Transformative Value Co-creation in Healthcare Services in the COVID-19 Era: The Case of Centro Cardiologico Monzino

The outbreak of COVID-19 has presented great challenges for health services targeted at patients with chronic diseases, such as cardiovascular disorders. Hospitals and medical clinics must find new and effective solutions to address the impacts on individual and collective well-being due to the increased diffusion of these types of diseases, especially during a pandemic. This implies the evolution of the service ecosystem through enhanced coordination and resource integration between different actors (patients, doctors, service providers, relatives, caregivers, etc.). The coordination process might be leveraged by technological devices aimed at integrating resources and co-creating transformative value (Anderson et al. 2013; Danaher and Gallan 2016; Anderson et al. 2018). This chapter, in particular, investigates how digital health technologies impact the evolution of the Italian healthcare service ecosystem in a transformative way through the study of the case of Centro Cardiologico Monzino. The study adopted a qualitative approach based on in-depth interviews with patients of Centro Cardiologico Monzino with cardiovascular pathologies who use digital health devices and doctors, caregivers, and other key informants who are experts in the Italian healthcare service ecosystem. Our findings illustrate how digital health contributes to value co-creation and to the enhancement of individual and collective well-being, considering the renewed interaction between different actors in the service ecosystem

Improvement of Telephone Communication in Elderly Cochlear Implant Patients

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Characterization of the ear canal bacterial flora present in hearing Aids (HA) wearing subjects

The use of hearing aids (HA) is considered a predisposing factor for ear microbial infections. We undertook this study to compare the presence and nature of the microbial flora inhabiting of ears of HA and non-HA (nHA) users. Swab samples of the ears of HA and nHA users were collected from the Institute of Otolaryngology, “Cattolica del Sacro Cuore” University “Agostino Gemelli”, Rome, Italy. Swab samples were taken from the ear canal of 57 HA and 33 nHA users. The components of the microbial flora present on each swab sample were identified and characterized at the level of species. A total of 41 different bacterial species were identified. A statistically significant prevalence of polymicrobial communities was found in ears presenting signs of inflammation (2.5 ± 1.7 vs 2.1 ± 1.3; P = 0.02) and in HA users (2.3 ± 1.2 vs 1.7 ± 1.0; P = 0.002). Few putative pathogens were detected. Candida albicans spp. was not isolated in our study. A small number of swab samples presented no microbial growth. Bacterial species isolated from HA users with and without inflammation were assayed for the ability to form a biofilm. Among gram-positive and gram-negative bacteria, S. aureus, CoNS, P. aeruginosa, and K. pneumoniae were found to be strong biofilm producers. S. aureus and P. aeruginosa, isolated only from the ears of HA and nHA users presenting signs of inflammation, were further analyzed for their antibiotic-resistance profile and characterized by the Multilocus Sequence Typing (MLST) assay. The highest rates of antibacterial resistance were in S. aureus to a penicillin (75.5%) and in P. aeruginosa, to amoxicillin-clavulanic acid, cefotaxime, ertapenem, tigecycline and trimethoprim-sulfamethoxazole (100%). Moreover, three S. aureus strains (37.5%) were methicillin-resistant (MRSA). Of the eight S. aureus isolates, we identified six sequence types (ST) indicating that 75% are likely independent clones. For what it concerned P. aeruginosa, six different STs were assigned. Interestingly, two out of the six strains presented newly identified ST values. This study sheds new light on the combined effect of the presence of HA devices and signs of external ear inflammation on the composition of the ear bacterial flora. Our results reinforce the need to practice careful hygiene of HA devices to prevent serious ear canal infections

Antileukotrienes Improve Naso-Ocular Symptoms and Biomarkers inPatients With NARES and Asthma

Objective: The aim of our study was to analyze the montelukast effectiveness in improving oculonasal symptoms, patient-reported outcomes (PROs), and eosinophilic biomarkers in patients with nonallergic rhinitis eosinophilic syndrome (NARES).Methods: We enrolled prospectively 80 symptomatic patients treated with 10 mg once a day of montelukast in mono-therapy for 2 months. All patients were investigated before and after treatment. Nasal symptoms (nasal obstruction, rhinor-rhoea, sneezing, nasal itching), ocular symptoms (redness/puffiness, watery eyes), and other PROs (olfactory dysfunction,difficulty going to sleep, nighttime awakenings, and nasal congestion on awakening) were scored by visual analogic scale. Thefollowing clinical scores were assessed: Total Nasal Symptom Score (T4NSS), Total Ocular Symptom Score (T2OSS), TotalSymptom Score of Patient-Reported Outcomes (TSS-PROs), and a Composite Symptoms Score (CSS). Patients were classified asresponders when a reduction of at least 50% of the CSS was observed. Before and after treatment, the eosinophilic biomarkersin nasal lavage were analyzed: nasal eosinophilia (number of eosinophils per high power field), eotaxin-1 and eotaxin-2.Results: Aft er tre atment, s ig nificant reductions were observed for all the symptom scores. Forty-two of 78 patients were con-sidered responders. A significant reduction of eosinophils in nasal mucosa and of levels of eotaxin-1 and eotaxin-2 in nasal lavagewere observed after treatment in responder patients. Patients with asthma had an increased probability to be responders.Conclusion: NARES patients may benefit from treatment with montelukast. In particular, the presence of concomitantasthma may be predictive of a greater efficacy

Search for heavy neutral lepton production in K+ decays

A search for heavy neutral lepton production in K + decays using a data sample collected with a minimum bias trigger by the NA62 experiment at CERN in 2015 is reported. Upper limits at the 10−7 to 10−6 level are established on the elements of the extended neutrino mixing matrix |Ue4| 2 and |Uμ4| 2 for heavy neutral lepton mass in the ranges 170–448 MeV/c2 and 250–373 MeV/c2, respectively. This improves on the previous limits from HNL production searches over the whole mass range considered for |Ue4|2 and above 300 MeV/c2 for |Uμ4|2

Futur dels teixits intel·ligents

Els teixits intel·ligents del futur es desenvolupen amb nous materials i amb tecnologies innovadores, però també amb clau d'eficiència ambiental. Es revisen tendències de la indústria tèxtil relacionades, entre d'altres, amb: Teixits funcionals i materials amb propietats singulars. e-Textil, wearables i gestió 4.0. Automatització, robòtica i impressió 3D. Ecologia industrial, impacte ambiental i valorització energètic

Review of Kaon Physics at CERN and in Europe

The Kaon physics program at CERN and in Europe will be presented. I will first give a short review of recent results form the NA48/2 and NA62 experiments, with special emphasis to the measurement of RK , the ratio of Kaon leptonic decays rates, K → eν and K → μν, using the full minimum bias data sample collected in 2007-2008. The main subject of the talk will be the study of the highly suppressed decay K → πνν. While its rate can be predicted with minimal theoretical uncertainty in the Standard Model (BR ∼ 8 × 10−11), the smallness of BR and the challenging experimental signature make it very difficult to measure. The branching ratio for this decay is thus a sensitive probe of the flavour sector of the SM. The aim of NA62 is the measurement of the K → πνν BR with ∼ 10% precision in two years of data taking. This will require the observation of 10K decays in the experiment's fiducial volume, as well as the use of high-performance systems for precision tracking, particle identification, and photon vetoing. These aspects of the experiment will also allow NA62 to carry out a rich program of searches for lepton flavour and/or number violating K decays. Data taking will start in October 2014. The physics prospects and the status of the construction and commissioning of the NA62 experiment will be presented. In the last part of the talk I will report on Kaon physics results and prospects from other experiments at CERN (e.g. LHCb) and in Europe (e.g. KLOE and KLOE-2) and briefly mention the status in US

Measurement of the very rare K+→π+ννˉK^+ \to \pi^+ \nu \bar\nu decay

The decay K+→π+νν¯ , with a very precisely predicted branching ratio of less than 10−10 , is among the best processes to reveal indirect effects of new physics. The NA62 experiment at CERN SPS is designed to study the K+→π+νν¯ decay and to measure its branching ratio using a decay-in-flight technique. NA62 took data in 2016, 2017 and 2018, reaching the sensitivity of the Standard Model for the K+→π+νν¯ decay by the analysis of the 2016 and 2017 data, and providing the most precise measurement of the branching ratio to date by the analysis of the 2018 data. This measurement is also used to set limits on BR(K+→π+X ), where X is a scalar or pseudo-scalar particle. The final result of the BR(K+→π+νν¯ ) measurement and its interpretation in terms of the K+→π+X decay from the analysis of the full 2016-2018 data set is presented, and future plans and prospects are reviewed

The Role of a Polymer-Based E-Nose in the Detection of Head and Neck Cancer from Exhaled Breath

The aim of our study was to assess whether a polymer-based e-nose can distinguish head and neck cancer subjects from healthy controls, as well as from patients with allergic rhinitis. A total number of 45 subjects participated in this study. The first group was composed of 15 patients with histology confirmed diagnosis of head and neck cancer. The second group was made up of 15 patients with diagnoses of allergic rhinitis. The control group consisted of 15 subjects with a negative history of upper airways and/or chest symptoms. Exhaled breath was collected from all participants and sampled by a polymer-based e-nose (Cyranose 320, Sensigent, Pasadena, CA, USA). In the Principal Component Analysis plot, patients with head and neck cancer clustered distinctly from the controls as well as from patients with allergic rhinitis. Using canonical discriminant analysis, the three groups were discriminated, with a cross validated accuracy% of 75.1, p < 0.01. The area under the curve of the receiver operating characteristic curve for the discrimination between head and neck cancer patients and the other groups was 0.87. To conclude, e-nose technology has the potential for application in the diagnosis of head and neck cancer, being an easy, quick, non-invasive and cost-effective tool

Addressing Tensions and Paradoxes in Sustainable Wine Industry: The Case of the Association “Le Donne Del Vino”

Practising sustainable business in the wine industry requires addressing social, economic and environmental goals. This paper focuses on the process of addressing tensions and paradoxes amongst these goals at the different levels of the service ecosystem in the Italian sustainable wine industry and on the platformisation role at the meso level. The study adopts a qualitative approach based on 23 in-depth interviews with associates of Le Donne del Vino. The collected data were triangulated with those derived from participatory observations and the analysis of secondary data. The study’s findings reveal that the presence of an organisation at the meso level activates the harmonisation of value co-creation within the service ecosystem. This is achieved by intervening in the four different paradoxes, namely, belonging, learning, organising and performing, which emerge from the adoption of a sustainable approach