A connecting system for cardiological lexicons

The purpose of this paper is to present the approach and the development of a software application ("lexicons connecting" system) to correlate effectively and unambiguously the correspondence between the specialist medical vocabulary and the familiar medical vocabulary for the cardiovascular domain. To investigate the question, the idea, the design, and the implementation of such system will be described. To this end, firstly, a number of research methodologies will be examined including domain ontologies development, database design and implementation. Then, the following implementation methodology and its results are presented. Finally, an example of the application use will be depicted and future work will be briefly described

Cortical Inhibitory Imbalance in functional paralysis

Background: Functional neurological disorders are characterized by neurological symptoms that have no identifiable pathology and little is known about their underlying pathophysiology. Objectives: To analyze motor cortex excitability and intracortical inhibitory and excitatory circuits' imbalance in patients with flaccid functional weakness. Methods: Twenty-one consecutive patients with acute onset of flaccid functional weakness were recruited. Single and paired-pulse transcranial magnetic stimulation (TMS) protocols were used to analyze resting motor thresholds (RMT) and intracortical inhibitory (short interval intracortical inhibition - SICI) and excitatory (intracortical facilitation - ICF) circuits' imbalance between the affected and non-affected motor cortices. Results: We observed a significant increase in RMT and SICI in the affected motor cortex (p < 0.001), but not for ICF, compared to the contralateral unaffected side. Conclusion: This study extends current knowledge of functional weakness, arguing for a specific central nervous system abnormality which may be involved in the symptoms' pathophysiology

Patient experiences of anxiety, depression and acute pain after surgery: a longitudinal perspective

This study sought to explore the impact of the psychological variables anxiety and depression, on pain experience over time following surgery. Eighty-five women having major gynaecological surgery were assessed for anxiety, depression and pain after surgery. To gain further understanding, 37 patients participated in a semi-structured taped telephone interview 4–6 weeks post-operatively. Pre-operative anxiety was found to be predictive of post-operative anxiety on Day 2, with patients who experienced high levels of anxiety before surgery continuing to feel anxious afterwards. By Day 4 both anxiety and depression scores increased as pain increased and one-third of the sample experienced levels of anxiety in psychiatric proportions whilst under one-third experienced similar levels of depression. These findings have significant implications for the provision of acute pain management after surgery. Future research and those managing acute pain services need to consider the multidimensional effect of acute pain and the interface between primary and secondary care

Axillary lymphadenopathy at the time of COVID-19 vaccination: ten recommendations from the European Society of Breast Imaging (EUSOBI).

Unilateral axillary lymphadenopathy is a frequent mild side effect of COVID-19 vaccination. European Society of Breast Imaging (EUSOBI) proposes ten recommendations to standardise its management and reduce unnecessary additional imaging and invasive procedures: (1) in patients with previous history of breast cancer, vaccination should be performed in the contralateral arm or in the thigh; (2) collect vaccination data for all patients referred to breast imaging services, including patients undergoing breast cancer staging and follow-up imaging examinations; (3) perform breast imaging examinations preferentially before vaccination or at least 12 weeks after the last vaccine dose; (4) in patients with newly diagnosed breast cancer, apply standard imaging protocols regardless of vaccination status; (5) in any case of symptomatic or imaging-detected axillary lymphadenopathy before vaccination or at least 12 weeks after, examine with appropriate imaging the contralateral axilla and both breasts to exclude malignancy; (6) in case of axillary lymphadenopathy contralateral to the vaccination side, perform standard work-up; (7) in patients without breast cancer history and no suspicious breast imaging findings, lymphadenopathy only ipsilateral to the vaccination side within 12 weeks after vaccination can be considered benign or probably-benign, depending on clinical context; (8) in patients without breast cancer history, post-vaccination lymphadenopathy coupled with suspicious breast finding requires standard work-up, including biopsy when appropriate; (9) in patients with breast cancer history, interpret and manage post-vaccination lymphadenopathy considering the timeframe from vaccination and overall nodal metastatic risk; (10) complex or unclear cases should be managed by the multidisciplinary team

Off-label long acting injectable antipsychotics in real-world clinical practice: a cross-sectional analysis of prescriptive patterns from the STAR Network DEPOT study

Introduction Information on the off-label use of Long-Acting Injectable (LAI) antipsychotics in the real world is lacking. In this study, we aimed to identify the sociodemographic and clinical features of patients treated with on- vs off-label LAIs and predictors of off-label First- or Second-Generation Antipsychotic (FGA vs. SGA) LAI choice in everyday clinical practice. Method In a naturalistic national cohort of 449 patients who initiated LAI treatment in the STAR Network Depot Study, two groups were identified based on off- or on-label prescriptions. A multivariate logistic regression analysis was used to test several clinically relevant variables and identify those associated with the choice of FGA vs SGA prescription in the off-label group. Results SGA LAIs were more commonly prescribed in everyday practice, without significant differences in their on- and off-label use. Approximately 1 in 4 patients received an off-label prescription. In the off-label group, the most frequent diagnoses were bipolar disorder (67.5%) or any personality disorder (23.7%). FGA vs SGA LAI choice was significantly associated with BPRS thought disorder (OR = 1.22, CI95% 1.04 to 1.43, p = 0.015) and hostility/suspiciousness (OR = 0.83, CI95% 0.71 to 0.97, p = 0.017) dimensions. The likelihood of receiving an SGA LAI grew steadily with the increase of the BPRS thought disturbance score. Conversely, a preference towards prescribing an FGA was observed with higher scores at the BPRS hostility/suspiciousness subscale. Conclusion Our study is the first to identify predictors of FGA vs SGA choice in patients treated with off-label LAI antipsychotics. Demographic characteristics, i.e. age, sex, and substance/alcohol use co-morbidities did not appear to influence the choice towards FGAs or SGAs. Despite a lack of evidence, clinicians tend to favour FGA over SGA LAIs in bipolar or personality disorder patients with relevant hostility. Further research is needed to evaluate treatment adherence and clinical effectiveness of these prescriptive patterns

The Role of Attitudes Toward Medication and Treatment Adherence in the Clinical Response to LAIs: Findings From the STAR Network Depot Study

Background: Long-acting injectable (LAI) antipsychotics are efficacious in managing psychotic symptoms in people affected by severe mental disorders, such as schizophrenia and bipolar disorder. The present study aimed to investigate whether attitude toward treatment and treatment adherence represent predictors of symptoms changes over time. Methods: The STAR Network \u201cDepot Study\u201d was a naturalistic, multicenter, observational, prospective study that enrolled people initiating a LAI without restrictions on diagnosis, clinical severity or setting. Participants from 32 Italian centers were assessed at three time points: baseline, 6-month, and 12-month follow-up. Psychopathological symptoms, attitude toward medication and treatment adherence were measured using the Brief Psychiatric Rating Scale (BPRS), the Drug Attitude Inventory (DAI-10) and the Kemp's 7-point scale, respectively. Linear mixed-effects models were used to evaluate whether attitude toward medication and treatment adherence independently predicted symptoms changes over time. Analyses were conducted on the overall sample and then stratified according to the baseline severity (BPRS < 41 or BPRS 65 41). Results: We included 461 participants of which 276 were males. The majority of participants had received a primary diagnosis of a schizophrenia spectrum disorder (71.80%) and initiated a treatment with a second-generation LAI (69.63%). BPRS, DAI-10, and Kemp's scale scores improved over time. Six linear regressions\u2014conducted considering the outcome and predictors at baseline, 6-month, and 12-month follow-up independently\u2014showed that both DAI-10 and Kemp's scale negatively associated with BPRS scores at the three considered time points. Linear mixed-effects models conducted on the overall sample did not show any significant association between attitude toward medication or treatment adherence and changes in psychiatric symptoms over time. However, after stratification according to baseline severity, we found that both DAI-10 and Kemp's scale negatively predicted changes in BPRS scores at 12-month follow-up regardless of baseline severity. The association at 6-month follow-up was confirmed only in the group with moderate or severe symptoms at baseline. Conclusion: Our findings corroborate the importance of improving the quality of relationship between clinicians and patients. Shared decision making and thorough discussions about benefits and side effects may improve the outcome in patients with severe mental disorders

Internationalized knowledge-intensive business service (KIBS) for servitization: a microfoundation perspective

PurposeA paucity of studies has used a microfoundation lens to examine servitization processes in internationalized knowledge-intensive business service (KIBS) companies. The research aims to bridge this gap by considering knowledge sharing as a form of both codified knowledge and informal feedback knowledge; it also assesses whether the adoption of knowledge transfer and translation practices in a servitization process positively moderates the effect of knowledge transformation on knowledge sharing for internationalized KIBS companies.Design/methodology/approachBy adopting a microfoundation lens, the research offers an empirical analysis to identify the relations between codified and tacit knowledge in servitization processes within internationalized KIBS companies. The study is based on 326 respondents from 30 KIBS companies. A multiple regression analysis was used for hypotheses testing.FindingsThe authors found significant relations among the use of electronic documents in the servitization process (formal codified knowledge), personal advice in servitization (informal feedback knowledge) and knowledge sharing in internationalized KIBS companies. Findings also support the indirect effect assumed in the hypothesis between knowledge transformation and knowledge sharing in internationalized KIBS companies, which is positively moderated by the adoption of cross-cultural knowledge practices in the servitization process.Originality/valueTo the best of the authors' knowledge, this research provides the first conceptual model of the use of a microfoundation lens to examine knowledge sharing in internationalized KIBS companies. The micro level features individual knowledge sharing in the servitization process, while the meso level focuses on knowledge transformation in KIBS companies and the adoption of knowledge transfer and translation practices in the servitization process

The impact of innovation failure:Entrepreneurship adversity or opportunity?

Innovation is key to the economic performance of firms. However, several types of risks and uncertainties often lead to high failure rates in innovation projects, to the extent that failure is now considered a typical step in an innovation process. If innovation failure was provoking stress in the past, the current socio-economic contexts makes if it something to regularly deal with and learning from. However, there still is a dilemma on whether innovation failure should be considered as an opportunity or a trauma for the firm. Exploring the three steps of an innovation failure, that is identifying, analyzing and experimenting, the present research offers new insights on the nature of innovation failure at an individual and team levels. In particular, via an inductive approach this study provides fours key approaches to understanding innovation failure. First, we have uncovered a wide range of approaches to organizational management and ‘Spaghetti’ organizational models of innovation that perceive failure as an opportunity for the innovation process. Secondly, our study identified what seems to be a widespread perception of innovation failure as a trauma, which encourages the culture of openness to failure and to share knowledge of failing innovations. Such views apply not only at organizational but also at individual and team levels. Third, our results serve to encourage individuals, teams and organizations to find new ways to learn from failures in innovation projects, and to have a less centralized management and control over innovation. Fourth, in our perception of the domain, failure could become the ‘new normal’ and a mean to generate new knowledge. This stimulates new directions in the decision-making process, towards novel pathways to innovation

B2B green marketing strategies for European firms:implications for people, planet and profit

The present research addresses the gap in studies on B2B marketing comparing a diverse set of socio-economic factors (ROA and Tobin’ s Q) and its effects on people, planet, and profit. Studies in the past have shown that firms haven't been able to gain a long-term competitive advantage by using environmental strategies. Hence, the research analyses how 371 B2B firms from developed and emerging European countries achieve competitive advantage through green marketing strategies. Additionally, those firms are also assessed in reference to their level of engagement with environmental, social, and governance strategies. Our findings highlight that the more the engagement in green marketing by B2B firms, the greater the green competitive advantage that B2B firms in developed European markets can achieve. Hence, the study explores the relationship of B2B marketing, environmental sustainability, and corporate profitability, providing insights into how European firms can balance their financial objectives with their social and environmental responsibilities. The originality of the research stressed the need to pursue social and environmental goals and to preserve the future of people, planet, and profit through green marketing strategies. Investing in future business models and green competitive advantage is especially important for B2B European emerging firms' markets