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PurposeEmployees are considered as important contributors to service innovation, but the literature is not unanimous about what employee involvement in service innovation entails. To advance theoretical understanding of the topic, this paper develops a conceptual framework for analysing employee involvement in service innovations, reviews existing research on the topic and proposes a research agenda.Design/methodology/approachDifferent modes of employee involvement in service innovation are distinguished based on two dimensions: (1) the intensity of employee influence on service innovation and (2) the breadth of the innovation activity in which employees are involved. This conceptual framework is abductively developed through a literature review of empirical service innovation studies to identify and analyse whether and how these modes of employee involvement are manifested in the service innovation literature.FindingsThe findings delineate six modes of employee involvement in the reviewed service innovation studies. Employees are primarily seen as having a strong influence on situated innovation activities but a limited influence on systemic innovation activities. The findings show that more research is needed to assess the connections between different modes of employee involvement.Practical implicationsThe findings can be used by practitioners to assess the possibilities different modes of employee involvement may bring to service innovation activities.Originality/valueThe proposed conceptual framework and the analysis of current research and research gaps in service innovation studies provide a clear research agenda for progressing multidimensional understanding of employee involvement in service innovation.

Although enterprise crowdsourcing systems that aim to harness the collective intelligence of employees for innovation purposes are proliferating, little is known about how they may impact organisations and their culture. To shed light on this problem, this paper conducts a case study to investigate an engineering consultancy's efforts to implement an internal crowdsourcing as part of an effort to change the innovation culture of the organisation. Taking the starting point in the literature on the relationship between IT and organisational culture and enterprise crowdsourcing, this paper underscores the interplay between innovation culture and information technology. The study finds that enterprise crowdsourcing systems can contribute to small changes of the innovation culture of an organisation along several cultural determinants, including behaviours that encourage innovation, communication and knowledge sharing, employees' relationships, support mechanisms, and strategy.

Objective To evaluate the efficacy of Perceptual Learning in improving the peripheral reading performance of patients with Stargardt disease (STGD). Design Prospective observational randomized study. Participants Fourteen consecutive patients (7 females, 7 males; median age of 50.4 ± 12.8 years) with STGD were analyzed and divided into two groups: Group A received “Win-flash” as Perceptual Learning training and Group B was used as control. Methods Subjects underwent an ophthalmic evaluation at baseline, after perceptual learning training and at 6 months of follow-up. Outcomes measured included reading speed, contrast sensitivity and fixation stability. Results Reading speed improved of 51,7% after training in group A. Visual acuity, contrast sensitivity and fixation stability enhanced in group A after training from 0.89 (±0.09) LogMAR to 0.75 (±0.2) LogMAR (t(6)= 3.6, p= 0.001), from 0.8 (±0.3) LogC (0.6 − 0.9) to 1.3 (±0.3) LogC (t(13)=3.17, p= 0.003) and from 59.3 % (± 24.3) to 71.5 % (± 20.4) (t(13)=1.8 p= 0.04), respectively. No changes were found in group B. At 6-monts of follow-up, visual acuity and contrast sensitivity decreased in group A. Conclusions STGD patients receiving “Win-flash training”, as PL technique, showed an improvement of reading performance on a real-world task. Early follow-up for perceptual learning re-intervention should be considered.

Idea competitions can help organizations innovate and IT support can make it easier to enrol participants, facilitate collaboration and manage the process. Thus far, the literature on IT‐enabled idea competitions has focused mainly on engaging external actors; consequently, we know less about the internal engagement of employees. Moreover, although the literature reveals several challenges in managing internal IT‐enabled idea competitions, there are no comprehensive empirical accounts of how these challenges manifest in organizational contexts. Against this backdrop, we investigate how an engineering consultancy adapted an IT‐enabled idea competition to support innovation, innovation awareness and knowledge sharing. This descriptive case study provides a detailed analysis of the breakdowns that manifested, what triggered the breakdowns, and how the organization responded. Our analysis reveals that the system required substantial adaptation, and, although it addressed well‐known challenges in managing idea competitions, other challenges surfaced. We combine these empirical insights with extant literature to propose a model for understanding and explaining how our case organization handled the breakdowns that occurred while implementing the idea competition system. Idea competitions can help organizations innovate and IT support can make it easier to enrol participants, facilitate collaboration and manage the process. Thus far, the literature on IT‐enabled idea competitions has focused mainly on engaging external actors; consequently, we know less about the internal engagement of employees. Moreover, although the literature reveals several challenges in managing internal IT‐enabled idea competitions, there are no comprehensive empirical accounts of how these challenges manifest in organizational contexts. Against this backdrop, we investigate how an engineering consultancy adapted an IT‐enabled idea competition to support innovation, innovation awareness and knowledge sharing. This descriptive case study provides a detailed analysis of the breakdowns that manifested, what triggered the breakdowns, and how the organization responded. Our analysis reveals that the system required substantial adaptation, and, although it addressed well‐known challenges in managing idea competitions, other challenges surfaced. We combine these empirical insights with extant literature to propose a model for understanding and explaining how our case organization handled the breakdowns that occurred while implementing the idea competition system.

Limbic encephalitis is an inflammatory process of the limbic structures, with polymorphic clinical features, caused by paraneoplastic and nonparaneoplastic conditions and infections. We describe a case of neurosyphilis limbic encephalitis, presenting with reversible Geschwind syndrome (hyperreligiosity and hypergraphia) and mood disorder due to the predominant involvement of left mesial temporal structures in a previously healthy 34-year-old, left-handed woman. Because neurosyphilis can mimic common neuropsychiatric syndromes, it should be included in the differential diagnosis of psychiatric disorders with suspected general medical causes. This case of nondominant limbic encephalopathy caused by syphilis infection highlights the relevance of a careful investigation for secondary psychotic, mood, and personality disorders when assessing new-onset psychiatric illness and the importance of a multidisciplinary approach to provide a better outcome in patients with neurosyphilis.

Social innovation is an emerging theme within innovation theory, and so is the concept of public service innovation networks for social innovation (PSINSIs). The purpose of this article is to explore how social innovation in Danish public services is conceptualised and enacted through the lenses of public service innovation networks for social innovation. To do this, a thorough integrative review of the literature dealing with the Danish context is conducted. The Danish context is interesting in order to investigate these network arrangements, firstly because they are not well understood in the context of the Nordic welfare states, which Denmark is part of, and then because municipalities and civil society have historically had a mutually dependent relationship in Denmark. The article highlights that social innovation is framed in several ways in the Danish public sector. In particular, the results show that the literature can be grouped according to four themes: (1) samskabelse (co-creation), (2) collaboration with civil society, (3) social entrepreneurs and social innovation and (4) public–private innovation partnerships. Moreover, the article presents and discusses a number of Danish empirical projects that may be understood through the lens of the PSINSI framework. Hence, the paper contributes with new theoretical perspectives, in addition to contributing to practice.

Purpose: To report a case of macular choroidal osteoma treated with photodynamic therapy. Observations: A 34-years old woman with decreased visual acuity in her left eye came to our observation for assessment of an amelanotic choroidal tumor in the left eye. On the basis of ophthalmoscopic and echographic features the tumor was diagnosed as choroidal osteoma. Imaging examination revealed subretinal fluid involving the foveal area associated with alterations of outer neuroepithelial layers and photoreceptors without evidence of choroidal neovascularization. Foveal sparing standard fluence rate photodynamic therapy was performed. After treatment, subretinal fluid reabsorption and visual acuity recovery was noted with progressive restoration of foveal architecture. Due to the relapse of fluid and visual impairment, 1 year after treatment, a second PDT session was made using the same parameters and protocol of treatment. Despite a complete subretinal fluid reabsorption and visual acuity recovery the second treatment was complicated by the development of subretinal fibrosis. Conclusions: PDT is effective to induce subretinal fluid reabsorption and visual recovery in choroidal osteoma located in the macular area. However, the risk of possible complications related to the treatment have to be considered.

BACKGROUND A high level of glycosylated haemoglobin (HbA1c), which is a nonenzymatic glycosylation product, is correlated with an increased risk of developing microangiopathic complications in Diabetes Mellitus (DM). Erythrocyte membrane fluidity could provide a complementary index to monitor the development of complications since it is influenced by several hyperglycaemia-induced pathways and other independent risk factors. MATERIALS AND METHODS 15 healthy controls and 33 patients with long-duration (≥20 years) type 1 Diabetes Mellitus (T1DM) were recruited. Diabetic subjects were classified into two groups: T1DM, constituted by 14 nonretinopathic patients, and T1DM + RD, constituted by 19 patients in any stage of diabetic retinopathy. Red blood cells (RBC) were incubated with the fluorescent Laurdan probe and median values of Generalized Polarization (GP), representative of membrane fluidity, were compared between the two groups. Baseline characteristics among groups have been compared with Student's t test or ANOVA. Values of P

International audience; Social innovation, in the context of public innovation, has gained increased attention in the literature, and is approached relative to the third sector, to social enterprises, or as practices initiated by the public sector. However, the interplay among these actors in enabling social innovation is still underexplored. Therefore, the article investigates the role of social entrepreneurs from outside the public sector in enabling public sector innovation networks. Since social innovation is inherently relational, four cases demonstrating how social entrepreneurs have pushed the boundaries of public sector services, and hence expanded public innovation networks, are analysed.

Introduction The purpose of this case series was to report the potential role of cyclophosphamide (CY) on bleb survival and to evaluate the safety of the trabeculectomy procedure under immunosuppressant systemic therapy. Case series Five eyes of five patients with unresponsive to intraocular pressure (IOP) lowering medication, progressive glaucoma, underwent mytomicin C (MMC) augmented phaco-trabeculectomy, performed by the same surgeon, A.G., during the period from May 2015 to January 2016. All patients were treated with low doses of systemic CY at the time of surgery, to control their relapsing progressive multiple sclerosis (MS) form. Results During a mean follow-up period of 20.6 ± 8.1 months, for cases of “complete success” (when the IOP was

Purpose: To report the results of a patient’s tailored therapeutic approach using a second course of interventional radiotherapy (brachytherapy) in patients with locally recurrent uveal melanoma. Material and methods: Patients who had already undergone ocular brachytherapy treated at our IOC (Interventional Oncology Center) were considered. Five patients who has received a second course of treatment with a plaque after local recurrences were included in our study. Re-irradiation was performed with Ruthenium-106 (prescribed dose to the apex 100 Gy) or with Iodine-125 plaques (prescribed dose to the apex 85 Gy). Moreover, a systematic literature search was conducted through three electronic databases, including Medline/PubMed, Scopus, and Embase. Results: All patients were initially treated with Ruthenium-106 plaque; the re-irradiation was performed with Ruthenium-106 plaque in three cases and with Iodine in two cases. Mean time between the first and the second plaque was 56.8 months (range, 25-93 months). Local tumor control rate was 100%, no patient underwent secondary enucleation owing to re-treatment failure. Distant metastasis occurred in 1 patient after 6 months from re-treatment. After a median follow-up of 44.2 months (range, 26-65 months) from re-treatment, all patients experienced worsening of the visual acuity (median visual acuity was 0.42 at time of recurrence and decline to 0.24 at the most recent follow-up); cataract occurred in two cases, no patient developed scleral necrosis. We considered 2 papers for a systematic review. Conclusions: In selected cases, especially in presence of marginal local recurrence, a personalized re-treatment strategy with a plaque may offer high probability of tumor control and organ preservation but worsening of visual acuity.

To analyze Stargardt disease (STGD) by morpho-functional examination and investigate the relationship between morpho-functional measures and reading performance.Observational case series study.Fifteen patients with STGD.Twenty-six eyes of 15 patients underwent complete ophthalmic evaluation. Spectral domain optical coherence tomography, fundus autofluorescence (FAF), best corrected visual acuity (BCVA), and microperimetric examinations were performed. FAF and optical coherence tomography (OCT) overlap on microperimetric images was obtained in order to evaluate both tomographic and FAF features passing through the eccentric fixation area. Both morphologic features and functional data were correlated with magnification of prescribed device and reading rate.Univariable analysis showed a significant correlation between magnification power and greatest linear dimension of both OCT and FAF (r = 0.69 and r = 0.67; p0.05). Magnification power was related to best corrected visual acuity (r = 0.56; p0.05). Retinal sensitivity map (r = 0.57; p0.05) was considered an indicator of reading rate. Magnification levels showed a positive correlation with eccentric preferred retinal location (p = 0.03) and the degree of FAF alteration (normal, dishomogeneous, ipoautofluorescence; p0.0001).As a result of the overlapping of OCT/FAF imaging on microperimetric exam, residual activity of outer retinal layers passing through the eccentric fixation area seems to be related with required magnification and reading rate. Identification of morpho-functional parameters is helpful for designing a customized rehabilitative program.

Introduction and purpose Choroidal metastases (CM) are the most common intraocular malignancies. With longer survival rates for cancer patients, CM will be increasingly encountered. We evaluated clinical and ultrasonographic (US) characteristics of CM in order to identify diagnostic biomarkers that correlate with the primary tumor site. Methods The medical records of all patients with CM evaluated at the Ocular Oncology Unit between February 2010 and March 2020 were analyzed. Results 82 eyes of 70 patients were included. The primary cancer site was lung in 26 patients (37%), breast in 23 (33%), kidney in 9 (13%), gastrointestinal in 5 (7%), thyroid in 5 (7%), parathyroids and prostate respectively in 2 (3%). Fifty-five patients (78%) had other systemic metastases at the time of ocular diagnosis. Ten (14%) patients had no history of primary cancer. Bilateral CM were found in 20 patients (29%); fifty-six eyes (68%) had a single CM. The epicenter of CM was predominantly macula (43 eyes, 52%). The mean thickness was 4,1 mm (range 1,8–12,3). US structure was inhomogeneous in 67 eyes (82%). Reflectivity was mainly medium (39%) and medium-low (39%). In particular, CM from lung cancer showed lower reflectivity than those from the breast (p = 0,02). CM deriving from lung cancer were typically dome-shaped, whereas CM originating from breast were characteristically plateau shaped (p = 0,02). Seventy-four (91%) eyes presented fluid on optical coherence tomography. Conclusion We significatively found that CM from lung cancer generally appear dome-shaped with medium-low internal reflectivity, whereas those from breast cancer typically present a plateau appearance and higher internal reflectivity. Though it is hard to identify the site of the primary tumor relying exclusively on clinical and US aspects, morphology and internal reflectivity can be considered as diagnostic biomarkers. Thus, the origin of the primary tumor can be suspected by integrating a constellation of findings.

PURPOSE To compare visual outcomes and local tumor control between two groups of patients with amelanotic choroidal melanoma treated with brachytherapy alone, or neoadjuvant photodynamic therapy before brachytherapy. METHODS Patients diagnosed with amelanotic choroidal melanoma were recruited for the study and divided into two groups: brachytherapy alone (Group A) and photodynamic therapy preceding brachytherapy (Group B). Patients of both groups were selected to be comparable. RESULTS Twenty-six patients with amelanotic choroidal melanoma were enrolled in the study. Within Group B, 1 month after photodynamic therapy, ultrasonography showed reduction of tumor height in 11 patients (73.4%). The mean doses of irradiation to macula and optic nerve, at baseline were 74.37 and 52.07 Gy, whereas after photodynamic therapy there was a decrease of 17.26% (P = 0.008) and 21.22% (P = 0.025), respectively. In terms of visual acuity, a mean decrease of 14 ETDRS letters and 5 ETDRS letters was observed at 24 months follow-up, in Groups A and B, respectively (P = 0.001). CONCLUSION Photodynamic therapy as neoadjuvant therapy before brachytherapy reduces tumor thickness in 73.4% of cases. As a result, a decrease of radiation toxic effects on visual function could be obtained, without compromising disease control.

This article discusses different ways in which users may be involved in the ideation phase of service innovation and the results and limitations of such involvement. The study compares the use of a blog and two differently setup future workshops (one with users only and the other with a mix of users and employees) in a library. The authors' study shows that the blog is efficient in giving the users voice whereas the mixed workshop method (involving users and employees) is particularly efficient at qualifying and further developing ideas. The findings suggest that methods for involving users in ideation should be carefully selected and combined to achieve optimum benefits and avoid potential disadvantages.

This paper examines the co-evolution of public governance and innovation, and proposes an adaptation of Hartley's model to take into consideration such co-evolution. This model is then applied to a longitudinal case study of the digitalization of Roskilde University Library. The theoretical and empirical analysis yields four main results. First, it is shown that the transition from a New Public Management approach towards a Networked Governance mode implies a greater distribution of knowledge and innovation across different organisational levels within public administrations. Interactions between such organisational levels crucially affect the development of new public services. Second, a more articulated view of users in public sector innovation is developed. It is argued that: (i) users play distinct roles at different stages in innovation processes, with relatively greater involvement in minor incremental changes; (ii) user-driven innovations have significantly increased with the diffusion of ICTs and Web based public services; and (iii) complex innovations are facilitated by face-to-face meetings between public servants and users. Third, it is suggested that changes in governance modes affect the balance between the different actors involved, thus influencing the nature and intensity of innovation. Fourth and finally, it is argued that the transition towards a networked governance approach requires information policies which persist over time, and are designed to increase collaboration between different (public and private) actors.

Purpose: Combined hamartoma of the retina and retinal pigment epithelium is a rare benign tumor characterized by a variable combination of glial, vascular, and pigmented components. The purpose of our study was to analyze the features of combined hamartoma of the retina and retinal pigment epithelium on optical coherence tomography angiography. Methods: Small case series of two cases of combined hamartoma of the retina and retinal pigment epithelium with macular and optic nerve involvement, evaluated with multimodal imaging including optical coherence tomography, fluorescein angiography, and optical coherence tomography angiography. Results: On optical coherence tomography, combined hamartoma of the retina and retinal pigment epithelium is characterized by disruption of the inner neurosensory retina and a variable degree of involvement of the external retina. Optical coherence tomography angiography showed diffuse alterations of the retinal vessels of the superficial and deeper layers, extended to the peripapillary area. Vessel abnormalities included increased tortuosity and caliber of vessels, vascular traction, and vessel stretching within the lesion. Conclusion: Optical coherence tomography angiography allows in-depth multilayer analysis of tumor vascular network, highlighting the fine abnormalities of retinal vasculature characteristic of combined hamartoma of the retina and retinal pigment epithelium.

Purpose or Objective:To present the results of a patient therapeutic approach using a second course of Interventional Radiotherapy (Brachytherapy) in a setting of patients with local recurrence of uveal melanoma. Material and Methods: Patients who had already undergone ocular brachytherapy at IOC (Interventional Oncology Center) of the “Gemelli ART” (Advanced Radiation Therapy) of Rome were considered. In this group, five patients with a local recurrence that received a second course of treatment with a plaque were included in our analysis. The reirradiation was performed with a plaque of Ruthenium-106 (dose prescribed to the apex 100 Gy) or of Iodine-125 (dose prescribed to the apex 85Gy).

Although introduced for the treatment of maculopathies, photodynamic therapy (PDT) is now largely used in some eye cancers treatment. The selective tissue damage with PDT is achieved by sequestration of the photosensitizer in the target tissue and focal activation of the photosensitizer by low energy directed light. In this way, it is possible to achieve the destruction of the tumor tissue by safeguarding the surrounding healthy structures. Our study describes the clinical uses and efficacy of photodynamic therapy in ocular oncology.

YouTube has now evolved into a powerful medium for social interaction. Utilizing YouTube for enhancing marketing endeavours is a strategy practiced by marketing professionals across several industries. This paper rationalizes on the different strategies of leveraging YouTube-based platforms for effective destination marketing by the hospitality industry (hotels) and provides insights on the critical drivers and challenges embedded within YouTube-based community interactions for destination marketing. The comments made by YouTube users have been subjected to a content analysis and the results are reported under the five broad clusters of virtual communities. More broadly, the typology of virtual communities is adapted to evaluate the YouTube platform for effective destination marketing.

Purpose The purpose of this study was to study the incidence and factors influencing retinal displacement in eyes treated for rhegmatogenous retinal detachment (RRD) with pars plana vitrectomy (PPV) and gas or silicone oil. Methods This was a prospective observational case series. One hundred twenty-five eyes with macula-off RRD from 125 patients underwent 25-gauge PPV at two vitreoretinal institutional practices. Eyes without proliferative vitreoretinopathy (PVR) or PVR grade A were tamponated with sulfur hexafluoride (SF6) gas, whereas eyes with PVR grade B received 1000 centistokes silicone oil (SO). The patients postured face-down immediately after surgery. Blue-fundus autofluorescence (B-FAF) pictures were obtained at each follow-up examination. Main outcome measures were incidence and direction of retinal displacement. Results Ninety-seven eyes (77.6%) were tamponated with SF6 and 28 eyes (22.4%) with SO. After retinal reattachment, displacement was observed in 44 of 125 (35.2%) eyes (40 eyes in the SF6 group and 4 eyes in the SO group, respectively). The type of tamponade, specifically gas, was the only significant predictor of retinal displacement (P = 0.007). The displacement was downward in 39 (88.6%) eyes (36 tamponated with SF6 and 3 with SO) and upward in 5 (11.4%) eyes (4 tamponated with SF6 and 1 with SO). Conclusions Displacement of the retina after repair of macula-off RRD with PPV is observed using either SF6 gas or SO. Downward and upward displacements may occur with both tamponades, but downward dislocation is more common. Of the factors potentially implicated in favoring displacement that were studied, only the type of tamponade, specifically the gas, was significant.

The purpose of this article is to investigate the technological attributes of Estonian e-Residency that facilitates or hinder its adoption for international virtual entrepreneurship. To conduct the study, the theory of Diffusion of Innovations is applied and a qualitative study of adopters of e-Residency for entrepreneurial purposes is conducted. The findings show a variety of attributes of e-Residency that to varying degrees influence the adoption process including felt needs, perceived risk and uncertainty. The article corroborates and adds to previous research on the adoption of technology and e-services by investigating a particular type of e-service, namely e-Residency.

Purpose: To report the case of a 13-year-old girl with torpedo maculopathy, evaluated with multimodal morpho-functional retinal imaging, including fundus photography, infra-red and blue fundus autofluorescence, swept-source optical coherence tomography (OCT), en face OCT, OCT angiography and microperimetry (MP). Observations: On fundus examination, a torpedo-like hypopigmented lesion was observed temporal to the fovea in the left eye. OCT showed disruption of outer retinal layers and the presence of a subretinal cleft. On OCTA, a diffuse attenuation of signal from choriocapillaris was observed along the lesion. Functional analysis with MP revealed a reduction of retinal sensitivity over the lesion. Conclusions: and importance: On OCTA, torpedo maculopathy is characterized by vascular alterations of the choriocapillaris along the lesion. Keywords: Optical coherence tomography angiography, Torpedo maculopathy, Microperimetry, Swept-source optical coherence tomography, En face optical coherence tomography

This article presents the results of a study investigating user involvement in the idea generation phase of service innovation, and discusses advantages and limitations of such involvement. Specifically, the study compares the use of social media such as blogs and future workshops to generate idea for service innovations in the context of a research library. Our study shows that the blog is good in opening up for user contributions, while the future workshop involving users and employees is particularly good at qualifying and further developing ideas. The findings suggest therefore that methods for user involvement should be carefully selected and combined to achieve optimum benefits and avoid potential disadvantages.

PURPOSE To analyze the relationship between swelling of the arcuate nerve fiber layer (SANFL) and long-term decrease of retinal nerve fiber layer thickness after internal limiting membrane peeling for idiopathic epiretinal membrane, and to investigate if SANFL is related to a mechanical surgical damage. METHODS Prospective, interventional consecutive case series of 46 eyes that underwent combined epiretinal membrane/internal limiting membrane peeling for idiopathic epiretinal membrane. Infrared, blue autofluorescence, color fundus imaging and measurement of retinal nerve fiber layer thickness in six peripapillary sectors by spectral-domain optical coherence tomography were performed preoperatively and at 2 weeks, 1, 3, 6, and 12 months after surgery. The presence of SANFL was checked postoperatively on infrared and blue autofluorescence fundus imaging, and the extent of each SANFL was measured on infrared fundus images. RESULTS Areas of SANFL were identified in 39 eyes (84.8%) at 2-week follow-up. Retinal nerve fiber layer thickness significantly decreased in the temporal sectors at 1, 6, and 12 months (P < 0.0001). The linear extent of SANFL was significantly correlated with the percentage of reduction in retinal nerve fiber layer thickness in the temporal (R = 0.45; P < 0.0001) and infero-temporal (R = 0.23; P = 0.0008) sectors at 12 months of follow-up. Correspondence between sites of surgical grasping and the points of origin of SANFL was demonstrated on blue autofluorescence fundus images superimposed on intraoperative surgical frames. CONCLUSION Early postoperative SANFL is correlated with late focal retinal nerve fiber layer thinning in the temporal sectors. Intraoperative surgical grasping seems to be a leading factor for the onset of SANFL.

Purpose – The purpose of this paper is to present research findings on the relation between internal/external sources of innovation and information and communication technology (ICT) as a supporter/enabler of facilities management (FM) organizations, as well as on the strategic orientation towards open innovation of FM organizations. Design/methodology/approach – This study uses a qualitative research approach. The data collection includes qualitative semi-structured interviews with key FM managers and directors and secondary material such as company brochures, reports and information provided on the participating companies’ websites. Findings – The results show that the FM organizations in the study sample are starting to develop and engage in open FM service innovations, even though they still mostly conduct closed innovation activities. The findings show that FM organizations mostly take an ambidextrous strategic orientation towards FM service innovations, while they also embrace an exploration approach. Concerning the role of ICT in FM service innovations, the study shows that in the explorative organizations, ICT was mostly an enabler, while in the ambidextrous organizations, ICT mostly supported and enabled the innovations in question. Only in two innovation instances was ICT identified as having a utility role. Practical implications – The findings of this study challenge researchers and managers to rethink how and why a strategic orientation towards innovation, the sources of innovation and the role of ICT might affect service innovation in FM organizations. One important implication for FM managers and researchers is the importance that the government might have as an external source in fostering FM service innovations, especially in light of changing environmental requirements, such as energy consumption. FM managers should also consider how they could use ICT to improve and innovate FM services and service delivery and the kind of sources (external/internal) they should use to carry out this task. Originality/value – This paper contributes to the empirical and theoretical understanding of the sources of innovation and ICT as a supporter/enabler, as well as the strategic orientation towards innovation in FM organizations.

Purpose : To develop a predictive model and nomogram for maculopathy occurrence at 3 years after 106 Ru/ 106 Rh plaque brachytherapy in uveal melanoma. Material and methods : Clinical records of patients affected by choroidal melanoma and treated with 106 Ru/ 106 Rh plaque from December 2006 to December 2014 were retrospectively reviewed. Inclusion criteria were: dome-shaped melanoma, distance to the fovea > 1.5 mm, tumor thickness > 2 mm, and follow-up > 4 months. The delivered dose to the tumor apex was 100 Gy. Primary endpoint of this investigation was the occurrence of radiation maculopathy at 3 years. Analyzed factors were as follows: gender, age, diabetes, tumor size (volume, area, largest basal diameter and apical height), type of plaque, distance to the fovea, presence of exudative detachment, drusen, orange pigment, radiation dose to the fovea and sclera. Univariate and multivariate Cox proportional hazards analyses were used to define the impact of baseline patient factors on the occurrence of maculopathy. Kaplan-Meier curves were used to estimate freedom from the occurrence of the maculopathy. The model performance was evaluated through internal validation using area under the ROC curve (AUC), and calibration with Gronnesby and Borgan tests. Results : One hundred ninety-seven patients were considered for the final analysis. Radiation-related maculopathy at 3 years was observed in 41 patients. The proposed nomogram can predict maculopathy at 3 years with an AUC of 0.75. Distance to fovea appeared to be the main prognostic factor of the predictive model (hazard ratio of 0.83 [0.76-0.90], p < 0.01). Diabetes (hazard radio of 2.92 [1.38-6.20], p < 0.01), and tumor volume (hazard radio of 21.6 [1.66-281.14], p = 0.02) were significantly predictive for maculopathy occurrence. The calibration showed no statistical difference between actual and predicted maculopathy (p = 1). Conclusions : Our predictive model, together with its nomogram, could be a useful tool to predict the occurrence of radiation maculopathy at 3 years after the treatment.

PurposeThe purpose of this paper is to investigate innovation in the facilities management sector by conducting an empirical study.Design/methodology/approachThis study uses a qualitative research approach to investigate the research question. Data collection includes qualitative semi‐structured interviews with key facility management managers and directors, secondary material such as company brochures and reports and participation to workshops and conferences on facility management.FindingsThe main results are that big service providers perceive innovation as a strategic activity and see themselves as innovative companies. Facilities management (FM) service customers with their own FM department present mixed results. Some perceive innovation as a strategic priority and have clear innovation strategies. Others perceive themselves as not being innovative, even though they might be. The organizations belonging to the category “ICT Supplier/consultants” perceive themselves as innovative organizations and their innovations are both driven by the user needs and by the desire to improve their competitiveness. The types of perceived FM innovations found in the study can be mainly categorized as service, contract, process and business model innovations. Finally, the study shows that ICT is perceived to be a driver of FM innovations and that FM organizations use both closed and open innovation strategies.Practical implicationsThese results can be used by FM managers, innovation researchers and FM researchers alike. For FM managers the results provide some useful information about how innovation is addressed in FM provider and customer companies. FM researchers can get a picture of what is going on in the FM innovation landscape in Denmark. Finally, service researchers can get some insights about service innovation in a specific and under‐researched service field: facility management services.Originality/valueThis paper contributes to the understanding of innovation and innovation types in facility management companies.

This article involves a qualitative study of factors impacting the adoption of ICT solutions in the Danish facility management supply chain. The results show that there are a number of drivers and barriers that influence the adoption of ICT solutions in this service sector. These have been grouped under three major categories: organizational factors including strategic and operational factors; external environmental factors including supplier interdependence and industry characteristics; and technological factors including compatibility and complexity. The study is relevant to researchers concerned with ICT adoption, operations and service management (especially facilities management) as well as operation managers and ICT managers.

Purpose – The paper aims to investigate how customers may contribute to radical innovation in consultancy services and the conditions needed for customers to be involved in such radical service innovations. Design/methodology/approach – The paper uses a qualitative case study approach including rich descriptions based primarily on interviews to investigate an extreme example of successful customer involvement in the development of radical service innovations at Ramboll, a leading Scandinavian engineering consultancy. Findings – The study reveals that customers may be involved in radical innovation processes to different degrees. However, actively involving customers in radical services innovation require a relationship between the customer company and the service provider that might be described as a partnership in which ongoing learning takes place to develop new solutions. The findings reveal that unsolved problems as well as personal trust are key in making customers involved in radical service innovations. Customers involved actively are further characterised by possessing high expertise and extraordinary personal engagement. Research limitations/implications – As in all case studies, the main limitation of the study is the generalisability of the findings. More cases would help to shed light on the generalisability of the findings across other radical innovation projects within the same company or in similar types of company. Originality/value – The study contributes with new and detailed insights into both how to involve customers in radical service innovations and the conditions and challenges found in doing so.

Government ‘e-service’ as a subfield of the e-government domain has been gaining attention to practitioners and academicians alike due to the growing use of information and communication technologies at the individual, organizational, and societal levels. This paper conducts a thorough literature review to examine the e-service research trends during the period between 2005 and 2009 mostly in terms of research methods, theoretical models, and frameworks employed as well as type of research questions. The results show that there has been a good amount of papers focusing on ‘e-Service’ within the field of e-government with a good combination of research methods and theories. In particular, findings show that technology acceptance, evaluation and system architecture are the most common themes, which circa half of the studies surveyed focus on the organizational perspective and that the most employed research methods are case studies and surveys, often with a mix of both types of methodologies.

This study explores how some kinds of ICT uses, as well as social capital and other means of access to knowledge resources, are related to company performance in a knowledge-intensive business cluster. Data were collected through a survey of companies in the Medicon Valley biotech region located in Denmark and Southern Sweden. Responding companies included established producers of biotechnologyrelated products as well as small biotechnology start-up firms emphasizing research and development. The results suggest that when ICT use was aimed at accessing and enhancing human and intellectual capital, such as use of online databases for recruitment, intranets to enhance employee access to information and education, and collaborative tools to connect with off-premise researchers, companies reported better performance outcomes. Social capital in the form of connections to people who can provide access to information and opportunity predicted company performance, particularly for small start-up companies. The pattern of results complements prior work that establishes the importance of social capital in regional business clusters by demonstrating how ICT use complements personal relationships to enhance the likelihood of success among companies in the region.

PurposeThe paper aims to provide an insight about factors affecting business‐to‐business e‐commerce adoption and implementation in small to medium‐sized enterprises (SMEs), highlighting similarities and differences between Danish and Australian SMEs.Design/methodology/approachThe research is based on a wide literature review, focused on proposing a theoretical model of technological, environmental and organisational factors influencing e‐commerce adoption and implementation. Subsequently, a questionnaire based on the research model has been developed and face‐to‐face interviews were conducted in Danish and Australian companies.FindingsThe findings both corroborate previous results about significant factors affecting SMEs' business‐to‐business e‐commerce adoption and implementation and provide new, interesting insights. The study also finds many similarities and differences between Denmark and Australia.Research limitations/implicationsThe main limitation relates to the difficulty of generalisation of the findings to a larger population of SMEs. To overcome this, a statistical survey is planned to be conducted in the future.Practical implicationsThe results of the empirical research provide indication to SMEs interested to adopt business‐to‐business e‐commerce, large companies interested to conduct e‐commerce transactions with small and medium‐size companies and policy makers.Originality/valueThis paper both contributes to enhancing the understanding of the factors affecting business‐to‐business e‐commerce adoption and implementation in SMEs and provides some interesting perspectives from Denmark and Australia.

The concept of e-services has gained increasing use lately. There is, however, no general agreement as to the precise meaning and scope of the term. The research purpose of the present article is, therefore, to discuss the e-service concept, its strengths and scope, and thereby contribute to the general understanding and definition of the term. Furthermore, the article aims at examining one of the primary conditions for the development of e-services, namely the codification of knowledge in connection with knowledge intensive services. [Article copies are available for purchase from InfoSci-on-Demand.com]

Based on a wide-ranging literature review, we argue that the information and communications technology (ICT) infrastructure has not received adequate attention for its role in the development and maintenance of industrial clusters. This article develops expectations for how firms in an industrial cluster make use of a public, broadband ICT infrastructure, particularly in support of e-commerce applications. We further address the question of whether ICT use, by enabling stronger ties to non-cluster partners, can weaken clusters. A case study of a successful biotechnology cluster in Denmark and Sweden—the Medicon Valley—is used to explore ICT use in a knowledge-intensive cluster context. We conclude that ICT use appears to strengthen rather than weaken the Medicon Valley cluster, and that firms located within a cluster appear to gain some unique advantages from their ICT usage that are not necessarily available to firms outside the cluster.

Purpose: To evaluate the efficacy and safety of intravitreal bevacizumab in proliferative diabetic retinopathy (PDR) patients. Methods: This interventional case series study included 15 eyes of 10 patients with bilateral PDR: 13 eyes with severe PDR and active new vessels (NV) and two eyes with recurrent vitreous haemorrhages. Study eyes received a single intravitreal injection of 1.25 mg (0.05 ml) bevacizumab. All eyes were followed up for 3 months, and eight of them for 9 months. Reinjection was performed in three eyes 4–6 months after the first injection. Study eyes were evaluated by fluorescein angiography at baseline, 1, 3 and 9 months. Quantitative planimetric analysis (QPA) of NV area was measured before and after treatment. All eyes received or completed panretinal photocoagulation (PRP) 1 month after the first injection. Results: As early as at 1 month, all study eyes had a regression (paired t-test, P = 0.01) of QPA-estimated NV area. The eyes with recurrent vitreous haemorrhages had clearing of bleeding. These early effects were maintained at 3 months for all eyes and tended to be stable at 9 months. The fast and measurable efficacy of bevacizumab allowed a subsequent complete and safe PRP. Conclusion: Intravitreal bevacizumab did not reveal any side-effects and was effective in the regression of NV areas and the resolution of vitreous haemorrhages. This approach is potentially useful in allowing (within a planned temporal window) a safe and efficient PRP to be performed while minimizing the risk of its complications.

This study is an investigation of the environmental, organizational and technological drivers of Internet commerce adoption and implementation in small businesses. To conduct the study, the Tornatsky and Fleischer model was adopted and tested in seven small businesses located in Southern Italy. The main contribution of the study lies in the fact that it shows that the environmental context has a key role in the adoption and implementation of e-commerce in SMEs. This is over and above factors related to technology characteristics (e.g. benefits and barriers) and organizational characteristics (e.g. slack resources) that have been extensively investigated elsewhere. Environmental factors of special importance are government intervention, public administration and external pressure from competitors, suppliers and buyers.

Purpose: To verify the efficacy of 25-gauge pars plana vitrectomy (PPV) for the management of posteriorly dislocated lens material after complicated cataract extraction and to determine in what patients this approach offers the optimal benefit in terms of efficacy and safety, considering the amount of retained nuclear material and the duration of surgery. Methods: Forty eyes of 40 patients with retained lens fragments undergoing early (within 1 week) or late (within >1 week) 25-gauge PPV were retrospectively reviewed. The amount of dislocated nuclear material was graded by the surgeon intraoperatively, and the patients were divided into two groups according to the nuclear grading: group A (≤50% dropped nucleus) and group B (>50% dropped nucleus). The presence of brunescent nuclear pieces was considered. The outcomes measured included best-corrected visual acuity (BCVA) and postoperative complications such as retinal detachment, cystoid macular edema (CME) and postoperative ocular hypertension or hypotonia. Results: The patients had a mean age of 78 years. The mean preoperative logarithm of the minimum angle of resolution (logMAR) BCVA was 0.57 ± 0.24 (20/80). A significant positive correlation was found between nuclear material grade and PPV duration (R2 = 0.81, p < 0.0001). None of the patients had dislocation of brunescent nuclear pieces. On postoperative day 1, the mean postoperative intraocular pressure was 16.75 ± 2.7 mm Hg, with no case of ocular hypotonia. At 6 months of follow-up, the mean logMAR BCVA improved to 0.23 ± 0.3 (20/32). Retinal detachment developed in 4 patients (10%), occurring only in patients of group B (p < 0.002). Four patients with late PPV developed postoperative CME, with no case of CME among patients with early vitrectomy (p = 0.014). Conclusion: Removal of dislocated lens fragments after complicated cataract surgery can be effectively managed with 25-gauge PPV, although it appears to be most efficient for cases with a limited amount of dislocated lens material. In consideration of the higher rate of retinal detachment observed in cases of prolonged PPV time, the expected duration of surgery should be taken into account when choosing the best surgical approach. Visual outcomes are not affected by the timing of PPV, whereas early vitrectomy seems to prevent the onset of inflammatory macular edema.

Purpose. To report the risk of methicillin-resistantStaphylococcus aureus(MRSA) ocular infection after UVA-riboflavin corneal collagen cross-linking in a patient with atopic dermatitis.Methods. A 22-year-old man, with bilateral evolutive keratoconus and atopic dermatitis, underwent UVA-riboflavin corneal cross-linking and presented with rapidly progressive corneal abscesses and cyclitis in the treated eye five days after surgery. The patient was admitted to the hospital and treated with broad-spectrum antimicrobic therapy.Results. The patient had positive cultures for MRSA, exhibiting a strong resistance to antibiotics. Antibiotic therapy was modified and targeted accordingly. The intravitreal reaction is extinguished, but severe damage of ocular structures was unavoidable.Conclusion. Riboflavin/UVA corneal cross-linking is considered a safe procedure and is extremely effective in halting keratoconus’ progression. However, this procedure is not devoid of infectious complications, due to known risk factors and/or poor patients’ hygiene compliance in the postoperative period. Atopic dermatitis is a common disease among patients with keratoconus andStaphylococcus aureuscolonization is commonly found in patients with atopic dermatitis. Therefore, comorbidity with atopic dermatitis should be thoroughly assessed through clinical history before surgery. A clinical evaluation within three days after surgery and the imposition of strict personal hygiene rules are strongly recommended.

Electronic commerce is becoming one of the drivers of competition and is starting to play an important role in the structural change of industry. This article shows how electronic commerce might affect the Scientific, Technical and Medical publishing sector. The focus is on the electronic journal as a substitute for the paper journal, the new entrants (Internet-based), as well as their implications for the industry structure, with emphasis on disintermediation and electronic intermediation. The paper also argues that most publishers have re-engineered or are re-engineering for electronic commerce, thus operating both in the market-place and the market-space and coexisting with the new Internet-based-only publishers.

PURPOSE: The purpose of this study was to evaluate 1-year functional and structural effects of intravitreal bevacizumab for subfoveal choroidal neovascularization secondary to pathologic myopia (myopic choroidal neovascularization). METHODS: Fifteen eyes with myopic choroidal neovascularization participated in this prospective interventional, noncomparative case series. All patients were treated with one intravitreal injection of 1.25 mg bevacizumab. Retreatments were performed in case of persistent or recurrent leakage on fluorescein angiography and/or intraretinal fluid on optical coherence tomography. Evaluation of best-corrected visual acuity using Early Treatment of Diabetic Retinopathy Study criteria, MP-1 microperimetry, optical coherence tomography, and fluorescein angiography were performed before treatment and 1 month, 3 months, 6 months, and 1 year after treatment. RESULTS: After a follow-up of 12 months, best-corrected visual acuity improved on average of 0.23 logarithm of the minimum angle of resolution. Mean macular sensitivity within the central 8 degrees increased on average of 2.62 dB at 12-month postinjection. The mean number of measurement points within the central absolute scotoma reduced significantly from 12.47 before treatment to 6.27 at 1-year follow-up. An improvement of fixation stability from baseline was observed in 9 patients (60%). No treatment adverse events were evidenced. CONCLUSION: Improvement of macular sensitivity and fixation stability 1 year after intravitreal bevacizumab for myopic choroidal neovascularization suggest a stable and progressive macular function recovery. The mean treatment session was 1.53, with 53.3% of patients needing only a single intravitreal bevacizumab injection, supporting a potential long-lasting efficacy of intravitreal bevacizumab treatment.