Purpose – During the past decade, there has been vast investment in Enterprise Resource Planning (ERP) system packages, in addition to a significant increase in the importance of acceptance by users of the ERP system regarding the success or failure of ERP implementation. The purpose of this paper is to identify the external factors which influence ERP system acceptance. The work is motivated by the realization that transformational leadership (TL) and ERP system self-efficacy are critical external factors that can affect ERP system acceptance. Design/methodology/approach – A framework has been developed from a study of literature in the field of TL, ERP system self-efficacy and the technology acceptance model (TAM). A survey utilizing a questionnaire was used to collect data and a total of 151 usable responses were analyzed by using the partial least squares method. Findings – The results of the study indicate that TL can either directly or indirectly influence perceived usefulness via the assimilation of self-efficacy in a positive manner. Also, TL has been found to have a positive influence on perceived ease of use both directly and indirectly via application of self-efficacy measures. Research limitations/implications – The findings were drawn from two Iranian companies, hence the results are not necessarily generalizable to other nations and other cultures. Practical implications – Management should provide TL development programs for their ERP leaders and encourage them to implement transformation in a manner that could increase assimilation and application of self-efficacy when using the ERP system. Originality/value – The study can provide ERP managers with a better understanding of how they can use TL behavior and skills in motivating and enhancing employees’ self-efficacy in order to achieve ERP system usage success.

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Introduction: Thrombocytopenia (TP) is associated with poor outcome in patients who are critically ill with pneumonia, burns, and H1N1 influenza. To our knowledge, no similar study in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has been conducted to date. The aim of this study was to determine the impact of platelet count on the outcome of patients with AECOPD. Material and methods: Patients admitted to our teaching hospital for AECOPD were divided into two cohorts, those with and without TP. The outcome of all patients was followed. Results: Of the 200 patients with AECOPD, 55 (27.5%) had TP. Of these, 14 (25.5%) died in the hospital, whereas of the 145 non-TP patents, 11 (7.5%) died (p-value = 0.001). There was a significantly higher transfer rate to the ICU and mechanical ventilation in TP patients. The mean platelet count was significantly lower in patients who died than those who were discharged (161,672 vs. 203,005 cell/µL; p-value = 0.017). There was negative correlation between duration of hospitalization and platelet count. Conclusion: TP was associated with poor outcome in AECOPD. TP could be considered as a marker for the assessment of inflammation and prognosis in AECOPD patients based on its cost-effective features.

Although perceived organizational support (POS) and organizational citizenship behaviors (OCBs) have long received research attention, little is known of the effects of POS and OCBs in the IS usage context, specifically in the context of enterprise resource planning (ERP) continuance. In this study, the authors integrate three research streams, including POS, OCBs, and ERP continuance intention into one model in order to investigate whether POS and OCBs: altruism, conscientiousness, courtesy, civic virtue, and sportsmanship affect ERP users' continuance intention. Grounded on social exchange theory (SET), this study examined the influence of POS on OCBs, satisfaction, and continuance. In addition, the authors also assessed the mediating effects of OCBs between POS and continuance. A survey utilizing a questionnaire was used to collect data and a total of 250 usable responses were analyzed by using partial least squares (PLS). The authors found that POS indirectly influence continuance intention through satisfaction and OCBs. Conscientiousness, civic virtue, and sportsmanship mediated the relationship between POS and continuance intention, but altruism and courtesy do not. Also, a number of implications for both researchers and managers are proposed.

The skin metastasis of papillary thyroid carcinoma (PTC) is a rare condition and the lesions should be differentiated from primary skin tumors. The scalp is the most frequent site which is involved in skin metastasis of PTC. It shows the poor outcome and aggressive nature of disease. In this report, we aim to present a case report of a 64 year-old female with scalp metastasis of PTC in the context of disseminated pulmonary and liver metastasis.