Prostate Health Index (Phi) and Prostate Cancer Antigen 3 (PCA3) Significantly Improve Prostate Cancer Detection at Initial Biopsy in a Total PSA Range of 2-10 ng/ml

Many efforts to reduce prostate specific antigen (PSA) overdiagnosis and overtreatment have been made. To this aim, Prostate Health Index (Phi) and Prostate Cancer Antigen 3 (PCA3) have been proposed as new more specific biomarkers. We evaluated the ability of phi and PCA3 to identify prostate cancer (PCa) at initial prostate biopsy in men with total PSA range of 2-10 ng/ml. The performance of phi and PCA3 were evaluated in 300 patients undergoing first prostate biopsy. ROC curve analyses tested the accuracy (AUC) of phi and PCA3 in predicting PCa. Decision curve analyses (DCA) were used to compare the clinical benefit of the two biomarkers. We found that the AUC value of phi (0.77) was comparable to those of %p2PSA (0.76) and PCA3 (0.73) with no significant differences in pairwise comparison (%p2PSA vs phi p = 0.673, %p2PSA vs. PCA3 p = 0.417 and phi vs. PCA3 p = 0.247). These three biomarkers significantly outperformed fPSA (AUC = 0.60), %fPSA (AUC = 0.62) and p2PSA (AUC = 0.63). At DCA, phi and PCA3 exhibited a very close net benefit profile until the threshold probability of 25%, then phi index showed higher net benefit than PCA3. Multivariable analysis showed that the addition of phi and PCA3 to the base multivariable model (age, PSA, %fPSA, DRE, prostate volume) increased predictive accuracy, whereas no model improved single biomarker performance. Finally we showed that subjects with active surveillance (AS) compatible cancer had significantly lower phi and PCA3 values (p < 0.001 and p = 0.01, respectively). In conclusion, both phi and PCA3 comparably increase the accuracy in predicting the presence of PCa in total PSA range 2-10 ng/ml at initial biopsy, outperforming currently used %fPSA

Kaempferol, myricetin and fisetin in prostate and bladder cancer: A systematic review of the literature

Prostate and bladder cancer represent the two most frequently diagnosed genito-urinary malignancies. Diet has been implicated in both prostate and bladder cancer. Given their prolonged latency and high prevalence rates, both prostate and bladder cancer represent attractive candidates for dietary preventive measures, including the use of nutritional supplements. Flavonols, a class of flavonoids, are commonly found in fruit and vegetables and are known for their protective effect against diabetes and cardiovascular diseases. Furthermore, a higher dietary intake of flavonols was associated with a lower risk of both bladder and prostate cancer in epidemiological studies. In this systematic review, we gathered all available evidence supporting the anti-cancer potential of selected flavonols (kaempferol, fisetin and myricetin) against bladder and prostate cancer. A total of 21, 15 and 7 pre-clinical articles on bladder or prostate cancer reporting on kaempferol, fisetin and myricetin, respectively, were found, while more limited evidence was available from animal models and epidemiological studies or clinical trials. In conclusion, the available evidence supports the potential use of these flavonols in prostate and bladder cancer, with a low expected toxicity, thus providing the rationale for clinical trials that explore dosing, settings for clinical use as well as their use in combination with other pharmacological and non-pharmacological interventions

Shaping sustainable service ecosystems: an analysis of some possible enhancing factors

Over the last years, sustainability and sustainable development have gained momentum also in-service research. Thus, this works is aimed at investigating the evolutionary path that links the Viable Systems Approach (VSA), service systems and service ecosystems perspectives to the most recent challenges of sustainability. Therefore, the analysis has been focused on start-ups’ ability to survive contributing to the shaping of a service ecosystem, which long-term viability can be ensured merging efficiency, effectiveness and sustainability targets. In this direction, the way networked interactions, occurring between a number of different actors (e.g., start-ups, customers, incubators, venture capitalists, other corporations, banks, education and financial institutions, governments) and facilitated by the most recent technologies, can shape a sustainable service ecosystem able to ensure viability to the actors who populate it has been investigated. To this end, an empirical analysis has been conducted to better define the main processes that can shape a start-ups’ sustainable service ecosystem. This work represents one of the first attempts to investigate start-ups’ surviving according to a service ecosystem perspective. An agenda for further research has been defined in order to further advance the analysis

Value Co-Creation Mechanisms for the Sustainability of a Digitally-Based Museum Ecosystem: A Focus on F.A.I. (Fondo Ambiente Italiano)

Recent research on value co-creation has recognized the importance of digital technologies and digital platforms in adding efficiency, effectiveness, and sustainability to value co-creation. The availability of new and advanced digital technologies has also pervaded the mechanisms at the core of value co-creation, facilitating the interactions among spatially, temporally, and organizationally dispersed actors. Research has associated the ecosystem perspective with digital platforms underlining their potential in facilitating a multi-actor long-lasting online resource integration. To contribute to the debate on the digital value co-creation, this study has been based on the analysis of a specific service domain such as the cultural heritage, with a focus on museums. This study approaching museum digital transformation according to ecosystem perspective aims at better understanding how digital platforms boost resource integration, exploiting the value that networked ecosystem actors co-create digitally, enhancing museums’ resources protection, research, exploitation, and utilization

Moving towards a people-centric smart city. A systematic literature review

European cities are getting smarter. Smart technologies such as the Internet of Things (IoT), Internet of Everything (IoE), and other AI-based technologies, are being injected more directly into the lives of citizens. Smart cities are seen as evolving ecosystems in which multiple actors act, react and interact over time to foster innovative solutions and provide better services for citizens. Despite the growing interest, existing research has to make key advances, important gaps persist as scholars lag behind theoretical development and rarely take into account the most important element of a city: people. Business and management scholars have focused on how to define strategies in smart cities, local policy, and others investigated the challenges of building a smart city. Few concerns deal with humans. In addressing these shortcomings, we tried to highlight why any smart city should be a community that learns, adapts, co-creates, and innovates. The purpose of this study is to investigate the human perspective that goes beyond the focus on technology related to smart cities in Europe, through an analysis in depth on how and how much citizens make cities smart. The focus is on people and their well-being combined with the shared knowledge and development that arises from each player in the ecosystem. To get an overall vision of the people-centric smart city we carry out an exploratory literature review with a PRISMA protocol that guides the identification of the studies to be included in the review. We finally provide implications for scholars and practitioners and suggest future research opportunities

New trends for service eco-systems analysis, a ‘sustainable’ approach, Implications for destination management

This paper aims at combining literature on service ecosystems and sustainability in order to deal with the emerging conceptualization of sustainable service ecosystems. To reach this goal, a literature review on both sustainability and service ecosystem, and the analysis of these two topics in tourism-based and destination management literature has been conducted. Following the results of literature review, a theoretical multi-level model of a tourism-based sustainable service eco-system has been provided. The model consists of meta-, macro-, meso-, and micro-level in order to highlight the way each of the actors shaping these levels can affect the sustainability of a service ecosystem. The result of our research paves the way for further investigation, both on the theoretical and on the empirical side

Defining Health Service Eco-System “Infection”: A Critical Analysis of Patient Surveys

Purpose – This paper focuses on the analysis of the most common tools that health care organizations use to assess the quality of the delivered services, the patient surveys. In line with the results of a systematic literature review on the issue, the study embraces service ecosystem perspective to understand why these surveys are unable to grasp actors’ disposition to co-create value for the health care system. Methodology – An in-depth literature review based on PRISMA framework explored 34 works on the topic of patient surveys in order to trace the evolution of the relationship users/providers and to highlight the criticalities related to the adoption of patient surveys in service-oriented era. The study discusses critically their efficacy to understand how they can affect (positively or negatively) the viability of a health care service eco-system. Findings – The literature review highlights patient surveys inability in grasping the real perception that patients have of experienced services and in involving them in value co-creation, through their engagement in service design and delivery. Moreover, the results reveal the need to adopt Service Dominant (S-D) Logic and service eco-system perspective to reread the traditional tools to measure quality in healthcare. For this reason, the metaphor of health service eco-system “infection” is launched, depicting the negative influence of patient satisfaction surveys on value co-creation and the subsequent service eco-system viability. Practical implications – The study shows that assuming a service eco-system perspective based on S-D logic, health care system should boost and preserve value co-creation processes. Moreover, institutions should foster those “rules of the game” that institutionalize the contribution of health providers to value co-creation, defining specific strategies to avoid the “infections” of health care service eco-system, e.g. investing and promoting non-detrimental tools. Originality – This study represents one of the first attempts to reread the tools used to assess patient embracing a service eco-system perspective. Interesting implications have been presented in terms of the negative effect that traditional assessment tools have on providers, patients and the whole society

Comparing two approaches to team building: a performance measurement evaluation

Purpose This paper reports a study that compares two different team-building approaches. The first one is the traditional top-down management approach. The second one is a hybrid bottom-up approach based on the consensus model. The aim of this paper is to determine which of the two approaches is the most effective across a number of performance measurements. Design/methodology/approach A case study is presented using data collected and analysed from a small family-owned vehicle maintenance firm. A mixed methods approach to data collection is utilized, including participant observation, focus groups, survey questionnaires and organizational performance reports. A convenience sample of eight routine maintenance jobs was selected for team performance comparison purposes. The measures used for comparing the two team approaches were lead time, customer satisfaction ratings and employees’ satisfaction ratings. Findings The teams assembled using the consensus approach performed better than those selected using the traditional top-down approach across all three performance measures, i.e. the jobs were completed faster and both customers and employees were more satisfied. Research limitations/implications This is an exploratory case study limited to one small family-owned business and, as such, findings may not be generalizable. Practical implications As an alternative to manager selected work teams, managers should involve and empower employees to select their own teams. This has the potential to offer benefits for both customers and employees of faster delivery times and increase satisfaction, as well as increase productivity for the firm. Originality/value This is the first field study to compare the performance of a hybrid, bottom-up approach to team building with the performance of a more traditional management, top-down approach to team building. It paves the way for a wider study to be conducted in the future to test the findings’ generalizability