NETWORK ANALYSIS FOR PERFORMANCE CONTROL IN THE GOVERNANCE OF INTERCONNECTED LOCAL TRANSPORT COMPANIES

This paper discusses a network-analysis approach to the performance control of integrated built-environment systems based on efficiency, effectiveness, and adequacy. We apply this perspective to the governance of systems of local transport companies in built environments, which are frequently organized as networks. To this end, we propose a multi-dimensional grid of first- and second-order ties to locate network units and individuate the adequacy or appropriateness of network structures for performance control. In this field, issues connected to transport systems such as sustainability play a crucial role in defining structures and processes of network performance control. We empirically examine a pilot case of local public transport companies in the Forlì-Cesena area (Italy), testing network adequacy and giving evidence for the optimal localization of governance among units dedicated to providing transport services. Our results also support the hypothesis that, although structural centralization was ostensibly oriented towards increasing governance, the structure actually devolved into decentralized control at the periphery of the network, diminishing the effectiveness of initiatives

A Game-Theoretic Approach to Coalition Formation in Fog Provider Federations

In this paper we deal with the problem of making a set of Fog Infrastructure Providers (FIPs) increase their profits when allocating their resources to process the data generated by IoT applications that need to meet specific QoS targets in face of time-varying workloads. We show that if FIPs cooperate among them, by mutually sharing their workloads and resources, then each one of them can improve its net profit. By using a game-theoretic framework, we study the problem of forming stable coalitions among FIPs. Furthermore, we propose a mathematical optimization model for profit maximization to allocate IoT applications to a set of FIPs, in order to reduce costs and, at the same time, to meet the corresponding QoS targets. Based on this, we propose an algorithm, based on cooperative game theory, that enables each FIP to decide with whom to cooperate in order to increase its profits. The effectiveness of the proposed algorithm is demonstrated through an experimental evaluation considering various workload intensities. The results we obtain from these experiments show the ability of our algorithm to form coalitions of FIPs that are stable and profitable in all the scenarios we consider

Understanding knowledge translation in university–industry research projects: a case analysis in the automotive sector

Purpose – In this paper, we depart from extant conceptualisations of knowledge translation mechanisms to examine projects as a way to achieve effective knowledge transfer. Our empirical analysis focused on a university–industry research project in the automotive industry. Design/methodology/approach – The empirical analysis was based on a qualitative investigation. We analysed material collected within a research project involving a partnership between two universities and Fiat-Chrysler Automotive (FCA), a multi-brand auto manufacturer with a product range covering several different market segments. We used three data collection techniques: internal document analysis, participant observation and semi-structured interviews. Findings – Our findings show that, in a U-I research project, goals represent a key dimension to support knowledge translation. Defining the goal implies an ongoing negotiation process, where researchers and company employees work together, in order to converge towards a shared meaning of the goal. In this sense, goal orientation and goal-based interaction have significant implications for knowledge translation processes

N-arylbenzamides: extremely simple scaffolds for the development of novel estrogen receptor agonists.

The research of estrogen receptor (ER) ligands has benefited in the last decade from the implementation of combinatorial chemistry. The general pharmacophore has been identified and subsequently a multitude of compounds have been synthesized. Surprisingly, up to now simple amides have not been taken into consideration. Here we show that amides resulting from the condensation of hydroxybenzoic acids with aminophenols result in compounds retaining the pharmacophore structure of an ER ligand with a clear estrogenic activity

Celecoxib inhibits proliferation and survival of chronic myelogeous leukemia (CML) cells via AMPK-dependent regulation of β-catenin and mTORC1/2.

CML is effectively treated with tyrosine kinase inhibitors (TKIs). However, the efficacy of these drugs is confined to the chronic phase of the disease and development of resistance to TKIs remains a pressing issue. The anti-inflammatory COX2 inhibitor celecoxib has been utilized as anti-tumour drug due to its anti-proliferative activity. However, its effects in hematological malignancies, in particular CML, have not been investigated yet. Thus, we tested biological effects and mechanisms of action of celecoxib in Philadelphia-positive (Ph+) CML and ALL cells.We show here that celecoxib suppresses the growth of Ph+ cell lines by increasing G1-phase and apoptotic cells and reducing S- and G2-phase cells. These effects were independent of COX2 inhibition but required the rapid activation of AMP-activated protein kinase (AMPK) and the consequent inhibition mTORC1 and 2. Treatment with celecoxib also restored GSK3β function and led to down-regulation of β-catenin activity through transcriptional and post-translational mechanisms, two effects likely to contribute to Ph+ cell growth suppression by celecoxib.Celecoxib inhibited colony formation of TKI-resistant Ph+ cell lines including those with the T315I BCR-ABL mutation and acted synergistically with imatinib in suppressing colony formation of TKI-sensitive Ph+ cell lines. Finally, it suppressed colony formation of CD34+ cells from CML patients, while sparing most CD34+ progenitors from healthy donors, and induced apoptosis of primary Ph+ ALL cells.Together, these findings indicate that celecoxib may serve as a COX2-independent lead compound to simultaneously target the mTOR and β-catenin pathways, key players in the resistance of CML stem cells to TKIs

INTERORGANIZATIONAL RELATIONSHIPS IN ITALIAN LOGISTIC PLATFORMS: THE ROLE OF META-LOGISTIC OPERATORS

ABSTRACT The logistic system as an element giving a competitive advantage to individual organizations and business firm systems alike, is now becoming increasingly relevant (Håkansson e Persson, 2004). In particular, logistic platforms (in Italian, interporti) carry out a highly central role in the Italian economic system, in that apart from facilitating interconnections between various transport modalities, also facilitate the role of ports as links joining up overland routes with sea routes (Boscacci F., 2003). Many logistic studies, and more generally studies relating to supply chain management adopt a systems-type perspective, in which continuous interaction takes place between actors and activities characterizing the system and bringing about its success. In this sense, as Christopher claims (1992), "real competition is not [any more] company against company but rather supply chain against supply chain" (p.14). The aim of the paper is analysing the activities carried out within the logistic platforms infrastructures, amongst which a leading role is played by a certain special typology of actor, defined as Meta-Logistic Operators (MLOs)

"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 ± 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys

Effect of exogenous estrogens and progestogens on the course of migraine during reproductive age

We systematically reviewed data about the effect of exogenous estrogens and progestogens on the course of migraine during reproductive age. Thereafter a consensus procedure among international experts was undertaken to develop statements to support clinical decision making, in terms of possible effects on migraine course of exogenous estrogens and progestogens and on possible treatment of headache associated with the use or with the withdrawal of hormones. Overall, quality of current evidence is low. Recommendations are provided for all the compounds with available evidence including the conventional 21/7 combined hormonal contraception, the desogestrel only oral pill, combined oral contraceptives with shortened pill-free interval, combined oral contraceptives with estradiol supplementation during the pill-free interval, extended regimen of combined hormonal contraceptive with pill or patch, combined hormonal contraceptive vaginal ring, transdermal estradiol supplementation with gel, transdermal estradiol supplementation with patch, subcutaneous estrogen implant with cyclical oral progestogen. As the quality of available data is poor, further research is needed on this topic to improve the knowledge about the use of estrogens and progestogens in women with migraine. There is a need for better management of headaches related to the use of hormones or their withdrawal

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic