Step, Error, and Event Frameworks in Endovascular Aortic Repair

Objective: Competency-based surgical education requires detailed and actionable feedback to ensure adequate and efficient skill development. Comprehensive operative capture systems such as the Operating Room Black Box (ORBB; Surgical Safety Technologies, Inc), which continuously records and synchronizes multiple sources of intraoperative data, have recently been integrated into hybrid rooms to provide targeted feedback to endovascular teams. The objective of this study is to develop step, error, and event frameworks to evaluate technical performance in elective endovascular aortic repair (EVAR) comprehensively captured by the ORBB (Surgical Safety Technologies, Inc; Toronto, Canada). Methods: This study is based upon a modified Delphi consensus process to create evaluation frameworks for steps, errors, and events in EVAR. International experts from Vascular Surgery and Interventional Radiology were identified, based on their records of publications and invited presentations, or serving on relevant journal editorial boards. In an initial open-ended survey round, experts were asked to volunteer a comprehensive list of steps, errors, and events for a standard EVAR of an infrarenal aorto-iliac aneurysm (AAA). In subsequent survey rounds, the identified items were presented to the expert panel to rate on a 5-point Likert scale. Delphi survey rounds were repeated until the process reached consensus with a predefined agreement threshold (Cronbach α>0.7). The final frameworks were constructed with items achieving an agreement (responses of 4 or 5) from greater than 70% of experts. Results: Of 98 invited proceduralists, 38 formed the expert consensus panel (39%), consisting of 29 vascular surgeons and 9 interventional radiologists, with 34% from North America and 66% from Europe. Consensus criteria were met following the third round of the Delphi consensus process (Cronbach α=0.82–0.93). There were 15, 32, and 25 items in the error, step, and event frameworks, respectively (within-item agreement=74%–100%). Conclusion: A detailed evaluation tool for the procedural steps, errors, and events in infrarenal EVAR was developed. This tool will be validated on recorded procedures in future work: It may focus skill development on common errors and hazardous steps. This tool might be used to provide high-quality feedback on technical performance of trainees and experienced surgeons alike, thus promoting surgical mastery.

Performance evaluation of a flatbed maize dryer with a biomass heat source

The technical performance of a 3-tonne capacity flatbed grain dryer was assessed based on its drying rate and drying efficiency. In addition, the quality of maize grains dried in the drying system was investigated through stress-crack analysis and germination test. Maize grains at an initial moisture content of 18.4% ± 0.1% (wb) were dried to a safe moisture content of 13.3% ± 0.2% (wb) in 5 hours, resulting in a drying rate of 1.02%/h at a drying efficiency of 67.35%. The average temperature observed in the plenum (55.8°C±1.5°C) was about twice higher than the ambient temperature during the drying period. The use of the flatbed dryer did not have any adverse effect on the viability of grains dried with a stress-crack index of 75 and percentage germination of 90%. This study demonstrated the viability of using the flatbed biomass-assisted dryer for drying maize and can reduce post-harvest losses of maize at the smallholder level. Int. J. Agril. Res. Innov. Tech. 11(2): 37-41, Dec 2021

E-Commerce Customers Behavior Research Using Cohort Analysis: A Case Study of COVID-19

Cohort analysis is a new practical method for e-commerce customers’ research, trends in their behavior, and experience during the COVID-19 crisis. The purpose of the research is to validate the efficiency of this method on the e-commerce records data set and find out the critical factors associated with customer awareness and loyalty levels. The cohort analysis features engineering, descriptive statistics, and exploratory data analysis are the main methods used to reach the study purpose. The research results showed that cohort analysis could answer various business questions and successfully solve real-world problems in e-commerce customer research. It could be extended to analyze user satisfaction with a platform’s technical performance and used for infrastructure monitoring. Obtained insights on e-commerce customers’ awareness and loyalty levels show the likeliness of a user to make a purchase or interact with the platform. Key e-business aspects from a customer point of view are analyzed and augment the user-experience understanding to strengthen customers’ relationships in e-commerce.

Technical performance analysis of different types of spirometers

Background The spirometer is an important element in lung function examinations, and its accuracy is directly related to the accuracy of the results of these examinations and to the diagnosis and treatment of diseases. Our aim was to conduct a performance analysis of the detection techniques of differential pressure and ultrasonic portable spirometers commonly used in China. Methods A standard flow/volume simulator was used to analyze the performance (accuracy, repeatability, linearity, impedance, and so on) of portable spirometers, 4 imported and 6 domestic, based on 13 curves generated by different air sources in the ISO 26782:2009 standard. A Bland–Altman diagram was used to evaluate the consistency between the values measured by the spirometers and the simulator. Results The pass rates for accuracy, repeatability, linearity, and impedance for the 10 different portable spirometers were 50%, 100%, 70%, and 70%, respectively. Only 30% (3/10) of the spirometers—2 domestic and 1 imported—met all standards of quality and performance evaluation, while the rest were partially up to standard. In the consistency evaluation, only 3 spirometers were within both the consistency standard range and the acceptability range. Conclusion The quality and performance of different types of portable spirometers commonly used in the clinic differ. The use of a standard flow/volume simulator is helpful for the standard evaluation of the technical performance of spirometers.

Experiences With Conservation Agriculture in the Eastern Gangetic Plains: Farmer Benefits, Challenges, and Strategies That Frame the Next Steps for Wider Adoption

While there are numerous studies that explore the agronomic and the economic benefits of Conservation Agriculture in South Asia, only few studies have explored the farmers' experiences and the drivers of its adoption. This study aims to learn directly from current users through exploration of their decision processes, evaluations, and experiences in extrapolating the concept for the broader scaling of Conservation Agriculture across the Eastern Gangetic Plains (EGPs) of South Asia. We analyzed a total of 57 qualitative and semi-structured individual interviews with the farmers who are currently implementing Conservation Agriculture practices across six locations. These farmers faced a variety of hurdles including hesitation in accepting and adopting the technology, technical performance challenges, information gaps, and subsidy/project dependence. To overcome these, respondents adopted various strategic approaches such as assuming the role of an educator by sharing their knowledge with other farmers in the community, changing mindsets for stover retention, adoption through self-investment, and opting for communal purchase of machinery to reduce project dependence. This led farmers to identify a range of benefits including improved socio-economic condition, increased respect in the community, and increased free time to pursue diverse interests and opportunities. Additionally, strengthened information networks such as improved interpersonal connection with agricultural universities, government extension systems, and local farmers groups have positively enhanced the uptake, allowing them to overcome further limitations. These findings provide novel learnings on how farmers overcome nine key friction points, and what this means for increasing the farmer uptake of new practices across the region, which are crucial for successful future interventions as implemented by the government and development organizations.

Various Geometric Configuration Proposals for Dovetail Wooden Horizontal Structural Members in Multistory Building Construction

Adhesives and metal fasteners have an important place in the content of engineered wood products (EWPs). However, adhesives may cause toxic gas emissions due to their petroleum-based nature, while metal fasteners may adversely affect the reusability of these products. These issues also raise important questions about the sustainability and environmental friendliness of EWPs. Thus, there is still room for a solution that is solid and completely pure wood, adhesive- and metal-connectors-free dovetail wood board elements (DWBEs). There are many studies on the technological, ecological, and economic aspects of these products in the literature, but no studies have been conducted to assess the technical performance of DWBEs. This chapter focuses on DWBEs by proposing various geometric configurations for horizontal structural members in multistory building construction through architectural modeling programs. In this architectural design phase, which is one of the first but most important stages, the proposed configurations are based on a theoretical approach, considering contemporary construction practices rather than structural analysis or mechanical simulation. Further research, including technical performance tests, will be undertaken after this critical phase. It is believed that this chapter will contribute to the dissemination of DWBEs for innovative architectural and structural applications, especially in multistory wooden structures construction.

Influential Indicators and Measurements of Mediating and Moderating Roles on SME Performance

Overcoming the failure of SMEs has been an important research topic. The critical research finding is that it has verified the essential elements of performance improvement. We presented a solution to the research question, "Is there a causal relationship between the effect on SMEs' success on capacity and business performance?". We analyzed whether the competence of SMEs had a mediating effect between success variables and performance. Secondary effects were empirically studied by converting independent variables to Higher-Order Component (HOC). The second-order variable of management influenced financial, non-financial, and technical performance, and the second-order variable of technology affected technical performance. As a result of introducing demographic variables as a controlling variable for performance, gender, and year of establishment showed a moderating effect on technical and non-financial performance. We expect to contribute to practical application to SME CEOs and government policymakers, support organizations, academia, and industry.

Expertise in colonoscopy intubation does not predict diagnostic accuracy: a simulation-based study

Background and study aims Studies have linked cecal intubation rate with adenoma detection rate; however, the direct association between technical performance during colonoscopy intubation and withdrawal has never been explored. Thus, it remains unclear whether gentle and efficient intubation predicts superior mucosal inspection. The aim of this study was to investigate the correlation between performance during intubation and withdrawal in a simulation-based setup. Methods Twenty-four physicians with various experience in colonoscopy performed twice on the Endoscopy Training System (ETS). Intubation skills were evaluated by assessing tasks on the ETS related to intubation (scope manipulation and loop management) and use of a computerized assessment tool called the 3D-Colonoscopy Progression Score (3D-CoPS). Diagnostic accuracy was defined by the number of polyps found during the ETS task of mucosal inspection. Pearson’s correlations were calculated to explore associations between intubation skill and diagnostic accuracy. Results The correlation analysis between 3D-CoPS and number of polyps found during mucosal inspection revealed a weak and insignificant correlation (0.157, P = 0.3). Likewise, an insignificant correlation was seen between ETS intubation and number of polyps found (0.149, P = 0.32). Conclusions We found no evidence to support that technical performance during intubation is correlated with mucosal inspection performance in a simulation-based setting.

Ethics, Digital Rights Management, and Cyber Security

Cloud content hosting and redistribution is enabling convenient and easy access to online content thereby accelerating the adoption and penetration of internet in past two decades. The current Industry 4.0 revolution and adoption and acceleration efforts are leveraging cloud computing as a means to store, retrieve, and share data. This makes the internet a relatively vulnerable to content abuse and increase the demand of clear consent before data consumption and redistribution. The growth of cloud computing and management technologies is penetrating in the market, and digital rights management (DRM) practices are needed for better and ethically safe online space. This chapter talks about state-of-the-art DRM paradigms being proposed in the literature and critically discusses their technical performance, flexibility, and immutability challenges. This chapter will clarify internet governance implementation roadmap for Industry 4.0 revolution by critically analyzing the cloud technology stack and ethical features by advocating Cloud DRM.