Firms’ knowledge assets represent vital resources that contribute, in general, to corporate performance and value creation. At an earlier stage, they are expected to help enhance the operational ...efficiency of firms they belong to. In this light, under a Resource-Based Theory framework, we intend to find whether and to what extent this expectancy is verified also during the recent crisis in Italy. In more detail, we considered 612 firm-year observations relating to the Italian listed companies during three consecutive years - 2010, 2011 and 2012 (when the financial crisis reached its peak in Italy) - analysing overall about 7.000 data/numbers under a Fixed Effects Panel Data Model. The findings are robust: we document a significant positive correlation between Operational Efficiency and Patent assets & Intellectual Property Rights, Goodwill, Trademarks & Licenses, while we do not find a correlation with reference to Research & Development Capital (and Advertising investments), also controlling for employees, leverage and time/sector dummies. In the midst of a very turbulent period, most intellectual assets (the former) appear from the efficiency point of view more valuable and reliable than others (the latter) in hampering the profitability drop. Hence, unlike the tangible and financial assets, such resources are prospected to be strategic levers that make it possible to maintain efficiency or to enable a faster recovery in terms of wasted efficiency. That is, in turbulent times, technology, marketing-related and contractual-legal assets appear significantly associated with operational efficiency and therefore beneficial to corporate results.
This systematic review (SR) and meta-analysis aims to compare the surgery-related results and oncological outcomes between SH and RH in patients with early-stage cervical cancer.
We systematically ...searched databases including PubMed, Embase and Cochrane to collect studies that compared oncological and surgery-related outcomes between SH and RH groups in patients with stage IA2 and IB1 cervical cancer. A random-effect model calculated the weighted average difference of each primary outcome via Review Manager V.5.4.
Seven studies comprising 6977 patients were included into our study. For oncological outcomes, we found no statistical difference in recurrence rate OR = 0.88; 95% CI (0.50, 1.57); P = 0.68 and Overall Survival (OS) OR = 1.23; 95% CI (0.69, 2.19), P = 0.48. No difference was detected in the prevalence of positive LVSI and lymph nodes metastasis between the two groups. Concerning surgery-related outcomes, the comprehensive effects revealed that the bladder injury OR = 0.28; 95% CI (0.08, 0.94), P = 0.04 and bladder disfunction OR = 0.10; 95% CI (0.02, 0.53), P = 0.007 of the RH group were higher compared to the SH group.
This meta-analysis suggested there are no significant differences in terms of both recurrence rate and overall survival among patients with stage IA2-IB1 cervical cancer undergoing SH or RH, while the SH group has better surgery-related outcomes. These data confirm the need to narrow the indication for RH in early-stage cervical cancer.
Objective
Direct insertion of the trocar is an alternative method to Veress needle insertion for the creation of pneumoperitoneum. We conducted a systematic review and meta-analysis to compare these ...two entry closed techniques.
Data source
A systematic review of the literature was done on PubMed, MEDLINE, Embase, Scopus, and EBSCO.
Methods
The literature search was constructed until May 01, 2022, around search terms for “Veress,” “direct trocar,” “needle,” “insertion,” and “laparoscopic ways of entry.” This systematic review was reported according to the PRISMA Statement 2020.
Results
Sixteen controlled trials (RCTs) and 5 observational studies were included in the systematic review. We found no significant differences in the risk of major complication during the access manoeuvres between DTI and VN: bowel injuries (OR = 0.76, 95% CI: 0.24–2.36,
P
= 0.63), major vascular injuries (OR = 1.74, 95% CI 0.56–5.38,
P
= 0.34), port site hernia (OR = 2.41, 95% CI: 0.28–20.71,
P
= 0.42). DTI has a lower risk of minor complications such as subcutaneous emphysema (OR = 5.19 95% CI: 2.27–11.87,
P
< 0.0001), extraperitoneal insufflation (OR = 5.93 95% CI: 1.69–20.87,
P
= 0.006), omental emphysema (OR = 18.41, 95% CI: 7. 01–48.34,
P
< 0.00001), omental bleeding (OR = 2.32, 95% CI: 1.18–4.55,
P
= 0.01), and lower number of unsuccessful entry or insufflation attempts (OR = 2.25, 95% CI: 1.05–4.81,
P
= 0.04). No significant differences were found between the two groups in terms of time required to achieve complete insufflation (MD = − 15.53, 95% CI: − 91.32 to 60.27,
P
= 0.69), trocar site bleeding (OR = 0.66, 95% CI, 0.25–1.79,
P
= 0.42), and trocar site infection (OR = 1.19, 95% CI, 0.34–4.20,
P
= 0.78).
Conclusion
There were no statistically significant differences in the risk of major complications during the access manoeuvres between DTI and VN. A lower number of minor complications were observed in DTI compared with those in Veress access.
The present article deals with a new, modern business management paradigm founded on both the social and the environmental responsibility of firms intended as powerful instruments to match the issue ...of sustainability with corporate performance and value creation (thus evolving from the classical shareholder value to a new, more comprehensive, shared value view). The Directive 2013/34/EU required the disclosure of large enterprises and groups’ non-financial and diversity information. At the same time, a growing number of proactive companies that behave with real initiatives more compliant to the so-called Stakeholder Theory have become quite familiar to produce CSR and sustainability reports periodically to share with the community their relevant responsibility actions and achievements (3 P results or triple-bottom-line performance, as a for-profit, people, planet). Such a complex, behavioral, and informative approach follows the corporate governance setting and management strategy within the ethical domain (business ethics). In this perspective, we conduct a systematic research study on the economic literature that showed a focus on the possible relation between the responsible behavior/information and the economic/financial performance of firms, analyzing both the empirical findings and theoretical works significantly investigating the effect of sustainability indicators on financial and market results. According to the general studies, socially responsible policies can produce a positive impact on company performance by many advantages such as the reduction of operating costs and financial risks, an increase of efficiency and competitiveness, the improvement of the company’s reputation, and a related increase in consumer confidence; despite preceding studies pointed out that CSR investments and responsibility policies (representing the result of an agency conflict between managers and shareholders) would generate just an increase in costs and a consequent decline in the performance of companies. The consideration of the ESG (environmental, social, and governance) – which completes the CSR issue – and its new goals in the long run, even as a component of the holistic enterprise risk management system, finally enables us to reinterpret the fundamental competitive advantage of firms in a sustainability key. In particular, the environmental, social, and governance extra-performance over the industry may show to be more ‘value-relevant’ than the absolute ESG ratings itself. In conclusion, the social, environmental, and governance responsibilities (to all stakeholders) are building a set of dynamic capabilities and actions which reveal a new competitive (X) Factor of the modern corporation.
Keywords: CSR, Environmental-Social-Governance, Economic Performance, Value Creation; Stakeholder Theory, Sustainability Disclosure.
The neoplastic “stromal” cells in giant cell tumor of bone (GCTB) harbor a mutation in the H3F3A gene, which causes alterations in the epigenome. Current systemic targeted therapies, such as ...denosumab, do not affect the neoplastic cells, resulting in relapse upon treatment discontinuation. Therefore, this study examined whether targeting the epigenome could eliminate the neoplastic cells from GCTB. We established four novel cell lines of neoplastic “stromal” cells that expressed the H3F3A p.G34W mutation. These cell lines were used to perform an epigenetics compound screen (n = 128), which identified histone deacetylase (HDAC) inhibitors as key epigenetic regulators in the neoplastic cells. Transcriptome analysis revealed that the neoplastic cells expressed all HDAC isoforms, except for HDAC4. Therefore, five HDAC inhibitors targeting different HDAC subtypes were selected for further studies. All GCTB cell lines were very sensitive to HDAC inhibition in both 2D and 3D in vitro models, and inductions in histone acetylation, as well as apoptosis, were observed. Thus, HDAC inhibition may represent a promising therapeutic strategy to eliminate the neoplastic cells from GCTB lesions, which remains the paramount objective for GCTB patients who require life-long treatment with denosumab.
Pharmacological agents such as prostaglandins (dinoprostone and misoprostol) are commonly used to reduce the duration of labor and promote vaginal delivery. However, key safety considerations with ...its use include an increased risk of uterine rupture, tachysystole and hyperstimulation of pregnant women, which could potentially lead to a non-reassuring fetal heart rate and to fetal hypoxemia. The aim of this systematic review was to assess maternal and fetal outcomes between misoprostol group (PGE1) and dinoprostone group (PGE2)
We search on MEDLINE (PubMed), CINHAL (EBSCOhost), EMBASE, Scopus (Ovid), CENTRAL (January 1, 1998, to December 31, 2022). Patients were eligible if they presented at greater than 36 weeks gestation with an indication for induction of labor and a single live cephalic fetus. We conducted a meta-analysis of data for both primary (cesarean section rate, instrumental deliveries rate, tachysystole, uterine rupture, post-partum haemorrage; chorionamiositis) and secondary outcomes (Apgar at 5 min <7, meconium-stained liquor, NICU admission, infant death) using odds-ratio (OR) as a measure of effect-size. Risk of bias assessment was performed with RoB-I. We performed statistical analyses using Cochrane RevMan version 5.4 software.
We found 39 RCTs comparing the outcomes of interest between misoprostol and dinoprostone. The pooled effect showed no statistically significant difference between the two groups in terms of cesarean section rate OR: 0.94; 95% CI 0.84–1.05, instrumental deliveries rate OR: 1.04; 95% CI: 0.90–1.19; p = 0.62, tachysystole OR: 1.21; 95% CI: 0.91–1.60; p = 0.19, post-partum hemorrhage OR: 0.85; 95% CI: 0.62–1.15p = 0.30, chorioamnionitis OR: 0.94; 95% CI: 0.76–1.17p = 0.59, Apgar at 5 min < 7 OR: 0.83; 95% CI: 0.61–1.12, p = 0.21, meconium-stained liquor OR: 1.11; 95% CI: 0.97–1.27p = 0.59, NICU admission group OR: 0.91; 95% CI: 0.77–1.09, infant death OR: 0.57; 95% CI: 0.22–1.44. After performing a sub-group analysis based on the type of prostaglandins administrations (oral, vaginal gel, vaginal pessary), results did not change substantially.
This systematic review and meta-analysis demonstrate that misoprostol and dinoprostone appear to have a similar safety profile.
Introduction & Objective Allergic sensitization is an essential step in the development of allergic airway inflammation to birch pollen (BP); however, this process remains to be fully elucidated. ...Recent scientific advances have highlighted the importance of the allergen context. In this regard, microbial patterns (PAMPs) present on BP have attracted increasing interest. As these PAMPs are recognized by specialized pattern recognition receptors (PRRs), this study aims at investigating the roles of intracellular PRRs and the inflammasome regulator NLRP3. Methods We established a physiologically relevant intranasal and adjuvant-free sensitization procedure to study BP-induced systemic and local lung inflammation. Results Strikingly, BP-sensitized Nlrp3 -deficient mice showed significantly lower IgE levels, Th2-associated cytokines, cell infiltration into the lung, mucin production and epithelial thickening than their wild-type counterparts, which appears to be independent of inflammasome formation. Intriguingly, bone-marrow chimera revealed that expression of NLRP3 in the hematopoietic system is required to trigger an allergic response. Conclusion Overall, this study identifies NLRP3 as an important driver of BP-induced allergic immune responses.
BACKGROUNDThere is insufficient high-quality evidence to either support or discourage water birth (WB). OBJECTIVESTo examine different maternal complications of WB compared to standard land birth ...(LB). The primary outcomes were postpartum hemorrhage and genital trauma. The secondary outcome included the risk of retained placenta and shoulder dystocia. METHODSWe searched the electronic databases including PubMed, MEDLINE, Embase, Scopus, EBSCO. In addition, we searched in Google Scholar and ClinicalTrials.gov. The pooled results were used to evaluate the association between WB and obstetric outcomes. This systematic review (SR) was reported according to PRISMA statement 2020. Statistical meta-analyses were performed using Cochrane RevMan version 5.4 software (http://www.cochrane.org). RESULTSThis systematic review included 22 studies (20 observational studies and 2 RCT). The pooled results showed lower risk of major PPH compared to the LB group (OR = 0.76, 95% CI: 0.66-0.89), no significant difference (OR: 0.94, 95% CI: 0.50-1.78) in the incidence of minor PPH (500-1000 mL blood loss) between WB and LB, no significant difference in the rate of third- and fourth-degree lacerations (OR = 0.87, 95% CI: 0.71-1.07) and in the incidence of retained placenta (OR = 1.30, 95% CI: 0.50-3,35), fewer shoulder dystocia for WB (OR = 0.42, 95% CI: 0.35-0.50). However, compared with the LB group, the rate of first-second-degree tears in the WB group increased by 45% (OR = 1.45, 95% CI: 1.16-1.81). CONCLUSIONWe support ACOG guidelines recommendation for further RCT to assess the impact of water immersion during delivery on maternal outcomes.
Hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM) are the most common medical complications in pregnancy. Physical exercise is considered to be safe and beneficial ...during pregnancy. Moreover, pregnancy could be considered as an opportunity for healthcare providers to promote positive lifestyle behavior and optimize the well-being of pregnant women. Since there are few up-to-date reviews evaluating the role of exercise and the risks of developing obstetrical complications, we performed a review to investigate the effects of physical activity and exercise during pregnancy compared to a control group, focusing on the risk of development of HDP and GDM. We searched Medline and Web of Science, including only randomized controlled trials (RCTs) and systematic reviews. This review supports a beneficial effect of exercise and provides evidence that it significantly decreases the risk of HDP and GDM.
Abstract Background and Aim Pelvic inflammatory disease (PID) is usually managed by conservative treatment, but in selected cases, especially in the presence of a tubo‐ovarian abscess (TOA), surgical ...management is a recognized treatment option. We compared the trends in managing PID and short‐term outcomes before and during the SARS‐CoV‐2 pandemic. Methods This is a retrospective study performed in three Italian gynecological centers. We included patients admitted to hospital with a diagnosis of PID. Demographic characteristics, management, time to diagnosis, and time to treatment were compared before versus during the SARS‐CoV‐2 pandemic. Results One hundred nineteen PID patients were screened, eighty‐one before the SARS‐CoV‐2 pandemic, and thirty‐eight after the onset. At admission, leukocytosis (median 19.73 vs. 13.99 WBC/mm 3 , p ‐value = 0.02) was significantly higher in patients who underwent surgery after the onset of the pandemic. TOA incidence was higher in patients who underwent surgery during the SARS‐CoV‐2 pandemic, but the difference did not reach statistically significance ( p = 0.06). The proportion of patients treated with surgery dropped to 26.3% after the onset from 46% of patients before the onset of pandemic ( p = 0.03). Furthermore, a higher percentage of emergency surgical procedures on day 0 of hospital admission were performed after the onset of the pandemic (50% vs. 13.1%, p = 0.01). Conclusions In this retrospective cohort study, we found that the SARS‐CoV‐2 pandemic influenced the clinical presentation and management of PID in favor of conservative treatment. Patients who underwent surgery during the SARS‐CoV‐2 pandemic had higher inflammatory markers.
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