Learning curves in robot-assisted spine surgery: a systematic review and proposal of application to residency curricula

OBJECTIVE Spine robots have seen increased utilization over the past half decade with the introduction of multiple new systems. Market research expects this expansion to continue over the next half decade at an annual rate of 20%. However, because of the novelty of these devices, there is limited literature on their learning curves and how they should be integrated into residency curricula. With the present review, the authors aimed to address these two points. METHODS A systematic review of the published English-language literature on PubMed, Ovid, Scopus, and Web of Science was conducted to identify studies describing the learning curve in spine robotics. Included articles described clinical results in patients using one of the following endpoints: operative time, screw placement time, fluoroscopy usage, and instrumentation accuracy. Systems examined included the Mazor series, the ExcelsiusGPS, and the TiRobot. Learning curves were reported in a qualitative synthesis, given as the mean improvement in the endpoint per case performed or screw placed where possible. All studies were level IV case series with a high risk of reporting bias. RESULTS Of 1579 unique articles, 97 underwent full-text review and 21 met the inclusion and exclusion criteria; 62 articles were excluded for not presenting primary data for one of the above-described endpoints. Of the 21 articles, 18 noted the presence of a learning curve in spine robots, which ranged from 3 to 30 cases or 15 to 62 screws. Only 12 articles performed regressions of one of the endpoints (most commonly operative time) as a function of screws placed or cases performed. Among these, increasing experience was associated with a 0.24- to 4.6-minute decrease in operative time per case performed. All but one series described the experience of attending surgeons, not residents. CONCLUSIONS Most studies of learning curves with spine robots have found them to be present, with the most common threshold being 20 to 30 cases performed. Unfortunately, all available evidence is level IV data, limited to case series. Given the ability of residency to allow trainees to safely perform these cases under the supervision of experienced senior surgeons, it is argued that a curriculum should be developed for senior-level residents specializing in spine comprising a minimum of 30 performed cases.

Evaluating Sustainability of Mass Rapid Transit Stations in Dubai

A transport business that has reached financial sustainability is one that is providing a service at a price that not only covers its costs but also creates a profit for upcoming contingencies. A focus on rail infrastructure financial sustainability is of paramount importance to guarantee the availability of punctual rail transport to remote potential users. To evaluate the sustainability of mass rapid transit on the relation among hypothetical key aspects of sustainability—perception of property; willingness to pay for maintenance, repair, and operations; confidence in the Roads and Transport Authority; and citizen participation in the rail project—and railway service punctuality, the most important result variable, was studied according to the specialized literature on rail transport sustainability. Leading information was collected by means of personal questionnaires of more than 1000 railway users according to the Krejcie Morgan formula for the calculation of the sample size knowing the population size. Qualitative plus quantitative information was gathered from different ways (technical test of the rail system, discussions with users, focus-group discussions, and interviews with key informers).The outputs by means of the statistical analysis allowed understanding two key perceptions. Firstly, beyond a half decade after construction, during a system intervention, a smaller perception of public property for the railway system was related to better service punctuality. This idea contrasts with the vast majority of the publications, which highlight a regular, direct relationship between perception of property and sustainability of railway systems. Secondly, in spite of three-quarters of users accepting that they would contribute monetarily for maintenance, repair, and operations service, such payments were not imminent because of the lack of confidence in the Roads and Transport Authority. In this situation, more than one-third of the metro stations were identified as non-punctual, beyond a half decade after construction.

1,8-naphthyridine derivatives: an updated review on recent advancements of their myriad biological activities

Among all nitrogen-containing heterocycles, the 1,8-naphthyridine scaffold has recently gained an immense amount of curiosity from numerous researchers across fields of medicinal chemistry and drug discovery. This new attention can be ascribed to its versatility of synthesis, its reactiveness and the variety of biological activities it has exhibited. Over the past half-decade, numerous diverse biological evaluations have been conducted on 1,8-naphthyridine and its derivatives in a quest to unravel novel pharmacological facets to this scaffold. Its potency to treat neurodegenerative and immunomodulatory disorders, along with its anti-HIV, antidepressant and antioxidant properties, has enticed researchers to look beyond its broad-spectrum activities, providing further scope for exploration. This review is a consolidated update of previous works on 1,8-naphthyridines and their analogs, focusing on the past 5 years.

Rostow’s Stages of Growth and Bangladesh: To Which Stage Does Bangladesh Belong?

Albeit facing ample challenges as encountered by most developing countries of the world, Bangladesh’s economy has consistently been prepared for take-off. There are quite a number of glairing failures but the commendable successes it has attained throughout the last one and a half-decade in macro-management of the economy have shaped a ground for take-off, which may pave the way for resolving many of the critical development problems such as poverty, illiteracy, unemployment, and low productivity within a foreseeable future. This is not a synthetic arrangement to sterilize pessimism into the expectation of false hope, rather assist build, in what has already been attained, a foundation for what ought to be done next. It is rather some sort of confidence-building based on some positive modification that has already taken place within the economy. From the five stages growth model of Rostow, the stage ‘take-off’ has been deliberately chosen to precise an emphatic drive that a developing country needs in setting dynamism in its economy for sustained development. The stipulations for ‘transition’ and therefore the ground setting required for ‘take-off’ are planned as prompt and timely actions needed for a desperate nation aspiring fast development of the country. This study depicts the different stages of Rostow’s growth model and tries to figure out the current stage of growth of Bangladesh. The study also employs how Bangladesh’s development model and development management model play an important role to spice up the growth sector and the acceleration of the economic uplift of the country.

HUMAN RESOURCE PLANNING IN AN INDIAN CEMENT INDUSTRY: A DIOGNOSTIC STUDY

The ‘ABC’ Cement Industries Ltd has entrenched in the year 1955 in the most economically disadvantaged and industrially deprived location of Southern India. After words, the industry nourished as a very big cement industry in the region. Subsequently, the founders put their sustained efforts to emerge the ABC industry as a market leader. From the past half decade the company was creating thousands of employment opportunities to the unemployed youth in the region. At the outset the ABC cement industry produced only 200mts per day and later it has increased its production to 4000 TPDs after contraption. The then dynamic founder entrepreneur under whose custodianship the ABC cement industry was flourished, such founder was passed away and the industry is looked after by their heriditaries.

INSIGHTS IN TO THE EMPLOYEE TRAINING PROGRAMMES OF INDIAN CEMENT INDUSTRY: AN EMPIRICAL STUDY

The ‘ABC’ Cement Industries Ltd has entrenched in the year 1955 in the most economically disadvantaged and industrially deprived location of Southern India. After words, the industry nourished as a very big cement industry in the region. Subsequently, the founders put their sustained efforts to emerge the ABC industry as a market leader. From the past half decade the company was creating thousands of employment opportunities to the unemployed youth in the region. At the outset the ABC cement industry produced only 200mts per day and later it has increased its production to 4000 TPDs after contraption. The then dynamic founder entrepreneur under whose custodianship the ABC cement industry was flourished, such founder was passed away and the industry is looked after by their heriditaries.

Trans* media ecology: The emergence of gender variant selfies in print

Despite having become more visible in popular and academic discourses over the last half decade, trans* selfies are not new. In this article, I examine an early set of trans* selfies featured in a sexploitation periodical published in the United States during the early 1960s. I show how numerous media, including bodies, clothing, cosmetics, photographs and magazines, produced a socio-technical environment through which trans* subjects composed alternative gender expressions and identities, formed intimate networks and created conditions of possibility for the eventual re-emergence of trans* selfies via digital social media platforms. Merging trans* theory with media ecology, I develop trans* media ecology as a conceptual frame from which to locate the always imbricated – but never complete – becoming of gendered bodies and media. Methodologically, trans* media ecology adopts three guiding principles: (1) genders are media, (2) genders depend on media and (3) genders and media change.

Impact of Demonetization on Employment in India: Issues and Challenges of Labour Market

Demonetization is a conventional practice in monetary policy to embark upon black money. However, it was meant to be suddenly implemented. Long-ago, demonetization has taken place twice but it failed because the idea is to tackle the black money existing in circulation. This wasn’t for tackling corruption that’s what Government is not saying that 100% corruption will be tackled and also if announcement and time would have been given, this step might not have been successful in controlling black money and counterfeit currency in circulation coming from Pakistan, Nepal or other countries. Demonetization is a course of extraction of an exacting form of currency from circulation. The existing form of money has chosen from transmission and retired, to be put back with new notes or coins. The newest demonetization measures taken by the Indian Government on November 8th 2016, in an attempt to hold back corruption and black money has resulted in a massive amount of involuntary consequences. While the key objective following this budge is commendable, the planning and implementation of the scheme left much to be required from a policy point of view. This step has caused rolling impact throughout the economy, departing the most sectors reasonably crippled owing to the unanticipated cash crisis. The labour market in India has been witnessing numerous uncertainties including the problem of world recession, and growing ‘automation’ particularly in the manufacturing sector. More precisely, in the last one and a half decade, India has emerged a global power in terms of the development or diffusion of new technology in the form of ICT. ICT intensity, defined as the ratio of ICT investment to non ICT investment, has increased significantly across industries led to ‘automation’ in most production (and distribution). Its impact on productivity led growth, and direct employment is well documented. However, its negative employment impact, particularly in the ICT using manufacturing sector has largely been ignored. So, in a situation, when the debate, whether the net employment impact of ICT on the economy as a whole is positive, is still un-conclusive; any major policy change like ‘demonetization’ is likely to make the employment scenario further volatile by causing uncertainties to rise in labour market, mainly the informal employment.