Innovation Center Research Articles

Examination of the effects of innovation development, technology management and big data analytics capability in information technology companies

PurposeThe main purpose of examining innovation development (ID), technology management (TM) and big data analytics capability (BDAC) from the perspective of information technology companies is to help these companies optimize their business strategies and increase their competitiveness. When these concepts are considered together, it is aimed to present suggestions that information technology companies can increase their innovation capacities, optimize their technology portfolios and develop their big data analytics capacities.Design/methodology/approachData were collected from information technology companies working on big data analytics in technoparks in Istanbul. In the research, the Marmara region of Turkey was preferred because it is the region where the information technology sector is most common. In total, 503 questionnaires were collected. SmartPLS (4.0.8.4) licensed software was used in the research, and the results are presented with tables and figures.FindingsAs a result of the analysis of the data, it is supported by hypotheses that ID and TM have positive effects as independent variables and BDAC has positive effects as both independent and mediation variables.Research limitations/implicationsIn terms of the limitations of the research, since the data were collected only from the information technology companies in the technoparks in Istanbul, it would not be correct to generalize the analysis results. For this reason, it is recommended to develop a research model and contribute to the literature by considering this limited situation for similar studies to be conducted in the future.Practical implicationsBy focusing on ID, it is important for companies to analyze their innovation processes and increase their ID capacity. On the subject of TM, analyses help companies identify their current technological infrastructure and development needs and optimize their technology portfolios. Big data analytics is an important tool that companies can use in their decision-making processes. Therefore, analyses of big data analytics can evaluate companies' current data analytics capacities and offer improvement suggestions.Originality/valueSo why are ID, TM and BDAC important? Why should a research model be developed to examine the effects of these variables? This situation can be understood by looking at the investments made by two world-class companies with headquarters in Istanbul/Turkey. L'Oréal Turkey integrates big data, cloud computing, artificial intelligence and digital platforms into its business processes by investing in new technologies and also makes a difference with innovation in environmental sustainability and social responsibility. PepsiCo, on the other hand, placed a great emphasis on innovation by opening its third Design and Innovation Center in Turkey and Europe in Istanbul. For this reason, examining the effects of ID, TM and big data analytics together in the research is important for the originality of the research. Examining these variables by focusing on their interactions and effects increases the originality of the subject.

Normalised similarity assessment to inform grouping of advanced multi-component nanomaterials by means of an Asymmetric Sigmoid function

This manuscript presents a procedure for similarity assessment as a basis for grouping of multi component nanomaterials (MCNMs). This methodology is an adaptation of the approach by Zabeo et al. (2022), which includes an impactful change: the calculated similarities are normalised in the [0,1] domain by means of asymmetric Logistic scaling to simplify comparisons among properties' distances. This novel approach allows for grouping of nanomaterials that is not affected by the dataset, so that group membership will not change when new candidates are included in the set of assessed materials. It can be applied to assess groups of MCNMs as well as mixed groups of multi and single component nanomaterials as well as chemicals. To facilitate the application of the proposed methodology, a software script was developed by using the Python programming language, which is currently undergoing migration to a user-friendly web-based tool. The presented approach was tested against a real industrial case study provided by the Andalusian Innovation Centre for Sustainable Solution (CIAC): SiO2-ZnO hybrid nanocomposite used in building coatings, which is designed to facilitate photocatalytic removal of NOx gases from the atmosphere. The results of applying the methodology in the case study demonstrated that ZnO is dissimilar from the other candidates mainly due to its different dissolution profiles.

Indonesia's Digital Economic Policy To Increase Economic Resilience

The growth of information and communication technology (ICT) has changed the way people live their lives and conduct business. The era of the Industrial Revolution 4.0, characterized by the use of digital technology and the Internet of Things (IoT), has created a new economic environment known as the “digital economy." In this context, digital economy policy becomes very important to support sustainable economic growth and improve national economic resilience. This research aims to analyze Indonesia's digital economy policy in developing the digital economy in the context of Society 5.0 and Industrial Revolution 4.0. The main focus of the research is how government policies can strengthen the national economy. This research uses a descriptive-qualitative method with secondary data collected through a systematic review. Data were collected from various scholarly sources, including relevant journals, research publications, reports, and websites. This qualitative approach generates descriptive notes and data that are integrated into the text for further analysis. When policies are implemented correctly, that is, by paying attention to and realizing the various aspects that have an impact on the policy implementation process, it will produce the maximum benefits, including the Integration, Interactivity, Transparency, Control, and Accountability (IITCA) factors. The research shows that digital economy policies have a significant positive impact on economic growth and resilience. The implementation of the Digital Economic Agreement Framework (DEFA) is expected to strengthen the MSME sector, attract investment, encourage innovation, increase productivity, and create high-quality jobs. The establishment of the Digital Innovation and Sustainable Economy Center (DISC) also plays an important role in supporting the transformation of businesses and organizations towards a sustainable digital economy. In addition, the Indonesian government has improved digital infrastructure, such as 4G networks, 5G technology, and low-earth orbit satellites, and launched digital literacy and skills programs to reduce the digital divide and strengthen economic resilience. An effective digital economy policy can be a powerful instrument to strengthen a country's economic resilience. Research results confirm that the implementation of digital economy policies not only drives economic growth but also improves social and financial inclusion. Collaboration between the public sector, the business world, and civil society is essential for the successful implementation of this policy. In addition, transparency and accountability in the implementation of digital policies, such as through the use of blockchain technology and digital payment systems, can reduce corruption and ensure that government assistance and support are well-targeted. Overall, digital economy policies play an important role in strengthening national economic resilience amid the challenges and opportunities of the digital era.

The Silicon Valley paradox: A qualitative interview study on the social, cultural, and ideological foundations of a global innovation center

Abstract Silicon Valley is both object of intense fascination and stark criticism. Academic observers have described it as a unique amalgamation of hippie culture, libertarian thinking, wild experimentation, but also scientific rigor, high-tech precision, and turbo-capitalism – a seemingly improbable, even paradoxical combination. Nevertheless, Silicon Valley continues to be an economic powerhouse and a global innovation hub. The current study explores its socio-cultural and ideological foundations through the lens of an insider perspective to find explanations for its stability and sustained success in light of conflicting components. Based on 15 interviews with Silicon Valley experts from start-ups, tech giants, and academic institutions, the study identifies several paradoxes on the level of ideology and environment, structure(s), and actors. These can be grouped into a binary, oppositional view, indeed describing the Silicon Valley paradox. However, alternative explanations are given, including the conceptualization as a non-dualist phenomenon.

Pathways through which intermittent preventive treatment for malaria in pregnancy influences child growth faltering: a mediation analysis.

Intermittent preventive treatment for malaria in pregnancy (IPTp) can improve birth outcomes, but whether it confers benefits to postnatal growth is unclear. We investigated the effect of IPTp on infant growth in Uganda and its pathways of effects using causal mediation analyses. We analyzed data from 633 infants born to mothers enrolled in a randomized trial of monthly IPTp with dihydroartemisinin-piperaquine (DP) vs sulfadoxine-pyrimethamine (SP) (NCT02793622). Weight and length were measured from 0-12 months of age. Using generalized linear models, we estimated effects of DP vs. SP on gravidity-stratified mean length-for-age (LAZ) and weight-for-length Z-scores (WLZ). We investigated mediation by placental malaria, gestational weight change, maternal anemia, maternal inflammation-related proteins, preterm birth, birth length, and birth weight. Mediation models adjusted for infant sex, gravidity, gestational age at enrollment, maternal age, maternal parasitemia at enrollment, education, and wealth. SP increased LAZ by 0.18-0.28 Z from birth through age 4 months compared to DP, while DP increased WLZ by 0.11-0.28 Z from 2-8 months compared to SP among infants of multigravidae. We did not observe these differences among primigravida. Mediators of SP included increased birth weight and length and maternal stem cell factor at delivery. Mediators of DP included placental malaria and birth length, maternal IL-18, CDCP1, and CD6 at delivery. In high malaria transmission settings, different IPTp regimens influenced infant growth among multigravidae through distinct pathways in the period of exclusive breastfeeding, when few other interventions are available. Stanford Center for Innovation and Global Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bill & Melinda Gates Foundation.

Examining How the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model Improves Health Equity for Underserved Communities and Safety Net Hospitals in New York State.

Safety net hospitals (SNHs) are essential to our healthcare ecosystem, providing quality healthcare to underserved communities. These institutions offer specialized services and acute medical care to populations facing structural or systemic healthcare barriers. However, for decades, the NYS Medicaid program reimbursed hospitals less than the cost of care, resulting in several independent SNHs becoming financially distressed, with many facing closure. Recently, the Center for Medicaid and Medicare Service Innovation Center (CMSI) introduced the State All-Payer Health Equity Approaches and Development (AHEAD) Model, which aims to support the financial needs of providers while also addressing the complex medical and social circumstances of underserved communities. This article will explore how the AHEAD model can be utilized as an alternative payment method for SNHs in New York State (NYS) to improve healthcare for underserved communities.

Advancing Higher Education with the Transition to Smart Universities: A Focus on Technology

This study explores the transformative journey of higher education towards smart universities, emphasizing integrating cutting-edge technologies such as augmented reality, virtual reality, artificial intelligence, and biometric systems. This evolution responds to the evolving demands of society, aiming to significantly enhance the educational experience while reimagining campus life and community involvement. It sheds light on the creation of immersive, interactive, and personalized learning landscapes that accommodate a diverse array of student requirements, including those with disabilities, setting a new standard in educational inclusivity. The discourse extends to the pivotal role of smart campuses, which are instrumental in forging safer, more inclusive, and environmentally sustainable educational realms. Furthermore, the paper highlights the importance of digital platforms in nurturing social bonds and community engagement, especially through the potent medium of alumni networks. By transitioning into centers of innovation and technological excellence, universities are equipping students for a future shaped by technology. The review highlights the transition’s challenges and opportunities, emphasizing the need to balance technological advancements with human-centric values, ensure equitable technology access, and maintain privacy. It presents the rise of smart universities as a pivotal step towards more interconnected, intelligent, and sustainable communities, significantly influencing education and societal development.

A paradox of size: Case-volume, financial outcomes, and risk in the enhancing oncology model baseline period.

e13809 Background: The Centers for Medicare and Medicaid Innovation’s (CMMI) Enhancing Oncology Model (EOM) is a risk-bearing, population-based value-based care (VBC) model requiring participating physician group practices (PGP) to take financial risk and performance accountability for episodes of care for seven common cancers. We studied the association between case volume, financial outcomes, and risk in the EOM. Methods: Using deidentified public use EOM baseline episode files (2016 - 2020), and the EOM Price Prediction Model provided by CMMI, we calculated the predicted baseline price (BP) per episode and savings (difference between baseline price and actual expenditures (AE)), grouped PGPs per baseline period by episode count (case volume), and evaluated the risk (variation of savings). ANOVA, F-test, and pair-wise tests were used to evaluate statistical significance. Results: Two-thirds of the 16,348 PGP appearances per time-period (n) had <72 episodes (average: 93.8, median: 36). Table 1 shows population and savings metrics. There was a significant effect of episode counts on savings (ANOVA/F-test: F(5,16342) = 24.5, p<0.0005). Post hoc pair-wise t-tests (Holm correction to adjust p) indicated groups with <72 episodes had increased risk (4.5:1, p<0.0005) and >361 episodes had the least risk (p<0.0005). Groups with <72 episodes had four times the median savings than groups with >361 episodes. Conclusions: As expected with the law of large numbers, groups with fewer episodes are exposed to higher risk and extremes of financial outcomes in EOM-like models while paradoxically generating better savings. The impact of case-mix differences among groups is apt for further exploration. Differences in PGP dynamics and provider like-mindedness with care transformation is one possible explanation for this paradox. Future models should incorporate risk mitigating modeling techniques (case-volume adjustments) or facilitate easier partnering arrangements to engage groups with fewer episodes. [Table: see text]

5-year multicenter analysis of clinical trial participation and total cost of care for older adults with cancer.

11013 Background: Clinical trial access particularly for older adults aged 65 years and above with cancer is impacted by multilevel barriers, including cost concerns to payers in the usual models of cancer care delivery. Alternative models recently studied include the Centers for Medicare and Medicaid Innovation’s Oncology Care Model (OCM), a value-based care pilot to enhance quality & reduce costs. Here, we investigated the association between clinical trial participation (CTP) and the total cost of care (TCOC) within this non-traditional model. Methods: We identified prospective longitudinal observational cohort of patients cared for in 11 states within 323 clinics in 14 multi-site community practices participating in OCM, in The US Oncology Network and extracted data (episode claims, medical records, episodes) from OCM performance periods (PP) 3-11 between 7/1/17 and 6/30/22. Propensity score matching by PP, age, gender, date of death, cancer type identified the analysis cohort of matched episodes, then stratified by trial participation (CTP vs usual care) to compare TCOC and drug expenditures. Results: Over 5 years, 121,717 unique patients (94% of whom were aged 65y+) received 282,604 episodes of cancer care in the community, most common cancers being breast, lung, multiple myeloma. Propensity score matching identified 13,260 matched episodes (6630 usual care, 6630 CTP). The actual expenditure differed by $2,341 per episode between CTP & usual care (CTP $43,890 vs usual care $41,548; p < 0.0001), while trial participation had significant savings against the OCM CTP benchmark ($4816 saved per CTP episode), compared to usual care vs its benchmark ($826 saved per usual care episode, p < 0.0001). Drug costs per episode did not differ between the two groups (CTP $29,516 vs usual care $30,553; p 0.54). Further breakdown shows that drug spending on anticancer agents (CTP $28,008 vs usual care $29,139) and other drugs including supportive care meds (CTP $1,511 vs usual care $1,414) did not differ significantly. Conclusions: Clinical trial participation saw relative cost savings against the benchmark compared to usual care, owing largely to the higher benchmark prices for CTP episodes in OCM’s risk-adjusted price prediction model, rather than an absolute cost savings to payers. Drug expenditures remain the largest contributor to total cost of care in this alternative model. The contributors to both drug expenditures as well as the absence of absolute cost savings between the two cohorts represent key areas for further investigation. CMMI Disclaimer: The statements contained in this document are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document.

CancerX Data Sprint: Advancing national oncology data standards through a unique public-private partnership.

e23283 Background: In a concerted effort to enhance the quality, accessibility, and effectiveness of comprehensive real-world cancer datasets, CancerX, a public-private partnership announced by the White House recently conducted a demonstration project, the CancerX Data Sprint. CancerX Data Sprint attempted a novel approach to quickly inform collective efforts of the Center for Medicare and Medicaid Innovation (CMMI), the National Cancer Institute (NCI), the US Food and Drug Administration (FDA), and the Office of the National Coordinator for Health Information Technology (ONC) to advance cancer-related data standards. Specifically, at the intersection of CMMI’s Enhancing Oncology Model (EOM) and the development of ONC’s United States Core Data for Interoperability (USCDI+) – Oncology extension, CancerX leveraged its unique model and broad membership to report novel insights to advance data-driven innovations in oncology research, care, and policy. Methods: From Sept to Dec 2023, the Data Sprint convened 150+ member organizations from industry and government partners to 1) Identify the high-value research questions that could be asked about the standardized real-world data (RWD) generated through EOM 2) Supplement the existing data elements with new ones to extend and enhance the ability to conduct scientific, clinical, and research inquiries with comprehensive datasets. The CancerX community opined via surveys, written feedback, and live workshops to identify key data elements, discuss their clinical value and technical feasibility, and consider their use in real-world settings as part of the comprehensive datasets. Results: Building on the current EOM clinical data elements, we identified and reported 15 new clinical data elements for considerations with high clinical utility and ease of technical abstraction. This comprehensive RWD encompasses a diverse range of patient demographics, clinical details, treatment histories, and outcomes, creating a more accurate and inclusive portrayal of cancer treatment effectiveness and patient journeys. This depth of information is crucial for optimizing the personalization of treatment pathways, conducting impact assessments, and addressing healthcare disparities. Essentially, the new datasets serve as a valuable repository of insights, driving advancements in cancer research, treatment and elevating care quality. Conclusions: CancerX remains committed to supporting federal data initiatives like USCDI+ Cancer standards development and others by providing recommendations for essential data elements implementation to enhance clinical utility, technical feasibility, and exchange of standardized cancer data. By adopting a unique approach and assembling an interdisciplinary group, we can ensure that data standardization efforts prioritize high-utility data elements, ultimately maximizing benefits for our patients.

Innovative infusion center assessments of chemotherapy-induced neurotoxicities: A pilot study supporting early and routine screenings as part of survivorship programs.

e24102 Background: More than 50% of patients treated with taxane and platinum chemotherapy experience neurotoxic adverse events due to treatment, including neuropathy, hearing loss or cognitive impairment. However, because risk factors and clinical trajectory of these toxicities remain poorly understood, it is not yet clear how or when patients should be screened. Innovative technology, such as tablet-based screening tools, create unique opportunities to capture patient symptoms, better understand potentially long-lasting side effects, and determine when to start either preventive or treatment/rehabilitation options. Methods: We assembled a multidisciplinary team from oncology, nursing, and audiology. IRB permission was obtained to perform a longitudinal observational pilot to assess the feasibility of performing chair-side neurotoxicity screenings in the infusion center of an urban safety net health system. Five infusion center nurses were recruited to collect data using a tablet-based application on 55 patients who met the inclusion criteria including chemotherapy-naive patients and fluent in English. Neuropathy and cognitive impairment were measured by validated standardized subjective scales (the Chemotherapy Induced Peripheral Neuropathy Assessment Tool, and the Attentional Function Index, respectively) and objective pure-tone audiometry (SHOEBOX Audiometry). Descriptive statistics were used to summarize outcome data. Results: Baseline assessments were completed on 48/55 patients with 37 completing at least one or up to 6 repeated assessments. All participants had baseline assessments before their first cycle by a chemo-certified RN in the infusion chair. Our sample included 55 adults aged 29 to 81 years, of whom 75% were females. 61% of participants were diagnosed with a gynecologic cancer, and 51% consented to receive Paclitaxel and Carboplatin chemotherapy regimen, 29% consented to receive Cisplatin chemotherapy, the remaining 20% consented to receive Oxaliplatin, Docetaxel, or Carboplatin alone. Significant changes occurred in all 3 symptoms by cycle 6 of chemotherapy with 45% of participants experiencing neuropathy, 13% experiencing a clinically significant change in hearing, and 30% experiencing self-reported cognitive concern by the 6th cycle. Ototoxicity and neurotoxicity scores followed the same trajectory of an increase or worsening in scores over time from cycle 1 to cycle 6. Conclusions: Use of innovative, portable tablet-based screening tool can be effectively used to capture symptoms of neuropathy chair-side as patients undergo chemotherapy. These observations support the need to better assess these approaches so that they can be used to optimize clinical outcomes and patient quality of life.

Prestige in Partnership: A Case Study in Leveraging University Excellence to Elevate Brand Success

Abstract As global competition in research continues to grow, universities are becoming key centres of innovation and knowledge generation. One of the most important factors attracting research institutions to a university is its brand. This article examines how universities can collaboratively establish and achieve research goals with research institutes, using a case study of Coventry University's partnership with the Lukasiewicz Research Network – Institute for Sustainable Technologies (Lukasiewicz–ITEE). The analysis highlights the significance of a strong brand in fostering sustainable relationships with other academic, research, and industrial partners. The practical implementation of Coventry University's strategies, including promoting research achievements and investing in relationship development, is explored. The study demonstrates that a university's reputation significantly enhances its appeal to potential research partners, thereby facilitating joint research projects and the commercialization of research outcomes.

Preparing for Value: Evaluating Organizational Culture in Health Care Transformation.

The health care industry is experiencing a transformative shift from traditional fee-for-service models to value-based care (VBC), emphasizing improved patient outcomes, enhanced quality, and reduced costs. While Centers for Medicare & Medicaid Services Innovation Center models focus on financial and quality outcomes, a critical opportunity for reform lies in organizational culture. VBC signifies a cultural and systemic evolution aligned with the quintuple aim of enhancing equitable patient outcomes, improving quality, reducing costs, and prioritizing provider well-being. Cultural impacts play a pivotal role in this transformation.

PARTICIPATORY APPROACH STRATEGY OF REGIONAL AND VILLAGE AUTHORITIES IN ACCELERATING INNOVATION IN WEST SUMBAWA REGENCY

This study aims to identify the efforts that can be undertaken by regional and village authorities to enhance innovations in West Sumbawa Regency. The research method used is qualitative-descriptive, employing observation, interviews, and literature study as data collection methods. Interviews were conducted with key informants who are knowledgeable about innovation developments in West Sumbawa Regency. The results of this study indicate that West Sumbawa Regency has significant innovation potential. However, existing innovations are still scattered, and efforts are needed to create an innovation ecosystem. By implementing several strategic steps based on good governance, an innovation ecosystem can be created to accelerate the enhancement of innovations. Another finding of this research explains the need for an innovation center that connects all ideas and concepts from innovators in West Sumbawa Regency. This step is considered to facilitate the community in building interconnected innovation networks. Therefore, through efforts such as village potential analysis, one village-one product initiatives, and innovation month, it is expected that the existing innovations in West Sumbawa Regency can be improved. Keywords: Regional innovation, West Sumbawa Regency, Innovation Ecosystem

창조경제혁신센터 발전방안에 관한 연구

This study selected 17 regional creative economic innovation centers, excluding two private autonomous innovation centers, out of a total of 19 nationwide, and conducted case studies based on previous studies, articles, center websites, internal data, and interviews with practitioners. To establish the identity of Creative Economy Innovation Centers as regional startup hubs and drivers of local innovation, it is necessary to redefine their roles not only through collaboration with universities but also through realigning their roles with relevant local institutions. Secondly, it was observed that most of the investment resources for Creative Economy Innovation Centers remain in the form of initial funding support. To facilitate the scale-up of early-stage startups, it is necessary to develop qualitative improvement measures from various perspectives, including support tailored to specific businesses and growth stages. Additionally, in response to the strengthening global and domestic ESG regulations, centers should consider implementing customized ESG management education and certification support for startups, as well as mentoring programs. Thirdly, to reduce regional disparities, Creative Economy Innovation Centers should actively operate open programs specific to each center and allocate budgets that allow for flexible engagement in collaborative projects within their internal structure. Policy measures are needed to address the issue of regional decline by considering business initiatives for local youth, which also contribute to the sustainability of startups. Furthermore, there is a need to expand educational programs and policy support for “born-global” startups that target niche global markets from the early stages of entrepreneurship. This study is meaningful in confirming and verifying that the various attempts and efforts needed to build a regional innovation start-up ecosystem, as well as quantitative results on supporting the growth of startups and existing local SMEs discovered and fostered through the Creative Economy Innovation Center, as well as job creation and maintenance based on regional economic growth, need to be maintained and developed continuously.

PERSON-CENTERED CARE MODEL WITH MULTIMORBIDITY

Multimorbidity is a national and global public health problem that causes a deterioration in people’s health and survival. Health system response is fragmented in several programs with low satisfaction and adherence in patients. Therefore, is advisable to move towards a strategy applying the principles of the Model of Comprehensive Community Health, where the focus ison people, who are activated for their health care. The Ancora Health Innovation Center of the “Universidad Católica” and the Metropolitan Southeast Health Service (SSMSO) carried out a pilot project to implement the Person-Centered Care Model with Multimorbidity (MACEP) aiming to prevent complications and reducing demand at secondary and tertiary care levels. Between 2017 and 2019, 20,642 people were intervened and to evaluate intervention impact they were compared with 32,661 people treated in neighboring not intervened Family Health Care Centers (CESFAM). Significant decreases in the risk of dying and hospitalization were found in the intervened population. Percentage level of MACEP implementation in the seven intervened family health care centers was also evaluated,verifying values from 41 to 100%. The economic evaluation of the pilot project showed higher costs in primary and secondary care, as well as significant savings at the tertiary level, witha net saving in the system total cost. In 2019, the Ministry of Health,drawing on MACEP's experience in the SSMSO, described the Strategy for Person-Centered Comprehensive Care in the Context of Multimorbidity (ECICEP) and began its implementation at the national level. In the case of a public policy that it is still very young,it becomes necessary to deepen the changes that ensure its progress and consolidation.

Promoting innovation and startups in neurosurgery in low- to middle-income countries: insights from the barrow innovation center.

Promoting innovation and startups in neurosurgery in low- to middle-income countries: insights from the barrow innovation center.

The promotion of Shanghai’s position and function in the global container shipping network

ABSTRACT Shanghai’s container throughput has ranked first worldwide for 13 consecutive years beginning in 2010, indicating that Shanghai has built an international shipping centre capable of allocating resources for global shipping factors. This study considers global container shipping and shipping service networks as research objects to examine the node status and connection directions of Shanghai in these two networks. It also identifies the comparative advantages and weaknesses of Shanghai and proposes countermeasures and suggestions. The results show that Shanghai ranks high in the global container shipping network and is a sub-centre of the Busan system. Shanghai performs well in the mid-to-low-end shipping service industry in the shipping service network; however, a clear gap exists in the high-end service industry between Shanghai and European port cities. Thus, Shanghai should vigorously implement an international development strategy, actively promote a coordinated development strategy between ports, and integrate the construction of the shipping centre with that of financial and technological innovation centres.

Advancing Access to Cell and Gene Therapies in Medicaid

This Viewpoint presents the components of the payment model and the implementation challenges among the Center for Medicare and Medicaid Innovation, state Medicaid agencies, patients, and manufacturers.

Effects of the COVID-19 Pandemic on Patient Navigation for Health-Related Social Needs: Reflections From the Accountable Health Communities Model.

This paper uses data from the Center for Medicare & Medicaid Innovation's Accountable Health Communities (AHC) Model to assess the effects of the COVID-19 pandemic on patient navigation (PN) for health-related social needs. We analyzed evaluation data from 28 organizations implementing the Center for Medicare & Medicaid Innovation's AHC Model. We first distilled themes from 81 stakeholder interviews conducted in 2021. We then analyzed quantitative beneficiary-level data on acceptance of navigation among 133,173 unique Medicare and Medicaid beneficiaries who were eligible for navigation between January 2019 and March 2021. During the pandemic, interview participants described greater complexity of patients' cases and uncertainty regarding community service availability. Changes to navigation staffing and mode led to improvements in navigation quality and efficiency, but also challenges such as reduced rapport with patients. The pandemic increased navigator stress and burnout but also deepened appreciation for navigation among navigators and their patients. Beneficiaries were more likely to accept navigation during the pandemic than before the pandemic ( P <.05). Changes in PN during the pandemic were perceived as both good and bad. Future work is needed to assess the long-term implications of pandemic-related changes to navigation for patients and navigators.