Innovation search: the role of innovation intermediaries in the search process

The aim of this paper is to explore how innovation search is conceptualised, given that firms increasingly use innovation intermediaries. The paper examines the search processes which involves the role of innovation intermediaries in different stages of the innovation search process. The study discovered that innovation search activity is a much more extended and complex process, not being as targeted or as specific than previously conceptualised, and involves a set of search stages, which are associated with a loosely coupled iterative search process. Innovation intermediaries were also discovered to be undertaking new, more extended roles in the search process, through, for example, combining new search procedures with online digital platforms.publishedVersio

Further evolution in the pharmaceutical sector : changes in the division of labour and the markets for technology

The pharmaceutical sector has undergone many changes, particularly in the past several decades. The purpose of this research was to ascertain the existence of further changes to the division of labour and changes in the markets for technology within the sector. This research was also undertaken to understand the specific issues that may be impacting the division of labour and the changes in the markets for technology including the role of finance and the role of a surplus of unexploited knowledge. The division of labour between large and small new firms was initially more pronounced as the fully integrated firms continued to develop, manufacture and market drugs while 'classical biotechnology' firms pursued an exploratory business model of supplying knowledge and early stage drug candidates to these fully integrated companies (McKelvey, 2008). However, firms are changing in this sector and changes may be evident that have not been discussed in the literature to date. A new type of firm is evident within this sector, the No Research Development Only (NRDO) firm, as well as changes in the existing firms. This has impacted markets for technology as changes are also apparent in the way in which firms exchange products and knowledge. A combined quantitative and qualitative study was used to answer the research questions. A random sample of 100 EU and US companies that own and develop drug products was generated. Descriptive statistics were gathered to form a database of information and case studies were compiled to provide in-depth data related to a sample of eight firms. The newly identified NRDO firms do not possess internal capabilities to discover their own products; surprising given the historically research intensive nature of the types of small firms that operate in this sector. There also appears to be changes in the markets for technology as large firms are selling drug candidates to these hitherto research-intensive discovery and development (DD) firms who are willing to in-license these drug candidates to bolster pipelines and financial valuations. Markets for knowledge in this sector have undoubtedly evolved and a more complex set of arrangements are evident. The roles of finance and a surplus of unexploited knowledge have played an important part in these changes as the sustained level of exploration in the sector has resulted in a greater number of exploitation opportunities. Overall there is evidence to support further evolution in the sector.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Development and optimisation of an improved derivatisation procedure for the determination of avermectins and milbemycins in bovine liver

peer-reviewedA robust procedure has been developed to overcome the instability problems experienced with the fluorescent derivative of eprinomectin. The procedure involves addition of acetic acid, together with the typical reagents methylimidazole and trifluoroacetic anhydride, to produce a fluorescent molecule that can be determined by high performance liquid chromatography (HPLC) with fluorescence detection. Derivatisation is completed in 30 min at 65 °C. This derivatisation procedure was shown to be suitable, also, for the related compounds, moxidectin, abamectin, doramectin and ivermectin. A multi-residue method for these compounds in bovine liver has been developed using the derivatisation procedure. Samples are extracted with acetonitrile; followed by clean-up on deactivated alumina and C18 solid phase extraction (SPE) cartridges. The method was validated using bovine liver fortified at levels of 4 and 20 mg kg21 with the drugs. The mean recovery ranged between 73 and 97%. The intraand inter-assay variations showed relative standard deviations typically of < 6% and < 14%, respectively. The limit of quantitation of the method is 2 mg kg21 (ppb)

Systematic review of communication technologies to promote access and engagement of young people with diabetes into healthcare

Background: Research has investigated whether communication technologies (e.g. mobile telephony, forums, email) can be used to transfer digital information between healthcare professionals and young people who live with diabetes. The systematic review evaluates the effectiveness and impact of these technologies on communication. Methods: Nine electronic databases were searched. Technologies were described and a narrative synthesis of all studies was undertaken. Results: Of 20,925 publications identified, 19 met the inclusion criteria, with 18 technologies assessed. Five categories of communication technologies were identified: video-and tele-conferencing (n = 2); mobile telephony (n = 3); telephone support (n = 3); novel electronic communication devices for transferring clinical information (n = 10); and web-based discussion boards (n = 1). Ten studies showed a positive improvement in HbA1c following the intervention with four studies reporting detrimental increases in HbA1c levels. In fifteen studies communication technologies increased the frequency of contact between patient and healthcare professional. Findings were inconsistent of an association between improvements in HbA1c and increased contact. Limited evidence was available concerning behavioural and care coordination outcomes, although improvement in quality of life, patientcaregiver interaction, self-care and metabolic transmission were reported for some communication technologies. Conclusions: The breadth of study design and types of technologies reported make the magnitude of benefit and their effects on health difficult to determine. While communication technologies may increase the frequency of contact between patient and health care professional, it remains unclear whether this results in improved outcomes and is often the basis of the intervention itself. Further research is needed to explore the effectiveness and cost effectiveness of increasing the use of communication technologies between young people and healthcare professionals

Compulsory Arbitration Agreements in Domestic and International Consumer Contracts

This paper examines the UK Unfair Terms in Consumer Contracts Regulations (UTCCR)'s prohibition on clauses in consumer contracts that mandate dispute settlement in an arbitration tribunal as potentially unfair and oppressive as against consumers because it denies their right to civil adjudication. The understanding of UTCCR's unfairness as developed by the UK House of Lords is not necessarily applicable to arbitration clauses because of the lower cost of such proceedings and the availability of legal aid, even in the international context. International arbitration decisions may also be reviewed for procedural irregularities under the New York Convention. Various European court decisions are reviewed where compulsory arbitration clauses in consumer contracts were evaluated for fairness to conclude that courts should be more receptive to such terms because of procedural advantages that they may accord to consumers

Treatment of hidradenitis suppurativa evaluation study: the THESEUS prospective cohort study

Background Hidradenitis suppurativa is a chronic inflammatory skin disease characterised by recurrent inflammatory lesions and skin tunnels in flexural sites such as the axilla. Deroofing of skin tunnels and laser treatment are standard hidradenitis suppurativa interventions in some countries but not yet introduced in the United Kingdom. Objective To understand current hidradenitis suppurativa management pathways and what influences treatment choices to inform the design of future randomised controlled trials. Design Prospective 12-month observational cohort study, including five treatment options, with nested qualitative interviews and an end-of-study consensus workshop. Setting Ten United Kingdom hospitals with recruitment led by dermatology and plastic surgery departments. Participants Adults with active hidradenitis suppurativa of any severity not adequately controlled by current treatment. Interventions Oral doxycycline 200 mg once daily; oral clindamycin and rifampicin, both 300 mg twice daily for 10 weeks initially; laser treatment targeting the hair follicle (neodymium-doped yttrium aluminium garnet or alexandrite); deroofing; and conventional surgery. Main outcome measures Primary outcome was the proportion of participants who are eligible, and hypothetically willing, to use the different treatment options. Secondary outcomes included proportion of participants choosing each of the study interventions, with reasons for their choices; proportion of participants who switched treatments; treatment fidelity; loss to follow-up rates over 12 months; and efficacy outcome estimates to inform outcome measure instrument responsiveness. Results Between February 2020 and July 2021, 151 participants were recruited, with two pauses due to the COVID-19 pandemic. Follow-up rates were 89% and 83% after 3 and 6 months, decreasing to 70% and 44% at 9 and 12 months, respectively, because pandemic recruitment delays prevented all participants reaching their final review. Baseline demographics included an average age of 36 years, 81% female, 20% black, Asian or Caribbean, 64% current or ex-smokers and 86% with a raised body mass index. Some 69% had moderate disease, 19% severe disease and 13% mild disease. Regarding the study’s primary outcome, laser treatment was the intervention with the highest proportion (69%) of participants who were eligible and hypothetically willing to receive treatment, followed by deroofing (58%), conventional surgery (54%), the combination of oral clindamycin and rifampicin (44%) and doxycycline (37%). Considering participant willingness in isolation, laser was ranked first choice by the greatest proportion (41%) of participants. The cohort study and qualitative study demonstrated that participant willingness to receive treatment was strongly influenced by their clinician. Fidelity to oral doxycycline was only 52% after 3 months due to lack of effectiveness, participant preference and adverse effects. Delays receiving procedural interventions were common, with only 43% and 26% of participants commencing laser therapy and deroofing, respectively, after 3 months. Treatment switching was uncommon and there were no serious adverse events. Daily pain score text messages were initiated in 110 participants. Daily responses reduced over time with greatest concordance during the first 14 days

Treatment of Hidradenitis Suppurativa Evaluation Study (THESEUS) : protocol for a prospective cohort study

Background: Hidradenitis suppurativa (HS) is a chronic, painful, inflammatory skin disease with estimates of prevalence in the European population of 1%–2%. Despite being a relatively common condition, the evidence base for management of HS is limited. European and North American management guidelines rely on consensus for many aspects of treatment and within the UK variations in management of HS have been identified. The HS James Lind Alliance Priority Setting Partnership (PSP) published a top 10 list of future HS research priorities including both medical and surgical interventions. The aims of the THESEUS study are to inform the design of future HS randomised controlled trials (RCTs) and to understand how HS treatments are currently used. THESEUS incorporates several HS PSP research priorities, including investigation of oral and surgical treatments. Core outcome domains have been established by the HIdradenitis SuppuraTiva cORe outcomes set International Collaboration (HISTORIC) and THESEUS is designed to validate instruments to measure the domains. Methods and analysis: The THESEUS study is a prospective observational cohort study. Participants, adults with active HS of any severity, will be asked to select one of five HS treatment options that is appropriate for their HS care. Participants will be allocated to their chosen treatment intervention and followed for a period of up to 12 months. Outcomes will be assessed at 3-monthly intervals using HISTORIC core outcome instruments. Video recordings of the surgical and laser operations will provide informational and training videos for future trials. Nested mixed-methods studies will characterise the interventions in clinical practice, understand facilitators and barriers to recruitment into future HS RCTs and examine patients’ and clinicians’ perspectives on HS treatment choices. Trial registration number: ISRCTN69985145

Treatment of hidradenitis suppurativa evaluation study (THESEUS): a prospective cohort study

Background Hidradenitis suppurativa (HS) is a chronic, painful disease affecting flexures and other skin regions, producing nodules, abscesses and skin tunnels. Laser treatment targeting hair follicles and deroofing of skin tunnels are standard HS interventions in some countries but rarely offered in the UK. Objectives To describe current UK HS management pathways and influencing factors to inform the design of future randomised controlled trials (RCTs). Methods THESEUS was a non-randomised 12-month prospective cohort study set in 10 UK hospitals offering five interventions: oral doxycycline 200mg daily; oral clindamycin and rifampicin both 300mg twice daily for 10 weeks, extended for longer in some cases; laser treatment targeting hair follicles; deroofing, and conventional surgery. Primary outcome was the combination of clinician-assessed eligibility and participant hypothetical willingness to receive each intervention. Secondary outcomes: proportion of participants selecting each intervention as their final treatment option; proportion who switch treatments; treatment fidelity, and attrition rates. THESEUS was prospectively registered on ISRCTN Registry: ISRCTN69985145. Results The recruitment target of 150 participants was met after 18 months, in July 2021, with two pauses due to the Covid-19 pandemic. Baseline demographics reflected the HS secondary care population: average age 36 years, 81% female, 20% non-white, 64% current or ex-smokers, 86% BMI≥25, 68% moderate disease, 19% severe, and 13% mild disease. Laser was the intervention with the highest proportion (69%) of participants eligible and willing to receive treatment, then deroofing (58%), conventional surgery (54%), clindamycin and rifampicin (44%), and doxycycline (37%). Laser was ranked first choice by the greatest proportion of participants (41%). Attrition rates were 11% and 17% after three and six months respectively. Concordance with doxycycline was 52% after three months due to lack of efficacy, participant choice and adverse effects. Delays with procedural interventions were common, with only 43% and 26% of participants starting laser and deroofing respectively after three months. Uptake of conventional surgery was too small to characterise the intervention. Switching treatment was uncommon and there were no serious adverse events. Conclusions THESEUS established laser treatment and deroofing for HS in the UK and demonstrated their popularity with patients and clinicians for future RCTs

Asymmetric Wolbachia Segregation during Early Brugia malayi Embryogenesis Determines Its Distribution in Adult Host Tissues

Wolbachia are required for filarial nematode survival and fertility and contribute to the immune responses associated with human filarial diseases. Here we developed whole-mount immunofluorescence techniques to characterize Wolbachia somatic and germline transmission patterns and tissue distribution in Brugia malayi, a nematode responsible for lymphatic filariasis. In the initial embryonic divisions, Wolbachia segregate asymmetrically such that they occupy only a small subset of cells in the developing embryo, facilitating their concentration in the adult hypodermal chords and female germline. Wolbachia are not found in male reproductive tissues and the absence of Wolbachia from embryonic germline precursors in half of the embryos indicates Wolbachia loss from the male germline may occur in early embryogenesis. Wolbachia rely on fusion of hypodermal cells to populate adult chords. Finally, we detect Wolbachia in the secretory canal lumen suggesting living worms may release bacteria and/or their products into their host

Health, education, and social care provision after diagnosis of childhood visual disability

Aim: To investigate the health, education, and social care provision for children newly diagnosed with visual disability.Method: This was a national prospective study, the British Childhood Visual Impairment and Blindness Study 2 (BCVIS2), ascertaining new diagnoses of visual impairment or severe visual impairment and blindness (SVIBL), or equivalent vi-sion. Data collection was performed by managing clinicians up to 1-year follow-up, and included health and developmental needs, and health, education, and social care provision.Results: BCVIS2 identified 784 children newly diagnosed with visual impairment/SVIBL (313 with visual impairment, 471 with SVIBL). Most children had associated systemic disorders (559 [71%], 167 [54%] with visual impairment, and 392 [84%] with SVIBL). Care from multidisciplinary teams was provided for 549 children (70%). Two-thirds (515) had not received an Education, Health, and Care Plan (EHCP). Fewer children with visual impairment had seen a specialist teacher (SVIBL 35%, visual impairment 28%, χ2p < 0.001), or had an EHCP (11% vs 7%, χ2p < 0 . 01).Interpretation: Families need additional support from managing clinicians to access recommended complex interventions such as the use of multidisciplinary teams and educational support. This need is pressing, as the population of children with visual impairment/SVIBL is expected to grow in size and complexity.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited