This article discusses microlevel actions undertaken by owner-managers, and how such actions affect stakeholders in enhancing the sustainability of small and medium enterprises (SMEs), the knowledge on which is lacking in the extant literature. The paper, by adopting an inductive analytical approach, draws key insights from the literature on microfoundations and sustainability and evidence from representatives of 5 Cultural and Creative Industry SMEs in Italy and of 5 in the United Kingdom. The findings suggest that owner-managers play a crucial role when engaging in sustainability activities jointly with employees and other stakeholders, through which individual-level actions enhance collective organizational-level sustainability practices. The U.K.and Italian cases highlight 2 contrasting approaches to dealing with sustainability; thus, the paper contributes to the emerging literature on SME microfoundations and sustainability.

Background Bacterial and fungal superinfections may complicate the course of hospitalized patients with COVID-19. Objectives To identify predictors of superinfections in COVID-19. Methods Prospective, observational study including patients with COVID-19 consecutively admitted to the University Hospital of Pisa, Italy, between 4 March and 30 April 2020. Clinical data and outcomes were registered. Superinfection was defined as a bacterial or fungal infection that occurred ≥48 h after hospital admission. A multivariate analysis was performed to identify factors independently associated with superinfections. Results Overall, 315 patients with COVID-19 were hospitalized and 109 episodes of superinfections were documented in 69 (21.9%) patients. The median time from admission to superinfection was 19 days (range 11–29.75). Superinfections were caused by Enterobacterales (44.9%), non-fermenting Gram-negative bacilli (15.6%), Gram-positive bacteria (15.6%) and fungi (5.5%). Polymicrobial infections accounted for 18.3%. Predictors of superinfections were: intestinal colonization by carbapenem-resistant Enterobacterales (OR 16.03, 95% CI 6.5–39.5, P < 0.001); invasive mechanical ventilation (OR 5.6, 95% CI 2.4–13.1, P < 0.001); immunomodulatory agents (tocilizumab/baricitinib) (OR 5.09, 95% CI 2.2–11.8, P < 0.001); C-reactive protein on admission >7 mg/dl (OR 3.59, 95% CI 1.7–7.7, P = 0.001); and previous treatment with piperacillin/tazobactam (OR 2.85, 95% CI 1.1–7.2, P = 0.028). Length of hospital stay was longer in patients who developed superinfections ompared with those who did not (30 versus 11 days, P < 0.001), while mortality rates were similar (18.8% versus 23.2%, P = 0.445). Conclusions The risk of bacterial and fungal superinfections in COVID-19 is consistent. Patients who need empiric broad-spectrum antibiotics and immunomodulant drugs should be carefully selected. Infection control rules must be reinforced.

Purpose This paper aims to investigate the potential of knowledge management (KM) as a discipline in helping understand and manage social and economic complexity. The paper highlights some of the potential relationships between KM in organisations and their economic performance. Finally, the authors assess the role of human resources and technological infrastructures in the relationship between organisation’s approach to KM and their performance. Design/methodology/approach The hypotheses are tested via a survey on a sample of managerial-level employees of information technology organisations located in the city of Brno in Czech Republic. The data collected are analysed using structural equation modelling (SEM) to study the relationship between KM; the workforce’s willingness and ability to collaborate and co-create value; and the organisations’ economic performance. Findings The research found that there is a direct and positive relationship between an organisation’s approach to KM and its economic performance. This study also shows that the workforce’s behaviour and the technological infrastructure of the organisation have a direct effect on business performance. Finally, the authors proposed that a link between human resource management and technology orientation must be established and supported by a KM strategy. Originality/value This paper offers a new perspective to the approach to KM in organisations. Reflections and empirical results underline the need for organisations to invest in the implementation of KM strategies that involve both the human resources and technological infrastructure as a way to improve the impact of knowledge on the companies’ economic performances.

Colorectal cancer (CRC) is one of the leading causes of mortality and morbidity in the world. It is a heterogeneous disease, which can be classified into different subtypes, characterized by specific molecular and morphological alterations. In this context, BRAF mutations are found in about 10% of CRC patients and define a particular subtype, characterized by a dismal prognosis, with a median survival of less than 12 months. Chemotherapy plus bevacizumab is the current standard therapy in first-line treatment of BRAF-mutated metastatic CRC (mCRC), with triplet (FOLFOXIRI) plus bevacizumab as a valid option in patients with a good performance status. BRAF inhibitors are not so effective as compared to melanoma, because of various resistance mechanisms. However, the recently published results of the BEACON trial will establish a new standard of care in this setting. This review provides insights into the molecular underpinnings underlying the resistance to standard treatment of BRAF-mutated CRCs, with a focus on their molecular heterogeneity and on the research perspectives both from a translational and a clinical point of view.

Purpose Poverty, hunger, inequalities, diseases, unsustainable use of resources, etc., in spite of scientific progress, still remains unsolved worldwide issues. All these issues relate to the challenges of sustainability and sustainable development that now call for urgent answers. The purpose of this paper is to explore how the service research community can respond to this call and to identify key areas of potential contribution. Design/methodology/approach After a brief review of selected service literature aimed at exploring its interest in the topics of sustainability and sustainable development, the authors develop the interpretative proposal identifying the key requirements of a global engagement in the challenge of sustainability and sustainable development and highlighting the potential contribution of service research. Findings Findings highlight the potential contribution of service research to the global challenge of sustainability and suggest acting upon education by considering the “T-Shaped” professional model as a possible reference for embedding sustainability in the education of future managers and addressing the need of interdisciplinary thinking through the systems approach. Research limitations/implications The proposed study of service literature is only an exploratory analysis of main contributions that does not aim to identify gaps but only to highlight the potential of a greater engagement of service research in the global call for a more sustainable and inclusive development. Practical implications A trans-disciplinary approach is also required. This implies the involvement of the business and the social real world. Originality/value This paper represents a novel call for engaging the service research community in a boundary-crossing collaboration with the aim of contributing to address the challenge of sustainability.

Objectives To evaluate the impact of low molecular weight heparin (LMWH) on the outcome of patients with SARS-CoV-2 pneumonia. Methods Prospective observational study including consecutive patients with laboratory confirmed SARS-CoV-2 pneumonia admitted to the University Hospital of Pisa (4th March-30th April 2020). Demographic, clinical, and outcome data were collected. The primary endpoint was 30-day mortality. The secondary endpoint was a composite of death or severe ARDS. LMWH, hydroxychloroquine, doxycycline, macrolides, antiretrovirals, remdesivir, baricitinib, tocilizumab, and steroids were evaluated as treatment exposures of interest. First, a Cox-regression analysis, in which treatments were introduced as time-dependent variables, was performed to evaluate the association of exposures and outcomes. Then, a time-dependent Propensity-score (PS) was calculated and a PS-matching performed for each treatment variable. Results Among 315 patients with SARS-CoV-2 pneumonia, 70 (22.2%) died during hospital stay. The composite endpoint was achieved by 114 (36.2%) patients. Overall, 244 (77.5%) patients received LMWH, 238 (75.5%) hydroxychloroquine, 201 (63.8%) proteases inhibitors, 150 (47.6%) doxycycline, 141 (44.8%) steroids, 42 (13.3%) macrolides, 40 (12.7%) baricitinib, 13 (4.1%) tocilizumab, and 13 (4.1%) remdesivir. At multivariate analysis, LMWH was associated with a reduced risk of 30-day mortality (HR 0.36 [95% CI 0.21-0.6], p<0.001) and composite endpoint (HR 0.61 [95% CI 0.39-0.95], p=0.029). The PS-matched cohort of 55 couples confirmed the same results for both primary and secondary endpoint. Conclusions This study suggests that LMWH might reduce the risk of in-hospital mortality and severe ARDS in Covid-19. Randomized controlled trials are warranted to confirm these preliminary findings.

By underlining the relevance of the use of ICTs, knowledge sharing and electronic markets for SMEs, it emerges the need for stimulating a debate on digitisation process of supply chain management (SCM). Electronic infrastructure in the service sector are reducing each kind of cost and improving multiply buyer-supplier relationships, facilitating negotiations and transactions. However, since the coordination costs are still high, the use of ICTs is limited. This phenomenon thus attracts the interests of scholars and practitioners. Although it still needs to further investigate. Especially, the optimal use of ICTs within SMEs' SCM have not been studied yet. Therefore, by leveraging on four proxies: ICTs specialised human resources, knowledge sharing activities, buyer-supplier relationships, adoption of electronic markets this optimal was analysed via structural equation modelling based on a sample of 1254 SMEs operating in the service sector in Italy.

Purpose The purpose of this paper is to contribute to the ongoing debate regarding the relationship between relational capital (RC) and firm performance, by investigating the moderation effect of firm size and its key role in defining conditions for competitive advantage. Design/methodology/approach The paper uses the interpretative lens of the resource dependence theory, and refreshes consolidated studies rooted in RC. It identifies a set of variables to measure the influence of RC on firm performance, including the cost of goods sold, interest expenses and earnings per share. Content analysis was used to capture specific features of corporate disclosure tools using 51 items pertinent to RC. The authors used a specific disclosure index drawing on data collected from 73 listed firms in France, Germany, Italy and the UK. Data covering the period from 2011 to 2013 were analyzed using six regression models. Findings Firm size has a moderating effect on the relationship between RC and some variables linked to firm performance. Originality/value The study combines an internal and external perspective to investigate the interplay between firms and market environments, and therefore, enriches the ongoing debate concerning the relationship between RC and firm performance. It outlines possible ways through which RC can become an effective source of competitive advantage.