Empowering early career pharmacists: Unleashing non-clinical competencies through pharmacy residency

INTRODUCTION

Pharmacy residency programs traditionally prioritize clinical skills development. However, non-clinical competencies, such as leadership, conducting education, and innovation, are now emerging as pivotal factors in propelling pharmacists toward excellence in practice. The extent to which these non-clinical skills are effectively fostered by residency programs remains unclear. This study aims to explore how residency programs propel the development of crucial non-clinical competencies such as leadership, conducting education, and innovation.

METHODS

Pharmacists who completed a pharmacy residency program and their preceptors from a tertiary teaching hospital took part in semi-structured interviews. Thematic analysis, employing an inductive approach and aided by NVivo software, was used to identify recurrent themes in the interview responses.

RESULTS

Competency development was shaped by four key themes: system-dependent facilitators, system-dependent barriers, individual resident attitudes, and pharmacy department influences. The structure of the residency program was perceived to strongly support competency development in conducting education. The impact on the leadership and innovation competencies development was comparatively lesser.

CONCLUSION

Pharmacy residency is perceived as effective in supporting non-clinical competency development when there is a clear structured framework with objectives and guidance for pre-defined activities and tasks known to support competency development. Ambiguity and a lack of standardized guidance in developing specific competencies were identified as factors that diminish their relevance for both residents and preceptors. To enhance residency programs, it is essential to establish clear frameworks, with pre-defined objectives and activities known to support competency development and supplement them with the necessary skills-building courses where appropriate.

Drivers of business model innovation in family firms: A dataset analysis

In recent years, both in the world of research and consulting, the concept of innovation in the business model has been gaining a lot of interest. As a result, an incipient number of scientific and popular publications are being generated, which try to delimit and explain this term, as well as work methodologies for its application in the business world. The family business field can benefit from the application of this approach. But, at the same time, it can also serve as an object of study since its special idiosyncrasy will allow to deepen the analysis of successful business models. To illustrate innovation in business models, data from 112 family firms representative of the regional economy are presented. The companies are also associated with the Murcian Association of Family Businesses (Amefmur). The collaboration with this organization has made it possible to obtain very valuable and representative information thanks to the support provided. The collection of information was carried out through an electronic survey. These data could be especially useful for establishing business recommendations for this type of companies and for analyzing other possible interrelationships of the variables available in the database.

Indigenous wisdom of a Kwatha to treat NASH: An insight into the mechanism

ETHNOPHARMACOLOGICAL RELEVANCE

Nonalcoholic fatty liver disease (NAFLD) is the most common severe liver disease globally, progressing further into nonalcoholic steatohepatitis (NASH) and hepatocellular carcinoma (HCC). Vasaguduchyadi Kwatha (VK) is an Ayurvedic formulation traditionally used to treat liver diseases and other metabolic complications. This study is an ethnopharmacological approach to unravel this indigenous remedy.

AIM OF THE STUDY

We aimed to discover the probable mechanism of action of VK against NASH in this study, using network pharmacology, molecular docking, in vitro study, and preclinical investigation.

METHODS AND RESULTS

Among the 55 components identified, 10 were confirmed based on mass, elution charecteristics, MS/MS analysis data, and fragmentation rules. Computational study indicated 92 targets involved in the central pathways of NASH, out of which only 15 targets and 9 VK constituents have significant docking scores. In vitro and in vivo analysis results showed that VK significantly reduces weight gain and improves insulin sensitivity, dyslipidemia, steatohepatitis and overall histological features of NASH compared to saroglitazar (SGZR).

CONCLUSION

Our detailed study yielded three signalling pathways related to NASH on which VK has maximum effect, bringing up a probable alternative treatment for NASH.

Health profession education hackathons: a scoping review of current trends and best practices

BACKGROUND

While the concept of hacking in education has gained traction in recent years, there is still much uncertainty surrounding this approach. As such, this scoping review seeks to provide a detailed overview of the existing literature on hacking in health profession education and to explore what we know (and do not know) about this emerging trend.

METHODS

This was a scoping review study using specific keywords conducted on 8 databases (PubMed, Embase, Scopus, Web of Science, ERIC, PsycINFO, Education Source, CINAHL) with no time limitation. To find additional relevant studies, we conducted a forward and backward searching strategy by checking the reference lists and citations of the included articles. Studies reporting the concept and application of hacking in education and those articles published in English were included. Titles, abstracts, and full texts were screened and the data were extracted by 2 authors.

RESULTS

Twenty-two articles were included. The findings are organized into two main categories, including (a) a Description of the interventions and expected outcomes and (b) Aspects of hacking in health profession education.

CONCLUSION

Hacking in health profession education refers to a positive application that has not been explored before as discovering creative and innovative solutions to enhance teaching and learning. This includes implementing new instructional methods, fostering collaboration, and critical thinking to utilize unconventional approaches.

The advancement of artificial intelligence in biomedical research and health innovation: challenges and opportunities in emerging economies

The advancement of artificial intelligence (AI), algorithm optimization and high-throughput experiments has enabled scientists to accelerate the discovery of new chemicals and materials with unprecedented efficiency, resilience and precision. Over the recent years, the so-called autonomous experimentation (AE) systems are featured as key AI innovation to enhance and accelerate research and development (R&D). Also known as self-driving laboratories or materials acceleration platforms, AE systems are digital platforms capable of running a large number of experiments autonomously. Those systems are rapidly impacting biomedical research and clinical innovation, in areas such as drug discovery, nanomedicine, precision oncology, and others. As it is expected that AE will impact healthcare innovation from local to global levels, its implications for science and technology in emerging economies should be examined. By examining the increasing relevance of AE in contemporary R&D activities, this article aims to explore the advancement of artificial intelligence in biomedical research and health innovation, highlighting its implications, challenges and opportunities in emerging economies. AE presents an opportunity for stakeholders from emerging economies to co-produce the global knowledge landscape of AI in health. However, asymmetries in R&D capabilities should be acknowledged since emerging economies suffers from inadequacies and discontinuities in resources and funding. The establishment of decentralized AE infrastructures could support stakeholders to overcome local restrictions and opens venues for more culturally diverse, equitable, and trustworthy development of AI in health-related R&D through meaningful partnerships and engagement. Collaborations with innovators from emerging economies could facilitate anticipation of fiscal pressures in science and technology policies, obsolescence of knowledge infrastructures, ethical and regulatory policy lag, and other issues present in the Global South. Also, improving cultural and geographical representativeness of AE contributes to foster the diffusion and acceptance of AI in health-related R&D worldwide. Institutional preparedness is critical and could enable stakeholders to navigate opportunities of AI in biomedical research and health innovation in the coming years.

Responsible coordination of municipal health and care services for individuals with serious mental illness: a participatory qualitative study with service users and professionals

BACKGROUND

Care coordination is crucial to ensure the health of individuals with serious mental illness. The aim of this study was to describe and analyze an inclusive innovation process for coordinating municipal health and care services for individuals with serious mental illness.

METHODS

We conducted café dialogues with professionals and service users with serious mental illness. The café dialogues engaged participants in conversation and knowledge exchange about care coordination, adressing topics of efficiency, challenges, and improvement. We used a responsible innovation framework to analyze the innovation process.

RESULTS

Responsible coordination requires promoting service users' health and ensuring communication and mutual awareness between professionals. Individual-level factors supporting responsible coordination included service users knowing their assigned professionals, personalized healthcare services, and access to meaningful activities. Provider-level factors included effective coordination routines, communication, information exchange, and professional familiarity. Results reflect professionals' and service users' perspectives on efficient care coordination, existing challenges, and measures to improve care coordination.

CONCLUSION

Café dialogues are an inclusive, participatory method that can produce insights into the responsible coordination of municipal health and care services for individuals with serious mental illness. The responsible innovation framework is helpful in identifying care coordination challenges and measures for responsible coordination.

Global Neurosurgical Challenges: a focus on Central Asia

Neurosurgical care in Central Asia is marked by significant variation across the region's five countries-Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan. This variation is influenced by factors such as limited modern technology, a shortage of neurosurgeons, and inadequate healthcare infrastructure. Despite these obstacles, there have been notable advancements in the field, particularly in Kazakhstan, where the number of neurosurgeons has increased, and specialized fields such as vascular neurosurgery and brain tumor management have seen significant progress. Other countries in the region, such as Uzbekistan, Tajikistan, and Kyrgyzstan, have also made strides in improving neurosurgical care. However, these advancements in neurosurgical care are insignificant to those seen globally which make standard neurosurgical care inaccessible to many patients in Central Asian countries due to shortages of neurosurgeons and limited facilities. The dearth of research data in some CA countries further emphasize the need for urgent intervention. Therefore, we recommend a multipronged approach involving targeted investments, policy reforms, international collaborations, and knowledge sharing is recommended to bolster neurosurgical care capabilities and expand access to essential care across Central Asia. This approach include establishing specialized neurosurgical training programs and fellowships, investing in infrastructure and technology for neurosurgical facilities, and fostering collaborations with international centers for training and research. Additionally, early introduction of neurosurgery education in medical schools, enhancing access to online education resources for neurosurgeons, and promoting the use of telemedicine for neurosurgical consultations and follow-up care are recommended.

Innovative remediation strategies for persistent organic pollutants in soil and water: A comprehensive review

Persistent organic pollutants (POPs) provide a serious threat to human health and the environment in soil and water ecosystems. This thorough analysis explores creative remediation techniques meant to address POP pollution. Persistent organic pollutants are harmful substances that may withstand natural degradation processes and remain in the environment for long periods of time. Examples of these pollutants include dioxins, insecticides, and polychlorinated biphenyls (PCBs). Because of their extensive existence, cutting-edge and environmentally friendly eradication strategies must be investigated. The most recent advancements in POP clean-up technology for soil and water are evaluated critically in this article. It encompasses a wide range of techniques, such as nanotechnology, phytoremediation, enhanced oxidation processes, and bioremediation. The effectiveness, cost-effectiveness, and environmental sustainability of each method are assessed. Case studies from different parts of the world show the difficulties and effective uses of these novel techniques. The study also addresses new developments in POP regulation and monitoring, highlighting the need of all-encompassing approaches that include risk assessment and management. In order to combat POP pollution, the integration of diverse remediation strategies, hybrid approaches, and the function of natural attenuation are also examined. Researchers, legislators, and environmental professionals tackling the urgent problem of persistent organic pollutants (POPs) in soil and water should benefit greatly from this study, which offers a complete overview of the many approaches available for remediating POPs in soil and water.

Entrepreneurship and innovation in Nigerian universities: Trends, challenges and opportunities

In a bid to improve entrepreneurial outcomes of graduates from Nigerian universities, the Nigerian government has launched a range of interventions, including a 2004 national policy mandating compulsory inclusion of entrepreneurship education in the curriculum, and support for the establishment and implementation of entrepreneurship development activities by university departments. However, not much is known about the operational nuances, challenges and impact cases that characterise the implementation of this national policy in such a vast, culturally diverse country as Nigeria. To address this lacuna, this study draws on qualitative data from five focus groups, crystalised with quantitative data from 151 students across four Nigerian Universities, to explicate the current trends, successes, and challenges of entrepreneurship development and innovation support in Nigerian universities. The paper offers recommendations on how the current policy on entrepreneurship education in Nigeria can be enhanced to improve student entrepreneurial aspirations and outcomes. It also signposts innovative pedagogic activities which could be deployed to achieve this.

Implications of corporate social responsibility on the financial and non-financial performance of the banking sector: A moderated and mediated mechanism

This study aims to investigate the influence of corporate social responsibility (CSR) on both financial and non-financial performance in the Pakistani banking sector by applying a quantitative research approach to the primary data from 405 branch managers in the Pakistani banking sector. Both financial and non-financial performance indicators are analyzed in relation to CSR practices. The CB-SEM findings of this study reveal a significant and positive correlation between CSR and both financial and non-financial performance. Our results demonstrate that CSR initiatives contribute to improved financial performance, reputation, and innovation within the sector. These findings confirm the importance of prioritizing social responsibility initiatives to enhance overall performance in the banking industry. This study provides valuable insights into the impact of CSR on performance in the context of the Pakistani banking sector. The research contributes to the existing literature by highlighting the positive relationship between CSR and financial/non-financial performance. The findings underscore the relevance of CSR practices for banks in Pakistan and emphasize the potential benefits of incorporating social responsibility initiatives into their operations. This study serves as a foundation for future research, encouraging further exploration of CSR's role in the banking industry and its implications for sustainable business practices.

Angulation and curvature of aortic landing zone affect implantation depth in transcatheter aortic valve implantation

In transcatheter aortic valve implantation (TAVI), final device position may be affected by device interaction with the whole aortic landing zone (LZ) extending to ascending aorta. We investigated the impact of aortic LZ curvature and angulation on TAVI implantation depth, comparing short-frame balloon-expanding (BE) and long-frame self-expanding (SE) devices. Patients (n = 202) treated with BE or SE devices were matched based on one-to-one propensity score. Primary endpoint was the mismatch between the intended (HPre) and the final (HPost) implantation depth. LZ curvature and angulation were calculated based on the aortic centerline trajectory available from pre-TAVI computed tomography. Total LZ curvature ( k L Z , t o t ) and LZ angulation distal to aortic annulus ( α L Z , D i s t a l ) were greater in the SE compared to the BE group (P < 0.001 for both). In the BE group, HPost was significantly higher than HPre at both cusps (P < 0.001). In the SE group, HPost was significantly deeper than HPre only at the left coronary cusp (P = 0.013). At multivariate analysis, α L Z , D i s t a l was the only independent predictor (OR = 1.11, P = 0.002) of deeper final implantation depth with a cut-off value of 17.8°. Aortic LZ curvature and angulation significantly affected final TAVI implantation depth, especially in high stent-frame SE devices reporting, upon complete release, deeper implantation depth with respect to the intended one.

Project ECHO®: a global cross-sectional examination of implementation success

BACKGROUND

Organizations implement innovations to disrupt the status quo and create value. Within sectors such as healthcare, innovations need to navigate large scale system and organizational factors to succeed. This research explores the implementation of a global innovation- Project ECHO®. Project ECHO® is a validated virtual communities of practice model organizational teams implement to build workforce capacity and capability. Project ECHO® has experienced broad global adoption, particularly within the healthcare sector, and is experiencing growth across other sectors. This study sought to examine the state of implementation success for Project ECHO® globally, to understand how these implementations compare across geographic and sectoral contexts, and understand what enablers/barriers exist for organizational teams implementing the innovation.

METHODS

An empirical study was conducted to collect data on 54 Project ECHO® implementation success indicators across an international sample. An online survey questionnaire was developed and distributed to all Project ECHO® hub organizations globally to collect data. Data was analyzed using descriptive statistics.

RESULTS

The 54 implementation success indicators measured in this survey revealed that the adoption of Project ECHO® across 13 organizations varied on a case-by-case basis, with a strong rate of adoption within the healthcare sector. Implementation teams from these organizations successfully implemented Project ECHO® within 12-18 months after completing Immersion partner launch training and operated 51 ECHO® Networks at the time of data collection. Implementation teams which liaised more regularly with ECHO® Superhub mentors often went on to launch a higher number of ECHO® Networks that were sustained over the longer term. This suggests that these implementation teams better aligned and consolidated their Project ECHO® pilots as new innovations within the local context and strategic organizational priorities. Access to research and evaluation capability, and a more automated digital client relationship management system were key limitations to showcasing implementation success outcomes experienced by the majority of implementation teams.

CONCLUSIONS

These findings make a valuable contribution to address a knowledge gap regarding how a global sample of organizations adopting Project ECHO® measured and reported their implementation successes. Key successes included pre-launch experimentation and expansion, Superhub mentorship, stakeholder engagement, and alignment to strategic priorities.

Influence of Curcuma Longa extract in citral addition on functional properties of thin films with triple-layer structure based on furcellaran and gelatin

In this study, we obtained triple-layer films based on furcellaran and gelatin, in which the middle layer was enriched with extract of Curcuma longa in citral. This newly developed material underwent a comprehensive characterisation process to identify significant improvements in its functional properties. Both SEM, XRD and FTIR analyzes indicated the formation of interactions not only between the components but also between the film layers. Notably, the incorporation of the natural extract led to a significant reduction in solubility, decreasing it from 74.79 % to 57.25 %, while enhancing thermal stability expressed as a melting point elevating it from 147.10 °C in the control film to 158.80 °C in the film with the highest concentration of the active ingredient. Simultaneously, the addition of this active ingredient resulted in decreased water contact angle (WCA) values, rendering the film more hydrophilic. The produced films exhibit great promise as packaging materials, particularly within the food industry, and the conducted research is marked by its forward-looking and developmental approach.

Waste to resource recovery at a marina: Empirical evidence of upstream and downstream innovation for circularity

In 2021, an Australian research centre partnered with a regional marina and shipyard where 90 businesses build, refit, and maintain boats in premium condition. Tenants and owners grapple with environmental waste management issues. Since there is a gap in applying action research but numerous calls to co-produce solutions and participate in translating ideas into practice, action research was used in this case study involving upstream and downstream innovation for circularity. Mixed methods data was collected through interviews, stakeholder workshops, and waste audits. A strategic action plan was created for closing the loop on waste. Interventions included tackling toxic, degradable products with natural alternatives, trading and remanufacturing materials to extend product life cycles, testing problematic materials, and pursuing product stewardship. This study is novel because it extends diffusion of innovation theory to real-world impact through a co-innovation process. Results underscore that ongoing achievements depend on properly sorting waste, accessing reprocessing facilities, and maintaining dedicated staff and partnerships, especially legislative support for making continuous improvement.

Total Nasal Reconstruction: Advances in Free Tissue Transfer for Internal Lining and Structural Support

Total nasal reconstruction is a complex challenge due to the need to establish new internal lining, internal structural support, and external skin covering that is both functional and esthetic. The medial femoral condyle corticoperiosteal free flap represents an innovative option for restoration internal structure and internal nasal lining. When used in conjunction with a paramedian forehead flap, acceptable results in both function and esthetics can be achieved.

Environmental corporate social responsibility practices and firm innovation: Complementarities and empirical evidence from Spanish firms

This study examines the complementarity effect of combining different types of environmental corporate social responsibility (ECSR) practices on firm innovation. We apply the complementarity approach to test whether the adoption of different ECSR practices (i.e. practices for fewer materials per unit produced [materials], less energy per unit produced [energy], or decreasing environmental impact [impact]) generates super-additive effects on firms' innovation, measured by innovations type: adoption, new-to-the-market, and new-to-the-firm innovation. We use data from the Spanish Community Innovation Survey for the period 2009-2014. The results show that the best combination of ECSR practices depends on the innovation type. For innovation adoption, all possible combinations of the three practices produce super-additive effects; however, the complementarity patterns differ for new-to-the-market and new-to-the-firm innovations. For new-to-the-market innovation, energy practices appear to be a key factor in fostering innovation when combined with materials or impact practices. For new-to-the-firm innovation, the combination of these three ECSR practices shows complementarity effects. These findings provide useful insights for the design of corporate social responsibility strategies.

What is context in knowledge translation? Results of a systematic scoping review

Knowledge Translation (KT) aims to convey novel ideas to relevant stakeholders, motivating their response or action to improve people's health. Initially, the KT literature focused on evidence-based medicine, applying findings from laboratory and clinical research to disease diagnosis and treatment. Since the early 2000s, the scope of KT has expanded to include decision-making with health policy implications.This systematic scoping review aims to assess the evolving knowledge-to-policy concepts, that is, macro-level KT theories, models and frameworks (KT TMFs). While significant attention has been devoted to transferring knowledge to healthcare settings (i.e. implementing health policies, programmes or measures at the meso-level), the definition of 'context' in the realm of health policymaking at the macro-level remains underexplored in the KT literature. This study aims to close the gap.A total of 32 macro-level KT TMFs were identified, with only a limited subset of them offering detailed insights into contextual factors that matter in health policymaking. Notably, the majority of these studies prompt policy changes in low- and middle-income countries and received support from international organisations, the European Union, development agencies or philanthropic entities.

Relationships between professional identity, motivation, and innovative ability among nursing intern students: A cross-sectional study

Objective

To explore the relationships among motivation, professional identity, and innovative ability of nursing intern students.

Background

Professional identity and innovative ability are important for nursing students' core competitiveness and care quality. During the internship, nursing students integrate theoretical knowledge and practice, and have a rapid growth. Motivation is positively associated with professional identity and innovative ability. However, there are limited studies examining the professional identity, motivation, and innovative ability of nursing intern students.

Design

A descriptive cross-sectional online study.

Methods

Students in the nursing schools in southwest and central of China were included in this study and conducted from June to July 2022. A total of 474 nursing intern students were recruited from 16 nursing schools. Research data were collected with "Participants' Demographics Form", "the Professional Identity Questionnaire for Nursing Students", "the Revised Life Goals Questionnaire", and "the Revised Multidimensional Innovative Questionnaire". Independent-sample t-tests, one-way analysis of variance, correlation coefficients, and structural equation modeling were used in data analysis. This study adhered to the STROBE guidelines.

Results

A significantly positive correlation was determined among the professional identity (67.55 ± 8.42), motivation (53.38 ± 5.54), and innovative ability (47.99 ± 5.46) of nursing students (r > 0.4, P < 0.001). Motivation had a mediating effect on professional identity and innovative ability (P = 0.003), accounting for 10.9% (0.075/0.689) of the total effect.

Conclusions

There was a positive correlation among professional identity, motivation, and innovative ability. Developing motivation and professional identity can enhance nursing intern students' ability to innovate.

Spurring SMEs' performance through business intelligence, organizational and network learning, customer value anticipation, and innovation - Empirical evidence of the creative economy sector in East Java, Indonesia

Several studies have explored firm performance in the post-Covid-19 pandemic era. However, there is not much research to find reports divulging the complex relationship dynamics between business intelligence, organizational and network learning, customer value anticipation, and creative economy-based small-medium enterprises (SMEs) performance in developing countries. This study aims to uncover the complexity of those relationships. The quantitative data were collected from 313 creative economy-based SMEs in East Java, Indonesia. Using PLS-SEM, this study disclosed that business intelligence practices could not directly impact SMEs' performance. Business intelligence will be crucial to SMEs' performance with the support of organizational learning as a mediator. The finding also confirmed the presence of serial mediation of organizational learning and innovation in the relationship between business intelligence and SMEs' performance. However, the role of network learning and innovation is also important, considering their relatively large direct impact on SMEs' performance. The theoretical implications of this research broke the boundaries of strategic management theory in resource-based view and knowledge-based view in the latest era, where creative economy-based SMEs have been able to mobilize resources to carry out business intelligence to realize innovation and high performance. Further research is suggested to explore the role of business intelligence in promoting specific performance areas, such as marketing performance, financial performance, and human resource management. In addition, it is advisable to choose more specific research subjects, including those in the culinary subsector, and pay attention to other areas, e.g., the demographics of respondents in the model as a control variable.

How to solve novel problems: the role of associative learning in problem-solving performance in wild great tits Parus major

Although problem-solving tasks are frequently used to assess innovative ability, the extent to which problem-solving performance reflects variation in cognitive skills has been rarely formally investigated. Using wild breeding great tits facing a new non-food motivated problem-solving task, we investigated the role of associative learning in finding the solution, compared to multiple other non-cognitive factors. We first examined the role of accuracy (the proportion of contacts made with the opening part of a string-pulling task), neophobia, exploration, activity, age, sex, body condition and participation time on the ability to solve the task. To highlight the effect of associative learning, we then compared accuracy between solvers and non-solvers, before and after the first cue to the solution (i.e., the first time they pulled the string opening the door). We finally compared accuracy over consecutive entrances for solvers. Using 884 observations from 788 great tits tested from 2010 to 2015, we showed that, prior to initial successful entrance, solvers were more accurate and more explorative than non-solvers, and that females were more likely to solve the task than males. The accuracy of solvers, but not of non-solvers, increased significantly after they had the opportunity to associate string pulling with the movement of the door, giving them a first cue to the task solution. The accuracy of solvers also increased over successive entrances. Our results demonstrate that variations in problem-solving performance primarily reflect inherent individual differences in associative learning, and are also to a lesser extent shaped by sex and exploratory behaviour.

Strategic aspects for the commercialization of nanomedicines

The projected growth of the nanomedicine market mirrors the increase in commercial interest and investment in the field. Yet, amidst this optimism, research efforts have often been geared towards developing innovative materials, and less on bringing these innovations to market. In this article, we present a strategic approach of 'commercialization by design' to overcome various challenges related to commercialization. This approach shifts the focus from materials-centric development to one driven by market demands, evaluating nanomedicines considering factors like reimbursement restrictions and unmet medical needs, and aiming to generate robust evidence for regulatory authorities, Health Technology Assessment bodies and Payers alike. We highlight the linkages from the market backwards to the preclinical phase, where nanomedicines are tailored to specific clinician-identified requirements. Transitioning from a technology 'push' model to one with market 'pull' will enhance the commercial success of nanomedicines.

A realistic aneurysm clipping simulation combining 3D-printed and placenta-based models-how I do it

INTRODUCTION

Neurovascular surgery, particularly aneurysm clipping, is a critical skill for aspiring neurosurgeons. However, hands-on training opportunities are limited, especially with the growing popularity of endovascular techniques. To address this challenge, we present a novel neurovascular surgical training station that combines synthetic 3D-printed models with placental vascular structures to create a semi-realistic surgical field.

METHODS

Our model consists of three components: a 3D-printed skull replica with anatomical landmarks, a malleable silicone parenchyma with a Sylvian fissure, and vascular layers (placenta). The placental vascular layer is catheterized and perfused to replicate pulsatile flow, offering a realistic aneurysm simulation. This innovative training station provides a cost-effective solution (approximately 200 USD once) without ethical constraints. Surgeons can practice essential skills such as Sylvian fissure dissection, managing anatomical constraints like bone, and achieving proximal vascular control. The model's realism allows for training in various scenarios, including clipping with different hand orientations and handling ruptures realistically.

CONCLUSION

Our neurovascular surgical station bridges the gap between existing training models, offering affordability, ecological considerations, and minimal ethical concerns. It empowers neurosurgery residents to refine their skills in handling both emergencies and elective cases under close-to-real surgical conditions, with the potential for independent practice and senior supervision.

Affective Trust in the Supervisor and Innovative Work Behavior: The Effects of Proactive Skill Development and Learning Goal Orientation

The main objective of this study was to examine the relationship between affective trust in the supervisor and innovative work behavior. In addition, this paper investigated the mediating role of proactive skill development in the affective trust - innovative work behavior relationship and the moderating role of learning goal orientation in the affective trust - proactive skill development relationship. Data for this study were collected from 220 employees drawn from four FMCG (fast moving consumer goods) companies based in Pakistan. Multiple regression analyses and the bootstrapping procedure were used to test the research hypotheses. Results revealed that proactive skill development partially mediated the effects of affective trust in the supervisor on innovative work behavior. Furthermore, we found that learning goal orientation strengthened the direct effect of affective trust in the supervisor on proactive skill development and also strengthened its indirect effect on innovative work behavior. The theoretical and practical implications of our results and the limitations of this research are discussed.

Fostering innovation and sustainable thinking in surgery: an evaluation of a surgical hackathon

INTRODUCTION

Surgery represents a major source of carbon emissions, with numerous initiatives promoting more sustainable practices. Healthcare innovation and the development of a digitally capable workforce are fundamental in leveraging technologies to tackle challenges, including sustainability in surgery.

METHODS

A surgical hackathon was organised with three major themes: (1) how to make surgery greener, (2) the future of plastic surgery in 10 years, and (3) improving healthcare outcomes using machine learning. Lectures were given on sustainability and innovation using the problem, innovation, market size, strategy and team (PIMST) framework to support their presentations, as well as technological support to translate ideas into simulations or minimum viable products. Pre- and post-event questionnaires were circulated to participants.

RESULTS

Most attendees were medical students (65%), although doctors and engineers were also present. There was a significant increase in delegates' confidence in approaching innovation in surgery (+20%, p < 0.001). Reducing waste packaging (70%), promoting recyclable material usage (56%) and the social media dimension of public perceptions towards plastic surgery (40%) were reported as the most important issues arising from the hackathon. The top three prizes went to initiatives promoting an artificial intelligence-enhanced operative pathway, instrument sterilisation and an educational platform to teach students research and innovation skills.

CONCLUSIONS

Surgical hackathons can result in significant improvements in confidence in approaching innovation, as well as raising awareness of important healthcare challenges. Future innovation events may build on this to continue to empower the future workforce to leverage technologies to tackle healthcare challenges such as sustainability.

Making more of less: using divestitures to unlock pharmaceutical innovation

Pharmaceutical managers have been encouraged to look to acquisitions and alliances for innovation. However, the literature warns that the capacity of a company to 'absorb' new knowledge is limited. Here, we introduce corporate divestitures as a tool for freeing up managerial attention. We build a sample of 349 companies, which announced 1784 divestitures and filed 63523 patents, over a 15-year period. We show that innovating companies that divest more produce more and improved patents, and those that divest to create corporate focus also produce more breakthroughs. In doing so, we introduce divestitures as an innovation tool, highlight the importance of the absorptive capacity of a company when discussing innovation, and add nuance to the discussion on external tools for innovation.

Tinkering with care: Implementing extended-release buprenorphine depot treatment for opioid dependence

We examine how extended-release buprenorphine depot (BUP-XR) is put to use and made to work in implementation practices, attending to how care practices are challenged and adapted as a long-acting technology is introduced into service in opioid agonist treatment (OAT) in Australia. Our approach is informed by ideas in science and technology studies (STS) emphasising the irreducible entanglement of care practices and technology, and in particular the concept of 'tinkering' as a practice of adaptation. To make our analysis, we draw on qualitative interview accounts (n = 19) of service providers involved in BUP-XR implementation across five sites. Our analysis considers the disruptive novelty of BUP-XR. Tinkering to make a novel technology work in practice slows down the expectation of implementation in relation to transformative innovation, despite the promise of dramatic or rapid change. Tinkering allowed for more open relations, for new care practices that departed from the routine and familiar, opening potential for how BUP-XR could be put to use and made to work in its new situation, and as its situation evolved along-with its implementation. Flexibility and openness of altering relations was, however, at times, held in tension with inflexibility and closure. This analysis identifies a concern for what is made present and what is made absent in the altered care network affected by BUP-XR, with the multiple effects of supervised daily dosing practices thrown into relief as they become absented. Tinkering to implement BUP-XR locally connects with a broader assemblage of trial and movement in the constitution of treatment. The introduction of long-acting technologies prompts new questions about embedded implementation practices, including supervised dosing, urinalysis, the time and place of psychosocial support, and how other social aspects of care might be recalibrated in drug treatment.

Cutting-edge technology and automation in the pathology laboratory

One of the goals of pathology is to standardize laboratory practices to increase the precision and effectiveness of diagnostic testing, which will ultimately enhance patient care and results. Standardization is crucial in the domains of tissue processing, analysis, and reporting. To enhance diagnostic testing, innovative technologies are also being created and put into use. Furthermore, although problems like algorithm training and data privacy issues still need to be resolved, digital pathology and artificial intelligence are emerging in a structured manner. Overall, for the field of pathology to advance and for patient care to be improved, standard laboratory practices and innovative technologies must be adopted. In this paper, we describe the state-of-the-art of automation in pathology laboratories in order to lead technological progress and evolution. By anticipating laboratory needs and demands, the aim is to inspire innovation tools and processes as positively transformative support for operators, organizations, and patients.

The "STAR WARS: The First Jedi" Program-Effects of Gamification on Psychological Well-Being of College Students

Background: College students are particularly susceptible to developing mental health problems. Gamification can be a powerful teaching strategy to favor motivation and behavioral changes for the improvement of psychological well-being. Purpose: To analyze the effect of a 14-week gamification-based physical education teaching program on psychological well-being of college students. Materials and Methods: A total of 112 college students (21.22 ± 2.55 years) were recruited and assigned to a gamification-based group or a control group. The intervention group participated in a gamification-based program under the framework of "STAR WARS" science fiction sage. Participants from this group used a mobile app with a countdown timer and the way for them to gain lifetime was by doing physical activity (PA) and formative challenges. The control group did not experience the gamification approach itself as their classes were based on traditional methodology. They were asked to maintain their usual lifestyle and were not required to do PA. Emotional intelligence, personal initiative, entrepreneurial attitude, resilience, and self-efficacy were self-reported. Results: The gamification-based group showed a significantly higher improvement of emotional intelligence (P ≤ 0.006), personal initiative (P ≤ 0.033), entrepreneurial attitude (P < 0.001), resilience (P = 0.002), and self-efficacy (P < 0.001), compared with the control group. Overall effect sizes were of medium magnitude for emotional intelligence and personal initiative, large magnitude for entrepreneurial attitude, and small magnitude for resilience and self-efficacy. Conclusion: Gamification and the use of mobile apps may become powerful teaching strategies to motivate college students toward healthier lifestyle behaviors that have psychological well-being benefits.

What Makes Us Smart?

How did humans become clever enough to live in nearly every major ecosystem on earth, create vaccines against deadly plagues, explore the oceans depths, and routinely traverse the globe at 30,000 feet in aluminum tubes while nibbling on roasted almonds? Drawing on recent developments in our understanding of human evolution, we consider what makes us distinctively smarter than other animals. Contrary to conventional wisdom, human brilliance emerges not from our innate brainpower or raw computational capacities, but from the sharing of information in communities and networks over generations. We review how larger, more diverse, and more optimally interconnected networks of minds give rise to faster innovation and how the cognitive products of this cumulative cultural evolutionary process feedback to make us individually "smarter"-in the sense of being better at meeting the challenges and problems posed by our societies and socioecologies. Here, we consider not only how cultural evolution supplies us with "thinking tools" (like counting systems and fractions) but also how it has shaped our ontologies (e.g., do germs and witches exist?) and epistemologies, including our notions of what constitutes a "good reason" or "good evidence" (e.g., are dreams a source of evidence?). Building on this, we consider how cultural evolution has organized and distributed cultural knowledge and cognitive tasks among subpopulations, effectively shifting both thinking and production to the level of the community, population, or network, resulting in collective information processing and group decisions. Cultural evolution can turn mindless mobs into wise crowds by facilitating and constraining cognition through a wide variety of epistemic institutions-political, legal, and scientific. These institutions process information and aid better decision-making by suppressing or encouraging the use of different cultural epistemologies and ontologies.

How to overcome biases against creativity: The role of familiarity with and confidence in original solutions

Despite the societal relevance of creative ideas, humans favor traditional over more original solutions, conceivably because of the increased uncertainty that comes with trying novel approaches. Here, we tested whether this anti-creativity bias can be counteracted by increasing familiarity with, and confidence in, creative solutions. Participants chose between creative and traditional uses for given objects. In study 1 (N = 67 international adults), these objects repeated either identically or conceptually during the experiment; and in study 2 (N = 68 international adults), choice options were either self-generated or externally provided. Spatial and temporal measures of response selection indicated an implicit bias towards the traditional approach, independent of repetition type (study 1). This attraction towards the norm was also found for self-generated creative ideas, but it was considerably reduced compared to other-generated ideas (study 2). Instead of increasing familiarity, building confidence in creative solutions might thus be the key to reduce corresponding uncertainty and promote successful creative ideation.

Drivers of employment dynamics of AI innovators

Based on an analysis of companies developing artificial intelligence (AI) technologies, this study offers fresh evidence on the role of innovation as one of the drivers of employment growth. GMM-SYS estimates on a worldwide longitudinal dataset covering 4,184 firms that patented inventions involving AI technologies between 2000 and 2016 show a positive and significant impact of AI patent families on employment. The effect, presumably of product innovations, is small in magnitude and limited to service sectors and younger firms, which are at the forefront of the leaders of the AI revolution. We also detect some evidence of increasing returns, suggesting that innovative companies more focused on AI technologies are achieving larger impacts in terms of job creation.

Starting from the needs: what are the appropriate sources to co-create innovative solutions for persons with disabilities?

PURPOSE

Technical solutions could facilitate activities and participation in individuals with disabilities. For the development of solutions, hackathons are a method of interdisciplinary collaboration. For hackathon, the definition of pain points that require solutions is crucial. We aimed to determine engineers' preferences and expectations regarding pain point qualities.

METHODS

We used a collaborative approach involving individuals with disability, families, and healthcare professionals to determine pain points for use by engineering students during a disability Hackathon. A pain point bank was built using 3 upstream sources: a survey (350 responses, 20 pain points selected), interviews (8 children, 13 pain points), and a multidisciplinary workshop based on design thinking methods (45 people, 32 pain points). A fourth source was 20 adults with disabilities present during the Hackathon. Engineering students rated pain point qualities from each source in a questionnaire that included closed questions relating to predefined criteria: achievability, specificity, relevance and attractiveness and open questions to collect non-predefined quality criteria.

RESULTS

Pain points from the workshop were most frequently used (48%); followed by on-site discussions with mentors (43%), the survey (38%), and interviews (31%). On-site discussions received the highest quality ratings followed by the workshop, survey, and interviews. Three quality criteria emerged from the responses to open questions: "representative", "empathy", and "real-need".

CONCLUSIONS

To be actionable by engineers, pain points must relate to real needs, be achievable, specific, relevant and attractive but also representative and arouse empathy. We devised a checklist of qualities along with a toolbox of methods to achieve each.

Implications For RehabilitationThe first step of the development of technical solutions for children and individuals with disabilities is the identification of their needs and their adequate formulation to be submitted to technical solutions providers.Daily life needs of individuals with disability were gathered for an engineering hackathon and proposed as pain points to 400 engineering students.To facilitate the development of solutions by engineers, pain points must relate to real needs, be specific, relevant, achievable and attractive; be representative and arouse empathy; a toolbox of needs collection methods is proposed to achieve each of those qualities.Discussions with individuals with disability and health professionals should be provided.

A survey of perceptions of exposure to new technology in residents and practicing ophthalmologists

BACKGROUND

Incorporation of the rapid advances in ophthalmologic surgical and diagnostic techniques inherent in the field poses a challenge to residency training programs. This study investigates exposure to new technologies during residency and perception of its impact on practice patterns.

METHODS

Ophthalmology residents at various training levels and practicing ophthalmologists who had completed their training were invited to participate in a survey study assessing exposure to various technologies in residency and in practice. Data collection occurred from December 2022 to June 2023. Descriptive statistics were performed.

RESULTS

The study received 132 unique responses, including 63 ophthalmology residents and 69 practicing ophthalmologists. 65.2% (n = 45) of practicing ophthalmologists and 47.6% (n = 30) of current residents reported discussion/training on newly developed products on the market (e.g. premium IOLS, MIGS), was "minimally discussed but not emphasized" or "not discussed at all" in residency. 55.1% (n = 38) of practicing ophthalmologists reported that exposure to new technologies during residency did influence types of technologies employed during practice. The majority resident physicians reported enjoying being trained on newer technology and feeling more prepared for future changes in the field (95.2%, n = 60) and felt that having industry partnerships in residency enhances education and training (90.5%, n = 57).

CONCLUSIONS

Considering how to maximize exposure to newer technologies/devices during residency training is important, and may contribute to training more confident, adaptable surgeons, who are more likely to critically consider new technologies and adopt promising ones into their future clinical practice.

Which roads lead to access? A global landscape of six COVID-19 vaccine innovation models

BACKGROUND

Unequal and inequitable access to Covid-19 vaccines in low- and middle-income countries (L&MICs) was a major political, ethical and public health failure in the pandemic. However, vaccine developers' practices were not monolithic, but rather, took diverse approaches to supplying different countries, with important implications for global access.

RESULTS

Using data on R&D investments, regulatory approvals, manufacturing and purchase agreements, and vaccine deliveries, we identified six distinct innovation models that apply across the 14 COVID-19 vaccines with more international presence from 2020-2022. "Western Early Arrivers" Pfizer/BioNTech and Moderna supplied the largest volumes quickly and prioritized high-income countries (HICs) from registration to vaccine delivery. "Western Latecomers" Janssen and Novavax supplied intermediate volumes later, also prioritizing HICs but with a greater proportion to L&MICs. "Major Chinese Developers" Sinopharm and Sinovac supplied intermediate volumes early, primarily to middle-income countries (MICs). "Russian Developer" Gamaleya completed development early but ultimately supplied small volumes, primarily to middle-income countries (MICs). "Cosmopolitan Developer" Oxford/AstraZeneca supplied large volumes early to HICs and MICs at the lowest prices. Finally, "Small MIC Developers" CanSino, Bharat Biotech, Medigen, Finlay Institute and the Center for Genetic Engineering and Biotechnology (CGEB), exported relatively small volumes to a few MICs. Low-income countries (LICs) were not targeted by any developer, and received far fewer doses, later, than any other income group. Almost all developers received public funding and other forms of support, but we found little evidence that such support was leveraged to expand global access.

CONCLUSIONS

Each of the six innovation models has different implications for which countries get access to which vaccines, how quickly, and at which prices. Each offers different strengths and weaknesses for achieving equitable access. Our findings also suggest that Western firms had the greatest capacity to develop and deliver vaccines quickly during the pandemic, but such capacity is rapidly becoming more globally distributed with MICs playing a significant role, especially in supplying other MICs. Given the critical role of public support in enabling pandemic vaccine development and supply, governments have both the capacity and responsibility to craft international rules that will make responses to future pandemics more equitable and effective.

Exploring the Unknown: Evaluating ChatGPT's Performance in Uncovering Novel Aspects of Plastic Surgery and Identifying Areas for Future Innovation

BACKGROUND

Artificial intelligence (AI) has emerged as a powerful tool in various medical fields, including plastic surgery. This study aims to evaluate the performance of ChatGPT, an AI language model, in elucidating historical aspects of plastic surgery and identifying potential avenues for innovation.

METHODS

A comprehensive analysis of ChatGPT's responses to a diverse range of plastic surgery-related inquiries was performed. The quality of the AI-generated responses was assessed based on their relevance, accuracy, and novelty. Additionally, the study examined the AI's ability to recognize gaps in existing knowledge and propose innovative solutions. ChatGPT's responses were analysed by specialist plastic surgeons with extensive research experience, and quantitatively analysed with a Likert scale.

RESULTS

ChatGPT demonstrated a high degree of proficiency in addressing a wide array of plastic surgery-related topics. The AI-generated responses were found to be relevant and accurate in most cases. However, it demonstrated convergent thinking and failed to generate genuinely novel ideas to revolutionize plastic surgery. Instead, it suggested currently popular trends that demonstrate great potential for further advancements. Some of the references presented were also erroneous as they cannot be validated against the existing literature.

CONCLUSION

Although ChatGPT requires major improvements, this study highlights its potential as an effective tool for uncovering novel aspects of plastic surgery and identifying areas for future innovation. By leveraging the capabilities of AI language models, plastic surgeons may drive advancements in the field. Further studies are needed to cautiously explore the integration of AI-driven insights into clinical practice and to evaluate their impact on patient outcomes.

LEVEL OF EVIDENCE V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Custom-Made Implant Fabrication for Chin Augmentation Using Piled-Up Expanded Polytetrafluoroethylene Sheets: An Innovative Surgical Technique and Literature Review

BACKGROUND

Alloplastic chin augmentation is the most common esthetic surgical treatment to reshape the chin. However, factory-made chin implants are typically standardized rather than custom-made and have potential to cause complications. Although the fabrication of custom-made implants by using computer-assisted planning and 3D-printing technology has become widespread, the process has several disadvantages, including long preoperative prosthesis preparation times, high costs, and unsuitability for patients with asymmetric chins or those who undergo combined mandibuloplasty before implant placement. The present study developed an innovative chin augmentation technique involving stacked expanded polytetrafluoroethylene (e-PTFE) sheets that is suitable for most patients and has minimal side effects.

MATERIALS AND METHODS

A retrospective review of a single surgeon's experience was performed over a 2 year period for patients who underwent a procedure involving piled-up e-PTFE sheets for alloplastic chin augmentation. This study analyzed the outcomes, complications (temporary nerve numbness, wound infection, hematoma formation, and implant displacement), and patient satisfaction during follow-up.

RESULTS

Between January 2018 and December 2020, 38 patients underwent the procedure involving piled-up e-PTFE sheets for alloplastic chin augmentation. Six patients (15.8%) experienced nerve-related temporary numbness, and one (2.6%) experienced wound infection. None had developed major complications such as implant displacement or wound infection at follow-up. Moreover, the patients demonstrated a high level of satisfaction with the surgical results.

CONCLUSION

Piled-up e-PTFE sheets can be used to produce custom-fit porous polyethylene chin implants that result in minimal complications and a very high satisfaction rate.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Intrinsic Motivation and Institutional Limitations: Key Implementation Determinants of Psychological First Aid Training

Psychological first aid (PFA) trainings are conducted to train frontline care workers in practical and emotional support to people who have been recently affected by stressful events. The aim of this study was to describe the determinants of the implementation behavior of a PFA training strategy in Chile and to provide theoretical information on the factors that influence trainers' self-efficacy. For this purpose, the Determinants of Implementation Behavior Questionnaire, administered online to a sample of 117 PFA trainers throughout Chile, was used. The results indicate that the main facilitators for implementation originate in the intrinsic motivation of the trainers, while the barriers are mainly found in the limited institutional opportunities offered by the context. Evidence was also found on the effect of motivation and context on trainer self-efficacy. PFA trainers may need to invest a lot of psychological resources to overcome the barriers encountered during implementation.

Assessing the impact of urban planning policies on renewable energy: A case a China using the DID estimation model

The ongoing pace of urbanization poses a substantial obstacle to the concurrent progress of both financial and ecological development. Recognizing this challenge, governments globally are formulating cutting-edge strategies for urban renewal to ensure the long-term sustainability of cities. In this context, we employ a difference-in-differences model to scrutinize the intricate relationship between smart cities and the growth of renewable energy, utilizing the Chinese smart city pilot program as a pertinent experiment. This analytical approach provides novel insights into the underlying reasons behind this correlation. The research yields three noteworthy findings. Firstly, it underscores the indispensable role of pilot initiatives in smart cities for advancing the cause of renewable energy. Secondly, the study reveals a positive and beneficial interplay between creativity, economic inclusion, and the utilization of technological innovation in experimental urban programs, suggesting a potential multiplier effect. Thirdly, the local context significantly influences the impact of smart city pilots, with the dissemination of renewable energy being particularly effective in resource-rich, metropolitan, and coastal cities. Observable impacts of current smart city experiment on energy security and sustainable development are already apparent. The research findings contribute fresh perspectives to the complex challenges of sustainable energy production and urban planning, especially in developing countries like China.

Addressing the Rhino in the Room: ChatGPT Creates "Novel" Patent Ideas for Rhinoplasty

Background

OpenAI's ChatGPT can generate novel ideas for a number of applications. The aim of this study was to prompt the chatbot to generate possible innovations in aesthetic surgery relating to rhinoplasty.

Methods

ChatGPT was prompted to develop rhinoplasty patents. The resulting outputs were tabulated and categorized based on technology domain and anatomic location. A Google Patents search was conducted to find uses of the term "rhinoplasty" between 2021 and 2023. Patents not pertaining to rhinoplasty were excluded. Filed patents were compared with those generated by ChatGPT to determine predictive power.

Results

A total of 40 patents resulted from ChatGPT and 42 Google Patents from 2021 to 2023 were included. Patents generated without a detailed description command were related to preoperative planning (35%), intraoperative tools (30%), functional evaluation (15%), and 3D printing and implants (10%). Patents with a detailed description command resulted in the majority being postoperative tools (40%), followed by intraoperative tools (30%), 3D printing and implants (10%), and nonsurgical (10%) categories. The anatomic locations included the airway, dorsum, septum, and nasal tip. ChatGPT's predictive power yielded 45% for the detailed prompting, which was higher than the prompt without the detail command.

Conclusions

ChatGPT has reasonable potential to generate ideas for innovations in plastic surgery with the assistance of an experienced surgeon-innovator. With new artificial intelligence generations and updates, chatbots will continue to improve. Determining whether these technologies can assist in the later portions of the patent process beyond idea generation will be crucial.

Will Large Increases in the NIH Budget Promote More Meaningful Medical Innovation?

Kesselheim proposes doubling the NIH's budget to promote clinically meaningful pharmaceutical innovation. Since the effects of a previous doubling (from 1998-2003) were mixed, I argue that policymakers should couple future budget growth with investments in experimentation and evaluation.

Teaching cardiopulmonary resuscitation using virtual reality: A randomized study

BACKGROUND

The main functions of healthcare professionals include training and health education. In this sense, we must be able to incorporate new technologies and serious game to the teaching cardiopulmonary resuscitation.

METHODS

a multicenter, comparative and cross-sectional study was carried out to assess the learning of resuscitation of a group that was trained with the use of serious gaming with virtual reality, as compared to a control group trained with conventional classroom teaching.

RESULTS

the mean quality obtained in chest compressions for the virtual reality group was 86.1 % (SD 9.3), and 74.8 % (SD 9.5) for the control group [mean difference 11.3 % (95 % CI 6.6-16.0), p < 0.001]. Salivary Alpha-Amylase was 218.882 (SD 177.621) IU/L for the virtual reality group and 155.190 (SD 116.746) IU/L for the control group [mean difference 63.691 (95 % CI 122.998-4.385), p = 0.037].

CONCLUSION

using virtual reality and serious games can improve the quality parameters of chest compressions as compared to traditional training.

Asymmetric role of green energy, innovation, and technology in mitigating greenhouse gas emissions: evidence from India

The primary cause of environmental degradation, which poses a danger to the long-term viability of the ecosystem, is the emission of greenhouse gases (GHG). For this reason, the Glasgow Climate Pact (COP26) established a decarbonization goal in response to this ecological concern, for which all economic players have a responsibility. India is among the participants who have a target set for them to decarbonize their economies by the year 2060 via the use of green energy and the advancement of science and innovation. Nevertheless, the asymmetrical effect of green energy, technology, and innovation on India's decarbonization program was not sufficiently explored in the prior study; hence, this research aims to fill this literature vacuum by considering India's GHG emissions from 1990 to 2020 by leveraging the non-linear autoregressive distributed lag (NARDL) model. The findings reveal the asymmetric influences of variables of interest on GHG emissions during the short and long term and under positive and negative shocks. Regarding the positive shock, long-term findings demonstrate that innovation and technical know-how grow GHG emissions and accelerate environmental degradation. However, a negative shock in innovations and technological know-how is opposed to a positive shock and improving environmental conditions. Further, positive shocks in green energy boost environmental effectiveness by reducing GHG secretions in India. In contrast, the negative shock in green energy deteriorates the environment by triggering GHG releases. These factual findings compel the Indian government to prioritize green technologies in addition to green energy generation to decouple economic growth from greenhouse gas emissions and meet rising energy demands.

Research and innovation paving the way for climate neutrality in urban transport: Analysis of 362 cities on their journey to zero emissions

The EU Mission on Climate Neutral and Smart Cities is an ambitious initiative aiming to involve a wide range of stakeholders and deliver 100 climate-neutral and smart cities by 2030. We analysed the information submitted in the expressions of interest by 362 candidate cities. The majority of the cities' strategies for climate neutrality include urban transport as a main sector and combine the introduction of new technologies with the promotion of public transport and active mobility. We combined the information from the EU Mission candidate cities with data from the CORDIS and TRIMIS databases, and applied a clustering algorithm to measure proximity to foci of H2020 funding. Our results suggest that preparedness for the EU Mission is correlated with research and innovation activities on transport and mobility. Horizon 2020 activities specific to transport and mobility significantly increased the likelihood of a city to be a candidate. Among the various transport technology research pathways, smart mobility appears to have a major role in the development of solutions for climate neutrality.

Has pharmaceutical innovation reduced the average cost of U.S. health care episodes?

A number of authors have argued that technological innovation has increased U.S. health care spending. We investigate the impact that pharmaceutical innovation had on the average cost of U.S. health care episodes during the period 2000-2014, using data from the Bureau of Economic Analysis' Health Care Satellite Account and other sources. We analyze the relationship across approximately 200 diseases between the growth in the number of drugs that have been approved to treat the disease and the subsequent growth in the mean amount spent per episode of care, controlling for the growth in the number of episodes and other factors. Our estimates indicate that mean episode cost is not significantly related to the number of drugs ever approved 0-4 years before, but it is significantly inversely related to the number of drugs ever approved 5-20 years before. This delay is consistent with the fact (which we document) that utilization of a drug is relatively low during the first few years after it was approved, and that some drugs may have to be consumed for several years to have their maximum impact on treatment cost. Our estimates of the effect of pharmaceutical innovation on the average cost of health care episodes are quite insensitive to the weights used and to whether we control for 3 covariates. Our most conservative estimates imply that the drugs approved during 1986-1999 reduced mean episode cost by 4.7%, and that the drugs approved during 1996-2009 reduced mean episode cost by 2.1%. If drug approvals did not affect the number of episodes, the drugs approved during 1986-1999 would have reduced 2014 medical expenditure by about $93 billion. However, drug approvals may have affected the number, as well as the average cost, of episodes. We also estimate models of hospital utilization. The number of hospital days is significantly inversely related to the number of drugs ever approved 10-19 years before, controlling for the number of disease episodes. Our estimates imply that the drugs approved during 1984-1997 reduced the number of hospital days by 10.5%. The hospital cost reduction was larger than expenditure on the drugs.

Outcomes of a "virtual think tank" to establish collaborative leadership initiative plans ("CLIPs")

Goal

The American Association of Colleges of Pharmacy (AACP) Leadership Development Special Interest Group (LD SIG) held a one-hour "Virtual Think Tank" (VTT) interactive session in 2020 for pharmacy educators interested in leadership development. The purpose of this study was to evaluate the quantitative and qualitative outcomes of this VTT.

Methods

VTT attendees worked together in small groups created based on pre-selected common interest areas related to leadership development to create collaborative leadership initiative plans (CLIPs), which were ideas for new collaborative scholarly or programmatic initiatives.

Principal findings

Quantitative outcomes of this VTT included statistically significant increases in positive perceptions toward the organization hosting the VTT regarding networking, scholarly collaboration, educational collaboration, and professional service opportunities, as well as significant improvements in attitudes regarding engagement with the sponsoring organization. Additionally, 18.4% of VTT attendees continued communicating with CLIP groups post-VTT and 13.2% of respondents indicated that they successfully implemented the CLIP ideas that were generated during the VTT. Qualitative outcomes included findings that the two most commonly encountered barriers were insufficient traction of the initial idea and lack of time (41.9% (n = 13) for both). Other barriers included lack of alignment with priorities at 12.9% (n = 4).

Practical applications

This leadership VTT for pharmacy academicians led to development and implementation of important scholarly and programmatic outcomes, and fostered cross-institutional partnerships. Findings from this study evaluating a VTT provide a framework of expectations for other organizations seeking to implement a similar initiative.

Making research everybody's business-Innovation to introduce Foundation doctors to research

In order to train a future workforce able to meet the needs of its patients it is vital to ensure that opportunities to engage in research are inbuilt to training programmes. This strategy meets national recommendations recently published by NIHR, RCP and GMC. A nationally funded expansion of 'standard' Foundation programmes offers a unique opportunity to develop innovative new posts which include exposure to clinical research. In NHSE Midlands a pilot Foundation Year two (F2) post in Diabetes Research was implemented in August 2022, embedded into a standard Foundation programme. Subjective evaluation of the post, by F2 doctors and trainers, has been very positive and a further two posts in Research and Innovation commence August 2023 and 2024. These unique and geographically co-located programmes also aim to support the widening participation in medicine agenda. This model could be adapted within any Foundation School.

Can fintech pave the way for a transition towards low-carbon economy? Examination based on machine learning algorithm

Realizing the coordination between the economic and environmental systems through a green growth model is an important goal for China to enter the high-quality development stage. Meanwhile, financial technology (fintech) is rapidly developing in China. To explore the relationship between the two, this research uses panel data from 276 cities in China from 2011 to 2022 and empirically tests through constructing econometric models and machine learning algorithms. The empirical result shows that fintech has an impact on green growth. Specifically, there is a U-shaped relationship between fintech and green growth, meaning that before a certain stage, fintech may have a certain inhibitory effect on green growth. After fintech exceeds a certain development level, it will promote the improvement of green growth. Further mediation tests show that innovation plays a mediating role in the impact of fintech on green growth. Additionally, this research also conducts consistency tests based on different criteria including the location, scale, and financial development level of cities. Based on the research findings, policy suggestions are proposed in this paper to promote the development of fintech and stimulate the growth of the green economy. Overall, our research sheds more light on the fintech-green growth linkage and provides new insights into comprehending the role of fintech in advancing towards a low-carbon economy.

Challenges experienced by pediatric nurses in the process of developing innovative products: A qualitative study

OBJECTIVE

As essential healthcare providers, nurses are key to contributing innovations to improve the quality of care. This study aimed to explore the challenges pediatric nurses face in developing and patenting innovative products.

METHOD

A qualitative descriptive design has been used in this study. The study sample consists of pediatric nurses who had developed innovative products and successfully obtained product registrations. Purposive sampling was used to select 17 pediatric nurses who met the inclusion criteria. Data were collected through semi-structured, individual, in-depth interviews.

RESULTS

Two main themes and two related subthemes were identified. The first main theme is 'product development and management challenges.' The subthemes of this theme are 'unknown ecosystem' and 'burnout.' The second theme is 'protecting ideas and innovation.' The subthemes of this theme are 'fear of idea theft' and 'dead patents.'

CONCLUSION

Nurses face challenges, such as taking part in an unfamiliar innovation ecosystem, burnout due to long processes, and fear of idea theft. At the same time, commercialization of these innovations and market demand emerge as additional challenges.

PRACTICE IMPLICATIONS

Identifying the challenges experienced by pediatric nurses during the innovation process can help to develop strategies to overcome difficulties, create an innovation culture, and increase the quality of pediatric patient care.