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Background: Medical device expenditures have increased in the 21st century, with cardiac devices comprising an outsized portion of the market. Meanwhile, the disproportionate share of FDA recalls of cardiac devices is often overshadowed. Using the FDA 510(k) premarket notification pathway and FDA recalls issued from 2000 to 2020, this project seeks to engage our understanding of innovation and recalls in the cardiac device space., Methods: 510(k) premarket notification submission dates, outcomes, and recalls from 1/1/2000 to 12/31/2019 were obtained from publicly available FDA data as a function of cardiac device innovation. We compared the annual number of 510(k) premarket clearances and FDA recalls from 1/1/2000 to 12/31/2009 to 1/1/2010 to 12/31/2019., Results: We found 343 moderate risk cardiac medical devices cleared for sale between the years 2000 and 2020. Comparing the last 10 years of the study period to the first, the yearly number of cleared devices decreased 39.7 %, from 21.4 to just 12.9 (p = 0.0019), defying positive trends in U.S. GDP and healthcare expenditures. Meanwhile, the number of FDA recalls issued for these devices increased 94.5 % from 7.3 to 14.2 recalls per year (p = 0.031). 215 device recalls were issued; 78 % Class II and 16 % Class I which constitute serious, potentially fatal recalls., Conclusions: While United States healthcare spending continues to trend upward, there was a distinct decrease in the number of new and updated cardiac devices entering the market between 2000 and 2020. Meanwhile, recalls of these devices have uncomfortably increased. Together, these trends suggest cardiac device innovation has become risk averse., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Interventional cardiology is on the cusp of a significant transformation as we approach 2050, driven by emerging trends and groundbreaking technological innovations. This mini review explores the pivotal developments shaping the field, focusing on three key areas: Emerging Trends in Interventional Cardiology, Technological Innovations: The Next Frontier, and the Future Era of Intervention Cardiology from 2024 to 2050. Emerging trends, including advancements in imaging and artificial intelligence, are revolutionizing diagnosis and treatment, allowing for more precise and personalized interventions. Technological innovations, such as robotic-assisted procedures and bioresorbable stents, are redefining the landscape, enhancing procedural accuracy, and expanding access to care through remote interventions. Looking ahead to 2050, we anticipate a future where interventional cardiology is increasingly driven by minimally invasive techniques, AI-driven decision-making, and personalized medicine, offering unprecedented improvements in patient outcomes and reshaping the way cardiovascular diseases are managed., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests that can influence the work reported in this article., (Copyright © 2024 Elsevier Inc. All rights reserved.)

For 350 years, we have known that the human body hosts microbes, then called "animalcules". For over a century, following the demonstration of the role of some of these microbes in diseases, questions have arisen about the role of the largely predominant ones colonizing human skin and mucous surfaces, particularly the rich microbial ecosystem of the intestine, the gut microbiota. From the invention of germ-free life - axenism - which experimentally validated the human-microbe symbiosis, resulting from a long coevolution, to the development of anaerobic culture methods, then to the invention of molecular diagnosis, deep sequencing opening up metagenomic and omics approaches in general, a remarkable race has taken place between technological innovations and conceptual advances. This race, beyond the exhaustive description of the microbiota in its intra- and inter-human diversity, and the essential symbiotic functions of the microbiome, has paved the way for a new field of medicine: microbial medicine., (© 2024 médecine/sciences – Inserm.)

This paper empirically investigates the impact of digital finance on the breakthrough innovation of enterprises with a sample of A-share listed companies in Shanghai and Shenzhen from 2011 to 2022. It is found that digital finance can promote corporate breakthrough innovation, and presents certain structural heterogeneity characteristics. The mechanism test shows that digital finance has the dual attributes of a financing platform and a social platform, which can promote breakthrough innovation by alleviating corporate financing constraints and expanding corporate social networks. Heterogeneity analysis reveals that the role of digital finance in promoting breakthrough innovation is characterized by regional heterogeneity, with digital finance playing a greater role in promoting breakthrough innovation in provinces with a low level of development of the banking sector, provinces with a high level of development of the capital market sector, and the central region. In addition, the degree of firms' external financing dependence and the degree of product market competition can strengthen the positive effect of digital finance on firms' breakthrough innovation. This paper enriches the related research on the impact of digital finance on enterprise innovation, and provides theoretical basis and policy insights on how digital finance can better assist the innovation-driven development strategy., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Yanmin Shi. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

This paper examines the impact of the digital economy on sustainable development, using panel data from cities at the prefecture level and above in China from 2011 to 2019. The results indicate: (1) The digital economy is conducive to boosting growth, increasing employment, reducing energy consumption, and cutting emissions, thereby promoting sustainable development. These findings prove robust. (2) Mechanism test outcomes reveal that, from the perspective of technological innovation, the digital economy can promote sustainable development through increasing R&D input and enhancing innovation output. (3) An extended analysis of the risk of a digital "divide" demonstrates that "dividend" of the digital economy is primarily manifests in spurring economic growth, enhancing energy efficiency, and strengthening environmental protection in lagging regions, while the digital "divide" effect is manifested in the stronger employment stimulating effect of developed regions versus backward areas. The results of this study not only enrich the relevant research system, but also provide empirical evidence to support accelerating digital transformation, strengthening technological innovation governance, and advancing sustainable development., Competing Interests: The authors declare that they have no competing interests., (Copyright: © 2024 He et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

To fully understand and predict the impact of nanotechnologies, a truly multidisciplinary approach is required. However, the practicalities relating to how innovation, commercialisation, risk assessment, informatics, and governance in nanotechnology should intersect remain somewhat of a black box. To begin to shed light on this intersection, we identify a need to place 'purpose' at the heart of the nanotechnology innovation ecosystem. There is a growing appetite for responsible, sustainable, and purposeful innovation from business, financiers, regulators, consumers, and other stakeholders - an appetite that we foresee will permeate all spheres of commercialisation, including that of nanotechnology. Ultimately, nanotechnologies will only have the ability to sustainably address the global challenges of the 21st century if they are developed and implemented with purpose, and in full consideration of their social and environmental impacts. We (re)define purpose as it relates to sustainable nanotechnology innovation, in an effort to create a more-broadly shared language that can bridge the diverse stakeholder needs and perspectives that are required to address these challenges. To enable innovation, standardisation, promote interdisciplinarity, increase transparency, and enhance regulatory and corporate accountability, we propose a four stage, principles-based framework for purposeful nanotechnology development. This framework offers a practical way forward for nanotechnology innovation, shedding light on how nano-impact can be approached by multidisciplinary teams and describing how interrelated systems and stakeholders can interact successfully to achieve shared goals., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

The digital economy is now the expected norm for economic development, warranting strategic importance for enterprise digital transformation. Nonetheless, enterprises have a lengthy journey to embark upon for digital transformation. On the one hand, resource-based demands pose a significant challenge due to the development characteristics of the initiative; on the other hand, excessive emphasis on economic gains may result in severe environmental issues. Therefore, this paper examines whether green innovation, which combines environmental and economic benefits, can effectively address the above dilemma. The study includes all A-share listed companies from 2010 to 2020 as the research sample, and empirically investigates the impact of green innovation on enterprise digital transformation and its mechanism based on resource-based view. The study concluded that (i) green innovation has a significant positive impact on corporate digital transformation performance, exhibiting asymmetric effects. The robustness tests confirmed the validity of the findings. (ii) Enterprises that actively engage in green innovation can effectively reduce their financial constraints, enhance their operational capacity, and enable the efficient allocation of resources, thereby promoting digital transformation within the enterprise. (iii) There is a regional imbalance in the conversion of green innovation performance into economic performance. The aforementioned results offer fresh insights for investigating the connection between green innovation and digital transformation. Additionally, these findings hold significant implications for the discourse on the synergistic advancement of the environment and economy., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 She, Zhang. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

To investigate the interplay among technological innovation, industrial structure, production methodologies, economic growth, and environmental consequences within the paradigm of a green economy and to put forth strategies for sustainable development, this study scrutinizes the limitations inherent in conventional deep learning networks. Firstly, this study analyzes the limitations and optimization strategies of multi-layer perceptron (MLP) networks under the background of the green economy. Secondly, the MLP network model is optimized, and the dynamic analysis of the impact of technological innovation on the digital economy is discussed. Finally, the effectiveness of the optimization model is verified by experiments. Moreover, a sustainable development strategy based on dynamic analysis is also proposed. The experimental results reveal that, in comparison to traditional Linear Regression (LR), Decision Tree (DT), Random Forest (RF), Support Vector Machine (SVM), and Naive Bayes (NB) models, the optimized model in this study demonstrates improved performance across various metrics. With a sample size of 500, the optimized model achieves a prediction accuracy of 97.2% for forecasting future trends, representing an average increase of 14.6%. Precision reaches 95.4%, reflecting an average enhancement of 19.2%, while sensitivity attains 84.1%, with an average improvement of 11.8%. The mean absolute error is only 1.16, exhibiting a 1.4 reduction compared to traditional models and confirming the effectiveness of the optimized model in prediction. In the examination of changes in industrial structure using 2020 data to forecast the output value of traditional and green industries in 2030, it is observed that the output value of traditional industries is anticipated to decrease, with an average decline of 11.4 billion yuan. Conversely, propelled by the development of the digital economy, the output value of green industries is expected to increase, with an average growth of 23.4 billion yuan. This shift in industrial structure aligns with the principles and trends of the green economy, further promoting sustainable development. In the study of innovative production methods, the green industry has achieved an increase in output and significantly enhanced production efficiency, showing an average growth of 2.135 million tons compared to the average in 2020. Consequently, this study highlights the dynamic impact of technological innovation on the digital economy and its crucial role within the context of a green economy. It holds certain reference significance for research on the dynamic effects of the digital economy under technological innovation., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Liu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The paper uses spatial panel data on the number of patents in the field of sports in each province from 2017-2022 to explore the spatial and temporal evolution process of the innovation capacity of China's sports industry and analyze its development trend based on theories related to economic geography, using exploratory spatial data analysis (ESDA) and Spatial-temporal correlation analysis research methods. The study shows that: 1. there is a large spatial regional disparity in the innovation capacity of China's sports industry, showing an obvious pattern of strength in the east and weakness in the west. 2. there is an obvious phenomenon of spatial agglomeration in the innovation capacity of China's sports industry and the agglomeration phenomenon in space is gradually increasing. 3. there is a spatial spillover effect in the innovation capacity of China's sports industry, and the inward spillover continues to strengthen mainly into Zhejiang, Fujian and Jiangsu provinces, while the outward spillover mainly goes to Guangdong, Hubei, Hebei, Hunan, Sichuan. Sports industry innovation capacity development put forward three suggestions: to promote the development of sports industry in the northwest region; to play the advantages of regional characteristics of sports industry; to accelerate the integration of neighboring regions to build the process. in order to help the high-quality development of sports industry., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Chen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Theories of scientific and technological change view discovery and invention as endogenous processes 1,2 , wherein previous accumulated knowledge enables future progress by allowing researchers to, in Newton's words, 'stand on the shoulders of giants' 3-7 . Recent decades have witnessed exponential growth in the volume of new scientific and technological knowledge, thereby creating conditions that should be ripe for major advances 8,9 . Yet contrary to this view, studies suggest that progress is slowing in several major fields 10,11 . Here, we analyse these claims at scale across six decades, using data on 45 million papers and 3.9 million patents from six large-scale datasets, together with a new quantitative metric-the CD index 12 -that characterizes how papers and patents change networks of citations in science and technology. We find that papers and patents are increasingly less likely to break with the past in ways that push science and technology in new directions. This pattern holds universally across fields and is robust across multiple different citation- and text-based metrics 1,13-17 . Subsequently, we link this decline in disruptiveness to a narrowing in the use of previous knowledge, allowing us to reconcile the patterns we observe with the 'shoulders of giants' view. We find that the observed declines are unlikely to be driven by changes in the quality of published science, citation practices or field-specific factors. Overall, our results suggest that slowing rates of disruption may reflect a fundamental shift in the nature of science and technology., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)

The vast majority of thyroid cancers originate from follicular cells. We outline outstanding issues at each step along the path of cancer patient care, from prevention to post-treatment follow-up and highlight how emerging technologies will help address them in the coming years. Three directions will dominate the coming technological landscape. Genomics will reveal tumoral evolutionary history and shed light on how these cancers arise from the normal epithelium and the genomics alteration driving their progression. Transcriptomics will gain cellular and spatial resolution providing a full account of intra-tumor heterogeneity and opening a window on the microenvironment supporting thyroid tumor growth. Artificial intelligence will set morphological analysis on an objective quantitative ground laying the foundations of a systematic thyroid tumor classification system. It will also integrate into unified representations the molecular and morphological perspectives on thyroid cancer., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Healthcare teams must be deliberately cultivated to reach their full potential. Shifting focus from individual performance to a team's collective competence allows for targeted and evidence-based interventions that support teamwork and improve patient outcomes. We reviewed essential concepts drawn from team science and explored the practical applications of teaming. Reproductive endocrinology and infertility healthcare providers play a pivotal role by teaching, modeling, and fostering teaming attitudes and behaviors. Through teaming, we can maximize our teams' ability to learn, innovate, compete with other teams, and thrive in today's healthcare environment., (Copyright © 2021 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)

Subcontractors depend heavily on their prime contractor and thus find it very risky to enter a new business on their own. This study proposes a framework for these subcontractors to develop blue ocean technologies related to their prime contractor. First, the primary technologies predicted to be promising are extracted from the business reports of the prime contractor. Sub-technologies are then selected through a patent-based search using keywords and International Patent Classification codes of the primary technologies. From them, blue ocean technologies are proposed by optimizing the weighted mean of the min-max normalized market value, degree of competition in the technology market, and subcontractors' potential technological capabilities for each sub-technology. This study shows that subcontractors can enhance their technology competitiveness by finding a low-risk blue ocean technology. Our empirical research on the subcontractors of a semiconductor firm identified technological patent fields for them to pursue. From our framework, subcontractors can identify blue ocean technologies by considering their prime contractor's future industrial areas and technologies of interest as well as their own technological capabilities. Furthermore, the prime contractors can gain the synergy effect of technology expansion through cooperation., Competing Interests: The authors have declared that no competing interests exist.

Introduction: Robot-assisted surgery is becoming increasingly adopted by multiple surgical specialties. There is evidence of inherent risks of utilising new technologies that are unfamiliar early in the learning curve. The development of standardised and validated training programmes is crucial to deliver safe introduction. In this review, we aim to evaluate the current evidence and opportunities to integrate novel technologies into modern digitalised robotic training curricula., Methods: A systematic literature review of the current evidence for novel technologies in surgical training was conducted online and relevant publications and information were identified. Evaluation was made on how these technologies could further enable digitalisation of training., Results: Overall, the quality of available studies was found to be low with current available evidence consisting largely of expert opinion, consensus statements and small qualitative studies. The review identified that there are several novel technologies already being utilised in robotic surgery training. There is also a trend towards standardised validated robotic training curricula. Currently, the majority of the validated curricula do not incorporate novel technologies and training is delivered with more traditional methods that includes centralisation of training services with wet laboratories that have access to cadavers and dedicated training robots., Conclusions: Improvements to training standards and understanding performance data have good potential to significantly lower complications in patients. Digitalisation automates data collection and brings data together for analysis. Machine learning has potential to develop automated performance feedback for trainees. Digitalised training aims to build on the current gold standards and to further improve the 'continuum of training' by integrating PBP training, 3D-printed models, telementoring, telemetry and machine learning., (© 2020. The Author(s).)

Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

The third 'Symposium for the Next Generation of Stem Cell Research' (SY-Stem) was held virtually on 3-5 March 2021, having been cancelled in 2020 due to the COVID-19 pandemic. As in previous years, the meeting highlighted the work of early career researchers, ranging from postgraduate students to young group leaders working in developmental and stem cell biology. Here, we summarize the excellent work presented at the Symposium, which covered topics ranging from pluripotency, species-specific aspects of development and emerging technologies, through to organoids, single-cell technology and clinical applications., Competing Interests: Competing interests The authors declare no competing or financial interests., (© 2021. Published by The Company of Biologists Ltd.)

Magnetic resonance imaging (MRI) is often considered the gold-standard test for characterizing cardiac as well as noncardiac structure and function. However, many patients with cardiac implantable electronic devices (CIEDs) and/or severe renal dysfunction are unable to undergo this test because of safety concerns. In the past 10 years, newer-generation CIEDs and gadolinium-based contrast agents (GBCAs) as well as coordinated care between imaging and heart rhythm device teams have mitigated risk to patients and improved access to MRI at many hospitals. The purpose of this statement is to review published data on safety of MRI in patients with conditional and nonconditional CIEDs in addition to patient risks from older and newer GBCAs. This statement was developed through multidisciplinary collaboration of pan-Canadian experts after a relevant and independent literature search by the Canadian Agency for Drugs and Technologies in Health. All recommendations align with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Key recommendations include: (1) the development of standardized protocols for patients with a CIED undergoing MRI; (2) patients with MRI nonconditional pacemakers and pacemaker dependency should be programmed to asynchronous mode and those with MRI nonconditional transvenous defibrillators should have tachycardia therapies turned off during the scan; and (3) macrocyclic or newer linear GBCAs should be used in preference to older GBCAs because of their better safety profile in patients at higher risk of nephrogenic systemic fibrosis., (Copyright © 2021 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)

The COVID pandemic generated unparalleled operational disruption. C-suites and chief nurse executives responded to create capacity and clinical readiness despite enormous uncertainty. Innovations were put in place to combat the care crisis; however, is there merit in continuing these innovations as the pandemic subsides? Examining highly impactful operational innovations that were rapidly implemented during the pandemic should be prioritized as organizations seek to establish their new normal., Competing Interests: The author declares no conflicts of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

The first therapeutic use of insulin by Frederick Banting and Charles Best in 1921 revolutionized the management of type 1 diabetes and considerably changed the lives of many patients with other types of diabetes. In the past 100 years, significant pharmacological advances took place in the field of insulin therapy, bringing closer the goal of optimal glycemic control along with decreased diabetes-related complications. Despite these developments, several challenges remain, such as increasing treatment flexibility, reducing iatrogenic hypoglycemia, and optimizing patient quality of life. Ongoing innovations in insulin therapy (e.g., new insulin analogs, alternative routes of insulin administration, and closed-loop technology) endeavor to overcome these hurdles and change the landscape of diabetes mellitus management. This report highlights recent advances made in the field of insulin therapy and discusses future perspectives.

Advances in diabetes technologies have enabled the development of automated closed-loop insulin delivery systems. Several hybrid closed-loop systems have been commercialised, reflecting rapid transition of this evolving technology from research into clinical practice, where it is gradually transforming the management of type 1 diabetes in children and adults. In this review we consider the supporting evidence in terms of glucose control and quality of life for presently available closed-loop systems and those in development, including dual-hormone closed-loop systems. We also comment on alternative 'do-it-yourself' closed-loop systems. We remark on issues associated with clinical adoption of these approaches, including training provision, and consider limitations of presently available closed-loop systems and areas for future enhancements to further improve outcomes and reduce the burden of diabetes management.

The discovery of insulin in 1921 enabled pharmaceutical production of animal insulins for the treatment of people with type 1 diabetes by 1922. The last several decades have witnessed enormous scientific progress in the therapy of type 1 diabetes, yet some developments have been incremental, and insulin is not a cure. Herein, I highlight key scientific advances potentially poised to improve the quality of life and treatment outcomes in type 1 diabetes. These innovations range from newer insulin analogues to the development of smart insulins, oral and weekly insulins, glucose sensors and closed-loop insulin-delivery devices, as well as strategies for durable human beta cell replacement coupled with selective immune manipulation to preserve beta cell function. Finally, progress in the prediction and prevention of type 1 diabetes highlights the ongoing challenges and potential for altering the natural history of the disease or eliminating type 1 diabetes altogether.

Insulin replacement therapy for diabetes mellitus seeks to minimise excursions in blood glucose concentration above or below the therapeutic range (hyper- or hypoglycaemia). To mitigate acute and chronic risks of such excursions, glucose-responsive insulin-delivery technologies have long been sought for clinical application in type 1 and long-standing type 2 diabetes mellitus. Such 'smart' systems or insulin analogues seek to provide hormonal activity proportional to blood glucose levels without external monitoring. This review highlights three broad strategies to co-optimise mean glycaemic control and time in range: (1) coupling of continuous glucose monitoring (CGM) to delivery devices (algorithm-based 'closed-loop' systems); (2) glucose-responsive polymer encapsulation of insulin; and (3) mechanism-based hormone modifications. Innovations span control algorithms for CGM-based insulin-delivery systems, glucose-responsive polymer matrices, bio-inspired design based on insulin's conformational switch mechanism upon insulin receptor engagement, and glucose-responsive modifications of new insulin analogues. In each case, innovations in insulin chemistry and formulation may enhance clinical outcomes. Prospects are discussed for intrinsic glucose-responsive insulin analogues containing a reversible switch (regulating bioavailability or conformation) that can be activated by glucose at high concentrations.

In the rapidly changing high-tech industry, firms that produce multi-generational products struggle to consistently introduce new products that are superior in innovativeness. However, developing innovative products in a short time sequence period is likely to cause quality problems. Therefore, considering time and resource constraints, two kinds of strategies are commonly employed: sequential innovation strategy, sequentially introducing a new generation of technology product at every launch interval, ensuring timely innovativeness but with relatively uncertain quality, or quality strategy, intermittently introducing a new generation of products, together with a derivative model between generations to enhance the quality. In this study, we propose a framework for a cost-benefit analysis that compares these two strategies by considering competition between firms within a generation as well as that within a firm across multiple generations (i.e., cannibalization) throughout the launch cycle of high-tech products. We apply our proposed framework to the smartphone market and conduct a sensitivity analysis. The results are expected to contribute to strategic decision-making related to the introduction of multi-generational technology products., Competing Interests: No authors have competing interests.

Competing Interests: Disclosure: The author indicated that no external funding was received for any aspect of this work. The Disclosure of Potential Conflicts of Interest form is provided with the online version of the article (http://links.lww.com/JBJS/G348).

Evidence-based STI (science, technology, and innovation) policy making requires accurate indicators of innovation in order to promote economic growth. However, traditional indicators from patents and questionnaire-based surveys often lack coverage, granularity as well as timeliness and may involve high data collection costs, especially when conducted at a large scale. Consequently, they struggle to provide policy makers and scientists with the full picture of the current state of the innovation system. In this paper, we propose a first approach on generating web-based innovation indicators which may have the potential to overcome some of the shortcomings of traditional indicators. Specifically, we develop a method to identify product innovator firms at a large scale and very low costs. We use traditional firm-level indicators from a questionnaire-based innovation survey (German Community Innovation Survey) to train an artificial neural network classification model on labelled (product innovator/no product innovator) web texts of surveyed firms. Subsequently, we apply this classification model to the web texts of hundreds of thousands of firms in Germany to predict whether they are product innovators or not. We then compare these predictions to firm-level patent statistics, survey extrapolation benchmark data, and regional innovation indicators. The results show that our approach produces reliable predictions and has the potential to be a valuable and highly cost-efficient addition to the existing set of innovation indicators, especially due to its coverage and regional granularity., Competing Interests: The authors DL and JK founded and are employed by istari.ai. Istari.ai develops a “InnoProb” innovation prediction service based on the methodology presented in this article. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

The risk of aerosol transmission has been a key factor for the rapid dissemination of the coronavirus pandemic. Transportation of coronavirus disease 2019 (COVID-19)-infected patients with active air leaks could expose unprotected health care personnel and other patients to aerosolized viral particles. We devised a way to avoid aerosolization while the chest tube drain is on water seal. It involves placing an Ultipor100 viral filter on the suction port of the drain system as well as sealing off the safety valve. This mechanism allows positive pressure from an air leak to escape while on water seal while trapping viral particles., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 International Anesthesia Research Society.)

Entrepreneurship activity varies significantly across cities. We use the novel data for 1,652 ecosystem actors across sixteen cities in nine developing and transition economies during 2018-2019 to examine the role that institutional context plays in facilitating the productive entrepreneurship and reducing the unproductive entrepreneurship. This study is the first to develop and test a model of multi-dimensional institutional arrangements in cities. It demonstrates that not just that institutions matter in shaping the entrepreneurship ecosystem in cities, but in particular those institutional arrangements enhancing the productive and reducing unproductive entrepreneurship. Our findings suggest that differences between normative, cognitive, and regulatory pillars are associated with variance in both types of entrepreneurship in cities. For the formation of productive and high-growth entrepreneurs, all three pillars of institutional arrangement matter. For unproductive entrepreneurship normative pillar of institutions and the role of civil society matter most. This study has theoretical and practical implications for entrepreneurship ecosystem policy in cities., Competing Interests: The authors have declared that no competing interests exist.

Why has the health care delivery paradigm and its integral transactions and interactions been left to muddle through, using archaic, 20th century modes and processes of delivery that are overlaid with byz antine medical record databases that pass for "cut ting-edge" technology? What is stalling the digital revolution in the provision of health care services to consumers? Understanding how and why this has happened requires that we briefly explore the evo lution of health care in the United States. Topics discussed include (1): morbidity and mortality: the public health era: (2) Medicare era: the advance of diagnostic and therapeutic technology; (3) the power of the consumer: patient-centered informatics; and (4) planning and execution of strategic transformation of provision of care informatics. Without an informatics focus, our health care system will continue limping along, costing more money and delivering many years of disability. Our most viable solutions revolve around using informatics to measure, guide and become the transformation. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Objective: To review the current status of robotic training and the impact of various training platforms on the performance of robotic surgical trainees., Data Sources: Literature review of Google Scholar and PubMed. The search terms included a combination of the following: "robotic training," "simulation," "robotic curriculum," "obgyn residency robotic training," "virtual reality robotic training," "DaVinci training," "surgical simulation," "gyn surgical training." The sources considered for inclusion included peer-reviewed articles, literature reviews, textbook chapters, and statements from various institutions involved in resident training., Methods of Study Selection: A literature search of Google Scholar and PubMed using terms related to robotic surgery and robotics training, as mentioned in the "Data Sources" section., Results: Multiple novel platforms that use machine learning and real-time video feedback to teach and evaluate robotic surgical skills have been developed over recent years. Various training curricula, virtual reality simulators, and other robotic training tools have been shown to enhance robotic surgical education and improve surgical skills. The integration of didactic learning, simulation, and intraoperative teaching into more comprehensive training curricula shows positive effects on robotic skills proficiency. Few robotic surgery training curricula have been validated through peer-reviewed study, and there is more work to be completed in this area. In addition, there is a lack of information about how the skills obtained through robotics curricula and simulation translate into operating room performance and patient outcomes., Conclusion: Data collected to date show promising advances in the training of robotic surgeons. A diverse array of curricula for training robotic surgeons continue to emerge, and existing teaching modalities are evolving to keep up with the rapidly growing demand for proficient robotic surgeons. Futures areas of growth include establishing competency benchmarks for existing training tools, validating existing curricula, and determining how to translate the acquired skills in simulation into performance in the operating room and patient outcomes. Many surgical training platforms are beginning to expand beyond discrete robotic skills training to procedure-specific and team training. There is still a wealth of research to be done to understand how to create an effective training experience for gynecologic surgical trainees and robotics teams., (Copyright © 2020. Published by Elsevier Inc.)

Objective: Asynchronous technologies such as mobile health, e-mail, e-consult, and social media are being added to in-person and synchronous service delivery. To ensure quality care, clinicians need skills, knowledge, and attitudes related to technology that can be measured. This study sought out competencies for asynchronous technologies and/or an approach to define them. Methods: This 6-stage scoping review of Pubmed/Medline, APA PsycNET, PsycINFO and other databases was based on a broad research question, "What skills are needed for clinicians and trainees to provide quality care using asynchronous technologies for children and adolescents, and how can they be made measurable to implement, teach and evaluate?" The search focused on key words in 4 concept areas: (a) competencies; (b) asynchronous technology; (c) synchronous telepsychiatry, telebehavioral or telemental health; and (d) clinical. The screeners reviewed the full-text articles based on inclusion (mesh of the key words) and exclusion criteria. Results: From a total of 5,877 potential references, 2 authors found 509 eligible for full text review and found 110 articles directly relevant to the concepts. Clinical studies discuss clinical, technical and administrative workflow rather than competencies, though behavioral health professions' position statements advise on adapting care and training. Existing technology competencies for video, social media, mobile health, and other asynchronous technologies were used to build a framework. Training, faculty development, and organizational suggestions are suggested. Conclusions: Research is needed on how to implement and evaluate asynchronous competencies to ensure quality clinical care and training, which is a paradigm shift for participants. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The twenty-first century has already recorded more than ten major epidemic or pandemic virus emergence events, including the ongoing and devastating coronavirus disease 2019 (COVID-19) pandemic. As viral disease emergence is expected to accelerate, these data dictate a need for proactive approaches to develop broadly active family-specific and cross-family therapeutics for use in future disease outbreaks. Emphasis should focus not only on the development of broad-spectrum small-molecule and antibody direct-acting antivirals, but also on host-factor therapeutics, including repurposing previously approved or in-pipeline drugs. Another new class of therapeutics with great antiviral therapeutic potential is RNA-based therapeutics. Rather than only focusing on known risks, dedicated efforts must be made toward pre-emptive research focused on outbreak-prone virus families, ultimately offering a strategy to shorten the gap between outbreak and response. Emphasis should also focus on orally available drugs for outpatient use, if possible, and on identifying combination therapies that combat viral and immune-mediated pathologies, extend the effectiveness of therapeutic windows and reduce drug resistance. While such an undertaking will require new vision, dedicated funding and private, federal and academic partnerships, this approach offers hope that global populations need never experience future pandemics such as COVID-19.

Biopharmaceuticals are innovative solutions that have revolutionized the treatment of important chronic diseases and malignancies. The approval of biosimilar products has become a complex and balanced process, and there are versions of drugs with established biosimilarity that can offer a more accessible treatment option to patients. The objective of this work was to identify the advancement of these technologies by means of patent and article analysis based on technological and scientific prospection. In patent document recovery, Derwent Innovation Index (DWPI) and PatentInspiration databases were used. The research was based on the search of the selected terms in the title, summary, and claims of the documents through a search strategy containing IPC code and keywords. In articles recovery, the Web of Science tool was used in the search of scientific publications dated from the last 5 years. The search resulted in a total of 2295 individual patent documents and 467 families using DWPI database, 769 individual patents and 205 families using PatentInspiration, and 2602 articles using Web of Science database. Additionally, this work describes the number of organizations that contribute to this area, where they are, how much development they have undergone, and the inventors/authors involved. Based on the number of publications registered, there is an important prominence for scientific research in mAbs. In terms of innovation, it is expected that several therapeutic drugs are already under regulatory review, which will allow drugs to be approved over the next few years and will thus generate a continuous flow of new products based on immunotherapies, mAbs, and biosimilar drugs. These drugs have become essential weapons for the treatment of significant diseases, and the increasing trend in the number of related scientific and technological publications contributes to making these therapies available to the greatest number of people., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2021 José F. Santos-Neto et al.)

Competing Interests: Competing interests: We have read and understood BMJ policy on declaration of interests and have no relevant interests to declare.