Policy Responses to the Healthy Aging Challenge: Confronting Hybridity with Social Innovation.

Tackling the issue of healthy aging in society is complex. It requires an interdisciplinary perspective and different forms of innovation. This article provides a commentary on the role of innovation policy in addressing healthy aging, particularly in the UK context. We argue that the wide range of economic activities related to healthy aging is part of a hybrid domain rather than a single sector. This represents a new generation of innovation policy for healthy aging which prioritizes understanding how different actors can be connected to support a spectrum of types of innovation which will contribute to providing better goods, services, and practices for older people. We explore social innovation as it relates to hybrid domains such as healthy aging and discuss the role of place in creating policy which generates both societal and market value. We recommend that policymakers use these concepts to build a better understanding of the economies that are evolving around healthy aging and where opportunities exist to better conceptualize, connect, and support actors, initiatives, and places to optimize economic potential and social outcomes.

Building alternative payment models in health care.

Introduction: Global interest is growing in new value-based models of financing, delivering, and paying for health care services that could produce higher-quality and lower cost outcomes for patients and for society. However, research indicates evidence gaps in knowledge related to alternative payment models (APMs) in early experimentation phases or those contracted between private insurers and their health care provider-partners. The aim of this research was to understand and update the literature related to learning how industry experts design and implement APMs, including specific elements of their models and their choice of stakeholders to be involved in the design and contractual details. Methods: A literature review was conducted to guide the research focus and to select themes. The sample was selected using snowball sampling to identify subject matter experts (SMEs). Researchers conducted 16 semi-structured interviews with SMEs in the US, the Netherlands, and Germany in September and October 2021. Interviews were transcribed and using Braun and Clarke's six-phase approach to thematic analysis, researchers independently read, reviewed, and coded participants' responses related to APM design and implementation and subsequently reviewed each other's codes and themes for consistency. Results: Participants represented diverse perspectives of the payer, provider, consulting, and government areas of the health care sector. We found design considerations had five overarching themes: (1) population and scope of care and services, (2) benchmarking, metrics, data, and technology; (3) finance, APM type, risk adjustment, incentives, and influencing provider behavior, (4) provider partnerships and the role of physicians, and (5) leadership and regulatory issues. Discussion: This study confirmed several of the core components of APM model designs and implementations found in the literature and brought insights on additional aspects not previously emphasized, particularly the role of physicians (especially in leadership) and practice transformation/care processes necessary for providers to thrive under APM models. Importantly, researchers found significant concerns relevant for policymakers about regulations relating to health data sharing, rigid price-setting, and inter-organizational data communication that greatly inhibit the ability to experiment with APMs and those models' abilities to succeed long-term.

CNS Drug Discovery in Academia: Where Basic Research Meets Innovation.

The involvement of academic research in drug discovery is consistently growing. However, academic projects seldom advance to clinical trials. Here, we assess the landscape of drug discovery within the National Centre of Competence in Research (NCCR) TransCure launched by the Swiss National Science Foundation to foster basic research and early-stage drug discovery on membrane transporters. This included transporters in central nervous system (CNS) disorders, which represent a huge unmet medical need. While idea championship, sustainable funding, collaborations between disciplines at the interface of academia and industry are important for translational research, Popperian falsifiability, strong intellectual property and a motivated startup team are key elements for innovation. This is exemplified by the NCCR TransCure spin-off company Synendos Therapeutics, a clinical stage biotech company developing the first selective endocannabinoid reuptake inhibitors (SERIs) as novel treatment for neuropsychiatric disorders. We provide a perspective on the challenges related to entering an uncharted druggable space and bridging the often mentioned "valley of death". The high attrition rate of drug discovery projects in the CNS field within academia is often due to the lack of meaningful animal models that can provide pharmacological proof-of-concept for potentially disruptive technologies at the earliest stages, and the absence of solid intellectual property.

Antitumor activity of anlotinib in malignant melanoma: modulation of angiogenesis and vasculogenic mimicry.

Malignant melanoma presents a formidable challenge due to its aggressive metastatic behavior and limited response to current treatments. To address this, our study delves into the impact of anlotinib on angiogenesis and vasculogenic mimicry using malignant melanoma cells and human umbilical vein endothelial cells. Evaluating tubular structure formation, cell proliferation, migration, invasion, and key signaling molecules in angiogenesis, we demonstrated that anlotinib exerts a dose-dependent inhibition on tubular structures and effectively suppresses cell growth and invasion in both cell types. Furthermore, in a mouse xenograft model, anlotinib treatment resulted in reduced tumor growth and vascular density. Notably, the downregulation of VEGFR-2, FGFR-1, PDGFR-ß, and PI3K underscored the multitargeted antitumor activity of anlotinib. Our findings emphasize the therapeutic potential of anlotinib in targeting angiogenesis and vasculogenic mimicry, contributing to the development of novel strategies for combating malignant melanoma.

Chemical Innovation and Agrifood Systems in Switzerland: A Short Perspective of the Sustainable Development Goals.

Chemical innovation plays a key role to support the agrifood system with the final goal to deliver secure, healthy food for a growing population. The underlying link between chemical innovation, agrifood system and the 2030 sustainable agenda may have received less attention than it deserves. Here we provide an overview of the agrifood system and the Sustainable Development Goals (SDGs), alongside distinct aspects of the innovation with a focus on the Swiss reality are presented. Finally, the critical and unspoken role of soil for a wide range of SDGs is underlined. Some major axes on how chemical research and technologies can set new pathway to innovate through soil are discussed.

Complex artificial intelligence models for energy sustainability in educational buildings.

Energy consumption of constructed educational facilities significantly impacts economic, social and environment sustainable development. It contributes to approximately 37% of the carbon dioxide emissions associated with energy use and procedures. This paper aims to introduce a study that investigates several artificial intelligence-based models to predict the energy consumption of the most important educational buildings; schools. These models include decision trees, K-nearest neighbors, gradient boosting, and long-term memory networks. The research also investigates the relationship between the input parameters and the yearly energy usage of educational buildings. It has been discovered that the school sizes and AC capacities are the most impact variable associated with higher energy consumption. While 'Type of School' is less direct or weaker correlation with 'Annual Consumption'. The four developed models were evaluated and compared in training and testing stages. The Decision Tree model demonstrates strong performance on the training data with an average prediction error of about 3.58%. The K-Nearest Neighbors model has significantly higher errors, with RMSE on training data as high as 38,429.4, which may be indicative of overfitting. In contrast, Gradient Boosting can almost perfectly predict the variations within the training dataset. The performance metrics suggest that some models manage this variability better than others, with Gradient Boosting and LSTM standing out in terms of their ability to handle diverse data ranges, from the minimum consumption of approximately 99,274.95 to the maximum of 683,191.8. This research underscores the importance of sustainable educational buildings not only as physical learning spaces but also as dynamic environments that contribute to informal educational processes. Sustainable buildings serve as real-world examples of environmental stewardship, teaching students about energy efficiency and sustainability through their design and operation. By incorporating advanced AI-driven tools to optimize energy consumption, educational facilities can become interactive learning hubs that encourage students to engage with concepts of sustainability in their everyday surroundings.

"The Green Peace" How ICG can prevent complications in endometriosis surgery?

This literature review summarises the investigation into using Indocyanine Green (ICG) in the surgical management of endometriosis, focusing mainly on its application in Deep Endometriosis (DE). The study reviews the development, fluorescence characteristics, and clinical usage of ICG in enhancing the precision of identifying endometrial lesions during surgery. Emphasizing the technology's contribution to improved lesion visualisation, the paper discusses how ICG facilitates increased diagnostic accuracy, potentially reducing recurrence rates and the necessity for subsequent interventions. Additionally, it explores ICG's role in minimizing the risk of iatrogenic injuries, especially in ureteral endometriosis, and its utility in surgical decision-making for rectosigmoid endometriosis by evaluating bowel perfusion. Conclusively, while acknowledging the clear benefits of ICG integration in endometriosis surgical procedures, the abstract calls for more extensive research to validate its efficacy and cost-efficiency in the broader context of endometriosis treatment.

Pepea Pamoja:† Applying the Ecological Validity Framework to co-develop a wellbeing and behavioural training program for caregivers of young children with autism in low-resource settings of Kenya and the United States.

BACKGROUND: Autism is a complex neurodevelopmental disability with global prevalence of one in 100 individuals. Poor access to interventions in both under-resourced regions of high-income countries and low- and middle-income countries has deleterious effects on the health and wellbeing of individuals with autism and their families. Our objective was to utilize a reciprocal innovation framework and participatory methods to adapt and co-develop a culturally grounded group-based wellbeing and naturalistic developmental behavioural intervention (NDBI) training program for caregivers of young children with autism to be implemented in Kenya and rural Indiana. METHODS: This study was conducted within the Academic Model Providing Access to Healthcare (AMPATH) program. An evidence-informed Naturalistic Developmental Behavioral Intervention (NDBI) previously utilized in Indiana was adapted and iteratively refined using the Ecological Validity Framework (EVF) by a team of US and Kenyan disability experts. Key adaptations to the program were made across the EVF domains of language, persons, metaphors/content, concepts, goals, methods, and context. RESULTS: Substantial cultural adaptations were made to the NDBI following the EVF model, including the addition of traditional Kenyan cultural practices, use of narrative principles, and focus on daily routines over play. Pepea, the adapted program, involves 10 group sessions covering content in basic education on autism, positive caregiver coping strategies, and behavioural skills training to promote child communication and reduce challenging behaviour. Key adaptations for Pepea were integrated back into a US NDBI caregiver training program. CONCLUSIONS: This study fills a critical gap by detailing the adaptation process of a caregiver wellbeing and naturalistic developmental behavioural training program for caregivers of children with autism in low-resource settings. Our next steps are to report on mixed-methods outcomes from pilot implementation. Our long-term goal is to apply these insights to advance sustainable and scalable autism intervention services across the globe.

Responsible innovation: Mitigating the food safety aspects of cultured meat production.

There is much interest in cultured (cultivated) meat as a potential solution to concerns over the ecological and environmental footprint of food production, especially from animal-derived food products. The aim of this critical review is to undertake a structured analysis of existing literature to (i) identify the range of materials that could be used within the cultured meat process; (ii) explore the potential biological and chemical food safety issues that arise; (iii) identify the known and also novel aspects of the food safety hazard portfolio that will inform hazard analysis and risk assessment approaches, and (iv) position a responsible innovation framework that can be utilized to mitigate food safety concerns with specific emphasis on cultured meat. Although a number of potential food safety hazards are identified that need to be considered within a food safety plan, further research is required to validate and verify that these food safety hazards have been suitably controlled and, where possible, eliminated. The responsible innovation framework developed herein, which extends beyond hazard analysis and traditional risk assessment approaches, can be applied in multiple contexts, including this use case of cultured meat production.

Effectiveness of a Multifaceted Implementation Strategy to Increase Equitable Hospital at Home Utilization: An Interrupted Time Series Analysis.

BACKGROUND: The number of Hospital-at-Home (HaH) programs rapidly increased during the COVID-19 pandemic and after issuance of Centers for Medicare and Medicaid Services' (CMS) Acute Hospital Care at Home (AHCaH) waiver. However, there remains little evidence on effective strategies to equitably expand HaH utilization. OBJECTIVE: Evaluate the effects of a multifaceted implementation strategy on HaH utilization over time. DESIGN: Before and after implementation evaluation using electronic health record (EHR) data and interrupted time series analysis, complemented by qualitative interviews with key stakeholders. PARTICIPANTS: Between December 2021 and December 2022, we identified adults hospitalized at six hospitals in North Carolina approved by CMS to participate in the AHCaH waiver program. Eligible adults met criteria for HaH transfer (HaH-eligible clinical condition, qualifying home environment). We conducted semi-structured interviews with 12 HaH patients and 10 referring clinicians. INTERVENTIONS: Two strategies were studied. The discrete implementation strategy (weeks 1-12) included clinician-directed educational outreach. The multifaceted implementation strategy (weeks 13-54) included ongoing clinician-directed educational outreach, local HaH assistance via nurse navigators, involvement of clinical service line executives, and individualized audit and feedback. MEASURES: We assessed weekly averaged HaH capacity utilization, weekly counts of unique referring providers, and patient characteristics. We analyzed themes from qualitative data to determine barriers and facilitators to HaH use. RESULTS: Our evaluation showed week-to-week increases in HaH capacity utilization during the multifaceted implementation strategy period, compared to discrete-period trends (slope-change odds ratio-1.02, 1.01-1.04). Counts of referring providers also increased week to week, compared to discrete-period trends (slope-change means ratio-1.05, 1.03-1.07). The increase in HaH utilization was largest among rural residents (11 to 34%). Barriers included HaH-related information gaps and referral challenges; facilitators included patient-centeredness of HaH care. CONCLUSIONS: A multifaceted implementation strategy was associated with increased HaH capacity utilization, provider adoption, and patient diversity. Health systems may consider similar, contextually relevant multicomponent approaches to equitably expand HaH.

Applications, limitations and advancements of ultra-low-field magnetic resonance imaging: A scoping review.

Background: Ultra-low-field magnetic resonance imaging (ULF-MRI) has emerged as an alternative with several portable clinical applications. This review aims to comprehensively explore its applications, potential limitations, technological advancements, and expert recommendations. Methods: A review of the literature was conducted across medical databases to identify relevant studies. Articles on clinical usage of ULF-MRI were included, and data regarding applications, limitations, and advancements were extracted. A total of 25 articles were included for qualitative analysis. Results: The review reveals ULF-MRI efficacy in intensive care settings and intraoperatively. Technological strides are evident through innovative reconstruction techniques and integration with machine learning approaches. Additional advantages include features such as portability, cost-effectiveness, reduced power requirements, and improved patient comfort. However, alongside these strengths, certain limitations of ULF-MRI were identified, including low signal-to-noise ratio, limited resolution and length of scanning sequences, as well as variety and absence of regulatory-approved contrast-enhanced imaging. Recommendations from experts emphasize optimizing imaging quality, including addressing signal-to-noise ratio (SNR) and resolution, decreasing the length of scan time, and expanding point-of-care magnetic resonance imaging availability. Conclusion: This review summarizes the potential of ULF-MRI. The technology's adaptability in intensive care unit settings and its diverse clinical and surgical applications, while accounting for SNR and resolution limitations, highlight its significance, especially in resource-limited settings. Technological advancements, alongside expert recommendations, pave the way for refining and expanding ULF-MRI's utility. However, adequate training is crucial for widespread utilization.

Virtual simulation training for postpartum hemorrhage in low-to-moderate-volume hospitals in the US.

Background: Maternal mortality in the United States is rising and many deaths are preventable. Emergencies, such as postpartum hemorrhage, occur less frequently in non-teaching, rural, and urban low-birth volume hospitals. There is an urgent need for accessible, evidence-based, and sustainable inter-professional education that creates the opportunity for clinical teams to practice their response to rare, but potentially devastating events. Objective: To assess the feasibility of virtual simulation training for the management of postpartum hemorrhage in low-to-moderate-volume delivery hospitals. Study design: The study occurred between December 2021 and March 2022 within 8 non-academic hospitals in the United States with low-to-moderate-delivery volumes, randomized to one of two models: direct simulation training and train-the-trainer. In the direct simulation training model, simulation faculty conducted a virtual simulation training program with participants. In the train-the-trainer model, simulation faculty conducted virtual lessons with new simulation instructors on how to prepare and conduct a simulation course. Following this training, the instructors led their own simulation training program at their respective hospitals. The direct simulation training participants and students trained by new instructors from the train-the-trainer program were evaluated with a multiple-choice questionnaire on postpartum hemorrhage knowledge and a confidence and attitude survey at 3 timepoints: prior to, immediately after, and at 3 months post-training. Paired t-tests were performed to assess for changes in knowledge and confidence within teaching models across time points. ANOVA was performed to test cross-sectionally for differences in knowledge and confidence between teaching models at each time point. Results: Direct simulation training participants (n=22) and students of the train-the-trainer instructors (n=18) included nurses, certified nurse midwives and attending physicians in obstetrics, family practice or anesthesiology. Mean pre-course knowledge and confidence scores were not statistically different between direct simulation participants and the students of the instructors from the train-the-trainer course (79%+/-13 versus 75%+/-14, respectively, P-value=.45). Within the direct simulation group, knowledge and confidence scores significantly improved from pre- to immediately post-training (knowledge score mean difference 9.81 [95% CI 3.23-16.40], P-value<.01; confidence score mean difference 13.64 [95% CI 6.79-20.48], P-value<.01), which were maintained 3-months post-training. Within the train-the-trainer group, knowledge and confidence scores immediate post-intervention were not significantly different compared with pre-course or 3-month post-course scores. Mean knowledge scores were significantly greater for the direct simulation group compared to the train-the-trainer group immediately post-training (89%+/-7 versus 74%+/-8, P-value<.01) and at 3-months (88%+/-7 versus 76%+/-12, P-value<.01). Comparisons between groups showed no difference in confidence and attitude scores at these timepoints. Both direct simulation participants and train-the-trainer instructors preferred virtual education, or a hybrid structure, over in-person education. Conclusion: Virtual education for obstetric simulation training is feasible, acceptable, and effective. Utilizing a direct simulation model for postpartum hemorrhage management resulted in enhanced knowledge acquisition and retention compared to a train-the-trainer model.

Revolutionizing urogynecology: Machine learning application with patient-centric technology: Promise, challenges, and future directions.

In an epoch where digital innovation is redefining the medical landscape, electronic health records (EHRs) stand out as a pivotal transformative force. Urogynecology, a discipline anchored in intricate patient histories and meticulous follow-ups, is on the brink of profound transformation due to these digital strides. While EHRs have unified patient data, challenges related to data privacy, interoperability, and access persist. In response, we present Pelvic Health Place (PHPlace) - a multilingual, patient-centric application. Purposefully designed to bolster patient engagement, PHPlace provides clinicians with essential pre-consultation insights, streamlines the consent process, vividly delineates surgical pathways, and assures comprehensive long-term monitoring. This platform also establishes a foundation for global data amalgamation, promising to invigorate research and potentially harness artificial intelligence (AI) capabilities. With AI integration, we anticipate a more tailored treatment approach and enriched patient education, signaling a pivotal shift in urogynecology and emphasizing the imperative for ongoing academic inquiry.

Clinical learning experiences of healthcare professional students in a student-led clinical learning environment (SLCLE) - A mixed methods evaluation.

AIM: To evaluate healthcare professional (HCP) students clinical learning experiences' whilst undertaking placements in a student-led clinical learning environment (SLCLE) and any changes in self-reported ratings of confidence. BACKGROUND: The English NHS Long Term Workforce Plan (2023) highlights the need to expand domestic education of HCPs to meet workforce shortages. The demand for quality clinical placements to support the preparation of HCP students remains a challenge globally. A creative solution has been the development of student-led learning clinical environments in healthcare settings. SLCLEs provide high-quality learning experience, increase clinical placement capacity whilst maintaining patient care standards. A multisite NHS Trust adopted this model as evidence suggests HCP students will be better prepared on qualification to adopt registered practitioner professional responsibilities. This model has been integrated across three hospital sites within a large teaching hospital, providing care for a diverse population and designed to accommodate students from a range of HCP disciplines and higher educational institutions. DESIGN: A mixed methods convergent design. METHODS: An online survey was administered to SLCLE allocated nursing and allied health profession (AHP) undergraduate and graduate-entry first, second and third-year students (n=132). Face to face focus groups/individual interviews were undertaken with a purposive sample of student participants (n=80) to evaluate their experiences of clinical learning in SLCLEs. Survey data were analysed using descriptive statistics and paired t-tests, interviews using framework method. RESULTS: Undergraduate and graduate-entry students from four UK universities completed the survey (n=132), 103 students (78 %) responded. Most were year 2 students (n=43/42 %), pursuing nursing programmes (n=82/80 %). Most considered the SLCLE met their expectations (n=76/74 %), reported increased confidence post-placement (n=84/82 %), felt supported by staff (n=80/78 %), peers (n=93/90 %) and clinical educators (n=93/90 %). Self-reported confidence scores post-SLCLE were significantly higher than pre-SLCLE. On-line pre-placement information was infrequently accessed yet identified as an omission. Four themes were identified: (i) preconceptions and initial anxiety; (ii) empowerment, growth and a unique learning experience; (iii) collaborative inter-professional learning and support; and (iv) insights and anticipations. CONCLUSIONS: The SLCLE allocation enhanced students' confidence and knowledge. Support from clinical educators, ward staff and doctors was perceived as invaluable for creating a positive learning culture. Peer support and opportunities to lead care delivery contributed to students' professional development. The format and method for providing pre-placement information needs review as do strategies for avoiding delays in completing assessment documentation. Overall, the SLCLE experience offers much potential as a nurturing and effective learning environment for HCP students.

Transcatheter Fontan completion: Creation of an extracardiac Fontan.

Patients with functionally univentricular hearts are usually palliated surgically. There have been several reports of successful attempts to complete the Fontan procedure without surgery. The pathways created at the time of the preconditioning were largely reminiscent of the lateral tunnel Fontan. However, this approach is still confidentially limited to a small number of centers. In 2013, we designed a circuit that mimics the actual surgical technique of extracardiac total cavopulmonary connection to allow for transcatheter completion in an animal study. A polytetrafluoroethylene conduit was connected between the pulmonary artery and the inferior vena cava (IVC). The superior anastomosis was occluded to avoid flow between IVC and superior vena cava (SVC). The conduit was connected to the right atrium (RA) and a large fenestration was created to allow free flow from the IVC to the RA. Extrapolating our approach, a center reported the successful transcatheter completion of an extracardiac Fontan in a 6-year-old child. However, this technique is not directly transposable to our population of patients who require preconditioning in infancy. We report here an innovative extension of this technique that may allow preparing patients in infancy, ideally at the time of the Glenn in the future, to receive an extracardiac Fontan at 2 years/11 kg without additional surgery.

Measurement and evaluation of agricultural technological innovation efficiency in the Yellow River Basin of China under water resource constraints.

Improving the efficiency of agricultural technology innovation is an inevitable requirement for ecological protection and sustainable agricultural development in the Yellow River Basin. Under the background of prominent water resources constraints in the Yellow River Basin, the actual level and regional differences of agricultural technology innovation efficiency in the basin are analyzed, which will provide theoretical basis and data reference for the development plan of agricultural modernization in the Yellow River Basin. The construction of evaluation index system and the choice of method are the main factors that affect the measurement results. Therefore, this paper first selects input indicators such as water-saving technology level and output indicators such as total agricultural output value to construct an innovative evaluation index system of agricultural technology innovation efficiency in the Yellow River Basin under the consideration of water resources constraints. Secondly, the three-stage DEA model was used to eliminate the interference of external environmental variables, and the overall and regional agricultural technology innovation efficiency of the Yellow River Basin during 2011-2020 was measured with the data of prefecture-level cities under the constraint of water resources. Finally, from the perspective of the whole and the region, the spatio-temporal dynamic evolution law is analyzed and evaluated. The results show that: on the whole, the agricultural technology innovation efficiency in the Yellow River Basin is good and rising in a wave trend, the adjusted pure technology efficiency increases, while the scale efficiency decreases. From the regional perspective, although there is regional heterogeneity, the overall development trend is good, and the lower Yellow River has the highest efficiency, followed by the upper reaches and the middle reaches. From the perspective of the change law, the spatio-temporal evolution distribution shows a multi-polarization trend, and the different regions in the upper, middle and lower reaches show great differences. Therefore, promoting the innovation of water-saving technology and the integration of agricultural science and technology, promoting the integration of production, study and research, and strengthening the regional linkage mechanism are helpful to improve the competitiveness of agricultural science and technology and achieve sustainable agricultural development in the Yellow River Basin.

Identifying innovations produced by primary health care centers and evaluating their scalability: the SPRINT Occitanie cross-sectional study in France.

BACKGROUND: Practice-based research is one of the levers identified by the World Health Organization (WHO) to strengthen primary health care. The scaling of health and social care innovations has the potential to reduce inequities in health and to expand the benefits of effective innovations. It is now rapidly gaining the attention of decision-makers in health and social care, particularly in high-income countries. To meet the challenge of declining numbers of primary care physicians in France, Multi-professional Healthcare Centers (MHC) were created to bring together medical and paramedical professionals. They are a source of innovation in meeting the health challenges facing our populations. Specific methodology exists to identify health innovations and assess their scalability. A working group, including end-users and specialists, has adapted this methodology to the French context and the University department of general practice of Montpellier-Nîmes (France) launched a pilot study in Occitanie, a French region. OBJECTIVE: To identify and evaluate the scalability of innovations produced in pluri-professional healthcare centers in the Occitanie region. METHODS: A pilot, observational, cross-sectional study was carried out. The SPRINT Occitanie study was based on a questionnaire with two sections: MHC information and the modified Innovation Scalability Self-Administered Questionnaire (ISSaQ), version 2020. The study population was all 279 MHC in the Occitanie region. RESULTS: 19.3% (54) of MHC in the Occitanie region, responded fully or incompletely to the questionnaire. Four out of 5 U-MHCs were represented. Five MHC presented multiple innovations. The average per MHC was 1.94 (± 2.4) innovations. 26% of them (n = 9) had high scalability, 34% (n = 12) medium scalability and 40% (n = 14) low scalability. The main innovation represented (86%) were healthcare program, service, and tool. CONCLUSIONS: In our cross-sectional study, a quarter of the innovations were highly scalable. We were able to demonstrate the importance of MHC teams in working on primary care research through the prism of innovations. Primary-care innovations must be detected, evaluated, and extracted to improve their impact on their healthcare system.

Research elevation of bank lending and technological innovation in the excess liquidity countries.

This study examines the intellectual framework research in bank lending and technological innovation relationships in countries with high banking system liquidity. This study employs bibliometrics with R-studio tools and procedures to analyze documents regarding productions, collaborations, keyword occurrences, conceptual structure, and density and centrality occurrence's network. Combining data from the Web of Science and Scopus databases, this study obtained 939 documents from 527 sources with a significant opportunity for further elevation through combination with other themes. The development analysis based on the most related countries indicates that researchers from other countries have also conducted studies identified as having significant banking liquidity. Topic development and thematic evolution show that research on the role of bank lending on technological innovation evolves to environmental issues, with green credit as the most recent and emerging elaboration. For further direction, keywords in investment clusters can help elevate education, commerce, and impact clusters by combining them with research on government taxation, credit provision, sustainable development, and emission control themes.

Coupling coordination degree measurement and spatial characteristics analysis of green finance and technological innovation -Empirical analysis based on China.

The coordinated development of green finance and technological innovation is a key driver of China's high-quality economic growth and therefore deserves close attention. But are green finance and technological innovation really coordinated? This study establishes a coordinating coupling system to link green finance and technological innovation. 2010-2021 is chosen as the observation period, and 31 provinces in China are selected for study. This paper uses the coupling coordination model to investigate the development of the coupling coordination of technological innovation and green finance, and discusses its spatial distribution by the Moran index. The results show that, overall, the degree of coupling coordination between green finance and technological innovation shows a consistent upward trend. The trend is particularly strong in the East. Moreover, the coordination coupling between green finance and technological innovation has the spatial effect. And it shows a binary characteristic, with a decreasing trend observed from coastal to inland regions. These results remained valid after replacing weight matrix and sample size.The above findings have important policy implications for optimising the synergistic development of green finance and technological innovation and achieving high-quality economic development.