI07/00303). Instituto de Salud Carlos III (INT09/208)

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Effectiveness of family metacognitive training in mothers with psychosis and their adolescent children : a multicenter study protocol

More than half of women with psychosis take care of their children despite the difficulties caused by the disease. Additionally, these kids have a higher risk of developing a mental health disorder. However, no interventions have been developed to meet these needs. Metacognitive Training (MCT) is a psychological intervention that has demonstrated its efficacy in improving cognitive insight, symptom management and social cognition in people with first-episode psychosis (FEP). Additionally, MCT has shown better results in women than men with FEP. This study aims to adapt and evaluate the efficacy of MCT-F in mothers and adolescent children in an online group context with the main purpose of improving family relationships, cognitive awareness and symptoms in women with psychosis and increase their children's knowledge of the disease and their functioning. As secondary objectives, it also aims to evaluate improvements in metacognition, social cognition, symptoms, protective factors and self-perception of stigma. A quasi-experimental design with participants acting as their own control will be carried out. Forty-eight mothers with psychosis and their adolescent children (between 12 and 20 years old) recruited from a total of 11 adult mental health care centers will receive MCT-F. Participants will be evaluated 11 weeks before the intervention (T1), at baseline (T2), and post-intervention (T3) with a cognitive insight scale, as a primary outcome. Measures of metacognitive and social cognition, symptoms, cognitive functioning, family and social functioning, protective factors (self-esteem, resilience, and coping strategies) and self-perceived stigma will be addressed as secondary outcomes. Assessment will also address trauma and attachment in mothers and, lastly, the feasibility and acceptability of MCT-F in both participant groups. This will be the first investigation of the efficacy, acceptability, and viability of the implementation of MCT-F. The results of this study may have clinical implications, contributing to improving mothers' with psychosis and adolescents' functioning and better understanding of the disease, in addition to the possible protective and preventive effect in adolescents, who are known to be at higher risk of developing severe mental disorders. Clinical trial registration: , identifier [NCT05358457]

Patterns of sedentary behavior in overweight and moderately obese users of the Catalan primary-health care system

Prolonged sitting time (ST) has negative consequences on health. Changing this behavior is paramount in overweight/obese individuals because they are more sedentary than those with normal weight. The aim of the study was to establish the pattern of sedentary behavior and its relationship to health, socio-demographics, occupation, and education level in Catalan overweight/obese individuals.A descriptive study was performed at 25 healthcare centers in Catalonia (Spain) with 464 overweight/moderately obese patients, aged25 to 65 years. Exclusion criteria were chronic diseases which contraindicated physical activity and language barriers. Face-to-face interviews were conducted to collect data on age, gender, educational level, social class, and marital status. Main outcome was 'sitting time' (collected by the Marshall questionnaire); chronic diseases and anthropometric measurements were registered.464 patients, 58.4% women, mean age 51.9 years (SD 10.1), 76.1% married, 60% manual workers, and 48.7% had finished secondary education. Daily sitting time was 6.2 hours on working days (374 minutes/day, SD: 190), and about 6 hours on non-working ones (357 minutes/day, SD: 170). 50% of participants were sedentary ≥6 hours. The most frequent sedentary activities were: working/academic activities around 2 hours (128 minutes, SD: 183), followed by watching television, computer use, and commuting. Men sat longer than women (64 minutes more on working days and 54 minutes on non-working days), and individuals with office jobs (91 minutes),those with higher levels of education (42 minutes), and younger subjects (25 to 35 years) spent more time sitting.In our study performed in overweight/moderately obese patients the mean sitting time was around 6 hours which was mainly spent doing work/academic activities and watching television. Men, office workers, individuals with higher education, and younger subjects had longer sitting time. Our results may help design interventions targeted at these sedentary patients to decrease sitting time

Development of a prediction model for postoperative pneumonia A multicentre prospective observational study

BACKGROUND Postoperative pneumonia is associated with increased morbidity, mortality and costs. Prediction models of pneumonia that are currently available are based on retrospectively collected data and administrative coding systems. OBJECTIVE To identify independent variables associated with the occurrence of postoperative pneumonia. DESIGN A prospective observational study of a multicentre cohort (Prospective Evaluation of a RIsk Score for postoperative pulmonary COmPlications in Europe database). SETTING Sixty-three hospitals in Europe. PATIENTS Patients undergoing surgery under general and/or regional anaesthesia during a 7-day recruitment period. MAIN OUTCOME MEASURE The primary outcome was postoperative pneumonia. Definition: the need for treatment with antibiotics for a respiratory infection and at least one of the following criteria: new or changed sputum; new or changed lung opacities on a clinically indicated chest radiograph; temperature more than 38.3 degrees C; leucocyte count more than 12 000 mu l(-1). RESULTS Postoperative pneumonia occurred in 120 out of 5094 patients (2.4%). Eighty-two of the 120 (68.3%) patients with pneumonia required ICU admission, compared with 399 of the 4974 (8.0%) without pneumonia (P < 0.001). We identified five variables independently associated with postoperative pneumonia: functional status [odds ratio (OR) 2.28, 95% confidence interval (CI) 1.58 to 3.12], pre-operative SpO(2) values while breathing room air (OR 0.83, 95% CI 0.78 to 0.84), intra-operative colloid administration (OR 2.97, 95% CI 1.94 to 3.99), intra-operative blood transfusion (OR 2.19, 95% CI 1.41 to 4.71) and surgical site (open upper abdominal surgery OR 3.98, 95% CI 2.19 to 7.59). The model had good discrimination (c-statistic 0.89) and calibration (Hosmer-Lemeshow P = 0.572). CONCLUSION We identified five variables independently associated with postoperative pneumonia. The model performed well and after external validation may be used for risk stratification and management of patients at risk of postoperative pneumonia

Cardiac myosin activation with omecamtiv mecarbil in systolic heart failure

BACKGROUND The selective cardiac myosin activator omecamtiv mecarbil has been shown to improve cardiac function in patients with heart failure with a reduced ejection fraction. Its effect on cardiovascular outcomes is unknown. METHODS We randomly assigned 8256 patients (inpatients and outpatients) with symptomatic chronic heart failure and an ejection fraction of 35% or less to receive omecamtiv mecarbil (using pharmacokinetic-guided doses of 25 mg, 37.5 mg, or 50 mg twice daily) or placebo, in addition to standard heart-failure therapy. The primary outcome was a composite of a first heart-failure event (hospitalization or urgent visit for heart failure) or death from cardiovascular causes. RESULTS During a median of 21.8 months, a primary-outcome event occurred in 1523 of 4120 patients (37.0%) in the omecamtiv mecarbil group and in 1607 of 4112 patients (39.1%) in the placebo group (hazard ratio, 0.92; 95% confidence interval [CI], 0.86 to 0.99; P = 0.03). A total of 808 patients (19.6%) and 798 patients (19.4%), respectively, died from cardiovascular causes (hazard ratio, 1.01; 95% CI, 0.92 to 1.11). There was no significant difference between groups in the change from baseline on the Kansas City Cardiomyopathy Questionnaire total symptom score. At week 24, the change from baseline for the median N-terminal pro-B-type natriuretic peptide level was 10% lower in the omecamtiv mecarbil group than in the placebo group; the median cardiac troponin I level was 4 ng per liter higher. The frequency of cardiac ischemic and ventricular arrhythmia events was similar in the two groups. CONCLUSIONS Among patients with heart failure and a reduced ejection, those who received omecamtiv mecarbil had a lower incidence of a composite of a heart-failure event or death from cardiovascular causes than those who received placebo. (Funded by Amgen and others; GALACTIC-HF ClinicalTrials.gov number, NCT02929329; EudraCT number, 2016 -002299-28.)