Rethinking business models for innovation

One of the major challenges confronted by those in charge of technological innovation involves anticipating the value creation model sufficiently early on,in a highly uncertain context both as far as the technology itself is concerned and the potential market. Today, in many industrial sectors, the innovation boundaries have moved towards projects that are more and more exploratory and fuzzy. The simple optimisation of linear processes of the "stage-gate" type is no longer sufficient to build sustainable competitive advantages. The notion of Business Models, when applied to innovation, enables us to describe how a company creates value through innovation, generally within a business ecosystem, and how the value will be distributed between the actors involved. The authors of this book believe that the notions of Business Modelling and value creation are key to all the dimensions of successful innovation, whether technology, marketing, organisational or economically based. Rethinking Business Models for Innovation: this title describes the relationship between thinking, modelling, and also field-testing. The book is based on a series of nine recent cases of innovation involving company managers, often assisted by researchers (the co-authors of each chapter), and how they built and formalised their Business Models and then tested their strategies. After having discovered the variety of the cases, the reader will understand that every innovation situation generates specific questions about Business Models. However, we feel that we can identify three key issues that arise, more or less, in each of these projects. The chapters in this book build on these issues: the identification of sources of value and revenue models (the notion of value creation), the position of the company in the value-network or ecosystem (the sharing of value) and finally the evolution of Business MoDdels over time (the sustainability and the competitiveness of the company). The last chapter goes over all the contributions, exploring the notion of value in the Business Model approach.business model ; innovation ; value ; entrepreneurial project

: Lessons from entrepreneurial projects

International audienceOne of the major challenges confronted by those in charge of technological innovation involves anticipating the value creation model sufficiently early on,in a highly uncertain context both as far as the technology itself is concerned and the potential market. Today, in many industrial sectors, the innovation boundaries have moved towards projects that are more and more exploratory and fuzzy. The simple optimisation of linear processes of the "stage-gate" type is no longer sufficient to build sustainable competitive advantages. The notion of Business Models, when applied to innovation, enables us to describe how a company creates value through innovation, generally within a business ecosystem, and how the value will be distributed between the actors involved. The authors of this book believe that the notions of Business Modelling and value creation are key to all the dimensions of successful innovation, whether technology, marketing, organisational or economically based. Rethinking Business Models for Innovation: this title describes the relationship between thinking, modelling, and also field-testing. The book is based on a series of nine recent cases of innovation involving company managers, often assisted by researchers (the co-authors of each chapter), and how they built and formalised their Business Models and then tested their strategies. After having discovered the variety of the cases, the reader will understand that every innovation situation generates specific questions about Business Models. However, we feel that we can identify three key issues that arise, more or less, in each of these projects. The chapters in this book build on these issues: the identification of sources of value and revenue models (the notion of value creation), the position of the company in the value-network or ecosystem (the sharing of value) and finally the evolution of Business MoDdels over time (the sustainability and the competitiveness of the company). The last chapter goes over all the contributions, exploring the notion of value in the Business Model approach.L'innovation technologique, qu'elle soit conduite par des start-ups ou par de grandes entreprises, n'est plus une condition suffisante de la création de valeur. Créer de la valeur sur des marchés nouveaux nécessite le plus souvent de repenser l'organisation de l'entreprise, sa façon de faire des affaires, ses partenariats stratégiques, autrement dit, son business model. Cet ouvrage se veut un guide pour les porteurs de projets d'innovation en leur fournissant des outils de compréhension et d'analyse de la dimension stratégique de leur projet. Les études de cas présentées sont le fruit d'une collaboration étroite entre les porteurs de chacun des projets et des chercheurs en management de l'innovation reconnus. Au travers de ces cas, trois grandes problématiques sont abordées : l'identification des sources de valeur chez les clients potentiels, la position que l'entreprise pourra prendre dans son écosystème et enfin l'évolution des business models dans le temps. Sur chacun des cas, le lecteur aura accès à une compréhension fine des problèmes stratégiques posés par l'innovation ainsi que des outils de management mis en œuvre pour aider à réfléchir et à agir. (http://www.rethinkingbusinessmodel.net/

Variation in Structure and Process of Care in Traumatic Brain Injury: Provider Profiles of European Neurotrauma Centers Participating in the CENTER-TBI Study.

INTRODUCTION: The strength of evidence underpinning care and treatment recommendations in traumatic brain injury (TBI) is low. Comparative effectiveness research (CER) has been proposed as a framework to provide evidence for optimal care for TBI patients. The first step in CER is to map the existing variation. The aim of current study is to quantify variation in general structural and process characteristics among centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. METHODS: We designed a set of 11 provider profiling questionnaires with 321 questions about various aspects of TBI care, chosen based on literature and expert opinion. After pilot testing, questionnaires were disseminated to 71 centers from 20 countries participating in the CENTER-TBI study. Reliability of questionnaires was estimated by calculating a concordance rate among 5% duplicate questions. RESULTS: All 71 centers completed the questionnaires. Median concordance rate among duplicate questions was 0.85. The majority of centers were academic hospitals (n = 65, 92%), designated as a level I trauma center (n = 48, 68%) and situated in an urban location (n = 70, 99%). The availability of facilities for neuro-trauma care varied across centers; e.g. 40 (57%) had a dedicated neuro-intensive care unit (ICU), 36 (51%) had an in-hospital rehabilitation unit and the organization of the ICU was closed in 64% (n = 45) of the centers. In addition, we found wide variation in processes of care, such as the ICU admission policy and intracranial pressure monitoring policy among centers. CONCLUSION: Even among high-volume, specialized neurotrauma centers there is substantial variation in structures and processes of TBI care. This variation provides an opportunity to study effectiveness of specific aspects of TBI care and to identify best practices with CER approaches

Variation in general supportive and preventive intensive care management of traumatic brain injury: a survey in 66 neurotrauma centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study

Abstract Background General supportive and preventive measures in the intensive care management of traumatic brain injury (TBI) aim to prevent or limit secondary brain injury and optimize recovery. The aim of this survey was to assess and quantify variation in perceptions on intensive care unit (ICU) management of patients with TBI in European neurotrauma centers. Methods We performed a survey as part of the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. We analyzed 23 questions focused on: 1) circulatory and respiratory management; 2) fever control; 3) use of corticosteroids; 4) nutrition and glucose management; and 5) seizure prophylaxis and treatment. Results The survey was completed predominantly by intensivists (n = 33, 50%) and neurosurgeons (n = 23, 35%) from 66 centers (97% response rate). The most common cerebral perfusion pressure (CPP) target was > 60 mmHg (n = 39, 60%) and/or an individualized target (n = 25, 38%). To support CPP, crystalloid fluid loading (n = 60, 91%) was generally preferred over albumin (n = 15, 23%), and vasopressors (n = 63, 96%) over inotropes (n = 29, 44%). The most commonly reported target of partial pressure of carbon dioxide in arterial blood (PaCO2) was 36–40 mmHg (4.8–5.3 kPa) in case of controlled intracranial pressure (ICP) < 20 mmHg (n = 45, 69%) and PaCO2 target of 30–35 mmHg (4–4.7 kPa) in case of raised ICP (n = 40, 62%). Almost all respondents indicated to generally treat fever (n = 65, 98%) with paracetamol (n = 61, 92%) and/or external cooling (n = 49, 74%). Conventional glucose management (n = 43, 66%) was preferred over tight glycemic control (n = 18, 28%). More than half of the respondents indicated to aim for full caloric replacement within 7 days (n = 43, 66%) using enteral nutrition (n = 60, 92%). Indications for and duration of seizure prophylaxis varied, and levetiracetam was mostly reported as the agent of choice for both seizure prophylaxis (n = 32, 49%) and treatment (n = 40, 61%). Conclusions Practice preferences vary substantially regarding general supportive and preventive measures in TBI patients at ICUs of European neurotrauma centers. These results provide an opportunity for future comparative effectiveness research, since a more evidence-based uniformity in good practices in general ICU management could have a major impact on TBI outcome

Variation in neurosurgical management of traumatic brain injury

Background: Neurosurgical management of traumatic brain injury (TBI) is challenging, with only low-quality evidence. We aimed to explore differences in neurosurgical strategies for TBI across Europe. Methods: A survey was sent to 68 centers participating in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. The questionnaire contained 21 questions, including the decision when to operate (or not) on traumatic acute subdural hematoma (ASDH) and intracerebral hematoma (ICH), and when to perform a decompressive craniectomy (DC) in raised intracranial pressure (ICP). Results: The survey was completed by 68 centers (100%). On average, 10 neurosurgeons work in each trauma center. In all centers, a neurosurgeon was available within 30 min. Forty percent of responders reported a thickness or volume threshold for evacuation of an ASDH. Most responders (78%) decide on a primary DC in evacuating an ASDH during the operation, when swelling is present. For ICH, 3% would perform an evacuation directly to prevent secondary deterioration and 66% only in case of clinical deterioration. Most respondents (91%) reported to consider a DC for refractory high ICP. The reported cut-off ICP for DC in refractory high ICP, however, differed: 60% uses 25 mmHg, 18% 30 mmHg, and 17% 20 mmHg. Treatment strategies varied substantially between regions, specifically for the threshold for ASDH surgery and DC for refractory raised ICP. Also within center variation was present: 31% reported variation within the hospital for inserting an ICP monitor and 43% for evacuating mass lesions. Conclusion: Despite a homogeneous organization, considerable practice variation exists of neurosurgical strategies for TBI in Europe. These results provide an incentive for comparative effectiveness research to determine elements of effective neurosurgical care

Rôle des voies de signalisation de deux protéines kinases, Erk et Akt, dans l effet anti-œdémateux de l érythropoïétine

Notre équipe avait montré que l érythropoïétine (EPO) diminuait significativement l œdème cérébral (OC) des rats soumis à un traumatisme crânien diffus (TC). Cette diminution était accompagnée de modifications intracérébrales précoces de phosphorylation des protéines kinases Erk et Akt. Dans cette étude, nous avons tenté de mettre en évidence un lien causal entre les modifications de phosphorylation observées et la diminution de l œdème cérébral, par inhibition de ces protéines kinases. Afin d inhiber Erk et Akt directement en intracérébral, un modèle d injection intracérébroventriculaire a été validé par injection intracérébrale d encre de Chine et visualisation en microscopie optique. L inhibiteur de Erk, U0126 ou d Akt, LY294,002 ont été injectés juste avant le traumatisme crânien. L EPO (5 000 UI/kg) a été administrée par voie intraveineuse 30 minutes après le TC. La phosphorylation des protéines kinases était mesurée à 1 heure (H1) et l œdème cérébral était évalué par gravimétrie à 2 heures (H2). L inhibition de Akt n a pas modifié l OC post-TC et l administration d EPO est demeurée sur l OC. Akt ne semble donc pas jouer de rôle dans l effet anti-œdémateux de l EPO. Après inhibition de Erk, la diminution de l OC a été comparable à celle observée avec l EPO sans effet additif. Ces données suggèrent que l effet anti-œdémateux cérébral de l EPO après TC diffus pourrait être médié par l inhibition précoce de la phosphorylation Erk.Our team found that erythropoietin (EPO) significantly reduced the development of brain edema in a rat model of diffuse traumatic brain injury (TBI). This reduction was associated with early changes of brain phosphorylation of two protein kinases, Erk and Akt. In this study, we investigated the possible causal link between phosphorylation changes and brain edema. To specifically inhibit Erk and Akt, we developed a model with intracerebroventricular injection by using intracerebral injection of Indian ink and optical microscopy visualization. The ERK-1/-2 inhibitor, U0126, or the Akt inhibitor, LY294002 were administered before traumatic brain injury. EPO (5,000 IU/kg body weight) was intravenously administrated 30 mins after injury brain. Phosphorylation of Erk and Akt was measured 1 hour after insult (H1) and brain water content were measured 2 hours (H2) after insult by gravimetric technique. The inhibition of Akt pathway did not result in significant differences in brain water contain (BWC); the addition of post injury treatment with EPO significantly decreased BWC. Inhibition of Erk reduced BWC, no further reduction of brain edema was found when Erk was combined with EPO treatment. These results suggest that the anti-edematous effect of EPO after diffuse TBI could be mediated through an early inhibition of ERK phosphorylation.GRENOBLE1-BU Médecine pharm. (385162101) / SudocSudocFranceF

L’inscription, le masque et la donnée

Dans cet article, nous examinons les différentes interactions qui caractérisent un projet d’enquête en sciences sociales fondé sur l’exploitation des données du réseau social professionnel LinkedIn. Ce retour réflexif sur ce que nous appelons le « laboratoire invisible » de l’enquête nous permet de mettre en évidence les conflits d’interprétation qui naissent autour de la définition de ce qu’est une « donnée » tirée du web. Dès lors, la constitution d’une base de données ne doit pas apparaître comme une opération technique de la recherche mais comme un processus de transformation des « inscriptions » individuelles sur le réseau en « données », processus que nous appelons « datafication ». Ce processus passe par la confrontation de « masques » différents que posent sur ces inscriptions les acteurs du « laboratoire invisible » de la recherche : le sociologue et le spécialiste de l’information et du web mais aussi l’utilisateur du réseau, la plateforme et le régulateur public.This paper deals with the interactions that occur during a research project based on the exploitation of social media data gathered on LinkedIn. Our reflexive approach to what we call the invisible laboratory of the research project allows us to describe the conflicts of interpretations that characterizes those data and the definition of data on the web. The production of our dataset is described as a social process involving the transformation of users “inscriptions” into sociological data. We call this process “datafication” and study the many actors that are involved in it: the sociologist, the IT and web specialist, the LinkedIn user, the social media and the public body in charge of data privacy regulations.En este artículo se reflexiona sobre las diferentes interacciones que caracterizan a un proyecto de encuesta en ciencias sociales sobre la explotación de los datos de la red social profesional LinkedIn. Esta reflexión sobre lo que llamamos el «laboratorio invisible» de la encuesta permite destacar los conflictos de interpretación que surgen en torno a la definición de lo que es un dato tomado de la web. Por lo tanto, el establecimiento de una base de datos no debe aparecer como una operación técnica de la investigación, sino como un proceso de transformación de «inscripciones» individuales en la red en «datos», un proceso que llamamos «datafication». Este proceso implica la confrontación de «máscaras» que se ponen los actores del laboratorio invisible por encima de aquellas inscripciones: el sociólogo y el especialista de la información y de la web, sino también el usuario de la red, la plataforma y el regulador público

L’inscription, le masque et la donnée : Datafication du web et conflits d’interprétation autour des données dans un laboratoire invisible des sciences sociales

International audienceThis paper deals with the interactions that occur during a research project based on the exploitation of social media data gathered on LinkedIn. Our reflexive approach to what we call the invisible laboratory of the research project allows us to describe the conflicts of interpretations that characterizes those data and the definition of data on the web. The production of our dataset is described as a social process involving the transformation of users “inscriptions” into sociological data. We call this process “datafication” and study the many actors that are involved in it: the sociologist, the IT and web specialist, the LinkedIn user, the social media and the public body in charge of data privacy regulations.En este artículo se reflexiona sobre las diferentes interacciones que caracterizan a un proyecto de encuesta en ciencias sociales sobre la explotación de los datos de la red social profesional LinkedIn. Esta reflexión sobre lo que llamamos el “laboratorio invisible” de la encuesta permite destacar los conflictos de interpretación que surgen en torno a la definición de lo que es un dato tomado de la web. Por lo tanto, el establecimiento de una base de datos no debe aparecer como una operación técnica de la investigación, sino como un proceso de transformación de “inscripciones” individuales en la red en “datos”, un proceso que llamamos “datafication”. Este proceso implica la confrontación de “máscaras” que se ponen los actores del laboratorio invisible por encima de aquellas inscripciones: el sociólogo y el especialista de la información y de la web, sino también el usuario de la red, la plataforma y el regulador público.Dans cet article, nous examinons les différentes interactions qui caractérisent un projet d’enquête en sciences sociales fondé sur l’exploitation des données du réseau social professionnel LinkedIn. Ce retour réflexif sur ce que nous appelons le « laboratoire invisible » de l’enquête nous permet de mettre en évidence les conflits d’interprétation qui naissent autour de la définition de ce qu’est une « donnée » tirée du web. Dès lors, la constitution d’une base de données ne doit pas apparaître comme une opération technique de la recherche mais comme un processus de transformation des « inscriptions » individuelles sur le réseau en « données », processus que nous appelons « datafication ». Ce processus passe par la confrontation de « masques » différents que posent sur ces inscriptions les acteurs du « laboratoire invisible » de la recherche : le sociologue et le spécialiste de l’information et du web mais aussi l’utilisateur du réseau, la plateforme et le régulateur public

Craniectomy in diffuse traumatic brain injury.

International audienc

Effets comparés du mannitol 20% et du serum salé hypertonique 7,45% à charge osmolaire identique dans le traitement de l'hypertension intracranienne

Nous avons réalisé un essai clinique prospectif monocentrique, randomisé, en simple aveugle, afin de comparer les effets d'une administration unique et de charge osmotique égale de mannitol ou de sérum salé hypertonique sur la pression intracrânienne et divers paramètres d'intérêt du monitorage cérébral, systémique et biologique évalués pendant 2 heures. Les patients présentant une hypertension intracrânienne d'origine parenchymateuse ont été assignés par randomisation à recevoir soit 231 mL de mannitol 20%, soit 100 mL de sérum salé hypertonique 7,45% en 20 minutes (charge osmotique de 255 mosmoles). 10 patients ont été inclus dans chaque groupe. Les groupes ont été strictement comparables à T0. L'osmothérapie a entraîné une baisse significative de la PIC stable sur 2 heures et comparable entre les 2 traitements. Les vélocités diastoliques et moyennes de l'artère cérébrale moyenne mesurées par doppler transcrânien ont été significativement plus élevées dans le groupe mannitol. La diurèse a été significativement augmentée dans le groupe mannitol sans majoration des besoins de remplissage vasculaire. La natrémie et la chlorémie ont été significativement augmentées dans le groupe sérum salé hypertonique. Le mannitol et le sérum salé hypertonique en bolus unique et à charge osmotique identique ont eu des effets comparables sur la plupart des paramètres d'intérêt dans la prise en charge de l'hypertension intracrânienne, notamment la pression intracrânienne et la pression de perfusion cérébrale. Leurs indications respectives peuvent être posées, en particulier, sur des critères concernant la natrémie et le statut volémique du patient.GRENOBLE1-BU Médecine pharm. (385162101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF