Contextual impacts on industrial processes brought by the digital transformation of manufacturing: a systematic review

The digital transformation of manufacturing (a phenomenon also known as "Industry 4.0" or "Smart Manufacturing") is finding a growing interest both at practitioner and academic levels, but is still in its infancy and needs deeper investigation. Even though current and potential advantages of digital manufacturing are remarkable, in terms of improved efficiency, sustainability, customization, and flexibility, only a limited number of companies has already developed ad hoc strategies necessary to achieve a superior performance. Through a systematic review, this study aims at assessing the current state of the art of the academic literature regarding the paradigm shift occurring in the manufacturing settings, in order to provide definitions as well as point out recurring patterns and gaps to be addressed by future research. For the literature search, the most representative keywords, strict criteria, and classification schemes based on authoritative reference studies were used. The final sample of 156 primary publications was analyzed through a systematic coding process to identify theoretical and methodological approaches, together with other significant elements. This analysis allowed a mapping of the literature based on clusters of critical themes to synthesize the developments of different research streams and provide the most representative picture of its current state. Research areas, insights, and gaps resulting from this analysis contributed to create a schematic research agenda, which clearly indicates the space for future evolutions of the state of knowledge in this field

Car Sharing and Relocation Strategies: a Case Study Comparison in the Italian Market

The sharing economy represents an economic model based on the sharing of goods and services. In particular, this paper examines car sharing model, an attractive alternative to a self-owned car which has found large interest in the recent literature in different research fields. This study aims to investigate innovative and effective relocation strategies based on the analysis of data on users’ consumptions, for the constantly growing car sharing system. For this purpose, after a literature review, the paper presents a case study focused on the car repositioning algorithm developed by one of the market leader in this sector: car2go. More in detail, the paper evaluates differences and similarities in the strategic management of this model within the Italian context, through a comparison among the cities of Rome and Milan. Empirical results and practical implications for users will be provided, by highlighting opportunities and threats concerning the different settings

The impact of Digital Platforms on Business Models: an empirical investigation on innovative start-ups

Digital platforms have the ability to connect people, organizations and resources with the aim of facilitating the core interactions between businesses and consumers as well as assuring a greater efficiency for the business management. New business concepts, such as innovative start-ups, are therefore created based on innovation, scalability and the relationships within the community around them. The purpose of this work is to deeply understand the evolution of business models brought by innovative and dynamic companies operating through online platforms. In order to achieve the objectives set, an exploratory multiple-case study was designed based on in-depth structured interviews. The aim was to conduct a mixed analysis, in order to rely both on qualitative and quantitative data. The structured interview protocol was therefore designed to collect and then analyse data concerning the company profile and managers’ perspectives on the phenomenon of interest. The interview protocol was submitted in advance and then face-to-face interviews were carried out with the following professional figures: Chief Executive Officer (CEO), General Manager, Chief Technology Officer (CTO), Marketing Manager and Developers. Collected data were analysed and processed through the Canvas Business Model in order to clearly outline similarities and differences among the sample. Results can be considered under two viewpoints. On the one hand, this work provides a detailed overview of the companies interviewed, according to the dimensions of: reference market dynamics, type and number of customers, scalability. On the other one, they allow to identify some success patterns regarding key activities, key resources, channel mix strategy, costs management, value proposition, customer segmentation, key partners and the way to obtain revenues. Results from the multiple-case study with 15 Italian start-ups provide interesting insights by comparing the innovative business models developed and highlighting key differences and similarities. verall, the start-ups analyzed, operating in several sectors, showed great growth prospects and the possibility to create value for their customers through innovative products and services offered through digital platforms

Subtotal resection of vestibular schwannoma: evaluation with Ki-67 measurement, magnetic resonance imaging, and long-term observation

Purpose The aim of this study was to compare the postoperative clinical and radiological data of patients with vestibular schwannomas who were initially managed by near total resection (NTR) or subtotal resection (STR). The Ki-67 analysis results were compared with tumor regrowth to determine the presence of a correlation between this proliferative index and postoperative tumor regrowth. Study Design Seventeen adult patients (7 male, 10 female) were retrospectively reviewed. Nine (52.9%) and eight (47.1%) patients underwent NTR and STR, respectively. Postoperative clinical and radiological data associated with vestibular schwannoma growth were compared with the Ki-67 immunohistochemical analysis results. Results Evidence of clinically significant regrowth was observed in four (23.5%) patients. Patients who underwent NTR had a lower rate/incidence of tumor regrowth than did patients who underwent STR. Patients with a higher Ki-67 index had the highest tumor regrowth rates. Conclusions Our study indicates that assessment of the Ki-67 index may be useful for determining the probability of regrowth of vestibular schwannomas when only partial removal is accomplished

Business Models Innovation for Sustainable Urban Mobility in Small and Medium-Sized European Cities

Abstract Bad air conditions, limitless traffic, overloaded parking spaces are just some of the modern mobility problems that strike cities on a daily basis. The European Commission strives to address these issues by providing measures to improve the urban mobility situation in the small and medium-sized cities. The SUITS project (Supporting Urban Integrated Transport Systems: Transferable Tools for Authorities), which is financed under the umbrella of the HORIZON 2020 programme, aims at increasing the capacity of local authorities in Small and Medium (S-M) cities through the development and implementation of sustainable, integrated and accessible transport strategies and technologies. This paper aims to analyse and classify the innovative business models in the urban mobility sector that are aimed at increasing the capacity building of S-M cities' transportation authorities through the implementation of new mobility solutions. It describes the innovative mobility business identifying the most successful models of service and partnerships in the sector

Alteration of the growth hormone axis, visceral fat dysfunction, and early cardiometabolic risk in adults: the role of the visceral adiposity index

The aim of the study is to clarify the relationship between adipose tissue dysfunction, metabolic profile and growth hormone (GH)/insulin-like growth factor (IGF)-I secretion in healthy adult subjects. We investigated the metabolic profile in a cohort of 231 consecutive healthy subjects in relation to GH, IGF-I levels, and visceral adiposity index (VAI). Anthropometric measures, lipid profile, and glucose and insulin levels during oral glucose tolerance test, Homa-IR and ISI Matsuda, IGF-I and GH peak after GHRH plus Arginine test were analyzed. The subjects with high VAI showed lower GH peak (22.8 ± 11.1 vs. 42.2 ± 21.3 µg/L; p = 0.049) and lower IGF-I (presented as IGF-I under normal range, UNR) (0.54 ± 0.14 vs. 0.64 ± 0.12; p = 0.005) than group with normal VAI. ROC curve analysis identified the cut-off, able to detect subjects with high VAI, i.e., 31.8 µg/L for GH peak and 0.63 for IGF-1 UNR. The subjects with GH peak and IGF-I UNR under the cut-off showed significantly higher levels of VAI, systolic and diastolic blood pressure, glucose and insulin levels, Homa-IR, and lower ISI Matsuda, with a concomitant worse lipid profile (all p < 0.001). A strong relationship between GH axis, VAI and metabolic risk has been demonstrated. A percentage of apparently healthy subjects show a degree of visceral adipose dysfunction associated with GH and IGF-I levels that do not meet the criteria of overt GH deficiency (GHD). Long-term prospective studies could help to clarify and confirm whether a hypothetical condition of subclinical GHD could be taken into account as a new clinical entity

EDUCATIONAL TOURISM AND LOCAL DEVELOPMENT

Educational tourism is a new branch of tourism, which has experienced a significant increase in recent times, due to the important benefits it brings to the local communities. Universities and other educational specialized institutions may highly contribute, support and encourage local development through educational tourism. Students who benefit from studying abroad can be considered as symbolic educational tourists, and their stay is considered to have a high potential to generate benefits. The host university may facilitate the development of better relationships between tourists and local communities in order to contribute to the development of the local economy in a sustainable and resilient way. Education tourism has to be taken into account by all educational institutions due to the different learning opportunities that might be better exploited. This paper focuses on some indicators considered to be relevant for educational tourism

Bariatric surgery and diabetes remission: Sleeve gastrectomy or mini-gastric bypass?

AIM: To investigate the weight loss and glycemic control status [blood glucose, hemoglobin A1c (HbA1c) and hypoglycaemic treatment]. METHODS: The primary risk factor for type 2 diabetes is obesity, and 90% of all patients with type 2 diabetes are overweight or obese. Although a remarkable effect of bariatric surgery is the profound and durable resolution of type 2 diabetes clinical manifestations, little is known about the difference among various weight loss surgical procedures on diabetes remission. Data from patients referred during a 3-year period (from January 2009 to December 2011) to the University of Naples "Federico II" diagnosed with obesity and diabetes were retrieved from a prospective database. The patients were split into two groups according to the surgical intervention performed [sleeve gastrectomy (SG) and mini-gastric bypass (MGB)]. Weight loss and glycemic control status (blood glucose, HbA1c and hypoglycaemic treatment) were evaluated. RESULTS: A total of 53 subjects who underwent sleeve gastrectomy or mini-gastric bypass for obesity and diabetes were screened for the inclusion in this study. Of these, 4 subjects were excluded because of surgical complications, 7 subjects were omitted because young surgeons conducted the operations and 11 subjects were removed because of the lack of follow-up. Thirty-one obese patients were recruited for this study. A total of 15 subjects underwent SG (48.4%), and 16 underwent MGB (51.6%). After adjusting for various clinical and demographic characteristics in a multivariate logistic regression analysis, high hemoglobin A1c was determined to be a negative predictor of diabetes remission at 12 mo (OR = 0.366, 95%CI: 0.152-0.884). Using the same regression model, MGB showed a clear trend toward higher diabetes remission rates relative to SG (OR = 3.780, 95%CI: 0.961-14.872). CONCLUSION: Although our results are encouraging regarding the effectiveness of mini-gastric bypass on diabetes remission, further studies are needed to provide definitive conclusions in selecting the ideal procedure for diabetes remission

Lingual cyst with respiratory epithelium: the importance of differential diagnosis

Lingual cyst with respiratory epithelium (LCRE) is a very rare congenital cyst of the tongue, floor of the mouth, pharynx or hypopharynx with 21 cases reported in the literature (1, 2). Differential diagnosis is very important for patients presenting with lingual cysts, as this may impact treatment and follow-up. LCRE should be included in the different diagnosis of dermoid cyst (3), teratoid cyst (4), epidermoid cyst (5), thyroglossal duct cyst (6), lymphoepithelial cyst (7), mucocele or ranula (8). Each entity has a peculiar histologic presentation, although the clinical aspect may be very similar (1). The dermoid cyst is lined by a keratinized squamous epithelium and contains skin appendages in the cyst. Epidermoid cyst is similar to the dermoid cyst but is characterized by non-keratinized squamous epithelium and has a lumen filled of keratin. Teratoid cyst contains derivatives of the endoderm, ectoderm and/or mesoderm. The thyroglossal duct cyst is usually lined by columnar, stratified squamous epithelium, or an intermediate transition type of epithelium, with the mandatory presence of thyroid tissue in the cyst wall. Lymphoepithelial cyst is identified by the presence of the lymphoid aggregates in the cyst wall. A mucous retention cyst, so called mucocele or ranula, contains mucin and granulation tissue (1)

Retinal Pigment Epithelial and Outer Retinal Atrophy in Age-Related Macular Degeneration: Correlation with Macular Function

The purpose of this study was to investigate the relationship between the retinal pigment epithelium (RPE) and outer retina changes, expressed in terms of sub-RPE illumination (SRI) on optical-coherence tomography (OCT), and central retinal function, measured by visual acuity and focal electroretinogram (fERG), in patients with non-exudative age-related macular degeneration (neAMD). In this retrospective study, 29 eyes of 29 patients affected by early (24.14%), intermediate (41.38%), and advanced (34.48%) neAMD were evaluated. All enrolled eyes were studied with OCT to measure the total area of SRI, by using an automated standardized algorithm. Visual acuity and fERG were assessed. The area of SRI was negatively correlated with fERG amplitude (r &lt;= -0.4, p &lt;= 0.02) and best-corrected visual acuity (BCVA) (r &lt;= 0.4, p &lt;= 0.04). Our results indicate that the severity of retinal pigment epithelium and outer retina atrophy (RORA), indirectly quantified through the detection of SRI areas by commercial OCT algorithms, is correlated with central retinal dysfunction, as determined by visual acuity and fERG, supporting the combined use of structural exams and functional tests as valid tools to detect the extent of RPE and photoreceptors' disruption