Harnessing the power of artificial intelligence and robotics impact on attaining competitive advantage for sustainable development in hospitals with conclusions for future research approaches

Artificial intelligence (AI) and robotics have emerged as game-changing technologies with the potential to revolutionize the healthcare industry. In the context of hospitals, their integration holds the promise of not only improving patient care but also driving competitive advantage and fostering sustainable development. This review paper aims to explore and evaluate the impact of AI and robotics applications on attaining competitive advantage and promoting sustainable development in hospitals, examines the current landscape of AI and robotics adoption in healthcare settings and delve into their specific applications within hospitals, including AI-assisted diagnosis, robotic surgery, patient monitoring, and data analytics. A key finding is the insufficient use of KI to date in terms of promoting sustainable development in hospitals. Furthermore, attempts to analyze the potential benefits and challenges associated with these technologies in terms of enhancing patient outcomes, operational efficiency, cost savings, and differentiation from competitors. Drawing upon a comprehensive review of the existing literature and case studies, this paper provides valuable insights into the transformative potential of AI and robotics in hospitals.

Colicins and T6SS-based competition systems enhance enterotoxigenic E. coli (ETEC) competitiveness

Diarrheal diseases are still a significant problem for humankind, causing approximately half a million deaths annually. To cause diarrhea, enteric bacterial pathogens must first colonize the gut, which is a niche occupied by the normal bacterial microbiota. Therefore, the ability of pathogenic bacteria to inhibit the growth of other bacteria can facilitate the colonization process. Although enterotoxigenic Escherichia coli (ETEC) is one of the major causative agents of diarrheal diseases, little is known about the competition systems found in and used by ETEC and how they contribute to the ability of ETEC to colonize a host. Here, we collected a set of 94 fully assembled ETEC genomes by performing whole-genome sequencing and mining the NCBI RefSeq database. Using this set, we performed a comprehensive search for delivered bacterial toxins and investigated how these toxins contribute to ETEC competitiveness in vitro. We found that type VI secretion systems (T6SS) were widespread among ETEC (n = 47). In addition, several closely related ETEC strains were found to encode Colicin Ia and T6SS (n = 8). These toxins provide ETEC competitive advantages during in vitro competition against other E. coli, suggesting that the role of T6SS as well as colicins in ETEC biology has until now been underappreciated.

Effects of Septoglomus constrictum and Bacillus cereus on the competitive growth of Ageratina adenophora

Beneficial microorganisms play a pivotal role in the invasion process of exotic plants, including arbuscular mycorrhizal fungi (AMF) and Bacillus. However, limited research exists on the synergistic influence of AMF and Bacillus on the competition between both invasive and native plants. In this study, pot cultures of Ageratina adenophora monoculture, Rabdosia amethystoides monoculture, and A. adenophora and R. amethystoides mixture were used to investigate the effects of dominant AMF (Septoglomus constrictum, SC) and Bacillus cereus (BC), and the co-inoculation of BC and SC on the competitive growth of A. adenophora. The results showed that inoculation with BC, SC, and BC + SC significantly increased the biomass of A. adenophora by 14.77, 112.07, and 197.74%, respectively, in the competitive growth between A. adenophora and R. amethystoides. Additionally, inoculation with BC increased the biomass of R. amethystoides by 185.07%, while inoculation with SC or BC + SC decreased R. amethystoides biomass by 37.31 and 59.70% compared to the uninoculated treatment. Inoculation with BC significantly increased the nutrient contents in the rhizosphere soil of both plants and promoted their growth. Inoculation with SC or SC + BC notably increased the nitrogen and phosphorus contents of A. adenophora, therefore enhancing its competitiveness. Compared with single inoculation, dual inoculation with SC and BC increased AMF colonization rate and Bacillus density, indicating that SC and BC can form a synergistic effect to further enhance the growth and competitiveness of A. adenophora. This study reveals the distinct role of S. constrictum and B. cereus during the invasion of A. adenophora, and provide new clues to the underlying mechanisms of interaction between invasive plant, AMF and Bacillus.

A data-driven framing of player and team performance in U.S. Women's soccer

Introduction

In establishing historical benchmarks for success on the pitch and striving to achieve parity off it, the United States Women's National Team (USWNT) and the National Women's Soccer League (NWSL) have long served as standard bearers for professional women's soccer around the globe. However, off-field dilemmas and incessant juxtapositions to men's soccer frequently overshadow the elements that make U.S. women's soccer unique; that is, in the quest to expose and rid the women's game of blatant misconduct, discriminatory practices, and negative stereotypes, relatively little attention has been devoted to performance features that separate the U.S. women's soccer product from its competition. Because many of the issues hindering the progress of women's soccer are rooted in media and managerial practices that marginalize or ignore its positive traits, a need exists for analyses that will properly identify its innate characteristics and competitive advantages so that media members, managers, and fans can accurately frame their perceptions of women competing in the sport.

Methods

To this end, we collected reliable samples of public event data from 560 professional soccer matches and used ANOVAs and t-tests to identify the characteristics that distinguish U.S. women's soccer from other professional leagues and teams.

Results and Discussion

In doing so, we showed that the USWNT tends to shoot from more opportune areas and press opponents at a higher rate, and that the NWSL has recently been matched in quality across certain performance metrics by England's FA Women's Super League.

Reversion of Ceftazidime Resistance in Pseudomonas aeruginosa under Clinical Setting

Pseudomonas aeruginosa is an important nosocomial pathogen which frequently becomes resistant to most antibiotics used in chemotherapy, resulting in treatment failure among infected individuals. Although the evolutionary trajectory and molecular mechanisms for becoming β-lactam resistant have been well established for P. aeruginosa, the molecular basis of reversion from β-lactam resistant to susceptible is largely unexplored. In this study, we investigated the molecular mechanisms by which a ceftazidime-resistant clinical strain is converted to a ceftazidime-susceptible isolate under the clinical setting. RNA sequencing and genomic DNA reference mapping were conducted to compare the transcriptional profiles and chromosomal mutations between these two isolates. Our results demonstrate that a gain-of-function mutation in ampD, via deletion of a 53 bp duplicated nucleotide sequence, is the contributory factor for the conversion. Furthermore, we show for the first time that AmpD is involved in intraspecies competitiveness in P. aeruginosa. We also found that AmpD is not responsible for phenotypic changes between R1 and S2, including growth rate, motilities, pyocyanin, rhamnolipid, and biofilm production. This finding provides novel insights into the alteration of β-lactam sensitivity in P. aeruginosa under the clinical setting.

Stronger mutualistic interactions with arbuscular mycorrhizal fungi help Asteraceae invaders outcompete the phylogenetically related natives

Mutualistic interactions with arbuscular mycorrhizal fungi (AMF) greatly affect the outcome of plant-plant competition, especially for invasive plants competing against native plants. We examined the effects of AMF on the competition between invasive Asteraceae plants and the phylogenetically related native plants. We compared the performance of seven invasive Asteraceae plants from different genera with that of their phylogenetically related native counterparts in response to AMF in monocultures and mixed cultures. We investigated how interactions with AMF impact the competition between Asteraceae relatives. Total biomass increased with AMF colonization in both invasive and native plants. Arbuscular mycorrhizal fungi improved the competitiveness of invasive plants, but decreased that of native plants. Competition increased the shoot nitrogen, phosphorus and root myristic acid concentrations and relative expression of fatty acid transporter genes (RiFAT1 and RiFAT2) in AMF-colonized invasive plants, but decreased those in AMF-colonized native plants. Structural equation models indicated that the presence of AMF increased the uptake of phosphorus, but not nitrogen, by invasive plants, which probably provided more myristic acids to symbiotic AMF in return. These results suggest that invasive Asteraceae plants have greater mutualistic interactions with AMF than their phylogenetically related native counterparts, potentially contributing to invasion success.

TssI2-TsiI2 of Vibrio fluvialis VflT6SS2 delivers pesticin domain-containing periplasmic toxin and cognate immunity that modulates bacterial competitiveness

Vibrio fluvialis is a halophilic Gram-negative bacterium regarded as an emerging unusual enteric pathogen of increasing public health concern. Our previous work has identified two type VI secretion systems (T6SSs) in V. fluvialis, VflT6SS1, and VflT6SS2, and the latter is functional in mediating interbacterial competitiveness. However, its antibacterial effectors remain to be clarified. In this work, we focused on a new potential effector/immunity pair TssI2/TsiI2. Bioinformatics analysis revealed that the C-terminal domain of TssI2 belongs to a widespread family of pesticin, and its antibacterial toxicity and corresponding protection by TsiI2 were proved via bacterial killing assays, and their action sites were localized to the periplasm of bacterial cells. The interaction of TssI2 and TsiI2 was demonstrated by the bacterial adenylate cyclase two-hybrid, protein pull-down and isothermal titration calorimetry assays. Site-directed mutagenesis demonstrated that, in addition to Glu-844, Thr-863, and Asp-869, which correspond to three reported residues in pesticin of Yersinia pestis, additional residues including Phe-837, Gly-845, Tyr-851, Gly-867, Gln-963, Trp-975, and Arg-1000 were also proved to be crucial to the bactericidal activity of TssI2. Muramidase/lysozyme-related peptidoglycan (PG) hydrolase activities of TssI2 and its variants were validated with permeabilized Escherichia coli cells and purified PG substrate. Based on sequence homologies at C-terminals in various V. fluvialis isolates, TssI2 was subdivided into five clusters (12-22% identity among them), and the antibacterial activities of representative effectors from other four Clusters were also confirmed through periplasmic over-expression in E. coli host. Two selected cognate immunities were proved to confer protection against the toxicities of their effectors. Additionally, TsiI2, which belongs to Cluster I, exhibited cross-protection to effector from Cluster V. Together, current findings expand our knowledge of the diversity and consistency of evolved VgrG effectors in V. fluvialis and on how VflT6SS2 mediates a competitive advantage to gain a better survival.

Promoting Psychological Well-Being at Workplace through Protean Career Attitude: Dual Mediating Effect of Career Satisfaction and Career Commitment

The management paradigm of SMEs is changing due to the recent Fourth Industrial Revolution and the changing COVID-19 environment. To respond to these changes, companies are focusing on protean career attitude (PCA) and psychological well-being (PWB) of employees to improve corporate performance. Under these circumstances, this study investigated the structural relationship of the dual mediation effects of career commitment and career satisfaction in the relationship between PCA and PWB. To this end, this study targeted 307 employees of Korean small and medium-sized enterprises (SMEs), and the results are as follows. First, PCA was found to have a positive effect on career satisfaction and PCA was found to have a positive effect on career commitment. Second, PCA was found to have a significant effect on PWB. Third, career satisfaction, a parameter of this study, was found to have a positive impact on career commitment; in the relationship between PCA and PWB, the dual mediation effects of career satisfaction and career commitment were found to be significant. Finally, this study provided discussions and theoretical and practical implications based on those results, as well as directions for future research.

Core Technological Competence and Competitive Advantage: A Study on Chinese High-Tech SMEs

The purpose of this study was to examine the effect of core technology competence on the competitive advantage of high-tech SMEs (small- and mid-sized enterprises in China). Based on the 379 valid responses collected from a survey, structural equation modeling (SEM) was employed to examine the research model. Infrastructure and technology, state-of-the-art technology, innovative research and development (R&D) capability, and organizational flexibility all have a significant impact on the competitive advantage, while infrastructure and technology, state-of-the-art technology, and innovative R&D capability have a significant effect on organizational flexibility. Organizational flexibility plays a mediating role between innovative R&D capability's effect and competitive advantage. Under the continuous influence of COVID-19, we should promote development from the perspective of strengthening enterprise infrastructure and technology and improving organizational flexibility to gain a competitive advantage. This study reveals the internal relationship between core technology competence, organizational flexibility, and competitive advantage. The results of this study will help us to fully understand the survival status and competitive advantage of high-tech SMEs under COVID-19.

Rhizospheric Bacillus-Facilitated Effects on the Growth and Competitive Ability of the Invasive Plant Ageratina adenophora

The rhizospheric microbial community affects the population establishment of invasive plants in introduced areas, among which Bacillus has numerous functions in promoting plant growth. This study isolated and enriched the Bacillus community in the rhizospheric soil of the invasive plant Ageratina adenophora and the native accompanying plant Rabdosia amethystoides. The effects of these rhizospheric Bacillus communities on the growth and competition of A. adenophora and R. amethystoides were evaluated in pot experiments. The results showed that the number and diversity of Bacillus in the rhizospheric soil of A. adenophora were higher than those of R. amethystoides (A. adenophora: 122 strains in soil, 16 Bacillus taxa; R. amethystoides: 88 strains in soil, 9 Bacillus taxa). After Bacillus inoculation of A. adenophora in a pot experiment, Bacillus idriensis, Bacillus toyonensis and Bacillus cereus were accumulated in the rhizospheric of A. adenophora, which significantly increased the nitrate nitrogen (NO₃ ^--N) content in the soil and the total carbon and nitrogen concentrations in A. adenophora in the mixed treatment. The selective accumulation of Bacillus enhanced the competitive advantage of A. adenophora over the native accompanying plant; the corrected index of relative competition intensity of A. adenophora-inoculated Bacillus reached double that of the uninoculated treatment, and the growth of native plants was greatly suppressed under mixed planting. Our study confirmed that invasion of A. adenophora can lead to the accumulation of specific Bacillus taxa in the rhizospheric soil, which in turn can increase the competitive advantage of A. adenophora.

Understanding the Impact of Competitive Advantage and Core Competency on Regional Tourism Revitalization: Empirical Evidence in Taiwan

Competitive advantage and core competency are the unique capabilities and assets of an organization to provide valuable products or services to customers, thus giving the organization a better competitive position in the market than its competitors. In addition, how to create a competitive advantage is also one of the main objectives of business strategy. Therefore, this study focuses on understanding the decisive factors in regional revitalization and the relationship between business strategy, strategic alliance, and alliance performance through small and medium enterprises (SMEs) in Taiwan. This study selected a sample of 220 SMEs in Taiwan that had participated in the SME regional revitalization counseling program. The results showed that competitive advantage, core competency and strategic alliance partner selection had significant effects on alliance performance. In addition, core competency had an indirect effect on alliance performance through strategic alliance partner selection. However, competitive advantage did not have a significant effect on strategic alliance partner selection. Finally, this study proposes management implications and practical suggestions for SMEs' competitive advantage, core competency, and alliance performance.

Merger and Acquisitions Integration, Implementation as Innovative Approach Toward Sustainable Competitive Advantage: A Case Analysis From Chinese Sports Brands

Brand M&A has long been an extremely common strategy for expanding the scale of an organization and entering new business areas, but various signs show that many brand mergers and acquisitions (M&As) do not add value. They often lose money and fail. This research explores the value, scarcity, and non-replicability of resources in corporate M&A, as well as organizational resource management, innovation resource management, and implementation of the combination of resource utilization and brand strategy that incorporate M&As. Taking 03 of China's sporting shoe industry cases, this study uses the literature to collect, analyze, and organize the conversations of high-level managers to compare and integrate the motivations of corporate M&As to conduct confirmatory analysis. Using case studies and cross-border M&A related secondary data from 2014 to 2021 and supplemented by senior executives' conversations, 1,836 articles were collected as analysis units. The research results show that Chinese companies' cross-border M&A's main corporate strategic motives have four key elements: accelerated expansion, integration of resources, brand integration, rapid entry into the international market, and obstacles to the construction of new entrants. The research results also show that integrating resources and brand execution strategies after M&As correlates to their success or failure. The purpose of the research was first to discuss brand M&As and corporate strategies in the Taiwanese context. Secondly, it discusses the issue of the use of resources by the acquired party in specific to emerging trends in consumer resistance to innovation and acceptance of technological innovativeness in the sports industry brands. Third, it analyzes the effectiveness of brand strategy integration and implementation. Finally, it provides a strategic reference for brand M&As in the industry.

Study on Survival and Sustainable Development of Small- and Medium-Sized Tourism and Hospitality Enterprises in Macao Based on Regional Soft Environment and Competitive Advantage

The small- and medium-sized tourism and hospitality enterprises are the main forms of enterprises in Macao. This study put forward a new framework of survival and sustainable development from the perspective of competitive advantage and regional soft environment, which significantly holds theoretical and practical research value. The study obtained cross-sectional data of 317 small- and medium-sized tourism and hospitality enterprises in Macao through a large-scale questionnaire survey. This article used exploratory factor analysis and confirmatory factor analysis to test the reliability and validity of each factor system and its measurement scale. The variance analysis is used to judge the differences between the elements. The regression analysis is used to verify the hypothesis of a causal relationship between factors. The structural equation analysis is used to fit the model and make necessary amendments. The results reveal that the government service environment has a significant positive impact on the ability of an entrepreneur. In addition, the regional soft environment significantly impacts the competitive advantage of small- and medium-sized tourism and hospitality enterprises in Macao. Contrary, the impact of laws of Macao on the acquisition of financial resources and the promotion of entrepreneur ability and innovation ability is found insignificant. In conclusion, the results showed that market of Macao lacks venture investors where enterprises cannot obtain funds through angel financing or risk financing.

Achieving Human Resource Management Sustainability in Universities

The sustainability of human resource management (HRM) is the basis for an organization’s future growth and success. This study aims to investigate achieving HRM sustainability in universities. We use a quantitative research method design to investigate the factors that affect HRM sustainability at universities. The study was conducted during the spring and summer of 2020 at Iranian state universities. As the study’s statistical population included 2543 employees, a sample size of 334 employees was calculated using the Cochran formula. A questionnaire with 32 statements based on a 5-point Likert scale was used to collect the data, which were analyzed using PLS3 software. The findings show that human resource practices, social factors, psychological factors, employer branding, and economic factors have positive and significant effects on HRM sustainability at universities. Findings indicate that it is essential to consider the implementation of adequate HRM practices and related socio-economic and psychological supports for HRM sustainability in universities that can lead to the competitiveness of the higher education institutions such as universities.

The Imperative for Diversity and Inclusion in Interventional Radiology

OBJECTIVE. The purpose of our study was to review key social justice and competitive advantage arguments for diversity in interventional radiology (IR) to substantiate the need for a more inclusive workforce. CONCLUSION. As a specialty based on innovation and flexibility of thought, IR is well positioned to be a driver of diversity and inclusion in medicine. The status quo is far from ideal. Social justice and business advantage arguments provide us with the imperative for change.

The Packaging Regions of G1-Like PB2 Gene Contribute to Improving the Survival Advantage of Genotype S H9N2 Virus in China

The genotype S (G57) H9N2 virus, which first emerged in 2007 with the substitution of the G1-like PB2 gene for F98-like ones, has become the predominant genotype in the past 10 years. However, whether this substitution plays a role in the fitness of genotype S H9N2 viruses remains unknown. Comparison of the PB2 genes of F98-like and G1-like viruses revealed a close homology in amino acid sequences but great variations at nucleotide levels. We then determined if the packaging region, a unique sequence in each segment utilized for the assembly of the vRNA into virions, played a role in the fitness of the S genotype. The chimeric H9N2 virus with PB2 segments of the G1-like packaging regions significantly increased viral protein levels and polymerase activity. Substituting the packaging regions in the two terminals of F98-like PB2 with the sequence of G1-like further improved its competitive advantage. Substitution of the packaging regions of F98-like PB2 with those of G1-like sequences increased the infectivity of the chimeric virus in the lungs and brains of chicken at 3 days post infection (dpi) and extended the lengths of virus shedding time. Our study suggests that the packaging regions of the G1-like PB2 gene contribute to improve the survival advantage of the genotype S H9N2 virus in China.

Deletion of vp0057, a Gene Encoding a Ser/Thr Protein Kinase, Impacts the Proteome and Promotes Iron Uptake and Competitive Advantage in Vibrio parahaemolyticus

The marine bacterial pathogen Vibrio parahaemolyticus is a major cause of food-borne gastroenteritis. Recent findings have demonstrated that protein phosphorylation is fundamental to the regulation of many physiological processes in pathogenic bacteria, including bacterial virulence. However, the underlying mechanisms remain to be completely clarified. Using bioinformatics analysis, we found that VP0057 may be a potential Ser/Thr protein kinase with phosphorylation activity. Thus, we constructed the vp0057-deletion mutant (Δvp0057) from the wild-type V. parahaemolyticus serotype O3:K6 and employed a mass spectrometry-based proteomic strategy to characterize proteome-wide changes in response to vp0057 deletion, owing to the potential roles of VP0057 in V. parahaemolyticus. One hundred ninety-seven differentially expressed proteins were identified in the Δvp0057 strain compared with the wild-type strain, among which 135 proteins were upregulated and 62 proteins were downregulated. Detailed annotation of these differentially expressed proteins was conducted. Notably, iron-related and T6SS1-related proteins were upregulated in the Δvp0057 strain, corroborating the results by quantitative PCR. Further experiments proved that vp0057 deletion promotes Fe²⁺ and Fe³⁺ uptake and provides a growth competition advantage, which is controlled by iron-related and T6SS1-related proteins, respectively. Although the regulatory roles and mechanisms of VP0057 remain to be revealed in V. parahaemolyticus, our systemic analysis of the protein profile of Δvp0057 provides a promising starting point for the intensive exploration of VP0057.

Ahead of the Curve: Leveraging Antecedents of Corporate Entrepreneurship to Pull Off Competitive Advantage

Entrepreneurship is a highly dynamic and important endeavor that spills over to economic, technological, and social canvas of a society in this rapidly changing globalized economy. The purpose of the present quantitative study is to investigate the associations among information and communication technologies, innovation, absorptive capacity, CEO’s temporal leadership, and competitive advantage by considering corporate entrepreneurship as a mediator. These factors have been incorporated because they play a predominant role to vie in a competitive environment for entrepreneurial success and economic growth. We used the response of 460 organizations, acquired on a Likert scale, to examine how antecedents of corporate entrepreneurship contribute toward competitive advantage. Structural equation modeling was employed to analyze the measurement and structural relationships including the mediation effects of corporate entrepreneurship. All the relationships with corporate entrepreneurship were found significant except the direct effect of absorptive capacity on competitive advantage. Hence, the results established corporate entrepreneurship as a mediator to predict competitive advantage partially by information and communication technologies (ICT) use, innovation, and temporal leadership. The findings also reveal that absorptive capacity reaps an entire competitive advantage only through corporate entrepreneurship. Practically, the study would be invaluable for organizations, entrepreneurs, and managers to capture a lot of opportunities in effectively managing scarce resources.

Structural and Functional Analysis of BBA03, Borrelia burgdorferi Competitive Advantage Promoting Outer Surface Lipoprotein

BBA03 is a Borrelia burgdorferi outer surface lipoprotein encoded on one of the most conserved plasmids in Borrelia genome, linear plasmid 54 (lp54). Although many of its genes have been identified as contributing or essential for spirochete fitness in vivo, the majority of the proteins encoded on this plasmid have no known function and lack homologs in other organisms. In this paper, we report the solution NMR structure of the B. burgdorferi outer surface lipoprotein BBA03, which is known to provide a competitive advantage to the bacteria during the transmission from tick vector to mammalian host. BBA03 shows structural homology to other outer surface lipoproteins reflecting their genetic and evolutionary relatedness. Analysis of the structure reveals a pore in BBA03, which could potentially bind lipids.

The Effect of Relational Embeddedness, Absorptive Capacity, and Learning Orientation on SMEs' Competitive Advantage

The combination of external new knowledge and organizational capability has become a cornerstone in the internationalized enterprises. Sources of knowledge acquisition are among the most valuable resources that an internationalized firm can achieve competitive advantage. This study aims to explore this phenomenon between knowledge sources and competitive advantage in the context of internationalized small and medium enterprises (SMEs) mainly by a quantitative approach. Based on contextual nature of resource–capability–competitive, absorptive capacity has long been a critical construct in organizational studies, as well as referring relational embeddedness as potential drivers of absorptive capacity, which is moderated by learning orientation. This study also investigates the mediating effect of absorptive capacity in terms of knowledge absorption and integration on international competitive advantage. To gain insights and provide essential implications for internationalized SMEs from the global economy, this study adopted purposive sampling to collect 211 valid responses. Via the partial least-squares structural modeling, the relationships among relational embeddedness, potential and realized absorptive capacity, and competitive advantage were measured. The results suggest that relational embeddedness positively influences potential and realized absorptive capacity with moderating effect of learning orientation. Potential and realized absorptive capacities have full mediating effect between relational embeddedness and competitive advantage. This study concludes insights and implications for research and practice.

The Whi2p-Psr1p/Psr2p complex regulates interference competition and expansion of cells with competitive advantage in yeast colonies

Yeast form complex highly organized colonies in which cells undergo spatiotemporal phenotypic differentiation in response to local gradients of nutrients, metabolites, and specific signaling molecules. Colony fitness depends on cell interactions, cooperation, and the division of labor between differentiated cell subpopulations. Here, we describe the regulation and dynamics of the expansion of papillae that arise during colony aging, which consist of cells that overcome colony regulatory rules and disrupt the synchronized colony structure. We show that papillae specifically expand within the U cell subpopulation in differentiated colonies. Papillae emerge more frequently in some strains than in others. Genomic analyses further revealed that the Whi2p-Psr1p/Psr2p complex (WPPC) plays a key role in papillae expansion. We show that cells lacking a functional WPPC have a sizable interaction-specific fitness advantage attributable to production of and resistance to a diffusible compound that inhibits growth of other cells. Competitive superiority and high relative fitness of whi2 and psr1psr2 strains are particularly pronounced in dense spatially structured colonies and are independent of TORC1 and Msn2p/Msn4p regulators previously associated with the WPPC function. The WPPC function, described here, might be a regulatory mechanism that balances cell competition and cooperation in dense yeast populations and, thus, contributes to cell synchronization, pattern formation, and the expansion of cells with a competitive fitness advantage.

The theory and empirics of the structural reshaping of globalization

Petricevich and Teece's (2019) article on the reshaping of globalization raises profound issues on the theory and empirics of international business. The fracture in the world economy between the USA and China is the result of Government policy, but its relationship to rising VUCA (volatility, uncertainty, complexity, and ambiguity) elements in globalization is more complex than simple policy changes. This paper suggests that a reappraisal of theory is required, not least because of the eruption of Covid-19, but that internalization theory is the best source of theoretical restructuring in the face of the new empirical realities facing the global economy.

Increased Horizontal Transmission of Recombinant Marek's Disease Virus Due to Reticuloendotheliosis Virus Long Terminal Repeat Is the Major Competitive Advantage of the Virus Being a Prevalent Strain

GX0101 is the first field Marek's disease virus (MDV) recombinant with an REV LTR insert isolated in China. We speculated that there was a selective advantage of GX0101 becoming the more prevalent field strain from a very low percentage of recombinant virus. In the study, dual fluorescence quantitative real-time PCR (DF-qPCR) that detects GX0101 and GX0101ΔLTR simultaneously was established based on the genomic difference of GX0101 and its LTR deletion strain GX0101ΔLTR. MDV natural transmission was simulated in specific-pathogen-free (SPF) chicks, and continuous tracking of GX0101 and GX0101ΔLTR in chicks was carried out. The results showed that GX0101 possessed high horizontal transmission capacity, which could infect SPF chicks by contact in a short time and became the predominant strain following contact infections in chicken flocks. GX0101 still had a more significant advantage of horizontal transmission than GX0101ΔLTR after continuous passage even if the initially infectious dose was significantly lower. There were 72 differentially expressed MDV genes between GX0101 and GX0101ΔLTR, with the genes and gene products mainly involved in virus replication, tegument protein, glycoprotein, nucleocapsid protein, immune evasion, tumor development and/or pathogenesis, and hypothetical protein. Sixteen genes related to virus replication and transmission were significantly up-regulated. This is the first study to illuminate that increased horizontal transmission of recombinant MDV due to REV LTR was the competitive advantage of the virus being a prevalent strain and define the differential transcription profile of viral genes between GX0101 and GX0101ΔLTR. This will be helpful for in-depth study on the molecular mechanism of increased horizontal transmission of MDV by REV LTR.

Analysis of Nursing Education Excellence in Indonesia Using Baldrige Criteria

This research aimed to analyze nursing education excellence in 54 nursing schools in East Java, Indonesia, using Baldrige Criteria for Performance Excellence (BCFPE) to evaluate competitive advantage on an international level. Data were collected through interviews; questionnaires; and documentation from heads of departments, lecturers, and students. Data obtained using the Baldrige modified questionnaire were analyzed with descriptive statistics and then classified using the BCFPE score. Results showed that these schools of nursing were still in the early growth stages in all areas measured. Their overall achievement scores were below 50%. The schools of nursing could achieve world-class performance and competitive advantage in nursing education, emerging as industry leaders, by improving leadership; customer focus; strategic planning; measurement, analysis, and knowledge management; human resources focus; and learning process.

Perceptions of social, emotional, and functional values in patients with type 2 diabetes mellitus and their satisfaction with primary health care services

AIM

To explore the relationships between social, emotional, and functional values, and satisfaction of patients with type 2 diabetes mellitus (T2DM) with an emphasis on Lithuanian primary health care services providers.

BACKGROUND

Academics and practitioners are encouraging more research on service value conceptually and empirically. Primary health care settings (PHCS) use modern management of value creation for patients with chronic diseases to increase the satisfaction of patients. Satisfaction of patients is the most important factor of competitive advantage for the PHCS. In this study, perceived value concept is dealt with in a multidimensional way. The fact that the perceived value in health sector has not previously been examined as multidimentionally has increased the importance of this research.

METHODS

The study strategy is based on focus group discussions of executives and survey of patients with T2DM in the primary health care sector. The target of focus group discussions is to gain knowledge about factors developing the competitive advantage of PHCS. The survey of patients with T2DM is the background to test the conceptual model of perceived value importance on satisfaction. The study uses coefficients of correlation, exploratory factor analysis, and linear regression.

FINDINGS

The results of focus groups revealed the factors of competitive advantage related to perspectives of health policy, organization, human resources, and patients. The results of the survey established statistically significant links between social value and satisfaction, and functional value and satisfaction. Emotional value decreased satisfaction of patients with T2DM.

Using Service Blueprints to Visualize Pharmacy Innovations

Background: Applying the principles of service design can help pharmacists manage both the quality and patient perceptions of the services they provide. Service blueprints are a widely used service design tool that are rare in the healthcare literature. They can be used to design new services or revisit the design of established services. This paper describes service blueprints and their uses, and illustrates how to build one using an example. Methods: A blueprint is built for appointment-based medication synchronization services to illustrate the tool. Conclusions: Service blueprints permit pharmacists to better see and understand service processes. They clarify the process of service delivery and the roles of customers, service providers, and supporting services. They provide a way of depicting complex services in a concise visual way that communicates details at a glance. Pharmacists who utilize service blueprints can improve the consistency and quality of services provided, and they can increase the chance that every interaction with patients sends a positive message about the value of pharmacist services.

QuantumIS: A Qualia Consciousness Awareness and Information Theory Quale Approach to Reducing Strategic Decision-Making Entropy

This paper investigates the underlying driving force in strategic decision-making. From a conceptual standpoint, few studies empirically studied the decision-maker's intrinsic state composed of entropy and uncertainty. This study examines a mutual information theory approach integrated into a state of qualia complexity that minimizes exclusion and maximizes the interactions of the information system and its dynamic environment via logical metonymy, illusion, and epigenetics. The article questions whether decision-makers at all levels of the organization are responding from the consciousness of an objective quale from a more subjective qualia awareness in the narrow-sense perspective of individual instances of their conscious experience. To quantify this research question, we explore several hypotheses revolving around strategic information system decisions. In this research, we posit that the eigenvalues of factor analysis along with the reduction in the uncertainty coefficients of the qualia entropy will be balanced by the quale enthalpy of our information theory structural equation model of trust, flexibility, expertise, top management support, and competitive advantage performance. We operationalize the integration of the aforementioned top management support, information systems competencies, and competitive advantage performance concepts into the qualia consciousness awareness and information theory quale framework.

The development of a multidimensional Consumer Perceived Value scale in ophthalmology services

Objective: The aim of this study was to investigate the dimensionality of Consumer Perceived value in Romanian ophthalmology services. Material and Methods: The sample consisted of 173 consumers of private ophthalmology services, recruited using a systematic method. The design of the study was cross-sectional and the research instrument was a self-administered questionnaire, namely a Consumer Perceived Value Scale, developed by Chahal and Kumari. The dimensions of the Consumer Perceived Value were assessed by conducting an Exploratory Factor Analysis and the scale's reliability was checked with the Cronbach's alpha coefficient. Results: The findings of the Exploratory Factor Analysis revealed that all initial factors loaded properly and the Cronbach's alpha coefficients had values greater than the recommended threshold of 0.70. As such, the Consumer Perceived Value scale had a Cronbach's alpha coefficient of 0.77 and encompassed the following dimensions: transaction value, aesthetic value, efficiency value, self-gratification value, acquisition value and social interaction value. Conclusions: Applying efficient value strategies in ophthalmology services may ensure consumer satisfaction, loyalty, positive word-of-mouth and offer competitive advantages.

Revisiting the merits of a mandatory large group classroom learning format: an MD-MBA perspective

The role of classroom learning in medical education is rapidly changing. To promote active learning and reduce student stress, medical schools have adopted policies such as pass/fail curriculums and recorded lectures. These policies along with the rising importance of the USMLE (United States Medical Licensing Examination) exams have made asynchronous learning popular to the detriment of classroom learning. In contrast to this model, modern day business schools employ mandatory large group classes with assigned seating and cold-calling. Despite similar student demographics, medical and business schools have adopted vastly different approaches to the classroom. When examining the classroom dynamic at business schools with mandatory classes, it is evident that there's an abundance of engaging discourse and peer learning objectives that medical schools share. Mandatory classes leverage the network effect just like social media forums such as Facebook and Twitter. That is, the value of a classroom discussion increases when more students are present to participate. At a time when students are savvy consumers of knowledge, the classroom is competing against an explosion of study aids dedicated to USMLE preparation. Certainly, the purpose of medical school is not solely about the efficient transfer of knowledge - but to train authentic, competent, and complete physicians. To accomplish this, we must promote the inimitable and deeply personal interactions amongst faculty and students. When viewed through this lens, mandatory classes might just be a way for medical schools to leverage their competitive advantage in educating the complete physician.

Why Leading Consumer Product Companies Develop Proactive Chemical Management Strategies

Scholars have studied the various pressures that companies face related to socially responsible behavior when stakeholders know the particular social issues under consideration. Many have examined social responsibility in the context of environmental responsibility and the general approaches companies take regarding environmental management. The issue of currently unregulated, but potentially hazardous, chemicals in consumer products is not well understood by the general public, but a number of proactive consumer product companies have voluntarily adopted strategies to minimize use of such chemicals. These companies are exceeding regulatory requirements by restricting from their products chemicals that could harm human or environmental health, despite the fact that these actions are costly. They do not usually advertise the details of their strategies to end consumers. This article uses interviews with senior environmental directors of 20 multinational consumer product companies to investigate why these companies engage in voluntary chemicals management. The authors conclude that the most significant reasons are to achieve a competitive advantage and stay ahead of regulations, manage relationships and maintain legitimacy with stakeholders, and put managerial values into practice. Many of the characteristics related to the case of chemicals management are extendable to other areas of stakeholder management in which risks to stakeholders are either unknown or poorly understood.