Servitization allows manufacturing firms to differentiate themselves from rivals and become more competitive. Scholars have studied the service paradox, but analysis of the relationship between ...servitization and firm performance has provided inconclusive results. In terms of the antecedents that influence this relationship, the literature has tended to focus on firm and product characteristics but not on companies' innovative behavior. This article probes the relationship between servitization and firm performance by focusing on two forms of innovation (technological and open) that may exert an influence. The study draws on the resource‐based view literature to explain the role of interactions between technological innovation, service innovation, and open innovation in enhancing firm performance. Longitudinal empirical analysis was conducted with a sample of Spanish industrial firms for the period 2010–2016. Two time‐lagged models were built and analyzed. The results show that technological innovation influences servitization. This relationship is moderated by open innovation. Servitization mediates the relationship between technological innovation and firm performance. The findings contribute to the literature on servitization and innovation management. Innovation is posited as an antecedent to the service paradox. Products, services, and open innovation should be considered when firms design innovation strategies to improve their performance. Such innovation strategies should lead to an increase in servitization. Service innovation should be supported by open innovation to strengthen technological innovation potential.
Epidemiological studies show that adherence to a Mediterranean diet (MD) increases longevity; however, few studies are restricted to Mediterranean populations or explore the effect of a MD pattern ...that directly incorporates olive oil. Therefore the relationship between adherence to the MD and mortality was studied within the the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Spain). The EPIC-Spain analysis included 40 622 participants (37·7 % males) aged 29–69 years who were recruited from five Spanish regions in 1992–1996. During a mean follow-up of 13·4 years, 1855 deaths were documented: 913 from cancer, 399 from CVD, 425 from other causes and 118 from unknown causes of death. Risk of all-cause and cause-specific mortality was assessed according to the level of adherence to a relative MD (rMED) score, measured using an 18-unit scale incorporating nine selected dietary components. A high compared with a low rMED score was associated with a significant reduction in mortality from all causes (hazard ratio (HR) 0·79; 95 % CI 0·69, 0·91), from CVD (HR 0·66; 95 % CI 0·49, 0·89), but not from overall cancer (HR 0·92; 95 % CI 0·75, 1·12). A 2-unit increase in rMED score was associated with a 6 % (P < 0·001) decreased risk of all-cause mortality. A high olive oil intake and moderate alcohol consumption contributed most to this association. In this Spanish cohort, following an olive oil-rich MD was related to a significant reduction in all-cause mortality, and reduced the risk of mortality from CVD. These results support the important role that the MD pattern has on reducing mortality in Mediterranean countries.
Pediatric myopia has become a major international public health concern. The prevalence of myopia has undergone a significant increase worldwide. The purpose of this review of the current literature ...was to evaluate the peer-reviewed scientific literature on the efficacy and safety of low-dose atropine treatment combined with overnight orthokeratology for myopia control. A search was conducted in Pubmed and Web of Science with the following search strategy: (atropine OR low-dose atropine OR 0.01% atropine) AND (orthokeratology OR ortho-k) AND (myopia control OR myopia progression). All included studies improved myopia control by the synergistic effect of orthokeratology with low-dose atropine, compared with orthokeratology treatment alone. All studies included a short or medium follow-up period; therefore longer-term studies are necessary to validate these results.
Although there is some evidence suggesting that olive oil could reduce breast cancer (BC) risk, the epidemiological data are still relatively limited, not entirely consistent and mainly based on ...case–control studies. Therefore, we prospectively assessed the association between olive oil and BC risk in postmenopausal women from the Mediterranean cohorts within the European Prospective Investigation into Cancer and Nutrition. The analysis included 62,284 postmenopausal women recruited from Spain, Italy and Greece who had complete dietary data (collected from validated country‐specific dietary questionnaires). The risk of BC (overall and by hormone receptor subtypes) was assessed using hazards ratios (HRs) obtained from Cox proportional hazards regression, while adjusting for known BC risk factors. After a mean follow‐up of 9 years, 1,256 women were diagnosed with a primary incident invasive BC. The multivariate HRs for BC risk by olive oil intake (highest vs. lowest tertile of g/day/2,000 kcal) were 1.07 (95% CI = 0.91–1.25) in the adjusted model, 1.06 (95% CI = 0.91–1.24) in the model additionally adjusted for reproductive‐related factors and 1.10 (95% CI = 0.92–1.31) for the model additionally adjusted for dietary factors. There was no association between olive oil and risk of estrogen or progesterone receptor‐positive tumors, but a suggestion of a negative association with estrogens and progesterone receptor‐negative tumors. The results from our prospective study showed that olive oil consumption during adult life was not associated with the risk of BC. However, larger prospective studies are still needed to explore possible differences related to hormone receptor status.
To assess computer vision syndrome (CVS) in a preteen population through an adult‐validated CVS questionnaire and to evaluate how digital devices affect accommodative and binocular vision, we ...enrolled 309 preteens in this cross‐sectional study. An adult‐validated CVS questionnaire adapted to preteens was used for all subjects. Visual acuity testing, unilateral and alternate cover tests, and tests for accommodative and vergence responses were performed for all preteens. The mean age was 10.75 ± 0.67 (10–12) years. Subjects were divided into two groups: the mild CVS group with a mean CVS score ≤2 and the severe CVS group with a mean CVS score >2. Between the mild and severe CVS groups, statistically significant differences were found in near point of convergence break and recovery (P = 0.03 and P = 0.02, respectively) and distance negative fusional vergence break and recovery (P = 0.02 and P < 0.01, respectively). More children with severe CVS developed vergence disorders than those with mild CVS. Optometric clinical screening assessments could reduce ocular symptomatology and prevent long‐term effects. However, poor optometric findings might have occurred first, and the poor convergence skills resulted in the symptoms reported while using devices.
This observational, descriptive, cross‐sectional study assessed computer vision syndrome in preteens, with age ranging from 10 to 12 years, through a survey validated for adults and adapted for preteens. We performed the optometric examination, including clinic history, visual acuity, tropias and phorias, accommodation variables, and positive fusional vergence (PFV) and negative fusional vergence (NFV), to investigate the relationship of these variables to the use of digital devices. Statistically significant differences were found in near point convergence and distance NFV, and the difference tended to be significant in near NFV.
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In advanced cirrhosis, gut bacterial translocation is the consequence of intestinal barrier disruption and leads to bacterial infection. Bile acid abnormalities in cirrhosis could ...play a role in the integrity of the intestinal barrier and the control of microbiota, mainly through the farnesoid X receptor. We investigated the long-term effects of the farnesoid X receptor agonist, obeticholic acid, on gut bacterial translocation, intestinal microbiota composition, barrier integrity and inflammation in rats with CCl4-induced cirrhosis with ascites.
Cirrhotic rats received a 2-week course of obeticholic acid or vehicle starting once ascites developed. We then determined: bacterial translocation by mesenteric lymph node culture, ileum expression of antimicrobial peptides and tight junction proteins by qPCR, fecal albumin loss, enteric bacterial load and microbiota composition by qPCR and pyrosequencing of ileum mucosa-attached contents, and intestinal inflammation by cytometry of the inflammatory infiltrate.
Obeticholic acid reduced bacterial translocation from 78.3% to 33.3% (p<0.01) and upregulated the expression of the farnesoid X receptor-associated gene small heterodimer partner. Treatment improved ileum expression of antimicrobial peptides, angiogenin-1 and alpha-5-defensin, tight junction proteins zonulin-1 and occludin, and reduced fecal albumin loss and liver fibrosis. Enteric bacterial load normalized, and the distinctive mucosal microbiota of cirrhosis was reduced. Gut immune cell infiltration was reduced and inflammatory cytokine and Toll-like receptor 4 expression normalized.
In ascitic cirrhotic rats, obeticholic acid reduces gut bacterial translocation via several complementary mechanisms at the intestinal level. This agent could be used as an alternative to antibiotics to prevent bacterial infection in cirrhosis.
Metabolomics is a promising molecular tool to identify novel etiologic pathways leading to cancer. Using a targeted approach, we prospectively investigated the associations between metabolite ...concentrations in plasma and breast cancer risk.
A nested case-control study was established within the European Prospective Investigation into Cancer cohort, which included 1624 first primary incident invasive breast cancer cases (with known estrogen and progesterone receptor and HER2 status) and 1624 matched controls. Metabolites (n = 127, acylcarnitines, amino acids, biogenic amines, glycerophospholipids, hexose, sphingolipids) were measured by mass spectrometry in pre-diagnostic plasma samples and tested for associations with breast cancer incidence using multivariable conditional logistic regression.
Among women not using hormones at baseline (n = 2248), and after control for multiple tests, concentrations of arginine (odds ratio OR per SD = 0.79, 95% confidence interval CI = 0.70-0.90), asparagine (OR = 0.83 (0.74-0.92)), and phosphatidylcholines (PCs) ae C36:3 (OR = 0.83 (0.76-0.90)), aa C36:3 (OR = 0.84 (0.77-0.93)), ae C34:2 (OR = 0.85 (0.78-0.94)), ae C36:2 (OR = 0.85 (0.78-0.88)), and ae C38:2 (OR = 0.84 (0.76-0.93)) were inversely associated with breast cancer risk, while the acylcarnitine C2 (OR = 1.23 (1.11-1.35)) was positively associated with disease risk. In the overall population, C2 (OR = 1.15 (1.06-1.24)) and PC ae C36:3 (OR = 0.88 (0.82-0.95)) were associated with risk of breast cancer, and these relationships did not differ by breast cancer subtype, age at diagnosis, fasting status, menopausal status, or adiposity.
These findings point to potentially novel pathways and biomarkers of breast cancer development. Results warrant replication in other epidemiological studies.
Aims
Physical and psychiatric comorbidities are common in cancer patients and could impact their treatment and prognosis. However, the evidence base regarding the influence of comorbidities in the ...management and health service use of patients is still scant. In this research we investigated how physical comorbidities are related to the mental health and help‐seeking of cancer patients.
Methods
Data were obtained from the representative National Health Survey of Spain (2017). Participants were respondents who reported a cancer diagnosis (n = 484). These were also matched with controls without cancer history (n = 484) based on age, gender, and region. Four alternative physical comorbidities indices were created based on information regarding 28 chronic conditions. Outcomes of interest were psychological distress and having consulted a mental healthcare professional in the year before the survey.
Results
Thirty percent of cancer patients reported significant psychological distress but only 10% had consulted a professional. After adjusting for sociodemographic variables, among cancer patients each additional comorbidity was associated with 9% higher odds of reporting high psychological distress (odds ratio OR = 1.09, 95% confidence interval CI: 1.01–1.16) and 21% higher odds of having consulted a mental healthcare professional (OR = 1.21, 95% CI: 1.09–1.34). The effects of comorbidities depended on the type of index and were different in controls without cancer history.
Conclusion
Physical comorbidities in cancer patients are associated with higher risk of psychological distress and higher demand for mental health services. We encourage further research on this issue as it could improve mental health screening and management in oncologic care.
Introduction
The presence of iron deficiency (ID) in patients with acute heart failure (AHF) is high. There are few studies on the characteristics of these patients and the safety of ferric ...carboxymaltose administration (FCM).
Objective
Study the differences among patients with AHF based on the presence and type of ID as well as the safety of FCM administration in these patients.
Method
The AHF‐ID study is a multicentre, analytical, prospective follow‐up cohort including patients admitted to six Spanish hospitals for AHF. ID was defined as serum ferritin <100 μg/L (group A) or ferritin 100‐299 μg/L with a TSAT <20% (group B). In cases receiving FCM the appearance of adverse events was analysed. Adjusted Cox regression was used to determine the association with 30‐days reattendance for AHF after discharge.
Results
A total of 221 patients were recruited; 191 (86.4%) presented ID, 121 (63.4%) group A and 70 (36.6%) group B. There were scarce differences between the groups analysed. No differences were found in 30‐days reattendance for AHF. FCM was administered to 158 (71.5%) patients, with 8 (5.1%) presenting adverse events, the most frequent being digestive alterations. Treatment was not discontinued in any case.
Conclusions
There are scarce differences between the presence and the type of ID in patients with AHF. The administration of FCM in patients with ID and AHF is safe.
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