Uncovering the potential of innovation ecosystems in the healthcare sector after the COVID-19 crisis.

Industry 4.0 technologies are expected to enhance healthcare quality at the minimum cost feasible by using innovative solutions based on a fruitful exchange of knowledge and resources among institutions, firms and academia. These collaborative mechanisms are likely to occur in an innovation ecosystem where different stakeholders and resources interact to provide ground-breaking solutions to the market. The paper proposes a framework for studying the creation and development of innovation ecosystems in the healthcare sector by using a set of interrelated dimensions including, technology, value, and capabilities within a Triple-Helix model guided by focal actors. The model is applied to an exemplary Italian innovation ecosystem providing cloud and artificial intelligence-based solutions to general practitioners (GPs) under the focal role of the Italian association of GPs. Primary and secondary data are examined starting from the innovation ecosystem's origins and continuing until the COVID-19 crisis. The findings show that the pandemic represented the turning point that altered the ecosystem's dimensions in order to find immediate solutions for monitoring health conditions and organizing the booking of swabs and vaccines. The data triangulation points out the technical, organizational, and administrative barriers hindering the widespread adoption of these solutions at the national and regional levels, revealing several implications for health policy.

Determinants of FDI Localization in China: A County-Level Analysis for the Pharmaceutical Industry.

Foreign direct investments (FDIs) have been widely recognized as a crucial feature of the Chinese industrial development process. Over the past decades, China has been attracting huge amounts of inward FDIs as a consequence of both spontaneous market dynamics and place-based preferential policies at the sub-national level. However, the Chinese market exhibits large dissimilarities in terms of FDI localization across territories that are worth investigating at a more disaggregated level. In this regards, our study explores the determinants of attraction of inward FDIs in China, at the county level. It focuses on the pharmaceutical industry and attempts to assess whether factors related to location advantages, agglomeration dynamics, information cost effects and environmental regulation costs affect foreign firms' localization choices as well as invested amounts in that location. By means of discrete choice models, our paper confirms the findings of the prevalent literature about the positive effects of location advantages on pharmaceutical FDI attraction. Different from our expectations, a higher proportion of foreign enterprises do not stimulate significant effects on FDI localization, while preferential policies and sectoral agglomeration are positively correlated with the localization of pharmaceutical foreign firms. Finally, our results suggest that investing firms tend to avoid areas with strict environment regulation.

Acute appendicitis due to Cytomegalovirus in an apparently immunocompetent patient: a case report.

INTRODUCTION: In healthy subjects, Cytomegalovirus infection can be asymptomatic or manifest as mononucleosis syndrome, but organ disease has also been reported. However, in immunocompromised patients this infection can lead to its most significant and severe disease and even mortality. When Cytomegalovirus causes a gastrointestinal tract infection, it more commonly manifests with luminal tract disease and is usually characterized by ulcerative lesions. Appendicitis is a rare manifestation, and has been reported mainly in human immunodeficiency virus-infected patients or patients with other causes of immunocompromise. CASE PRESENTATION: The authors report on a case of acute primary Cytomegalovirus infection complicated with acute appendicitis due to Cytomegalovirus in an apparently immunocompetent 24-year-old Caucasian man also suffering from primary sclerosing cholangitis and ulcerative colitis. Diagnosis was based on clinical manifestations, serology results, as well as microbiological and histological findings. Treatment consisted of surgery and anti-Cytomegalovirus therapy. CONCLUSIONS: Cytomegalovirus should be included among the etiologic agents of acute appendicitis in patients with primary sclerosing cholangitis and ulcerative colitis. Currently, there are no definitive data regarding the frequency of Cytomegalovirus appendicitis and the role of anti-Cytomegalovirus treatment in human immunodeficiency virus-negative and apparently immunocompetent subjects.