Search results for: surgical innovation

Authors: Anis Al-Yakhiri

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Introduction: The World Health Organization (WHO) classifies malignant epithelial thyroid tumors into four major groups (papillary, follicular, medullar and undifferentiated) . Papillary thyroid carcinoma (PTC) is the most common type, for about eight out of ten thyroid cancers belong to this histological type. Radioactive iodine (RAI) is considered effective for patients with total or nearly total thyroidectomy, but the beneficial effects of RAI are still controversial. War conditions forced us to study alternative methods of using radioactive iodine in the treatment of patients with PTC. Material and methods: Between January 2014 and June 2021, in Al-Yakhiri hospital, 57 Total Thyroidectomy with Radical BilateralNeckDissection (RBND) were performed, 50 for malignant disease,7 for false positive cytology.RBND involves surgical clearance of Levels II-VI. Mean age was 40.7 years old and 92% of the patients were female. 7(14%) patients had hypothyroidism which required preoperative thyroid hormone treatment. The Thyroid Stimulating Hormone- Suppression Therapy (TSH-ST) immediately started after RBND for mostpatients on the first day. It consisted in reducing the level of TSH< 0.1 mIU/L. Results: The Apron flap was used on most operations (40)80% and with lateral extensions had 10(20%). RBND involves surgical clearance of Levels II-VI performed in all operated patients, besides that, 4(8%) of them had resection of sternocleidomastoid muscle (SCM) and accessory nerve (XIn) and internal jugular vein (IJV) withclearance of Levels IB. The PTC was the most common 80.9% (38 patients from 47)by histopathological report. and 4(8%) patients of 50 had resection of sternocleidomastoid muscle (SCM) and accessory nerve (XIn) and internal jugular vein (IJV). The postoperative mortality rate not observed (0%). The postoperative morbidity rate was 22.8% (n =13).Seroma(8.7%),Hypocalcimia(7%), Wound infection(5.3%), Bleeding(1.8%). To suppress TSH and growth of any residual thyroid theTSH-ST (levothyroxine150 – 600mcg)was performed in all patients 57(100%) on the first day afterRBND. We tracked the results of treatment for two years in 30 patients with PTC, only 3 of them received radioactive iodine abroad. Biennial Recurrence rate for PTC appeared in one woman (2%), who had RAI postoperatively in the form of neck lymph nodes metastasis. Conclusion: For patients with PTC, thyroidectomy plus prophylacticRBND is a safe and efficient procedure and it results in lower recurrence rate. Postoperative treatment with exogenous thyroid hormone in doses sufficient to suppress TSH (not less than 150mcg), decreases incidence of recurrence. Total Thyroidectomy with RBND followed by TSH-ST, in our opinion, applicable optimal treatment scheme care for this patient population.

Keywords: thyroid cancer, Yemen war, absence of radioactive iodine, neck dissection, surgery results

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Authors: Gianni Jacucci

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We present a retrospective on the development of a research group over the past 30+ years. We reflect on a change in observing the experience (1990-2024) of a university sociotechnical research group dedicated to instill change for innovation in client organisations and enterprises. Its cognitive and action trajectory is influenced by subjective factors: intention and interpretation. Continuity and change are both present: the trajectory of the group exhibits the dynamic interplay of two components of subjectivity, a change of focus in persistence of scheme, and a tension between stability and change. The paper illustrates the meanings the group gave to their practice while laying down mission-critical theoretical considerations – autopoiesis-. The aim of the work is to experience a fragment of phenomenological understanding (PU) of the cognitive dynamics of an STS-aware ICT uptake Laboratory during the digital revolution. PU is an intuitive going along the meaning, while staying close and present to the total situation of the phenomenon. Reading the codes that we observers invent in order to codify what nature is about, thus unveiling subconscious, autopoietic, reflexive feedback mechanisms of second order governance from work published over three decades by the ICT Lab, as if it were the narration of its cognitive autobiography. The paper brings points of discussion and insights of relevance for the STS community. It could be helpful in understanding the history of the community and in providing a platform for discussions on future developments. It can also serve as an inspiration and a historical capture for those entering the field.

Keywords: phenomenology, subjectivity, autopoiesis, interpretation schemes, change for innovation, socio technical research, social study of information systems

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Authors: Chandra Shekhar Majumder, Orin Sultana Jamie

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Background: Dacryocystorhinostomy (DCR) has been a widely accepted surgical intervention for nasolacrimal duct obstructions. Some previous studies demonstrated the potential benefits of the peroperative application of agents like Mitomycin-C (MMC) with DCR to improve surgical outcomes. Relevant studies are rare in Bangladesh, and there are controversies about the dose, duration of MMC, and outcome. Therefore, the present study aimed to investigate the comparative efficacy of DCR with and without MMC in a tertiary hospital in Bangladesh. Objective: The study aims to determine the outcome of a dacryocystorhinostomy with preoperative local use of mitomycin–C. Methods: An analytical study was conducted in the Department of Ophthalmology, Sir Salimullah Medical College & Mitford Hospital, Dhaka, from January 2023 to September 2023. Seventy patients who were admitted for DCR operation were included according to the inclusion and exclusion criteria. Patients were divided into two groups: those who underwent DCR with peroperative administration of 0.2 mg/ml Mitomycin-C for 5 minutes (Group I) and those who underwent DCR alone (Group II). All patients were subjected to detailed history taking, clinical examination, and relevant investigations. All patients underwent DCR according to standard guidelines and ensured the highest peroperative and postoperative care. Then, patients were followed up at 7th POD, 1-month POD, 3 months POD, and 6 months POD to observe the success rate between the two groups by assessing tearing condition, irrigation, height of tear meniscus, and FDDT- test. Data was recorded using a pre-structured questionnaire, and collected data were analyzed using SPSS 23. Results: The mean age of the study patients was 42.17±6.7 (SD) years and 42.29±7.1 (SD) years in Groups I and II, respectively, with no significant difference (p=0.945). At the 6th month’s follow-up, group I patients were observed with 94.3% frequency of symptom-free, 85.6% patency of lacrimal drainage system, 68.6% had tear meniscus <0.1mm and 88.6% had positive Fluorescence Dye Disappearance Test (FDDT test). In group II, 91.4% were symptom-free, 68.6% showed patency, 57.1% had a height of tear meniscus < 0.1 mm, and 85.6% had FDDT test positive. But no statistically significant difference was observed (p<.05). Conclusion: The use of Mitomycin-C preoperatively during DCR offers better postoperative outcomes, particularly in maintaining patency and achieving symptom resolution with more FDDT test positive and improvement of tear meniscus in the MMC group than the control group. However, this study didn’t demonstrate a statistically significant difference between the two groups. Further research with larger sample sizes and longer follow-up periods would be beneficial to corroborate these findings.

Keywords: dacryocystorhinostomy, mitomycin-c, dacryocystitis, nasolacrimal duct obstruction

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Authors: Spencer Liu, William Chan, Marlena Komatz, Tommy Ramos, Mark Trentalange, Faye Rim, Dae Kim, Mary Kelly, Samuel Schuessler, Roberta Stack, Justas Lauzadis, Kathryn DelPizzo, Seth Waldman, Alexandra Sideris

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Background & Significance: The increasing prevalence of cannabis use in the United States has important safety considerations in the perioperative setting, as chronic or heavy preoperative cannabis use may increase the risk of intraoperative complications, postoperative nausea and vomiting (PONV), increased postoperative pain levels, and acute side effects associated with cannabis use cessation. In this retrospective chart review study, we sought to determine the prevalence of self-reported cannabis use in the past 5-years at a single institution in New York City. We hypothesized that there is an increasing prevalence of preoperative self-reported cannabis use among adult and adolescent patients undergoing orthopedic surgery. Methods: After IRB approval for this retrospective study, surgical cases performed on patients 12 years of age and older at the hospital’s main campus and two ambulatory surgery centers between January 1st, 2018, and December 31st, 2023, with preoperatively self-disclosed cannabis use entered in the social history intake form were identified using the tool SlicerDicer in Epic. Case and patient characteristics were extracted, and trends in utilization over time were assessed by the Cochran-Armitage trend test. Results: Overall, the prevalence of self-reported cannabis use increased from 6.6% in 2018 to 10.6% in 2023. By age group, the prevalence of self-reported cannabis use among adolescents remained consistently low (2018: 2.6%, 2023: 2.6%) but increased with significant evidence for a linear trend (p < 0.05) within every adult age group. Among adults, patients who were 18-24 years old (2018: 18%, 2023: 20.5%) and 25-34 years old (2018: 15.9%, 2023: 24.2%) had the highest prevalences of disclosure, whereas patients who were 75 years of age or older had the lowest prevalence of disclosure (2018: 1.9%, 2023: 4.6%). Patients who were 25-34 years old had the highest percent difference in disclosure rates of 8.3%, which corresponded to a 52.2% increase from 2018 to 2023. The adult age group with the highest percent change was patients who were 75 years of age or older, with a difference of 2.7%, which corresponded to a 142.1% increase from 2018 to 2023. Conclusions: These trends in preoperative self-reported cannabis use among patients undergoing orthopedic surgery have important implications for perioperative care and clinical outcomes. Efforts are underway to refine and standardize cannabis use data capture at our institution.

Keywords: orthopedic surgery, cannabis, postoperative pain, postoperative nausea

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Authors: Sarah Mueller-Saegebrecht, André Brendler

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Business model innovation (BMI) as an intentional change of an existing business model (BM) or the design of a new BM is essential to a firm's development in dynamic markets. The relevance of BMI is also evident in the ongoing COVID-19 pandemic, in which start-ups, in particular, are affected by limited access to resources. However, first studies also show that they react faster to the pandemic than established firms. A strategy to successfully handle such threatening dynamic changes represents BMI. Entrepreneurship literature shows how and when firms should utilize BMI in times of crisis and which barriers one can expect during the BMI process. Nevertheless, research merging BMI barriers and crises is still underexplored. Specifically, further knowledge about antecedents and the effect of moderators on the BMI process is necessary for advancing BMI research. The addressed research gap of this study is two-folded: First, foundations to the subject on how different crises impact BM change intention exist, yet their analysis lacks the inclusion of barriers. Especially, entrepreneurship literature lacks knowledge about the individual perception of BMI barriers, which is essential to predict managerial reactions. Moreover, internal BMI barriers have been the focal point of current research, while external BMI barriers remain virtually understudied. Second, to date, BMI research is based on qualitative methodologies. Thus, a lack of quantitative work can specify and confirm these qualitative findings. By focusing on the crisis context, this study contributes to BMI literature by offering a first quantitative attempt to embed BMI barriers into a structural equation model. It measures managers' perception of BMI development and implementation barriers in the BMI process, asking the following research question: How does a manager's perception of BMI barriers influence BMI development and implementation in times of crisis? Two distinct research streams in economic literature explain how individuals react when perceiving a threat. "Prospect Theory" claims that managers demonstrate risk-seeking tendencies when facing a potential loss, and opposing "Threat-Rigidity Theory" suggests that managers demonstrate risk-averse behavior when facing a potential loss. This study quantitively tests which theory can best predict managers' BM reaction to a perceived crisis. Out of three in-depth interviews in the German chemical industry, 60 past BMIs were identified. The participating start-up managers gave insights into their start-up's strategic and operational functioning. After, each interviewee described crises that had already affected their BM. The participants explained how they conducted BMI to overcome these crises, which development and implementation barriers they faced, and how severe they perceived them, assessed on a 5-point Likert scale. In contrast to current research, results reveal that a higher perceived threat level of a crisis harms BM experimentation. Managers seem to conduct less BMI in times of crisis, whereby BMI development barriers dampen this relation. The structural equation model unveils a mediating role of BMI implementation barriers on the link between the intention to change a BM and the concrete BMI implementation. In conclusion, this study confirms the threat-rigidity theory.

Keywords: barrier perception, business model innovation, business model innovation barriers, crises, prospect theory, start-ups, structural equation model, threat-rigidity theory

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Authors: Mochamad Sugiarto, Yusmi Nw

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Goat farming became an important alternative in eradicating poverty in Banjarnegara District. The success of goat farming in delivering products through efficient business management will improve business competitiveness. Entrepreneurship based farming has been able to survive in an ever-changing and increasingly complex global economy. Entrepreneurial farmers characterized by the ability to provide products of goats by applying the principles of efficient business. To achieve, this requires an understanding and a positive outlook related to entrepreneurship involving the values of courage to take risks, creativity and innovation as well as management's ability to find and read the opportunities. Entrepreneurial orientation owned by farmers is an important spirit of farmers to make decision for developing the goat farming. Entrepreneurial orientation is the view of farmers against the values of confidence, result-oriented, future-oriented, and creativity/innovation in goat farming. This study aims to (1) identify the entrepreneurial orientation of goat farmers in Banjarnegara District (2) analyze business competitiveness (cost efficiency) of goat farming in the Banjarnegara District and (3) analyze the relationship between the entrepreneurial perception and cost efficiency of goat farming in the Banjarnegara District. 178 respondents (goat farmers) were taken using stratified random sampling based on altitude. Banjarnegara district with heterogeneous topography grouped into areas of high ( > 1500m), moderate (500m-1000m) and low ( < 500m). The goat farmers in Banjarnegara District has a moderate entrepreneurial orientation. The manage their goat farming efficiently by having R/C = 2.58. Strengthening the entrepreneurial orientation will significantly increase the cost efficiency, which has an impact on strengthening the competitiveness of goat farming in Banjarnegara District.

Keywords: entrepreneurial orientation, cost efficiency, farm competitiveness, goat farming

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Authors: Neeraj Vij, Christian Leber, Kenneth Schmidt

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Introduction: Total knee arthroplasty is a common procedure. It is well known that the biomechanics of the knee do not fully return to their normal state. Motion analysis has been used to study the biomechanics of the knee after total knee arthroplasty. The purpose of this scoping review is to summarize the current use of gait analysis in total knee arthroplasty and to identify the preoperative motion analysis parameters for which a systematic review aimed at determining the reliability and validity may be warranted. Materials and Methods: This IRB-exempt scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist strictly. Five search engines were searched for a total of 279 articles. Articles underwent a title and abstract screening process followed by full-text screening. Included articles were placed in the following sections: the role of gait analysis as a research tool for operative decisions, other research applications for motion analysis in total knee arthroplasty, gait analysis as a tool in predicting radiologic outcomes, gait analysis as a tool in predicting clinical outcomes. Results: Eleven articles studied gait analysis as a research tool in studying operative decisions. Motion analysis is currently used to study surgical approaches, surgical techniques, and implant choice. Five articles studied other research applications for motion analysis in total knee arthroplasty. Other research applications for motion analysis currently include studying the role of the unicompartmental knee arthroplasty and novel physical therapy protocols aimed at optimizing post-operative care. Two articles studied motion analysis as a tool for predicting radiographic outcomes. Preoperative gait analysis has identified parameters than can predict postoperative tibial component migration. 15 articles studied motion analysis in conjunction with clinical scores. Conclusions: There is a broad range of applications within the research domain of total knee arthroplasty. The potential application is likely larger. However, the current literature is limited by vague definitions of ‘gait analysis’ or ‘motion analysis’ and a limited number of articles with preoperative and postoperative functional and clinical measures. Knee adduction moment, knee adduction impulse, total knee range of motion, varus angle, cadence, stride length, and velocity have the potential for integration into composite clinical scores. A systematic review aimed at determining the validity, reliability, sensitivities, and specificities of these variables is warranted.

Keywords: motion analysis, joint replacement, patient-reported outcomes, knee surgery

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Authors: Desta Kebede Ayana, Lies Sercu, Demelash Mengistu

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The study is set in Ethiopia, a sub-Saharan multilingual, multiethnic African country, which has seen a significant increase in the number of universities in recent years. The aim of this growth is to provide access to education for all cultural and linguistic groups across the country. However, there are challenges in promoting intercultural competence among students in this diverse context. The aim of the study is to investigate the interculturalization of Ethiopian Higher Education Institutions as perceived by university lecturers and administrators. In particular, the study aims to determine the level of support for this educational innovation and gather suggestions for its implementation and institutionalization. The researchers employed semi-structured interviews with administrators and lecturers from two large Ethiopian universities to gather data. Thematic analysis was utilized for coding and analyzing the interview data, with the assistance of the NVIVO software. The findings obtained from the grounded analysis of the interview data reveal that while there are opportunities for interculturalization in the curriculum and campus life, support for educational innovation remains low. Administrators and lecturers also emphasize the government's responsibility to prioritize interculturalization over other educational innovation goals. The study contributes to the existing literature by examining an under-researched population in an under-researched context. Additionally, the study explores whether Western perspectives of intercultural competence align with the African context, adding to the theoretical understanding of intercultural education. The data for this study was collected through semi-structured interviews conducted with administrators and lecturers from two large Ethiopian universities. The interviews allowed for an in-depth exploration of the participants' views on interculturalization in higher education. Thematic analysis was applied to the interview data, allowing for the identification and organization of recurring themes and patterns. The analysis was conducted using the NVIVO software, which aided in coding and analyzing the data. The study addresses the extent to which administrators and lecturers support the interculturalization of Ethiopian Higher Education Institutions. It also explores their suggestions for implementing and institutionalizing intercultural education, as well as their perspectives on the current level of institutionalization. The study highlights the challenges in interculturalizing Ethiopian universities and emphasizes the need for greater support and prioritization of intercultural education. It also underscores the importance of considering the African context when conceptualizing intercultural competence. This research contributes to the understanding of intercultural education in diverse contexts and provides valuable insights for policymakers and educational institutions aiming to promote intercultural competence in higher education settings.

Keywords: administrators, educational change, Ethiopia, intercultural competence, lecturers

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Authors: Sang Ho Lee, Tae Heon Moon, Youn Taik Leem, Kwang Woo Nam

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Knowledge and IT inputs to other industrial production have become more important as a key factor for the competitiveness of national and regional economies, such as knowledge economies in smart cities. Knowledge and IT industries lead the industrial innovation and technical (r)evolution through low cost, high efficiency in production, and by creating a new value chain and new production path chains, which is referred as knowledge and IT dynamics. This study aims to investigate the knowledge and IT dynamics in Korea, which are analyzed through the input-output model and structural path analysis. Twenty-eight industries were reclassified into seven categories; Agriculture and Mining, IT manufacture, Non-IT manufacture, Construction, IT-service, Knowledge service, Non-knowledge service to take close look at the knowledge and IT dynamics. Knowledge and IT dynamics were analyzed through the change of input output coefficient and multiplier indices in terms of technical innovation, as well as the changes of the structural paths of the knowledge and IT to other industries in terms of new production value creation from 1985 and 2010. The structural paths of knowledge and IT explain not only that IT foster the generation, circulation and use of knowledge through IT industries and IT-based service, but also that knowledge encourages IT use through creating, sharing and managing knowledge. As a result, this paper found the empirical investigation on the knowledge and IT dynamics of the Korean economy. Knowledge and IT has played an important role regarding the inter-industrial transactional input for production, as well as new industrial creation. The birth of the input-output production path has mostly originated from the knowledge and IT industries, while the death of the input-output production path took place in the traditional industries from 1985 and 2010. The Korean economy has been in transition to a knowledge economy in the Smart City.

Keywords: knowledge and IT industries, input-output model, structural path analysis, dynamics of knowledge and it, knowledge economy, knowledge city and smart city

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Authors: Christina Wainikka, Besrat Tesfaye

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Several of the countries in the Baltic Sea region are ranked high in international innovations rankings, such as the Global Innovation Index and European Innovation Scoreboard. There are however some concerns in the performance of different countries. For example, there is a widely spread notion about “The Swedish Paradox”. Sweden is ranked high due to investments in R&D and patent activity, but the outcome is not as high as could be expected. SMEs in Sweden are also below EU average when it comes to registering intellectual property rights such as patents and trademarks. This study is concentrating on the protection of utility model. This intellectual property right does not exist in Sweden, but in for example Finland and Germany. The utility model protection is sometimes referred to as a “patent light” since it is easier to obtain than the patent protection but at the same time does cover technical solutions. In examining statistics on patent activities and activities in registering utility models it is clear that utility model protection is scarcely used in the countries that have the protection. In Germany 10 577 applications were made in 2021. In Finland there were 259 applications made in 2021. This can be compared with patent applications that were 58 568 in Germany in 2021 and 1 662 in Finland in 2021. In Sweden there has never been a protection for utility models. The only protection for technical solutions is patents and business secrets. The threshold for obtaining a patent is high, due to the legal requirements and the costs. The patent protection is there for often not chosen by SMEs in Sweden. This study examines whether the protection of utility models in other countries in the Baltic region provide SMEs in these countries with better options to protect their innovations. The legal methodology is comparative law. In order to study the effects of the legal differences statistics are examined and interviews done with SMEs from different industries.

Keywords: baltic sea region, comparative law, SME, utility model

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Authors: Tania Breton, Dorina Simeonov, Shauna MacEachern

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Ontario’s 10 Year Mental Health and Addictions Strategy has included the establishment of 18 Service Collaborative across the province; cross-sector tables in a specific region coming together to explore mental health and addiction system needs and adopting an intervention to address that need. The process is community led and supported by implementation teams from the Centre for Addiction and Mental Health (CAMH), using the framework of implementation science (IS) to enable evidence-based and sustained change. These justice initiatives are focused on the intersection of the justice system and the mental health and addiction systems. In this presentation, we will share the learnings, achievements and challenges of implementing innovative practices to the mental health and addictions needs of Ontarians within the justice system. Specifically, we will focus on the key points across the justice system - from early intervention and trauma-informed, culturally appropriate services to post-sentence support and community reintegration. Our approach to this work involves external implementation support from the CAMH team including coaching, knowledge exchange, evaluation, Aboriginal engagement and health equity expertise. Agencies supported the implementation of tools and processes which changed practice at the local level. These practices are being scaled up across Ontario and community agencies have come together in an unprecedented collaboration and there is a shared vision of the issues overlapping between the mental health, addictions and justice systems. Working with ministry partners has allowed space for innovation and created an environment where better approaches can be nurtured and spread.

Keywords: implementation, innovation, early identification, mental health and addictions, prevention, systems

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Authors: Cassey Younghans

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Background: Current health care trends demonstrate that there is an increasing number of patients being hospitalized with complex comorbidities. These complex needs require advanced therapies, and treatment goals often focus on doing everything possible to prolong life rather than focusing on the individual patient’s quality of life which is the goal of palliative care efforts. Patients benefit from palliative care in the early stages of the illness rather than after the disease progressed or the state of acuity has advanced. The clinical problem identified was that palliative care was not being implemented early enough in the disease process with patients who had complex medical conditions and who would benefit from the philosophy and skills of palliative care professionals. Purpose: The purpose of this quality improvement study was to increase the number of palliative care screenings and consults completed on adults after being admitted to one Non-ICU and Non-COVID hospital unit. Methods: A retrospective chart review assessing for possible missed opportunities to introduce palliation was performed for patients with six primary diagnoses, including heart failure, liver failure, end stage renal disease, chronic obstructive pulmonary disease, cerebrovascular accident, and cancer in a population of adults over the ago of 19 on one medical-surgical unit over a three-month period prior to the intervention. An educational session with the nurses on the benefits of palliative care was conducted by the researcher, and a screening tool was implemented. The expected outcome was to have an increase in early palliative care consultation with patients with complex comorbid conditions and a decrease in missed opportunities for the implementation of palliative care. Another retrospective chart review was completed following completion of the three month piloting of the tool. Results: During the retrospective chart review, 46 patients were admitted to the medical-surgical floor with the primary diagnoses identified in the inclusion criteria. Six patients had palliative care consults completed during that time. Twenty-two palliative care screening tools were completed during the intervention period. Of those, 15 of the patients scored a 7 or higher, suggesting that a palliative care consultation was warranted. The final retrospective chart review identified that 4 palliative consults were implemented during that time of the 31 patients who were admitted over the three month time frame. Conclusion: Educating nurses and implementing a palliative care screening upon admission can be of great value in providing early identification of patients who might benefit from palliative care. Recommendations – It is recommended that this screening tool should be used to help identify the patents of whom would benefit from a palliative care consult, and nurses would be able to initiated a palliative care consultation themselves.

Keywords: palliative care, screening, early, palliative care consult

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Authors: Grace C. Kuroki, Yixin Hu, Bailey Surtees, Rebecca Krimins, Nicholas J. Durr, Dara L. Kraitchman

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The purpose of this study was to perform a Phase I veterinary clinical trial with a low-cost, carbon-dioxide-based, passive thaw cryoablation device as proof-of-principle for application in pets and translation to third-world treatment of breast cancer. This study was approved by the institutional animal care and use committee. Client-owned dogs with subcutaneous masses, primarily lipomas or mammary cancers, were recruited for the study. Inclusion was based on clinical history, lesion location, preanesthetic blood work, and fine needle aspirate or biopsy confirmation of mass. Informed consent was obtained from the owners for dogs that met inclusion criteria. Ultrasound assessment of mass extent was performed immediately prior to mass cryoablation. Dogs were placed under general anesthesia and sterilely prepared. A stab incision was created to insert a custom 4.19 OD x 55.9 mm length cryoablation probe (Kubanda Cryotherapy) into the mass. Originally designed for treating breast cancer in low resource settings, this device has demonstrated potential in effectively necrosing subcutaneous masses. A dose escalation study of increasing freeze-thaw cycles (5/4/5, 7/5/7, and 10/7/10 min) was performed to assess the size of the iceball/necrotic extent of cryoablation. Each dog was allowed to recover for ~1-2 weeks before surgical removal of the mass. A single mass was treated in seven dogs (2 mammary masses, a sarcoma, 4 lipomas, and 1 adnexal mass) with most masses exceeding 2 cm in any dimension. Mass involution was most evident in the malignant mammary and adnexal mass. Lipomas showed minimal shrinkage prior to surgical removal, but an area of necrosis was evident along the cryoablation probe path. Gross assessment indicated a clear margin of cryoablation along the cryoprobe independent of tumor type. Detailed histopathology is pending, but complete involution of large lipomas appeared to be unlikely with a 10/7/10 protocol. The low-cost, carbon dioxide-based cryotherapy device permits a minimally invasive technique that may be useful for veterinary applications but is also informative of the unlikely resolution of benign adipose breast masses that may be encountered in third world countries.

Keywords: cryoablation, cryotherapy, interventional oncology, veterinary technology

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Authors: Narges Solaymani

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medical training of patients. Nursing is a very important profession in the societies of the world. Although in the past, all caregivers of the sick and disabled were called nurses, nowadays, a nurse is a person who has a university education in this field. There are nurses in bachelor's, master's, and doctoral degrees in nursing. New courses have been launched in the master's degree based on duty-oriented nurses. A nurse cannot have an independent treatment center but is a member of the treatment team in established treatment centers such as hospitals, clinics, or offices. Nurses can establish counseling centers and provide nursing services at home. According to the standards, the number of nurses should be three times the number of doctors or twice the number of hospital beds, or there should be three nurses for every thousand people. Also, international standards show that in the internal and surgical department, every 4 to 6 patients should have a nurse.

Keywords: Nurse, Intensive Care, CPR, Bandage

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Authors: Tristance Kee

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With an unprecedented increase in elderly population around the world, the severe lack of quality housing and health-and-safety provisions to serve this cohort cannot be ignored any longer. Many elderly citizens, especially singletons, live in unsafe housing conditions with poorly executed planning and design. Some suffer from deteriorating mobility, sight and general alertness and their sub-standard living conditions further hinder their daily existence. This research explains how concepts such as Universal Design and Co-Design operate in a high density city such as Hong Kong, China where innovative design can become an alternative solution where government and the private sector fail to provide quality elderly friendly facilities to promote a sustainable urban development. Unlike other elderly research which focuses more on housing policies, nursing care and theories, this research takes a more progressive approach by providing an in-depth impact assessment on how innovative design can be practical solutions for creating a more sustainable built environment. The research objectives are to: 1) explain the relationship between innovative design for elderly and a healthier and sustainable environment; 2) evaluate the impact of human ergonomics with the use of universal design; and 3) explain how innovation can enhance the sustainability of a city in improving citizen’s sight, sound, walkability and safety within the ageing population. The research adopts both qualitative and quantitative methodologies to examine ways to improve elderly population’s relationship to our built environment. In particular, the research utilizes collected data from questionnaire survey and focus group discussions to obtain inputs from various stakeholders, including designers, operators and managers related to public housing, community facilities and overall urban development. In addition to feedbacks from end-users and stakeholders, a thorough analysis on existing elderly housing facilities and Universal Design provisions are examined to evaluate their adequacy. To echo the theme of this conference on Innovation and Sustainable Development, this research examines the effectiveness of innovative design in a risk-benefit factor assessment. To test the hypothesis that innovation can cater for a sustainable development, the research evaluated the health improvement of a sample size of 150 elderly in a period of eight months. Their health performances, including mobility, speech and memory are monitored and recorded on a regular basis to assess if the use of innovation does trigger impact on improving health and home safety for an elderly cohort. This study was supported by district community centers under the auspices of Home Affairs Bureau to provide respondents for questionnaire survey, a standardized evaluation mechanism, and professional health care staff for evaluating the performance impact. The research findings will be integrated to formulate design solutions such as innovative home products to improve elderly daily experience and safety with a particular focus on the enhancement on sight, sound and mobility safety. Some policy recommendations and architectural planning recommendations related to Universal Design will also be incorporated into the research output for future planning of elderly housing and amenity provisions.

Keywords: elderly population, innovative design, sustainable built environment, universal design

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Authors: Thomas J. Bell III

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Pursuing a business degree is fraught with perplexing questions regarding the rising tuition cost and the immediate value of earning a degree. Any decision to pursue an undergraduate business degree is perceived to have value if it facilitates post-graduate job placement. Business programs have decreased value in the absence of innovation in business programs that close the skills gap between recent graduates and employment opportunities. Industry-based certifications are seemingly becoming a requirement differentiator among job applicants. Texas Wesleyan University offers a Computer Information System (CIS) program with an innovative curriculum that integrates industry-recognized certification training into its traditional curriculum with core subjects and electives. This paper explores a culture of innovation in the CIS business program curriculum that creates sustainable stakeholder value for students, employers, the community, and the university. A quantitative research methodology surveying over one-hundred students in the CIS program will be used to examine factors influencing the success or failure of students taking certification exams. Researchers will analyze control variables to identify specific correlations between practice exams, teaching pedagogy, study time, age, work experience, etc. This study compared various exam preparation techniques to corresponding exam results across several industry certification exams. The findings will aid in understanding control variables with correlations that positively and negatively impact exam results. Such discovery may provide useful insight into pedagogical impact indicators that positively contribute to certification exam success and curriculum enhancement.

Keywords: taking certification exams, exam training, testing skills, exam study aids, certification exam curriculum

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Authors: Mario Chiasson, Monique Boudreau

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Problem statement: Innovation in education has become a central topic of discussion at various levels, including schools and scholarly literature, driven by the global technological advancements of Industry 4.0. This study aims to contribute to the ongoing dialogue by examining the role of innovation in transforming school culture through the reimagination of traditional structures. The study argues that such a transformation necessitates an understanding and experience of systems leadership. This paper presents the case of the Francophone South School District, where a transformative initiative created an innovative learning environment by engaging students, teachers, and community members collaboratively through eco-communities. Traditional barriers and structures in education were dismantled to facilitate this process. The research component of this paper focuses on the Intr’Appreneur project, a unique initiative launched by the district team in the New Brunswick, Canada to support a system-wide transformation towards progressive and innovative organizational models. Methods This study is part of a larger research project that focuses on the transformation of educational systems in six pilot schools involved in the Intr’Appreneur project. Due to COVID-19 restrictions, the project was downscaled to three schools, and virtual qualitative interviews were conducted with volunteer teachers and administrators. Data was collected from students, teachers, and principals regarding their perceptions of the new learning environment and experiences. The analysis process involved developing categories, establishing codes for emerging themes, and validating the findings. The study emphasizes the importance of system leadership in achieving successful transformation. Results: The findings demonstrate that school principals played a vital role in enabling system-wide change by fostering a dynamic, collaborative, and inclusive culture, coordinating and mobilizing community members, and serving as educational role models who facilitated active and personalized pedagogy among the teaching staff. These qualities align with the characteristics of Leadership 4.0 and are crucial for successful school system transformations. Conclusion: This paper emphasizes the importance of systems leadership in driving educational transformations that extend beyond pedagogical and technological advancements. The research underscores the potential impact of such a leadership approach on teaching, learning, and leading processes in Education 4.0.

Keywords: leadership, system transformation, innovation, innovative learning environment, Education 4.0, system leadership

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Authors: Minna Salim, James Brady

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Postoperative nausea and pain (PONV) are adverse effects following surgical procedures. It is especially pronounced in patients undergoing orthognathic surgery, as their mouth is closed postoperatively using wires or rubber bands. Postoperative mouth closure increases the discomfort and risk of complications associated with nausea and vomiting. Many surgeons and institutions apply gastric decompression in hopes of aspirating stomach contents and, therefore, decreasing PONV incidence. This review observed that PONV incidence was not affected by gastric decompression overall. However, the effect of gastric decompression on PONV in orthognathic surgery was variable. This paper aims to summarize the findings of gastric decompression on PONV and to determine the need for it in orthognathic surgery.

Keywords: gastric decompression, nasogastric tube, orthognathic surgery, postoperative nausea, vomiting

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Authors: Juliette MacDonald, Jun Li, Wenji Xiang, Mingwei Zhao

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Shanghai International College of Fashion and Innovation (SCF) was created as a result of a collaborative partnership agreement between the University of Edinburgh and Donghua University. The College provides two programmes: Fashion Innovation and Fashion Interior Design and the overarching curriculum has the intention of developing innovation and creativity within an international learning, teaching, knowledge exchange and research context. The research problem presented here focuses on the multi-national/cultural faculty in the team, the challenges arising from difficulties in communication and the associated limitations of management frameworks. The teaching faculty at SCF are drawn from China, Finland, Korea, Singapore and the UK with input from Flying Faculty from Fashion and Interior Design, Edinburgh College of Art (ECA), for 5 weeks each semester. Rather than fully replicating the administrative and pedagogical style of one or other of the institutions within this joint partnership the aim from the outset was to create a third way which acknowledges the quality assurance requirements of both Donghua and Edinburgh, the academic and technical needs of the students and provides relevant development and support for all the SCF-based staff and Flying Academics. It has been well acknowledged by those who are involved in teaching across cultures that there is often a culture shock associated with transnational education but that the experience of being involved in the delivery of a curriculum at a Joint Institution can also be very rewarding for staff and students. It became clear at SCF that if a third way might be achieved which encourages innovative approaches to fashion education whilst balancing the expectations of Chinese and western concepts of education and the aims of two institutions, then it was going to be necessary to construct a framework which developed close working relationships for the entire teaching team, so not only between academics and students but also between technicians and administrators at ECA and SCF. The attempts at co-construction and integration are built on the sharing of cultural and educational experiences and knowledge as well as provision of opportunities for reflection on the pedagogical purpose of the curriculum and its delivery. Methods on evaluating the effectiveness of these aims include a series of surveys and interviews and analysis of data drawn from teaching projects delivered to the students along with graduate successes from the last five years, since SCF first opened its doors. This paper will provide examples of best practice developed by SCF which have helped guide the faculty and embed common core values and aims of co-construction regulations and management, whilst building a pro-active TNE (Trans-National Education) team which enhances the learning experience for staff and students alike.

Keywords: cultural co-construction, educational team management, multi-cultural challenges, TNE integration for teaching teams

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Authors: Aboubacar Garba Konte, Wei Jun, Li Xiaohui

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Nowadays companies are facing increasing pressure. The market environment changes more frequently than ever. Therefore, managers have to develop their agility, their performance and their capacity for innovation. Most companies look for managerial innovations to develop in their employees qualities such as motivation, commitment, creativity, autonomy or even the ability to adapt to change and manage intensive pressure. On a more collective level, companies are looking for teams that are able to organize, communicate and develop a form of collective intelligence based on cooperation and solidarity. Among the many managerial innovations that are currently developing, mindfulness (or mindfulness) is drawing the attention of a growing number of companies (Google, Apple, Sony, ING ...), These companies have implemented programs based on mindfulness. Although the concept of mindfulness and its effects have been the subject of in-depth research in the psychological field, research on mindfulness in the field of management is still in its infancy and it is necessary to evaluate its contribution to organizations. The purpose of this research is to evaluate the effects of a mindfulness training among the managers of a Malian textile company (CMDT). We conducted a case study on their experience and their managerial practices. In addition, we discuss the innovative nature of mindfulness in terms of managerial practice The results show significant positive effects on two major skills identified by managers that raise significant difficulties in their daily lives: their ability to supervise a team of employees with all that this implies in terms of interpersonal skills and their ability to organize and prioritize their activities. In addition, the research methodology sheds light on the innovative nature of mindfulness in a favorable organizational environment.

Keywords: mindfulness, manager, managerial innovation, relational skills, organization and prioritization

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Authors: Justin D. Olmanson, Fitsum Abebe, Valerie Jones, Eric Kyle, Xianquan Liu, Katherine Robbins, Guieswende Rouamba

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The history of education technology--and designing, adapting, and adopting technologies for use in educational spaces--is nuanced, complex, and dynamic. Yet, despite a range of continually emerging technologies, the design and development process often yields results that appear quite similar in terms of affordances and interactions. Through this study we (1) verify the extent to which designs have been constrained, (2) consider what might account for it, and (3) offer a way forward in terms of how we might identify and strategically sidestep these influences--thereby increasing the diversity of our designs with a given technology or within a particular learning domain. We begin our inquiry from the perspective that a host of co-influencing elements, fields, and meta narratives converge on the education technology design process to exert a tangible, often homogenizing effect on the resultant designs. We identify several elements that influence design in often implicit or unquestioned ways (e.g. curriculum, learning theory, economics, learning context, pedagogy), we describe our methodology for identifying the elemental positionality embedded in a design, we direct our analysis to a particular subset of technologies in the field of literacy, and unpack our findings. Our early analysis suggests that the majority of education technologies designed for use/used in US public schools are heavily influenced by a handful of mainstream theories and meta narratives. These findings have implications for how we approach the education technology design process--which we use to suggest alternative methods for designing/ developing with emerging technologies. Our analytical process and re conceptualized design process hold the potential to diversify the ways emerging and established technologies get incorporated into our designs.

Keywords: curriculum, design, innovation, meta narratives

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Authors: Samba Lamine Cisse, Cheick Oumar Tangara, Seynabou Sissoko, Mahamadou Diakite, Seydou Doumbia

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Introduction: Over the past two decades, the world has been constantly changing, with new trends in project management. These trends are transforming the methods and priorities of research project management. They include the rise of digital technologies, multidisciplinary, open science, and the pressure for high-impact results. Managers, therefore, find themselves at a crossroads between the challenges and opportunities offered by these new trends. This paper aims to identify the challenges and opportunities they face while proposing strategies for effectively navigating this dynamic context. Methodology: This is a qualitative study based on an analysis of the challenges and opportunities facing the University Clinical Research Center in terms of new technologies and project management methods. This blended approach provides an overview of emerging trends and practices. Results: This article shows how research managers can turn new research trends in their favor and how they can adapt to the changes they face to optimize the productivity of research teams while ensuring the quality and ethics of the work. It also explores the importance of developing skills in data management, international collaboration, and innovation management. Finally, it proposes strategies for responding effectively to the challenges posed by these new trends while strengthening the position of research managers as essential facilitators of scientific progress. Conclusion: Navigating this changing landscape requires research managers to be highly flexible and able to anticipate the realities of their institution. By adopting modern project management methodologies and cultivating a culture of innovation, they can turn challenges into opportunities and propel research toward new horizons. This paper provides a strategic framework for overcoming current obstacles and capitalizing on future developments in research.

Keywords: new trends, research management, opportunities, challenges

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Authors: Esra Yuce, Isil D. S. Yamaner, Murude Yazan

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Aims and objective: Antiresorptive agents including bisphosphonates and denosumab as strong suppressors of osteoclasts are the most commonly used antiresorptive medications for the treatment of osteoporosis which counteract the negative quantitative alteration of trabecular and cortical bone by inhibition of bone turnover. Oral bisphosphonate therapy for the treatment of osteopenia, osteoporosis or Paget's disease is associated with the low-grade risk of osteonecrosis of the jaw, while higher-grade risk is associated with receiving intravenous bisphosphonates therapy in the treatment of multiple myeloma and bone metastases. On the other hand, there has been a remarkable increase in incidences of antiresorptive related osteonecrosis of the jaw (ARONJ) in oral bisphosphonate users. This clinical presentation will evaluate the healing outcomes via piezoelectric bone surgery under the irrigation of PVP-I solution irrigation in patients received bisphosphonate therapy. Material-Method: The study involved 8 female and 5 male patients that have been treated for ARONJ. Among 13 necrotic sites, 9 were in the mandible and 4 were in the maxilla. All of these 13 patients treated with surgical debridement via piezoelectric bone surgery under irrigation by solution with 3% PVP-I concentration in combination with long-term antibiotic therapy and 5 also underwent removal of mobile segments of bony sequestrum. All removable prosthesis in 8 patients were relined with soft liners during the healing periods in order to eliminate chronic minor traumas. Results: All patients were on oral bisphosphonate therapy for at least 2 years and 5 of which had received intravenous bisphosphonates up to 1 year before therapy with oral bisphosphonates was started. According to the AAOMS staging system, four cases were stage II, eight cases were stage I, and one case was stage III. The majority of lesions were identified at sites of dental prostheses (38%) and dental extractions (62%). All patients diagnosed with ARONJ stage I had used unadjusted removable prostheses. No recurrence of the symptoms was observed during the present follow-up (9–37 months). Conclusion: Despite their confirmed effectiveness, the prevention and treatment of osteonecrosis of the jaw secondary to oral bisphosphonate therapy remain major medical challenges. Treatment with piezoelectric bone surgery with irrigation of povidone-iodine solution was effective for management of bisphosphonate-related osteonecrosis of the jaw. Taking precautions for patients treated with oral bisphosphonates, especially also denture users, may allow for a reduction in the rate of developing osteonecrosis of the maxillofacial region.

Keywords: antiresorptive drug related osteonecrosis, bisphosphonate therapy, piezoelectric bone surgery, povidone iodine

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Authors: Hsiao-Lin Fang

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The Patient Self-Determination Act is based on the belief that each life is unique. The act regards each patient as an autonomous entity and explicitly protects the patient’s rights to know and make decisions and choices while ensuring that the patient’s wish for a peaceful end is granted. Even when the patient is unconscious and unable to express himself/herself, the patient’s self-determination and its exercise are still protected under the law. The act also ensures that healthcare professionals (HCPs) have a specific set of rules to follow and complete legal protection when their patients are unable to express themselves clearly. This report is about a 55-year-old female patient who weighed 110 kg and was diagnosed with acute type A aortic dissection. The case was that the patient suddenly felt backache and nausea during sleep before daybreak and was therefore transferred to this hospital from the original one. After the doctor explained the patient’s conditions, it was concluded that surgery was necessary. However, the patient’s family was immediately against the surgery after having heard its possible complications. Nevertheless, the patient was still willing to receive the surgery. Being at odds with her family, the patient decided to sign the surgery agreement herself and agreed to receive the two surgical procedures: (1) ascending aorta replacement and (2) innominate artery debranching. After the surgery, the patient did not regain consciousness and therefore received computed tomography scanning of the brain, which revealed false lumen involving proximal left common carotid artery, left subclavian artery and innominate artery, and severe compression of the true lumen with total/subtotal occlusion in the left common carotid artery. On the following day, the doctor discussed two further surgical procedures: (1) endografting for descending aorta and (2) endografting for left common carotid artery and subclavian artery with the family. However, as the patient’s postoperative recovery of consciousness only reached the level of stupor and her family had no intention of subsequent healthcare for the patient, the family made the joint decision three days later to have the endotracheal tube removed from the patient and let her die a natural death. Suggestion: An advance directive (AD) can be created beforehand. Once the patient is in a special clinical state (e.g., terminal illness, permanent vegetative state, etc.), the AD can determine whether to sustain the patient’s life through ‘medical intervention’ or to respect the patient’s rights to choose a peaceful end and receive palliative care. Through the expression of self-determination, it is possible to respect the patient’s medical practice autonomy and protect the patient’s dignity and right to a peaceful end, thereby respecting and supporting the patient’s decision. This also allows the three sides: the patient, the family and the medical team to understand the patient’s true wish in the process of advance care planning (ACP) and thereby promote harmony in the HCP-patient relationship.

Keywords: intensive care unit patient, cardiovascular surgery, self-determination, advance directive

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Authors: Karthikeyan M., Paul M. J.

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This abstract describes a case of central pancreatectomy (CP) for a 50-year-old woman with a neuroendocrine tumor in the mid-body of the pancreas. CP, a parenchyma-sparing surgical option, preserves the distal pancreas and spleen, reducing the risk of pancreatic endocrine and exocrine insufficiency compared to traditional resections. The patient, initially misdiagnosed with transient ischemic attack, presented with hypoglycemic symptoms and was found to have a pancreatic lesion. Post-operative results were positive, with a reduction in pancreatic drain volume and normalization of blood sugar levels. This case highlights CP's efficacy in treating centrally located pancreatic lesions while maintaining pancreatic function.

Keywords: central pancreatectomy without anastomosis, no endocrine deficiency on follow-op, less post-op hospital stay, less post-op complications

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Authors: Galuh Pramesti

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In Indonesia, the rise of the middle class and consumer purchasing power has created a trend of shifting the traditional into a modern retail market. Development of the creative economy as an impact of the global economy has invaded the traditional market, due to low rents and minimum innovation, raising the issue of sustainability and urban resilience for survival of the traditional market. The study aims to understand the current market conditions by examining the challenges, resiliency, and identify the relationship between the traditional market and creative market. Using a single-case study approach as the research methodology, Santa Market has been chosen as the case study. It is a pilot project of collaboration between a traditional market and creative economy in Jakarta, Indonesia. The research was conducted as a qualitative study through in-depth interviews with the market vendors and the market management, besides a desk-based study of the leasing data and spatial analysis. The findings indicate traffic fluctuation as the main challenge. It is related to the tenant’s presence, rental fluctuation, gentrification, infrastructure, and market competition. Thus, the findings on resilience show a different response for creative and traditional markets. The traditional market’s response remained stable with minimum innovation, whereas the creative market relies on technological development. Regarding the relationship, supply and demand have become the main relationship occurring in Santa Market. It is then developed into the context of society and regulation. The conclusion provides recommendations for more solid regulation to protect the market tenants from stakeholder interests that can disrupt market viability, and a critical discussion on the concept of collaboration between traditional and creative markets. There is also a suggestion for further study on relation with the surroundings, to create a holistic study on how the collaboration can work well in the traditional market.

Keywords: creative economy, market sustainability, traditional market, urban resilience

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Authors: Shekoufeh Behdad, Amirhossein Yadegari, Leila Ghodrati, Saman Yadegari

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Context: Preoperative anxiety is a common psychological reaction experienced by all patients undergoing surgery. It can have negative effects on the patient's well-being and even impact surgical outcomes. Therefore, finding effective interventions to reduce preoperative anxiety is important in improving patient care. Research Aim: The aim of this study is to compare the effects of oral administration of zaleplon (5 mg) and alprazolam (0.5 mg) on preoperative anxiety levels in women undergoing gynecological abdominal surgery. Methodology: This study is a double-blind, randomized clinical trial conducted after receiving approval from the university's ethics committee and obtaining written informed consent from the patients. The night before the surgery, patients were randomly assigned to receive either 0.5 mg of alprazolam or 5 mg of zaleplon orally. Anxiety levels, measured using a 10-cm visual analog scale, and hemodynamic variables (blood pressure and heart rate) were assessed before drug administration and on the morning of the operation after the patient entered the pre-operation room. Findings: The study found that there were no significant differences in mean anxiety levels or hemodynamic variables before and after administration of either drug in both groups (P value > 0.05). This suggests that both 0.5 mg of alprazolam and 5 mg of zaleplon effectively reduce preoperative anxiety in women undergoing abdominal surgery without serious side effects. Theoretical Importance: This study contributes to the understanding of the effectiveness of alprazolam and zaleplon in reducing preoperative anxiety. It adds to the existing literature on pharmacological interventions for anxiety management, specifically in the context of gynecological abdominal surgery. Data Collection: Data for this study were collected through the assessment of anxiety levels using a visual analog scale and measuring hemodynamic variables, including systolic, diastolic, and mean arterial blood pressures, as well as heart rate. These measurements were taken before drug administration and on the morning of the surgery. Analysis Procedures: Statistical analysis was performed to compare the mean anxiety levels and hemodynamic variables before and after drug administration in the two groups. The significance of the differences was determined using appropriate statistical tests. Questions Addressed: This study aimed to answer the question of whether there are differences in the effects of alprazolam and zaleplon on preoperative anxiety levels in women undergoing gynecological abdominal surgery. Conclusion: The oral administration of both 0.5 mg of alprazolam and 5 mg of zaleplon the night before surgery effectively reduces preoperative anxiety in women undergoing abdominal surgery. These findings have important implications for the management of preoperative anxiety and can contribute to improving the overall surgical experience for patients.

Keywords: zaleplon, alprazolam, premedication, abdominal surgery

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Authors: Malathi Balakrishnan, Cheng Lee Ooi, Chander Vengadasalam

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The purpose of this study is to explore a case study of trainee teachers’ learning experience on innovating traditional games during the traditional game carnival. It explores issues arising from multiple case studies of trainee teachers learning experiences in innovating traditional games. A qualitative methodology was adopted through observations, semi-structured interviews and reflective journals’ content analysis of trainee teachers’ learning experiences creating and implementing innovative traditional games. Twelve groups of 36 trainee teachers who registered for Sports and Physical Education Management Course were the participants for this research during the traditional game carnival. Semi structured interviews were administrated after the trainee teachers learning experiences in creating innovative traditional games. Reflective journals were collected after carnival day and the content analyzed. Inductive data analysis was used to evaluate various data sources. All the collected data were then evaluated through the Nvivo data analysis process. Inductive reasoning was interpreted based on the Self Determination Theory (SDT). The findings showed that the trainee teachers had positive game participation experiences, game knowledge about traditional games and positive motivation to innovate the game. The data also revealed the influence of themes like cultural significance and creativity. It can be concluded from the findings that the organized game carnival, as a requirement of course work by the Institute of Teacher Training Malaysia, was able to enhance teacher trainers’ innovative thinking skills. The SDT, as a multidimensional approach to motivation, was utilized. Therefore, teacher trainers may have more learning experiences using the SDT.

Keywords: learning experiences, innovation, traditional games, trainee teachers

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Authors: Francis Deinmodei W. Poazi, Jasmine O. Tamunosiki-Amadi, Maurice Fems

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In recent times the resource-based view (RBV) of strategic management has recorded a sizeable attention yet there has not been a considerable scholarly and managerial discourse, debate and attention. As a result, this paper gives special bit of critical reasoning as well as top-notch analyses and relationship between RBV and organizational innovation. The study examines those salient aspects of RBV that basically have the will power in ensuring the organization's capacity to go for innovative capability. In achieving such fit and standpoint, the paper joins other relevant academic discourse and empirical evidence. To this end, a reasonable amount of contributions in setting the ground running for future empirical researches would have been provided. More so, the study is guided and built on the following strength and significance: Firstly, RBV sees resources as heterogeneity which forms a strong point of strength and allows organisations to gain competitive advantage. In order words, competitive advantage can be achieved or delivered to the organization when resources are distinctively utilized in a valuable manner more than the envisaged competitors of the organization. Secondly, RBV is significantly influential in determining the real resources that are available in the organization with a view to locate capabilities within in order to attract more profitability into the organization when applied. Thus, there will be more sustainable growth and success in the ever competitive and emerging market. Thus, to have succinct description of the basic methodologies, the study adopts both qualitative as well as quantitative approach with a view to have a broad samples of opinion in establishing and identifying key and strategic organizational resources to enable managers of resources to gain a competitive advantage as well as generating a sustainable increase and growth in profit. Furthermore, a comparative approach and analysis was used to examine the performance of RBV within the organization. Thus, the following are some of the findings of the study: it is clear that there is a nexus between RBV and growth of competitively viable organizations. More so, in most parts, organizations have heterogeneous resources domiciled in their organizations but not all organizations as it was specifically and intelligently adopting the tenets of RBV to strengthen heterogeneity of resources which allows organisations to gain competitive advantage. Other findings of this study reveal that of managerial perception of RBV with respect to application and transformation of resources to achieve a profitable end. It is against this backdrop, the importance of RBV cannot be overemphasized; the study is strongly convinced and think that RBV view is one focal and distinct approach that is focused on internal to outside strategy which engenders sourcing or generating resources internally as well as having the quest to apply such internally sourced resources diligently to increase or gain competitive advantage.

Keywords: resource-based view, innovation, organisation, recognition significant relationship and theoretical perspective

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Authors: Zeynep Busra Velioglu, Deniz Pulat, Beril Demirbakan, Burak Ozcan, Ece Bayrak, Cevat Erisken

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Bone tissue has the ability to perform a wide array of functions including providing posture, load-bearing capacity, protection for the internal organs, initiating hematopoiesis, and maintaining the homeostasis of key electrolytes via calcium/phosphate ion storage. The most common cause for bone defects is extensive trauma and subsequent infection. Bone tissue has the self-healing capability without a scar tissue formation for the majority of the injuries. However, some may result with delayed union or fracture non-union. Such cases include reconstruction of large bone defects or cases of compromised regenerative process as a result of avascular necrosis and osteoporosis. Several surgical methods exist to treat bone defects, including Ilizarov method, Masquelete technique, growth factor stimulation, and bone replacement. Unfortunately, these are technically demanding and come with noteworthy disadvantages such as lengthy treatment duration, adverse effects on the patient’s psychology, repeated surgical procedures, and often long hospitalization times. These limitations associated with surgical techniques make bone substitutes an attractive alternative. Here, it was hypothesized that a 3D printed scaffold will mimic trabecular bone in terms of biomechanical properties and that such scaffolds will support cell attachment and survival. To test this hypothesis, this study aimed at fabricating poly(lactic acid), PLA, structures using 3D printing technology for trabecular bone defects, characterizing the scaffolds and comparing with bovine trabecular bone. Capacity of scaffolds on human bone marrow stem cell (hBMSC) attachment and survival was also evaluated. Cubes with a volume of 1 cm³ having pore sizes of 0.50, 1.00 and 1.25 mm were printed. The scaffolds/grafts were characterized in terms of porosity, contact angle, compressive mechanical properties as well cell response. Porosities of the 3D printed scaffolds were calculated based on apparent densities. For contact angles, 50 µl distilled water was dropped over the surface of scaffolds, and contact angles were measured using ‘Image J’ software. Mechanical characterization under compression was performed on scaffolds and native trabecular bone (bovine, 15 months) specimens using a universal testing machine at a rate of 0.5mm/min. hBMSCs were seeded onto the 3D printed scaffolds. After 3 days of incubation with fully supplemented Dulbecco’s modified Eagle’s medium, the cells were fixed using 2% formaldehyde and glutaraldehyde mixture. The specimens were then imaged under scanning electron microscopy. Cell proliferation was determined by using EZQuant dsDNA Quantitation kit. Fluorescence was measured using microplate reader Spectramax M2 at the excitation and emission wavelengths of 485nm and 535nm, respectively. Findings suggested that porosity of scaffolds with pore dimensions of 0.5mm, 1.0mm and 1.25mm were not affected by pore size, while contact angle and compressive modulus decreased with increasing pore size. Biomechanical characterization of trabecular bone yielded higher modulus values as compared to scaffolds with all pore sizes studied. Cells attached and survived in all surfaces, demonstrating higher proliferation on scaffolds with 1.25mm pores as compared with those of 1mm. Collectively, given lower mechanical properties of scaffolds as compared to native bone, and biocompatibility of the scaffolds, the 3D printed PLA scaffolds of this study appear as candidate substitutes for bone repair and regeneration.

Keywords: 3D printing, biomechanics, bone repair, stem cell

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