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Purpose Cluster management organizations (CMOs) have emerged over the past few decades as intermediaries that support the competitiveness of place-based clusters of economic activity. Despite their economic origins, policymakers are now starting to experiment with a broader use for cluster policies that seeks to leverage CMOs to tackle societal challenges in approaches aligned with the concept of creating shared value (CSV). However, there remains a void in conceptual understanding around the specific roles that CMOs might play in overcoming the barriers faced by their members for CSV, which this paper aims to address. Bridging this gap presents an opportunity for cluster practitioners and policymakers in a context in which environmental and social sustainability are at the top of policy agendas. Design/methodology/approach Based on analysis of literature around collaborative approaches to CSV for mitigating transaction costs, the authors define the contours of a new conceptual framework for the roles that CMOs can play in fostering collective CSV. The authors illustrate how the different components of the framework are reflected in emerging cluster practice in the context of a new wave of European cluster-based projects tackling CSV elements. Findings The resulting framework reconciles the concepts of clusters and CSV by explicitly positioning CMOs as intermediaries for facilitating the CSV strategies of their members. CMOs embrace emergent strategy making that targets (tangible and intangible) collective CSV capabilities and addresses collective CSV challenges. Collective CSV can provide a theoretical anchor guiding future cluster policies to fully leverage the transformative potential of CMOs. This conceptual framework opens a promising empirical research agenda, particularly around evaluating the plurality of impacts of CMOs. Originality/value By stressing the social impact of CMOs alongside their well-understood economic impacts, and by enabling a categorization of functions that can support the monitoring of CMO activities toward collective CSV strategies, the framework provides a novel basis for inspiring further empirical research into the evidencing of these roles.

The severity of breakthrough cancer pain (BTcP) impacts patients' quality of life, increases the risk of anxiety and depression, lowers functional capacities, and may lead to poor compliance with cancer treatments. The aim of the current study was to assess, in a real-life setting, patient satisfaction with a fentanyl-pectin-nasal-spray (FPNS) for BTcP management in head and neck (H&N) cancer patients treated by radiotherapy. This non-interventional, prospective study was conducted in 92 adult H&N-cancer patients undergoing radiotherapy and who started FPNS treatment for BTcP. Throughout the radiotherapy period, the patients completed self-diaries to assess their BTcP episodes, FPNS use, satisfaction on FPNS efficiency (primary outcome), tolerability and ease of use. Prior to FPNS treatment, 86% of the patients were experiencing ≤4 BTcP episodes/day. During the radiotherapy period, the BTcP episodes were treated with a median dose of 100µg of FPNS. Patients were \"satisfied/very-satisfied\" with the efficiency (73% of assessments), ease of use (87% of assessments) and tolerability (87% of assessments) of FPNS. In total, 27% of patients reported at least one adverse event related to FPNS and 4% of patients discontinued treatment due to adverse events. None of the adverse events were serious. Patient quality of life was maintained throughout the radiotherapy period. This study showed, in a real-life setting, that a clear majority of H&N cancer patients treated with FPNS for BTcP throughout radiotherapy expressed satisfaction with this analgesic treatment.

According to Gallouj (2002), “KIBS rms are organizations that are particularly representative of the knowledge economy, since knowledge constitutes both their main input and output … the activity of KIBS providers can be said to consist of2.1 Introduction: KIBS in the Knowledge Society ... 67 2.1.1 Services and the Knowledge Society ... 67 2.1.2 Economic Importance of KIBS ... 702.2 KIBS as Innovation Drivers ... 73 2.3 Managing Innovation in KIBS and T-KIBS ...77

Ecuador's economic history has been closely linked to Theobroma cacao L cultivation, and specifically to the native fine flavour Nacional cocoa variety. The original Nacional cocoa trees are presently in danger of extinction due to foreign germplasm introductions. In a previous work, a few non-introgressed Nacional types were identified as potential founders of the modern Ecuadorian cocoa population, but so far their origin could not be formally identified. In order to determine the putative centre of origin of Nacional and trace its domestication history, we used 80 simple sequence repeat (SSR) markers to analyse the relationships between these potential Nacional founders and 169 wild and cultivated cocoa accessions from South and Central America. The highest genetic similarity was observed between the Nacional pool and some wild genotypes from the southern Amazonian region of Ecuador, sampled along the Yacuambi, Nangaritza and Zamora rivers in Zamora Chinchipe province. This result was confirmed by a parentage analysis. Based on our results and on data about pre-Columbian civilization and Spanish colonization history of Ecuador, we determined, for the first time, the possible centre of origin and migration events of the Nacional variety from the Amazonian area until its arrival in the coastal provinces. As large unexplored forest areas still exist in the southern part of the Ecuadorian Amazonian region, our findings could provide clues as to where precious new genetic resources could be collected, and subsequently used to improve the flavour and disease resistance of modern Ecuadorian cocoa varieties.

Key messageWe provide a database of 52 silvicultural scenarios recommended in French public forests including relevant dendrometric variables and metrics for carbon accounting. The dataset is available at https://doi.org/10.57745/QARRFS. Associated metadata are available at https://metadata-afs.nancy.inra.fr/geonetwork/srv/fre/catalog.search#/metadata/f76ed27f-325d-493b-8731-0995dcaa7805. Special attention was paid to offer carbon metrics required for the French Label Bas Carbone offset projects.

ObjectiveLittle is known about treatments provided by advanced life support (ALS) ambulance teams to patients with acute heart failure (AHF) during the prehospital phase, and their influence on short-term outcome. We evaluated the effect of prehospital care in consecutive patients diagnosed with AHF in Spanish emergency departments (EDs).MethodsWe selected patients from the EAHFE registry arriving at the ED by ALS ambulances with available follow-up data. We recorded specific prehospital ALS treatments (supplemental oxygen, diuretics, nitroglycerin, non-invasive ventilation) and patients were grouped according to whether they received low- (LIPHT; 0/1 treatments) or high-intensity prehospital therapy (HIPHT; > 1 treatment) for AHF. We also recorded 46 covariates. The primary endpoint was all-cause 7-day mortality, and secondary endpoints were prolonged hospitalisation (> 10 days) and in-hospital and 30-day mortality. Unadjusted and adjusted odds ratios were calculated to compare the groups.ResultsWe included 1493 patients [mean age 80.7 (10) years; women 54.8%]. Prehospital treatment included supplemental oxygen in 71.2%, diuretics in 27.9%, nitroglycerin in 13.5%, and non-invasive ventilation in 5.3%. The LIPHT group included 1041 patients (70.0%) with an unadjusted OR for 7-day mortality of 1.770 (95% CI 1.115–2.811; p = 0.016), and 1.939 (95% CI 1.114–3.287, p = 0.014) after adjustment for 16 discordant covariables. The adjusted ORs for all secondary endpoints were always > 1 in the LIPHT group, but none reached statistical significance.ConclusionsPatients finally diagnosed with AHF at then ED that have received LIPHT by the ALS ambulance teams have a poorer short-term outcome, especially during the first 7 days.

Background The genetic diversity of Mycoplasma agalactiae (MA) isolates collected in Spain from goats in an area with contagious agalactia (CA) was assessed using a set of validated and new molecular typing methods. Validated methods included pulsed field gel electrophoresis (PFGE), variable number of tandem repeats (VNTR) typing, and Southern blot hybridization using a set of MA DNA probes, including those for typing the vpma genes repertoire. New approaches were based on PCR and targeted genomic regions that diverged between strains as defined by in silico genomic comparisons of sequenced MA genomes. Results Overall, the data showed that all typing tools yielded consistent results, with the VNTR analyses being the most rapid method to differentiate the MA isolates with a discriminatory ability comparable to that of PFGE and of a set of new PCR assays. All molecular typing approaches indicated that the Spanish isolates from the endemic area in Murcia were very diverse, with different clonal isolates probably restricted to separate, but geographically close, local areas. Conclusions The important genetic diversity of MA observed in infected goats from Spain contrasts with the overall homogeneity of the genomic background encountered in MA from sheep with CA in Southern France or Italy, suggesting that assessment of the disease status in endemic areas may require different approaches in sheep and in goats. A number of congruent sub-typing tools are now available for the differentiation of caprine isolates with comparable discriminatory powers.

The study was funded by the United States Department of State (U.S. Foreign Ministry); the U.S. Embassy, Quito; the U.S. Department of Agriculture (USDA-ARS); the Instituto Nacional Autonomo de Investigaciones Agropecuarias (INIAP-Ecuador); and the Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD-France).(2013) Correction: Insight into the Wild Origin, Migration and Domestication History of the Fine Flavour Nacional Theobroma cacao L. Variety from Ecuador.

A series of social benefits targeting vulnerable groups, such as the elderly population, has been implemented in Ecuador over the last few decades. Elderly adults living in vulnerable conditions and not affiliated with social security are entitled to noncontributory pension assistance under the Human Development Transfer program. However, over one quarter of old-age beneficiaries still live in poverty and the recent fall in oil prices has put increasing pressure on government expenditures to deliver such schemes. This paper aims to assess the current needs of old-age adults based on expenditure data, and makes use of microsimulation techniques to evaluate the effect of covering those needs through an increase in pension assistance. Our results show that increasing pension assistance to match the level of the poverty line in Ecuador would reduce elderly poverty by 40% and would take 18% of old-age beneficiaries out of poverty. We analyze the effect of additional hypothetical reforms and discuss the importance of using microsimulation techniques, in particular to assess the effect of budget neutral reforms in a macroeconomic environment with low oil prices.