Robot-assisted carotid artery stenting: outcomes, safety, and operational learning curve

OBJECTIVE Over the past 2 decades, robots have been increasingly used in surgeries to help overcome human limitations and perform precise and accurate tasks. Endovascular robots were pioneered in interventional cardiology, however, the CorPath GRX was recently approved by the FDA for peripheral vascular and extracranial interventions. The authors aimed to evaluate the operational learning curve for robot-assisted carotid artery stenting over a period of 19 months at a single institution. METHODS A retrospective analysis of a prospectively maintained database was conducted, and 14 consecutive patients who underwent robot-assisted carotid artery stenting from December 2019 to June 2021 were identified. The metrics for proficiency were the total fluoroscopy and procedure times, contrast volume used, and radiation dose. To evaluate operator progress, the patients were divided into 3 groups of 5, 4, and 5 patients based on the study period. RESULTS A total of 14 patients were included. All patients received balloon angioplasty and stent placement. The median degree of stenosis was 95%. Ten patients (71%) were treated via the transradial approach and 4 patients (29%) via the transfemoral approach, with no procedural complications. The median contrast volume used was 80 mL, and the median radiation dose was 38,978.5 mGy/cm2. The overall median fluoroscopy and procedure times were 24.6 minutes and 70.5 minutes, respectively. Subgroup analysis showed a significant decrease in these times, from 32 minutes and 86 minutes, respectively, in group 1 to 21.9 minutes and 62 minutes, respectively, in group 3 (p = 0.002 and p = 0.008, respectively). CONCLUSIONS Robot-assisted carotid artery stenting was found to be safe and effective, and the learning curve for robotic procedures was overcome within a short period of time at a high-volume cerebrovascular center.

A Framework to Strengthen Learning Culture and Safeguards

Strengthening the learning culture and the safeguards in organizations can enhance safety and performance in preventing incidents. The effective implementation of human performance improvement and operational learning can support the organization in achieving these goals. However, there is no streamlined implementation framework that considers the alignment of strategic and tactical actions in the management system cycle to implement human performance improvement and operational learning. This paper presents an implementation framework that fills the above gaps. It consists of four steps: (1) establish/validate a strategic objective, (2) conduct an assessment, (3) develop a plan, and (4) execute the plan. The proposed framework also includes a site tour phase during operational learning as an alternative to storytelling, which has an inherent bias. This framework was tested in the land transportation system of one of Indonesia’s biggest oil producers.

DEVELOPMENT OF INSTRUMENTAL AND METHODOLOGICAL SUPPORT FOR THE ASSESSMENT OF STUDENTS ' KNOWLEDGE IN MATHEMATICS IN THE FRAMEWORK OF HYBRID INTELLIGENT LEARNING ENVIRONMENT

The article is devoted to the development of an integrated complex of knowledge base and artifi-cial intelligence tools for assessing students' knowledge in mathematics within the framework of a hybrid intellectual learning environment. In accordance with the structural diagrams of mod-els of intellectual assessment of knowledge and creative potential of schoolchildren in mathe-matics, the structure of the corresponding knowledge base is formalized. The knowledge base is developed within the framework of data mining methods to create a module for monitoring and assessing knowledge in mathematics. As a methodological basis for the development of a knowledge base, the idea of V.P. Bespalko about the representation of the possible structure of human activity in the form of suc-cessive levels of assimilation, reflecting the development of the student's experience in a given subject in the learning process. The levels of assimilation (student, typical, heuristic, research) are determined through the ability to solve problems of the corresponding type. A formalized in-dicator of a student's achievement of a particular level of assimilation of educational material (level of training) is the coefficient of assimilation; assessment of the assimilation of material on a specific topic or section is provided for both at each of the above levels, and in general. The examples of the formation of a knowledge base for assessing the skills and abilities of schoolchildren in algebra are considered. To model the educational process, we propose methods for solving clustering, dimen-sionality reduction and classification problems based on machine learning and artificial neural networks. The foundations for the development of integrated complexes of knowledge bases and artificial intelligence tools to ensure the educational process are presented. The results obtained are aimed at creating methods that provide the processes of operational learning, control and assessment of knowledge, competencies and procedures, the level of formation of subject and professional competencies of students in the information and educational intellectual environment.

Assessment of mediated interactivity within the scope of the Anthropological Theory of DidacticsValoración de la interactividad mediada en el ámbito de la Teoría Antropológica de la Didáctica

We present progress made in doctoral thesis «Configuration of the assessment practices of mathematics teachers at university». Preliminary analysis shows the predominance of «summative assessment» of learning, content-centered, aside from the teaching and study activities, producing poor operative learning outcomes. This didactic phenomenon entails the problem of establishing the conditions and constraints that hinder the development of a more functional kind of assessment that mediates these activities and obtain more operational learning. Finally, we construct the concept of assessment of mediated interactivity as a contribution to the design and management of didactic and mathematical praxeology.ResumenPresentamos los avances de la tesis doctoral: «Configuración de las prácticas evaluativas de los profesores de matemáticas en la universidad». Los análisis preliminares ponen de manifiesto el predominio de la «evaluación sumativa», centrada en contenidos, al margen de las actividades de enseñar y estudiar, produciendo aprendizajes poco operativos. Este fenómeno didáctico conduce a plantear el problema de establecer las condiciones y restricciones que dificultan o impiden el desarrollo de una evaluación más funcional, que medie en dichas actividades y logre aprendizajes más operativos. Finalmente, construimos el concepto de evaluación de la interactividad mediada como aporte al diseño de praxeologías didácticas y matemáticas.

The Usage of Civil Engineering Analysis in Order to Improve Cost and Material Management of Public Boarding School Rumah Tahfiz in Jalan Tembung

In the construction of structures, cost is one of the factors that support success. Cost is very important to meet all the needs of work ranging from material procurement to labor. For this reason, civil engineering analysis needs to be done to produce work cost planning as an initial guide in calculating building budget costs that include material, labor and unit price. In the civil engineering analysis of the the two-story building of Rumah Tahfiz, there were various kinds of structural works ranging from foundations to roofs, and also finishing in the form of floors to windows. Those work items make reading work design activities more complex. For this reason, the Tahfiz House Foundation requires the assistance of engineers in analyzing the drawing design, producing more reasonable material calculations and building costs using their own estimated price calculations. From the design analysis activities, Rumah Tahfiz Foundation can find out the details of building activities, materials used, and the cost requirements per section of structural work, aimed at measuring the cost needs until the structure was completed. The help of Civil engineering analysis on the building simplify Rumah Tahfiz foundation in understanding and implementing building process which have a sustainable impact on financial management for future operational learning activites

Key Processes for the Performance of Work-Integrated Learning in HE

In a changing business market due to state regulation, funding reductions, and generation evolution, HE providers target a high level of operational learning performance. Work Integrated Learning is a framework that complies with European Standards and Guidelines, leading to increased competences of the citizen all through life and career. But the consistency of the training offer with shareholders' projects is only ensured if a learning organization rigorously monitors the 5-step road map: an improvement cycle that nonetheless allows local adaptation when carrying out the training in the scope of Quality Assurance. Today, more than ever, the issue for excellence (sustainability, efficiency, welfare at work) requires the Pole of Expertise animation, which means training tutors (TIL). The winning-foursome is the new lever for innovation. The tremendous digital integration at all levels of the organization opens new dimensions to executive dashboards to support the change of paradigm between trainees and trainers, then questions training lifetime and leading model for transfer.