How to write a research protocol

Implementing and Monitoring Circular Business Models: An Analysis of Italian SMEs

The transition from a linear to a circular economy (CE) is at the center of the debate among institutions, enterprises, practitioners, and scholars. Small- and medium-sized enterprises (SMEs), with their high presence in the business environment, play a pivotal role in the successful implementation of CE principles. Therefore, this paper aims to understand the state of the CE among Italian SMEs, considering both their different sizes and sectors. This study investigates CE knowledge and application, strategic relevance, benefits from and barriers to the transition towards circular business models, and the use of CE-related performance indicators in management control and external reporting. Through an online survey carried out in cooperation with the Italian Confederation of Craft Trades and Small- and Medium-Sized Enterprises (CNA), we collected primary data from 623 respondents. Findings revealed the existence of cultural, technological, market and financial barriers, which have hampered the adoption of circular practices among Italian SMEs. Poor understanding of CE potential, combined with difficulty in raising public and private funds to finance the transition from linear to circular, are the greatest problems. To overcome such issues, we recommend serious intervention by public institutions, trade and consumer associations, and the higher education system to develop a climate more favorable to the CE.

A Modular Approach to Combine Postmarket Clinical Follow-Up Studies and Postmarket Surveillance Studies

BACKGROUND

The European Medical Device Regulation 2017/745 (MDR) has its date of application in May 2021. This new legislation has refined and expanded the need of manufacturers to have a postmarket surveillance (PMS) system. According to this legislation, a postmarket clinical follow-up (PMCF) plan is also required. Manufacturers of high-risk medical devices are obliged to conduct both PMCF and PMS studies. There is thus the need to generate evidence from clinical data.

OBJECTIVES

The conduct of several studies for PMS and PMCF can be cumbersome. We therefore aim to present a modular approach to combine PMS and PMCF studies into a single study.

MATERIALS AND METHODS

We extracted the topics listed in the MDR, especially Annex XV, Section 3, the Good Clinical Practice for medical devices (EN 14155:2020, Annex A). In addition, we added topics according to the SPIRIT and the SPIRIT-PRO statement and created a draft clinical investigation plan (CIP).

RESULTS

The CIP template is provided as part of the manuscript. The modular concept has passed the required regulatory and legal requirements for one specific study.

CONCLUSION

A modular approach for combining PMCF and PMS studies in a single CIP has been developed and implemented, and it is ready for use. The provided CIP template should enable other researchers and groups to adopt this concept according to their needs.