Search results for: surgical innovation

Authors: Sehrish Qayyum

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In this age of constant technology, asymmetrical warfare could not be won. Attuned psychometric study confirms that screaming sometimes is more productive than active retaliation against strong adversaries. Asymmetric warfare is a game of nerves and thoughts with least vigorous participation for large anticipated losses. It creates the condition of paraplegia with partial but permanent immobility, which effects the core warfare operations, being screams rather than active retaliation. When one’s own power is doubted, it gives power to one’s own doubt to ruin all planning either done with superlative cost-benefit analysis. Strategically calculated estimation of asymmetric warfare since the early WWI to WWII, WWII-to Cold War, and then to the current era in three chronological periods exposits that courage makes nations win the battle of warriors to battle of comrades. Asymmetric warfare has been most difficult to fight and survive due to unexpectedness and being lethal despite preparations. Thoughts before action may be the best-assumed strategy to mix Regional Security Complex Theory and OODA loop to develop the Paraplegic Resilience Policy Plan (PRPP) to win asymmetric warfare. PRPP may serve to control and halt the ongoing wave of terrorism, guerilla warfare, and insurgencies, etc. PRPP, along with a strategic work plan, is based on psychometric analysis to deal with any possible war condition and tactic to save millions of innocent lives such that lost in Christchurch New Zealand in 2019, November 2015 Paris attacks, and Berlin market attacks in 2016, etc. Getting tangled into self-imposed epistemic dilemmas results in regret that becomes the only option of performance. It is a descriptive psychometric analysis of war conditions with generic application of probability tests to find the best possible options and conditions to develop PRPP for any adverse condition possible so far. Innovation in technology begets innovation in planning and action-plan to serve as a rheostat approach to deal with asymmetric warfare.

Keywords: asymmetric warfare, psychometric analysis, PRPP, security

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Authors: Ugur Choban, Aruzhan Zhaksylyk, Assylbek Nurgabdeshov

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In recent years, there has been an increasing understanding of the value of encouraging entrepreneurial attitudes in university students. This is motivated by the belief that stimulating entrepreneurship not only promotes economic growth but also fosters innovation. This study looks at the complex link and addresses critical gaps between psychological capital and entrepreneurial intention among university students, with a specific emphasis on how contextual factors like academic support and past business experience impact this dynamic. Using a quantitative research method, data were gathered from a broad sample of 300 university students drawn from several faculties. The study used a questionnaire that included the Psychological Capital Questionnaire (PCQ) to assess psychological capital and a validated scale for entrepreneurial intention, as well as binary measures of academic support and prior entrepreneurial experience. Statistical investigations, including multigroup analyses performed with SmartPLS software, provided interesting insights into the effect of contextual factors on the relationship between psychological capital and entrepreneurial intention. The findings highlight that psychological capital had a strong favorable influence on university students' entrepreneurial inclinations. Furthermore, the study found that academic support enhances the influence of psychological capital on entrepreneurial intentions, emphasizing the significance of institutional backing in fostering entrepreneurial mindsets. Furthermore, students with prior entrepreneurial experience had a stronger propensity for entrepreneurship, showing a synergistic link between psychological capital and entrepreneurial background. These findings have both theoretical and practical implications. By explaining the mechanisms by which psychological capital promotes entrepreneurial intentions, the study contributes to the establishment of focused entrepreneurship education programs and support activities that are suited to student requirements. Policymakers may use these findings to create policies that encourage student entrepreneurship, ultimately encouraging economic development and innovation.

Keywords: academic support, entrepreneurial intentions, higher education institutions, psychological capital, prior entrepreneurial experience

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Authors: M. G. Cattaneo

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The non-effectiveness of certain codified human rights is particularly apparent with reference to the lack of access to essential drugs in developing countries, which represents a breach of the human right to receive adequate health assistance. This paper underlines the conflict and the legal contradictions between human rights, namely health rights, international Intellectual Property Rights, in particular patent law, as well as international trade law. The paper discusses the crucial links between R&D costs for innovation, patents and new medical drugs, with the goal of reformulating the hierarchies of priorities and of interests at stake in the international intellectual property (IP) law system. Different from what happens today, International patent law should be a legal instrument apt at rebalancing an axiological asymmetry between the (conflicting) needs at stake The core argument in the paper is the proposal of an alternative pathway, namely a feasible proposal for a patent law reform. IP laws tend to balance the benefits deriving from innovation with the costs of the provided monopoly, but since developing countries and industrialized countries are in completely different political and economic situations, it is necessary to (re)modulate such exchange according to the different needs. Based on this critical analysis, the paper puts forward a proposal, called Trading Time for Space (TTS), whereby a longer time for patent exclusive life in western countries (Time) is offered to the patent holder company, in exchange for the latter selling the medical drug at cost price in developing countries (Space). Accordingly, pharmaceutical companies should sell drugs in developing countries at the cost price, or alternatively grant a free license for the sale in such countries, without any royalties or fees. However, such social service shall be duly compensated. Therefore, the consideration for such a service shall be an extension of the temporal duration of the patent’s exclusive in the country of origin that will compensate the reduced profits caused by the supply at the price cost in developing countries.

Keywords: global health, global justice, patent law reform, access to drugs

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Authors: P. Weerkamp Bartholomeus

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Autism treatment evaluation is crucial for monitoring the development of an intervention at an early stage. ‘ReAttach’ is a new intervention based on the principles of attachment and social cognitive training. Practical research suggests promising results on a variety of developmental areas. Five years after the first ReAttach sessions these findings can be extended with qualitative research by means of follow-up interviews. The potential impact of this treatment on daily life functioning and well-being of autistic persons becomes clear.

Keywords: autism, innovation, treatment, social cognitive training

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Authors: Janaina Camile Pasqual Lofhagen, David Savarese, Veronika Vazhnik

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The urgency of the climate crisis requires both innovation and practicality. The energy transition framework allows industry to deliver resilient cities, enhance adaptability to change, pursue energy objectives such as growth or efficiencies, and increase renewable energy. This paper investigates a real-world application perspective for the use of biogas in Brazil and the U.S.. It will examine interventions to provide a foundation of infrastructure, as well as the tangible benefits for policy-makers crafting law and providing incentives.

Keywords: resilience, vulnerability, risks, biogas, sustainability.

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Authors: Suang K. Lau, Ismail Goolam, Rafid Al-Asady

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Background: The majority of patients with hepatocellular carcinoma (HCC) are not suitable for curative treatment, in the form of surgical resection or transplantation, due to tumour extent and underlying liver dysfunction. In these non-resectable cases, a variety of non-surgical therapies are available, including microwave ablation (MWA), which has shown increasing popularity due to its low morbidity, low reported complication rate, and the ability to perform multiple ablations simultaneously. Objective: The aim of this study was to evaluate the validity of MWA as a viable treatment option in the management of HCC and hepatic metastatic disease, by assessing its efficacy and complication rate at a tertiary hospital situated in Westmead (Australia). Methods: A retrospective observational study was performed evaluating patients that underwent MWA between 1/1/2017–31/12/2018 at Westmead Hospital, NSW, Australia. Outcome measures, including residual disease, recurrence rates, as well as major and minor complication rates, were retrospectively analysed over a 12-months period following MWA treatment. Excluded patients included those whose lesions were treated on the basis of residual or recurrent disease from previous treatment, which occurred prior to the study window (11 patients) and those who were lost to follow up (2 patients). Results: Following treatment of 106 new hepatic lesions, the complete response rate (CR) was 86% (91/106) at 12 months follow up. 10 patients had the residual disease at post-treatment follow up imaging, corresponding to an incomplete response (ICR) rate of 9.4% (10/106). The local recurrence rate (LRR) was 4.6% (5/106) with follow-up period up to 12 months. The minor complication rate was 9.4% (10/106) including asymptomatic pneumothorax (n=2), asymptomatic pleural effusions (n=2), right lower lobe pneumonia (n=3), pain requiring admission (n=1), hypotension (n=1), cellulitis (n=1) and intraparenchymal hematoma (n=1). There was 1 major complication reported, with pleuro-peritoneal fistula causing recurrent large pleural effusion necessitating repeated thoracocentesis (n=1). There was no statistically significant association between tumour size, location or ablation factors, and risk of recurrence or residual disease. A subset analysis identified 6 segment VIII lesions, which were treated via a trans-pleural approach. This cohort demonstrated an overall complication rate of 33% (2/6), including 1 minor complication of asymptomatic pneumothorax and 1 major complication of pleuro-peritoneal fistula. Conclusions: Microwave ablation therapy is an effective and safe treatment option in cases of non-resectable hepatocellular carcinoma and liver metastases, with good local tumour control and low complication rates. A trans-pleural approach for high segment VIII lesions is associated with a higher complication rate and warrants greater caution.

Keywords: hepatocellular carcinoma, liver metastases, microwave ablation, trans-pleural approach

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Authors: Samira-Sadat JamaliDinan, Haidar Almohri, Mohammad-Reza Nazem-Zadeh

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Lateralization of temporal lobe epilepsy (TLE) is very important for positive surgical outcomes. We propose a machine learning framework to ultimately identify the epileptogenic hemisphere for temporal lobe epilepsy (TLE) cases using magnetoencephalography (MEG) coherence source imaging (CSI) and diffusion tensor imaging (DTI). Unlike most studies that use classification algorithms, we propose an effective clustering approach to distinguish between normal and TLE cases. We apply the famous Minkowski weighted K-Means (MWK-Means) technique as the clustering framework. To overcome the problem of poor initialization of K-Means, we use particle swarm optimization (PSO) to effectively select the initial centroids of clusters prior to applying MWK-Means. We demonstrate that compared to K-means and MWK-means independently, this approach is able to improve the result of a benchmark data set.

Keywords: temporal lobe epilepsy, machine learning, clustering, magnetoencephalography

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Authors: Narges Solaymani

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Definition of Nurse: Nurse: A person who is educated and skilled in the field of scientific principles and professional skills of health care, treatment, and 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: Fayez Hanna, Viet Tran

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A 20 years old lady- primigravida 6 weeks pregnant with unremarkable past history, presented to the emergency department at the Royal Hobart Hospital, Tasmania, Australia, with hyperemesis gravidarum associated with, dehydration and complicated with hematemesis and chest pain resistant. Accordingly, we conducted laboratory investigations which revealed: FBC: WBC 23.9, unremarkable U&E, LFT, lipase and her VBG showed a pH 7.4, pCo2 36.7, cK+ 3.2, cNa+ 142. The decision was made to do a chest X-ray (CXR) after explaining the risks/benefit of performing radiographic investigations during pregnancy and considering the patient's plan for the termination of the pregnancy as she was not ready for motherhood for shared decision-making and consent to look for pneumoperitoneum to suggest perforated viscus that might cause the hematemesis. However, the CXR showed pneumomediastinum but no evidence of pneumoperitoneum or pneumothorax. Consequently, a decision was made to proceed with CT oesophagography with imaging pre and post oral contrast administration to identify a potential oesophageal tear since it could not be excluded using a plain film of the CXR. The CT oesophagography could not find a leak for the administered oral contrast and thus, no oesophageal tear could be confirmed but could not exclude the Mallory-Weiss tear (lower oesophageal tear). Further, the CT oesophagography showed an extensive pneumomediastinum that could not be confirmed to be pulmonary in origin noting the presence of bilateral pulmonary interstitial emphysema and pneumothorax in the apex of the right lung that was small. The patient was admitted to the Emergency Department Inpatient Unit for monitoring, supportive therapy, and symptomatic management. Her hyperemesis was well controlled with ondansetron 8mg IV, metoclopramide 10mg IV, doxylamine 25mg PO, pyridoxine 25mg PO, esomeprazole 40mg IV and oxycodone 5mg PO was given for pain control and 2 litter of IV fluid. The patient was stabilized after 24 hours and discharged home on ondansetron 8mg every 8 hours whereas the patient had a plan for medical termination of pregnancy. Three weeks later, the patient represented with nausea and vomiting complicated by a frank hematemesis. Her observation chart showed HR 117- other vital signs were normal. Pathology showed WBC 14.3 with normal U&E and Hb. The patient was managed in the Emergency Department with the same previous regimen and was discharged home on same previous regimes. Five days later, she presented again with nausea, vomiting and hematemesis and was admitted under obstetrics and gynaecology for stabilization then discharged home with a plan for surgical termination of pregnancy after 3-days rather than the previously planned medical termination of pregnancy to avoid extension of potential oesophageal tear. The surgical termination and follow up period were uneventful. The case is considered rare as pneumomediastinum is a very rare complication of hyperemesis gravidarum where vomiting-induced barotrauma leads to a ruptured oesophagus and air leak into the mediastinum. However no rupture oesophagus in our case. Although the combination of pneumothorax and pneumomediastinum without oesophageal tear was reported only 8 times in the literature, but none of them was due to hyperemesis gravidarum.

Keywords: Pneumothorax, pneumomediastinum, hyperemesis gravidarum, pneumopericardium

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Authors: Meshandren Naidoo

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An artificial intelligence (AI) system named DABUS 2021 made headlines when it became the very first AI system to be listed in a patent which was then granted by the South African patent office. This grant raised much criticism. The question that this research intends to answer is (1) whether, in South African patent law, an AI can be an inventor. This research finds that despite South African law not recognizing an AI as a legal person and despite the legislation not explicitly allowing AI to be inventors, a legal interpretative exercise would allow AI inventorship.

Keywords: artificial intelligence, creativity, innovation, law

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Authors: Malki Fatima Zahra Nadia, Kellal Chaimaa, Brahimi Houria

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The following research aims to measure the impact of innovative marketing in achieving product quality in the Algerian Petroleum Company. In order to achieve the aim of the study, a random sample of 60 individuals was selected and the answers were analyzed using structural equation modeling to test the study hypotheses. The research concluded that there is a strong relationship between innovative marketing and the quality of petroleum products.

Keywords: marketing, innovation, quality, petroleum products

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Authors: Sarah Müller-Sägebrecht

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Today’s volatile environment challenges executives to make the right strategic decisions to gain sustainable success. Entrepreneurship scholars postulate mainly positive effects of environmental changes on entrepreneurship behavior, such as developing new business opportunities, promoting ingenuity, and the satisfaction of resource voids. A strategic solution approach to overcome threatening environmental changes and catch new business opportunities is business model innovation (BMI). Although this research stream has gained further importance in the last decade, BMI research is still insufficient. Especially BMI barriers, such as inefficient strategic decision-making processes, need to be identified. Strategic decisions strongly impact organizational future and are, therefore, usually made in groups. Although groups draw on a more extensive information base than single individuals, group-interaction effects can influence the decision-making process - in a favorable but also unfavorable way. Decisions are characterized by uncertainty and risk, whereby their intensity is perceived individually differently. Individual risk-willingness influences which option humans choose. The special nature of strategic decisions, such as in BMI processes, is that these decisions are not made individually but in groups due to their high organizational scope. These groups consist of different personalities whose individual risk-willingness can vary considerably. It is known from group decision theory that these individuals influence each other, observable in different group-interaction effects. The following research questions arise: i) Which impact has the individual risk-willingness on BMI decisions? And ii) how do group interaction effects impact BMI decisions? After conducting 26 in-depth interviews with executives from the manufacturing industry, the applied Gioia methodology reveals the following results: i) Risk-averse decision-makers have an increased need to be guided by facts. The more information available to them, the lower they perceive uncertainty and the more willing they are to pursue a specific decision option. However, the results also show that social interaction does not change the individual risk-willingness in the decision-making process. ii) Generally, it could be observed that during BMI decisions, group interaction is primarily beneficial to increase the group’s information base for making good decisions, less than for social interaction. Further, decision-makers mainly focus on information available to all decision-makers in the team but less on personal knowledge. This work contributes to strategic decision-making literature twofold. First, it gives insights into how group-interaction effects influence an organization’s strategic BMI decision-making. Second, it enriches risk-management research by highlighting how individual risk-willingness impacts organizational strategic decision-making. To date, it was known in BMI research that risk aversion would be an internal BMI barrier. However, with this study, it becomes clear that it is not risk aversion that inhibits BMI. Instead, the lack of information prevents risk-averse decision-makers from choosing a riskier option. Simultaneously, results show that risk-averse decision-makers are not easily carried away by the higher risk-willingness of their team members. Instead, they use social interaction to gather missing information. Therefore, executives need to provide sufficient information to all decision-makers to catch promising business opportunities.

Keywords: business model innovation, decision-making, group biases, group decisions, group-interaction effects, risk-willingness

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Authors: Abhay Vir Singh Kanwar

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The pharmaceutical industry today is a multi-billion dollar business and yet disadvantages people in many corners of the globe who are still dying in large numbers from curable illnesses for lack of access to drugs. The astronomical prices of essential and life-saving drugs is not just an economic problem that can be settled through clever market strategies but is an ethical issue, given the accumulated wealth of today’s humanity and the sense of global justice that it increasingly comes to share. In this paper, I make a very practical argument for what I shall call ‘the ethical healthcare paradigm’, which, I propose, can replace the economistic paradigm that can still drive the healthcare sector without creating spillover effects on the market. Taking off from the ethical-philosophical argument for recognizing every individual’s right to capability to be healthy, I shall come to the focused practical proposal of the cost-rationalization and universal availability of essential, life-saving drugs through the undertaking of research and development funding for drug innovation by the business establishment as such in terms of the concept of CSR. The paper will first expose the concepts of basic and fundamental capabilities in relation to education and health, after which it will focus on the right to capability to be healthy of every person. In the third section, it will discuss the ‘ethical healthcare paradigm’ as opposed to the economistic health paradigm and will argue that the patient will have to be considered the primary stakeholder of this paradigm or the very ‘subject’ of healthcare. The next section will be on an ethical-historical critique of the pharmaceutical industry’s profit driven economism. The section after that will look at the business operation and the stages in the life cycle of a drug that comes to the market in order to understand the risks, strengths and problems of the pharmaceutical industry. Finally, the paper will discuss the concept of CSR in relation to the ethical healthcare paradigm in order to propose CSR funding in research and development for innovation on drugs so that life-saving drugs can be made available to every sick person cost-effectively.

Keywords: capability approach, healthcare, CSR, patient

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Authors: Zahid Ullah, Atlas Khan

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The rapid advancements in data collection, storage, and processing capabilities have led to an explosion of data in various domains. In this era of big data, mathematical sciences play a crucial role in uncovering valuable insights and driving informed decision-making through data analytics. The purpose of this abstract is to present the latest advances in mathematical sciences and their application in harnessing the power of data analytics. This abstract highlights the interdisciplinary nature of data analytics, showcasing how mathematics intersects with statistics, computer science, and other related fields to develop cutting-edge methodologies. It explores key mathematical techniques such as optimization, mathematical modeling, network analysis, and computational algorithms that underpin effective data analysis and interpretation. The abstract emphasizes the role of mathematical sciences in addressing real-world challenges across different sectors, including finance, healthcare, engineering, social sciences, and beyond. It showcases how mathematical models and statistical methods extract meaningful insights from complex datasets, facilitating evidence-based decision-making and driving innovation. Furthermore, the abstract emphasizes the importance of collaboration and knowledge exchange among researchers, practitioners, and industry professionals. It recognizes the value of interdisciplinary collaborations and the need to bridge the gap between academia and industry to ensure the practical application of mathematical advancements in data analytics. The abstract highlights the significance of ongoing research in mathematical sciences and its impact on data analytics. It emphasizes the need for continued exploration and innovation in mathematical methodologies to tackle emerging challenges in the era of big data and digital transformation. In summary, this abstract sheds light on the advances in mathematical sciences and their pivotal role in unveiling the power of data analytics. It calls for interdisciplinary collaboration, knowledge exchange, and ongoing research to further unlock the potential of mathematical methodologies in addressing complex problems and driving data-driven decision-making in various domains.

Keywords: mathematical sciences, data analytics, advances, unveiling

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Authors: Stefan Bradu, Daniel Siegel, Jameson Loyal, Andrea Leaf, Alana Kurtti, Usha Alapati, Jared Jagdeo

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Compared with all other variants of nodular melanoma, patients with polypoid nodular melanoma have the lowest 5-year survival rate. The pathophysiology and management of polypoid melanoma are scarcely reported in the literature. Although surgical excision is the cornerstone of melanoma management, treatment of polypoid melanoma is complicated by several negative prognostic factors, including early metastasis. This report demonstrates the successful treatment of a rapidly developing red nodular polypoid melanoma with metastasis using surgery and adjuvant nivolumab in a SARS-CoV-2-positive patient who delayed seeking care due to the COVID-19 pandemic. In addition to detailing the successful treatment approach, the immunosuppressive effects of SARS-2-CoV and its possible contribution to the rapid progression of polypoid melanoma are discussed. This case highlights the complex challenges of melanoma diagnosis and management during the COVID-19 pandemic.

Keywords: covid-19, dermatology, immunotherapy, melanoma, nivolumab

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Authors: Maureen Royce, Joshi Jariwala, Sally Kah

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Change is inevitable, but the change process is progressive. Organisational change is the process in which an organisation changes strategies, operational methods, systems, culture, and structure to affect something different in the organisation. This process can be continuous or developed over a period and driven by internal and external factors. Organisational change is essential if organisations are to survive in dynamic and uncertain environments. However, evidence from research shows that many change initiatives fail, leading to severe consequences for organisations and their resources. The complex models of third sector organisations, i.e., social enterprise, compounds the levels of change in these organisations. Interestingly, innovation is associated with a change in social enterprises due to the hybridity of product and service development. Furthermore, the creation of social intervention has offered a new process and outcomes to the lifecycle of change. Therefore, different forms of organisational innovation are developed, i.e., total, evolutionary, expansionary, and developmental, which affect the interventions of social enterprises. This raises both theoretical and business concerns on how the competing hybrid nature of social enterprises change, how change is managed, and the impact on these organisations. These perspectives present critical questions for further investigation. In this study, we investigate the impact of organisational change on employees and organisational development at DaDaFest –a disability arts organisation with a social focus based in Liverpool. The three main objectives are to explore the drivers of change and the implementation process; to examine the impact of organisational change on employees and; to identify barriers to organisation change and development. To address the preceding research objectives, qualitative research design is adopted using semi-structured interviews. Data is analysed using a six-step thematic analysis framework, which enables the study to develop themes depicting the impact of change on employees and organisational development. This study presents theoretical and practical contributions for academics and practitioners. The knowledge contributions encapsulate the evolution of change and the change cycle in a social enterprise. However, practical implications provide critical insights into the change management process and the impact of change on employees and organisational development.

Keywords: organisational change, change management, organisational change system, social enterprise

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Authors: Matthew P. Mancini, Vincent Ribiere

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Today’s workers face more numerous and complex challenges and are required to be increasingly interdependent and faster learners. Knowledge sharing activities between people have been understood as a significant element affecting organizational innovation performance. While they do have the potential to spark cognitive conflict, disagreement is important from an organizational perspective because it can stimulate the development of new ideas and perhaps pave the way for creativity, innovation, and competitive advantage. How teams cope with the cognitive conflict dimension of knowledge sharing and the associated interpersonal risk is what captures our attention. Specifically, assertive conflict management strategies have a positive influence on knowledge sharing behaviors, and team psychological safety has a positive influence on knowledge sharing intention. This paper focuses on explaining the impact that these factors have on the shaping of an individual’s decision to engage or not in knowledge sharing activities. To accomplish this, we performed an empirical analysis on the results of our questionnaire about knowledge-sharing related conflict management and team psychological safety in pharmaceutical enterprises located in North America, Europe, and Asia. First, univariate analysis is used to characterize behavior regarding conflict management strategy into two groups. Group 1 presents assertive conflict management strategies and group 2 shows unassertive ones. Then, by using SEM methodology, we evaluated the relationships between them and the team psychological safety construct with the knowledge sharing process. The results of the SEM analysis show that assertive conflict management strategies affect the knowledge sharing process the most with a small, but significant effect from team psychological safety. The findings suggest that assertive conflict management strategies are just as important as knowledge sharing intentions for encouraging knowledge sharing behavior. This paper provides clear insights into how employees manage the sharing of their knowledge in the face of conflict and interpersonal risk and the relative importance of these factors in sustaining productive knowledge sharing activities.

Keywords: cognitive dissonance, conflict management, knowledge sharing, organizational behavior, psychological safety

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Authors: Shah Awan, Fahad Sultan, Shahid Jan Kakakhel

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Higher education in the 21st century has been faced with game-changing developments impacting teaching and learning and also strengthening the academia and industry relationship. The academia and industry relationship plays a key role in economic development in developed, developing and emerging economies. The partnership not only explores innovation but also provide a real time experience of the theoretical knowledge. For this purpose, the paper assessing the role of HEC in the Pakistan and discusses the way in academia and industry contribute their role in improving Pakistani economy. Successive studies have reported the importance of innovation and technology , research development initiatives in public sector universities, and the significance of role of higher education commission in strengthening the academia and industrial relationship to improve performance and minimize failure. The paper presents the results of interviews conducted, using semi-structured interviews amongst 26 staff members of two public sector universities, higher education commission and managers from corporate sector.The study shows public sector universities face the several barriers in developing economy like Pakistan, to establish the successful collaboration between universities and industry. Of the participants interviewed, HEC provides an insufficient road map to improve organisational capabilities in facilitating and enhance the performance. The results of this study have demonstrated that HEC has to embrace and internalize support to industry and public sector universities to compete in the era of globalization. Publication of this research paper will help higher education sector to further strengthen research sector through industry and university collaboration. The research findings corroborate the findings of Dooley and Kirk who highlights the features of university-industry collaboration. Enhanced communication has implications for the quality of the product and human resource. Crucial for developing economies, feasible organisational design and framework is essential for the university-industry relationship.

Keywords: higher education commission, role, academia and industry relationship, Pakistan

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Authors: Amanda Grace Ahl, Matthew Brummer

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‘Smart cities’ are not always as ‘smart’ as the term suggests, which is not often covered in the associated academic and public policy literatures. In what has become known as the smart city approach to urban planning, governments around the world are seeking to harness the power of information and communications technology with increasingly advanced data analytics to address major social, economic, and environmental issues reshaping the ways people live. The definitional and theoretical boundaries of the smart city framework are broad and at times ambiguous, as is empirical treatment of the topic. However, and for all the disparity, in investigating any number of institutional and policy prescriptions to the challenges faced by current and emerging metropoles, scholarly thought has hinged overwhelmingly on value-positive conceptions of informatics-centered design. From enhanced quality of services, to increased efficiency of resources, to improved communication between societal stakeholders, the smart city design is championed as a technological wellspring capable of providing answers to the systemic issues stymying a utopian image of the city. However, it is argued that this ‘techtopia’, has resulted in myopia within the discipline as to value-negative implications of such planning, such as weaknesses in practicality, scalability, social equity and affordability of solutions. In order to more carefully examine this observation - that ‘stupid’ represents an omitted variable bias in the study of ‘smart’ - this paper reviews critical cases of unsuccessful smart city developments. It is argued that also understanding the negative factors affiliated with the development processes is imperative for the advancement of theoretical foundations, policies, and strategies to further the smart city as an equitable, holistic urban innovation. What emerges from the process-tracing carried out in this study are distinctly negative lessons of smart city projects, the significance of which are vital for understanding how best to conceive smart urban planning in the 21st century.

Keywords: case study, city management, innovation system, negative lessons, smart city development

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Authors: Ana Hol

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We live in a constantly changing environment where technology has become an integral component of our day to day life. We rely heavily on mobile devices, we search for data via web, we utilise smart home sensors to create the most suited ambiences and we utilise applications to shop, research, communicate and share data. Heavy reliance on technology therefore is creating new connections between STEM (Science, Technology, Engineering and Mathematics) fields which in turn rises a question of what the STEM education of the future should be like? This study was based on the reviews of the six Australian Information Systems students who undertook an international study tour to India where they were given an opportunity to network, communicate and meet local students, staff and business representatives and from them learn about the local business implementations, local customs and regulations. Research identifies that if we are to continue to implement and utilise electronic devices on the global scale, such as for example implement smart cars that can smoothly cross borders, we will need the workforce that will have the knowledge about the cars themselves, their parts, roads and transport networks, road rules, road sensors, road monitoring technologies, graphical user interfaces, movement detection systems as well as day to day operations, legal rules and regulations of each region and country, insurance policies, policing and processes so that the wide array of sensors can be controlled across country’s borders. In conclusion, it can be noted that allowing students to learn about the local conditions, roads, operations, business processes, customs and values in different countries is giving students a cutting edge advantage as such knowledge cannot be transferred via electronic sources alone. However once understanding of each problem or project is established, multidisciplinary innovative STEM projects can be smoothly conducted.

Keywords: STEM, curiosity, innovation, advancements

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Authors: Khadija Mushtaq, Mian Saqib Mehmood

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This paper attempts to determine the impact of leadership style and learning orientation on organizational performance in Pakistan. A sample of 158 middle managers selected from sports and surgical factories from Sialkot. The empirical estimation is based on a multiple linear regression analysis of the relationship between leadership style, learning orientation and organizational performance. Leadership style is measure through transformational leadership and transactional leadership. The transformational leadership has insignificant impact on organizational performance. The transactional leadership has positive and significant relation with organizational performance. Learning orientation also has positive and significant relation with organizational performance. Linear regression used to estimate the relation between dependent and independent variables. This study suggests top manger should prefer continuous process for improvement for any change in system rather radical change.

Keywords: transformational leadership, transactional leadership, learning orientation, organizational performance, Pakistan

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Authors: Mohammed Al-Yamani, Yaser Miaji

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DHL Customer Solutions and Innovation Department (CSI) have been experiencing difficulties while comparing quotes for different customers in different years. Currently, the employees are processing data by opening several loaded Excel files where the quotes are and manually copying values to another Excel Workbook where the comparison is made. This project consists of developing a new and effective database for DHL CSI department so that information is stored altogether on the same catalog. That being said, we have been assigned to find an efficient algorithm that can deal with the different formats of the Excel Workbooks to copy and store the express customer rates for core products (DOX, WPX, IMP) for comparisons purposes.

Keywords: DHL, solution design, ORACLE, EXCEL

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Authors: Robert E. Kenney, Richard B. Aguilar, Efrain Antunez, Gregory Schor-Haskin, Rafael Rey, Catie Falcon, Luis Arce

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This study sought to explore the effect of Sarapin injections on chronic knee pain (CKP). Many adults suffer from CKP which is most often attributed to osteoarthritis. Current treatment regimens for CKP involve the use NSAIDS medications, injections with steroids/analgesic, platelet rich plasma injections, or orthopedic surgical interventions. Sarapin is a commercially available homeopathic aqueous extract from the pitcher plant. Studies on the use of Sarapin as a treatment for cervical, thoracic, and lumbosacral facet joint nerve blocks have been performed with mixed results. There is little available evidence on the use of Sarapin in CKP. This study examines the effect of a series of 3 weekly injections of aqueous Sarapin in 95 elderly patients with CKP in a primary care setting. Cano Health, a primary care group, identified 95 successive patients with CKP from its multimodal physiotherapy program for chronic pain. Patients underwent evaluation by a clinician, underwent diagnostic Xrays of the knees, and the treatment plan with three weekly Sarapin injections was discussed. A pain and functional limitation survey (a modified Lower Extremity Functional Scale (mLEFS)) was administered prior to initiating treatment (Entry Survey (ES)). Each patient received an intraarticular injection of 2 cc of aqueous Sarapin with 1cc 1% lidocaine during weeks 1, 2 and 3. The mLEFS was administered again at week 4, one week after the third Sarapin injection (Exit Survey (ExS)). Demographics: Mean Age 62 +/- 9.8; 73% female; 89% Hispanic/Latino; mean time between ES and ExS was 27.5 +/-8.2 days. Survey: The mLEFS was based on a published Lower Extremity Functional Scale and each patient rated their pain or functional limitation from 0 (no difficulty) to 5 (severe difficulty) for 10 questions. Answers were summed and compared. Maximum score for severe difficulty would be 50 points. Results: Mean pain/functional scores: ES was 30.3 +/-12.1 and ExS was 19.5 +/- 12.5. This represents a relative improvement of 35.7% (P<0.00001). A total of 81% (77/95) of the patients showed improvement in symptoms at week four as assessed by the mLEFS. There were 11 patients who reported an increase in their survey scores while 7 patients reported no change. When evaluating the cohort that reported improvement, the ES was 30.9 +/-11.4 and ExS was 16.3 +/-9.8 yielding a 47.2% relative improvement (P<0.00001). Injections were well tolerated, and no adverse events were reported. Conclusions: In this cohort of 95 elderly patients with CKP, treatment with 3 weekly injections of Sarapin significantly improved pain and function as assessed by a mLEFS survey. The majority (81%) of patients responded positively to therapy, 12% had worsening symptoms and 7% reported no change. The use of intraarticular injections of Sarapin for CKP was shown to be an effective modality of treatment. Sarapin’s low cost, tolerability, and ease of use make it an attractive alternative to NSAIDS, steroids, PRP or surgical intervention for this common debilitating condition.

Keywords: Sarapin, intraarticular, chronic knee pain, osteoarthritis

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Authors: Sarah Bouayyad, Ajay Nigam, Meera Beena

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Acquired benign tracheoesophageal fistula is a rare medical condition that usually results from trauma, foreign bodies, or granulomatous infections. This is an unusual presentation of a male patient with a history of laryngectomy who had had over a period of several years inappropriately and vigorously used valve cleaning brushes to clean tracheal secretions, which had led to the formation of a tracheoesophageal fistula. Due to the patient’s obsessive habit, we couldn’t manage him using conventional surgical methods. Instead, we opted for the placement of a salivary bypass tube, which yielded good results and recovery. To the best of our knowledge, no other case of similar etiology has been published. We would like to highlight the importance of appropriate patient selection and education prior to performing a tracheoesophageal puncture to avoid developing life-threatening complications as demonstrated in our case report.

Keywords: tracheoesophageal fistula, speech valve, endoscopic insertion of salivary bypass tube, head and neck malignancies

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Authors: Shang Yee Chong

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Perioperative pain is a complex mechanism activated by various nociceptive, neuropathic, and inflammatory pathways. Opioids have long been a mainstay for analgesia in this period, even as we are continuously moving towards a multimodal model to improve pain control while minimising side effects. Dexmedetomidine, a potent alpha-2 agonist, is a useful sedative and hypnotic agent. Its use in the intensive care unit has been well described, and it is increasingly an adjunct intraoperatively for its opioid sparing effects and to decrease pain scores. We describe a case of a general surgical patient in whom minimal opioids was required with dexmedetomidine use. The patient was a 61-year-old Indian gentleman with a history of hyperlipidaemia and type 2 diabetes mellitus, presenting with rectal adenocarcinoma detected on colonoscopy. He was scheduled for a robotic ultra-low anterior resection. The patient was induced with intravenous fentanyl 75mcg, propofol 160mg and atracurium 40mg. He was intubated conventionally and mechanically ventilated. Anaesthesia was maintained with inhalational desflurane and anaesthetic depth was measured with the Masimo EEG Sedline brain function monitor. An initial intravenous dexmedetomidine dose (bolus) of 1ug/kg for 10 minutes was given prior to anaesthetic induction and thereafter, an infusion of 0.2-0.4ug/kg/hr to the end of surgery. In addition, a bolus dose of intravenous lignocaine 1.5mg/kg followed by an infusion at 1mg/kg/hr throughout the surgery was administered. A total of 10mmol of magnesium sulphate and intravenous paracetamol 1000mg were also given for analgesia. There were no significant episodes of bradycardia or hypotension. A total of intravenous phenylephrine 650mcg was given throughout to maintain the patient’s mean arterial pressure within 10-15mmHg of baseline. The surgical time lasted for 5 hours and 40minutes. Postoperatively the patient was reversed and extubated successfully. He was alert and comfortable and pain scores were minimal in the immediate post op period in the postoperative recovery unit. Time to first analgesia was 4 hours postoperatively – with paracetamol 1g administered. This was given at 6 hourly intervals strictly for 5 days post surgery, along with celecoxib 200mg BD as prescribed by the surgeon regardless of pain scores. Oral oxycodone was prescribed as a rescue analgesic for pain scores > 3/10, but the patient did not require any dose. Neither was there nausea or vomiting. The patient was discharged on postoperative day 5. This case has reinforced the use of dexmedetomidine as an adjunct in general surgery cases, highlighting its excellent opioid-sparing effects. In the entire patient’s hospital stay, the only dose of opioid he received was 75mcg of fentanyl at the time of anaesthetic induction. The patient suffered no opioid adverse effects such as nausea, vomiting or postoperative ileus, and pain scores varied from 0-2/10. However, intravenous lignocaine infusion was also used in this instance, which would have helped improve pain scores. Paracetamol, lignocaine, and dexmedetomidine is thus an effective, opioid-sparing combination of multi-modal analgesia for major abdominal surgery cases.

Keywords: analgesia, dexmedetomidine, general surgery, opioid sparing

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Authors: Manik Sharma

Abstract:

Understanding the anatomy and normal anatomical variations of the lower limb arterial system is undeniably important not only to understand the pathology involving the vessels of the lower limb but also as a part of endovascular intervention and surgical planning in cases that demand them as a part of treatment. There have been very few cases of duplication of SFA cited in the literature, close to six worldwide and this being the seventh case in the world and first to be reported in the Indian population. We incidentally came across this normal variant during US lower limb (US-LL) duplex scan in a patient with claudicating pain in bilateral lower limbs hence suspected of having peripheral vascular disease. It was confirmed on CT-Peripheral Angiography (CT-PA), which was done successively.

Keywords: peripheral vascular disease, claudicating pain, normal anatomical variants, endovascular intervention, duplication, CT-peripheral angiography, duplex scan, Iohexol

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Authors: Joanna Drzeżdżon

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Polyvinyl alcohol and its derivatives such as 2-chloro-2-propen-1-ol have found application in many industries. They are mainly used for the production of adhesives, thickeners and stabilizers of emulsion paints, and surgical threads. Moreover, polyvinyl alcohol derivatives are indispensable reagents in the synthesis of hemiacetals. Polyolefins derived from polyvinyl alcohol are obtained by using catalysts belonging to complex compounds of transition metal ions. The aim of the studies is to the synthesis of a new complex, i.e. dipicolinate oxovanadium(IV) complex with 4,4’-dimethoxy-2,2’-bipyridyl, and to determine its catalytic activities. Moreover, the another aim of the studies was to set conditions for 2-chloro-2-propen-1-ol oligomerization. The catalytic system has been based on the dipicolinate complex of oxovanadium(IV) with 4,4’-dimethoxy-2,2’-bipyridyl and MMAO-12. The results of the studies showed that how a new oxovanadium(IV) complex compound effects on the 2-chloro-2-propen-1-ol oligomerization. Moreover, the results revealed that new catalytic material is a highly active catalyst for the investigated oligomerization.

Keywords: 2-chloro-2-propen-1-ol, oligomerization, dipicolinate, vanadium, methylaluminoxane

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Authors: Langhit Kurar, Loren Charles

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Introduction: In light of recent BOAST 12 (August 2016) published guidance on management of ankle fractures, the project aimed to highlight key discrepancies throughout the care trajectory from admission to point of discharge at a district general hospital. Wide breadth of data covering three key domains: accident and emergency, radiology, and orthopaedic surgery were subsequently stratified and recommendations on note documentation, and outpatient follow up were made. Methods: A retrospective twelve month audit was conducted reviewing results of ankle fracture management in 37 patients. Inclusion criterion involved all patients seen at Darent Valley Hospital (DVH) emergency department with radiographic evidence of an ankle fracture. Exclusion criterion involved all patients managed solely by nursing staff or having sustained purely ligamentous injury. Medical notes, including discharge summaries and the PACS online radiographic tool were used for data extraction. Results: Cross-examination of the A & E domain revealed limited awareness of the BOAST 12 recent publication including requirements to document skin integrity and neurovascular assessment. This had direct implications as this would have changed the surgical plan for acutely compromised patients. The majority of results obtained from the radiographic domain were satisfactory with appropriate X-rays taken in over 95% of cases. However, due to time pressures within A & E, patients were often left without a post manipulation XRAY in a backslab. Poorly reduced fractures were subsequently left for a long period resulting in swollen ankles and a time-dependent lag to surgical intervention. This had knocked on implications for prolonged inpatient stay resulting in hospital-acquired co-morbidity including pressure sores. Discussion: The audit has highlighted several areas of improvement throughout the disease trajectory from review in the emergency department to follow up as an outpatient. This has prompted the creation of an algorithm to ensure patients with significant fractures presenting to the emergency department are seen promptly and treatment expedited as per recent guidance. This includes timing for X-rays taken in A & E. Re-audit has shown significant improvement in both documentation at time of presentation and appropriate follow-up strategies. Within the orthopedic domain, we are in the process of creating an ankle fracture pathway to ensure imaging and weight bearing status are made clear to the consulting clinicians in an outpatient setting. Significance/Clinical Relevance: As a result of the ankle fracture algorithm we have adapted the BOAST 12 guidance to shape an intrinsic pathway to not only improve patient management within the emergency department but also create a standardised format for follow up.

Keywords: ankle, fracture, BOAST, radiology

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Authors: Symbat Moldabekova

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This research explores the practice of decision-making in commercial banks in Kazakhstan. It focuses on recent technologies, such as contactless payments and QR code, and uses interviews with bank executives and industry practitioners to gain an understanding of how decisions are made and the role of financial assessment methods. The aim of the research is (1) to study the importance of financial techniques to evaluate IT investments; (2) to understand the role of different expert groups; (3) to explore how market trends and industry features affect decisions on IT; (4) to build a model that defines the real practice of decision-making on IT in commercial banks in Kazakhstan. The theoretical framework suggests that decision-making on IT is a socially constructed process, where actor groups with different background interact and negotiate with each other to develop a shared understanding of IT and to make more effective decisions. Theory and observations suggest that the more parties involved in the process of decision-making, the higher the possibility of disagreements between them. As each actor group has their views on the rational decision on an IT project, it is worth exploring how the final decision is made in practice. Initial findings show that the financial assessment methods are used as a guideline and do not play a big role in the final decision. The commercial banks of Kazakhstan tend to study experience of neighboring countries before adopting innovation. Implementing contactless payments is widely regarded as pinnacle success factor due to increasing competition in the market. First-to-market innovations are considered as priorities therefore, such decisions can be made with exemption of some certain actor groups from the process. Customers play significant role and they participate in testing demo versions of the products before bringing innovation to the market. The study will identify the viewpoints of actors in the banking sector on a rational decision, and the ways decision-makers from a variety of disciplines interact with each other in order to make a decision on IT in retail banks.

Keywords: actor groups, decision making, technology investment, retail banks

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Authors: Arthi Ganapathy, Arithra Banerjee, Saroj Kaler

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Abdominal aorta is the sole purveyor of all organs in the abdomen. Anomalies of its main trunk or its branches are to be meticulously observed as it effects the perfusion of an organ. Varying patterns of the testicular artery is one of them. The origin and course of testicular arteries have to be identified carefully during various surgical procedures like renal transplant, intra abdominal surgeries and even in orthopedic surgery like spine surgery. With the advent of new intra-abdominal therapeutic and diagnostic techniques, the anatomy of testicular arteries has assumed much more significance. Though the variations of the testicular vein are well documented, the variations of the testicular artery are not so frequent in incidence. We report a case of the bilateral aberrant origin of the testicular artery from polar renal arteries. We also discuss its developmental basis. Such anomalies if left unnoticed will lead to serious intraoperative complications during procedures on retroperitoneal organs. Any damage to testicular arteries will compromise the function of the gonads.

Keywords: cadaver, gonadal, renal, surgery

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