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Unveiling digitalisation in Italian viticulture: a field study on drivers and barriers
Get PDFPurpose – This study investigates the drivers and barriers to digitalisation in viticulture, focusing on the Italian wine
sector. Although digital transformation is widely recognised as necessary for its potential to bring significant
improvements to this industry, the determinants and barriers to this process are still unappreciated by research in
the field.
Design/methodology/approach – Due to the emerging nature of the research field, the paper adopts an explorative
field study based on focus groups involving a total of 36 participants as keynote actors in the wine sector industry,
including entrepreneurs, wine producers, agronomists and representatives of wine consortia across Italy.
Findings – The study reveals that various factors can promote the adoption and implementation of digital
technologies in viticulture. One of them is the large availability of data, innovations that improve business
models, and the quality and sustainability of wine production. However, the study also reveals perceived barriers
regarding digital technologies, such as economic constraints, a lack of digital skills, increased complexity in the
operation processes and a potential loss of wine tradition.
Originality/value – This paper explores an understudied area and uncovers several factors previously
overlooked by academia. It points out inconsistencies between the perceived drivers and barriers, demonstrating
the divergent perspectives among entrepreneurs regarding digitalisation
Exploiting cortical and peripheral somatosensory stimulation for inducing sensorimotor plasticity in humans
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An Antimicrobial Stewardship Program in Pancreatic Surgery Reduces the Infectious Risk of Colonized Bile, Reducing the Predictive Value of the Intraoperative Bile Culture - A Before-after Study on 1638 Pancreatoduodenectomies
No full textObjective: Evaluation of pancreatic surgery-specific antimicrobial stewardship (AMS) program on surgical site infections (SSI), focusing on bile microbiology and colonization. Summary of background data: Colonized bile is well known to increase the risk of SSIs after pancreatoduodenectomy (PD). However, AMS programs seem to reduce their occurrence. Methods: This observational before-after study included patients who underwent PD from 2015 to 2022 at a high-volume pancreatic center (#NCT04199494). Pre-AMS data spanned from January 2015 to November 2019, and post-AMS data from December 2019 to October 2022. Intraoperative bile samples were analyzed for microbiology. The AMS program involved preoperative rectal screening for multidrug-resistant bacteria to guide personalized surgical antibiotic prophylaxis (SAP). Tailored SAP was used for patients colonized with resistant pathogens. SSI rates, length of stay, major and pancreatic surgery-specific complications, and mortality were assessed using standard statistics. Results: Of 1,638 patients included, 1,321 (80.6%) had intraoperative bile sampling, with 909 samples (68.8%) testing positive for colonization. The most common bacteria were Enterobacterales (75%), 18% ESBL-producing, and Enterococci (60%), 4% of which were vancomycin-resistant. Colonized bile was associated with male gender, jaundice, biliary stenting, and positive rectal screening (P<0.05). Before AMS, colonized bile correlated with higher SSI rates (38% vs. 31%, P=0.008). Post-AMS, no significant difference was observed (29% vs. 28%, P=0.5). Tailored SAP reduced overall SSI (34% reduction, P=0.002) and superficial SSI (59% reduction, P=0.011). Conclusions: Pancreatic surgery-specific AMS with tailored SAP reduces SSIs and diminishes the predictive value of colonized bile for SSIs. Intraoperative bile cultures remain valuable for postoperative management
Esperienze di pazienti e operatori coinvolti nel processo di transizione dai servizi pediatrici ai centri dell’adulto per giovani con diabete di tipo 1 in Italia: lo studio TransiDEA (II fase)
No full textIntroduction: Type 1 diabetes mellitus (T1D) is a common chronic condition in children and adolescents, with increasing incidence. Adequate management is crucial for glycemic control and the prevention of complications. The transition from pediatric care centers to adult care centers is a critical phase, and its effectiveness varies among different countries and even within different areas of the same country. Materials and methods: In this qualitative study conducted in 2023, at least 30 patients with T1D who had undergone the transition between 2017 and 2022 were invited to participate by completing an online semi-structured questionnaire regarding their transition experiences. Additional questionnaires were administered to healthcare professionals to gather information on organizational barriers and patient expectations. Results: The survey conducted on 52 young adults with T1D from 5 Italian diabetes centers revealed that the transition to adult care typically occurs at an average age of 19.6 years. At the time of the survey, 73% of participants had not experienced acute complications, and 55.7% had optimal metabolic control prior to the transition. However, many patients encountered issues in the operational management of the transition, with about 40% describing the process as difficult, highlighting in some cases a feeling of "abandonment" and a desire for greater support and communication between pediatric and adult services. The majority of respondents reported an increase in autonomy in managing their diabetes. Discussion and conclusions: Although the transition process for patients with T1D is structured, the study reveals some gaps in communication and support between pediatric and adult care centers. A well-coordinated pathway is essential, considering the individual needs of patients and strengthening collaboration between care teams
Stakeholder Relationships in the Circular Economy. Conceptualizing Relational Approaches Through Systematic Literature Review
Get PDFCircular economy (CE) demands a stakeholder perspective. However, CE literature investigating the nature and the evolution of
stakeholder relationships for its effective implementation is not made explicit nor comprehensively conceptualized, resulting in
a lack of appreciation for stakeholders' role and a poor understanding of how their relationships can facilitate CE. To advance a
holistic overview in this regard, we conducted a systematic review of the literature on stakeholder relationships and CE. The in-depth
content analysis on 111 papers allowed us to conceptualize a novel matrix of four main stakeholder relational approaches
at the firm–stakeholder and stakeholder–firm perspectives: Informative, Reciprocal, Advocative, and Ecosystemic—that can en-
hance and support CE initiatives. We detected osmotic boundaries and discussed dynamism among the four approaches, leading
to a more nuanced understanding of stakeholder engagement in CE. The dynamism among stakeholder approaches constitutes a
future research opportunity to be explored empirically and beyond CE
Urinary Tumor DNA-based Liquid Biopsy in Bladder Cancer Management: A Systematic Review
No full textBackground and objective: Urinary tumor DNA (utDNA) has emerged as a promising biomarker in the care, diagnosis, early detection, recurrence monitoring, and prognosis of bladder cancer (BCa). Its noninvasive nature, ease of access, and cost effectiveness make it an attractive option for both patients and health care providers. This review describes the current state of utDNA as a marker of BCa. Methods: Articles published between 2015 and 2025 on current utDNA-based techniques in BCa were identified and analyzed for relevance and insight into utDNA research and usage. Key findings and limitations: Recent investigations underscore the noninvasiveness and superior tumor detection capabilities of utDNA, particularly in the detection of minimal residual disease. Moreover, utDNA provides actionable information, such as tumor grade and staging information, to support precise treatment decisions, including targeted immunotherapy regimens and bladder preservation strategies. Although utDNA has shown promising results in small studies, larger studies must be performed before it can be considered as a standard procedure in clinical practice. Conclusions and clinical implications: Urinary tumor DNA has demonstrated great potential to improve on most, if not all, stages of detection, treatment, and monitoring of BCa. By preserving the low cost and noninvasiveness of urine cytology, and by replacing its suboptimal accuracy with a precision rivaling and often exceeding cystoscopy and circulating tumor DNA-based methods, utDNA offers patients a more comfortable, repeatable, and accurate way of detecting BCa. With increased sensitivity and accuracy, everything from low-grade tumors to the earliest signs of recurrence can be detected more effectively, optimizing patient treatment courses and improving outcomes
Enhancing outcome prediction in patients with colorectal liver metastases undergoing hepatectomy: the synergistic impact of FIB-4 index and tumor burden score across KRAS profiles
No full textBackground: The prognostic value of Fibrosis-4 (FIB-4) index, concerning KRAS status (wild-type [wtKRAS] vs. mutated [mutKRAS]) remains unclear in post-hepatectomy colorectal liver metastases (CRLM). We evaluated the combined impact of FIB-4 and Tumor Burden Score (TBS) on overall survival (OS)/recurrence-free survival (RFS), stratified by KRAS status. Methods: CRLM patients undergoing hepatectomy (2000-2020) were analyzed, grouped by TBS/FIB-4. Results: Among 828 patients, 196 had high FIB-4. High TBS had worse 5-year OS (P < 0.001). In wtKRAS, high TBS correlated with worse OS (P < 0.001), but not in mutKRAS. High FIB-4 correlated with worse OS (P = 0.01). Sub-stratification showed no OS difference by FIB-4 in wtKRAS, but a difference in mutKRAS (P = 0.03). Multivariable analysis identified mutKRAS (HR: 1.90), high TBS (HR: 1.62), and FIB-4 (HR: 1.15) as mortality risk factors. The TBS-FIB-4-KRAS index had highest predictive accuracy. For RFS, TBS and FIB-4 independently stratified outcomes. High TBS was associated with worse RFS in wtKRAS (P < 0.001) but not in mutKRAS. High FIB-4 decreased RFS in mutKRAS (P = 0.001) but not in wtKRAS. FIB-4 was associated with a 10% increased recurrence risk. Conclusion: TBS and FIB-4, alongside KRAS status, should be considered to improve outcome predictions
Development and Application of an In-Capillary CE-DAD Method for the Inhibitory Screening of Natural Extracts Towards Acetylcholinesterase Enzyme
Get PDFBackground: The enzymatic activity of acetylcholinesterase (AChE) has been a focal point in neurodegenerative diseases research, particularly in relation to Alzheimer's disease. This is attributed to the significantly reduced levels of cholinergic neurons observed in Alzheimer's patients compared to healthy individuals. The strategy to mitigate the onset of these diseases in patients lies in the exploration of new potential AChE inhibitors with a focus also on natural extracts. A rapid and specific capillary electrophoresis method with direct ultraviolet detection (CZE-UV/Vis) was developed to screen natural extracts by assessing their potential to inhibit AChE. Materials and Methods: To enhance the specificity when analysing complex matrixes such as natural extracts, a sequential analysis approach based on the "sandwich model" was implemented using Ellman's reagent [5,5 '-dithiobis-(2-nitrobenzoic acid)] (DTNB) as a colorimetric indicator. Results: A reference inhibitor, neostigmine, was used for system validation through IC50 and Ki values determination by subsequent injections of acetylthiocholine substrate in the presence of neostigmine at increasing concentrations, and the enzyme combined with DTNB in borate-phosphate buffer (30 mM, pH 8.0). The enzymatic product was selectively detected at 412 nm. The validated system was applied to the analysis of seven natural extracts. Conclusions: Results demonstrated promising outcomes for identifying phytotherapeutic agents with potential applications in the prevention of neurodegenerative diseases. This method provides high selectivity and automation, offering a streamlined and effective approach for screening natural matrices containing potential AChE inhibitors
Stratifying the risk in liver surgery: performance in an Italian cohort of 3.280 liver resection for HCC
No full textBackground: Liver resection classifications have traditionally been based on the number of segments resected. However, with advancements in techniques and the diffusion of minimally invasive surgery (MiLS), these classifications may no longer adequately represent the complexities of modern liver surgery. This study evaluates five liver resection classifications using a multicenter Italian database of hepatocellular carcinoma resections with the main focus of catching surgical outcomes, rather than technical complexity. Methods: The study included 3280 resections (2436 open, 844 MiLS) from 25 Italian centers. Five classifications were assessed: Minor-Major, Segment-based, GK-LLR, S-L OLR, and CLISCO. Outcomes included morbidity, liver failure, and 90-day mortality. Chi-square or Fisher's exact tests were used for comparisons. Results: All classifications showed increased morbidity and mortality with higher complexity. For open resections, Minor-Major and Segment-based classifications successfully stratified patients for all outcomes, outperforming other systems. However, all classifications performed poorly for MiLS patients. Discussion: Minor-Major and Segment-based classifications remain the most accurate for predicting risks in open liver resections. The poor performance for MiLS patients highlights the need for a separate risk stratification tool for this approach. Current classifications do not always accurately represent the technical complexity and technological evolution in liver resection, particularly for MiLS procedures
Can the adoption of circular economy practices foster supply chain resilience and performance improvements?
No full textWhile a growing literature is showing interest in the circular economy (CE) paradigm, there is still a lack of consensus on whether the adoption of CE practices can help to cope with supply risks arising from an increasingly uncertain business environment in order to increase supply chain resilience (SCRES) and improve a firm's performance. Through a survey of Italian enterprises engaged with CE practices, this study aims to fill this literature gap, investigating whether the adoption of CE practices can initiate a path of increased SCRES, which can lead firms to improve their overall performance, thus proactively responding to environments characterised by high levels of supply risk. This study contributes to the debates about the paths connecting CE practices and firms' performance, especially in the context of vulnerabilities and disturbances, empirically demonstrating how firms might exploit the potential of CE by investing in SCRES. This study sheds light on the relationship between CE and SCRES, particularly underlying the most relevant paths of relationships between CE and those SCRES capabilities that can lead to performance improvements, particularly when the level of supply risk increases