Search results for: innovation outcomes

Authors: John Ayisi, Gideon M. Kivengea, George A. Ombakho

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In this emerging era of knowledge economy, universities, as major centres of learning and research, are becoming increasingly important as sources of ideas, knowledge, skills, innovation and technological advances. These ideas can be turned into new products, processes and systems needed to drive their respective national economies, and thus placing universities at the centre of the national innovation systems. Thus, commercialization of research outputs from universities to industry has become an area of strong policy interest in African countries. To assess the level of commercialization of research outputs in Kenyan universities, a standardized questionnaire covering seven sub-sections, namely: University Commercialization Environment, Management of Commercialization Activities, Commercialization Office, Intellectual Property Rights (IPRs), Early Stage Financing and Venture Capital; Industrial Linkages; and Technology Parks and Incubators was administered among a few selected public and private universities. Results show that all the universities have a strategic plan; though not all have innovation and commercialization as part of it. Half the nineteen surveyed universities indicated they have created designated offices for fostering commercialization. Majority have guidelines on IPRs which advocate IP to be co-owned by researcher/university. University-industry linkages are weak. Most universities are taking precursory steps to incentivise and encourage entrepreneurial activities among their academic staff and students, even though the level of resources devoted to them is low. It is recommended that building capacity in entrepreneurship among staff and students and committing more resources to R&D activities hold potential to increased commercialization of university research outputs.

Keywords: commercialization, knowledge, R&D, university

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Authors: Sushma Tejwani, Shoruba Dinakaran, Rupa Rokhade, K. Bhujang Shetty

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Introduction and aim: One of the major causes for failure of trabeculectomy is fibrosis and scarring of subconjunctival tissue around the bleb, and hence intra operative usage of anti-fibrotic agents like Mitomycin C (MMC) has become very popular. However, the long term effects of MMC like thin, avascular bleb, hypotony, bleb leaks and late onset endophthalmitis cannot be ignored, and may preclude its usage in routine trabeculectomy. In this particular study we aim to study the outcomes of trabeculectomy with and without MMC in uncomplicated glaucoma patients. Methods: Retrospective study of series of patients that underwent trabeculectomy with or without cataract surgery in glaucoma department of a tertiary eye care centre by a single surgeon for primary open angle glaucoma (POAG), angle closure glaucoma (PACG), Pseudoexfoliation glaucoma (PXF glaucoma). Patients with secondary glaucoma, juvenile and congenital glaucoma were excluded; also patients undergoing second trabeculectomy were excluded. The outcomes were studied in terms of IOP control at 1 month, 6 months, and 1 year and were analyzed separately for surgical outcomes with and without MMC. Success was considered if IOP was < 16 mmHg on applanation tonometry. Further, the necessity of medication, 5 fluorouracil (5FU) postoperative injections, needling post operatively was noted. Results: Eighty nine patient’s medical records were reviewed, of which 58 patients had undergone trabeculectomy without MMC and 31 with MMC. Mean age was 62.4 (95%CI 61- 64), 34 were females and 55 males. MMC group (n=31): Preoperative mean IOP was 21.1mmHg (95% CI: 17.6 -24.6), and 22 patients had IOP > 16. Three out of 33 patients were on single medication and rests were on multiple drugs. At 1 month (n=27) mean IOP was 12.4 mmHg (CI: 10.7-14), and 31/33 had success. At 6 months (n=18) mean IOP was 13mmHg (CI: 10.3-14.6) and 16/18 had good outcome, however at 1 year only 11 patients were available for follow up and 91% (10/11) had success. Overall, 3 patients required medication and one patient required postoperative injection of 5 FU. No MMC group (n=58): Preoperative mean IOP was 21.9 mmHg (CI: 19.8-24.2), and 42 had IOP > 16 mmHg. 12 out of 58 patients were on single medication and rests were on multiple drugs. At 1 month (n=52) mean IOP was14.6mmHg (CI: 13.2-15.9), and 45/ 58 had IOP < 16mmHg. At 6 months (n=31) mean IOP was 13.5 mmHg (CI: 11.9-15.2) and 26/31 had success, however at 1 year only 23 patients came for follow up and of these 87% (20/23) patients had success. Overall, 1 patient required needling, 5 required 5 FU injections and 5 patients required medication. The success rates at each follow up visit were not significantly different in both the groups. Conclusion: Intra-operative MMC usage may not be required in all patients undergoing trabeculectomy, and the ones without MMC also have fairly good outcomes in primary glaucoma.

Keywords: glaucoma filtration surgery, mitomycin C, outcomes of trabeculectomy, wound modulation

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Authors: Peter J. Fusco, Dave M. Mathew, Chris Mathew, Kenneth H. Levy, Kathryn S. Varghese, Stephanie Salazar-Restrepo, Serena M. Mathew, Sofia Khaja, Eamon Vega, Mia Polizzi, Alyssa Mullane, Adham Ahmed

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Background: Laparoscopic (LS) removal of neuroblastomas in children has been reported to offer favorable outcomes compared to the conventional open thoracotomy (OT) procedure. Critical perioperative measures such as blood loss, operative time, length of stay, and time to postoperative chemotherapy have all supported laparoscopic use rather than its more invasive counterpart. Herein, a pairwise meta-analysis was performed comparing perioperative outcomes between LS and OT in thoracoabdominal neuroblastoma cases. Methods: A comprehensive literature search was performed on PubMed, Ovid EMBASE, and Scopus databases to identify studies comparing the outcomes of pediatric patients with thoracoabdominal neuroblastomas undergoing resection via OT or LS. After deduplication, 4,227 studies were identified and subjected to initial title screening with exclusion and inclusion criteria to ensure relevance. When studies contained overlapping cohorts, only the larger series were included. Primary outcomes include estimated blood loss (EBL), hospital length of stay (LOS), and mortality, while secondary outcomes were tumor recurrence, post-operative complications, and operation length. The “meta” and “metafor” packages were used in R, version 4.0.2, to pool risk ratios (RR) or standardized mean differences (SMD) in addition to their 95% confidence intervals in the random effects model via the Mantel-Haenszel method. Heterogeneity between studies was assessed using the I² test, while publication bias was assessed via funnel plot. Results: The pooled analysis included 209 patients from 5 studies (141 OT, 68 LS). Of the included studies, 2 originated from the United States, 1 from Toronto, 1 from China, and 1was from a Japanese center. Mean age between study cohorts ranged from 2.4 to 5.3 years old, with female patients occupying between 30.8% to 50% of the study populations. No statistically significant difference was found between the two groups for LOS (SMD -1.02; p=0.083), mortality (RR 0.30; p=0.251), recurrence(RR 0.31; p=0.162), post-operative complications (RR 0.73; p=0.732), or operation length (SMD -0.07; p=0.648). Of note, LS appeared to be protective in the analysis for EBL, although it did not reach statistical significance (SMD -0.4174; p= 0.051). Conclusion: Despite promising literature assessing LS removal of pediatric neuroblastomas, results showed it was non-superior to OT for any explored perioperative outcomes. Given the limited comparative data on the subject, it is evident that randomized trials are necessary to further the efficacy of the conclusions reached.

Keywords: laparoscopy, neuroblastoma, thoracoabdominal, thoracotomy

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Authors: Jarrod Haar, David Brougham

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The present study explores the links between supporting employee well-being and the potential benefits to employee performance. We focus on employee innovative work behaviors (IWBs), which have three stages: (1) development, (2) adoption, and (3) implementation of new ideas and work methods. We explore the role of organizational support focusing on employee well-being via High-Performance Work Systems (HPWS). HPWS are HR practices that are designed to enhance employees’ skills, commitment, and ultimately, productivity. HPWS influence employee performance through building their skills, knowledge, and abilities and there is meta-analytic support for firm-level HPWS influencing firm performance, but less attention towards employee outcomes, especially innovation. We explore HPWS-wellbeing being offered (e.g., EAPs, well-being App, etc.) to capture organizational commitment to employee well-being. Under social exchange theory, workers should reciprocate their firm's offering of HPWS-wellbeing with greater efforts towards IWBs. Further, we explore playful work design as a mediator, which represents employees proactively creating work conditions that foster enjoyment/challenge but don’t require any design change to the job itself. We suggest HPWS-wellbeing can encourage employees to become more playful, and ultimately more innovative. Finally, beyond direct effects, we examine whether these relations are similar by gender and ultimately test a moderated mediation model. Using N=1135 New Zealand employees, we established measures with confirmatory factor analysis (CFA), and all measures had good psychometric properties (α>.80). We controlled for age, tenure, education, and hours worked and analyzed data using the PROCESS macro (version 4.2) specifically model 8 (moderated mediation). We analyzed overall IWB, and then again across the three stages. Overall, we find HPWS-wellbeing is significantly related to overall IWBs and the three stages (development, adoption, and implementation) individually. Similarly, HPWS-wellbeing shapes playful work design and playful work design predicts overall IWBs and the three stages individually. It only partially mediates the effects of HPWS-wellbeing, which retains a significant indirect effect. Moderation effects are supported, with males reporting a more significant effect from HPWS-wellbeing on playful work design but not IWB (or any of the three stages) than females. Females report higher playful work design when HPWS-wellbeing is low, but the effects are reversed when HPWS-wellbeing is high (males higher). Thus, males respond stronger under social exchange theory from HPWS-wellbeing, at least towards expressing playful work design. Finally, evidence of moderated mediation effects is found on overall IWBs and the three stages. Males report a significant indirect effect from HPWS-wellbeing on IWB (through playful work design), while female employees report no significant indirect effect. The benefits of playful work design fully account for their IWBs. The models account for small amounts of variance towards playful work design (12%) but larger for IWBs (26%). The study highlights a gap in the literature on HPWS-wellbeing and provides empirical evidence of their importance towards worker innovation. Further, gendered effects suggest these benefits might not be equal. The findings provide useful insights for organizations around how providing HR practices that support employee well-being are important, although how they work for different genders needs further exploration.

Keywords: human resource practices, wellbeing, innovation, playful work design

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Authors: Matjaž Šraml, Marko Renčelj, Tomaž Tollazzi, Chiara Gruden

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Road safety is a worldwide issue with numerous and heterogeneous factors influencing it. On the side, driver state – comprising distraction/inattention, fatigue, drowsiness, extreme emotions, and socio-cultural factors highly affect road safety. On the other side, the vehicle state has an important role in mitigating (or not) the road risk. Finally, the road environment is still one of the main determinants of road safety, defining driving task complexity. At the same time, thanks to technological development, a lot of detailed data is easily available, creating opportunities for the detection of driver state, vehicle characteristics and road conditions and, consequently, for the design of ad hoc interventions aimed at improving driver performance, increase awareness and mitigate road risks. This is the challenge faced by the i-DREAMS project. i-DREAMS, which stands for a smart Driver and Road Environment Assessment and Monitoring System, is a 3-year project funded by the European Union’s Horizon 2020 research and innovation program. It aims to set up a platform to define, develop, test and validate a ‘Safety Tolerance Zone’ to prevent drivers from getting too close to the boundaries of unsafe operation by mitigating risks in real-time and after the trip. After the definition and development of the Safety Tolerance Zone concept and the concretization of the same in an Advanced driver-assistance system (ADAS) platform, the system was tested firstly for 2 months in a driving simulator environment in 5 different countries. After that, naturalistic driving studies started for a 10-month period (comprising a 1-month pilot study, 3-month baseline study and 6 months study implementing interventions). Currently, the project team has approved a common evaluation approach, and it is developing the assessment of the usage and outcomes of the i-DREAMS system, which is turning positive insights. The i-DREAMS consortium consists of 13 partners, 7 engineering universities and research groups, 4 industry partners and 2 partners (European Transport Safety Council - ETSC - and POLIS cities and regions for transport innovation) closely linked to transport safety stakeholders, covering 8 different countries altogether.

Keywords: advanced driver assistant systems, driving simulator, safety tolerance zone, traffic safety

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Authors: Zainab A. Alaghbri, Labiba A., Esam A.

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Tuberculosis (TB) is the fourth leading cause of death in Yemen and is considered a major priority by the Ministry of Public Health. The war in Yemen has led to the emergence of one of the worst humanitarian crises in the world. These circumstances may lead to exacerbate the situation of tuberculosis. This study aims to describe the trend and incidence of TB in north and east governorates, Yemen 2019-2021 and provide recommendations for interventions. A descriptive analysis was conducted during July to September 2022. Data of TB cases were obtained from the national tuberculosis program as soft copy. The Data included the TB case collected and diagnosed during 2019-2021. The data contains the following variables: Sex, age, governorates, smear-positive cases, extra-pulmonary cases, and treatment outcomes. 16791 TB cases were notified for an overall case notification rate 65.5/100000 for all forms (smear positive and Extra-pulmonary), There was a slightly declined in 2020 and 2021 by 1%. Both the pulmonary smear positive and Extra pulmonary rates were slightly decreased from 8.8 to 7.7 and 13.5 to 12.8 / 100, 000 populations respectively. For Tuberculosis cases by type of patient, the incidence of extra-pulmonary was the highest (12,9, 11.3 and 12,2/100000) over the three years. However, the incidence of pulmonary failure was the lowest. The majority of cases were in the age group 25-34. The overall treatment success rate for smear-positive patients was 88%. Of the 627 patients with documented unsuccessful outcomes (e.g., failure, death, and default), 165 (23%) died, 52 (8.3%) failed treatment, and 410 (65%) defaulted. Overall, the magnitude of tuberculosis decreased over the periods reviewed. The proportion of Extra-pulmonary TB was the highest. The success rate achieved after treatment was below the levels established by the WHO End Tuberculosis Strategy (90%). Failure to complete treatment may be responsible for the low success rate. Monitoring and addressing the risk factors that were associated with treatment outcomes and duration may help improve the likelihood of achieving favorable outcomes among cases of smear-positive pulmonary TB.

Keywords: tuberculosis, trend, incidence, yemen

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Authors: Kwame Amoah

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Artificial intelligence (AI) has the prospect of transforming project management, significantly improving efficiency and accuracy. By automating specific tasks with defined guidelines, AI can assist project managers in making better decisions and allocating resources efficiently, with possible risk mitigation. This study explores how AI is already impacting project management and likely future AI's impact on the field. The AI's reaction has been a divided opinion; while others picture it as a destroyer of jobs, some welcome it as an innovation advocate. Both sides agree that AI will be disruptive and revolutionize PM's functions. If current research is to go by, AI or some form will replace one-third of all learning graduate PM jobs by as early as 2030. A recent survey indicates AI spending will reach $97.9 billion by the end of 2023. Considering such a profound impact, the project management profession will also see a paradigm shift driven by AI. The study examines what the project management profession will look like in the next 5-10 years after this technological disruption. The research methods incorporate existing literature, develop trend analysis, and conduct structured interviews with project management stakeholders from North America to gauge the trend. PM professionals can harness the power of AI, ensuring a smooth transition and positive outcomes. AI adoption will maximize benefits, minimize adverse consequences, and uphold ethical standards, leading to improved project performance.

Keywords: project management, disruptive teacnologies, project management function, AL applications, artificial intelligence

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Authors: Yi-Ting Chen, Yu-Fang Huang, Pei-Wei Wang, Hai-Wei Liang, Chun-Hao Lai, Mei-Lien Chen

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Background: Bisphenol A (BPA) is commonly used in consumer products, such as inner coatings of cans and polycarbonated bottles. BPA is considered to be an endocrine disrupting substance (EDs) that affects normal human hormones and may cause adverse effects on human health. Pregnant women and fetuses are susceptible groups of endocrine disrupting substances. Prenatal exposure to BPA has been shown to affect the fetus through the placenta. Therefore, it is important to evaluate the potential health risk of fetal exposure to BPA during pregnancy. The aims of this study were (1) to determine the urinary concentration of BPA in pregnant women, and (2) to investigate the association between BPA exposure during pregnancy and birth outcomes. Methods: This study recruited 117 pregnant women and their fetuses from 2012 to 2014 from the Taiwan Maternal- Infant Cohort Study (TMICS). Maternal urine samples were collected in the third trimester and questionnaires were used to collect socio-demographic characteristics, eating habits and medical conditions of the participants. Information about birth outcomes of the fetus was obtained from medical records. As for chemicals analysis, BPA concentrations in urine were determined by off-line solid-phase extraction-ultra-performance liquid chromatography coupled with a Q-Tof mass spectrometer. The urinary concentrations were adjusted with creatinine. The association between maternal concentrations of BPA and birth outcomes was estimated using the logistic regression model. Results: The detection rate of BPA is 99%; the concentration ranges (μg/g) from 0.16 to 46.90. The mean (SD) BPA levels are 5.37(6.42) μg/g creatinine. The mean ±SD of the body weight, body length, head circumference, chest circumference and gestational age at birth are 3105.18 ± 339.53 g, 49.33 ± 1.90 cm, 34.16 ± 1.06 cm, 32.34 ± 1.37 cm and 38.58 ± 1.37 weeks, respectively. After stratifying the exposure levels into two groups by median, pregnant women in higher exposure group would have an increased risk of lower body weight (OR=0.57, 95%CI=0.271-1.193), smaller chest circumference (OR=0.70, 95%CI=0.335-1.47) and shorter gestational age at birth newborn (OR=0.46, 95%CI=0.191-1.114). However, there are no associations between BPA concentration and birth outcomes reach a significant level (p < 0.05) in statistics. Conclusions: This study presents prenatal BPA profiles and infants in northern Taiwan. Women who have higher BPA concentrations tend to give birth to lower body weight, smaller chest circumference or shorter gestational age at birth newborn. More data will be included to verify the results. This report will also present the predictors of BPA concentrations for pregnant women.

Keywords: bisphenol A, birth outcomes, biomonitoring, prenatal exposure

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Authors: Nor Anisa

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This paper aims to describe the use of conservation and rehabilitation of Mangrove forests as an alternative area in protecting the natural environment and ecosystems and ecology, community education and innovation of sustainable industrial development such as oil companies, gas and coal. The existence of globalization encourages energy needs such as gas, diesel and coal as an unaffected resource which is a basic need for human life while environmental degradation and natural phenomena continue to occur in Indonesia, especially global warming, sea water pollution, extinction of animal steps. The phenomenon or damage to nature in Indonesia is caused by a population explosion in Indonesia that causes unemployment, the land where the residence will disappear so that this will encourage the exploitation of nature and the environment. Therefore, Pertamina as a state-owned oil and gas company carries out its social responsibility efforts, namely to carry out conservation and rehabilitation and management of Mangrove fruit seeds which will provide an educational effect on the benefits of Mangrove seed maintenance. The method used in this study is a qualitative method and secondary data retrieval techniques where data is taken based on Pertamina activity journals and websites that can be accounted for. So the conclusion of this paper is: the benefits and function of conservation of mangrove forests in Indonesia physically, chemically, biologically and socially and economically and can provide innovation to the CSR (Corporate Social Responsibility) of the company in continuing social responsibility in the scope of environmental conservation and social education.

Keywords: mangrove, environmental damage, conservation and rehabilitation, innovation of corporate social responsibility

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Authors: Naziema Begum Jappie

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Leadership and entrepreneurship in higher education have become critical components in navigating the evolving landscape of academia in the 21st century. This abstract explores the multifaceted relationship between leadership and entrepreneurship within the realm of higher education, emphasizing their roles in fostering innovation and sustainability. Higher education institutions, often characterized as slow-moving and resistant to change, are facing unprecedented challenges. Globalization, rapid technological advancements, changing student demographics, and financial constraints necessitate a reimagining of traditional models. Leadership in higher education must embrace entrepreneurial thinking to effectively address these challenges. Entrepreneurship in higher education involves cultivating a culture of innovation, risk-taking, and adaptability. Visionary leaders who promote entrepreneurship within their institutions empower faculty and staff to think creatively, seek new opportunities, and engage with external partners. These entrepreneurial efforts lead to the development of novel programs, research initiatives, and sustainable revenue streams. Innovation in curriculum and pedagogy is a central aspect of leadership and entrepreneurship in higher education. Forward-thinking leaders encourage faculty to experiment with teaching methods and technology, fostering a dynamic learning environment that prepares students for an ever-changing job market. Entrepreneurial leadership also facilitates the creation of interdisciplinary programs that address emerging fields and societal challenges. Collaboration is key to entrepreneurship in higher education. Leaders must establish partnerships with industry, government, and non-profit organizations to enhance research opportunities, secure funding, and provide real-world experiences for students. Entrepreneurial leaders leverage their institutions' resources to build networks that extend beyond campus boundaries, strengthening their positions in the global knowledge economy. Financial sustainability is a pressing concern for higher education institutions. Entrepreneurial leadership involves diversifying revenue streams through innovative fundraising campaigns, partnerships, and alternative educational models. Leaders who embrace entrepreneurship are better equipped to navigate budget constraints and ensure the long-term viability of their institutions. In conclusion, leadership and entrepreneurship are intertwined elements essential to the continued relevance and success of higher education institutions. Visionary leaders who champion entrepreneurship foster innovation, enhance the student experience, and secure the financial future of their institutions. As academia continues to evolve, leadership and entrepreneurship will remain indispensable tools in shaping the future of higher education. This abstract underscores the importance of these concepts and their potential to drive positive change within the higher education landscape.

Keywords: entrepreneurship, higher education, innovation, leadership

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Authors: Marita Canina, Carmen Bruno

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Digital Do It Yourself (DIY) is a contemporary socio-technological phenomenon, enabled by technological tools. The nature and potential long-term effects of this phenomenon have been widely studied within the framework of the EU funded project ‘Digital Do It Yourself’, in which the authors have created and experimented a specific Digital Do It Yourself (DiDIY) co-design process. The phenomenon was first studied through a literature research to understand its multiple dimensions and complexity. Therefore, co-design workshops were used to investigate the phenomenon by involving people to achieve a complete understanding of the DiDIY practices and its enabling factors. These analyses allowed the definition of the DiDIY fundamental factors that were then translated into a design tool. The objective of the tool is to shape design concepts by transferring these factors into different environments to achieve innovation. The aim of this paper is to present the ‘DiDIY Factor Stimuli’ tool, describing the research path and the findings behind it.

Keywords: co-design process, digital DIY, innovation, toolkit

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Authors: Chen Zhang; Qiang Wang

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With the rapid development of the new generation of digital technology, various industries have created more and more value by using digital technology, accelerating the digital transformation of various industries. The economic form of human society has evolved with the progress of technology, and in this context, the power conversion, transformation and upgrading of the manufacturing industry in terms of quality, efficiency and energy change has become a top priority. Based on the digitalization background, this paper analyzes the transformation and upgrading efficiency of the manufacturing industry and evaluates the impact of the driving factors, which have very important theoretical and practical significance. This paper utilizes qualitative research methods, entropy methods, data envelopment analysis methods and econometric models to explore the transformation and upgrading efficiency of manufacturing enterprises and driving factors. The study shows that the transformation and upgrading efficiency of the manufacturing industry shows a steady increase, and regions rich in natural resources and social resources provide certain resources for transformation and upgrading. The ability of scientific and technological innovation has been improved, but there is still much room for progress in the transformation of scientific and technological innovation achievements. Most manufacturing industries pay more attention to green manufacturing and sustainable development. In addition, based on the existing problems, this paper puts forward suggestions for improving infrastructure construction, developing the technological innovation capacity of enterprises, green production and sustainable development.

Keywords: digitization, manufacturing firms, transformation and upgrading, efficiency, driving factors

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Authors: Hamid Yazdani, Fatemeh Abbasi

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Biomimicry, where flora, fauna or entire ecosystems are emulated as a basis for design, is a growing area of research in the fields of architecture and engineering. This is due to both the fact that it is an inspirational source of possible new innovation and because of the potential it offers as a way to create a more sustainable and even regenerative built environment. The widespread and practical application of biomimicry as a design method remains however largely unrealised. A growing body of international research identifies various obstacles to the employment of biomimicry as an architectural design method. One barrier of particular note is the lack of a clear definition of the various approaches to biomimicry that designers can initially employ. Through a comparative literature review, and an examination of existing biomimetic technologies, this paper elaborates on distinct approaches to biomimetic design that have evolved. A framework for understanding the various forms of biomimicry has been developed, and is used to discuss the distinct advantages and disadvantages inherent in each as a design methodology. It is shown that these varied approaches may lead to different outcomes in terms of overall sustainability or regenerative potential. It is posited that a biomimetic approach to architectural design that incorporates an understanding of ecosystems could become a vehicle for creating a built environment that goes beyond simply sustaining current conditions to a restorative practice where the built environment becomes a vital component in the integration with and regeneration of natural ecosystems.

Keywords: biomimicry, bio-inspired design, ecology, ecomimicry, industrial ecology

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Authors: Peter Park, Alfonso Ayala, Douglas Saeks, Jordan Miller, Carmen Flores, Karen Nelson

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Introduction Hip fractures account for more than 300,000 hospital admissions every year. Many present as fragility fractures in geriatric patients with multiple medical comorbidities. Standardized protocols for the multidisciplinary management of this patient population have been shown to improve patient outcomes. A hip fracture protocol was implemented at a Level I Trauma center with a focus on pre-operative medical optimization and early surgical care. This study evaluates the efficacy of that protocol, including the early transition period. Methods A retrospective review was performed of all patients ages 60 and older with isolated hip fractures who were managed surgically between 2020 and 2022. This included patients 1 year prior and 1 year following the implementation of a hip fracture protocol at a Level I Trauma center. Results 530 patients were identified: 249 patients were treated before, and 281 patients were treated after the protocol was instituted. There was no difference in mean age (p=0.35), gender (p=0.3), or Charlson Comorbidity Index (p=0.38) between the cohorts. Following the implementation of the protocol, there were observed increases in time to surgery (27.5h vs. 33.8h, p=0.01), hospital length of stay (6.3d vs. 9.7d, p<0.001), and ED LOS (5.1h vs. 6.2h, p<0.001). There were no differences in in-hospital mortality (2.01% pre vs. 3.20% post, p=0.39) and complication rates (25% pre vs 26% post, p=0.76). A trend towards improved outcomes was seen after the early transition period but failed to yield statistical significance. Conclusion Early medical management and surgical intervention are key determining factors affecting outcomes following fragility hip fractures. The implementation of a hip fracture protocol at this institution has not yet significantly affected these parameters. This could in part be due to the restrictions placed at this institution during the COVID-19 pandemic. Despite this, the time to OR pre-and post-implementation was quicker than figures reported elsewhere in literature. Further longitudinal data will be collected to determine the final influence of this protocol. Significance/Clinical Relevance Given the increasing number of elderly people and the high morbidity and mortality associated with hip fractures in this population finding cost effective ways to improve outcomes in the management of these injuries has the potential to have enormous positive impact for both patients and hospital systems.

Keywords: hip fracture, geriatric, treatment algorithm, preoperative optimization

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Authors: Maha Salah Abdullah Ismail, Mahmoud M. Alsagheir, Mohammed Salah Abd Allah

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Acute respiratory distress syndrome (ARDS) is characterized by permeability pulmonary edema and refractory hypoxemia. Lung-protective ventilation is still the key of better outcome in ARDS. Prone position reduces the trans-pulmonary pressure gradient, recruiting collapsed regions of the lung without increasing airway pressure or hyperinflation. Prone ventilation showed improved oxygenation and improved outcomes in severe hypoxemic patients with ARDS. This study evaluates the effect of prone positioning on mechanically ventilated patients with ARDS. A quasi-experimental design was carried out at Critical Care Units, on 60 patients. Two tools were utilized to collect data; Socio demographic, medical and clinical outcomes data sheet. Results of the present study indicated that prone position improves oxygenation in patients with severe respiratory distress syndrome. The study recommended that use prone position in patients with severe ARDS, as early as possible and for long sessions. Also, replication of this study on larger probability sample at the different geographical location is highly recommended.

Keywords: acute respiratory distress syndrome, critical care, mechanical ventilation, prone position

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Authors: Saji Varghese

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Naturally dried and fallen coconut leaves and found in abundance in India and other coconut growing regions of the world. These fallen coconut leaves are usually burnt by farmers in landfills and open kitchens, leading to CO2 and particulate emissions. The innovation of biodegradable drinking straws from naturally dried and fallen coconut leaves by this researcher and his team has opened up opportunities to create value out of this agri-waste leading to i. prevention of burning of these discarded leaves ii. income generating opportunities to women in rural areas of coconut growing regions iii. an alternative to single use plastic straws. The team has developed five special purpose machines, which are deployed in the three villages on a pilot basis where 36 women are employed. The women are trained in the use of these machines, and the straws which are in good demand are sold globally. The present paper analyses the prospective impact of this innovation on the incomes of women working at the straw production centres and the consequent impact on their standards of living, The paper also analyses the impact of this innovation in the reduction of CO2 and particulate emissions and makes a case for support from Govt and Non Govt organizations in coconut growing regions to set up straw production centres to boost rural circular economy and to reduce carbon footprint and eliminate plastic pollution

Keywords: drinking straws, coconut leaves, circular economy, sustainability

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Authors: Xi Vivien Wu, Emily Neo Kim Ang, Yi Jung Tung, Wenru Wang

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Background and Objective: The increase in life expectancy and emphasis on self-reliance for the older adults are global phenomena. As such, lifelong learning in the community is considered a viable means of promoting successful and active aging. This systematic review aims to examine various lifelong learning programs for community-dwelling older adults and to synthesize the contents and outcomes of these lifelong learning programs. Methods: A systematic search was conducted in July to December 2016. Two reviewers were engaged in the process to ensure creditability of the selection process. Narrative description and analysis were applied with the support of a tabulation of key data including study design, interventions, and outcomes. Results: Eleven articles, which consisted of five randomized controlled trials and six quasi-experimental studies, were included in this review. Interventions included e-health literacy programs with the aid of computers and the Internet (n=4), computer and Internet training (n=3), physical fitness programs (n=2), music program (n=1), and intergenerational program (n=1). All studies used objective measurement tools to evaluate the outcomes of the study. Conclusion: The systematic review indicated lifelong learning programs resulted in positive outcomes in terms of physical health, mental health, social behavior, social support, self-efficacy and confidence in computer usage, and increased e-health literacy efficacy. However, the lifelong learning programs face challenges such as funding shortages, program cuts, and increasing costs. A comprehensive lifelong learning program could be developed to enhance the well-being of the older adults at a more holistic level. Empirical research can be done to explore the effectiveness of this comprehensive lifelong learning program.

Keywords: community-dwelling older adults, e-health literacy program, lifelong learning program, the wellbeing of the older adults

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Authors: Kitti Supchukun, Kris Angkanaporn, Teerapong Yata

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The product innovation using a nutraceutical delivery system on improving the growth performance of broilers is the product planning and development to solve the antibiotics banning policy incurred in the local and global livestock production system. Restricting the use of antibiotics can reduce the quality of chicken meat and increase pathogenic bacterial contamination. Although other alternatives were used to replace antibiotics, the efficacy was inconsistent, reflecting on low chicken growth performance and contaminated products. The product innovation aims to effectively deliver the selected active ingredients into the body. This product is tested on the pharmaceutical lab scale and on the farm-scale for market feasibility in order to create product innovation using the nutraceutical delivery system model. The model establishes the product standardization and traceable quality control process for farmers. The study is performed using mixed methods. Starting with a qualitative method to find the farmers' (consumers) demands and the product standard, then the researcher used the quantitative research method to develop and conclude the findings regarding the acceptance of the technology and product performance. The survey has been sent to different organizations by random sampling among the entrepreneur’s population including integrated broiler farm, broiler farm, and other related organizations. The mixed-method results, both qualitative and quantitative, verify the user and lead users' demands since they provide information about the industry standard, technology preference, developing the right product according to the market, and solutions for the industry problems. The product innovation selected nutraceutical ingredients that can solve the following problems in livestock; bactericidal, anti-inflammation, gut health, antioxidant. The combinations of the selected nutraceutical and nanostructured lipid carriers (NLC) technology aim to improve chemical and pharmaceutical components by changing the structure of active ingredients into nanoparticle, which will be released in the targeted location with accurate concentration. The active ingredients in nanoparticle form are more stable, elicit antibacterial activity against pathogenic Salmonella spp and E.coli, balance gut health, have antioxidant and anti-inflammation activity. The experiment results have proven that the nutraceuticals have an antioxidant and antibacterial activity which also increases the average daily gain (ADG), reduces feed conversion ratio (FCR). The results also show a significant impact on the higher European Performance Index that can increase the farmers' profit when exporting. The product innovation will be tested in technology acceptance management methods from farmers and industry. The production of broiler and commercialization analyses are useful to reduce the importation of animal supplements. Most importantly, product innovation is protected by intellectual property.

Keywords: nutraceutical, nano structure lipid carrier, anti-microbial drug resistance, broiler, Salmonella

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Authors: Tomola Obamuyi

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The banking system in Nigeria adopted innovative banking, with the aim of enhancing financial inclusion, and making financial services readily and cheaply available to majority of the people, and to contribute to the efficiency of the financial system. Some of the innovative services include: Automatic Teller Machines (ATMs), National Electronic Fund Transfer (NEFT), Point of Sale (PoS), internet (Web) banking, Mobile Money payment (MMO), Real-Time Gross Settlement (RTGS), agent banking, among others. The introduction of these payment systems is expected to increase bank efficiency and customers' satisfaction, culminating in better performance for the commercial banks. However, opinions differ on the possible effects of the various innovative payment systems on the performance of commercial banks in the country. Thus, this study empirically determines how commercial banks use innovation to gain competitive advantage in the specific context of Nigeria's finance and business. The study also analyses the effects of financial innovation on the performance of commercial banks, when different periods of analysis are considered. The study employed secondary data from 2009 to 2018, the period that witnessed aggressive innovation in the financial sector of the country. The Vector Autoregression (VAR) estimation technique forecasts the relative variance of each random innovation to the variables in the VAR, examine the effect of standard deviation shock to one of the innovations on current and future values of the impulse response and determine the causal relationship between the variables (VAR granger causality test). The study also employed the Multi-Criteria Decision Making (MCDM) to rank the innovations and the performance criteria of Return on Assets (ROA) and Return on Equity (ROE). The entropy method of MCDM was used to determine which of the performance criteria better reflect the contributions of the various innovations in the banking sector. On the other hand, the Range of Values (ROV) method was used to rank the contributions of the seven innovations to performance. The analysis was done based on medium term (five years) and long run (ten years) of innovations in the sector. The impulse response function derived from the VAR system indicated that the response of ROA to the values of cheques transaction, values of NEFT transactions, values of POS transactions was positive and significant in the periods of analysis. The paper also confirmed with entropy and range of value that, in the long run, both the CHEQUE and MMO performed best while NEFT was next in performance. The paper concluded that commercial banks would enhance their performance by continuously improving on the services provided through Cheques, National Electronic Fund Transfer and Point of Sale since these instruments have long run effects on their performance. This will increase the confidence of the populace and encourage more usage/patronage of these services. The banking sector will in turn experience better performance which will improve the economy of the country. Keywords: Bank performance, financial innovation, multi-criteria decision making, vector autoregression,

Keywords: Bank performance, financial innovation, multi-criteria decision making, vector autoregression

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Authors: O. Onigbogi, M. Onigbogi Jr., O. Ojo

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Background: The advances in mobile telephone technology has led to a rise in its use globally which has improved service delivery, empowered businesses and changed the way people access information. The practice of many health professionals has also been affected by the information and communications technology (ICT) revolution because they have better access to information. This study was conducted to assess the willingness to participate in mobile technology interventions to improve pregnancy outcomes in Lagos, Nigeria. Materials and Methods: A total of 238 respondents completed self-administered questionnaires. SPSS version 18 data editor was used to analyze data. Univariate odds ratios and 95% confidence intervals (95 % CI) were used to evaluate the correlates of Willingness to Use (WTU) mobile phones to receive health messages during pregnancy. Results: A total of 107 women (45% of the respondents) reported that they will be willing to receive health-related information on their phones during pregnancy. Greater willingness was associated with higher education (OR = 1.25, 95% CI: 1.13–1.53), involvement with community volunteer organizations (OR = 1.25, 95% CI: 1.05–1.52), monetary incentives (OR = 1.37, 95% CI: 1.14–1.45) and nulliparity (OR = 1.39, 95% CI: 1.02–1.42). Decreased willingness was associated with concerns about wrong interpretation of information (OR = 0.42, 95% CI: 0.21–0.54), poor mobile telephone service by providers (OR = 0.61, 95% CI: 0.52–0.78), increase in number of messages (OR = 0.78, 95% CI: 0.53–0.76). Conclusion: The level of WTU recorded indicates that much work still needs to be done before this novel approach could be used adopted in delivering health-related information. Incentives for would-be subjects should also be a part of the planning to encourage greater participation.

Keywords: mobile, outcomes, pregnancy, technology, telephone

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Authors: Everard van Kemenade

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Many quality improvement activities are planned. Leaders are strongly involved in missions, visions and strategic planning. They use, consciously or unconsciously, the PDCA-cycle, also know as the Deming cycle. After the planning, the plans are carried out and the results or effects are measured. If the results show that the goals in the plan have not been achieved, adjustments are made in the next plan or in the execution of the processes. Then, the cycle is run through again. Traditionally, the PDCA-cycle is advocated as a means to an end. However, PDCA is especially fit for planned, ordered, certain contexts. It fits with the empirical and referential quality paradigm. For uncertain, unordered, unplanned processes, something else might be needed instead of Plan-Do-Check-Act. Due to the complexity of our society, the influence of the context, and the uncertainty in our world nowadays, not every activity can be planned anymore. At the same time organisations need to be more innovative than ever. That provides leaders with ‘wicked tendencies’. However, that raises the question how one can innovate without being able to plan? Complexity science studies the interactions of a diverse group of agents that bring about change in times of uncertainty, e.g. when radical innovation is co-created. This process is called emergence. This research study explores the role of leadership in the emergence paradigm. Aim of the article is to study the way that leadership can support the emergence of innovation in a complex context. First, clarity is given on the concepts used in the research question: complexity, emergence, innovation and leadership. Thereafter a literature search is conducted to answer the research question. The topics ‘emergent leadership’ or ‘complexity leadership’ are chosen for an exploratory search in Google and Google Scholar using the berry picking method. Exclusion criterion is emergence in other disciplines than organizational development or in the meaning of ‘arising’. The literature search conducted gave 45 hits. Twenty-seven articles were excluded after reading the title and abstract because they did not research the topic of emergent leadership and complexity. After reading the remaining articles as a whole one more was excluded because the article used emergent in the limited meaning of ‗arising‘ and eight more were excluded because the topic did not match the research question of this article. That brings the total of the search to 17 articles. The useful conclusions from the articles are merged and grouped together under overarching topics, using thematic analysis. The findings are that 5 topics prevail when looking at possibilities for leadership to facilitate innovation: enabling, sharing values, dreaming, interacting, context sensitivity and adaptivity. Together they form In Dutch the acronym Medusa.

Keywords: complexity science, emergence, leadership in the emergence paradigm, innovation, the Medusa principles

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Authors: Zainur Rahman

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Meaningful work is the topic that will be discussed in this article, especially in changing period. It has an important role because by reaching meaningful work, it will drive to be positive in the workplace. Therefore, task performance will be increased and cynicism about organizational change (CAOC) will be reduced. Moreover, it is influenced by situational factor, which is transformational leadership. In this conceptual paper, the author discusses how the construct of meaningful work influenced by transformational leadership that will have impact on the follower’ work outcomes in the organizational change. It is proposed that the construct of meaningful work are susceptible with situational variable. Transformational leaders who are respectful on the process of humanizing the followers affect task performance and reduce CAOC in organizational change.

Keywords: transformational leadership, meaningful work, task performance, CAOC

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Authors: Vivek Anand, Rainer Naegele

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Industry 4.0 is a global mega-trend revolutionizing the world of advanced manufacturing, but also bringing up challenges for SMEs. In response, many regional, as well as digital Industry 4.0 Platforms, have been set up to boost the competencies of established enterprises as well as SMEs. The concept of 'Clusters' is a policy tool that aims to be a starting point to establish sustainable and self-supporting structures in industries of a region by identifying competencies and supporting cluster actors with services that match their growth needs. This paper is motivated by the idea that Clusters have the potential to enable firms, particularly SMEs, to accelerate the innovation process and transition to digital technologies. In this research, the efficacy of Industry 4.0 platforms as Cluster ecosystems is evaluated, especially for SMEs. Focusing on the Baden Wurttemberg region in Germany, an action research method is employed to study how SMEs leverage other actors on Industry 4.0 Platforms to further their Industry 4.0 journeys. The aim is to evaluate how such Industry 4.0 platforms stimulate innovation, cooperation and competitiveness. Additionally, the barriers to these platforms fulfilling their promise to serve as capacity building cluster ecosystems for SMEs in a region will also be identified. The findings will be helpful for academicians and policymakers alike, who can leverage a ‘cluster policy’ to enable Industry 4.0 ecosystems in their regions. Furthermore, relevant management and policy implications stem from the analysis. This will also be of interest to the various players in a cluster ecosystem - like SMEs and service providers - who benefit from the cooperation and competition. The paper will improve the understanding of how a dialogue orientation, a bottom-up approach and active integration of all involved cluster actors enhance the potential of Industry 4.0 Platforms. A strong collaborative culture is a key driver of digital transformation and technology adoption across sectors, value chains and supply chains; and will position Industry 4.0 Platforms at the forefront of the industrial renaissance. Motivated by this argument and based on the results of the qualitative research, a roadmap will be proposed to position Industry 4.0 Platforms as effective clusters ecosystems to support Industry 4.0 adoption in a region.

Keywords: cluster policy, digital transformation, industry 4.0, innovation clusters, innovation policy, SMEs and startups

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Authors: Hui-Yi Wang, Shu-Mei Chen, Mei-Fang Liu

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Background and purpose: Providing clinical experience in medical education is an important discipline method where students can gradually apply their academic knowledge to clinical situations. The purpose of this study was to establish self-assessment questionnaires for students to assess their learning outcomes for two fields of physical therapy, orthopedic physical therapy, and pediatric physical therapy, in a clinical fieldwork course. Methods: The questionnaires were developed based on the core competence dimensions of the course. The content validity of the questionnaires was evaluated and established by expert meetings. Among the third-year undergraduate students who took the clinical fieldwork course, there were 49 students participated in this study. Teachers arranged for the students to study two professional fields, and each professional field conducted a three-week clinical lesson. The students filled out the self-assessment questionnaires before and after each three-week lesson. Results: The self-assessment questionnaires were established by expert meetings that there were six core competency dimensions in each of the two fields, with 20 and 21 item-questions, respectively. After each three-week clinical fieldwork, the self-rating scores in each core competency dimension were higher when compared to those before the course, indicating having better clinical abilities after the lessons. The best self-rating scores were the dimension of attitude and humanistic literacy, and the two lower scores were the dimensions of professional knowledge and skills and problem-solving critical thinking. Conclusions: This study developed questionnaires for clinical fieldwork courses to reflect students' learning outcomes, including the performance of professional knowledge, practice skills, and professional attitudes. The use of self-assessment of learning performance can help students build up their reflective competencies. Teachers can guide students to pay attention to the performance of abilities in each core dimension to enhance the effectiveness of learning through self-reflection and improvement.

Keywords: physical therapy, clinical fieldwork course, learning outcomes assessment, medical education, self-reflection ability

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Authors: M. T. Becerra, F. Martín, P. Gutiérrez, S. Cubo, E. Iglesias, A. A. Sáenz del Castillo, P. Cañamero

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The consolidation of the European Higher Education Area (EHEA) in universities has led to significant changes in student training. This paper, part of a Teaching Innovation Project, starts from new training requirements that are fit within Undergraduate Thesis Project, a subject that culminate student learning. Undergraduate Thesis Project is current assessment system that weigh the student acquired training in university education. Students should develop a range of cross curricular competences such as public presentation of ideas, problems and solutions both orally and writing in Undergraduate Thesis Project. Specifically, we intend with our innovation proposal to provide resources that enable university students from Teacher Degree in Education Faculty of University of Extremadura (Spain) to develop the cross curricular competence of public speaking.

Keywords: interaction, public speaking, student, university

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Authors: Hans Schumann, Colin Domnauer, Louis Rosenberg

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In this study, machine learning techniques were deployed on real-time human swarm data to forecast the likelihood of outcomes for English Premier League matches in the 2020/21 season. These techniques included ensemble models in combination with neural networks and were tested against an industry standard of Vegas Oddsmakers. Predictions made from the collective intelligence of human swarm participants managed to achieve a positive return on investment over a full season on matches, empirically proving the usefulness of a new artificial intelligence valuing human instinct and intelligence.

Keywords: artificial intelligence, data science, English Premier League, human swarming, machine learning, sports betting, swarm intelligence

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Authors: Jamal Alasiri, Naif Hakeem, Saoud Almaslmani

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Background: Patients with humeral shaft fractures have two different treatment options. Surgical therapy has lesser risks of non-union, mal-union, and re-intervention than non-surgical therapy. These positive clinical outcomes of the surgical approach make it a preferable treatment option despite the risks of radial nerve palsy and additional surgery-related risk. We aimed to evaluate patients’ outcomes and return to work after surgical vs. non-surgical management of shaft humeral fracture. Methods: We used databases, including PubMed, Medline, and Cochrane Register of Controlled Trials, from 2010 to January 2022 to search for potential randomised controlled trials (RCTs) and cohort studies comparing the patients’ related outcome measures and return to work between surgical and non-surgical management of humerus fracture. Results: After carefully evaluating 1352 articles, we included three RCTs (232 patients) and one cohort study (39 patients). The surgical intervention used plate/nail fixation, while the non-surgical intervention used a splint or brace procedure to manage shaft humeral fracture. The pooled DASH effects of all three RCTs at six (M.D: -7.5 [-13.20, -1.89], P: 0.009) I2:44%) and 12 months (M.D: -1.32 [-3.82, 1.17], p:0.29, I2: 0%) were higher in patients treated surgically than in non-surgical procedures. The pooled constant Murley score at six (M.D: 7.945[2.77,13.10], P: 0.003) I2: 0%) and 12 months (M.D: 1.78 [-1.52, 5.09], P: 0.29, I2: 0%) were higher in patients who received non-surgical than surgical therapy. However, pooled analysis for patients returning to work for both groups remained inconclusive. Conclusion: Altogether, we found no significant evidence supporting the clinical benefits of surgical over non-surgical therapy. Thus, the non-surgical approach remains the preferred therapeutic choice for managing shaft humeral fractures due to its lesser side effects.

Keywords: shaft humeral fracture, surgical treatment, Patient-related outcomes, return to work, DASH

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Authors: Margaret Elaine J. Villamayor, Lobert A. Padua, Neil S. Bacaltos, Virgilio P. Bañez

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Significance: This study aimed to determine the prevalence of Hepatobiliary Tuberculosis (HBTB) with biliary obstruction and to compare the outcomes of ERCP versus PTBD in these patients. Methodology: This is a cross-sectional study involving patients from PGH who underwent biliary drainage from HBTB from January 2009 to June 2014. HBTB was defined as having evidence of TB (culture, smear, PCR, histology) or clinical diagnosis with the triad of jaundice, fever, and calcifications on imaging with other causes of jaundice excluded. The primary outcome was successful drainage and secondary outcomes were mean hospital stay and complications. Simple logistic regression was used to identify factors associated with success of drainage, z-test for two proportions to compare outcomes of ERCP versus PTBD and t-test to compare mean hospital stay post-procedure. Results: There were 441 patients who underwent ERCP and PTBD, 19 fulfilled the inclusion criteria. 11 underwent ERCP while 8 had PTBD. There were more successful cases in PTBD versus ERCP but this was not statistically significant (p-value 0.3615). Factors such as age, gender, location and nature of obstruction, vices, coexisting pulmonary or other extrapulmonary TB and presence of portal hypertension did not affect success rates in these patients. The PTBD group had longer mean hospital stay but this was not significant (p-value 0.1880). There were no complications reported in both groups. Conclusion: HBTB comprises 4.3% of the patients undergoing biliary drainage in PGH. Both ERCP and PTBD are equally safe and effective in the management of biliary obstruction from HBTB.

Keywords: cross-sectional, hepatobiliary tuberculosis, obstructive jaundice, endoscopic retrograde cholangiopancreatography, percutaneous transhepatic biliary drainage

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Authors: F. Demir

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Strategic Management is highly critical for all types of organizations. This paper examines maturity level of strategic management practices of public and private sector organizations in Turkey, and presents a conceptual model for assessing the maturity of strategic management in any organization. This research focuses on R&D intensive organizations (RDO) because it is claimed that such organizations are more innovative and innovation is a critical part of the model. The Strategic management maturity model (S-3M) is basically composed of six maturity levels with five different dimensions. Based on 63 organizations, the findings reveal that the average maturity of all organizations in the sample group is three out of five. It corresponds to the stage of ‘performed’. Results simply show that the majority of organizations from various industries and sectors implement strategic management activities; however, they experience multiple challenges to optimize strategic management processes and integrate organizational components with business strategies. Briefly, they struggle to become an innovative organization.

Keywords: strategic management maturity, innovation, developing countries, research and development

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Authors: Parastoo Parhizkar, Jaber Yaghini, Omid Fakheran

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Background: Third molar surgery is often associated with postoperative problems which cause serious impediments on daily activities and quality of life. Steroidal anti-inflammatory drugs may decrease these common post-operative complications. The purpose of this review is evaluating the available evidence regarding the efficacy of corticosteroids used as adjunctive therapy for patients undergoing third molar surgery. Methods: PubMed, Google scholar, Scopus, web of science, clinicaltrials.gov, scirus.com, Cochrane central register for controlled trials, LILACS, OpenGrey, centerwatch, isrctn, who.int and ebsco were searched without restrictions regarding the year of publication. Randomized clinical trials assessing patient-reported outcomes in patients undergoing surgical therapy, were eligible for inclusion. Study quality was assessed using the CONSORT-checklist. No meta-analysis was performed. Results: A total of twelve Randomized Clinical Trials were included in this study. Methylprednisolone and Dexamethasone may decrease postoperative side effects such as pain, trismus and edema. Based on the results both of them could improve patients’ satisfaction, and there is no significant difference between these two types of corticosteroids regarding the patient centered outcomes (p > 0.05). Intralesional and intravenous injection of Dexamethasone showed an equivalent result, with statistically significant better results (P < 0.05) in comparison with the oral treatment. Conclusion: various types of corticosteroids can enhance the patient’s satisfaction following third molar surgery. However, there is no significant difference between Dexamethasone, Prednisolone and Methylprednisolone groups in this regard. Comparing the various administration routs, local injection of Dexamethasone is quite simple, painless and cost-effective adjunctive therapy with better drug efficacy.

Keywords: third molar surgery, corticosteroids, patient-reported outcomes, health related quality of life

Procedia PDF Downloads 191