External Push Research Articles

What are the perceptions of faculty and academic leaders regarding the impact of accreditation on the continuous quality improvement process of undergraduate medical education programs at Caribbean medical schools?

BackgroundAccreditation and regulation are meant for quality assurance in higher education. However, there is no guarantee that accreditation ensures quality improvement. The accreditation for Caribbean medical schools varies from island to island, and it could be mandatory or voluntary, depending on local government requirements. Caribbean medical schools recently attained accreditation status to meet the Educational Commission for Foreign Medical Graduates (ECFMG) requirements by 2024. Literature suggests that accreditation impacts ECFMG certification rates and medical schools’ educational processes. However, no such study has examined accreditation’s impact on continuous quality improvement (CQI) in medical schools. This study aims to gather the perceptions and experiences of faculty members and academic leaders regarding the impact of accreditation on CQI across Caribbean medical schools.MethodsThis qualitative phenomenological study inquiries about the perceptions and experiences of faculty and academic leaders regarding accreditation’s impact on CQI. Purposive and snowball sampling techniques were used. Participants were interviewed using a semi-structured interview method. Fifteen participants were interviewed across ten Caribbean medical schools representing accredited medical schools, accreditation denied medical schools, and schools that never applied for accreditation. Interviews were audio recorded, and thematic data analysis was conducted.ResultsThematic analysis yielded six themes, including accreditation and CQI, CQI irrespective of accreditation, faculty engagement and faculty empowerment in the CQI process, collecting and sharing data, ECFMG 2024 requirements, and organizational structure of CQI.ConclusionsThere is ongoing quality improvement at Caribbean medical schools, as perceived by faculty members and academic leaders. However, most of the change process is happening because of accreditation, and the quality improvement is due to external push such as accreditation rather than internal motivation. It is recommended that Caribbean medical schools promote internal quality improvement irrespective of accreditation and embrace the culture of CQI.

Design and evaluation of a pneumatic actuation unit for a wasp-inspired self-propelled needle.

Transperineal laser ablation is a minimally invasive thermo-ablative treatment for prostate cancer that requires the insertion of a needle for accurate optical fiber positioning. Needle insertion in soft tissues may cause tissue motion and deformation, resulting in tissue damage and needle positioning errors. In this study, we present a wasp-inspired self-propelled needle that uses pneumatic actuation to move forward with zero external push force, thus avoiding large tissue motion and deformation. The needle consists of six parallel 0.25-mm diameter Nitinol rods driven by a pneumatic actuation system. The pneumatic actuation system consists of Magnetic Resonance (MR) safe 3D-printed parts and off-the-shelf plastic screws. A self-propelled motion is achieved by advancing the needle segments one by one, followed by retracting them simultaneously. The advancing needle segment has to overcome a cutting and friction force, while the stationary needle segments experience a friction force in the opposite direction. The needle self-propels through the tissue when the friction force of the five stationary needle segments overcomes the sum of the friction and cutting forces of the advancing needle segment. We evaluated the prototype's performance in 10-wt% gelatin phantoms and ex vivo porcine liver tissue inside a preclinical Magnetic Resonance Imaging (MRI) scanner in terms of the slip ratio of the needle with respect to the phantom or liver tissue. Our results demonstrated that the needle was able to self-propel through the phantom and liver tissue with slip ratios of 0.912-0.955 and 0.88, respectively. The prototype is a promising step toward the development of self-propelled needles for MRI-guided transperineal laser ablation as a method to treat prostate cancer.

Stable Rapid Sagittal Walking Control for Bipedal Robot Using Passive Tendon

This paper presents the development, control, and experimental validation of a novel bipedal robot with a passive tendon. The robot, featuring foldable legs, coaxial actuation, and compact folded size, is endowed with a leg configuration with a five-bar mechanism. Based on biological observations of human walking, a passive artificial tendon made of emulsion is fabricated to work in conjunction with a tensioning device, providing adaptive heel touchdown and toe push-off in sync with single-leg movement. The tailored control framework for the bipedal robot is further established with the double-layer architecture. The regulation layer employs the linear inverted pendulum (LIP) model to generate reference trajectory of the center of mass (CoM) with a dead-beat style of parameter adjustment. An inverse-dynamics-based whole-body controller (WBC) is applied to enforce the full-order dynamics of the bipedal robot to reproduce the LIP model’s behavior. We carry out the experiments on the physical prototype to evaluate the walking performance of the developed bipedal robot. The results show that the robot achieves stable walking at the speed of 0.8 m/s (almost twice the leg length/s) and exhibits robustness to external push disturbance.

Trends and Challenges in the Teaching of Ideological and Political Courses in the Era of Digital Transformation: A Case Study of the "Ideology, Morality, and the Rule of Law" Course

In an era where digital technologies are transforming societal productivity and the 20th National Congress of the CPC discusses the "advancement of education digitalization", the integration of ideological and political education (IPE) with digitalization represents the future path for IPE teaching in universities. Under the external push of digital technologies, endogenous changes in ideological and political education occur through the use of digital IPE resources, channels, and modes to enhance the vitality of IPE classrooms. However, in the implementation of digital IPE teaching reforms, challenges persist in ideological leadership, digital infrastructure, and educational philosophy.

Of discursive passports and checkpoints

This commentary advances the notions of passports and checkpoints as heuristics through which to theorise the external and internal push and pull of identity and desire within specific regimes of normativities and geopolitical imbalances. More specifically, passporting happens when normative regimes of representations issue what one could call discursive passports – that is, institutionalised identity bundles, which sediment over time, defining individuals as specific ‘types’. Such discursive passports are no less harmful than their material counterparts because they can constrain people’s access to resources in more pervasive and far-reaching ways than their identity documents do. On the other hand, checkpoints are interactional moments in which people police themselves and others in everyday interactions. Checkpoints can be 1) external, when one’s discursive positionings or emotional expressions are questioned or even blocked by other people, or 2) internal, when people police their sense of belonging and affective practices such as desire.

External Shocks, Cost Push and Stagflation in Iran

External Shocks, Cost Push and Stagflation in Iran

Intercalation oxidation: A strategy for MoS2 modification to enable photodegradation of pollutants

MoS2 and related modified materials have received more attention as core technologies in mineralized dye molecules, and the injection of intercalators into MoS2 interlayers to change the MoS2 layer spacing to obtain materials with desirable photocatalytic properties is the current trend in modification. Herein, intercalated oxide materials (MSMO/T) were prepared by oxygen-limited calcination, in which the chemical composition and the resulting structure can be effectively controlled to obtain the desired performance for photocatalytic degradation of pollutants by simply changing the calcination temperature. Due to the beneficial structure of MoS2-MoO3 formed by oxygen intercalation and the Z-type heterojunction formed between it and TiO2, the catalytic performance is presented that is superior to that of a single material. Specifically, the MoS2 is structurally engineered and bound by oxygen intercalation layers. Effective mineralized degradation of pollutants under visible light can be achieved within 120 min without external push, and the relevant characterization demonstrates excellent photoelectric properties and long-term durability, making it an efficient catalyst for degrading dye molecules in water. This work provides an efficient and convenient way to modify transition metal disulfides for use as advanced materials for photocatalysis as well as other applications.

How do enterprises achieve sustainable success in green manufacturing era? The impact of organizational environmental identity on green competitive advantage in China

PurposeDrawing on the “Resource- Capability – Competitive advantage” framework within Natural Resource-Based View, this study is purposed to address problems of manufacturing companies “turning into the green” issues, providing references for manufacturing companies to achieve green competitive advantage via internal motivation and identity perspectives.Design/methodology/approachThis study collected survey data from 112 Chinese manufacturing listed enterprises from the Shanghai Stock Exchange, and obtained 418 questionnaires. Following an empirical design, hierarchical regression analysis and Bootstrapping analysis were applied to examine these hypotheses.FindingsResults show that green innovation behaviors positively mediate the positive relationship between organizational environmental identity and green competitive advantage. Furthermore, slack resource not only positively moderates the interaction effect between organizational environmental identity and green product innovation behaviors, but also moderates the mediation role of green product innovation behavior in the main effect.Research limitations/implicationsThe study is limited to the data samples and dynamic evolution between variables. More longitudinal designs and diverse enterprise fields will be considered in future.Practical implicationsThe findings provide guidance for manufacturing enterprises to gain green competitive advantage in green manufacturing era from identity value origins. Moreover, the results provide practical suggestions for manufacturing enterprises to enhance green innovation behaviors and integrate useful but slack resources.Social implicationsThe findings provide implications for manufacturing industry to increase both the awareness of organizational environmental identity and green innovation behaviors, all of which helps promote the corporate environmental responsibility.Originality/valueThe study breaks the limitation of the existing literature which focuses on the influence of external push factors (e.g. environmental regulation), and bring new visions in constructing green competitive advantage in green manufacturing era, not only extending the identity theory and upper echelon theory, but also enriching the current studies on green management. Also, these findings provide deeper and new insights into risks and uncertain features of green manufacturing era, analyzing how polluted manufacturing enterprises obtain green competitive advantages through the mediating role of green innovation behaviors and the moderating role of slack resource.

Creating an ecosystem that enables acceleration of housing self-recovery in the post-disaster context

During reconstruction, the recovery actors might overlook the connections between external and internal push factors. These factors can positively impact the processes to accelerate and produce long-term benefits beyond construction. Consequently, the ecosystem which should strengthen the self-recovery initiatives cannot be formed. Whereas, inside the ecosystem, the function of the market can be amplified by government policies and strategies. External push, such as using contractor companies and imposing deadlines, can speed up the reconstruction but will have problems both in sustainability and inclusivity. Government or aid agencies might set deadlines for the reconstruction program. It might happen if all support systems are in place. A deadline is inevitable since the recovery program might be ended due to program closure. Expecting that imposing the deadline will accelerate the process will only be partially effective. On the other hand, applying the push factors needs to pay attention to the nature of the genuine housing recovery, i.e., self-recovery initiatives and local market capacities. Hence, those initiatives and capabilities should be strengthened by internal push. The capacities of the market actors, which are the architects, engineers, builders, hardware stores, and even homeowners, should be strengthened to meet the demand for massive reconstruction. The data for this research was collected through field observations to interview the market actors, government officers, and other recovery actors, such as service providers and aid organizations. The data was analyzed by referring to the relevant academic and grey literature to find the relation of actors’ capacities with timelines and the quality of houses constructed.

Design and evaluation of an MRI-ready, self-propelled needle for prostate interventions.

Prostate cancer diagnosis and focal laser ablation treatment both require the insertion of a needle for biopsy and optical fibre positioning. Needle insertion in soft tissues may cause tissue motion and deformation, which can, in turn, result in tissue damage and needle positioning errors. In this study, we present a prototype system making use of a wasp-inspired (bioinspired) self-propelled needle, which is able to move forward with zero external push force, thereby avoiding large tissue motion and deformation. Additionally, the actuation system solely consists of 3D printed parts and is therefore safe to use inside a magnetic resonance imaging (MRI) system. The needle consists of six parallel 0.25-mm diameter Nitinol rods driven by the actuation system. In the prototype, the self-propelled motion is achieved by advancing one needle segment while retracting the others. The advancing needle segment has to overcome a cutting and friction force while the retracting needle segments experience a friction force in the opposite direction. The needle self-propels through the tissue when the friction force of the five retracting needle segments overcomes the sum of the friction and cutting forces of the advancing needle segment. We tested the performance of the prototype in ex vivo human prostate tissue inside a preclinical MRI system in terms of the slip ratio of the needle with respect to the prostate tissue. The results showed that the needle was visible in MR images and that the needle was able to self-propel through the tissue with a slip ratio in the range of 0.78-0.95. The prototype is a step toward self-propelled needles for MRI-guided transperineal laser ablation as a method to treat prostate cancer.

Private companies: the missing link on the path to net zero

ABSTRACT Global consensus is growing on the contribution that corporations and finance must make towards the net-zero transition in line with the Paris Agreement goals. However, most efforts have ultimately focused on public companies. This article argues that such a focus falls short of providing a comprehensive approach to the problem of climate change. It particularly examines the contribution of private companies to climate change and the phenomenon of brown-spinning. We show that one cannot afford to ignore private companies in the net-zero transition. Yet, private companies lack several disciplining mechanisms available to public companies, such as institutional investor engagement, certain corporate governance arrangements, and transparency through regular disclosure obligations. Nevertheless, along with some equally applicable generic regulatory instruments, private companies might be subject to external push by their financiers, banks. The article closes with policy implications. Primarily, we discuss and evaluate the recent push to extend climate-related disclosure requirements to private companies.

Locating Trade Secrets under Indian Laws: A Sui Generis Mode of Protection

India has so far resisted the push from the United States of America (USA) to bring about separate legislation that regulates trade secrets. Reports and studies categorically show that such protection is desirable. It also forms part of the minimum requirements under TRIPs. In its defence, India has reiterated that mechanisms under common law exist to effectively protect trade secrets. This paper looks into these mechanisms, primarily the Indian Copyright Act, 1957(Copyright Act) and the Indian Contract Act, 1872 (Contract Act), and provides evidence to show that deciding on trade secret issues via these Acts in India undermines the basic premise of copyright, and ignores issues of treating confidential information as confidential. Literary work as mentioned in the Copyright Act and the settled position of law by judicial decisions is discussed in this paper. This forms the first argument in favour of sui generis protection for trade secrets. The second argument in favour of the sui generis mode of protection for trade secrets is that of retaining the confidentiality of information that is regulated by contracts. This aspect is, firstly, under-examined in evidence in the Indian cases. Secondly, under the Indian Contract Act, 1857, (Contract Act) whenever the elements of confidentiality are to be examined, it is circumvented or ignored. This thereby impedes the understanding of confidential information in these case laws. Hence, this study shows that courts have overtly interfered in the basic premise of contractual obligations vis-a-vis confidential information between two parties by reading into what constitutes a trade secret. It is this lacuna in both procedural and substantive fields that holds up the second argument for a sui generis mode of protection. The conclusions from this paper address a much-required regime change in the pre-existing model of protection of trade secrets in India not only as a result of the external push (that is necessitated by international pressure and India’s continued presence on the Priority Watch List) but also as a result of the internal indecisiveness in deciding matters before the Indian courts.

Japan’s strategic response to China’s geo-economic presence: quality infrastructure as a diplomatic tool

In the new millennium, Japan found a renewed interest in infrastructure investment and engaged in this policy issue with diplomatic initiatives and external partnerships with due attention to China’s geo-economic presence. In formulating strategies for infrastructure investment, Japan has presented and disseminated a specific idea of ‘quality infrastructure’ as a principal component of its external infrastructure push. This article seeks to trace the evolution of Japan’s ideational principles for quality infrastructure and elucidate policy motivation, policy objective, and external influence. It argues that Japan’s advocacy of quality infrastructure derived from domestic impetus to expand infrastructure exports and external impetus to compete against China’s infrastructural push through the Belt and Road Initiative (BRI). Japan advocated quality infrastructure as a strategic tool to pursue multiple policy objectives that shifted from justifying Japanese infrastructural push to using as means to check and accommodate the BRI, and to legitimising common governance principles for infrastructure investment. In relations to external influence, Japan’s persistence in norm-setting encouraged China to incorporate normative principles first at business dialogues and then embed common governance principles in its policy approach to infrastructure investment.

A composite robust reactive control strategy for quadruped robot under external push disturbance

In order to solve the walking stability problem of quadruped robot under lateral disturbance, a robust stabilization reactive control strategy based on capture point stability theory is proposed. This novel control strategy consists of an active adaptive stepping control strategy at the upper planning layer and a joint disturbance rejection controller based on virtual model control at the bottom layer. The adaptive stepping control strategy is based on the capture point stability theory, which determines the stable stepping point of the robot under the action of external disturbance according to the speed and attitude of the body, and the joint disturbance rejection controller at bottom layer realizes the stable torque control of the robot and adjusts the attitude of the body through the virtual model controller. Finally, the effectiveness of the designed composite control strategy is verified by co-simulation of Simulink and ADAMS. Simulation results show that the robot with the proposed composite reactive control strategy is able to cope with large external disturbance and recover to be stable from external force disturbance.

Finite State Machine-Based Motion-Free Learning of Biped Walking

Recently, deep reinforcement learning (DRL) is commonly used to create controllers for physically simulated characters. Among DRL-based approaches, imitation learning for character control using motion capture clips as tracking references has shown successful results in controlling various motor skills with natural movement. However, the output motion tends to be constrained close to the reference motion, and thus the learning of various styles of motion requires many motion clips. In this paper, we present a DRL method for learning a finite state machine (FSM) based policy in a motion-free manner (without the use of any motion data), which controls a simulated character to produce a gait as specified by the desired gait parameters. The control policy learns to output the target pose for each FSM state and transition timing between states, based on the character state at the beginning of each step and the user-specified gait parameters, such as the desired step length or maximum swing foot height. The combination of FSM-based policy learning and simple linear balance feedback embedded in the base controller has a positive synergistic effect on the performance of the learned policy. The learned policy allows the simulated character to walk as instructed by the continuously changing the gait parameters while responding to external perturbations. We demonstrate the effectiveness of our approach through interactive control, external push, comparison, and ablation studies.

The Opportunities and Challenges That the Belt and Road Initiative Brings: Analysis from Perspective of China-Pakistan Economic Corridor

Driven by the Belt and Road Initiative (BRI), China and Pakistan as all-weather strategic partners announced a big move to build the China-Pakistan Economic Corridor (CPEC) in 2015, aiming to link Pakistan’s Gwadar Port to China’s Xinjiang autonomous region. CPEC leads two countries into economic cooperation in critical areas including manufacture, energy, logistics and transport. The Belt and Road initiatives (BRI) project could bring economic avenues to Pakistan and foster regional and cross-regional economic growth as well as trade integration between Central Asia, South Asia, West Asia and East Asia. This paper not only makes a theoretical analysis of BRI and CPEC but also explores the reason why CPEC may succeed from the perspectives of the balanced growth development theory and the neoclassical growth theory. Theoretically, openness and massive capital are key factors for less developed economies to transfer into a sustainable growth state. However, these countries are disadvantageous in both openness and capital funds. Therefore, an external big push of massive investment is needed for them. Only through investing simultaneously in most complementary industries and regions, can they make economies to step into the growing path, and then to grow sustainably. Once the big push ignites the growth engine, economies acquire advantages of catch-up mechanism and converge to steady state. Therefore, CPEC focusing on aid-for-trade as well as substantial infrastructure development is capable of boosting economic prosperities for both China and Pakistan. In addition to theoretical analysis, this article identifies different types of socio-political impediments against BRI and CPEC, ranging from environmental aspects to socio-political structures. Pakistan has long been struggling with socio-political factors: low literacy rate, turbulent political situation, terrorist attacks, crimes, wars and corruption. All these negative factors pose essential challenges for transnational investment and infrastructure projects.

Laparoscopic Inguinal Gonadectomy in a Case of Familial Complete Androgen Insensitivity Syndrome and Inguinal Mass

Study Objective Technical video demonstrating steps of inguinal gonadectomy in a case of complete androgen insensitivity syndrome (CAIS) with gonads in the inguinal canal. Design Technical video (Canadian Task Force classification III). Setting Gynecology department at a tertiary care hospital. Patients or Participants A patient with CAIS and inguinal mass. Interventions Laparoscopic inguinal gonadectomy and peritoneal closure at deep inguinal ring. Measurements and Main Results Androgen insensitivity syndrome (AIS) is a X-linked disorder of sex development with androgen receptor resistance. Phenotypic females with primary amenorrhea along with presence of testes and XY karyotype is diagnostic of AIS. Gonadectomy is usually advised in these patients as they are at risk of testicular germ cell tumor in undescended testis. The testes can be located at any position of embryological descent pathway. The patient in the present video is a 21 years old unmarried female with CAIS and testes present in inguinal canal. Her two siblings were also diagnosed with the same syndrome and one had undergone gonadectomy through inguinal incision. Laparoscopic inguinal gonadectomy is a minimally invasive approach with less intraoperative complications and pain, shorter hospital stay, faster postoperative recovery and aesthetically smaller scars. Laparoscopic inguinal gonadectomy is technically challenging as gonads are located in inguinal canal. We performed laparoscopic peritoneum dissection at the level of deep inguinal ring, identified the gonads and traction was applied aided with external push at level of external inguinal ring for successful retraction of gonads. Adequate closure of peritoneum at site of deep inguinal ring will prevent inguinal hernia in future. Conclusion Laparoscopic inguinal gonadectomy although technically difficult should be preferred over open inguinal incision to reduce postoperative morbidity. Technical video demonstrating steps of inguinal gonadectomy in a case of complete androgen insensitivity syndrome (CAIS) with gonads in the inguinal canal. Technical video (Canadian Task Force classification III). Gynecology department at a tertiary care hospital. A patient with CAIS and inguinal mass. Laparoscopic inguinal gonadectomy and peritoneal closure at deep inguinal ring. Androgen insensitivity syndrome (AIS) is a X-linked disorder of sex development with androgen receptor resistance. Phenotypic females with primary amenorrhea along with presence of testes and XY karyotype is diagnostic of AIS. Gonadectomy is usually advised in these patients as they are at risk of testicular germ cell tumor in undescended testis. The testes can be located at any position of embryological descent pathway. The patient in the present video is a 21 years old unmarried female with CAIS and testes present in inguinal canal. Her two siblings were also diagnosed with the same syndrome and one had undergone gonadectomy through inguinal incision. Laparoscopic inguinal gonadectomy is a minimally invasive approach with less intraoperative complications and pain, shorter hospital stay, faster postoperative recovery and aesthetically smaller scars. Laparoscopic inguinal gonadectomy is technically challenging as gonads are located in inguinal canal. We performed laparoscopic peritoneum dissection at the level of deep inguinal ring, identified the gonads and traction was applied aided with external push at level of external inguinal ring for successful retraction of gonads. Adequate closure of peritoneum at site of deep inguinal ring will prevent inguinal hernia in future. Laparoscopic inguinal gonadectomy although technically difficult should be preferred over open inguinal incision to reduce postoperative morbidity.

Current account drivers and exchange rate regimes in Central and Eastern Europe

The paper seeks to determine the factors that drive the current account dynamics of the 11 EU members from Central and Eastern Europe (CEE). Panel data models are estimated on annual data for the period 1997–2017 and both domestic pull factors and external push factors are included. The models are, as a key innovation, estimated separately for floating and fixed exchange rate regimes. The current account exhibits substantial persistence in both cases. For the floaters, the current account is driven by domestic factors while external factors appear unimportant. For the fixers, the current account is mainly driven by external factors, suggesting there is substantial vulnerability to external developments. The analysis underscores the importance of the exchange rate regime for the drivers of the current account balance in the CEE countries.

Impact of Academic Achievement Orientation in the Context of Private and Public Sector University Students

The problem of the study was to explore the impact of academic achievement orientation in the context of private and public sector university students; it further aimed to investigate the impact of demographic variations such as gender, age, semester, birth order, number of siblings, discipline and family income in determining the level of academic achievement orientation of private and public sector university students. The achievement orientation attitude scale developed by Ansari was used to measure achievement orientations, which was consisted of 10 items. Data was collected through a stratified random sampling technique. Data were analyzed with various statistics, which provided an insight that students differ in terms of academic achievement orientations. Results revealed that students of public sector universities have higher academic achievement orientations. It is also recommended that at the university level, students may also learn self-management and ought to work hard in order to achieve their academic goals without an external push.

Business model innovation in corporate entrepreneurship: exploratory insights from corporate accelerators

Corporate accelerators are a rapidly growing entrepreneurial phenomenon occurring in different business contexts and business models within corporate entrepreneurship. Corporate accelerators are considered as an innovation fostering approach within new ventures provided by start-ups. The aim of the paper is twofold: firstly, to explore the motives behind corporations’ engagement with start-ups in launching corporate accelerators, and secondly, to identify the corporate benefits and challenges of this business model innovation. The research design is based on a qualitative interpretative approach exploiting a triangulation of methods by using in-depth interviews (IDI) with corporate managers involved in development of corporate accelerators as well as a focus group interview (FGI) with industry experts. In addition, secondary data were applied to strengthen the exploratory research. The study demonstrates that a wide range of benefits stem from the accelerator activities which can ultimately can initiate changes in large companies. Our research expands on prior findings and suggests that corporate accelerators are driven by internal and external push and pull motives. The study contributes to expanding the scope of corporate entrepreneurship research in regard to the challenges and benefits of corporate accelerators. It provides evidence that corporate accelerators are a source of innovation that can be used to foster entrepreneurial-market logic and entrepreneurial learning.