142 research outputs found

    Co-creation in new product development: Which drivers of consumer participation?

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    The present study investigates co-creation in new product development by providing a conceptual background in the psychological factors favoring consumer participation in company processes. The work explores the consumers' profiles willing to participate in co-creation, through the identification of their personality traits, key motivations, and barriers. Two product typologies are investigated, namely high-tech and high-touch products through survey research on a sample of Italian consumers. Results from structural equation modeling show that consumers' personality traits affect the perceived motivations and barriers to co-create, in turn shaping their willingness to co-create. Furthermore, consumer willingness to co-create varies depending on the product typology. Under a managerial viewpoint, the research study provides practitioners with keys to design targeted co-creation activities, fitting with the specific product typology and audience, and to devise the most suitable participation incentives to offer

    "Lock therapy": da utopia a realtà

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    Negli ultimi anni la presenza di cateteri venosi centrali permanenti (CVCp), quale accesso vascolare per l'emodialisi, rappresenta un'evenienza sempre più comune. Il problema principale del CVCp è rappresentato dal biofilm che a sua volta determina un aumento di rischio d'infezione e di trombosi. Recentemente è stata posta particolare attenzione alla soluzione di chiusura "lock" del CVCp. L'eparina andrebbe abbandonata poiché induce più rapidamente lo sviluppo di biofilm ed espone il paziente a rischio di sanguinamento dovuto all'overspil-ling. La soluzione citrato (3.8%) determina attualmente il migliore rapporto rischio/beneficio sul funzionamento del CVC, ma non offre vantaggi sulla riduzione delle infezioni. Le soluzioni con citrato ipertonico (46.7%) e con antibiotico (AML) andrebbero riservate solo su pazienti con elevata incidenza di episodi d'infezione e nei quali non è possibile una sostituzione del CVCp. Le AML andrebbero usate per periodi brevi per il rischio di sviluppo di resistenze. Per l'etanolo è necessario attendere l'esito di importanti trial. Nella corretta gestione del CVC, qualunque "lock" sia utilizzato, va sempre ricordato il continuo addestramento del personale e l'applicazione delle misure igieniche universali

    Uso degli anticoagulanti orali per la prevenzione della trombosi dei cateteri venosi centrali per emodialisi

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    Central venous catheters (CVCs) are fundamental in the management of hemodialysis. Despite major efforts to provide arteriovenous access, their use is increasing in dialysis units worldwide. The presence of a catheter inside a vein increases the risk of thrombosis, both within the catheter and in the vein. Thrombosis is a serious complication because it can lead to inefficient dialysis, alter the venous circulation, and facilitate infections. In this article, questions regarding anticoagulant treatment in dialysis patients with CVCs are explored and specific suggestions offered for clinical practice, based on the evidence available and the personal experience of the authors. Should CVC-induced thrombosis be treated? The duration, site and extension of the thrombotic complication should be assessed. If thrombosis is recent and symptomatic, heparin treatment followed by oral anticoagulant therapy is suggested. Is oral anticoagulant therapy useful for primary prevention of thrombosis, both within the CVC and the vein where the catheter is inserted? The available evidence favoring the use of oral anticoagulant therapy is not entirely convincing. At any rate, before such treatment is started the balance between the antithrombotic efficacy and the possible side effects should be carefully weighed. Is oral anticoagulant therapy useful for secondary prevention of CVC thrombosis? If a permanent CVC is in place and its position is correct and the blood flow < 250 mL/min, we recommend - before replacing the CVC - thrombolytic treatment followed by oral anticoagulants, aiming at an INR target between 2 and 3. Are the side effects of oral anticoagulant therapy an issue? The use of anticoagulants in renal failure carries an increased risk of complications, in particular bleeding and vascular calcifications, which could annul the advantages derived from reduced thrombotic events. Before starting oral anticoagulant therapy we suggest to carefully evaluate if there are potential overall benefits and to pay attention to concomitant antiplatelet therapy

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    Establishment of the effectiveness of early versus late stem cell gene therapy in Mucopolysaccharidosis II for treating central versus peripheral disease

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    Mucopolysaccharidosis type II (MPSII) is a rare paediatric X-linked lysosomal storage disease, caused by heterogeneous mutations in the IDS gene, which result in accumulation of heparan sulphate and dermatan sulphate within cells. This leads to severe skeletal abnormalities, hepatosplenomegaly and cognitive deterioration. The progressive nature of the disease is a huge obstacle to achieve full neurological correction. Although current therapies can only treat somatic symptoms, a lentivirus-based hematopoietic stem cell gene therapy (HSCGT) approach has recently achieved improved central nervous system neuropathology in the MPSII mouse model following transplant at 2-months of age. Here we evaluate neuropathology progression in 2-month, 4-month and 9-month-old MPSII mice and using the same HSCGT strategy we investigated somatic and neurological disease attenuation following treatment at 4-months of age. Our results showed gradual accumulation of heparan sulphate between 2 and 4 months of age, but full manifestation of microgliosis/astrogliosis as early as 2 months. Late HSCGT fully reversed the somatic symptoms, thus achieving the same degree of peripheral correction as early therapy. However, late treatment resulted in slightly decreased efficacy in the CNS, with poorer brain enzymatic activity, together with reduced normalisation of heparan sulphate over-sulphation. Overall, our findings confirm significant lysosomal burden and neuropathology in 2-month-old MPSII mice. Peripheral disease is readily reversible by LV.IDS-HSCGT regardless of age of transplant, suggesting a viable treatment for somatic disease. However, in the brain, higher IDS enzyme levels are achievable with early HSCGT treatment, and later transplant seems to be less effective, supporting the view that the earlier patients are diagnosed and treated, the better the therapy outcome

    Indicazioni all\u2019uso delle protesi vascolari per l\u2019accesso emodialitico : un\u2019esperienza italiana basata sul consenso

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    In Italy, the use of arteriovenous grafts (AVGs) is limited (1-4%) due to different approaches to vascular access management compared to other countries, where guidelines that may not apply to the Italian setting have been produced. Therefore, the Vascular Access Study Group of the Italian Society of Nephrology produced this position paper, providing a list of 8 recommendations built upon current guidelines. The most controversial and innovative issues of the existing guidelines have been summed up in 12 different topics. We selected 60 Italian dialysis graft experts, nephrologists and vascular surgeons (PP1SIN Study Investigators). They were asked to express their approval or disapproval on each issue, thus creating a new method to share and exchange information. Almost all agreed on specific criteria for the choice of AVG over native arteriovenous fistulas (AVF) and tunneled venous catheters (tVC) and on the necessary conditions to implant them. They did not fully agree on the use of AVG in obese patients and patients at risk of developing ischemia, as an alternative to brachiobasilic fistula with vein transposition, and in case of a poorly organized setting. When AVF is feasible, it should be preferred. AVGs are indicated when superficial veins are unavailable or to repair an AVF (bridge graft). An AVG is an alternative to tVC if the expected patient survival is long enough to allow clinical benefits. The ultimate choice of the graft type is made by the physician in charge of the surgical intervention. Antithrombotic prophylaxis may be justified in some cases

    Microbial inactivation properties of a new antimicrobial/antithrombotic catheter lock solution (citrate/methylene blue/parabens)

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    Background. Microbial infections are the most serious complications associated with indwelling central venous catheters. A catheter lock solution that is both antibacterial and antithrombotic is needed. The goal of this study was to determine whether a new catheter lock solution containing citrate, methylene blue and parabens has antimicrobial properties against planktonic bacteria and against sessile bacteria within a biofilm. These effects were compared to the antimicrobial properties of heparin at 2500 units/ml
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