International Alliance Strategies: A Case Study of the Indonesian Medical Device Industry

This study aims to investigate how the multinational corporations form alliance strategies with local businesses under the dynamic institutional environment in the Indonesian context. We used a qualitative approach with a case study of the medical device industry to examine how the institutional environment affects the choice of the strategic alliance. By collecting the qualitative data, including interviews, observations and archival data, the interpretive approach was adopted to understand social worlds from the point of view of participants. We identified five types of alliance strategies: the wholly owned subsidiary with contractual collaboration, the wholly owned subsidiary with the licence agreement, the international trade with the licence agreement, joint venture and outsourcing. There are also two main issues of the institutional environments that determine the choice of alliance strategic: the restriction for foreign companies to carry out direct selling and the new policy that introduces the electronic procurement system. This study provides evidence of the role of the institutional environment on collaboration strategies between the multinational enterprises from the developed countries and the local distributors from Indonesia. The results extend the concept of international business in the Asian context

Intestinal Oxygenotherapy of Critical Conditions

The latent or mist diagnosed dysfunction of the small intestine is a common disorder in critically ill patients. Intestinal oxygenotherapy is one of the alternative ways to normalize the coordinated activity of the smooth muscles of the digestive tract.Purpose of the study. To determine the effect of intestinal oxygenotherapy in patients with enteropathies of critical conditions on the dynamics of biomarkers of the intestinal wall permeability and ischemia.Materials and methods. An open prospective descriptive study of 12 critically ill patients (7 adults, 5 children) with multiple organ failure and evident or saspected dysfunction of the gastrointestinal tract. Pediatric patients included children with congenital heart disease who underwent open-heart surgery for the purpose of radical or palliative correction.Results. Complications related to the intestinal oxygenotherapy were not observed. On the contrary, its use in children coincided with the positive clinical dynamics: elimination of intestinal paresis, normalization of digestion of enteral nutrition. However, it is difficult to interpret the results unambiguously. Serum citrulline concentration in children is an objective marker of the functional state of the gastrointestinal tract: in the vast majority of the control points its level was <20 μmol/l; it means a very severe intestinal damage. Serum I-FABP concentration was<100 pg/ml in a significant number of control points, which, by contrast, does not allow to talk about the intestinal wall severe ischemic disturbances. In adults, the initial serum citrulline concentration was <20 μmol/l in the vast majority of control points; but by days 5—6 after the onset of intestinal oxygenation, in the majority of patients the citrulline levels exceeded >20 μmol/l (up to 80 μmol/l). No correlation between serum citrulline and I-FABP concentrations in adults was found.Conclusion. Intestinal oxygenotherapy is a promising therapeutic technique for prevention and correction of enteropathies. The method may appear especially effective in treatment of anaerobic (i.e. Cl. defficile-assosiated colitis) infection. The diagnostic value of plasma citrulline and I-FABP concentrations needs further confirmation

ROLE OF THE NOTCH1 GENE IN FORMATION OF AORTIC ANEURYSM

Aim. To evaluate the impact of genetics in development of thoracic aneurysm in patients with tricuspid valve (TAV) and bicuspid aortic valve (BAV) based on the analysis and search for mutations in NOTCH1.Material and methods. In the study, 60 patients included with the dilation of thoracic aorta more than 40 mm and 200 patients with no aortic pathology, included in the comparison group. All patients underwent echocardiographic assessment on Vivid 7 (GE, USA) equipment, by standard protocol. For molecular genetics we utilized the strategy of targeted mutation screening, including the analysis of 10 of 34 exones of the gene NOTCH1, performed with the direct sequencing.Results. Patients with BAV were younger than those with no inborn defect. Arterial hypertension was verified only in every second BAV patient. Also, maximal rates of blood pressure were significantly lower in patients with inborn defects (р<0,02). As a result of genetic analysis in the studied group, in 9 patients with inborn defect and 2 patients with TAV there were 10 variants found of aminoacid replacement in 6 among 10 analyzed exones, of those 5 replacements — synonimic, and the mutation S2449R was found first time. Mutations P1227S, E1305K, R1279H and D1267N were found at the site of Notch1 protein binding with DLL4, of those 3 are highly pathogenic, that could influence the protein-protein interactions Notch1 with DLL4 leading to formation on aneurysm.Conclusion. Mutations P1227S D1267, E1305K in the gene NOTCH1, being highly pathogenic, may lead to the changes of protein functioning via Notch signalling disorder, that is more characteristic for BAV patients

Variants of RBM20 gene in pediatric patients with dilated cardiomyopathy

Aim. Description of three clinical cases of pediatric patients with dilated cardiomyopathy (DCMP) and an analysis of their genetic causes.Material and methods. Using the method of targeted sequencing, data were obtained on the presence of pathogenic variants of the RBM20 gene in three pediatric patients with DCMP.Results. Three cases of childhood DCMP development, associated with structural disorders in the RBM20 gene, are particularly described. It is known that RBM20 is involved in the splicing of mRNA of the TTN gene encoding the titin protein. A splicing disorder associated with pathogenic variants in the RBM20 gene can lead to a change in biomechanical and signaling processes in myocardial cells, causing pathological dilated remodeling and rhythm disorders.Conclusion. Variants in the RBM20 gene are associated with severe DCMP with a childhood debut. In some cases, the progression of RBM20-associated cardiomyopathies is associated with an infectious disease. Further study of the molecular mechanisms of the pathogenesis of DCMP associated with pathogenic variants in the TTN and RBM20 genes is extremely relevant for both clinical cardiology and fundamental medicine

Personal brand equity:Scale development and validation

Crafting a personal brand has become an important factor for career success. Despite the growing literature on topics associated with personal brands, the conceptualization and measurement of personal brand equity (PBE) have received little attention. By drawing upon and integrating the marketing and careers literatures on branding, we reconceptualized the definition of PBE and delineated its dimensions and conceptual boundaries. Furthermore, we developed a 12-item scale to measure PBE. Among seven different samples (total N = 3,273), including two samples of employees, this study tested the construct and criterion-related validity of the PBE scale. First, exploratory and confirmatory factor analyses supported a three-dimensional structure of PBE (brand appeal, brand differentiation, and brand recognition). In two samples, the convergent and discriminant validity of the PBE scale was established. Finally, this study showed that PBE predicts perceived employability, career success, and job performance. The PBE scale offers new opportunities to understand and measure career behaviors by considering individuals’ personal brand positioning