Vitamina D nativa o attivata: quale forma è indispensabile?

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Reporting di sostenibilità degli operatori logistici in Europa: analisi degli indicatori

Obiettivi: L’affermazione di una nuova concezione del valore, basata sulle qualità e non sull’insostenibile aumento delle quantità di merci e consumi, induce gli operatori logistici alla ricerca di azioni che possano essere nel contempo economicamente efficienti ed efficaci, ecologicamente sopportabili e socialmente giuste. Il presente lavoro ha l’obiettivo di investigare e identificare le azioni sostenibili - economiche, ambientali e sociali - intraprese dagli operatori logistici. Metodologia: Il quadro teorico è stato costruito attraverso lo studio della letteratura accademica nazionale e internazionale. La parte empirica è stata sviluppata attraverso l’analisi dei più recenti report di sostenibilità degli operatori logistici operanti in Europa, redatti secondo gli standard della Global Reporting Initiative. Risultati: Gli operatori logistici possono contribuire in modo significativo al cambiamento paradigmatico in atto, facilitando e favorendo, in qualità di fornitori di servizi, il raggiungimento della sostenibilità della supply chain. Limiti della ricerca: Il presente lavoro costituisce la fase preliminare di un più approfondito progetto di ricerca che indaghi le iniziative di sostenibilità degli operatori logistici a livello mondiale e che consideri un arco temporale di osservazione utile a tracciare il trend in atto. Implicazioni pratiche: Sia l’accademia che il mondo professionale possono trovare utile l’analisi della letteratura sul tema e i primi risultati ottenuti, in quanto sono posti in evidenzia i principali tratti di sostenibilità degli operatori logistici che già hanno intrapreso il percorso verso la sostenibilità. Originalità del lavoro: Gli studi della letteratura esistente sugli operatori logistici e la sostenibilità si basano quasi esclusivamente sulla sostenibilità ambientale e l’ecoefficienza, mentre manca un approccio sistemico capace di superare i problemi odierni mediante la valorizzazione della multidimensionalità. Il lavoro contribuisce a colmare questo gap

Alkaline phosphatases in the complex chronic kidney disease-mineral and bone disorders

Alkaline phosphatases (APs) remove the phosphate (dephosphorylation) needed in multiple metabolic processes (from many molecules such as proteins, nucleotides, or pyrophosphate). Therefore, APs are important for bone mineralization but paradoxically they can also be deleterious for other processes, such as vascular calcification and the increasingly known cross-talk between bone and vessels. A proper balance between beneficial and harmful activities is further complicated in the context of chronic kidney disease (CKD). In this narrative review, we will briefly update the complexity of the enzyme, including its different isoforms such as the bone-specific alkaline phosphatase or the most recently discovered B1x. We will also analyze the correlations and potential discrepancies with parathyroid hormone and bone turnover and, most importantly, the valuable recent associations of AP's with cardiovascular disease and/or vascular calcification, and survival. Finally, a basic knowledge of the synthetic and degradation pathways of APs promises to open new therapeutic strategies for the treatment of the CKD-Mineral and Bone Disorder (CKD-MBD) in the near future, as well as for other processes such as sepsis, acute kidney injury, inflammation, endothelial dysfunction, metabolic syndrome or, in diabetes, cardiovascular complications. However, no studies have been done using APs as a primary therapeutic target for clinical outcomes, and therefore, AP's levels cannot yet be used alone as an isolated primary target in the treatment of CKD-MBD. Nonetheless, its diagnostic and prognostic potential should be underlined

Phosphate overload accelerates vascular aging in uremic patients

Vascular calcification is a very common event in atients affected by diabetes and chronic kidney disease (CKD). Recently, it has been well documented that abnormalities in mineral and bone metabolism in CKD patients are associated with increased morbidity and mortality. Elevated serum phosphate and calcium-phosphate product levels play an important role in the pathogenesis of vascular mineralization in uremic patients and also appear to be associated with increased cardiovascular mortality. Together with classical passive precipitation of calcium-phosphate in soft tissues, during the last decade it has been demonstrated that inorganic phosphate may cause extraskeletal calcification directly through a real “ossification” of the tunica media in the vasculature of CKD patients. Therefore, control of phosphate retention is now an even more crucial target of treatment in patients affected by chronic kidney disease

Horizontal network collaboration by entrepreneurial ventures: a supply chain finance perspective

Purpose – The present paper aims at understanding how horizontal network collaborations between small and medium enterprises (SMEs) can be designed and implemented to take advantage of a supply chain finance (SCF) perspective. Design/methodology/approach – This study presents an SCF literature background identifying four literature gaps, and in response to them it adopts an action research approach. The empirical analysis is developed on a network-case study: a horizontal collaboration project between small businesses of the Italian wine industry and their supply chains. Findings – SMEs can play an active role in developing – in terms of design and implementation – their collaborative networks by taking advantage of an SCF perspective for themselves, and their customers, based on the reorganization of relationships interface processes. Taking this perspective can be a concrete and crucial way to sustain the development of SMEs and their supply chains in an actual competitive context. Research limitations/implications – The paper identifies the theoretical gaps in the literature, suggests new research areas that deserve to be more deeply investigated and connects case-related results to the key concepts. The empirical part presents a real case application that proposes a complete roadmap for managers and practitioners who wish to experience similar projects. Practical implications – This network-case study storyline, presenting an overview of ten years of meetings, with related purposes, is suggesting a roadmap for design and implementation of horizontal network as managerial implications. These kinds of active research projects, with a collaborative mixed team of academics and practitioners, and involving a multilayer group of participants, are positive examples for closing the bridge between companies and academia, which enhance this network of small businesses active in trying to improve their competitiveness working together. Originality/value – The value of the paper is to embrace a supply chain-oriented perspective for an SME, independent of the financial system and based on inventory flow management. Very little literature focuses on inventory-based research within the SCF framework, designed for real implementation in horizontal network collaboration by entrepreneurial ventures

Trattamento dell'iperparatiroidismo secondario: calciomimetici, attivatori selettivi del recettore della vitamina D (VDRAs) o terapia combinata

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Calcium-sensing receptor and calcium kidney stones

Calcium nephrolithiasis may be considered as a complex disease having multiple pathogenetic mechanisms and characterized by various clinical manifestations. Both genetic and environmental factors may increase susceptibility to calcium stones; therefore, it is crucial to characterize the patient phenotype to distinguish homogeneous groups of stone formers. Family and twin studies have shown that the stone transmission pattern is not mendelian, but complex and polygenic. In these studies, heritability of calcium stones was calculated around 50