Pulsed Radiofrequency as a Standalone Treatment for Adhesive Capsulitis

Adhesive capsulitis is a pathology that affects the shoulder and can have a particularly long and disabling course. The usual therapies are treatment with non-steroidal anti-inflammatory drugs (NSAID) and painkillers, steroid injections, physiotherapy, and surgical treatment. This case report describes the effect of a single treatment with pulsed radiofrequency of the suprascapular nerve in a diabetic patient affected by this pathology, for whom steroid injections were contraindicated. Three weeks after the treatment, the reduction of pain and the improvement of ROM (range of movement) allowed the patient to start an adequate physiotherapy treatment, which was not feasible until that moment due to the severe pain despite NSAIDS therapy. The peculiarity of this work consists in the accurate measure of the impact of the analgesic treatment alone in improving the ROM and muscular activation in the patient. The patient was able to correctly perform physiotherapy only once the pain was reduced, after PRF (pulsed radio frequency) treatment. This study has two limitations: being a case report and not a prospective randomized study, and observing the kinematic and pain aspects for a limited period of time. Finally, the case report draws attention to the importance of cooperation between the various health figures involved in the treatment of patients suffering from adhesive capsules

An exon-specific U1 small nuclear RNA (snRNA) strategy to correct splicing defects

A significant proportion of disease-causing mutations affect precursor-mRNA splicing, inducing skipping of the exon from the mature transcript. Using F9 exon 5, CFTR exon 12 and SMN2 exon 7 models, we characterized natural mutations associated to exon skipping in Haemophilia B, cystic fibrosis and spinal muscular atrophy (SMA), respectively, and the therapeutic splicing rescue by using U1 small nuclear RNA (snRNA). In minigene expression systems, loading of U1 snRNA by complementarity to the normal or mutated donor splice sites (5′ss) corrected the exon skipping caused by mutations at the polypyrimidine tract of the acceptor splice site, at the consensus 5′ss or at exonic regulatory elements. To improve specificity and reduce potential off-target effects, we developed U1 snRNA variants targeting non-conserved intronic sequences downstream of the 5′ss. For each gene system, we identified an exon-specific U1 snRNA (ExSpeU1) able to rescue splicing impaired by the different types of mutations. Through splicing-competent cDNA constructs, we demonstrated that the ExSpeU1-mediated splicing correction of several F9 mutations results in complete restoration of secreted functional factor IX levels. Furthermore, two ExSpeU1s for SMA improved SMN exon 7 splicing in the chromosomal context of normal cells. We propose ExSpeU1s as a novel therapeutic strategy to correct, in several human disorders, different types of splicing mutations associated with defective exon definition

Prediction of morbidity and mortality after early cholecystectomy for acute calculous cholecystitis : results of the SPRi.MACC study

Peer reviewe

ECLAPTE: Effective Closure of LAParoTomy in Emergency-2023 World Society of Emergency Surgery guidelines for the closure of laparotomy in emergency settings

Laparotomy incisions provide easy and rapid access to the peritoneal cavity in case of emergency surgery. Incisional hernia (IH) is a late manifestation of the failure of abdominal wall closure and represents frequent complication of any abdominal incision: IHs can cause pain and discomfort to the patients but also clinical serious sequelae like bowel obstruction, incarceration, strangulation, and necessity of reoperation. Previous guidelines and indications in the literature consider elective settings and evidence about laparotomy closure in emergency settings is lacking. This paper aims to present the World Society of Emergency Surgery (WSES) project called ECLAPTE (Effective Closure of LAParoTomy in Emergency): the final manuscript includes guidelines on the closure of emergency laparotomy

Diversity and ethics in trauma and acute care surgery teams: results from an international survey

Background Investigating the context of trauma and acute care surgery, the article aims at understanding the factors that can enhance some ethical aspects, namely the importance of patient consent, the perceptiveness of the ethical role of the trauma leader, and the perceived importance of ethics as an educational subject. Methods The article employs an international questionnaire promoted by the World Society of Emergency Surgery. Results Through the analysis of 402 fully filled questionnaires by surgeons from 72 different countries, the three main ethical topics are investigated through the lens of gender, membership of an academic or non-academic institution, an official trauma team, and a diverse group. In general terms, results highlight greater attention paid by surgeons belonging to academic institutions, official trauma teams, and diverse groups. Conclusions Our results underline that some organizational factors (e.g., the fact that the team belongs to a university context or is more diverse) might lead to the development of a higher sensibility on ethical matters. Embracing cultural diversity forces trauma teams to deal with different mindsets. Organizations should, therefore, consider those elements in defining their organizational procedures. Level of evidence Trauma and acute care teams work under tremendous pressure and complex circumstances, with their members needing to make ethical decisions quickly. The international survey allowed to shed light on how team assembly decisions might represent an opportunity to coordinate team member actions and increase performance

Intellectual Capital and Strategic Positioning Within Italian Small and Medium Accounting Practices

Abstract: Strategic positioning implementation involves the fit with different elements of intellectual capital in order to enhance organizational effectiveness. Interestingly, there is a lack of analysis about how small and medium enterprises (SMEs) exploit knowledge resources in order to foster their desired strategic positioning. This paper presents a mixed method research within the context of Small and Medium Accounting Practices (SMAPs). A quantitative analysis involving 1.210 questionnaires was developed to understand SMAPs behavior. Additionally a multiple case study with three firms was developed in order to understand actions concretely developed by SMAPs to implement Intellectual Capital (IC)

Knowledge Management and cultural change in a knowledge-intensive public organization. The case of Swissmedic

Swissmedic, the Swiss Agency for Therapeutic Products, is a public institution of the Swiss government. It is affiliated to the Federal Department of Home Affairs. Swissmedic started its journey through Knowledge Management (KM) back in 2012. The company developed several KM tools such as wikis and CoPs. However, since its early stages, KM at Swissmedic has been primarily focused on the people who work for the organization. It is therefore not just a matter of deciding which tools to use to retain or transfer the employees’ knowledge. The real challenge is how to encourage and improve communication and collaboration between people within the organization. According to Swissmedic, managers are the primary drivers of the culture change. They support and communicate the required change, and employees take their cue from them (top-down). The first phase of development lasted from 2012 to 2014, with the aim of developing a shared management philosophy that takes account of the particular characteristics of a specialist organization and its protagonists – knowledge workers. The second phase in 2015-2016 was about training the management skills. The third phase, ongoing from 2017 to 2019 (expected), is about determining the values that are relevant to knowledge workers in a specialist organization. For Swissmedic these values are trust, reciprocity, appreciation, and interest. The commitment shown by the Executive Director was fundamental in this context. It was most important for the acceptance of the whole concept, and it enabled the institution to declare specific measures like a structured knowledge transfer as mandatory for employees moving positions. According to Swissmedic, it is essential to support the management in transferring and incorporating the lessons learned into their everyday work as well as to provide specific offers for their teams (e.g., recommended knowledge transfer, lessons learned, basic wiki courses, etc.)

Towards a Social Knowledge Management in a Knowledge-Intensive Public Organization

Abstract: Knowledge-intensive organizations can benefit from introducing knowledge management procedures. In this sense, human capital plays a relevant role in helping the organization to work and act in a more knowledge-oriented perspective. A so-called “Social Knowledge Management” is highly recommended to be sure that everybody in the organization is able to change his/her behavior to work in a knowledge-sharing perspective. The experience of Swissmedic, the Swiss Agency for Therapeutic Products, can help to understand this phenomenon, especially within public sector organizations. Swissmedic, a public institution of the Swiss Government, affiliated to the Federal Department of Home Affair, can be defined as a knowledge-intensive organization; this means that much of the work it does is intellectual. Its employees are well-educated knowledge workers, and knowledge is the primary factor that determines the success of the organization. Swissmedic started to develop a Knowledge Management system back in 2012. At first, the company concentrated on acquiring and developing several KM tools related to the specific industry, such as wikis and CoPs. However, it came pretty clear since its early stages, that Knowledge Management at Swissmedic had to be primarily focused on the human resources who work for the organization. Managers of Swissmedic do think that a living knowledge culture based on respect, transparency, individual responsibility, and flexibility is the only way to create an integrative and participative working environment. The real challenge is how to encourage and improve communication and collaboration between people within the organization, leading to a so-called "Social Knowledge Management." According to the experience of Swissmedic, managers are the primary drivers of the culture change. They support and communicate the required change, and employees take their cue from them (top-down). Enhancing a culture through Knowledge Management was the primary goal for all the first phase of development (2012 to 2014), to foster a shared management philosophy that takes account of the particular characteristics of a specialist organization and its protagonists. The second phase (2015-2016) was about training the management skills, especially leadership. The third phase, ongoing from 2017, is about determining the values that are relevant to knowledge workers. According to Swissmedic's experience, these values lie in trust, reciprocity, appreciation, and interest

From output to outcome measures in the public sector: a structured literature review

Purpose The purpose of this paper is to perform an analysis of the current literature providing a deep contribution to understanding the paradigm shift from output to outcome measures in the public sector. Thus, the main aim is to provide relevant insights of both theoretical and empirical studies, offering a critique of the schemes and the research methods used and underlining future research opportunities for the compelling (or underestimated) contents and new emerging trends. Design/methodology/approach Articles published in main public management and administration journals, as internationally recognized, are analyzed using a structured literature review methodology. The paper investigates selected contributions published in Association of Business Schools (ABS) (Chartered Association of Business Schools \u2013 UK] Grade 4, 3 and 2 journals specializing in the field of \u201cPublic Sector Management,\u201d dealing with the topic of performance measurement, from output to outcome. Findings Findings are described defying a framework that deepens emerging elements of current literature such as main countries analyzed, main research topics highlighted, research methods applied (qualitative versus quantitative; case studies, interviews, comparative studies etc.), different definitions of \u201coutput\u201d and \u201coutcome,\u201d top keywords and their connections. Originality/value The paper\u2019s findings aim to offer insights and a current \u201cshared vision\u201d into the state of the art and possible future research avenues on the topic of output and outcome measures in the public sector fostering the development of further studies especially in the direction of sustainability