Influence of Social Exchange Relationship and Work Engagement on Creative Work Involvement: Mediation of Individual Innovative Behavior

The study probed the effect of social exchange relationship and work engagement on creative work involved with the assistance of mediation of individual innovative behavior of employees on work. Responses to a survey of 450 employees from the different service sector were used to the study hypotheses. Correlation and regression were done to see the impact of work engagement on employees’ creativity and individual innovative behavior with the assistance of social exchange relationship. This study shows the significant relation between social exchange relationship and creative work involvement. It also shows that employees should be provided with the resources so that they can perform well and also to be appreciated for their novel ideas which help the organization to progress. Individual innovative behavior also mediates connection among leader-member exchange and creative work involvement

Influence of Social Exchange Relationship and Work Engagement on Creative Work Involvement: Mediation of Individual Innovative Behavior

The study probed the effect of social exchange relationship and work engagement on creative work involved with the assistance of mediation of individual innovative behavior of employees on work. Responses to a survey of 450 employees from the different service sector were used to the study hypotheses. Correlation and regression were done to see the impact of work engagement on employees’ creativity and individual innovative behavior with the assistance of social exchange relationship. This study shows the significant relation between social exchange relationship and creative work involvement. It also shows that employees should be provided with the resources so that they can perform well and also to be appreciated for their novel ideas which help the organization to progress. Individual innovative behavior also mediates connection among leader-member exchange and creative work involvement

Direct and Indirect effect of Knowledge Management Practices on Firm Innovation via Knowledge Application

This study examines the relationship between knowledge management practices and firm innovation with the mediating effect of knowledge application. For the said purposes, data were collected from 140 firms that belong to the services sector. 600 questionnaires were distributed in the services sector by using the drop-off and pick up technique. The number of returned questionnaires was 545, but 45 questionnaires were rejected because they did not contain the required information. A simple random sampling technique is used for the data collection. The sampling technique followed the steps recommended for studies utilizing structural equational modeling (SEM). The data was entered into SPSS and AMOS for structural equation modeling. The empirical analysis shows that knowledge generation and knowledge diffusion have a significant positive effect on firm innovation while knowledge storage does not affect firm innovation. Moreover, knowledge application mediates the relationship between knowledge generation, knowledge storage, and firm innovation. While knowledge application does not play the mediation role between knowledge diffusion and innovation performance. Also, this study furnishes several future directions for academic scholars and participation. The limitations have also been discussed. Keywords:  Knowledge Management Practices; Knowledge Generation; Knowledge Application; Knowledge Storage; Knowledge Diffusion; Innovation Performance JEL Classifications: O31; O32 DOI: https://doi.org/10.32479/irmm.1019

Effect of hospital volume on outcomes of total hip arthroplasty: A systematic review and meta-analysis

Background: A shift in the healthcare system towards the centralization of common yet costly surgeries, such as total hip arthroplasty (THA), to high-volume centers of excellence, is an attempt to control the economic burden while simultaneously enhancing patient outcomes. The volume-outcome relationship suggests that hospitals performing more treatment of a given type exhibit better outcomes than hospitals performing fewer. This theory has surfaced as an important factor in determining patient outcomes following THA. We performed a systematic review with meta-analyses to review the available evidence on the impact of hospital volume on outcomes of THA.Materials and methods: We conducted a review of PubMed (MEDLINE), OVID MEDLINE, Google Scholar, and Cochrane library of studies reporting the impact of hospital volume on THA. The studies were evaluated as per the inclusion and exclusion criteria. A total of 44 studies were included in the review. We accessed pooled data using random-effect meta-analysis.Results: Results of the meta-analyses show that low-volume hospitals were associated with a higher rate of surgical site infections (1.25 [1.01, 1.55]), longer length of stay (RR, 0.83[0.48-1.18]), increased cost of surgery (3.44, [2.57, 4.30]), 90-day complications (RR, 1.80[1.50-2.17]) and 30-day (RR, 2.33[1.27-4.28]), 90-day (RR, 1.26[1.05-1.51]), and 1-year mortality rates (RR, 2.26[1.32-3.88]) when compared to high-volume hospitals following THA. Except for two prospective studies, all were retrospective observational studies.Conclusions: These findings demonstrate superior outcomes following THA in high-volume hospitals. Together with the reduced cost of the surgical procedure, fewer complications may contribute to saving considerable opportunity costs annually. However, a need to define objective volume-thresholds with stronger evidence would be required

ROLE OF SONOELASTOGRAPHY IN THE EVALUATION OF THYROID NODULES

Thyroid nodular disease is one of the most common endocrine disorder. B mode ultrasound provides useful characteristic information about thyroid nodules but it has noticeably low accuracy to differentiate benign from malignant. Fine needle aspiration is widely been used in differentiation of benign and malignant thyroid nodules but it is an invasive procedure. Sonoelastography is a newly developed non- invasive technique which uses ultrasound and gives information about the stiffness of tissue. It estimates the hardness of thyroid lesions in association with adjacent tissues and assists in the differentiation of benign from malignant nodules.Objective:The objective of this study was to evaluate the role sonoelastography in the evaluation of thyroid nodules. Methods:This study was conducted on 72 Patients of age between 18-80 years of either gender at Institute of Nuclear Medicine and Oncology Lahore (INMOL) Pakistan, from 25 March 2019 to 23 August 2019 for duration of five months. Elastography was performed using Toshiba Aplio 500.  Patient having one or more solid nodules in thyroid on conventional ultrasound examination were included in the study and the sonoelastography of nodules was confirmed with histopathological findings of nodules. Results: A total 72 participants were included in our study. The mean age of participants was 42.11 years. Gender distribution shows that 51.4% (n=37) were male and 48.6% (n=35) were female. Sonoelastographic strain ratio of 55.6% nodules (n=40) was more than 2.1(malignant feature) and 44.4% nodules (n=32) have less than 2.1 (benign). Histopathology showed 56.9% of participants (n=41) have malignant nodules and 43.1% (n=31) have benign nodules. The comparison of sonoelastography and histopathology in reference with nodules shows that the results of histopathology and sonoelastography were same and support each other. Conclusion: Sonoelastography is non-invasive and cost-effective imaging technique to diagnose thyroid nodules either benign or malignant. Keywords: Ultrasound Elastography, Thyroid Nodules, Benign, Malignant, Fine Needle Aspiration. DOI: 10.7176/JHMN/66-08 Publication date:September 30th 201

Impact of Institutional Environmental Factors on Project Performance-An Analysis on the Construction Projects in Lahore, Pakistan

The construction industry has experienced a dramatic boom in theeconomy over the last two years, due to the significance of CPEC in Pakistan. In the project’s performance, the role and concept of Institutional Environment have been extensively studied in previous literature. However, the analysis of these strategic constructs in construction firms has been minimal. Still, a gap exists in institutional factors concerning project performance. This paper aims to address this gap posits that Institutional Environmental Factors (IEFs) may impact the performance of the construction projects; also, there may be some factors that can impede or promote the performance of these projects. Data were collected from a sample of some construction firms’ management teams through semi-structured interviews. Study results suggested that coercive & normative factors of the institutional environment have a significant impact on the project performance concerning time delays and cost escalation. However, mimetic factors have less impact. This study also tries to assimilate the importance of institutional factors with the policy-making aspects of construction firms which can affect the performance of the projects. Future implications and limitations of the study are also discussed

Response of Daclatasvir and Sofosbuvir in Treatment-Naïve, HCV Genotype 3, Non-Cirrhotic Pakistani Population: 1 Year Follow-Up Experience

using daclatasvir and sofosbuvir in treatment-naive, non-cirrhotic HCV genotype 3 Pakistani population. Methodology: From January 2017 to February 2019, HCV patients who met the inclusion criteria were included in this open-label, non-randomized, uncontrolled observational trial at HBS General Hospital in Islamabad. A 12-week course of oral daclatasvir and sofosbuvir therapy was administered to each participant. Each patient got 400mg of sofosbuvir and 60mg of daclatasvir. Treatment outcomes included sustained virological response (SVR12 and SVR24), rapid virological response (RVR), and end-of-treatment response (ETR) as primary and secondary respectively. Results: There were 105 participants in the study, of which 72.3% were male and 27.6% were female. RVR for male was 92% (p=0.002), while it was 89.65% for female (p=0.004). 96.05% of the male and 93.1% of the female achieved ETR (p=0.002). Both 93.1% of female and 93.4% of male had SVR12 (p=0.001). A single male patient experienced relapse after achieving SVR12 (p=060). SVR24 rates for male and female were 92.1% (p=0.003) and 93.1%, (p=0.003) respectively. The combination therapy was well-tolerated, with the primary side effect being fatigue (36% in males, 44% in females). Conclusion: The combination therapy of daclatasvir and sofosbuvir demonstrated both safety and efficacy in treating treatment-naïve, non-cirrhotic individuals with HCV genotype 3 in Pakistan. The study underscores the potential of direct-acting antiviral agents in addressing the challenge of HCV infections

Strategic Flexibility and Organizational Performance: Mediating Role of Innovation

Strategic flexibility is deemed to be an important organizational capability for enhancing innovation and improving organizational performance (OP) in uncertain, turbulent, and ever-changing business environments. Many studies have investigated the impact of strategic flexibility on innovation and OP in various contexts and found that strategic flexibility enhances innovation and improves OP. Other studies have found negative association or no association between strategic flexibility and OP. Therefore, it is not much clear whether strategic flexibility improves OP directly or through innovation. Especially, the mediating role of innovation in the association between strategic flexibility and OP in engineering project-based organizations has not been fully grabbed in prior literature and Pakistan remained unexplored. This study has strived to examine the mediating role of innovation in the association between strategic flexibility and OP in this context. Drawing upon resource based and dynamic capability views, an explanatory model was developed and tested by applying PLS-SEM higher order component modeling approach using sample data from 184 organizations in Pakistan. The results revealed that strategic flexibility is positively associated with innovation and OP. Innovation is positively associated with OP. The association between strategic flexibility and OP is partially mediated by innovation. The study promotes academic rigor and provides a new theoretical model. Mangers, decision-makers, and policy-makers can utilize the results to update their plans to achieve sustainable OP. The other organizations in various countries operating under similar conditions can also take the advantage of this study