Search results for: SMEs survival

Authors: Jyothi Nagraj, Sudeshna Mukherjee, Rajdeep Chowdhury

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Autophagy has recently been linked with cancer cell survival post drug insult contributing to acquisition of resistance. However, the molecular signaling governing autophagic survival response is poorly explored. In our study, in osteosarcoma (OS) cells cisplatin shock was found to activate both MAPK and autophagy signaling. An activation of JNK and autophagy acted as pro-survival strategy, while ERK1/2 triggered apoptotic signals upon cisplatin stress. An increased sensitivity of the cells to cisplatin was obtained with simultaneous inhibition of both autophagy and JNK pathway. Furthermore, we observed that the autophagic stimulation upon drug stress regulates other developmentally active signaling pathways like the Hippo pathway in OS cells. Cisplatin resistant cells were thereafter developed by repetitive drug exposure followed by clonal selection. Basal levels of autophagy were found to be high in resistant cells to. However, the signaling mechanism leading to autophagic up-regulation and its regulatory effect differed in OS cells upon attaining drug resistance. Our results provide valuable clues to regulatory dynamics of autophagy that can be considered for development of improved therapeutic strategy against resistant type cancers.

Keywords: JNK, autophagy, drug resistance, cancer

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Authors: Mekni Sabrine, Nouira Mariem

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Background and aim: Allogeneic hematopoietic stem cell transplantation is a curative treatment for several hematological diseases; however, it has a non-negligible morbidity and mortality depending on several prognostic factors, including pre-transplant hyperferritinemia. The aim of our study was to estimate the impact of hyperferritinemia on survivals and on the occurrence of post-transplant complications. Methods: It was a longitudinal study conducted over 8 years and including all patients who had a first allograft. The impact of pretransplant hyperferritinemia (ferritinemia ≥1500) on survivals was studied using the Kaplan Meier method and the COX model for uni- and multivariate analysis. The Khi-deux test and binary logistic regression were used to study the association between pretransplant ferritinemia and post-transplant complications. Results: One hundred forty patients were included with an average age of 26.6 years and a sex ratio (M/F)=1.4. Hyperferritinemia was found in 33% of patients. It had no significant impact on either overall survival (p=0.9) or event -free survival (p=0.6). In multivariate analysis, only the type of disease was independently associated with overall survival (p=0.04) and event-free survival (p=0.002). For post-allograft complications: The occurrence of early documented infections was independently associated with pretransplant hyperferritinemia (p=0.02) and the presence of acute graft versus host disease( GVHD) (p<10-3). The occurrence of acute GVHD was associated with early documented infection (p=0.002) and Cytomegalovirus reactivation (p<10-3). The occurrence of chronic GVHD was associated with the presence of Cytomegalovirus reactivation (p=0.006) and graft source (p=0.009). Conclusion: Our study showed the significant impact of pre-transplant hyperferritinemia on the occurrence of early infections but not on survivals. Early and more accurate assessment iron overload by other tests such as liver magnetic resonance imaging with initiation of chelating treatment could prevent the occurrence of such complications after transplantation.

Keywords: allogeneic, transplants, ferritin, survival

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Authors: Getahun Nigusie

Abstract:

Background; antiretroviral treatment reduce HIV-related morbidity, and prolonged survival of patients however, there is lack of up-to-date information concerning the treatment long term effect on the survival of HIV positive children especially in the study area. Objective: To assess incidence and predictors of mortality among HIV positive children on ART in public hospitals of Harer town who were enrolled from 2011 to 2021. Methodology: Institution based retrospective cohort study was conducted among 429 HIV positive children enrolled in ART clinic from January 1st 2011 to December30th 2021. Data were collected from medical cards by using a data extraction form, Descriptive analyses were used to Summarized the results, and life table was used to estimate survival probability at specific point of time after introduction of ART. Kaplan Meier survival curve together with log rank test was used to compare survival between different categories of covariates, and Multivariate Cox-proportional hazard regression model was used to estimate adjusted Hazard rate. Variables with p-values ≤0.25 in bivariable analysis were candidates to the multivariable analysis. Finally, variables with p-values < 0.05 were considered as significant variables. Results: The study participants had followed for a total of 2549.6 child-years (30596 child months) with an overall mortality rate of 1.5 (95% CI: 1.1, 2.04) per 100 child-years. Their median survival time was 112 months (95% CI: 101–117). There were 38 children with unknown outcome, 39 deaths, and 55 children transfer out to different facility. The overall survival at 6, 12, 24, 48 months were 98%, 96%, 95%, 94% respectively. being in WHO clinical Stage four (AHR=4.55, 95% CI:1.36, 15.24), having anemia(AHR=2.56, 95% CI:1.11, 5.93), baseline low absolute CD4 count (AHR=2.95, 95% CI: 1.22, 7.12), stunting (AHR=4.1, 95% CI: 1.11, 15.42), wasting (AHR=4.93, 95% CI: 1.31, 18.76), poor adherence to treatment (AHR=3.37, 95% CI: 1.25, 9.11), having TB infection at enrollment (AHR=3.26, 95% CI: 1.25, 8.49),and no history of change their regimen(AHR=7.1, 95% CI: 2.74, 18.24), were independent predictors of death. Conclusion: more than half of death occurs within 2 years. Prevalent tuberculosis, anemia, wasting, and stunting nutritional status, socioeconomic factors, and baseline opportunistic infection were independent predictors of death. Increasing early screening and managing those predictors are required.

Keywords: human immunodeficiency virus-positive children, anti-retroviral therapy, survival, Ethiopia

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Authors: Sarbjit Singh

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This framework development explored the status of GSCM in manufacturing SMEs and concluded that there was a significant gap w.r.t carbon emissions measurement in the supply chain activities. The measurement of carbon emissions within supply chains is important green initiative toward its reduction. The majority of the SMEs were facing the problem to quantify the green house gas emissions in its supply chain & to make it a low carbon supply chain or GSCM. Thus, the carbon management initiatives were amalgamated with the supply chain activities in order to measure and reduce the carbon emissions, confirming the GHG protocol scopes. Henceforth, it covers the development of carbon management software (CMS) tool to quantify carbon emissions for effective carbon management. This tool is cheap and easy to use for the industries for the management of their carbon emissions within the supply chain.

Keywords: w.r.t carbon emissions, carbon management software, supply chain management, Indian Industry

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Authors: Mohammad ASadian, Samira RajiAsadabadi

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Osteoporosis is very common, particularly in post-menopausal women and is characterized by a decrease in bone mass and strength. Osteoporosis also affects the jawbone and it is considered a potential contraindication to the placement of dental implants. The present paper reviews the literature regarding the effect of osteoporosis on the osseointegration of implants. Experimental models have shown that osteoporosis affects the process of osseointegration, which can be reversed by treatment. However, studies in subjects with osteoporosis have shown no differences in the survival of the implants compared to healthy individuals. Therefore, osteoporosis cannot be considered a contraindication for implant placement. Oral bisphosphonates are the most commonly used pharmacological agents in the treatment of osteoporosis. Although there have been cases of osteonecrosis of the jaw in patients treated with bisphosphonates, they are very rare and it is more usually associated with intravenous bisphosphonates in patients with neoplasms or other serious diseases. Nevertheless, patients treated with bisphosphonates must be informed in writing about the possibility of this complication and must give informed consent. Ceasing to use of bisphosphonates before implant placement does not seem to be necessary.

Keywords: Osteoporosis, dental implant, bisphosphonates, survival

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Authors: Rajeshkumar U. Sambhe

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Large scale Indian manufacturers started implementing Six Sigma to their supply core to fulfill the endless need of high quality products. As well, they initiated encouraging their suppliers to apply the well-ascertain SS management practice and kept no resource for supplier enterprises, generally small midsized enterprises to think for the admittance of Six Sigma as a quality promotion drive. There are many issues to study for requisite changes before the introduction of Six Sigma in auto SMEs. This paper converges on impeding factors while implementing SS drive and also pinpoints the gains achieved through successful implementation. The result of this study suggest some operational guidelines for effective implementation of Six Sigma from evidences acquired through research questionnaire and interviews with industrial professionals, apportioned to assort auto sector mid-sized enterprises (MSEs) in India.

Keywords: indian automotive SMEs, quality management practices, six sigma imperatives, problems faced in six sigma implementation, benefits, some guidelines for implementation

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Authors: Stéphanie Looser, Walter Wehrmeyer

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Given the limited research on Small and Mediumsized Enterprises’ (SMEs) contribution to Corporate Social Responsibility (CSR) and even scarcer research on Swiss SMEs, this paper helps to fill these gaps by enabling the identification of supranational SME parameters and to make a contribution to the evolving field of these topics. Thus, the paper investigates the current state of SME practices in Switzerland and across 15 other countries. Combining the degree to which SMEs demonstrate an explicit (or business case) approach or see CSR as an implicit moral activity with the assessment of their attributes for “variety of capitalism” defines the framework of this comparative analysis. According to previous studies, liberal market economies, e.g. in the United States (US) or United Kingdom (UK), are aligned with extrinsic CSR, while coordinated market systems (in Central European or Asian countries) evolve implicit CSR agendas. To outline Swiss small business CSR patterns in particular, 40 SME owner-managers were interviewed. The transcribed interviews were coded utilising MAXQDA for qualitative content analysis. A secondary data analysis of results from different countries (i.e., Australia, Austria, Chile, Cameroon, Catalonia (notably a part of Spain that seeks autonomy), China, Finland, Germany, Hong Kong (a special administrative region of China), Italy, Netherlands, Singapore, Spain, Taiwan, UK, US) lays groundwork for this comparative study on small business CSR. Applying the same coding categories (in MAXQDA) for the interview analysis as well as for the secondary data research while following grounded theory rules to refine and keep track of ideas generated testable hypotheses and comparative power on implicit (and the lower likelihood of explicit) CSR in SMEs retrospectively. The paper identifies Swiss small business CSR as deep, profound, “soul”, and an implicit part of the day-to-day business. Similar to most Central European, Mediterranean, Nordic, and Asian countries, explicit CSR is still very rare in Swiss SMEs. Astonishingly, also UK and US SMEs follow this pattern in spite of their strong and distinct liberal market economies. Though other findings show that nationality matters this research concludes that SME culture and its informal CSR agenda are strongly formative and superseding even forces of market economies, nationally cultural patterns, and language. In a world of “big business”, explicit “business case” CSR, and the mantra that “CSR must pay”, this study points to a distinctly implicit small business CSR model built on trust, physical closeness, and virtues that is largely detached from the bottom line. This pattern holds for different cultural contexts and it is concluded that SME culture is stronger than nationality leading to a supra-national, monolithic SME CSR approach. Hence, classifications of countries by their market system or capitalism, as found in the comparative capitalism literature, do not match the CSR practices in SMEs as they do not mirror the peculiarities of their business. This raises questions on the universality and generalisability of management concepts.

Keywords: CSR, comparative study, cultures of capitalism, small, medium-sized enterprises

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Authors: Khalil Trigui, Rafik Ben Said, Fourat Akrout, Neji Aloui

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In this study, we examined in the first part the eco-biology of Artemia (A.salina) collected from Sahline Salt Lake (governorate of Monastir: Tunisia) during an annual cycle. The correlations between environmental factors and some biological parameters of Artemia were determined. The results obtained showed that the environmental factors affected the biology of Artemia. The highest abundance was recorded in May (550 ± 2,16 ind/l) and all life history stages existed with different seasonal proportions. The Artemia population is bisexual with ovoviviparous reproduction at the beginning and oviparous at the end of the life cycle. We also recorded the dominance of males at the start and the females at the end of the cycle. During all the study period, the size of mature females is bigger than that of males. The fertility obtained resulted in a significant production of cysts compared to the nauplii. A negative correlation with highly significant effect was deduced between environmental factors (temperature and salinity) and the production of nauplii (ovoviviparity) in contrast with dissolved oxygen. In the second part of our work is consecrated to the mastery of breeding Artemia. For this, we tested the effect of five external factors (temperature, salinity, dissolved oxygen, light intensity and food) on the survival of this crustacean. Thereby, the survival rates of Artemia were affected by the different values of studied factors. The recorded results showed that Artemia salina has an optimum temperature ranged from 25 to 27°C with a survival rate ranging from 84 to 88%. The optimal salinity to breed Artemia salina was 37 psu (62 ± 0,23%). Nevertheless, this crustacean was able to survive and withstand the salinity of 0 psu (freshwater). The optimum concentration of dissolved oxygen was 7mg/l with a survival rate of 87,11 ± 0,04%. An optimum light intensity of 10 lux revealed a survival rate equal to 85,33 ± 0,01%. The results also showed that the preferred micro-algae by Artemia is Dunaliella salina with a maximum survival rate of the order of 80 ± 0,15%. There is a significant effect for all experienced parameters on the survival of Artemia reared except the nature of food.

Keywords: Artemia salina, biology, breeding, ecology, Sahline salt lake

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Authors: Daniel P. Kisangau, Ken M. Hosea, Herbert V. M. Lyaruu, Cosam C. Josep, Zakaria H. Mbwambo, Pax J. Masimba

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Crude extracts of Dracaena steudneri bark (DSB), Sapium ellipticum bark (SEB) and Capparis erythrocarpos root (CER) were investigated for their antifungal activity in immunocompromised mice infected with Candida albicans in an in vivo mice infection model. The results revealed a substantial dose dependency in all treatments given, with mice survival to the end of the experiment correlating well to the dose levels. At a dose of 400 mg/kg, C. erythrocarpos was the most effective with mice survival of 60% and organ burden clearance ranging from 64.0%-99.9% (P<0.0001) in all treatments. At the same dose, the least effective plant was S. ellipticum which had a mice survival of 20% and organ burden clearance ranging from 78.0%-96.6 (P>0.05). Mice survival for D. steudneri was 30% with organ burden clearance ranging from 89.0%-99.9% (P<0.05). All mice receiving no active treatment died before ten days post infection. In all treatment groups, there was a steady decline in mean weights of mice immediately after immunosuppression followed by gradual recovery in some cases which appeared to be dose dependent a few days post infection. Thus, extracts of D. steudneri and C. erythrocarpos portrayed the most significant potential as sources of antifungal drugs.

Keywords: antifungal activity, medicinal plants, candida albicans, East Africa

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Authors: Moujib Bahri, Ouafa Sakka, Kallel Rahim

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This study builds on the literature about the effects of corruption on economic growth at the firm level, which analyzes how the payment of bribes affect organizational performance. Traditionally, the literature distinguishes two points of view regarding the impact of corruption: grease view and sand view. The grease view is based on the idea that corruption can compensate for the negative effect of red tape on firms’ activities such as innovation and exports. Therefore, some firms will be motivated to pay some additional money to officials in order to reduce the delay related to bureaucratic procedures. On the contrary, the second point of view considers that corruption sands the wheels of the economy and distorts resource allocation because it increases agency and transaction costs and reduces the returns on the investment. We have tested the effect of corruption on innovation and export activities on a sample of 537 Tunisian manufacturing small and medium enterprises (SMEs) using structural equation modeling and path analysis. Tunisia has undergone a revolution in 2010 and since then, the country is experiencing a political instability and economic hardships. Our results do not support the greasing hypothesis suggesting that corruption can reduce the negative effect of bureaucratic delays and the hard access of companies to public services related to exports. Instead, our results support the sanding hypothesis according to which corruption hinders SMEs’ exports through its negative influence on innovation. Furthermore, our results show that the interaction between excessive bureaucratic red tape and corruption has a negative effect on exports. However, the interaction between political instability and corruption increases exports.

Keywords: corruption, exports, SMEs, economic conditions

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Authors: Yemane Hailu Fissuh, Zhongzhan Zhang

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a systematic observation from a defined time of origin up to certain failure or censor is known as survival data. Survival analysis is a major area of interest in biostatistics and biomedical researches. At the heart of understanding, the most scientific and medical research inquiries lie for a causality analysis. Thus, the main concern of this study is to investigate the causal effect of treatment on survival time conditional to the possibly time-varying covariates. The theory of causality often differs from the simple association between the response variable and predictors. A causal estimation is a scientific concept to compare a pragmatic effect between two or more experimental arms. To evaluate an average treatment effect on survival outcome, the estimating equation was adjusted for time-varying covariates under the semi-parametric transformation models. The proposed model intuitively obtained the consistent estimators for unknown parameters and unspecified monotone transformation functions. In this article, the proposed method estimated an unbiased average causal effect of treatment on survival time of interest. The modified estimating equations of semiparametric transformation models have the advantage to include the time-varying effect in the model. Finally, the finite sample performance characteristics of the estimators proved through the simulation and Stanford heart transplant real data. To this end, the average effect of a treatment on survival time estimated after adjusting for biases raised due to the high correlation of the left-truncation and possibly time-varying covariates. The bias in covariates was restored, by estimating density function for left-truncation. Besides, to relax the independence assumption between failure time and truncation time, the model incorporated the left-truncation variable as a covariate. Moreover, the expectation-maximization (EM) algorithm iteratively obtained unknown parameters and unspecified monotone transformation functions. To summarize idea, the ratio of cumulative hazards functions between the treated and untreated experimental group has a sense of the average causal effect for the entire population.

Keywords: a modified estimation equation, causal effect, semiparametric transformation models, survival analysis, time-varying covariate

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Authors: Nursel Koyuncu, Nihal Ata Tutkun

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Frailty model is a survival model that takes into account the unobserved heterogeneity for exploring the relationship between the survival of an individual and several covariates. In the recent years, proposed survival models become more complex and this feature causes convergence problems especially in large data sets. Therefore selection of sample from these big data sets is very important for estimation of parameters. In sampling literature, some authors have defined new sampling schemes to predict the parameters correctly. For this aim, we try to see the effect of sampling design in semi-parametric frailty model. We conducted a simulation study in R programme to estimate the parameters of semi-parametric frailty model for different sample sizes, censoring rates under classical simple random sampling and ranked set sampling schemes. In the simulation study, we used data set recording 17260 male Civil Servants aged 40–64 years with complete 10-year follow-up as population. Time to death from coronary heart disease is treated as a survival-time and age, systolic blood pressure are used as covariates. We select the 1000 samples from population using different sampling schemes and estimate the parameters. From the simulation study, we concluded that ranked set sampling design performs better than simple random sampling for each scenario.

Keywords: frailty model, ranked set sampling, efficiency, simple random sampling

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Authors: Moujib Bahri, Rahim Kallel, Ouafa Sakka

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Corruption is a phenomenon that increases uncertainty and risk of SMEs as it undermines the quality of the business environment and the easy access to public services. Our research builds on existing research on corruption's effects on economic growth at the firm level. Several papers have analyzed the effect of firms’ payments of bribes on their performance; however, only limited research has investigated the link between corruption, innovation, and exports. Drawing on principal-agent theory, we explore how corruption weakens the institutional context and makes the business environment unsound and not conducive to innovation and exports. This study employs data from The Enterprise Surveys conducted in Tunisia between March 2013 and July 2014 by the World Bank, the European Bank for Reconstruction and Development (EBRD) and the European Investment Bank (EIB). The main objective of this survey was to gain a better understanding of Tunisian firms’ perception of the environment in which they operate. Since 2011, the country's political situation has become fragile and unstable, and public services are perceived as inefficient and corrupt. We test our hypotheses on a sample of 537 Tunisian manufacturing SMEs using structural equation modeling and path analysis. We find that political instability leads to higher level of corruption, and that excessive business licensing regulations create a fertile ground for bribery. Our findings do not support the greasing hypothesis suggesting that corruption can reduce the negative effect of bureaucratic delays and the hard access of companies to public services related to innovation and exports. Instead, our results support the sanding hypothesis according to which corruption hinders innovation activities and exports. Furthermore, corruption is found to, negatively and significantly, impact firms’ ownership of quality certificates. Our results suggest that, in an environment with a high level of corruption, governments and policymakers interested in assisting SMEs with their innovation and export activities should have a better control on corruption to allow them developing those activities without being forced to bribe government officers.

Keywords: corruption, innovation, exports, SMEs

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Authors: Wahab Ali, Oyebade K. Oyedotun, Adnan Khashman

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Breast cancer remains a threat to the woman’s world in view of survival rates, it early diagnosis and mortality statistics. So far, research has shown that many survivors of breast cancer cases are in the ones with early diagnosis. Breast cancer is usually categorized into stages which indicates its severity and corresponding survival rates for patients. Investigations show that the farther into the stages before diagnosis the lesser the chance of survival; hence the early diagnosis of breast cancer becomes imperative, and consequently the application of novel technologies to achieving this. Over the year, mammograms have used in the diagnosis of breast cancer, but the inconclusive deductions made from such scans lead to either false negative cases where cancer patients may be left untreated or false positive where unnecessary biopsies are carried out. This paper presents the application of artificial neural networks in the prediction of severity of breast tumour (whether benign or malignant) using mammography reports and other factors that are related to breast cancer.

Keywords: breast cancer, intelligent classification, neural networks, mammography

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Authors: Getahun Nigusie Demise

Abstract:

Background; antiretroviral treatment reduce HIV-related morbidity, and prolonged survival of patients however, there is lack of up-to-date information concerning the treatment long term effect on the survival of HIV positive children especially in the study area. Objective: The aim of this study is to assess the incidence and predictors of mortality among HIV positive children on antiretroviral therapy (ART) in public hospitals of Harer town who were enrolled from 2011 to 2021. Methodology: Institution based retrospective cohort study was conducted among 429 HIV positive children enrolled in ART clinic from January 1st 2011 to December30th 2021. Data were collected from medical cards by using a data extraction form, Descriptive analyses were used to Summarized the results, and life table was used to estimate survival probability at specific point of time after introduction of ART. Kaplan Meier survival curve together with log rank test was used to compare survival between different categories of covariates, and Multivariate Cox-proportional hazard regression model was used to estimate adjusted Hazard rate. Variables with p-values ≤0.25 in bivariable analysis were candidates to the multivariable analysis. Finally, variables with p-values < 0.05 were considered as significant variables. Results: The study participants had followed for a total of 2549.6 child-years (30596 child months) with an overall mortality rate of 1.5 (95% CI: 1.1, 2.04) per 100 child-years. Their median survival time was 112 months (95% CI: 101–117). There were 38 children with unknown outcome, 39 deaths, and 55 children transfer out to different facility. The overall survival at 6, 12, 24, 48 months were 98%, 96%, 95%, 94% respectively. being in WHO clinical Stage four (AHR=4.55, 95% CI:1.36, 15.24), having anemia(AHR=2.56, 95% CI:1.11, 5.93), baseline low absolute CD4 count (AHR=2.95, 95% CI: 1.22, 7.12), stunting (AHR=4.1, 95% CI: 1.11, 15.42), wasting (AHR=4.93, 95% CI: 1.31, 18.76), poor adherence to treatment (AHR=3.37, 95% CI: 1.25, 9.11), having TB infection at enrollment (AHR=3.26, 95% CI: 1.25, 8.49),and no history of change their regimen(AHR=7.1, 95% CI: 2.74, 18.24), were independent predictors of death. Conclusion: more than half of death occurs within 2 years. Prevalent tuberculosis, anemia, wasting, and stunting nutritional status, socioeconomic factors, and baseline opportunistic infection were independent predictors of death. Increasing early screening and managing those predictors are required.

Keywords: human immunodeficiency virus-positive children, anti-retroviral therapy, survival, treatment, Ethiopia

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Authors: Yaxian Chen, Yeonhee Park

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Driven by evolving FDA recommendations, modern clinical trials demand innovative designs that strike a balance between statistical rigor and ethical considerations. Covariate-adjusted response-adaptive (CARA) designs bridge this gap by utilizing patient attributes and responses to skew treatment allocation in favor of the treatment that is best for an individual patient’s profile. However, existing CARA designs for survival outcomes often hinge on specific parametric models, constraining their applicability in clinical practice. In this article, we address this limitation by introducing a CARA design for survival outcomes (CARAS) based on the Cox model and a variance estimator. This method addresses issues of model misspecification and enhances the flexibility of the design. We also propose a group sequential overlapweighted log-rank test to preserve type I error rate in the context of group sequential trials using extensive simulation studies to demonstrate the clinical benefit, statistical efficiency, and robustness to model misspecification of the proposed method compared to traditional randomized controlled trial designs and response-adaptive randomization designs.

Keywords: cox model, log-rank test, optimal allocation ratio, overlap weight, survival outcome

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Authors: Yori Gidron, Maartje Mol, Norbert Foudraine, Frits Van Osch, Joop Van Den Bergh, Moshe Farchi, Maud Straus

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Background: The worldwide pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-COV2), which began in 2019, also known as Covid-19, has infected over 136 million people and tragically took the lives of over 2.9 million people worldwide. Many of the complications and deaths are predicted by the inflammatory “cytokine storm.” One way to progress in the prevention of death is by finding a predictive and protective factor that inhibits inflammation, on the one hand, and which also increases anti-viral immunity on the other hand. The vagal nerve does precisely both actions. This study examined whether vagal nerve activity, indexed by heart-rate variability (HRV), predicts survival in patients with Covid-19. Method: We performed a pseudo-prospective study, where we retroactively obtained ECGs of 271 Covid-19 patients arriving at a large regional hospital in The Netherlands. HRV was indexed by the standard deviation of the intervals between normal heartbeats (SDNN). We examined patients’ survival at 3 weeks and took into account multiple confounders and known prognostic factors (e.g., age, heart disease, diabetes, hypertension). Results: Patients’ mean age was 68 (range: 25-95) and nearly 22% of the patients had died by 3 weeks. Their mean SDNN (17.47msec) was far below the norm (50msec). Importantly, relatively higher HRV significantly predicted a higher chance of survival, after statistically controlling for patients’ age, cardiac diseases, hypertension and diabetes (relative risk, H.R, and 95% confidence interval (95%CI): H.R = 0.49, 95%CI: 0.26 – 0.95, p < 0.05). However, since HRV declines rapidly with age and since age is a profound predictor in Covid-19, we split the sample by median age (40). Subsequently, we found that higher HRV significantly predicted greater survival in patients older than 70 (H.R = 0.35, 95%CI: 0.16 – 0.78, p = 0.01), but HRV did not predict survival in patients below age 70 years (H.R = 1.11, 95%CI: 0.37 – 3.28, p > 0.05). Conclusions: To the best of our knowledge, this is the first study showing that higher vagal nerve activity, as indexed by HRV, is an independent predictor of higher chances for survival in Covid-19. The results are in line with the protective role of the vagal nerve in diseases and extend this to a severe infectious illness. Studies should replicate these findings and then test in controlled trials whether activating the vagus nerve may prevent mortality in Covid-19.

Keywords: Covid-19, heart-rate Variability, prognosis, survival, vagal nerve

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Authors: Hani Belhadj, Daoud Harzallah, Seddik Khennouf, Saliha Dahamna, Mouloud Ghadbane

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In this study, Lactobacillus strains isolated from pollen were identified by means of phenotypic and genotypic methods, At pH 2, most strains proved to be acid resistants, with losses in cell viability ranging from 0.77 to 4.04 Log orders. In addition, at pH 3 all strains could grew and resist the acidic conditions, with losses in cell viability ranging from 0.40 to 3.61 Log orders. It seems that, 0.3% and 0.5% of bile salts does not affect greatly the survival of most strains, excluding Lactobacillus sp. BH1398. Survival ranged from 81.0±3.5 to 93.5±3.9%. In contrast, in the presence of 1.0% bile salts, survival of five strains was decreased by more than 50%. Lactobacillus fermentum BH1509 was considered the most tolerant strain (77.5% for 1% bile) followed by Lactobacillus plantarum BH1541 (59.9% for 1% bile). Furthermore, all strains were resistant to colistine, clindamycine, chloramphenicol, and ciprofloxacine, but most of the strains were susceptible to Peniciline, Oxacillin, Oxytetracyclin, and Amoxicillin. Functionally interesting Lactobacillus isolates may be used in the future as probiotic cultures for manufacturing fermented foods and as bioactive delivery systems.

Keywords: probiotics, lactobacillus, pollen, bile, acid tolerance

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Authors: Ginés Hernández-Cánovas, Mª Camino Ramón-Llorens, Johanna Koëter-Kant

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This paper uses a survey data-set of 837 Spanish SMEs to analyze the association between borrower discouragement and prior firm´s strategic decisions, while controlling for firm and owner characteristics. While existing literature has neglected factors limiting the demand for resources by an overreliance on arguments which attempt to explain the existence of discouraged borrowers solely in terms of lack of access to supply of credit. The objective of this paper is to show that factors limiting the demand for resources and, therefore, reducing the availability of funds, can be traced back to the firm manager´s decision. Our hypothesis is that managers that undertake strategic decisions seeking growth or improvement in their business performance participate more in the banking market than those showing contentment with their current business situation. Our results shows that SMEs that undertake an active role in research and development activities and that achieve improvements in the operating performance of their business are less likely to be discouraged from applying for a loan. Who needs credit and who applies for credit is important for firms, prospective lenders and policymakers interested in the financial health of these firms. Credit constrained firms are less likely to invest in R&D and to introduce new products, possibly harming long-term economic growth. Knowing how important borrower discouragement is in Europe, is important for judging the priority which should be attached to government policies aimed at reducing its effects. For example, policy makers could encourage the transparency about credit eligibility and conditions in order to reduce discouragement.

Keywords: discouragement, financial constraints, SMEs financing

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Authors: Khondokar Farid Ahmmed, Robin Bown

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It is widely recognized that the formal financing of Small and Medium Size Enterprises (SMEs) by Private Commercial Banks (PCBs) is restricted. Due to changing financial market competition, SMEs are now important customers to PCBs in the member countries of the Asian Development Bank (ADB). Various initiatives in enhancing the efficiency of risk assessment of PCBs have failed in increasing financing accessibility in the traditional financing system where information asymmetry is a key constraint. In this circumstance, PCBs need to undertake a holistic approach. Holistic approach refers to methods that attempt to fundamentally change established traditions. To undertake holistic approach, this study intends to find the entire established financing culture between PCBs and SMEs in a new lens beyond the tradition on the basis of two basic questions: “What is the traditional lending culture between PCBs and SMEs” and “What could be potential role of PCBs to develop that culture where focusing on SME financing to PCBs". This study considered formal SME financing in Bangladesh by focusing on SMEs applying for their first loan. Bangladesh is a member country of ADB. The data collection method is semi-structured and we utilized face-to-face interviews with in-depth branch managers, higher officials and owner-managers of SME customers of PCBs and higher officials of SME Foundation and the Bangladesh central bank. Discourse analysis method was used for data analysis on the frame of thematic discussion fully based on participants’ views. The research found that branch managers and loan officers have a high level of power in assessing and financing decision-making. There is a changing attitude in PCB sector in requiring flexible collateral assets. Branch managers (Loan Officers) consider value of business prospect of owner-mangers as complementary of collateral assets. However, the study found the assessment process of business prospect is entirely unstructured and linked with socio-cultural settings that does not support PCBs’ changing manner in terms of collateral requirement. The study redefined and classified collateral assets to include all financing constructs in a structure. The degree of value of the collateral assets determines the degree of business prospects. This study suggested applying an outside classroom-learning paradigm such as “knowledge tour” to enhance the value of the kinds of collateral assets. This is the scope of PCBs in increasing SMEs’ financing eligibility in win-win basis. The findings and proposition could be effective in other ADB member countries and audiences in the field.

Keywords: CCA, financing, information asymmetry, PCA, PCB, financing

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Authors: Naomi Seidu, Edward Poluyi, Chibuikem Ikwuegbuenyi, Eghosa Morgan

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The current poor prognosis of glioblastoma has called for the need for an improvement in treatment methods in order to improve its survival rate. Despite the different interventions currently available for this tumor, the average survival is still only a few months. (12-15). The aim is to create a more favorable prognosis and have a reduction in the resistance to treatment currently being experienced, even with surgical interventions and chemotherapy. From the available literature, there is a relationship between the presence of HOX genes (Homeobox genes) and glioblastoma, which could be attributable to the increasing treatment resistance. Hence silencing these genes can be a key to improving survival rates of glioblastoma. A series of studies have highlighted the role that HOX genes play in glioblastoma prognosis. Promotion of human glioblastoma initiation, aggressiveness, and resistance to Temozolomide has been associated with HOXA9. The role of HOX gene expression in cancer stem cells should be studied as it could provide a means of designing CSC-targeted therapies, as CSCs play a part in the initiation and progression of solid tumors.

Keywords: GBM- glioblastoma, HOXA gene- homeobox genes cluster, signaling pathways, temozolomide

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Authors: Julia B. Kischkat, Charlie D. Waters

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This research aims to understand the factors that may affect the survival and productivity of Pacific salmonids through two components. The first component is lab-based and aims to improve high-performance liquid chromatography to better quantify vitamin deficiencies such as thiamine. The lab work is conducted at the National Oceanic and Atmospheric Administration (NOAA) Ted Stevens Marine Research Institute in Juneau, Alaska. Deficiencies in thiamine have been shown to reduce the survival of salmonids at early life stages. The second component involves the analysis of a 22-year data set of migration timing of juvenile Coho Salmon, Dolly Varden, Steelhead, and returning adult Steelhead at Little Port Walter, Alaska. The statistical analysis quantifies their migration fluctuations and whether they correlate to various environmental conditions such as temperature, salinity, and precipitation.

Keywords: climate change, smolt timing, phenology, migration timing, salmon, time series analysis, ecology, chemistry, fisheries science

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Authors: Javier Sanchez Vidal, Ciarán Mac An Bhaird, Brian Lucey

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This study examines the decision by firm owners not to apply for intermediated debt due to a perception that their application will be rejected. Based on a sample of SMEs in 9 European countries over the period 2009-2011, we examine potential explanatory factors for borrower discouragement, including firm, macroeconomic, regulatory and banking industry variables. Compared with firms that applied for bank loans, discouraged borrowers are smaller, younger, have declining turnover and an increasing debt/assets ratio. Perceived willingness of banks to lend rather than the company’s own credit history is more important to encourage applications. Perceptions of refusal are procyclical and may be self-perpetuating. Increased concentration in the banking sector reduces discouragement, indicating the importance of relationship banking. Transmission of macro effects through the banking system and economic environment may also lead to higher levels of discouragement. A good regulatory scheme is also advisable, either for the lenders or the borrowers (overall the good ones).

Keywords: entrepreneurial finance, discouraged borrowers, banking, financial crisis, eurozone

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Authors: Osama Shakeel

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The objective of the paper is to study the clinic-pathological factors, survival analyses, recurrence rate, metastatic rate, risk factors and the management of cutaneous malignant melanoma at Shaukat Khanum Memorial Cancer Hospital and Research Center. Methodology: From 2014 to 2017, all patients with a diagnosis of cutaneous malignant melanoma (CMM) were included in the study. Demographic variables were collected. Short and long term oncological outcomes were recorded. All data were entered and analyzed in SPSS version 21. Results: A total of 28 patients were included in the study. Median age was 46.5 +/-15.9 years. There were 16 male and 12 female patients. The family history of melanoma was present in 7.1% (n=2) of the patients. All patients had a mean survival of 13.43+/- 9.09 months. Lower limb was the commonest site among all which constitutes 46.4%(n=13). On histopathological analyses, ulceration was seen in 53.6% (n=15) patients. Unclassified tumor type was present in 75%(n=21) of the patients followed by nodular 21.4% (n=6) and superficial spreading 3.5%(n=1). Clark level IV was the commonest presentation constituting 46.4%(n=13). Metastases were seen in 50%(n=14) of the patients. Local recurrence was observed in 60.7%(n=17). 64.3%(n=18) lived after one year of treatment. Conclusion: CMM is a fatal disease. Although its disease of fair skin individuals, however, the incidence of CMM is also rising in this part of the world. Management includes early diagnoses and prompt management. However, mortality associated with this disease is still not favorable.

Keywords: malignant cancer of skin, cutaneous malignant melanoma, skin cancer, survival analyses

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Authors: Ugbor Raphael Oluchukwu

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The survey research design was adopted to examine whether liquidity and cash management practices of owner-managed firms in South East Nigeria influence their profitability, growth and survival. Four independent variables (accounting systems, working capital management, budgetary control, and managerial planning) were used in the evaluation which was restricted to eight small firms. Results indicate that one variable, working capital management alone dominate the liquidity perception of owner managers. As a result, owner managers find it difficult to meet maturing business obligations as growth sets in. The study also reveals that the four independent variables have significant impact on the profitability, growth and survival of owner managed firms. Owner managers are therefore advised to undertake regular entrepreneurship training in order to upgrade their liquidity and cash management knowledge and practices to enhance their overall performance.

Keywords: liquidity management, owner-managed firm, profitability, survival

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Authors: Paulina Solórzano Salgado, Luis Rodrigo Valencia Pérez, Alberto de Jesús Pastrana Palma

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In this research, it is presented a digital maturity framework, which contributes to the development of small and medium-sized enterprises (SMEs) in the commercial sector. This proposal is based on three important concepts: Marketing activities in the enterprise, information and communication technologies ICT, as well as Innovation. Prior to the development of this framework, was formulated a quantitative assessment tool through a literature review, and was validated with a method used by experts, and which determines the relationship of digital marketing and innovation activities in companies. The instrument was applied to 64 Mexican companies from the Made in Mexico database, which allowed both descriptive results and correlation results. These contributed to the development of the methodology, and confirming that the management of digital marketing has a positive relation with innovation activities of companies. Also, that analytics in digital marketing is a source for its development. In this paper, the management stages and activities are presented to be developed by companies in order to generate knowledge, which will allow them to reach its digital maturity.

Keywords: digital marketing, digital maturity, innovation, SMEs

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Authors: Shizrah Jamal, Robia Ghafoor, Farhan Raza

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Porcelain fused to metal crown is the most versatile variety of crown that is commonly placed worldwide. Various complications have been reported in the PFM crowns with use over the period of time. These include chipping of the porcelain, recurrent caries, loss of retention, open contacts, and tooth fracture. The objective of the present study was to determine the frequency of these complications in crowns cemented over a period of five years in a tertiary care hospital and also to report the survival of these crowns. A retrospective study was conducted in Dental clinics, Aga Khan University Hospital in which 150 PFM crowns cemented over a period of five years were evaluated. Patient demographics, oral hygiene habits, para-functional habits, crown insertion and follow-up dates were recorded in a specially designed proforma. All PFM crowns fulfilling the inclusion criteria were assessed both clinically and radiographically for the presence of any complication. SPSS version 22.0 was used for statistical analysis. Frequency distribution and proportion of complications were determined. Chi-square test was used to determine the association of complications of PFM crowns with multiple variables including tooth wear, opposing dentition and betel nut chewing. Kaplan- meier survival analysis was used to determine the survival of PFM crowns over the period of five years. Level of significance was kept at 0.05. A total of 107 patients, with a mean age of 43.51 + 12.4 years, having 150 PFM crowns were evaluated. The most common complication observed was open proximal contacts (8.7%) followed by porcelain chipping (6%), decementation (5.3%), and abutment fracture (1.3%). Chi square test showed that there was no statistically significant association of PFM crown complication with tooth wear, betel nut and opposing dentition (p-value <0.05). The overall success and survival rates of PFM crowns turned out to be 78.7 and 84.7% respectively. Within the limitations of the study, it can be concluded that PFM crowns are an effective treatment modality with high success and survival rates. Since it was a single centered study; the results should be generalized with caution.

Keywords: chipping, complication, crown, survival rate

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Authors: Oscar Javier Herrera Ochoa, Ivan Dario Romero Fonseca

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This paper presents a design of a model for planning the distribution logistics operation. The significance of this work relies on the applicability of this fact to the analysis of small and medium enterprises (SMEs) of dry freight in Bogotá. Two stages constitute this implementation: the first one is the place where optimal planning is achieved through a hybrid model developed with mixed integer programming, which considers the transhipment operation based on a combined load allocation model as a classic transshipment model; the second one is the specific routing of that operation through the heuristics of Clark and Wright. As a result, an integral model is obtained to carry out the step by step planning of the distribution of dry freight for SMEs in Bogotá. In this manner, optimum assignments are established by utilizing transshipment centers with that purpose of determining the specific routing based on the shortest distance traveled.

Keywords: transshipment model, mixed integer programming, saving algorithm, dry freight transportation

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Authors: Azizah Hashim, Rohana Ngah

Abstract:

Transformation of Economic Development is aimed to transform Malaysia to become a high-income developed nation with a knowledge-based economy by 2020. To achieve this national agenda, the country needs to further strengthen its economic development, growth and well-being. Therefore, this study aspires to examine the relationship between market orientation, human resource management and adoption of information communication technology and SMEs performance and cash management as a mediator. This study will employ quantitative approaches. Questionnaires will be distributed to managers and owners in service sectors. The data collected will be analyzed using SPSS and Structural Equation Modelling. Resource Based Theory (RBT) adopts as an integral part of management literature that explains the performance of organizations through building resources and implement of their strategies.

Keywords: small medium enterprises (SMEs), market orientation, human resource management, adoption of information communication technology

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Authors: Mohd Fitri Mansor, Noor Hidayah Abu, Hussen Nasir

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Human capital is one of valuable assets to the organization in order to sustain organization performance and to achieve both employees and employer objectives. The aim of the study is to examine the powerful of both Human Resource practices (i.e. Training & Development and Compensation & Rewards) towards sustaining SME’s performance. The objectives of the current study are to examine the relationship between training and development as well as compensation and rewards in sustaining Malaysian SME’s performance. Finally, is to identify the strongest variable contribute to the sustainability of SMEs performance. The result from 80 Malaysian SME’s owners found that both variables training & development and compensation & rewards significantly contributes to the sustainability of SME,s performance. Meanwhile, the strongest variable contributes to the sustainability of SMEs performance was training and development. The study contributes to the knowledge and awareness to the SME’s owners an important or the powerful of human resource practices in sustaining their organization performance.

Keywords: training and development, compensation and rewards, sustainability, SME’s performance

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