On the Determinants of the Reach of Innovation-related Collaboration in Small Firms

This paper takes as its starting point an item of relatively recent academic orthodoxy: the insistence that ‘…interactive learning and collective entrepreneurship are fundamental to the process of innovation’ (Lundvall, 1992, p. 9). From this, academics have frequently taken “interactive” to imply “inter-organisational” and, whilst one might be concerned by this too casual conflation, there is a growing consensus that firms’ embeddedness in collaborative networks matters for their innovative performance (Gilsing et al., 2008).

Geographical distance of innovation collaborations

This paper explores the geographical distance of innovation collaborations in high tech small firms. We test if absorptive capacity is a key determinant. Drawing on survey data from a sample of 316 Dutch high-tech small firms, engaging in 1.245 collaborations, we find most partners to be ‘local’. However, controlling for a variety of potential influences, higher R&D expenditure is positively related to collaboration with more distant organisations.  

Aldosterone status associates with insulin resistance in patients with heart failure-data from the ALOFT study

<b>Background</b>: Aldosterone plays a key role in the pathophysiology of heart failure. In around 50% of such patients, aldosterone 'escapes' from inhibition by drugs that interrupt the renin-angiotensin axis; such patients have a worse clinical outcome. Insulin resistance is a risk factor in heart failure and cardiovascular disease. The relationship between aldosterone status and insulin sensitivity was investigated in a cohort of heart failure patients. <b>Methods</b>: 302 patients with New York Heart Association (NYHA) class II-IV heart failure on conventional therapy were randomized in ALiskiren Observation of heart Failure Treatment study (ALOFT), designed to test the safety of a directly acting renin inhibitor. Plasma aldosterone and 24-hour urinary aldosterone excretion as well as fasting insulin and Homeostasis model assessment of insulin resistance (HOMA-IR) were measured. Subjects with aldosterone escape and high urinary aldosterone were identified according to previously accepted definitions. <b>Results</b>: Twenty per-cent of subjects demonstrated aldosterone escape and 34% had high urinary aldosterone levels. At baseline, there was a positive correlation between fasting insulin and plasma(r=0.22 p<0.01) and urinary aldosterone(r=0.19 p<0.03). Aldosterone escape and high urinary aldosterone subjects both demonstrated higher levels of fasting insulin (p<0.008, p<0.03), HOMA-IR (p<0.06, p<0.03) and insulin-glucose ratios (p<0.006, p<0.06) when compared to low aldosterone counterparts. All associations remained significant when adjusted for potential confounders. <b>Conclusions</b>: This study demonstrates a novel direct relationship between aldosterone status and insulin resistance in heart failure. This observation merits further study and may identify an additional mechanism that contributes to the adverse clinical outcome associated with aldosterone escape

Association between urinary sodium, creatinine, albumin, and long term survival in chronic kidney disease

Dietary sodium intake is associated with hypertension and cardiovascular risk in the general population. In patients with chronic kidney disease, sodium intake has been associated with progressive renal disease, but not independently of proteinuria. We studied the relationship between urinary sodium excretion and urinary sodium:creatinine ratio and mortality or requirement for renal replacement therapy in chronic kidney disease. Adults attending a renal clinic who had at least one 24-hour urinary sodium measurement were identified. 24-hour urinary sodium measures were collected and urinary sodium:creatinine ratio calculated. Time to renal replacement therapy or death was recorded. 423 patients were identified with mean estimated glomerular filtration rate of 48ml/min/1.73m<sup>2</sup>. 90 patients required renal replacement therapy and 102 patients died. Mean slope decline in estimated glomerular filtration rate was -2.8ml/min/1.73m<sup>2</sup>/year. Median follow-up was 8.5 years. Patients who died or required renal replacement therapy had significantly higher urinary sodium excretion and urinary sodium:creatinine but the association with these parameters and poor outcome was not independent of renal function, age and albuminuria. When stratified by albuminuria, urinary sodium:creatinine was a significant cumulative additional risk for mortality, even in patients with low level albuminuria. There was no association between low urinary sodium and risk, as observed in some studies. This study demonstrates an association between urinary sodium excretion and mortality in chronic kidney disease, with a cumulative relationship between sodium excretion, albuminuria and reduced survival. These data support reducing dietary sodium intake in chronic kidney disease but further study is required to determine the target sodium intake

Remote collaboration and innovative performance:the moderating role of R&D intensity

Collaboration with geographically distant partners may enhance a firm’s innovative performance. In practice, however, this may be complicated as personal contacts are more limited so that effective search and transfer of remote partners’ tacit knowledge is hampered. We tested the potential moderating role of R&D intensity which, by indicating technology-oriented absorptive capacity, may mitigate the problems associated with remote collaboration. Drawing on survey data of 248 high-tech small firms, we find that remote collaboration is positively related with innovation performance, but at low R&D intensity, the relationship vanishes

Business advice and lending in small firms

The literature on lending to small firms has primarily focused on the mechanisms and methods used to evaluate entrepreneurs and businesses and on the types of firms that are more likely to experience unfavourable application outcomes. That is, the focus of most empirical research is on supply-side decisions. The current research attempts to shed some light on demand-side considerations. Drawing upon data collected as the UK SME Finance Monitor (2011–2014), we identify links between entrepreneurs' diligence, business risk and finance-related advice-seeking prior to initiating loan and overdraft applications. The results show evidence of the usefulness of advice in ameliorating, both structural and strategic, business risk and improving the prospects of successful debt applications to banks

Alterations in vascular function in primary aldosteronism - a cardiovascular magnetic resonance imaging study

Introduction: Excess aldosterone is associated with increased cardiovascular risk. Aldosterone has a permissive effect on vascular fibrosis. Cardiovascular magnetic resonance imaging (CMR) allows study of vascular function by measuring aortic distensibility. We compared aortic distensibility in primary aldosteronism (PA), essential hypertension (EH) and normal controls and explored the relationship between aortic distensibility and pulse wave velocity (PWV).<p></p> Methods: We studied PA (n=14) and EH (n=33) subjects and age-matched healthy controls (n=17) with CMR, including measurement of aortic distensibility, and measured PWV using applanation tonometry. At recruitment, PA and EH patients had similar blood pressure and left ventricular mass.<p></p> Results: Subjects with PA had significantly lower aortic distensibilty and higher PWV compared to EH and healthy controls. These changes were independent of other factors associated with reduced aortic distensibility, including aging. There was a significant relationship between increasing aortic stiffness and age in keeping with physical and vascular aging. As expected, aortic distensibility and PWV were closely correlated.<p></p> Conclusion: These results demonstrate that PA patients display increased arterial stiffness compared to EH, independent of vascular aging. The implication is that aldosterone invokes functional impairment of arterial function. The long-term implications of arterial stiffening in aldosterone excess require further study.<p></p&gt

Control of Emi2 activity and stability through Mos-mediated recruitment of PP2A.

Before fertilization, vertebrate eggs are arrested in meiosis II by cytostatic factor (CSF), which holds the anaphase-promoting complex (APC) in an inactive state. It was recently reported that Mos, an integral component of CSF, acts in part by promoting the Rsk-mediated phosphorylation of the APC inhibitor Emi2/Erp1. We report here that Rsk phosphorylation of Emi2 promotes its interaction with the protein phosphatase PP2A. Emi2 residues adjacent to the Rsk phosphorylation site were important for PP2A binding. An Emi2 mutant that retained Rsk phosphorylation but lacked PP2A binding could not be modulated by Mos. PP2A bound to Emi2 acted on two distinct clusters of sites phosphorylated by Cdc2, one responsible for modulating its stability during CSF arrest and one that controls binding to the APC. These findings provide a molecular mechanism for Mos action in promoting CSF arrest and also define an unusual mechanism, whereby protein phosphorylation recruits a phosphatase for dephosphorylation of distinct sites phosphorylated by another kinase

ACTH and Polymorphisms at Steroidogenic Loci as Determinants of Aldosterone Secretion and Blood Pressure

The majority of genes contributing to the heritable component of blood pressure remain unidentified, but there is substantial evidence to suggest that common polymorphisms at loci involved in the biosynthesis of the corticosteroids aldosterone and cortisol are important. This view is supported by data from genome-wide association studies that consistently link the CYP17A1 locus to blood pressure. In this review article, we describe common polymorphisms at three steroidogenic loci (CYP11B2, CYP11B1 and CYP17A1) that alter gene transcription efficiency and levels of key steroids, including aldosterone. However, the mechanism by which this occurs remains unclear. While the renin angiotensin system is rightly regarded as the major driver of aldosterone secretion, there is increasing evidence that the contribution of corticotropin (ACTH) is also significant. In light of this, we propose that the differential response of variant CYP11B2, CYP11B1 and CYP17A1 genes to ACTH is an important determinant of blood pressure, tending to predispose individuals with an unfavourable genotype to hypertension.</p

Interprofessional Simulation in Accredited Paramedic Programs

Introduction: Healthcare leaders advocate for interprofessional education as a means to promote collaborative practice, enhance interdisciplinary communication, and improve patient safety in the health professions. There is little evidence specific to interprofessional simulation in paramedic education. Methods: The National Association of EMS Educators (NAEMSE) surveyed paramedic programs that were accredited or in the process of becoming accredited. Program respondents were asked to characterize their resources and their use of those resources, and then were asked about their perceptions pertaining to simulation in their program. Chi-square analysis was used to compare characteristics of programs that participated in interdisciplinary simulation with those that did not. Results: Of the 389 of 638 (61%) paramedic program survey respondents, 44% (159 of 362) report interprofessional simulation. They perceived they used the right amount of simulation more frequently than other paramedic programs X2 (1, N=362) = 8.425, p X2 (1, N=362) = 11.751, pX2 (1, N=356) = 8.838, pX2 (1, N=362) = 4.704, pX2 (1, N=362) = 11.508 pX2 (1, N=362) = 5.495, pX2 (1, N=359) = 12.595, p\u3c0.01.Conclusion: This research suggests that paramedic programs conducting interdisciplinary simulation indicated they have greater access to resources and faculty training to support simulation