European Acquisitions in the United States:Re-examining Olivetti-Underwood Fifty Years Later

While Italy's catch-up in the course of the 20th century has been nothing short of extraordinary, it has failed to produce a large number of global business players. Nonetheless, half a century ago an Italian company concluded what was at the time the largest-ever foreign takeover of a US company. The paper analyzes the Olivetti's acquisition of Underwood and frames it in the broader picture of the literature on the management and performance of foreign companies in the United States. We provide a historical narrative focused on three main issues: 1) head office control and subsidiary autonomy; 2) Olivetti's adaptation to the American business system; 3) the development of internal knowledge resources within the subsidiary. Lessons and implications are relevant for business historians and management scholars in general.FDI, acquisition, control, adaptation, knowledge resources, Olivetti, Underwood

Deliverable D10.4.1

This deliverable describes the final status of Task 10.4 of Workpackage 10 of the euHeart project. The aim of this task is to develop a prototype of an endovascular simulator of cardiac radiofrequency ablation. More precisely, its purpose is to simulate the patient-specific catheter navigation and radiofre- quency ablation of ventricular tachycardia. Since deliverable 10.4.1, work on the simulator prototype has focused on the development of a user interface and the integration of two software compo- nents : endovascular simulation and electrophysiology simulation. The first component aims at modeling the deformation of catheters and guidewires inside vessels and to generate a realistic visualization of the vis- ible X-ray images. The second component is focused on the simulation of electrophysiology. We have chosen the Mitchell-Schaeffer phenomenological model to represent the evolution of action potential on the myocardium. The integration of those 2 software components is difficult because they should both run simultaneously in real-time. To this end, we have developed a multi-thread framework allowing to parallelize the computation of the catheter deformation and the cardiac electrophysiology while sharing a minimum num- ber of information. We have also developed a user interface that can display X-ray images, 3D view of the heart and simulated electro-physiology signals measured at the tip of the catheter. An example of simulation is provided starting from the endovascular navi- gation from the veina cava and finishing with the radiofrequency ablation of endocardial tissue inside the right ventricle

Deliverable D10.4.2

This deliverable describes the final status of Task 10.4 of Workpackage 10 of the euHeart project. The aim of this task is to develop a prototype of an endovascular simulator of cardiac radiofrequency ablation. More precisely, its purpose is to simulate the patient-specific catheter navigation and radiofre- quency ablation of ventricular tachycardia. Since deliverable 10.4.1, work on the simulator prototype has focused on the development of a user interface and the integration of two software compo- nents : endovascular simulation and electrophysiology simulation. The first component aims at modeling the deformation of catheters and guidewires inside vessels and to generate a realistic visualization of the vis- ible X-ray images. The second component is focused on the simulation of electrophysiology. We have chosen the Mitchell-Schaeffer phenomenological model to represent the evolution of action potential on the myocardium. The integration of those 2 software components is difficult because they should both run simultaneously in real-time. To this end, we have developed a multi-thread framework allowing to parallelize the computation of the catheter deformation and the cardiac electrophysiology while sharing a minimum num- ber of information. We have also developed a user interface that can display X-ray images, 3D view of the heart and simulated electro-physiology signals measured at the tip of the catheter. An example of simulation is provided starting from the endovascular navi- gation from the veina cava and finishing with the radiofrequency ablation of endocardial tissue inside the right ventricle

Interactive Training System for Interventional Electrocardiology Procedures

International audienceRecent progress in cardiac catheterization and devices has allowed the development of new therapies for severe cardiac diseases like arrhythmias and heart failure. The skills required for such interventions are very challenging to learn, and are typically acquired over several years. Virtual reality simulators may reduce this burden by allowing trainees to practice such procedures without risk to patients. In this paper, we propose the first training system dedicated to cardiac electrophysiology, including pacing and ablation procedures. Our framework involves the simulation of a catheter navigation that reproduces issues intrinsic to intra-cardiac catheterization, and a graphics processing unit (GPU)-based electrophysiological model. A multi-threading approach is proposed to compute both physical simulations (navigation and electrophysiology) asynchronously. With this method, we reach computational performances that account for user interactions in real-time. Based on a scenario of cardiac arrhythmia, we demonstrate the ability of the user-guided simulator to navigate inside vessels and cardiac cavities with a catheter and to reproduce an ablation procedure involving: extra-cellular potential measurements, endocardial surface reconstruction, electrophysiol-ogy mapping, radio-frequency (RF) ablation, as well as electrical stimulation. A clinical evaluation assessing the different aspects of the simulation is presented. This works is a step towards computerized medical learning curriculum

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

Chromosome 10p deletion in a patient with hypoparathyroidism, severe mental retardation, autism and basal ganglia calcifications.

Chromosome 10p terminal deletions have been associated with a DiGeorge like phenotype. Haploinsufficiency of the region 10p14-pter, results in hypoparathyroidism, sensorineural deafness, renal anomaly, that is the triad that features the HDR syndrome. Van Esch (2000) identified in a HDR patient, within a 200 kb critical region, the GATA3 gene, a transcription factor involved in the embryonic development of the parathyroids, auditory system and kidneys. We describe a new male patient, 33-year-old, with 10p partial deletion affected by hypocalcemia, basal ganglia calcifications and a severe autistic syndrome associated with mental retardation. Neurologically he presented severe impairment of language, hypotonia, clumsiness and a postural dystonic attitude. A peripheral involvement of auditory pathways was documented by auditory evoked potentials alterations. CT scan documented basal ganglia calcifications. Hyperintensity of the lentiform nuclei was evident at the MRI examination. Renal ultrasound scan was normal. Haploinsufficiency for GATA3 gene was documented with FISH analysis using cosmid clone 1.2. Phenotypic spectrum observed in del (10p) is more severe than the classical DGS spectrum. GATA3 has been found to regulate the development of serotoninergic neurons. A serotoninergic dysfunction may be linked with autism in this patient

Genital Lymphedema and How to Deal with It: Pearls and Pitfalls from over 38 Years of Experience with Unusual Lymphatic System Impairment

Background and Objectives: Conservative treatment represents an essential pillar of lymphedema management, along with debulking and physiologic surgeries. Despite the consistent number of treatment options, there is currently no agreement on their indications and possible combinations. When dealing with unusual lymphedema presentation as in the genitalia (Genital Lymphedema-GL), treatment choice becomes even more difficult. The authors aimed to present their targeted algorithm of single and combined treatment modalities for rare GL in order to face this paucity of information. Materials and Methods: Data were collected from a prospectively maintained database since January 1983, and cases of GL that were managed in the authors' department were selected. Only patients that were treated in the authors' institution and presented a minimum follow-up of 3 months were admitted to the current study. Results: From January 1983 to July 2021, 19 patients with GL were recruited. All the patients were male, and their ages ranged from 21 to 73 years old (average: 52). Ten cases (52.6%) presented with ISL (International Society of Lymphology) stage I, five (26.3%) were stage II and four (21.1%) were stage III. GL was managed with conservative treatment (12 cases), LVA (LymphaticoVenous Anastomosis) (3) or surgical excision (4). In a mean follow-up of 7.5 years (range: 3 months-11 years), no major complications occurred, and all cases reached improvements in functional and quality of life terms. Conclusions: Contrary to the predominant thought of the necessity to avoid surgery in unusual lymphedema presentations such as GL, they can be managed using targeted multimodal approaches or by adapting well-known procedures in unusual ways to achieve control of disease progression and improve patients' quality of life

Assessment of serum IGF-1 concentrations in the diagnosis of isolated childhood-onset GH deficiency: A proposal of the Italian Society for Pediatric Endocrinology and Diabetes (SIEDP/ISPED)

The diagnosis of GH deficiency (GHD) is based on the measurement of peak GH responses to pharmacological stimuli. Pharmacological stimuli, however, lack precision, accuracy, are not reproducible, are invasive, non-physiological and some may even be hazardous. Furthermore, different GH commercial assays used to measure GH in serum yield results that may differ considerably. In contrast to GH, IGF-I can be measured on a single, randomly-obtained blood sample. A review of the available data indicates that IGF-I measurement in the diagnosis of childhood-onset isolated GHD has a specificity of up to 100%, with a sensitivity ranging from about 70 to 90%. We suggest an algorithm in which circulating levels of IGF-I together with the evaluation of auxological data, such as growth rate and growth, may be used to assess the likelihood of GHD in pre-pubertal children

Assesment of serum IGF-I concentrations in the diagnosis of isolated childhood-onset GH deficiency: A proposal of the Italian Society for Pediatric Endocrinology and Diabetes (SIEDP/ISPED)

The diagnosis of GH deficiency (GHD) is based on the measurement of peak GH responses to pharmacological stimuli. Pharmacological stimuli, however, lack precision, accuracy, are not reproducible, are invasive, non-physiological and some may even be hazardous. Furthermore, different GH commercial assays used to measure GH in serum yield results that may differ considerably. In contrast to GH, IGF-I can be measured on a single, randomly-obtained blood sample. A review of the available data indicates that IGF-I measurement in the diagnosis of childhood-onset isolated GHD has a specificity of up to 100%, with a sensitivity ranging from about 70 to 90%. We suggest an algorithm in which circulating levels of IGF-I together with the evaluation of auxological data, such as growth rate and growth, may be used to assess the likelihood of GHD in pre-pubertal children