Search results for: surgical innovation

Authors: Felix Brito

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With the growth of online learning, several higher education institutions have attempted to incorporate technology in their curriculum. Successful technology implementation projects really on technology infrastructure and on the acceptance of education professionals towards innovation. This research study is aimed at illustrating the relevance of the human component in technology implementation projects in higher education by describing the Learning Management System implementation project executed by instructional designers working for a higher education institution in the southeast region of the United States. An analysis of the Transformative Leadership Theory, the Technology Acceptance Model, and the Diffusion of Innovation Process provide the support for a solid understanding of this issue and address recommendations for future technology implementation projects in higher education institutions.

Keywords: diffusion of innovation process, instructional design, leadership, learning management systems, online learning, technology acceptance model, transformative leadership theory

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Authors: Palak V. Patel, Jessica Pixley, Steven R. Feldman

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Introduction: Basal cell carcinoma (BCC) is the most common skin cancer worldwide and requires substantial resources to treat. When choosing between indicated therapies, providers consider their associated adverse effects, efficacy, cosmesis, and function preservation. The patient’s tumor burden, infiltrative risk, and risk of tumor recurrence are also considered. Treatment cost is often left out of these discussions. This can lead to financial toxicity, which describes the harm and quality of life reductions inflicted by high care costs. Methods: We studied the guidelines set forth by the American Academy of Dermatology for the treatment of BCC. A PubMed literature search was conducted to identify the costs of each recommended therapy. We discuss costs alongside treatment efficacy and side-effect profile. Results: Surgical treatment for BCC can be cost-effective if the appropriate treatment is selected for the presenting tumor. Curettage and electrodesiccation can be used in low-grade, low-recurrence tumors in aesthetically unimportant areas. The benefits of cost-conscious care are not likely to be outweighed by the risks of poor cosmesis or tumor return ($471 BCC of the cheek). When tumor burden is limited, MMS offers better cure rates and lower recurrence rates than surgical excision, and with comparable costs (MMS $1263; SE $949). Surgical excision with permanent sections may be indicated when tumor burden is more extensive or if molecular testing is necessary. The utility of surgical excision with frozen sections, which costs substantially more than MMS without comparable outcomes, is less clear (SE with frozen sections $2334-$3085). Less data exists on non-surgical treatments for BCC. These techniques cost less, but recurrence-risk is high. Side-effects of nonsurgical treatment are limited to local skin reactions, and cosmesis is good. Cryotherapy, 5-FU, and MAL-PDT are all more affordable than surgery, but high recurrence rates increase risk of secondary financial and psychosocial burden (recurrence rates 21-39%; cost $100-270). Radiation therapy offers better clearance rates than other nonsurgical treatments but is associated with similar recurrence rates and a significantly larger financial burden ($2591-$3460 BCC of the cheek). Treatments for advanced or metastatic BCC are extremely costly, but few patients require their use, and the societal cost burden remains low. Vismodegib and sonidegib have good response rates but substantial side effects, and therapy should be combined with multidisciplinary care and palliative measures. Expert-review has found sonidegib to be the less expensive and more efficacious option (vismodegib $128,358; sonidegib $122,579). Platinum therapy, while not FDA-approved, is also effective but expensive (~91,435). Immunotherapy offers a new line of treatment in patients intolerant of hedgehog inhibitors ($683,061). Conclusion: Dermatologists working within resource-compressed practices and with resource-limited patients must prudently manage the healthcare dollar. Surgical therapies for BCC offer the lowest risk of recurrence at the most reasonable cost. Non-surgical therapies are more affordable, but high recurrence rates increase the risk of secondary financial and psychosocial burdens. Treatments for advanced BCC are incredibly costly, but the low incidence means the overall cost to the system is low.

Keywords: nonmelanoma skin cancer, basal cell skin cancer, squamous cell skin cancer, cost of care

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Authors: Garg Ramneesh, Uppal Sanjeev, Mittal Rajinder, Shah Sheerin, Jain Vikas, Singla Bhupinder

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Introduction: Despite advances in trauma care, a classification system for soft tissue injuries of the face still needs to be objectively defined. Aim: To develop a classification system for soft tissue injuries of the face; that is objective, easy to remember, reproducible, universally applicable, aids in surgical management and helps to develop a structured data that can be used for future use. Material and Methods: This classification system includes those patients that need surgical management of facial injuries. Associated underlying bony fractures have been intentionally excluded. Depending upon the severity of soft tissue injury, these can be graded from 0 to IV (O-Abrasions, I-lacerations, II-Avulsion injuries with no skin loss, III-Avulsion injuries with skin loss that would need graft or flap cover, and IV-complex injuries). Anatomically, the face has been divided into three zones (Zone 1/2/3), as per aesthetic subunits. Zone 1e stands for injury of eyebrows; Zones 2 a/b/c stand for nose, upper eyelid and lower eyelid respectively; Zones 3 a/b/c stand for upper lip, lower lip and cheek respectively. Suffices R and L stand for right or left involved side, B for presence of foreign body like glass or pellets, C for extensive contamination and D for depth which can be graded as D 1/2/3 if depth is still fat, muscle or bone respectively. I is for damage to facial nerve or parotid duct. Results and conclusions: This classification system is easy to remember, clinically applicable and would help in standardization of surgical management of soft tissue injuries of face. Certain inherent limitations of this classification system are inability to classify sutured wounds, hematomas and injuries along or against Langer’s lines.

Keywords: soft tissue injuries, face, avulsion, classification

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Authors: Wildan Maulana, Machfudz Sa'idi

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Yogyakarta is a city with the most students in Indonesia, more than 250 thousand students living in Yogyakarta and more than 140 universities in Yogyakarta. Therefore, Yogyakarta is a very strategic place for the culinary business. Food is a basic requirement of all living things, and the tasty food and cheap is the target of almost all students. The objective of this paper is to give an idea and the innovation of culinary business in Yogyakarta who apply the concept sociopreneur and technology as a tool to facilitate the course of this business. KedaiKampus is a startup that brings the food business operators such as food stalls, restaurants or angkringan (a traditional restaurant of Indonesia) and people who want to find the food with the best price and the best taste. The uniqueness of this business is offered weekly and monthly food packages for students in particular or for everyone who needs and will be delivered to their homes each every hour meal. KedaiKampus is also a marketspace for industrial and culinary houses, using technology based mobile application and website will allow the food industry to connect them with customers, but it also allows them to know the customer's desire for food trending in the market. The application to be developed is designed for ease of access to customers in finding their favorite foods and convenience for the culinary home to create amazing culinary innovation.

Keywords: marketplace, sociopreneur, culinary, meal

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Authors: Lizbeth Puerta, Enselmina Marín

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The purpose of this research is to present a survey to be applied to professors of public universities, to identify the factors that benefit or hinder the university-industry relation. Hence, this research studies some elements that integrate the variables: Knowledge management, technology management, and technology transfer; to define the existence of a relation between these variables and the industry necessities of innovation. This study is exploratory, descriptive and non-experimental. The research question is: What is the impact of the knowledge management, the technology management, and the technology transfer, made by administrative support areas of the public universities, in the industries innovation? Thus, literature review was made to identify some elements that should be considered to design a survey that allows to obtain valid information to the study variables. After this, the survey was developed, and the Content Validity Analysis was made through the Lawshe Model. The analysis indicated that the Content Validity Index (CVI) was 0.80. Hence, it was determined that this survey presents acceptable psychometric properties to be used as an evaluation tool.

Keywords: innovation, knowledge management, technology management, technology transfer

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Authors: Vasuki Rayapati, Bhanu Duggal

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Trans catheter aortic valve replacement (TAVR) is the recommended treatment over surgical aortic valve replacement (SAVR) for high-risk groups, patients >75 years of age with severe symptomatic Aortic stenosis (AS). In high income countries TAVR is more cost effective because of – i) Reduction in total length of stay including less number of days in ICU ii) Non-procedural costs like cost of general anaesthesia are higher for SAVR. In India, there are two kinds of hospitals – Public and Private. Most patients visit public sector hospitals than private sector hospitals. In a LMIC like India, especially in the Public health sector cost of TAVR is prohibitive. In a small study from three (public) hospitals in India, it was envisaged that cost of TAVR should decrease at least by 2/3 to be a cost effective option in Public health sector for severe AS.

Keywords: cost effectiveness, TAVR vs SAVR, LMIC, HTA

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Authors: Dimitra V. Peristeri, Hussameldin M. Nour, Amiya Ahsan, Sameh Abogabal, Krishna K. Singh, Muhammad Shafique Sajid

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Introduction: The use of optimal skin antiseptic agents for the prevention of surgical site infection (SSI) is of critical importance, especially during abdominal surgical procedures. Alcohol-based chlorhexidine gluconate (CHG) and aqueous-based povidone-iodine (PVI) are the two most common skin antiseptics used nowadays. The objective of this article is to evaluate the effectiveness of alcohol-based CHG versus aqueous-based PVI used for skin preparation before abdominal surgery to reduce SSIs. Methods: Standard medical databases such as MEDLINE, Embase, Pubmed, and Cochrane Library were searched to find randomised, controlled trials (RCTs) comparing alcohol-based CHG skin preparation versus aqueous-based PVI in patients undergoing abdominal surgery. The combined outcomes of SSIs were calculated using an odds ratio (OR) with 95% confidence intervals (95% CI). All data were analysed using Review Manager (RevMan) Software 5.4, and the meta-analysis was performed with a random effect model analysis. Results: A total of 11 studies, all RCTs, were included (n= 12072 participants), recruiting adult patients undergoing abdominal surgery. In the random effect model analysis, the use of alcohol-based CHG in patients undergoing abdominal surgery was associated with a reduced risk of SSI compared to aqueous-based PVI (OR: 0.84; 95% CI [0.74, 0.96], z= 2.61, p= 0.009). Conclusion: Alcohol-based CHG may be more effective for preventing the risk of SSI compared to aqueous-based PVI agents in abdominal surgery. The conclusion of this meta-analysis may add a guiding value to reinforce current clinical practice guidelines.

Keywords: skin preparation, surgical site infection, chlorhexidine, skin antiseptics

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Authors: Dae Kyung Choi, Won Man Park, Kyungsoo Kim, Yoon Hyuk Kim

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The interspinous process devices have been recently used due to its advantages such as minimal invasiveness and less subsidence of the implant to the osteoporotic bone. In this paper, we have analyzed the influences of ligature tightening of several interspinous process devices using finite element analysis. Four types of interspinous process implants were inserted to the L3-4 spinal motion segment based on their surgical protocols. Inferior plane of L4 vertebra was fixed and 7.5 Nm of extension moment were applied on superior plane of L3 vertebra with 400N of compressive load along follower load direction and pretension of the ligature. The stability of the spinal unit was high enough than that of intact model. The higher value of pretension in the ligature led the decrease of dynamic stabilization effect in cases of the WallisTM, DiamTM, Viking, and Spear®. The results of present study could be used to evaluate surgical option and validate the biomechanical characteristics of the spinal implants.

Keywords: interspinous process device, bone fracture risk, lumbar spine, finite element analysis

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Authors: Richard Mababu Mukiur

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Leadership is an important drive that plays a key role in the success and development of organizations, particularly in the current context of digital transformation, highly competitivity and globalization. Leaders are persons that hold a dominant and privileged position within an organization, field, or sector of activities and are able to manage, motivate and exercise a high degree of influence over other in order to achieve the institutional goals. They achieve commitment and engagement of others to embrace change, and to make good decisions. Leadership studies in higher education institutions have examined how effective leaders hold their organizations, and also to find approaches which fit best in the organizations context for its better management, transformation and improvement. Moreover, recent studies have highlighted the impact of leadership styles on organizational performance and innovation capacities, since some styles give better results than others. Effective leadership is part of learning process that take place through day-to-day tasks, responsibilities, and experiences that influence the organizational performance, innovation and engagement of employees. The adoption of appropriate leadership styles can improve organization results and encourage learning process, team skills and performance, and employees' motivation and engagement. In the case of case of Information Technology sector, leadership styles are particularly crucial since this sector is leading relevant changes and transformations in the knowledge society. In this context, the main objective of this study is to analyze managers leadership styles with their relation to organizational performance and innovation that may be mediated by learning organization process and demographic variables. Therefore, it was hypothesized that the transformational and transactional leadership will be the main style adopted in Information Technology sector and will influence organizational performance and innovation capacity. A sample of 540 participants from Information technology sector has been determined in order to achieve the objective of this study. The Multifactor Leadership Questionnaire was administered as the principal instrument, Scale of innovation and Learning Organization Questionnaire. Correlations and multiple regression analysis have been used as the main techniques of data analysis. The findings indicate that leadership styles have a relevant impact on organizational performance and innovation capacity. The transformational and transactional leadership are predominant styles in Information technology sector. The effective leadership style tend to be characterized by the capacity of generating and sharing knowledge that improve organization performance and innovation capacity. Managers are adopting and adapting their leadership styles that respond to the new organizational, social and cultural challenges and realities of contemporary society. Managers who encourage innovation, foster learning process, share experience are useful to the organization since they contribute to its development and transformation. Learning process capacity and demographic variables (age, gender, and job tenure) mediate the relationship between leadership styles, innovation capacity and organizational performance. The transformational and transactional leadership tend to enhance the organizational performance due to their significant impact on team-building, employees' engagement and satisfaction. Some practical implications and future lines of research have been proposed.

Keywords: leadership styles, tranformational leadership, organisational performance, organisational innovation

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Authors: Sabita Mahapatra

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‘Going green’ has been an emerging issue worldwide driving companies to continuously enhance their green capabilities and implement innovative green practices to protect the environment and improve business performance. Green has become a contemporary business environmental issue. The resource advantage theory is adopted in the present study to observe the impact of marketing orientation and green innovation practices on environmental and firm’s performance. The small and medium firms compared to large firms have different approach towards market orientation as a strategic tool. The present study proposes a conceptual framework regarding the impact of market orientation on environmental and firm’s performance through green innovation practices in the context of small and medium scale industries (SMEs). The propositions developed in the present paper would provide scope for future research study to validate the conceptual framework in the emerging economy like India.

Keywords: market orientation, green innovation practices, environment performance, corporate performance, emerging market

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Authors: Joseph Mary Ssembatya, Blessing Michael Taremwa

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Background: Multiple schwannomas are typically associated with neurofibromatosis type 1 (NF1), but rare cases occur independently of neurofibromatosis. Schwannomas are benign, slow-growing tumors, primarily affecting the cervical and lumbar spine. When large, they may extend over multiple vertebral levels, posing surgical challenges. Case Presentation: A 13-year-old Ugandan Munyankore female patient, presented with a 6-year history of progressive quadriparesis, particularly in the lower limbs. Clinical examination showed hypertonia and hyperreflexia, with no indicators of neurofibromatosis or prior trauma. MRI revealed two “kissing” schwannomas extending from C2 to T2 in the cervical spine. Decompressive surgery was performed through laminoplasty and partial lesion resection, and histology confirmed schwannoma. Two weeks postoperatively, the patient experienced cerebrospinal fluid (CSF) leakage, neck pain, and headache, which required re-operation and duraplasty. Following these interventions, the patient’s neurological status stabilized, with noted improvement in lower limb strength. Discussion: “Kissing” schwannomas are most frequently documented in the cerebellopontine angle, rarely in the spine, and even more rarely in children. While multiple schwannomas are often associated with NF2, this case had no family history or clinical signs of the disorder. Giant invasive spinal schwannomas (GISS) that span multiple vertebrae demand intricate surgical approaches due to their proximity to neurovascular structures. Conclusion: This is the first reported case of kissing cervical schwannomas in a young patient from a low- to middle-income country. Surgical decompression, though challenging, is critical for neurological recovery in such advanced cases.

Keywords: kissing schwannoma, cervical spine, low resource, young, uganda

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Authors: Sundaresan Soundararajan, Chor Ngee Tan

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Introduction: Pyogenic spondylitis, otherwise treated conservatively with long term antibiotics, would require surgical debridement and reconstruction in about 10% to 20% of cases. The classical approach adopted many surgeons have always been anterior approach in ensuring thorough and complete debridement. This, however, comes with high rates of morbidity due to the nature of its access. Direct lateral retroperitoneal approach, which has been growing in usage in degenerative lumbar diseases, has the potential in treating pyogenic spondylitis with its ease of approach and relatively low risk of complications. Aims/Objectives: The objective of this study was to evaluate the effectiveness and clinical outcome of using lateral approach surgery in the surgical management of pyogenic spondylitis of the lumbar spine. Methods: Retrospective chart analysis was done on all patients who presented with pyogenic spondylitis (lumbar discitis/vertebral osteomyelitis) and had undergone direct lateral retroperitoneal lumbar vertebral debridement and posterior instrumentation between 2014 and 2016. Data on blood loss, surgical operating time, surgical complications, clinical outcomes and fusion rates were recorded. Results: A total of 6 patients (3 male and 3 female) underwent this procedure at a single institution by a single surgeon during the defined period. One patient presented with infected implant (PLIF) and vertebral osteomyelitis while the other five presented with single level spondylodiscitis. All patients underwent lumbar debridement, iliac strut grafting and posterior instrumentation (revision of screws for infected PLIF case). The mean operating time was 308.3 mins for all 6 cases. Mean blood loss was reported at 341cc (range from 200cc to 600cc). Presenting symptom of back pain resolved in all 6 cases while 2 cases that presented with lower limb weakness had improvement of neurological deficits. One patient had dislodged strut graft while performing posterior instrumentation and needed graft revision intraoperatively. Infective markers normalized for all patients subsequently. All subjects also showed radiological evidence of fusion on 6 months follow up. Conclusions: Lateral approach in treating pyogenic spondylitis is a viable option as it allows debridement and reconstruction without the risk that comes with other anterior approaches. It allows efficient debridement, short surgical time, moderate blood loss and low risk of vascular injuries. Clinical outcomes and fusion rates by this approach also support its use as practical MIS option surgery for such infection cases.

Keywords: lateral approach, minimally invasive, pyogenic spondylitis, XLIF

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Authors: Guoqiang Yu, Mehrana Mohtasebi, Jinghong Sun, Thomas Pittman

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Malignant glioma (MG) is the most common type of primary malignant brain tumor. Surgical resection of MG remains the cornerstone of therapy, and the extent of resection correlates with patient survival. A limiting factor for resection, however, is the difficulty in differentiating the tumor from normal tissue during surgery. Fluorescence imaging is an emerging technique for real-time intraoperative visualization of MGs and their boundaries. However, most clinical-grade neurosurgical operative microscopes with fluorescence imaging ability are hampered by low adoption rates due to high cost, limited portability, limited operation flexibility, and lack of skilled professionals with technical knowledge. To overcome the limitations, we innovatively integrated miniaturized light sources, flippable filters, and a recording camera to the surgical eye loupes to generate a wearable fluorescence eye loupe (FLoupe) device for intraoperative imaging of fluorescent MGs. Two FLoupe prototypes were constructed for imaging of Fluorescein and 5-aminolevulinic acid (5-ALA), respectively. The wearable FLoupe devices were tested on tumor-simulating phantoms and patients with MGs. Comparable results were observed against the standard neurosurgical operative microscope (PENTERO® 900) with fluorescence kits. The affordable and wearable FLoupe devices enable visualization of both color and fluorescence images with the same quality as the large and expensive stationary operative microscopes. The wearable FLoupe device allows for a greater range of movement, less obstruction, and faster/easier operation. Thus, it reduces surgery time and is more easily adapted to the surgical environment than unwieldy neurosurgical operative microscopes.

Keywords: fluorescence guided surgery, malignant glioma, neurosurgical operative microscope, wearable fluorescence imaging device

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Authors: Sean McCarthy, Patrice M. Ludwig, Will Watson

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This exploratory case study explores the deployment of Social Network Analysis (SNA) in mapping community assets in an interdisciplinary, undergraduate, team-taught course focused on income insecure populations in a rural area in the US. Specifically, it analyzes how students were taught to collect data on community assets and to visualize the connections between those assets using Kumu, an SNA data visualization tool. Further, the case study shows how social network data was also collected about student teams via their written communications in Slack, an enterprise messaging tool, which enabled instructors to manage and guide student research activity throughout the semester. The discussion presents how SNA methods can simultaneously inform both community-based research and social innovation pedagogy through the use of data visualization and collaboration-focused communication technologies.

Keywords: social innovation, social network analysis, pedagogy, problem-based learning, data visualization, information communication technologies

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Authors: Venere Ferraro, Silvia Ferraris

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We live in a world pervaded by new advanced technologies that have been changing the way we live and experience the surrounded. Besides, new technologies enable product innovation at different levels. Nevertheless, innovation does not lie just in the technological development and in its hard aspects but also in the meaningful use of it for the final user. In order to generate innovative products, a new perspective is needed: The shift from an instrument-oriented view of the technology towards a broader view that includes aspects like aesthetics, acceptance, comfort, and sociability. In many businesses, the user experience of the product is considered the key battlefield to achieve product innovation. (Holland 2011) The use of new technologies is indeed useless without paying attention to the user experience. This paper presents a workshop activity conducted at Design School of Politecnico di Milano in collaboration with Chiba University and aimed at generating innovative design concepts of high-tech mask. The students were asked to design the user experience of a new mask by exploiting emerging technologies such as wearable sensors and information communication technology (ICT) for a chosen field of application: safety or sport. When it comes to the user experience, the mask is a very challenging design product, because it covers aspects of product interaction and, most important, psychological and cultural aspects related to the impact on the facial expression. Furthermore, since the mask affects the face expression quite a lot, it could be a barrier to hide with, or it could be a mean to enhance user’s communication to others. The main request for the students was to take on a user-centered approach: To go beyond the instrumental aspects of product use and usability and focus on the user experience by shaping the technology in a desirable and meaningful way for the user reasoning on the metaphorical and cultural level of the product. During the one-week workshop students were asked to face the design process through (i) the research phase: an in-deep analysis of the user and field of application (safety or sport) to set design spaces (brief) and user scenario; (ii) the idea generation, (iii) the idea development. This text will shortly go through the meaning of the product innovation, the use and application of wearable technologies and will then focus on the user experience design in contrast with the technology-driven approach in the field of product innovation. Finally authors will describe the workshop activity and the concepts developed by the students stressing the important role of the user experience design in new product development.

Keywords: product innovation, user experience, technological exploitation, wearable technologies

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Authors: Aneeq Sarwar

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This study assesses the interaction between environmental and intellectual property policy on the rate of invention of environmental inventions and specifically tests for whether there is a synergy between stricter IP regimes and stronger environmental policies. The empirical analysis uses firm and industry-level data from seven OECD countries from 2009 to 2015. We also introduce a new measure of environmental inventions using a Natural Language Processing Topic Modelling technique. We find that intellectual property policy strictness demonstrates greater effectiveness in encouraging inventiveness in environmental inventions when used in combination with stronger environmental policies. This study contributes to existing literature in two ways. First, it devises a method for better identification of environmental technologies, we demonstrate how our method is more comprehensive than existing methods as we are better able to identify not only environmental inventions, but also major components of said inventions. Second, we test how various policy regimes affect the development of environmental technologies, we are the first study to examine the interaction of the environmental and intellectual property policy on firm level innovation.

Keywords: environmental economics, economics of innovation, environmental policy, firm level

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Authors: Joanna Konstantinou

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The study is about the challenges faced by entrepreneurs in a crisis context and in turbulent economies. The scope is to determine which factors, if any, are related to the success of a new business venture, such as innovation, access to funding and capital, enhanced digital skills, employment relations and organizational culture as well as a company’s strategic orientation towards international markets. The crisis context has been recorded to have affected the number of SMEs in the Greek economy, the number of people employed as well as the volume of the output produced. Although not all SMEs have been equally impacted by the crisis, which has been identified to affect certain sectors more than others, and although research is not exhaustive in that end, employment relations and patterns, firm’s age, and innovation practices in relation to employees’ learning curve seem to have a positive correlation with the successful survival and resilience of the firm. The aim is to identify important factors that can contribute positively to the success of a startup business, and that will allow businesses to acquire resilience and survive economic adversities, and it will focus on businesses of the Greek economy, the country with the longer lasting economic crisis and the findings will be lessons to learn for other economies.

Keywords: entrepreneurship, innovation, crisis, challenges

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Authors: Oliveira M., Gonçalves L., Francisco I., Caramelo F., Vale F., Sanz D., Domingues M., Lopes M., Moreia D., Lopes T., Santos T., Cardoso H.

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The ARTHUR project consists of a platform that allows the virtual performance of maxillofacial surgeries, offering, in a photorealistic concept, the possibility for the patient to have an idea of the surgical changes before they are performed on their face. For this, the system brings together several image formats, dicoms and objs that, after loading, will generate the bone volume, soft tissues and hard tissues. The system also incorporates the patient's stereophotogrammetry, in addition to their data and clinical history. After loading and inserting data, the clinician can virtually perform the surgical operation and present the final result to the patient, generating a new facial surface that contemplates the changes made in the bone and tissues of the maxillary area. This tool acts in different situations that require facial reconstruction, however this project focuses specifically on two types of use cases: bone congenital disfigurement and acquired disfiguration such as oral cancer with bone attainment. Being developed a cloud based solution, with mobile support, the tool aims to reduce the decision time window of patient. Because the current simulations are not realistic or, if realistic, need time due to the need of building plaster models, patient rates on decision, rely on a long time window (1,2 months), because they don’t identify themselves with the presented surgical outcome. On the other hand, this planning was performed time based on average estimated values of the position of the maxilla and mandible. The team was based on averages of the facial measurements of the population, without specifying racial variability, so the proposed solution was not adjusted to the real individual physiognomic needs.

Keywords: 3D computing, image processing, image registry, image reconstruction

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Authors: Nadya Patel, Jawn Lim

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Foresight 3.0 is a synergistic methodology that encompasses systems analysis, future studies, capacity building, and forward planning. These components are interconnected, fostering a collective anticipatory intelligence that promotes societal resilience (Ravetz, 2020). However, traditional applications of these strands can often fall short, leading to missed opportunities and narrow perspectives. Therefore, Foresight 3.0 champions a holistic approach to tackling complex issues, focusing on systemic transformations and power dynamics. Businesses are pivotal in preparing the workforce for an increasingly uncertain and complex world. This necessitates the adoption of innovative tools and methodologies, such as Foresight 3.0, that can better equip young employees to anticipate and navigate future challenges. Firstly, the incorporation of its methodology into workplace training can foster a holistic perspective among employees. This approach encourages employees to think beyond the present and consider wider social, economic, and environmental contexts, thereby enhancing their problem-solving skills and resilience. This paper discusses our research on integrating Foresight 3.0's transformative principles with a newly developed Critical Design Futures (CDF) framework to equip organisations with the ability to innovate for the world's most complex social problems. This approach is grounded in 'collective forward intelligence,' enabling mutual learning, co-innovation, and co-production among a diverse stakeholder community, where business transformation and innovation are achieved.

Keywords: business transformation, innovation, foresight, critical design

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Authors: Umi Pudji Astuti, Dedi Sugandi

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The effectiveness of agricultural extension is determined by the component in the agricultural extension system among others are agricultural extension methods. Effective methods should be selected and defined based on the characteristics of the target, the resources, the materials, and the objectives to be achieved. Citrus agribusiness development in Lebong is certainly supported by the role of stakeholders and citrus farmers, as well as the proper dissemination methods. Adoption in the extension process substantially can be interpreted as the changes of behavior process such as knowledge (cognitive), attitudes (affective), and skill (psycho-motoric) in a person after receiving "innovation" from extension submitted by target communities. Knowledge and perception are needed as a first step in adopting a innovation, especially of citrus agribusiness development in Lebong. The process of Specific technology adoption is influenced by internal factors and farmer perceptions of technological innovation. Internal factors such as formal education, experience trying to farm, owned land, production farm goods. The output of this study: 1) to analyze the effectiveness of field trial methods in improving cognitive and affective farmers; 2) Knowing the relationship of adoption level and knowledge of farmers; 3) to analyze the factors that influence farmers' adoption of citrus technology innovation. The method of this study is through the survey to 40 respondents in Rimbo Pengadang Sub District, Lebong District in 2014. Analyzing data is done by descriptive and statistical parametric (multiple linear functions). The results showed that: 1) Field trip method is effective to improve the farmer knowledge (23,17% ) and positively affect the farmer attitude; 2) the knowledge level of PTKJS innovation farmers "positively and very closely related".; 3) the factors that influence the level of farmers' adoption are internal factors (education, knowledge, and the intensity of training), and external factors respondents (distance from the house to the garden and from the house to production facilities shop).

Keywords: affect, adoption technology, citrus gerga, effectiveness dissemination

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Authors: Omaymah AlAzhari

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Nomadic tribes have always had the need to relocate and build shelters, moving from one site to another in search of food, water, and natural resources. They are affected by weather and seasonal changes and consequently started innovating textiles to build better shelters. Their solutions came from the observation of their natural environment, material, and surroundings. The textile innovation of nomadic tribes has led designers to create environmentally responsive products, such as Ceginskas Lindström’s new self-shading tent membrane developed by her ‘smocking’ technique. ‘AlRahala’ Nomadic Bedouin tribes from the Middle East and North African region have used textiles as a fundamental architectural element in their tent structure, ‘Bayt AlShar’ (House of Hair). The nomadic tribe has innovated their textile to create a fabric that is more suited to change in climatic and weather conditions. Based on the research of existing literature and documents, as well as analysis of photographs and videos, to conclude that the traditional textiles and innovations done by nomadic tribes may be a rich source of information for designers, which can provide innovative solutions for manufacturing modern-day textiles.

Keywords: ‘AlRahala’ nomadic tribes, ‘Bayt AlShar’, tent structure, textile innovation

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Authors: Anny Lucrece Nlend Nkott, Ludovic Temple

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The appearance in 2012 of the CRISPR-CaS9 genome editing technique marks a turning point in the field of genetics. This technique would make it possible to create new varieties quickly and cheaply. Although some consider CRISPR-CaS9 to be revolutionary, others consider it a potential societal threat. To document the controversy, we explain the socioeconomic conditions under which this technique could be accepted for the creation of a rainfed rice variety in Madagascar. The methodological framework is based on 38 individual and semistructured interviews, a multistakeholder forum with 27 participants, and a survey of 148 rice producers. Results reveal that the acceptability of genome editing requires (i) strengthening the seed system through the operationalization of regulatory structures and the upgrading of stakeholders' knowledge of genetically modified organisms, (ii) assessing the effects of the edited variety on biodiversity and soil nitrogen dynamics, and (iii) strengthening the technical and human capacities of the biosafety body. Structural mechanisms for regulating the seed system are necessary to ensure safe experimentation of genome editing techniques. Organizational innovation also appears to be necessary. The study documents how collective learning between communities of scientists and nonscientists is a component of systemic processes of varietal innovation. This study was carried out with the financial support of the GENERICE project (Generation and Deployment of Genome-Edited, Nitrogen-use-Efficient Rice Varieties), funded by the Agropolis Foundation.

Keywords: CRISPR-CaS9, varietal innovation, seed system, innovation system

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Authors: M. Khalid Alamgir, Javed Ahsan Bhatti, M. Zafarullah Khan

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Thin film of amorphous carbon (DLC) was deposited on 316 steel using Nd: YAG laser having energy 300mJ. Pure graphite was used as a target. The vacuum in the deposition chamber was generated in the range of 10-6 mbar by turbo molecular pump. Ratio of sp3 to sp2 content shows amorphous nature of the film. This was confirmed by Raman spectra having two peaks around 1300 cm-1 i.e. D-band to 1700 cm-1 i.e. G-band. If sp3 bonding ratio is high, the films behave like diamond-like whereas, with high sp2, films are graphite-like. The ratio of sp3 and sp2 contents in the film depends upon the deposition method, hydrogen contents and system parameters. The structural study of the film was carried out by XRD. The hardness of the films as measured by Vickers hardness tester and was found to be 28 GPa. The EDX result shows the presence of carbon contents on the surface in high rate and optical microscopy result shows the smoothness of the film on substrate. The film possesses good adhesion and can be used to coat surgical instruments.

Keywords: DLC, thin film, Raman spectroscopy, XRD, EDX

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Authors: Christian T. Lystbaek

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Background: The importance of innovation management has traditionally been ascribed to private production companies, however, there is an increasing interest in public services innovation management. One of the major theoretical challenges arising from this situation is to understand public values justifying public services innovation management. However, there is not single and stable definition of public value in the literature. The research question guiding this paper is: What is the supposed added value operating in the public sphere? Methodology: The study takes an action research strategy. This is highly contextualized methodology, which is enacted within a particular set of social relations into which on expects to integrate the results. As such, this research strategy is particularly well suited for its potential to generate results that can be applied by managers. The aim of action research is to produce proposals with a creative dimension capable of compelling actors to act in a new and pertinent way in relation to the situations they encounter. The context of the study is a workshop on public services innovation within elderly care. The workshop brought together different actors, such as managers, personnel and two groups of users-citizens (elderly clients and their relatives). The process was designed as an extension of the co-construction methods inherent in action research. Scenario methods and focus groups were applied to generate dialogue. The main strength of these techniques is to gather and exploit as much data as possible by exposing the discourse of justification used by the actors to explain or justify their points of view when interacting with others on a given subject. The approach does not directly interrogate the actors on their values, but allows their values to emerge through debate and dialogue. Findings: The public values related to public services innovation management in elderly care were identified in two steps. In the first step, identification of values, values were identified in the discussions. Through continuous analysis of the data, a network of interrelated values was developed. In the second step, tracking group consensus, we then ascertained the degree to which the meaning attributed to the value was common to the participants, classifying the degree of consensus as high, intermediate or low. High consensus corresponds to strong convergence in meaning, intermediate to generally shared meanings between participants, and low to divergences regarding the meaning between participants. Only values with high or intermediate degree of consensus were retained in the analysis. Conclusion: The study shows that the fundamental criterion for justifying public services innovation management is the capacity for actors to enact public values in their work. In the workshop, we identified two categories of public values, intrinsic value and behavioural values, and a list of more specific values.

Keywords: public services innovation management, public value, co-creation, action research

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Authors: Nermeen Elbeltagy, Sara Hassan, Tamer Hosny, Mostafa Abdelaziz

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Introduction: Adequate postoperative analgesia after caesarean section (CS) is crucial as it impacts the distinct surgical recovery needs of the parturient. Over recent years, there has been increased interest in regional nerve block techniques with promising results on efficacy. These techniques reduce the need for additional analgesia, thereby lowering the incidence of drug-related side effects. As postoperative pain after cesarean is mainly due to abdominal incision, the transverses abdomenis plane ( TAP ) block is a relatively new abdominal nerve block with excellent efficacy after different abdominal surgeries, including cesarean section. Objective: The main objective is to compare ultrasound-guided TAP block provided by the anesthesiologist with TAP provided by the surgeon through a caesarean incision regarding the duration of postoperative analgesia, intensity of analgesia, timing of mobilization, and easiness of the procedure. Method: Ninety pregnant females at term who were scheduled for delivery by elective cesarean section were randomly distributed into two groups. The first group (45) received spinal anesthesia and postoperative ultrasound guided TAP block using 20ml on each side of 0.25% bupivacaine which was provided by the anesthesiologist. The second group (45) received spinal anesthesia plus a TAP block using 20ml on each side of 0.25% bupivacaine, which was provided by the surgeon through the cesarean incision. Visual Analogue Scale (VAS) was used for the comparison between the two groups. Results: VAS score after four hours was higher among the TAP block group provided by the surgeon through the surgical incision than the postoperative analgesic profile using ultrasound-guided TAP block provided by the anesthesiologist (P=0.011). On the contrary, there was no statistical difference in the patient’s dose of analgesia after four hours of the TAP block (P=0.228). Conclusion: TAP block provided through the surgical incision is safe and enhances early patient’s mobilization.

Keywords: TAP block, CS, VAS, analgesia

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Authors: Arthi Ganapathy, Rati Tandon, Saroj Kaler

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Introduction: A thorough knowledge of variations in lung anatomy is of prime significance during surgical procedures like lobectomy, pneumonectomy, and segmentectomy of lungs. The arrangement of structures in the lung hilum act as a guide in performing such procedures. The normal pattern of arrangement of hilar structures in the right lung is eparterial bronchus, pulmonary artery, hyparterial bronchus and pulmonary veins from above downwards. In the left lung, it is pulmonary artery, principal bronchus and pulmonary vein from above downwards. The arrangement of hilar structures from anterior to posterior in both the lungs is pulmonary vein, pulmonary artery, and principal bronchus. The bronchial arteries are very small and usually the posterior most structures in the hilum of lungs. Aim: The present study aims at reporting the variations in hilar anatomy (arrangement and number) of lungs. Methodology: 75 adult formalin fixed cadaveric lungs from the department of Anatomy AIIMS New Delhi were observed for variations in the lobar anatomy. Arrangement of pulmonary hilar structures was meticulously observed, and any deviation in the pattern of presentation was recorded. Results: Among the 75 adult lung specimens observed 36 specimens were of right lung and the rest of left lung. Seven right lung specimens showed only 2 lobes with an oblique fissure dividing them and one left lung showed 3 lobes. The normal pattern of arrangement of hilar structures was seen in 22 right lungs and 23 left lungs. Rest of the lung specimens (14 right and 16 left) showed a varied pattern of arrangement of hilar structures. Some of them showed alterations in the sequence of arrangement of pulmonary artery, pulmonary veins, bronchus, and others in the number of these structures. Conclusion: Alterations in the pattern of arrangement of structures in the lung hilum are quite frequent. A compromise in knowledge of such variations will result in inadvertent complications like intraoperative bleeding during surgical procedures.

Keywords: fissures, hilum, lobes, pulmonary

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Authors: Kashvi Jain, Adam Burston

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Right-wing social movements are a dominant force in American politics, as evidenced by the January 6th Insurrection, the prevalence of extremist conspiracy theories, and a nationwide surge in hate crime. Despite an abundance of scholarship on contemporary right-wing extremism, there is little scholarship that explains their rise. This paper examines how the white power movement developed through tactical innovation and strategic use of increasingly powerful digital technologies. Using qualitative content analysis of archived digital bulletin boards and websites, we examine right-wing extremists’ digital communication during three consequential time periods of tactical and technological innovation: pre-internet (1980s), web 1.0 (1990s), and web 2.0 (2000s). Our analysis suggests that right-wing activists innovatively exploited the features and affordances of digital technologies and their knowledge of free speech rights to spread supremacist collective identity and ideology. Beyond our empirical contribution, we offer policy advice that school administrators can employ to limit hate.

Keywords: leaderless resistance, technological affordances, anti-defamation league, white power movement, tactical

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Authors: Cristina Chaminade, Mandar Kulkarni, Balaji Parthasarathy, Monica Plechero

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The characteristics of a regional innovation system (RIS) and the specificity of the knowledge base of an industry may contribute to create peculiar paths for innovation and development of firms’ geographic extended innovation networks. However, the relative empirical evidence in emerging economies remains underexplored. The paper aims to fill the research gap by means of some recent qualitative research conducted in 2016 in Beijing (China) and Bangalore (India). It analyzes cases studies of firms in the new media industry, a sector that merges different IT competences with competences from other knowledge domains and that is emerging in those RIS. The results show that while in Beijing the new media sector results to be more in line with the existing institutional setting and governmental goals aimed at targeting specific social aspects and social problems of the population, in Bangalore it remains a more spontaneous firms-led process. In Beijing what matters for the development of innovation networks is the governmental setting and the national and regional strategies to promote science and technology in this sector, internet and mass innovation. The peculiarities of recent governmental policies aligned to the domestic goals may provide good possibilities for start-ups to develop innovation networks. However, due to the specificities of those policies targeting the Chinese market, networking outside the domestic market are not so promoted. Moreover, while some institutional peculiarities, such as a culture of collaboration in the region, may be favorable for local networking, regulations related to Internet censorship may limit the use of global networks particularly when based on virtual spaces. Mainly firms with already some foreign experiences and contact take advantage of global networks. In Bangalore, the role of government in pushing networking for the new media industry at the present stage is quite absent at all geographical levels. Indeed there is no particular strategic planning or prioritizing in the region toward the new media industry, albeit one industrial organization has emerged to represent the animation industry interests. This results in a lack of initiatives for sustaining the integration of complementary knowledge into the local portfolio of IT specialization. Firms actually involved in the new media industry face institutional constrains related to a poor level of local trust and cooperation, something that does not allow for full exploitation of local linkages. Moreover, knowledge-provider organizations in Bangalore remain still a solid base for the IT domain, but not for other domains. Initiatives to link to international networks seem therefore more the result of individual entrepreneurial actions aimed at acquiring complementary knowledge and competencies from different domains and exploiting potentiality in different markets. From those cases, it emerges that role of government, soft institutions and organizations in the two RIS differ substantially in the creation of barriers and opportunities for the development of innovation networks and their specific aim.

Keywords: regional innovation system, emerging economies, innovation network, institutions, organizations, Bangalore, Beijing

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Authors: Eric Lai, Sarah Lorger, David Eisinger, Richard Waugh

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Introduction: Percutaneous embolization of varicoceles has shown similar outcomes to surgery. However, there are advantages of radiological intervention as patients are not exposed to general anaesthesia, experience a quicker recovery and face a lower risk of major complications. Radiological interventions are also preferable after a failed surgical approach. We evaluate clinical outcomes of percutaneous embolization at a tertiary hospital in Sydney, Australia. Methods: Retrospective case series without a control group from a single site (Royal Prince Alfred Hospital, Sydney, Australia). A data search was performed on the interventional radiology database with the word “varicocele” between February 2017 and March 2022. 62 patients were identified. Each patient file was reviewed and included in the study if they met the inclusion criteria. Results: A total of 56 patients were included. 6 patients were excluded as they did not receive intervention after the initial diagnostic venography. Technical success was 100%. Complications were seen in 3 patients (5.3%). The complications included post-procedural pain and fever, venous perforation with no clinical adverse outcome, and a mild allergic reaction to contrast. Recurrence occurred in 3 patients (5.6%), all of whom received a successful second procedure. DISCUSSION: This study demonstrates comparable rates of technical success, complication rate and recurrence to other studies in the literature. When compared to surgical outcomes, the results were also similar. The main limitation is multiple patients lack long-term follow-up beyond 1 year, resulting in potential underestimation of the recurrence rate. Conclusion: Percutaneous embolization of varicocele is a safe alternative to surgical intervention.

Keywords: varicocele, interventional radiology, urology, radiology

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Authors: Marta Fernández Olmos, Jorge Fleta, Talia Gómez

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This article shares the results of a temporal analysis of the literature on imports of intermediate inputs based on review techniques. The aim of this paper is to identify the main lines of research, their trends, topics, and the research agenda. The internationalization field has attracted considerable scholars and practitioners’ attention in recent years and has grown, rapidly, resulting in a large body of knowledge scattered in different areas of specialization. However, there are no studies that are entirely restricted to imports, intermediate inputs and innovation performance. The performance analysis provided an updated overview of the evolution of the importing literature from 1970 to 2022 and quantitatively identified the most productive and influential journals, articles, authors, and countries. The results show that the current topics are mainly based on modes of importing, innovation performance of importing intermediate imports and collaborations. Future lines of research are identified from topics with lower co-occurrence, such as artificial intelligence, entrepreneurship, and alternative business models such as multinational enterprises (MNEs) versus non-MNEs.

Keywords: imports, intermediate inputs, innovation performance, review

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