37 research outputs found

    The role of managers in enacting two-step institutional work for radical innovation in professional organizations.

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    Radical innovation in professional settings faces an institutional challenge. Professionals enjoy autonomy predicated on jurisdictional knowledge and can resist radical innovation if their interests are threatened. Our study examines if and how managers mediate professional resistance and ensure that radical innovation can take hold. A comparative case study of 12 Italian hospitals introducing integrated service configurations shows that managers may hold back from introducing radical innovation where they judge professional resistance as insurmountable. Executives reinforce, rather than challenge, the status quo, and discourage middle managers from further actions. Where the professional context is more receptive because of micro-institutional affordances, then, managers enact different tactics. Managers may centralize decision-making through political work, which however increases professional resistance and hinder radical innovation. Managers may adopt project management approaches, which facilitate local experiments, but struggle to scale-up the radical innovation. Most successful cases are characterized by executive and middle managers enacting a two-step institutional work, which reconfigures the regulative, normative and cognitive foundations of professional boundaries and practice. The comparative study shows how managers can support radical innovation in collaboration with professionals. In the two-step institutional work, executive and middle managers develop stable alliances with local professional groups to provide cognitive/normative foundations of radical innovation; second, they allow professionals to inhabit nascent institutional arrangements to make sense of how these fit with their prevailing interests, norms, and beliefs; third, they co-develop new structures/rules that encourage professionals to pursue radical innovation; finally, they perform maintenance work to preserve professionals’ attachment to new institutions

    Users’ search mechanisms and risks of inappropriateness in healthcare innovations : the role of literacy and trust in professional contexts

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    In the context of professional service organizations, user engagement with knowledge search might generate significant risks of inappropriateness to innovation processes. Previous research suggests that professionals would then keep users at arms' length, controlling the design and implementation of innovations internally. This study overcomes this view investigating how professional service organizations can enable users' knowledge search while controlling for the risks of inappropriateness. Combining a qualitative research on 5 innovation processes in healthcare organizations with quantitative research on 110 service users, our findings highlight that professional providers, such as senior clinicians, shaped their tactics according to the ‘threats’ of laggards, i.e. users searching knowledge outside of professional logics of appropriateness; more than to the opportunities of lead-user communities. Professional providers sought to “activate” users' engagement with knowledge search by investing on their literacy, i.e. showing the basics of the logic of appropriateness informing their decision; and on trust relationships, i.e. becoming transparent on the criteria of knowledge selection during the innovation processes

    Neuronopathic Gaucher disease models reveal defects in cell growth promoted by Hippo pathway activation

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    Gaucher Disease (GD), the most common lysosomal disorder, arises from mutations in the GBA1 gene and is characterized by a wide spectrum of phenotypes, ranging from mild hematological and visceral involvement to severe neurological disease. Neuronopathic patients display dramatic neuronal loss and increased neuroinflammation, whose molecular basis are still unclear. Using a combination of Drosophila dGBA1b loss-of-function models and GD patient-derived iPSCs differentiated towards neuronal precursors and mature neurons we showed that different GD- tissues and neuronal cells display an impairment of growth mechanisms with an increased cell death and reduced proliferation. These phenotypes are coupled with the downregulation of several Hippo transcriptional targets, mainly involved in cells and tissue growth, and YAP exclusion from nuclei. Interestingly, Hippo knock-down in the GBA-KO flies rescues the proliferative defect, suggesting that targeting the Hippo pathway can be a promising therapeutic approach to neuronopathic GD.A combination of Drosophila dGBA1b loss-of-function models and Gaucher Disease (GD) patient-derived iPSCs reveals an impairment in GD neuronal cell growth and that Hippo pathway hyperactivation contributes to the impairment

    P1245 Polymorphic Variants of HSD3B1 Gene Confer Different Outcome in Specific Subgroups of Patients Infected With SARS-CoV-2

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    Introduction: Severe respiratory syndrome coronavirus 2 (SARS-CoV-2) uses the androgen receptor (AR), through ACE2 receptor and TMPRSS2, to enter nasal and upper airways epithelial cells. Genetic analyses revealed that HSD3B1 P1245C polymorphic variant increases dihydrotestosterone production and upregulation of TMPRSS2 with respect to P1245A variant, thus possibly influencing SARS-CoV-2 infection. Our aim was to characterize the HSD3B1 polymorphism status and its potential association with clinical outcomes in hospitalized patients with COVID-19 in Southern Switzerland. Materials and Methods: The cohort included 400 patients hospitalized for COVID-19 during the first wave between February and May 2020 in two different hospitals of Canton Ticino. Genomic DNA was extracted from formalin-fixed paraffin-embedded tissue blocks, and HSD3B1 gene polymorphism was evaluated by Sanger sequencing. Statistical associations were verified using different test. Results: HSD3B1 polymorphic variants were not associated with a single classical factor related to worse clinical prognosis in hospitalized patients with SARS-CoV-2. However, in specific subgroups, HSD3B1 variants played a clinical role: intensive care unit admission was more probable in patients with P1245C diabetes compared with P1245A individuals without this comorbidity and death was more associated with hypertensive P1245A>C cases than patients with P1245A diabetes without hypertension. Discussion: This is the first study showing that HSD3B1 gene status may influence the severity of SARS-CoV-2 infection. If confirmed, our results could lead to the introduction of HSD3B1 gene status analysis in patients infected with SARS-CoV-2 to predict clinical outcome. Keywords: HSD3B1 gene polymorphism; Likelihood-ratio tests; SARS-CoV-2; androgen receptor; direct sequencing

    Esophageal emergencies : WSES guidelines

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    The esophagus traverses three body compartments (neck, thorax, and abdomen) and is surrounded at each level by vital organs. Injuries to the esophagus may be classified as foreign body ingestion, caustic ingestion, esophageal perforation, and esophageal trauma. These lesions can be life-threatening either by digestive contamination of surrounding structures in case of esophageal wall breach or concomitant damage of surrounding organs. Early diagnosis and timely therapeutic intervention are the keys of successful management.Peer reviewe

    La confiance mutuelle dans l'espace pénal européen/Mutual Trust in the European Criminal Area

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    L'ouvrage constitue une rĂ©flexion approfondie sur la problĂ©matique de la confiance mutuelle dans l'espace pĂ©nal europĂ©en, un thĂšme d’une brĂ»lante actualitĂ© dĂšs lors que l'importance de la confiance mutuelle dans cet espace va croissant

    Product innovation in family versus nonfamily firms:an exploratory analysis

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    How family firms manage product innovation remains an overlooked topic in existing business research. This happens despite the fact that family businesses play a crucial role across all economies, and they often use technological innovation to nurture their competitive advantage. By drawing upon the resource-based view of the firm as well as agency, stewardship, and behavioral theories and using empirical evidence gathered through a multiple case study, the paper studies how and why the anatomy of the product innovation process differs between family and nonfamily firms. The analysis shows that family businesses differ from nonfamily ones as regards product innovation strategies and organization of the innovation process

    Searching for factors influencing technological asset value

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    Purpose: The purpose of this paper is twofold: firstly, to identify the factors that are capable of influencing the value of a technological asset that is exchanged in the context of a business transaction and, secondly, to identify the direction of the relationship between each factor and the technological asset value. Design/methodology/approach: First of all, an in-depth analysis of the available literature about the assessment of technological asset value was conducted. Then a panel study was organised, involving several intellectual property managers and consultants and senior practitioners working in the field of IP assessment. Finally, an illustrative case study was conducted. Findings: The paper proposes a framework that encompasses the following classes of factors: asset related; firm related; context related; risk related; and transaction related. It is shown that these factors are capable of influencing the value of a technological asset that is exchanged in the context of a business transaction and the direction of their impact is indicated. Practical implications: The paper is believed to be a useful instrument capable of supporting managers and appraisers who, in the context of a specific business transaction involving the exchange of a technological asset between the counterparts, are called to assess its value. Originality/value: The value of a technological asset is typically estimated through monetary techniques (cost, income and market methods) that often turn out to be disappointing in practice. This is mainly due to their quantitative nature, that impedes them to appropriately take into account qualitative variables capable of affecting the value of the asset. This paper is the first attempt, to the best knowledge of the authors, that draws together these variables in a comprehensive form and suggests the direction of their impact on the asset value
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