This work presents a multiple case study analysis aimed at depicting a managerial perspective for the implementation of a transformation path towards Industry 4.0 (I4.0) in manufacturing value chain. Starting from the analysis of the literature on values and impacts of digitalization and I4.0 in operations and supply chain management, the research investigates three key dimensions to take into account when defining the digital transformation path from a managerial perspective: investments in I4.0 technologies, ability in perceiving the path towards digital transformation, and knowledge sharing. For each dimension, patterns of managerial practices and related challenges for the implementation of the I4.0 paradigm has been identified, building on the insights and experiences of different players of the manufacturing supply chain (companies, ranging from large enterprises to SMEs, service and technology providers, competence centres). The results proposed in terms of key challenges, common mistakes and best practices according to the level of digital implementation, represent an overview of reference that can support companies in understanding which are the most important issues to be addressed when facing the adoption of digital and innovative technologies.

The growing elderly population and the increased incidence of mild cognitive impairment (MCI) and Alzheimer’s disease (AD) call for the improvement of the quality and the efficacy of the healthcare and social support services. Exercise and cognitive stimulation have been demonstrated to mitigate cognitive impairment and oxidative stress (OxS) has been recognized as a factor that contributes to the advancement of neurodegenerative diseases. Taking these aspects into account, the impact of a novel virtual reality (VR)-based program combining aerobic exercise and cognitive training has been evaluated in the pilot study proposed here. Ten patients (aged 73.3 ± 5.7 years) with MCI (Mini-Mental State Examination, MMSE: 23.0 ± 3.4) were randomly assigned to either 6 weeks physical and cognitive training (EXP) or control (CTR) group. Evaluations of cognitive profile, by a neuropsychological tests battery, and OxS, by collection of blood and urine samples, were performed before and at the end of the experimental period. The assessment of the patients’ opinions toward the intervention was investigated through questionnaires. EXP group showed a tendency towards improvements in the MMSE, in visual-constructive test and visuo-spatial tests of attention, while CTR worsened. EXP group showed a greater improvement than CTR in the executive test, memory functions and verbal fluency. No statistical significance was obtained when comparing within and between both the groups, probably due to small number of subjects examined, which amplifies the effect of the slight heterogeneity in scores recorded. Despite a greater worsening of Daily Living Activities tests, all participants reported a better performance in real life, thanks to the elicited self-perceived improvement. After training intervention OxS (i.e., reactive oxygen species (ROS) production, oxidative damage of lipids and DNA) decreased resulting in significantly (range p < 0.05–0.001) lower in EXP vs. CTR group. Although not conclusive, the recorded effects in the present study are promising and suggest that this proposal would be a useful tool in support of cognitive training reducing OxS too. However, further studies on larger scale samples of patients are needed.

Natural resources are recognized among the key determinants for the improvement of wellness, and thus the development and sustainability of health tourism destinations. This study applied a systematic review to investigate the contributions mapping and analyzing under different perspectives the value of the natural resources of a destination and related activities for health tourism. The main research topics identified from a review of 52 papers include the analysis and exploitation of natural resources in health tourism, the nature-based factors considered in clustering of tourists and their motivations, the development of value offer and marketing, as well as the cultural issues. Research gaps and future directions are summarized in a research agenda laying the foundations for the development of a multidisciplinary research stream focused on nature-based health tourism. Results also represent a key reference for managers and policy makers to identify key issues, areas of intervention and practices for industry development in the health tourism destinations through an effective and sustainable exploitation of natural resources.

We present the architecture and usability evaluation of virtual reality system—“Positive Bike”—designed for improving cognitive and motor conditions in frail elderly patients. The system consists of a cycle-ergometer integrated in an immersive virtual reality system (CAVE) which allows combining motor and cognitive exercises according to a “dual-task” paradigm. We tested the usability and user’s experience of the prototype in a pilot evaluation study that involved five elderly patients. The prototype was tested in one-session training to understand the limitations and areas for improvement of our system. The evaluation consisted in (i) usability assessment using the system usability scale; (ii) evaluation of user’s engagement using the flow state scale; and (iii) expert evaluation involving interviews with domain experts. Results showed a good usability, both for system usability scale and the semi-structured interview. The level of flow (i.e., enjoyment with the task at hand) measured using the short flow state scale, was also high. Analysis of semi-structured interview carried out with domain experts provided further indications to improve the system. Overall, these findings show that, despite some limitations, the system is usable and provides an enjoyable user’s experience.

Frailty is a clinical condition affecting the elderly population which results in an increased risk of falls. Previous studies demonstrated that falls prevention programs are effective, but they suffer from low adherence, especially when subjects have to train unsupervised in their homes. To try to improve treatment adherence, virtual reality and social media have been proposed as promising strategies for the increase of users’ motivation and thus their willingness to practice. In the context of smart homes, this work presents SocialBike, a virtual reality-based application aimed at improving the clinical outcomes of older frail adults in their houses. Indeed, SocialBike is integrated in the “house of the future” framework and proposes a Dual Task training program in which the users are required to cycle on a stationary bike while recognizing target animals or objects appearing along the way. It also implements the possibility of training with other users, thus reducing the risk of social isolation. Within SocialBike, users can choose the multiplayer mode they prefer (i.e., collaborative or competitive), and are allowed to train following their own attitude. SocialBike’s validation, refinement, and business model are currently under development, and are briefly discussed as future works.

This work presents a digital-twin-based framework focused on orchestrating human-centered processes toward Industry 5.0. By including workers and their digital replicas in the loop of the digital twin, the proposed framework extends the traditional model of the factory’s digital twin, which instead does not adequately consider the human component. The overall goal of the authors is to provide a reference architecture to manufacturing companies for a digital-twin-based platform that promotes harmonization and orchestration between humans and (physical and virtual) machines through the monitoring, simulation, and optimization of their interactions. In addition, the platform enhances the interactions of the stakeholders with the digital twin, considering that the latter cannot always be fully autonomous, and it can require human intervention. The paper also presents an implemented scenario adhering to the proposed framework’s specifications, which is also validated with a real case study set in a factory plant that produces wooden furniture, thus demonstrating the validity of the overall proposed approach.