Empresa Familiar en Economías en Transición: Un Estudio Exploratorio de la Empresa Privada

This paper aims to explore the background of transition economies observing the new phenomenon of private enterprise in the Republic of Cuba and franchising in Venezuela. We provide an outline of the changes expected in this former central-planned economies, the key traits that might rise on the aftermath of the transition, the current state of private enterprise in Cuba. We suggest how franchising could be a solution to develop a strong entrepreneurial families in transition economies with future suggestions for researchEste documento tiene como objetivo explorar los antecedentes de las economías en transición observando el nuevo fenómeno de la empresa privada en la República de Cuba y las franquicias en Venezuela. Proporcionamos un resumen de los cambios esperados en estas antiguas economías de planificación centralizada, los rasgos clave que podrían surgir a raíz de la transición, el estado actual de la empresa privada en Cuba. Sugerimos cómo la franquicia podría ser una solución para desarrollar familias emprendedoras fuertes en economías en transición con futuras sugerencias para la investigació

Phygital: un nuevo modo de entrada en retail y en franquicias

Phygital retail is an experience that blends the virtual with the physical world extending the boundaries of the physical store. In Phygital retail, traditional, and digital firms coincide in a physical context that transforms the discovery process of goods and services into an adventure filled with hedonic and theatrical experiences. Consumers are seeking these types of experiences similar as being in a video game where artificial intelligence blends with role playing where the consumer is the center of the experience. These new marketplaces are being developed in high traffic cities where young consumers seek to experience brands in new ways. Digital native brands as well as traditional ones have been implementing this alternative mode of entry and being a new phenomenon, it has not taken the attention of scholars. Motivated by this research gap, this paper aims to explore the application of the phygital retail by observing the case of Neighborhood Goods in United States and WOW Concept in Spain. This paper presents an exploratory view of phygital retail and provides future lines of research of the phenomena. It will contribute to starting the academic conversation toward these new phenomena in retail as consumers are expanding the boundaries of the physical store format.Phygital retail es una experiencia que mezcla el mundo virtual con el físico, al extender las fronteras de la tienda física. En phygital retail, las firmas digitales y tradicionales coinciden en un entorno físico que transforma el proceso de conocer sobre los productos y servicios en una aventura llena de experiencias hedónicas y teatrales. Los consumidores buscan este tipo de experiencia, en donde se sienten que están en un juego de vídeo que integra la inteligencia artificial y el juego de roles, en donde el consumidor es el centro de la experiencia. Estos nuevos marketplaces están siendo desarrollados en ciudades con un alto tráfico, en donde los consumidores jóvenes buscan nuevas formas de interactuar con las marcas. Marcas nativas digitales, al igual que las tradicionales, han estado implementando este modo alterno de entrada, el cual, por ser de aplicación reciente, no ha sido observado aún por investigadores. Motivados por esta limitación en la literatura, este artículo aspira a explorar la aplicación de phygital retail mediante un análisis de caso de la empresa Neighborhood Goods, en los Estados Unidos, y WOW Concept, en España. Este artículo presenta una mirada exploratoria al phygital retail y provee nuevas líneas de investigación sobre el fenómeno. El artículo contribuye a comenzar la conversación sobre este nuevo fenómeno en retail, en donde los consumidores expanden las fronteras del formato físico tradicional

Phygital: un nuevo modo de entrada en retail y en franquicias

Phygital retail is an experience that blends the virtual with the physical world extending the boundaries of the physical store. In Phygital retail, traditional, and digital firms coincide in a physical context that transforms the discovery process of goods and services into an adventure filled with hedonic and theatrical experiences. Consumers are seeking these types of experiences similar as being in a video game where artificial intelligence blends with role playing where the consumer is the center of the experience. These new marketplaces are being developed in high traffic cities where young consumers seek to experience brands in new ways. Digital native brands as well as traditional ones have been implementing this alternative mode of entry and being a new phenomenon, it has not taken the attention of scholars. Motivated by this research gap, this paper aims to explore the application of the phygital retail by observing the case of Neighborhood Goods in United States and WOW Concept in Spain. This paper presents an exploratory view of phygital retail and provides future lines of research of the phenomena. It will contribute to starting the academic conversation toward these new phenomena in retail as consumers are expanding the boundaries of the physical store format.Phygital retail es una experiencia que mezcla el mundo virtual con el físico, al extender las fronteras de la tienda física. En phygital retail, las firmas digitales y tradicionales coinciden en un entorno físico que transforma el proceso de conocer sobre los productos y servicios en una aventura llena de experiencias hedónicas y teatrales. Los consumidores buscan este tipo de experiencia, en donde se sienten que están en un juego de vídeo que integra la inteligencia artificial y el juego de roles, en donde el consumidor es el centro de la experiencia. Estos nuevos marketplaces están siendo desarrollados en ciudades con un alto tráfico, en donde los consumidores jóvenes buscan nuevas formas de interactuar con las marcas. Marcas nativas digitales, al igual que las tradicionales, han estado implementando este modo alterno de entrada, el cual, por ser de aplicación reciente, no ha sido observado aún por investigadores. Motivados por esta limitación en la literatura, este artículo aspira a explorar la aplicación de phygital retail mediante un análisis de caso de la empresa Neighborhood Goods, en los Estados Unidos, y WOW Concept, en España. Este artículo presenta una mirada exploratoria al phygital retail y provee nuevas líneas de investigación sobre el fenómeno. El artículo contribuye a comenzar la conversación sobre este nuevo fenómeno en retail, en donde los consumidores expanden las fronteras del formato físico tradicional

Cabbage and fermented vegetables : From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19

Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT(1)R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT(1)R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.Peer reviewe

Nrf2-interacting nutrients and COVID-19 : time for research to develop adaptation strategies

There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPAR gamma:Peroxisome proliferator-activated receptor, NF kappa B: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2 alpha:Elongation initiation factor 2 alpha). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT(1)R axis (AT(1)R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Colombian consensus recommendations for diagnosis, management and treatment of the infection by SARS-COV-2/ COVID-19 in health care facilities - Recommendations from expert´s group based and informed on evidence

La Asociación Colombiana de Infectología (ACIN) y el Instituto de Evaluación de Nuevas Tecnologías de la Salud (IETS) conformó un grupo de trabajo para desarrollar recomendaciones informadas y basadas en evidencia, por consenso de expertos para la atención, diagnóstico y manejo de casos de Covid 19. Estas guías son dirigidas al personal de salud y buscar dar recomendaciones en los ámbitos de la atención en salud de los casos de Covid-19, en el contexto nacional de Colombia

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

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat