Search

PurposeThe purpose of this study is to focus on analyzing how the set of green intangibles held by wineries and their members, i.e. green intellectual capital (GIC), affects green innovation performance (GIP). Specifically, the study aims to investigate how GIP is influenced by GIC through the mediating role of the variable knowledge management (KM) and corporate social responsibility (CSR).Design/methodology/approachThe study proposes a conceptual model, based on previous studies, which is tested through structural equations (PLS-SEM) with data collected from 202 Spanish wineries.FindingsThe results of the research indicate that there is a positive and significant relationship between GIC and GIP. Furthermore, CSR and KM partially mediate the relationship between these two variables, playing a key role in the environmental management of wineries.Originality/valueThe present research, therefore, contributes to the literature in several ways. First, the study advances the understanding of GIC as well as its link with GIP. Second, the research aims to fill the gap in the literature through the study of CSR and KM as mediating variables in such a link. Third, to the best of the authors’ knowledge, the model proposed has not been previously addressed in the academic literature, thus representing an advance in scientific knowledge. Fourthly, no research has addressed the study of environmental intangibles in the wine industry, with this research, therefore, being a pioneer in contextualizing the study of GIC in this increasingly knowledge-intensive industry.

PurposeThis research focuses on analysing the effect of wine tourism on green product and process innovations developed by Spanish wineries. In addition, age, size and membership in a protected designation of origin (PDO) are introduced as control variables to increase the precision of the cause–effect relationship analysed.Design/methodology/approachThe study proposes a conceptual model based on previous studies, which is tested using structural equations (partial least squares structural equation modelling [PLS-SEM]) with data collected from 202 Spanish wineries.FindingsThe research results show that wine tourism activity has a positive and significant influence on green product and process innovation.Originality/valueThe research contributes to the academic literature in several ways. First, the study advances knowledge and understanding of the benefits generated by wine tourism. Second, the research contributes to the literature that analyses the wine tourism–sustainability link, since it is predicted that this type of tourism can increase the capacity for green innovation. Third, to the best of the authors’ knowledge, there is no previous research that has analysed wine tourism as a catalytic variable for green innovation. Fourth, the proposed theoretical model has not been previously addressed in the academic literature, so the study represents an important advance in scientific knowledge.

PurposeThe research focuses on analysing the effect of wine tourism (WT) on the green performance (GP) of Spanish wineries, as well as the mediating role of green intellectual capital (GIC) and the moderating effect of circular economy practices (CEPs) developed by wineries in this main relationship. In addition, age, size and protected designation of origin (PDO) membership are introduced as control variables to increase the precision of the cause–effect relationships analysed.Design/methodology/approachA conceptual model is proposed through the literature review carried out and then verified through structural equation modelling (PLS-SEM) based on data obtained from a survey of 202 Spanish wineries between September 2021 and January 2022.FindingsThe results of the study show that WT activity has a positive and significant effect on the GP of wineries, also demonstrating the mediating effect of GIC and the moderating role of CEPs in this relationship.Originality/valueThe study contributes to the academic literature in several ways. First, to the best of our knowledge, no previous study has addressed the impact of WT on the set of wineries' ecological intangibles. Second, to the authors’ knowledge, no previous study has analysed the mediating effect of GIC on the WT-GP relationship. Third, there is no previous attempt to deal with the moderating role of CEPs in the main relationship under analysis. Fourth, the proposed theoretical model has not been previously addressed in the academic literature.

Resumen Introduccion Los resultados de la reparacion de la hernia paraestomal (HP) basados en datos provenientes de registros son escasos. El objetivo del presente trabajo es analizar los datos recogidos sobre la HP en el Registro Nacional de Hernia Incisional (EVEREG) y asi evaluar las practicas actuales y resultados en la reparacion de una HP. Metodos Se analizan los datos de la cohorte de HP registradas en el periodo desde julio de 2012 hasta junio de 2018. Se analizan las complicaciones, recidivas y factores asociados a ellas de la cohorte completa de HP, independientemente del tipo de estoma al que se asocian. Posteriormente, se realiza el mismo analisis del grupo de HP con relacion a una colostomia (grupo mas numeroso). Resultados Se estudiaron 353 HP. De estas, 259 (73%) fueron HP en el contexto de una colostomia terminal, 74 (21%) en el de una ileostomia terminal y 20 (6%) en el de una ureteroileostomia (Bricker). La edad media global fue de 68,7 ± 11,1 anos y 135 (38%) pacientes fueron del sexo femenino. El abordaje abierto y la cirugia electiva fueron predominantes (78% y 92%, respectivamente). El 99% se reparo con una malla sintetica no absorbible. Las complicaciones postoperatorias globales fueron altas (30,6%), asi como la recurrencia global (27,5%) tras un seguimiento medio de 9,4 meses. Conclusiones La reparacion de la HP es poco frecuente comparada con el conjunto de reparaciones de la hernia incisional. La cirugia de la HP parece relacionarse con un porcentaje elevado de complicaciones postoperatorias y recidiva.

Objetivos: La lesión del nervio laríngeo recurrente es una grave complicación en cirugía tiroidea. El propósito del presente estudio es analizar la utilizad de la neuromonitorización vagal continua intraoperatoria en un hospital terciario.Material y métodos: Estudio observacional, analítico y retrospectivo que recoge pacientes intervenidos de cirugía tiroidea con neuromonitorización en un periodo de 14 meses. La pérdida de señal se define como amplitud final nerviosa < 100 µV, realizándose laringoscopia postquirúrgica ante la sospecha de lesión nerviosa. El análisis estadístico se realizó con el programa SPSS® V25,0, con p < 0,05.Resultados: Se incluyeron 120 pacientes intervenidos, registrándose en el 24,2 % pérdida de señal. Factores de riesgo para lesión fueron bocio intratorácico (OR 5,31; IC 95 % 1,56 – 17,99; p = 0,007), cirugía cervical previa (OR 5,76; IC 95 % 0,64 – 51,97; p = 0,119) y patología maligna (OR 1,44; IC 95 % 0,16 – 12,79; p = 0,743). Fue posible el cambio de estrategia quirúrgica en 7 casos. En el seguimiento posterior se cuantificó parálisis recurrencial transitoria en 27 pacientes y permanente en 4.Discusión: La neuromonitorización parece reducir la incidencia de parálisis laríngea porque aumenta la seguridad en la identificación del nervio recurrente y reduce su manipulación durante la cirugía.Conclusiones: La neuromonitorización intraoperatoria es útil para identificar el nervio laríngeo recurrente y advierte del riesgo potencial de lesión, permitiendo cambiar la estrategia quirúrgica para evitar la parálisis bilateral de cuerdas vocales.

PurposeThis study aims to analyze the relationships between knowledge management, internationalization and ambidexterity, also exploring the influence of these variables on Spanish hotel chain performance. Hypotheses are proposed from the dynamic capabilities and knowledge-management views of the firm.Design/methodology/approachThe research model was tested on a sample of 70 Spanish hotel chains applying variance-based structural equation modeling (partial least squares).FindingsThe results show that Spanish hotel chains that use knowledge management processes achieve a greater degree of internationalization and this increases their organizational ambidexterity. This study can also confirm a direct, positive and significant relationship between organizational ambidexterity and performance.Research limitations/implicationsThis research shows that knowledge may be considered an essential resource to improve hotel firms’ results. Spanish hotel firms should manage their knowledge to stimulate international activity because this could enhance learning capabilities related to organizational ambidexterity and positively influence performance.Originality/valueThe present paper analyzes relationships between variables that had not previously been analyzed in a single model, including knowledge management, the degree of internationalization of hotel chains, ambidexterity and performance.

Knowledge is a basic factor of competitiveness with a firm’s exploration and exploitation capabilities acting as the main antecedents of innovation. However, a firm has two main options to obtain new knowledge: internal generation and external acquisition. This paper analyzes how tourism firms located in tourist districts develop ambidexterity through the combination of co-exploration and co-exploitation. Specifically, we study how the features that characterize a tourist district, such as the level of firm and institutional agglomeration, affect the development of co-exploration and co-exploitation capabilities, taking into account the mediation effect of social capital. The population under study includes all the Spanish hotels located in Spanish coastal towns, making a total sample of 210 establishments. The results confirm that agglomeration has a positive impact on the ambidexterity of Spanish hotels. Moreover, the results show that agglomeration causes an increase of social capital in hotels, and that social capital has a positive impact on ambidexterity. We find that social capital partially mediates the effect of agglomeration on ambidexterity. Some implications for managers and policymakers are presented.

Background In a previous study, we found that Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) overpredicts morbidity risk in emergency gastrointestinal surgery. Our aim was to find a POSSUM equation adjustment. Methods A prospective observational study was performed on 2,361 patients presenting with a community-acquired gastrointestinal surgical emergency. The first 1,000 surgeries constituted the development cohort, the second 1,000 events were the first validation intramural cohort, and the remaining 361 cases belonged to a second validation extramural cohort. Results (1) A modified POSSUM equation was obtained. (2) Logistic regression was used to yield a statistically significant equation that included age, hemoglobin, white cell count, sodium and operative severity. (3) A chi-square automatic interaction detector decision tree analysis yielded a statistically significant equation with 4 variables, namely cardiac failure, sodium, operative severity, and peritoneal soiling. Conclusions A modified POSSUM equation and a simplified scoring system (aLicante sUrgical Community Emergencies New Tool for the enUmeration of Morbidities [LUCENTUM]) are described. Both tools significantly improve prediction of surgical morbidity in community-acquired gastrointestinal surgical emergencies.

El objetivo de la investigación fue determinar la actitud que predomina frente al uso de métodos anticonceptivos en los estudiantes del 4to y 5to de secundaria de la institución educativa “Francisco Bolognesi” de Villa El Salvador, 2018. El estudio fue de tipo descriptivo, con enfoque cuantitativo, diseño no experimental y corte transversal. Se trabajó con una muestra de 83 estudiantes de 4to y 5to año de secundaria, la muestra fue seleccionada de forma no probabilística, los mismos que cumplieron con los criterios de selección y exclusión. Se recolectaron los datos con la técnica de la encuesta utilizándose como instrumento un cuestionario de escala ordinal con tres dimensiones cognitiva, afectiva y conductual, estableciéndose los niveles de medición favorable, indiferente y desfavorable, siendo el instrumento adaptado de su autor original. La confiabilidad obtuvo un valor de 0,93 lo que indicó que el instrumento es altamente confiable. Se utilizó la estadística descriptiva codificando los datos en el programa Excel 2016, los cuales fueron procesados y analizados a través del software estadístico SPSS 25 concluyéndose que la actitud que predomina frente al uso de métodos anticonceptivos fue la actitud conductual en el nivel indiferente en un 74,7 % en los estudiantes del 4to y 5to de secundaria de la institución educativa “Francisco Bolognesi” de Villa El Salvador, 2018. Lima Norte Escuela de Posgrado Evaluación y Aprendizaje

Mastocytosis comprises a heterogeneous group of disorders characterized by mast cell accumulation and proliferation in distinct organs. Kounis syndrome is defined as the concurrence of acute coronary syndromes with mast cell activation in a setting of allergic or hypersensitivity reactions. This is the first reported case of an intraoperative Kounis syndrome as the onset of an indolent systemic mastocytosis probably triggered by succinylated gelatin infusion during general anesthesia. The presentation of this case is intended to contribute to the knowledge of mastocytosis and Kounis syndrome at the time of diagnostic workup during intraoperative anaphylaxis or myocardial ischemia.

Mastocytosis comprises a heterogeneous group of disorders characterized by mast cell accumulation and proliferation in distinct organs. Kounis syndrome is defined as the concurrence of acute coronary syndromes with mast cell activation in a setting of allergic or hypersensitivity reactions. This is the first reported case of an intraoperative Kounis syndrome as the onset of an indolent systemic mastocytosis probably triggered by succinylated gelatin infusion during general anesthesia. The presentation of this case is intended to contribute to the knowledge of mastocytosis and Kounis syndrome at the time of diagnostic workup during intraoperative anaphylaxis or myocardial ischemia.

The paper analyzes how the traditional variables that define a firm’s organizational structure (formalization, complexity, and centralization) influence knowledge performance (the degree to which a firm generates knowledge and uses it to reach a competitive advantage). Three hypotheses are tested using a sample of 164 large Spanish firms. The results show that organizational complexity and centralization exert a positive and a negative influence, respectively, on knowledge performance, which confirms the two hypotheses related to these variables. However, the analysis reveals no empirical evidence to confirm the hypothesis that formalization and knowledge performance are related positively.El propósito de este trabajo es analizar cómo las variables tradicionales de la estructura organizativa (formalización, complejidad y centralización) influyen en knowledge performance, entendido éste como el grado en que una empresa genera nuevo conocimiento y lo utiliza para alcanzar una ventaja competitiva. Tras revisar la literatura, se formulan tres hipótesis que son contrastadas en una muestra de 164 grandes empresas españolas. Los resultados muestran que la complejidad y la centralización se asocian de forma positiva y negativa, respectivamente, con knowledge performance, confirmando las dos hipótesis relacionadas con estas variables. Sin embargo, no se ha encontrado evidencia empírica que confirme la hipótesis que vinculaba positivamente la formalización y knowledge performance.

The paper analyzes how the traditional variables that define a firm’s organizational structure (formalization, complexity, and centralization) influence knowledge performance (the degree to which a firm generates knowledge and uses it to reach a competitive advantage). Three hypotheses are tested using a sample of 164 large Spanish firms. The results show that organizational complexity and centralization exert a positive and a negative influence, respectively, on knowledge performance, which confirms the two hypotheses related to these variables. However, the analysis reveals no empirical evidence to confirm the hypothesis that formalization and knowledge performance are related positively.

Tomando como base diversas perspectivas teóricas y la literatura sobre la empresa familiar, este trabajo teórico tiene como objetivo mostrar, mediante un modelo conceptual, el potencial que ofrecen los intangibles que presenta este tipo de organización para hacer frente al fenómeno de la complejidad. De acuerdo con este modelo, concluimos que la empresa familiar reúne las características propias de los sistemas complejos con capacidad de adaptación. Señalamos que este tipo de organización está dotado de un conjunto de intangibles específicos, básicos para el desarrollo de capacidades dinámicas que permitan hacer frente a la complejidad del entorno. La gestión de estas capacidades desde la perspectiva de la complejidad facilita el desarrollo de procesos de auto-organización que dan como resultado innovaciones en diversos ámbitos, permitiendo la adaptación a un entorno complejo. Taking as a reference various theoretical approaches as well as the literature on the family firm, and using a conceptual model, the present theoretical paper has as its aim to show the potential offered by the intangibles present in this type of organization, which allows it to face the phenomenon of complexity. The application of this model leads us to conclude that the family firm gathers the characteristics, which are typical of complex systems with an adaptation capacity. It is highlighted in our research work that such an organisation owns a set of specific intangibles, which turn out to be essential for the development of dynamic capabilities allowing it to cope with the complexity that characterises its business environment. The management of these capabilities from a complexity perspective makes it easier to develop self-organisation processes, which give rise to innovations in a variety of fields, thus permitting the adaptation to a complex environment.

Precede al tít. : "Jesus, Maria, Joseph" Copia digital : Diputación Provincial de Zaragoza. Servicio de Archivos y Bibliotecas, 2010 Datos de tít. sacados de p.1, y mención de responsabilidad del final del texto Texto fechado en Zaragoza, en 1736 Sign.: A\p8\s

Background Most infections with human papillomavirus (HPV) are resolved without clinical intervention, but a minority evolves into chronic lesions of distinct grades, including cervical-uterine cancer. It is known that in most cases the immune system mediates elimination of HPV infection. However, the mechanism of immune evasion leading to HPV persistence and development of early cervical lesions is not fully understood. The aim of the present work was to evaluate the potential of peripheral blood leukocytes (PBL) from low-grade squamous intraepithelial lesions (LSIL) patients to be activated ex-vivo by vaccine antigens, the participation of cytotoxic lymphocytes and regulatory T cells, and to determine the secretion of Th1 and Th2 cytokines mediated by stimulation of T cell receptors. Results We found that PBL from LSIL patients showed a significantly lower proliferation rate to vaccine antigens as compared to that of healthy donors, even though there was not a difference in the presence of antibodies to those antigens in sera from both groups. We did not find differences in either the frequency of CD4 + CD25 + FoxP3+ in PBL, or the levels of IL-4, IL-5 and IL-10 in plasma or conditioned media from PBL incubated with TcR agonists in vitro, between the two groups. However, we detected a lower production of IL-2 and a higher proportion of CD8 + IFNγ + cells in PBL from LSIL patients as compared with PBL from normal donors. We also observed that PBL from patients infected by HPV-16 and −18 were not able to proliferate in the presence of soluble HPV antigens added to the culture; however, a high level of proliferation was attained when these antigens were presented by activated dendritic cells. Conclusions Our results suggest that the immunodeficiency reported in LSIL patients could be due to the inability of specific cytotoxic T lymphocytes that for some unknown reason are present but unable to mount a response when challenged with their antigens, probably related to an in situ IL-2 production deficiency.