2 research outputs found

    INVESTIGATING THE IMPACT OF CIVIL LIBERTIES AND CREATIVE CLASS ON INNOVATION OUTPUT AND ECONOMIC GROWTH: AN EMPIRICAL CASE STUDY FOR PAKISTAN

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    Innovations play a crucial role to foster the economic growth and sustainable development by addressing urgent economic and social needs, and by enhancing productivity and competitiveness. Due to its significance, this study examines the impact of civil liberties and creative class on innovation output in case of Pakistan. Innovation output is proxied by patent and trademark applications of residents of Pakistan. The study employs a time series data over the period of 1982-2014 and negative binomial method to test the hypotheses empirically. The results implicitly support the hypotheses that lesser civil liberties are negatively related to the innovation output. Whereas, explicitly lesser civil liberties negatively but insignificantly related to the patent applications and are significantly positively related to the trademark applications. Creative class and school enrollment positively significantly related to the innovation output. Other factors such as, political rights and foreign direct investment negatively insignificantly relates to the trademark applications whereas positively significantly relates to patent applications. Expenditures on education as percentage of GDP (Proxy of R&D) negatively and significantly relates to trademark applications but negatively insignificantly to patent applications

    Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

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    Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)
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