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Wang X, Fan LW, Zhang H, Zhou P. Cost trajectory of hydrogen fuel cell technology in China. iScience 2025; 28:112359. [PMID: 40292328 PMCID: PMC12032936 DOI: 10.1016/j.isci.2025.112359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Revised: 02/24/2025] [Accepted: 04/02/2025] [Indexed: 04/30/2025] Open
Abstract
Reducing the cost of hydrogen fuel cell technology is crucial in propelling the hydrogen economy and achieving decarbonized energy systems. This study identifies the hydrogen fuel cell cost trajectory through a multi-stage learning curve model, highlighting technology learning mechanisms across different stages. Findings show that innovation and production contribute to cost reduction, and the learning by researching holds a more significant role presently, while the learning by doing takes precedence in the long term, achieving a 14% learning rate. The cost predictions imply that the system cost of hydrogen fuel cell is expected to fall below 1,000 yuan/kW after 2031. Moreover, the scenario analyses highlight the conducive role of various hydrogen production technologies and the evolution of cost influencing factors on cost reduction. Our research provides critical insights into the evolving dynamics of technological learning and cost trajectory in the hydrogen fuel cell industry, with significant implications for policy-making.
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Affiliation(s)
- Xue Wang
- School of Economics and Management & Institute of Energy Economics and Policy, China University of Petroleum (East China), Qingdao 266580, China
- Institute of Energy Economics and Policy, China University of Petroleum (East China), Qingdao 266580, China
| | - Li-Wei Fan
- School of Economics and Management & Institute of Energy Economics and Policy, China University of Petroleum (East China), Qingdao 266580, China
- Institute of Energy Economics and Policy, China University of Petroleum (East China), Qingdao 266580, China
| | - Hongyan Zhang
- School of Economics and Management & Institute of Energy Economics and Policy, China University of Petroleum (East China), Qingdao 266580, China
- Institute of Energy Economics and Policy, China University of Petroleum (East China), Qingdao 266580, China
| | - Peng Zhou
- School of Economics and Management & Institute of Energy Economics and Policy, China University of Petroleum (East China), Qingdao 266580, China
- Institute of Energy Economics and Policy, China University of Petroleum (East China), Qingdao 266580, China
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Rinawati DI, Keeley AR, Itsubo N, Managi S. Beyond carbon: Environmental and social impacts of Japan's vehicle electrification transition. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2025; 383:125509. [PMID: 40294485 DOI: 10.1016/j.jenvman.2025.125509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2024] [Revised: 04/06/2025] [Accepted: 04/21/2025] [Indexed: 04/30/2025]
Abstract
This study evaluates Japan's transition to electrified vehicles by analyzing environmental and social impacts across the vehicle life cycle (2020-2050) under three scenarios: business-as-usual (BAU), Widespread, and the 2035 internal combustion engine vehicle (ICEV) ban. Using Environmentally Extended Input-Output Life Cycle Assessment (EEIO-LCA) with the LIME3 method, environmental impacts on human health, social assets, biodiversity, and primary production were monetized into a unified monetary indicator (USD). Social impacts were quantified via Social Life Cycle Assessment using the Social Hotspot Database. Cumulative environmental impacts are projected at 236.6, 237, and 231.1 billion USD for BAU, Widespread, and ICEV ban scenarios, respectively. While rapid electrification reduces human health impacts during operation phase, these gains are offset by increased impacts from manufacturing and electricity generation. Social impacts reach 9,410, 11,133, and 15,268 billion medium risk hours equivalent for the respective scenarios, with over 50 % of social impacts by 2050 shifting to China, Rest of Asia, and Africa under the ICEV ban scenario due to battery production. Our result shows that the ICEV ban could reduce environmental impacts by 2.3 % compared to BAU but increases social impacts by 62 %. It indicates that high electrification slightly lowers environmental impacts but greatly increases social impacts. Extending battery lifespans and improving fuel economy could reduce the ICEV ban's environmental and social impacts to 190.5 billion USD and 9921.4 billion mrheq, respectively. Complementary measures-like supply chain due diligence and transparency, environmentally and socially integrated policy design, battery recycling-are essential to prevent unintended global social consequences.
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Affiliation(s)
- Dyah Ika Rinawati
- Department of Urban and Environmental Engineering, School of Engineering, Kyushu University, Fukuoka, Japan; Department of Industrial Engineering, Diponegoro University, Semarang, Indonesia
| | - Alexander Ryota Keeley
- Department of Urban and Environmental Engineering, School of Engineering, Kyushu University, Fukuoka, Japan; Urban Institute, Kyushu University, Fukuoka, Japan
| | - Norihiro Itsubo
- Faculty of Science and Engineering, Waseda University, Tokyo, Japan
| | - Shunsuke Managi
- Department of Urban and Environmental Engineering, School of Engineering, Kyushu University, Fukuoka, Japan; Urban Institute, Kyushu University, Fukuoka, Japan.
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Denu M, Landry A, Mangione F, David P. From factory school to digital simulation: A multidisciplinary human-centred intervention for improving training in circular manufacturing systems. APPLIED ERGONOMICS 2025; 128:104547. [PMID: 40311259 DOI: 10.1016/j.apergo.2025.104547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2024] [Revised: 04/17/2025] [Accepted: 04/25/2025] [Indexed: 05/03/2025]
Abstract
The environmental emergency is pushing companies toward a circular economy, necessitating a transformation of manufacturing systems to tackle circularity challenges. In uncertain environments where complex tasks require high human involvement, operator training is critical to maintain production performance and protect health. In this context, a remanufacturing company of electronic products is studied. The paper questions the company's training processes, to make operators operational more quickly while preserving their health. A multidisciplinary team in industrial engineering, occupational psychology, and ergonomics conducts experiments in a learning factory to collect data. Then, a digital simulation integrating inter-individual variabilities and operator health is presented, in a research context where humans are rarely integrated in industrial simulation. Findings suggest a need for detailed operator modelling in simulation and thanks to the creation of persona to reflect differences. Simulation outcomes inform the industrial application, leading to a new task breakdown for training operators.
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Affiliation(s)
- Maxence Denu
- Univ. Grenoble Alpes, CNRS, Grenoble INP°, G-SCOP, 38000, Grenoble, France; Institute of Engineering Univ, Grenoble Alpes, France.
| | - Aurélie Landry
- Univ. Grenoble Alpes, CNRS, Grenoble INP, LIG, 38000, Grenoble, France.
| | - Fabien Mangione
- Univ. Grenoble Alpes, CNRS, Grenoble INP°, G-SCOP, 38000, Grenoble, France; Institute of Engineering Univ, Grenoble Alpes, France
| | - Pierre David
- Univ. Grenoble Alpes, CNRS, Grenoble INP°, G-SCOP, 38000, Grenoble, France; Institute of Engineering Univ, Grenoble Alpes, France
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Stinchfield G, Khalife N, Ammari BL, Morgan JC, Zamarripa M, Laird CD. Mixed-Integer Linear Programming Formulation with Embedded Machine Learning Surrogates for the Design of Chemical Process Families. Ind Eng Chem Res 2025; 64:8299-8311. [PMID: 40291387 PMCID: PMC12022974 DOI: 10.1021/acs.iecr.4c03913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2024] [Revised: 12/30/2024] [Accepted: 02/24/2025] [Indexed: 04/30/2025]
Abstract
There is a need for design strategies that can support rapid and widespread deployment of new energy systems and process technologies. In a previous work, we introduced process family design as an alternative method to traditional and modular design approaches. In this article, we develop piecewise linear surrogates using Machine Learning (ML) models and the Optimization and Machine Learning Toolkit (OMLT) to show how process families can be designed to reduce manufacturing costs and deployment timelines. We formulate this problem as a nonlinear Generalized Disjunctive Program (GDP), which, following transformation, results in a large-scale mixed-integer nonlinear programming (MINLP) problem. This large-scale problem is intractable using traditional MINLP approaches. By using ML surrogates to predict required system costs and performance indicators, we can approximate the nonlinearities in the GDP to generate an efficient mixed-integer linear programming (MILP) formulation. We apply the ML surrogate approach to two case studies in this work. One case study involves designing a family of carbon capture systems to cover a set of different flue gas flow rates and inlet CO2 concentrations, while the second case study focuses on a water desalination process, where we design a family of these processes for a variety of salt concentrations and flow rates. In both of these case studies, our approach based on ML surrogates is able to find optimal solutions in reasonable computational time and yield solutions comparable to those of a previously reported approach for solving the problem.
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Affiliation(s)
- Georgia Stinchfield
- Department
of Chemical Engineering, Carnegie Mellon
University, Pittsburgh, Pennsylvania 15213, United States
| | - Natali Khalife
- Department
of Chemical Engineering, Carnegie Mellon
University, Pittsburgh, Pennsylvania 15213, United States
| | - Bashar L. Ammari
- Department
of Chemical Engineering, Carnegie Mellon
University, Pittsburgh, Pennsylvania 15213, United States
| | - Joshua C. Morgan
- National
Energy Technology Laboratory (NETL), Pittsburgh, Pennsylvania 15236, United States
| | - Miguel Zamarripa
- National
Energy Technology Laboratory (NETL), Pittsburgh, Pennsylvania 15236, United States
- NETL
Support Contractor, Pittsburgh, Pennsylvania 15236, United States
| | - Carl D. Laird
- Department
of Chemical Engineering, Carnegie Mellon
University, Pittsburgh, Pennsylvania 15213, United States
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Baturu M, Öztürk M, Bayrak Ö, Erturhan S, Seckiner I. Assessing the educational value of laparoscopic radical nephrectomy videos on YouTube®: A comparative analysis of short versus long videos. J Minim Access Surg 2025; 21:119-125. [PMID: 38557956 PMCID: PMC12054948 DOI: 10.4103/jmas.jmas_355_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/31/2024] [Accepted: 01/31/2024] [Indexed: 04/04/2024] Open
Abstract
INTRODUCTION To evaluate the quality of laparoscopic radical nephrectomy videos and determine the extent to which they are informative and educational for healthcare professionals. PATIENTS AND METHODS We used the YouTube ® search engine to search for the term 'laparoscopic radical nephrectomy' with time filters of 4-20 min (Group 1) and >20 min (Group 2) and then sorted the results uploaded chronologically before January 2023. One hundred videos were analysed for each group. The reliability of the videos was assessed using the Journal of American Medical Association (JAMA) Benchmark Criteria and DISCERN questionnaire scores (DISCERN). Educational quality was assessed using the Global Quality Score (GQS) and a 20-item objective scoring system (OSS) for laparoscopic nephrectomy. The popularity of the videos was evaluated using the video power index (VPI). RESULTS The mean video duration was 8.9 ± 4.3 min in Group 1 and 52.02 ± 31.09 min in Group 2 ( P < 0.001). The mean JAMA (2.49 ± 0.61) and OSS scores (60 ± 12.3) were higher in Group 2 than in Group 1, while no significant difference was observed in the mean GQS (2.53 ± 0.7, 2.39 ± 0.88, respectively) between the groups ( P < 0.001, P = 0.039, P = 0.131, respectively). CONCLUSION While the standardisation of surgical videos published on YouTube ® and the establishment of auditing mechanisms do not seem plausible, high total OSS, periprocedural OSS, and VPI scores, and high OSS, JAMAS, GQS and DISCERN scores in long videos indicate that such videos offer a greater contribution to education.
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Affiliation(s)
- Muharrem Baturu
- Department of Urology, Medical Faculty, Gaziantep University, Gaziantep, Turkey
| | - Mehmet Öztürk
- Department of Urology, 25 Aralık State Hospital, Gaziantep, Turkey
| | - Ömer Bayrak
- Department of Urology, Medical Faculty, Gaziantep University, Gaziantep, Turkey
| | - Sakıp Erturhan
- Department of Urology, Medical Faculty, Gaziantep University, Gaziantep, Turkey
| | - Ilker Seckiner
- Department of Urology, Medical Faculty, Gaziantep University, Gaziantep, Turkey
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Li X, Guo S, Yao K, Ge Z, Li Y, Hu J, Xia H. Learning curve of transanal minimally invasive surgery for rectal neoplasm. Front Oncol 2025; 15:1545589. [PMID: 40201352 PMCID: PMC11975934 DOI: 10.3389/fonc.2025.1545589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2024] [Accepted: 03/10/2025] [Indexed: 04/10/2025] Open
Abstract
Objectives The field of view through transanal endoscopic provides new treatment approaches for solving complex clinical problems. TAMIS belongs to single-port endoscopic surgery, and the operation is complex. Analyzing the learning curve of TAMIS aims to facilitate its better clinical promotion. Methods A retrospective cohort study analyzed the clinical data of 58 patients who underwent TAMIS by the same surgeon from January 2018 to October 2024. The learning curve of TAMIS was obtained using the cumulative sum (CUSUM) analysis, and the optimal number of surgeries was determined based on the peak value of the curve, Clinical indicators such as operative time, intraoperative blood loss, positive rate of circumferential margin, length of postoperative hospital stay, and incidence of postoperative complications were compared at different stages. Results All 58 patients successfully underwent TAMIS. The optimum curve equation was y=0.016x 3-2.0556x 2+67.240x-150.103, R 2 = 0.950, P<0.05. According to the peak value of the curve, 22 cases were determined as the minimum cumulative required cases for surgeons to cross the TAMIS learning curve. 58 cases were divided into two groups: the learning improvement group (Pre-proficiency) of the first 22 cases, and the proficiency group (Post-proficiency) of the latter 36 cases. Compared with Pre-proficiency stage, the Post-proficiency stage had shorter surgery duration, less intraoperative blood loss, and shorter length of postoperative hospital stay (P<0.05). There was no statistically significant difference in the observation indicators including positive rate of circumferential margin and incidence of postoperative complications between the two groups (P>0.05). Conclusions The learning curve of TAMIS can be divided into Pre-proficiency stage and Post-proficiency stage. 22 surgeries may be the number of surgeries required to cross the TAMIS learning curve.
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Affiliation(s)
- Xingwang Li
- Department of General Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Shaanxi, China
- Department of General Surgery, Huaihe Hospital Affiliated to Henan University, Henan, China
| | - Shaoqing Guo
- Department of General Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Shaanxi, China
| | - Kunhou Yao
- Department of General Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Shaanxi, China
| | - Zheng Ge
- Department of General Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Shaanxi, China
- Department of General Surgery, Huaihe Hospital Affiliated to Henan University, Henan, China
| | - Yuewei Li
- Department of General Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Shaanxi, China
| | - Junhong Hu
- Department of Colorectal and Anal Surgery, First Affiliated Hospital of Zhengzhou University, Henan, China
| | - Hongping Xia
- Department of General Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Shaanxi, China
- Department of General Surgery, Huaihe Hospital Affiliated to Henan University, Henan, China
- Zhongda Hospital, School of Medicine, Advanced Institute for Life and Health, Southeast University, Jiangsu, China
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Sharma S, Haldar P, Kumar V, Chawla A, Logani A. Learning Curve for Dynamic Navigation Procedure during Endodontic Management of Permanent Maxillary Anterior Teeth with Pulp Canal Calcification: A Risk-Adjusted Cumulative Summation Analysis of a Single Operator's Experience. J Endod 2025; 51:295-302. [PMID: 39708915 DOI: 10.1016/j.joen.2024.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2024] [Revised: 12/07/2024] [Accepted: 12/12/2024] [Indexed: 12/23/2024]
Abstract
INTRODUCTION The dynamic navigation system (DNS) in endodontics presents a significant learning curve. This cross-sectional study aimed to assess the number of cases required to achieve consistent performance in DNS-assisted treatment of maxillary anterior teeth with pulp canal calcification. METHODS A series of DNS procedures were performed on 45 calcified maxillary anterior teeth with pulp necrosis by a single endodontist who had no prior clinical DNS experience. Preoperative cone-beam computed tomography was obtained. After trace registration and calibration, drilling was executed using a low-speed bur. Once the canal was located and scouted to the working length, a postoperative cone-beam computed tomography was taken immediately. Angular deviation (AD), linear deviation (LD), and operating time (OT) were measured. The learning curve was evaluated using the risk-adjusted cumulative sum analysis method. RESULTS The overall success rate in locating canals was 93.33% (95% CI 80.7, 98.3). The mean (±SD) for AD, LD and OT was 3.21 ± 2.23°, 0.52 ± 0.33 mm and 34.14 ± 13.18 minutes, respectively. For AD, 2 distinct peaks were observed at the 5th and 18th cases, identifying 3 learning phases: Phase I (cases 1-5), Phase II (cases 6-18), and Phase III (cases 19-45). Similarly, LD exhibited peaks at the 13th and 28th cases. Two peaks for OT were identified at the 7th and 26th cases. CONCLUSIONS Achieving technical proficiency in locating calcified canals using DNS required approximately 18 to 28 cases, indicating a significant learning curve that must be overcome for optimal accuracy.
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Affiliation(s)
- Sidhartha Sharma
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India.
| | - Partha Haldar
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Vijay Kumar
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Amrita Chawla
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Ajay Logani
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
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Pratama YW, Gidden MJ, Greene J, Zaiser A, Nemet G, Riahi K. Learning, economies of scale, and knowledge gap effects on power generation technology cost improvements. iScience 2025; 28:111644. [PMID: 39868052 PMCID: PMC11761306 DOI: 10.1016/j.isci.2024.111644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 10/15/2024] [Accepted: 12/17/2024] [Indexed: 01/28/2025] Open
Abstract
Cost reductions are essential for accelerating clean technology deployment. Because multiple factors influence costs, traditional one-factor learning models, solely relying on cumulative installed capacity as an explanatory variable, may oversimplify cost dynamics. In this study, we disentangle learning and economies of scale effects at unit and project levels and introduce a knowledge gap concept to quantify rapid technological change's impact on costs. Our results show that a substantial proportion of cost declines in several technologies is attributable to economies of scale rather than learning processes. Thus, relying on one-factor learning may underestimate cost declines during upscaling periods for technologies with strong economies of scale effects and overestimate reductions for those approaching maximum size. Notably, the knowledge gap concept can endogenously capture how rapidly technology sizes can evolve through learning. These insights can improve decision-making and highlight the benefits of separating learning and economies of scale effects to estimate technology costs.
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Affiliation(s)
- Yoga W. Pratama
- International Institute for Applied Systems Analysis, Laxenburg, Lower Austria, Austria
| | - Matthew J. Gidden
- International Institute for Applied Systems Analysis, Laxenburg, Lower Austria, Austria
| | - Jenna Greene
- Nelson Institute Center for Sustainability and the Global Environment, University of Wisconsin – Madison, Madison, WI, USA
| | - Andrew Zaiser
- La Follette School of Public Affairs, University of Wisconsin – Madison, Madison, WI, USA
| | - Gregory Nemet
- La Follette School of Public Affairs, University of Wisconsin – Madison, Madison, WI, USA
| | - Keywan Riahi
- International Institute for Applied Systems Analysis, Laxenburg, Lower Austria, Austria
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Mariani MS, Battiston F, Horvát EÁ, Livan G, Musciotto F, Wang D. Collective dynamics behind success. Nat Commun 2024; 15:10701. [PMID: 39702328 PMCID: PMC11659592 DOI: 10.1038/s41467-024-54612-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 11/15/2024] [Indexed: 12/21/2024] Open
Abstract
Understanding the collective dynamics behind the success of ideas, products, behaviors, and social actors is critical for decision-making across diverse contexts, including hiring, funding, career choices, and the design of interventions for social change. Methodological advances and the increasing availability of big data now allow for a broader and deeper understanding of the key facets of success. Recent studies unveil regularities beneath the collective dynamics of success, pinpoint underlying mechanisms, and even enable predictions of success across diverse domains, including science, technology, business, and the arts. However, this research also uncovers troubling biases that challenge meritocratic views of success. This review synthesizes the growing, cross-disciplinary literature on the collective dynamics behind success and calls for further research on cultural influences, the origins of inequalities, the role of algorithms in perpetuating them, and experimental methods to further probe causal mechanisms behind success. Ultimately, these efforts may help to better align success with desired societal values.
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Affiliation(s)
- Manuel S Mariani
- URPP Social Networks, University of Zurich, CH-8050, Zurich, Switzerland.
| | - Federico Battiston
- Department of Network and Data Science, Central European University, Vienna, Austria
| | - Emőke-Ágnes Horvát
- School of Communication, Northwestern University, Evanston, IL, USA
- McCormick School of Engineering, Northwestern University, Evanston, IL, USA
- Northwestern Institute on Complex Systems, Northwestern University, Evanston, IL, USA
| | - Giacomo Livan
- Dipartimento di Fisica, Università degli Studi di Pavia, 27100, Pavia, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Pavia, 27100, Pavia, Italy
- Department of Computer Science, University College London, London, WC1E 6EA, UK
| | - Federico Musciotto
- Department of Physics and Chemistry, University of Palermo, I-90128, Palermo, Italy
| | - Dashun Wang
- McCormick School of Engineering, Northwestern University, Evanston, IL, USA
- Center for Science of Science and Innovation, Northwestern University, Evanston, IL, USA
- Ryan Institute on Complexity, Northwestern University, Evanston, IL, USA
- Kellogg School of Management, Northwestern University, Evanston, IL, USA
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Teparrukkul H, Serichetaphongse P, Chengprapakorn W, Arunjaroensuk S, Mattheos N, Pimkhaokham A. Training outcomes of novice clinicians in the use of dynamic computer assisted implant surgery: A prospective comparative study. J Dent Sci 2024; 19:S122-S127. [PMID: 39807253 PMCID: PMC11725117 DOI: 10.1016/j.jds.2024.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 07/15/2024] [Indexed: 01/16/2025] Open
Abstract
Background/Purpose The increasing importance of computer assisted implant surgery (CAIS) in the practice of implant dentistry calls for adequate education and training of clinicians. However, limited evidence exists to support optimal educational strategies and best practices. This study aimed to investigate the effectiveness of distributed training with dynamic CAIS (d-CAIS) on the precision of freehand implant placement by inexperienced operators. Materials and methods Six senior undergraduate dental students underwent simulation training in freehand implant surgery (5 implants) followed by distributed training in d-CAIS (6 implants). A final assessment of freehand implant placement (5 implants) was conducted thereafter. Outcomes were compared to a benchmark set by an experienced surgeon who repeated the same simulation exercises. Total surgical time and implant placement precision were recorded. Results The average precision of implant placement improved significantly after the d-CAIS training for novice operators. 3D platform deviation (1.63 ± 0.85 vs 0.92 ± 0.23; P < 0.001), 3D apical deviation (1.93 ± 0.88 vs 1.21 ± 0.19; P < 0.001), and angular deviation (5.27 ± 2.30 vs 2.74 ± 1.37; P < 0.001). The students achieved platform deviation comparable to this of the expert, but lagged in angle, apex precision, and total surgical time. Conclusion Short-term, distributed simulation training with d-CAIS can significantly enhance the precision of freehand implant placement by novice operators. However, novice operators still lagged at certain aspects of precision and surgical time when compared with the performance of an experienced surgeon in the same setup.
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Affiliation(s)
- Hatsapon Teparrukkul
- Department of Esthetic Restorative and Implant Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Pravej Serichetaphongse
- Faculty of Dentistry, Siam University, Bangkok, Thailand
- Dental Center, Bumrungrad International Hospital, Bangkok, Thailand
| | - Wareerat Chengprapakorn
- Department of Prosthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Sirida Arunjaroensuk
- Oral and Maxillofacial Surgery and Digital Implant Surgery Research Unit, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Nikos Mattheos
- Oral and Maxillofacial Surgery and Digital Implant Surgery Research Unit, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Atiphan Pimkhaokham
- Oral and Maxillofacial Surgery and Digital Implant Surgery Research Unit, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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11
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Derex M, Edmiston P, Lupyan G, Mesoudi A. Trade-offs, control conditions, and alternative designs in the experimental study of cultural evolution. Proc Natl Acad Sci U S A 2024; 121:e2322886121. [PMID: 39556742 PMCID: PMC11621820 DOI: 10.1073/pnas.2322886121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 07/26/2024] [Indexed: 11/20/2024] Open
Abstract
Although the theoretical foundations of the modern field of cultural evolution have been in place for over 50 y, laboratory experiments specifically designed to test cultural evolutionary theory have only existed for the last two decades. Here, we review the main experimental designs used in the field of cultural evolution, as well as major findings related to the generation of cultural variation, content- and model-based biases, cumulative cultural evolution, and nonhuman culture. We then identify methodological advances that demonstrate the iterative improvement of cultural evolution experimental methods. Finally, we focus on one common critique of cultural evolution experiments, the appropriate individual learning control condition needed to demonstrate cumulative culture, and present an original experimental investigation relevant to this critique. Participants completed a combinatorial innovation task allowing for cumulative improvement over time in one of four commonly used experimental designs/conditions: social learners in chains, social learners in groups, individual learners experiencing an extended session lasting the same accumulated time as an entire chain or group, and individual learners experiencing repeated sessions adding up to the same total time. We found that repeated individual learning resulted in superior performance to any other condition. We discuss these findings in light of the relevance of the specific criticism of previous experimental studies that purport to have demonstrated cumulative culture. We also use our findings to discuss the broad trade-offs that participants face when learning individually and socially in different contexts, including variable acquisition costs, redundancy of effort in groups, and cognitive and motivational fatigue.
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Affiliation(s)
- Maxime Derex
- Institute for Advanced Study in Toulouse, Toulouse School of Economics, Toulouse31080, France
| | - Pierce Edmiston
- Department of Psychology, University of Wisconsin-Madison, Madison, WI53706
| | - Gary Lupyan
- Department of Psychology, University of Wisconsin-Madison, Madison, WI53706
| | - Alex Mesoudi
- Centre for Ecology and Conservation, University of Exeter, CornwallTR10 9FE, United Kingdom
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Ayed A, Kallidonis P, Tatanis V, Peteinaris A, Liatsikos E, Natchagande G. The learning curve for robotic-assisted pyeloplasty in urologists with no prior robotic experience using an ex-vivo model: A prospective, controlled study. Arch Ital Urol Androl 2024; 96:12990. [PMID: 39692415 DOI: 10.4081/aiua.2024.12990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2024] [Accepted: 09/09/2024] [Indexed: 12/19/2024] Open
Abstract
INTRODUCTION Despite the increasing trend of utilizing robotic techniques in pyeloplasty, little is known about the learning curve for robot-assisted pyeloplasty (RAP) amongst urologists with no prior robotic experience. Therefore, the present study aimed to evaluate the learning curve of residents in the last year or recently appointed urologists performing RAP using an ex-vivo model. METHODS A prospective ex-vivo model study was conducted including participants who were either residents in the last year or recently appointed urologists. All participants had obtained the E-BLUS certification, or they were able to complete its 4 tasks successfully in a dry lab, without prior robotic experience. Each participant performed four consecutive RAPs using the avatera system on an ex-vivo porcine model. The primary endpoint of the present study was the change in the average time to complete the anastomosis from the first to the fourth attempt. RESULTS Nine urologists and 8 residents were enrolled in this study. Each surgeon demonstrated a reduction in the time to complete anastomosis from the 1st to 4th attempt with an average of value of 4.41 ± 1.06 minutes (p = 0.003). The decrease in time was statistically significant in both urologists and residents subgroups (4.5 ± 1.41 minutes p = 0.049 and 4.33 ± 0.71 minutes p = 0.035 respectively). CONCLUSIONS The training on the ex-vivo model could lead, in only a few attempts, to a significant improvement in skills and in the required time of experienced-naïve surgeons to complete an RAP.
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Affiliation(s)
| | | | | | | | | | - Gilles Natchagande
- University Clinic of Urology Andrology, National University Hospital Center, Hubert Koutoukou MAGA of Cotonou.
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13
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Mitsuoka H, Terai Y, Miyano Y, Ozawa T, Suzuki T. Skill Mastery and Learning Curve Analysis in Fenestrated Endovascular Aortic Repair with Physician-Modified Endograft. Ann Vasc Dis 2024; 17:264-269. [PMID: 39359560 PMCID: PMC11444836 DOI: 10.3400/avd.oa.24-00037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 06/05/2024] [Indexed: 10/04/2024] Open
Abstract
Objectives: This study aims to delineate the unique learning curve for fenestrated endovascular aortic repair (FEVAR) at our institution. Materials and Methods: We measured the FEVAR-specific procedure time (FSPT) as the duration from device deployment to bridging stent completion. To maintain consistency in technical complexity, the study focused on 38 cases with four-fenestration FEVAR for juxtarenal abdominal aortic aneurysms, selected from 103 of all FEVAR procedures between June 2011 and February 2024. In these cases, superior mesenteric and bilateral renal arteries were preserved with fenestration with bridging stents insertion, while celiac arteries fenestrations without fenestrations. Learning curve and cumulative sum (CUSUM) analyses assessed FSPT reduction against increased FEVAR experiences. Results: A significant learning curve was observed, with the procedure time (y) and experience (X) correlation given by y = -39.95 log(X) + 283.6 (R2 = 0.5758). CUSUM indicated that 30 to 50 cases were required for skill stabilization and maturation. Conclusion: Our endovascular team required 30-50 cases to establish reliable FEVAR proficiency. Beyond cumulative experiences, pivotal elements in the learning trajectory seemed to include technological advancements and team augmentation.
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Affiliation(s)
- Hiroshi Mitsuoka
- Department of Cardiovascular Surgery, Shizuoka City Shizuoka Hospital, Shizuoka, Shizuoka, Japan
| | - Yasuhiko Terai
- Department of Cardiovascular Surgery, Shizuoka City Shizuoka Hospital, Shizuoka, Shizuoka, Japan
| | - Yuta Miyano
- Department of Cardiovascular Surgery, Shizuoka City Shizuoka Hospital, Shizuoka, Shizuoka, Japan
| | - Takahiro Ozawa
- Department of Cardiovascular Surgery, Shizuoka City Shizuoka Hospital, Shizuoka, Shizuoka, Japan
| | - Takahiro Suzuki
- Department of Cardiovascular Surgery, Shizuoka City Shizuoka Hospital, Shizuoka, Shizuoka, Japan
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14
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Wang W, Zhuang M, Tao B, Wang F, Wu Y. Learning curve of dynamic navigation-assisted zygomatic implant surgery: An in vitro study. J Prosthet Dent 2024; 132:178.e1-178.e12. [PMID: 38609763 DOI: 10.1016/j.prosdent.2024.03.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 03/23/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024]
Abstract
STATEMENT OF PROBLEM Dynamic computer-assisted zygomatic implant surgery (dCAZIS) has been reported to provide clinical efficacy with high accuracy and low risk of complications. However, the learning curve before performing dCAZIS effectively is unknown. PURPOSE The purpose of this in vitro study was to explore the learning curve of dCAZIS in dentists with different levels of experience in implant dentistry and navigation surgery. MATERIAL AND METHODS Six senior dental students were randomly divided into 3 groups for initial training (FH-CI group: pretraining on freehand conventional implant surgery; FH-ZI group: pretraining on freehand ZI surgery; DN-CI group: pretraining on conventional implant surgery under dynamic navigation). Then, every operator conducted 6 repeated dCAZIS training sessions on edentulous 3-dimensional (3D) printed skull models and was asked to complete a self-report questionnaire after each training session. A total of 36 postoperative cone beam computed tomography (CBCT) scans with 144 ZI osteotomy site preparations were obtained and superimposed over the preoperative design for accuracy measurements. The operation time, 3D deviations, and results of the self-reports were recorded. Comparisons among groups were analyzed with independent-sample Kruskal-Wallis tests (α=.05), and correlations between study outcomes and the number of practices were calculated. RESULTS Operator experience and increased practice times did not significantly affect the accuracy of dCAZIS (P>.05). However, the operation time varied among groups (P<.001), and significantly shortened with more practice, reaching 11.51 ±1.68 minutes at the fifth attempt in the FH-CI group (P<.001 compared with the first practice), 14.48 ±3.07 minutes at the third attempt in the FH-ZI group (P=.038), and 8.68 ±0.58 minutes at the sixth attempt in the DN-CI group (P<.001). All groups reached their own learning curve plateau stage within 6 practice sessions. As the number of practice sessions increased, the results from the self-report questionnaires gradually improved. CONCLUSIONS Among dentists with different levels of experience in implant dentistry and navigation surgery, dCAZIS was found to have a learning curve with respect to operation time but not implant accuracy. Experience in ZI surgery had little impact on the learning curve of dCAZIS, but experience in navigation surgery was a key factor.
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Affiliation(s)
- Wenying Wang
- Graduate student, Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, PR China
| | - Minjie Zhuang
- Graduate student, Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, PR China
| | - Baoxin Tao
- Graduate student, Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, PR China
| | - Feng Wang
- Professor, Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, PR China
| | - Yiqun Wu
- Professor, Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, PR China.
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15
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Cypel S, Bouche PA, Heliere G, David G, Rony L. Junior surgeon learning curve for performing digital planning of a first-line uncemented total hip prothesis. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2024; 34:2709-2715. [PMID: 38758389 DOI: 10.1007/s00590-024-03986-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/08/2024] [Indexed: 05/18/2024]
Abstract
PURPOSE Preoperative digital planning of total hip arthroplasty (THA) anticipates difficulties while increasing implant survival. The objective was to establish the learning curve to produce a reliable and reproducible preoperative planning for THA. We hypothesize that a learning curve exists for planning, and we want to determine the number of procedures required to accomplish it. METHODS This prospective study included patients for THA from 02/11/2019 to 01/11/2022. Ten junior (Juniors) and senior surgeons (Seniors) had received dedicated training in the use of the software. Modeling was done blindly by Juniors and Senior before surgery on a standardized front pelvis X-ray (mediCAD 2D Classic Hospital software). Statistical analyses to establish the learning curve were done to compare the Juniors and Seniors. RESULTS 60% of the Juniors achieved competence after 31.5 ± 12.9 [14-54] planning sessions for the acetabular implant, and 80% after 30.3 ± 8.3 [17-40] planning sessions for the femoral implant. Femoral neck size was achieved by all ten Juniors after 23.1 ± 6.8 [17-38] planning. The offset was correctly restored on the plan by 30% of the Juniors after 33.5 ± 11.6 [18-46] planning. CONCLUSION There is a learning curve for 2D planning of uncemented THA. The different planning items seem to have different learning curves. Compared to Seniors, the completion of 75 planning sessions is not sufficient in totality. The competence of the Juniors for the acetabular implant, the length of the neck and the size of the femoral stem are mostly acquired before 75 sessions. LEVEL OF EVIDENCE Prospective study-Level II.
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Affiliation(s)
- S Cypel
- Département de Chirurgie Osseuse, CHU-Angers, 4, rue Larrey, 49933, Angers Cedex 9, France
| | - P-A Bouche
- Service d'orthopédie, Hopital Lariboisière, 2 rue Ambroise Paré, 75015, Paris, France
| | - G Heliere
- Département de Chirurgie Osseuse, CHU-Angers, 4, rue Larrey, 49933, Angers Cedex 9, France
| | - G David
- Département de Chirurgie Osseuse, CHU-Angers, 4, rue Larrey, 49933, Angers Cedex 9, France
| | - L Rony
- Département de Chirurgie Osseuse, CHU-Angers, 4, rue Larrey, 49933, Angers Cedex 9, France.
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16
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Alomari A, Alsarraj M, Alqarni S. The learning curve in endoscopic transsphenoidal skull-base surgery: a systematic review. BMC Surg 2024; 24:135. [PMID: 38705991 PMCID: PMC11070087 DOI: 10.1186/s12893-024-02418-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 04/20/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND The endoscopic endonasal transsphenoidal approach (EETA) has revolutionized skull-base surgery; however, it is associated with a steep learning curve (LC), necessitating additional attention from surgeons to ensure patient safety and surgical efficacy. The current literature is constrained by the small sample sizes of studies and their observational nature. This systematic review aims to evaluate the literature and identify strengths and weaknesses related to the assessment of EETA-LC. METHODS A systematic review was conducted following the PRISMA guidelines. PubMed and Google Scholar were searched for clinical studies on EETA-LC using detailed search strategies, including pertinent keywords and Medical Subject Headings. The selection criteria included studies comparing the outcomes of skull-base surgeries involving pure EETA in the early and late stages of surgeons' experience, studies that assessed the learning curve of at least one surgical parameter, and articles published in English. RESULTS The systematic review identified 34 studies encompassing 5,648 patients published between 2002 and 2022, focusing on the EETA learning curve. Most studies were retrospective cohort designs (88%). Various patient assortment methods were noted, including group-based and case-based analyses. Statistical analyses included descriptive and comparative methods, along with regression analyses and curve modeling techniques. Pituitary adenoma (PA) being the most studied pathology (82%). Among the evaluated variables, improvements in outcomes across variables like EC, OT, postoperative CSF leak, and GTR. Overcoming the initial EETA learning curve was associated with sustained outcome improvements, with a median estimated case requirement of 32, ranging from 9 to 120 cases. These findings underscore the complexity of EETA-LC assessment and the importance of sustained outcome improvement as a marker of proficiency. CONCLUSIONS The review highlights the complexity of assessing the learning curve in EETA and underscores the need for standardized reporting and prospective studies to enhance the reliability of findings and guide clinical practice effectively.
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Affiliation(s)
- Abdulraheem Alomari
- Neurosurgery Department, East Jeddah Hospital, 2277 King Abdullah Rd, Al Sulaymaniyah, 22253, Jeddah, Saudi Arabia.
| | - Mazin Alsarraj
- Otolaryngology and Head and Neck Surgery Department, King Abdullah Medical Complex, Prince Nayef Street, Northern Abhor, 23816, Jeddah, Saudi Arabia
| | - Sarah Alqarni
- Neurosurgery Department, King Abdulaziz Medical City, 21423, Jeddah, Saudi Arabia
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17
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Hall A, Olsen C, Dribben W, Glaser J, Hanson M. Aeromedical Evacuation, the Expeditionary Medicine Learning Curve, and the Peacetime Effect. Mil Med 2024; 189:e843-e847. [PMID: 37715683 DOI: 10.1093/milmed/usad353] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/02/2023] [Accepted: 08/24/2023] [Indexed: 09/18/2023] Open
Abstract
INTRODUCTION Organizational proficiency increases with experience, which is known as a learning curve. A theoretical peacetime effect occurs when knowledge and skills degrade during peacetime. In this study, the intertheater evacuation system was examined for evidence of a military learning curve and peacetime effect. MATERIALS AND METHODS Data on medical evacuations from U.S. Central Command occurring between January 1, 2003, and December 31, 2022, were acquired from the TRANSCOM Regulating and Command & Control Evacuation System. Priority mission evacuation time corresponding to peak periods of activity in Iraq and Afghanistan and minimal activity in Afghanistan was analyzed. Any reduction or increase in the delivery time of casualties would be considered a change in proficiency. RESULTS There was a marginal monthly decline of 0.019 days (27.4 min) to perform a priority evacuation from Iraq (95% confidence interval [CI], 0.009 to 0.028 days, P < .001) and a decline of 0.010 days (14.4 min) from Afghanistan (95% CI, 0.003 to 0.016 days, P = .004) over 40 months from peak monthly average times. There was a monthly marginal increase in priority evacuation average time from Afghanistan of 0.008 days (11.5 min) (95% CI, 0.005 to 0.011, P < .001) between January 2013 and December 2020. The number of monthly evacuations estimated to maintain or improve monthly average evacuation time is approximately 50. CONCLUSIONS An intertheater aeromedical evacuation system increased in proficiency during periods of conflict and declined during relative peacetime. There is evidence of a peacetime effect on intertheater aeromedical evacuation.
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Affiliation(s)
- Andrew Hall
- USCENTCOM Office of the Command Surgeon, MacDill AFB, FL 33621, USA
| | - Cara Olsen
- Department of Preventive Medicine & Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | | | - Jacob Glaser
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
- Providence Regional Medical Center, Everett, WA 98201, USA
| | - Matthew Hanson
- AFSOC Office of the Command Surgeon, Hurlburt Field, FL 32544, USA
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18
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Lenton TM, Scheffer M. Spread of the cycles: a feedback perspective on the Anthropocene. Philos Trans R Soc Lond B Biol Sci 2024; 379:20220254. [PMID: 37952624 PMCID: PMC10645129 DOI: 10.1098/rstb.2022.0254] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 06/20/2023] [Indexed: 11/14/2023] Open
Abstract
What propelled the human 'revolutions' that started the Anthropocene? and what could speed humanity out of trouble? Here, we focus on the role of reinforcing feedback cycles, often comprised of diverse, unrelated elements (e.g. fire, grass, humans), in propelling abrupt and/or irreversible, revolutionary changes. We suggest that differential 'spread of the cycles' has been critical to the past human revolutions of fire use, agriculture, rise of complex states and industrialization. For each revolution, we review and map out proposed reinforcing feedback cycles, and describe how new systems built on previous ones, propelling us into the Anthropocene. We argue that to escape a bleak Anthropocene will require abruptly shifting from existing unsustainable 'vicious cycles', to alternative sustainable 'virtuous cycles' that can outspread and outpersist them. This will need to be complemented by a revolutionary cultural shift from maximizing growth to maximizing persistence (sustainability). To achieve that we suggest that non-human elements need to be brought back into the feedback cycles underlying human cultures and associated measures of progress. This article is part of the theme issue 'Evolution and sustainability: gathering the strands for an Anthropocene synthesis'.
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Affiliation(s)
| | - Marten Scheffer
- Wageningen University, Wageningen NL-6700 AA, The Netherlands
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19
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Koo B, Son K, Lee JM, Kim SY, Jin MU, Lee KB. Prediction of learning curves of wired and wireless intraoral scanners. Sci Rep 2023; 13:21661. [PMID: 38066236 PMCID: PMC10709622 DOI: 10.1038/s41598-023-48855-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
This clinical study aimed to predict the learning curve of wireless and wired intraoral scanners (IOSs) and to compare the reduction patterns of working time. Overall, 14 participants were enrolled in the study. The intraoral scanning procedure was repeated four times, each using wireless and wired IOSs (i700; MEDIT). The work time from the first to the 600th iterations was predicted using the Wright model. Regarding statistical analysis, the Mann-Whitney U-test was performed for comparison between wireless and wired IOSs and between groups with and without an IOS usage experience, and the Friedman test was performed to evaluate the time reduction (α = 0.05). There was a significant difference between wireless and wired IOSs in the first (P = 0.008) and the third (P = 0.035) iterations. Moreover, the time for 600 iterations was statistically significantly different between wireless and wired IOSs (P < 0.05); however, there was no significant difference after the sixth iteration (e.g., seventh iteration: P = 0.062). In wireless IOS, no significant difference was found between participants with and without an IOS usage experience after the 34th iteration (P = 0.053). The difference in the learning effect between wireless and wired IOSs can be overcome by initial learning; however, an IOS usage experience can affect the learning time of wireless IOSs.
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Affiliation(s)
- Boncheol Koo
- Department of Prosthodontics, School of Dentistry, Kyungpook National University, 2177 Dalgubuldaero, Jung-gu, Daegu, 41940, Republic of Korea
| | - Keunbada Son
- Advanced Dental Device Development Institute (A3DI), Kyungpook National University, Daegu, Republic of Korea
| | - Ji-Min Lee
- Advanced Dental Device Development Institute (A3DI), Kyungpook National University, Daegu, Republic of Korea
- Department of Dental Science, Graduate School, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - So-Yeun Kim
- Department of Prosthodontics, School of Dentistry, Kyungpook National University, 2177 Dalgubuldaero, Jung-gu, Daegu, 41940, Republic of Korea
| | - Myoung-Uk Jin
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea.
| | - Kyu-Bok Lee
- Department of Prosthodontics, School of Dentistry, Kyungpook National University, 2177 Dalgubuldaero, Jung-gu, Daegu, 41940, Republic of Korea.
- Advanced Dental Device Development Institute (A3DI), Kyungpook National University, Daegu, Republic of Korea.
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20
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McGovern L, Alarcón-Lladó E, Garnett EC, Ehrler B, van der Zwaan B. Perovskite Solar Modules for the Residential Sector. ACS ENERGY LETTERS 2023; 8:4862-4866. [PMID: 37969249 PMCID: PMC10644372 DOI: 10.1021/acsenergylett.3c02111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 10/13/2023] [Indexed: 11/17/2023]
Affiliation(s)
- Lucie McGovern
- Faculty
of Science (HIMS, IOP and/or IAS), University
of Amsterdam, Amsterdam 1098 XH, The Netherlands
- Center
for Nanophotonics, AMOLF, Amsterdam 1098 XG, The Netherlands
| | - Esther Alarcón-Lladó
- Faculty
of Science (HIMS, IOP and/or IAS), University
of Amsterdam, Amsterdam 1098 XH, The Netherlands
- Center
for Nanophotonics, AMOLF, Amsterdam 1098 XG, The Netherlands
| | - Erik C. Garnett
- Faculty
of Science (HIMS, IOP and/or IAS), University
of Amsterdam, Amsterdam 1098 XH, The Netherlands
- Center
for Nanophotonics, AMOLF, Amsterdam 1098 XG, The Netherlands
| | - Bruno Ehrler
- Center
for Nanophotonics, AMOLF, Amsterdam 1098 XG, The Netherlands
| | - Bob van der Zwaan
- Faculty
of Science (HIMS, IOP and/or IAS), University
of Amsterdam, Amsterdam 1098 XH, The Netherlands
- TNO
Energy Transition Studies, Amsterdam 1043 NT, The Netherlands
- School
of Advanced International Studies (SAIS), Johns Hopkins University, Bologna 40126, Italy
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21
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McGovern L, Garnett EC, Veenstra S, van der Zwaan B. A techno-economic perspective on rigid and flexible perovskite solar modules. SUSTAINABLE ENERGY & FUELS 2023; 7:5259-5270. [PMID: 38013782 PMCID: PMC10596340 DOI: 10.1039/d3se00828b] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/25/2023] [Indexed: 11/17/2023]
Abstract
Perovskite solar cells have shown considerable developments in the last decade, and commercial applications are drawing closer. In this article, we present a techno-economic study of perovskite PV technologies. We compare published data on manufacturing costs of single-junction perovskite modules and find that they are dependent on the module design (rigid or flexible) and vary from 10 to almost 100 € per m2. We calculate the LCOE as a function of module efficiency and stability for a set of four module cost scenarios at 12.5, 25, 50, and 100 € per m2. The resulting LCOE varies from 4.3 to 25.5 ct kW-1 h-1 and shows low potential for immediate competition with crystalline silicon PV in the utility sector. Perovskite PV's competitive advantage lies in both lighter and less rigid modules, and in the development of tandem modules together with silicon. We hence extend the LCOE equation to highlight the benefit of producing flexible low-weight modules by roll-to-roll manufacturing, and modify the LCOE maps to showcase the benefits of tandem modules. Based on learning curve analyses applied to the CAPEX of single-junction and tandem modules, we develop three scenarios for the evolution of the LCOE of perovskite modules from 2025 to 2050. Under the optimistic scenarios, we find that the LCOE could reduce to 2.8 ct kW-1 h-1 by 2050.
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Affiliation(s)
- Lucie McGovern
- University of Amsterdam, Faculty of Science (HIMS, IOP and/or IAS) Amsterdam The Netherlands
- AMOLF, Center for Nanophotonics Amsterdam The Netherlands
| | - Erik Christian Garnett
- University of Amsterdam, Faculty of Science (HIMS, IOP and/or IAS) Amsterdam The Netherlands
- AMOLF, Center for Nanophotonics Amsterdam The Netherlands
| | - Sjoerd Veenstra
- TNO Solar Energy, Partner in Solliance Eindhoven The Netherlands
| | - Bob van der Zwaan
- University of Amsterdam, Faculty of Science (HIMS, IOP and/or IAS) Amsterdam The Netherlands
- TNO Energy Transition Studies Amsterdam The Netherlands
- Johns Hopkins University, School of Advanced International Studies (SAIS) Bologna Italy
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22
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Noll B, Steffen B, Schmidt TS. The effects of local interventions on global technological change through spillovers: A modeling framework and application to the road-freight sector. Proc Natl Acad Sci U S A 2023; 120:e2215684120. [PMID: 37812716 PMCID: PMC10589666 DOI: 10.1073/pnas.2215684120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 05/31/2023] [Indexed: 10/11/2023] Open
Abstract
To address global sustainability challenges, (public) policy interventions are needed to induce or accelerate technological change. While most policy interventions occur on the local level, their innovation effects can spill over to other jurisdictions, potentially having global impact. These spillovers can increase or reduce the incentive for interventions. Lacking to date are computational models that capture these spillover dynamics. Here, we devise a conceptual and methodological approach to quantify ex ante the effects of local demand-side interventions on global competition between incumbent and novel technologies. We introduce two factors that moderate global spillovers-relative size of selection environments and relative innovation potential of competing technologies. Our approach incorporates both factors in a techno-economic discrete choice model that evaluates technology competition over time through endogenized technological learning. We apply this modeling framework to the case of road freight. Different demand-pull interventions and shocks are modeled to assess spillover effects. In the case of road freight, electric vehicles experience growth in most application segments but can still be accelerated substantially through public policy intervention-spillovers occur if strong public interventions are introduced in large regions or in multiple combined regions under club policy interventions. These findings are discussed in the context of club policy interventions and a modeled geopolitical shock in China. A full sensitivity analysis of model input parameters and intervention or shock dynamics reveals high model robustness. Finally, we discuss the implications of the road-freight case study as it might inform the progress of other niche technologies in transitioning sectors.
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Affiliation(s)
- Bessie Noll
- Energy and Technology Policy Group, Swiss Federal Institute of Technology, ETH Zurich, Zurich8092, Switzerland
| | - Bjarne Steffen
- Climate Finance and Policy Group, Swiss Federal Institute of Technology, ETH Zurich, Zurich8092, Switzerland
- Institute of Science, Technology and Policy, Swiss Federal Institute of Technology, ETH Zurich, Zurich8092, Switzerland
| | - Tobias S. Schmidt
- Energy and Technology Policy Group, Swiss Federal Institute of Technology, ETH Zurich, Zurich8092, Switzerland
- Institute of Science, Technology and Policy, Swiss Federal Institute of Technology, ETH Zurich, Zurich8092, Switzerland
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23
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Lin PL, Zheng F, Shin M, Liu X, Oh D, D'Attilio D. CUSUM learning curves: what they can and can't tell us. Surg Endosc 2023; 37:7991-7999. [PMID: 37460815 PMCID: PMC10520215 DOI: 10.1007/s00464-023-10252-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/23/2023] [Indexed: 09/27/2023]
Abstract
INTRODUCTION There has been increased interest in assessing the surgeon learning curve for new skill acquisition. While there is no consensus around the best methodology, one of the most frequently used learning curve assessments in the surgical literature is the cumulative sum curve (CUSUM) of operative time. To demonstrate the limitations of this methodology, we assessed the CUSUM of console time across cohorts of surgeons with differing case acquisition rates while varying the total number of cases used to calculate the CUSUM. METHODS We compared the CUSUM curves of the average console times of surgeons who completed their first 20 robotic-assisted (RAS) cases in 13, 26, 39, and 52 weeks, respectively, for their first 50 and 100 cases, respectively. This analysis was performed for prostatectomy (1094 surgeons), malignant hysterectomy (737 surgeons), and inguinal hernia (1486 surgeons). RESULTS In all procedures, the CUSUM curve of the cohort of surgeons who completed their first 20 procedures in 13 weeks demonstrated a lower slope than cohorts of surgeons with slower case acquisition rates. The case number at which the peak of the CUSUM curve occurs uniformly increases when the total number of cases used in generation of the CUSUM chart changes from 50 to 100 cases. CONCLUSION The CUSUM analyses of these three procedures suggests that surgeons with fast initial case acquisition rates have less variability in their operative times over the course of their learning curve. The peak of the CUSUM curve, which is often used in surgical learning curve literature to denote "proficiency" is predictably influenced by the total number of procedures evaluated, suggesting that defining the peak as the point at which a surgeon has overcome the learning curve is subject to routine bias. The CUSUM peak, by itself, is an insufficient measure of "conquering the learning curve."
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Affiliation(s)
- Peng-Lin Lin
- Intuitive Surgical, 1020 Kifer Road, Sunnyvale, CA, 94086-5304, USA.
| | - Feibi Zheng
- Intuitive Surgical, 1020 Kifer Road, Sunnyvale, CA, 94086-5304, USA
| | - Minkyung Shin
- Intuitive Surgical, 1020 Kifer Road, Sunnyvale, CA, 94086-5304, USA
| | - Xi Liu
- Intuitive Surgical, 1020 Kifer Road, Sunnyvale, CA, 94086-5304, USA
| | - Daniel Oh
- Intuitive Surgical, 1020 Kifer Road, Sunnyvale, CA, 94086-5304, USA
| | - Daniel D'Attilio
- Intuitive Surgical, 1020 Kifer Road, Sunnyvale, CA, 94086-5304, USA
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Bladin O, Young N, Nordquist J, Roy J, Järnbert-Pettersson H, Sandblom G, Löfgren J. Learning curve in open groin hernia surgery: nationwide register-based study. BJS Open 2023; 7:zrad108. [PMID: 37882629 PMCID: PMC10601449 DOI: 10.1093/bjsopen/zrad108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 08/07/2023] [Accepted: 08/22/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Current recommendations regarding the number of open groin hernia repairs that surgical trainees are required to perform during their residency are arbitrarily defined and vary between different curricula. This register-based study sought to investigate the learning curve of surgeons performing open anterior mesh repair for groin hernia by assessing hernia recurrence rates, surgical complications and operating times in relation to the number of procedures performed. METHOD Nationwide data on open anterior mesh repair for groin hernia performed by surgical residents were collected from the Swedish Hernia Register between 2005 and 2020. The data were analysed in a cohort undergoing procedures carried out by surgeons performing their first registered repair as resident general surgeons. Repairs by surgeons with fewer than 30 repairs were excluded. RESULTS A total of 38 845 repairs carried out by 663 surgeons were included. Operation time decreased with increasing number of performed procedures, mean (s.d.) operation time was 79 (26) min for the first 15 procedures and 60 (23) min after 241 procedures (P <0.001). A turning point where complication rates began to decrease was seen after 60 procedures. Complication rates were 3.6 per cent (396 of 10 978) for procedures 31-60 and 2.7 per cent (157 of 5 798) for procedures 61-120 (P = 0.002). There was no significant relationship between the number of procedures performed and the rate of operation on for recurrence (P = 0.894). CONCLUSION Sixty performed procedures during surgical residency is a reasonable target for achieving competency to perform open anterior mesh repair for groin hernia safely without supervision.
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Affiliation(s)
- Olof Bladin
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Nathalie Young
- Acute and Trauma Surgery, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset Karolinska Institute, Stockholm, Sweden
| | - Jonas Nordquist
- Department of Medicine (Huddinge), Karolinska Institute, Stockholm, Sweden
| | - Joy Roy
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Hans Järnbert-Pettersson
- Department of Clinical Science and Education, Södersjukhuset Karolinska Institute, Stockholm, Sweden
| | - Gabriel Sandblom
- Department of Clinical Science and Education, Södersjukhuset Karolinska Institute, Stockholm, Sweden
- Department of Surgery, Södersjukhuset, Stockholm, Sweden
| | - Jenny Löfgren
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
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25
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Alkatout I, Maass N, Günther V. [The Importance of Feedback in Proctoring in Robotic Surgery - a Cornerstone of the Concept of Success?]. Zentralbl Chir 2023; 148:347-358. [PMID: 37187184 PMCID: PMC10415024 DOI: 10.1055/a-2068-4270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 02/24/2023] [Indexed: 05/17/2023]
Abstract
Robot-assisted surgical methods are a development and supplement to conventional laparoscopy. Thus, appropriate training of surgeons in this specialty is indispensable. Especially for the initial phase, simulation programs - similar to those used in aviation - are ideally suited to introduce surgeons to the technically challenging surgical procedure. Later on, but still at the beginning of the learning curve, proctoring has proven its worth in order to allow the surgeon to be trained on site, to train him individually and to introduce him to more complex cases. An essential component of successful training concepts is the feedback: after some time and in written form, the surgeon to be trained receives a summary or a guideline, which describes the existing situation as well as suggestions for improvement and future potential. The implementation of such feedback allows the surgeon, in addition to the number of cases completed, to put his self-assessment into perspective and adjust development goals. Thus, feedback is the crucial interface between the beginning of a learning curve and advanced surgical skills, including the possibility of realistic self-assessment.
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Affiliation(s)
- Ibrahim Alkatout
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland
| | - Nicolai Maass
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland
| | - Veronika Günther
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland
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Zeyen E, Victoria M, Brown T. Endogenous learning for green hydrogen in a sector-coupled energy model for Europe. Nat Commun 2023; 14:3743. [PMID: 37353489 DOI: 10.1038/s41467-023-39397-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 06/08/2023] [Indexed: 06/25/2023] Open
Abstract
Many studies have shown that hydrogen could play a large role in the energy transition for hard-to-electrify sectors, but previous modelling has not included the necessary features to assess its role. They have either left out important sectors of hydrogen demand, ignored the temporal variability in the system or neglected the dynamics of learning effects. We address these limitations and consider learning-by-doing for the full green hydrogen production chain with different climate targets in a detailed European sector-coupled model. Here, we show that in the next 10 years a faster scale-up of electrolysis and renewable capacities than envisaged by the EU in the REPowerEU Plan can be cost-optimal to reach the strictest +1.5oC target. This reduces the costs for hydrogen production to 1.26 €/kg by 2050. Hydrogen production switches from grey to green hydrogen, omitting the option of blue hydrogen. If electrolysis costs are modelled without dynamic learning-by-doing, then the electrolysis scale-up is significantly delayed, while total system costs are overestimated by up to 13% and the levelised cost of hydrogen is overestimated by 67%.
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Affiliation(s)
- Elisabeth Zeyen
- Department of Digital Transformation in Energy Systems, Faculty of Process Engineering, TU Berlin, Einsteinufer 25 (TA 8), Berlin, 10587, Berlin, Germany.
- Institute for Automation and Applied Informatics (IAI), Karlsruhe Institute of Technology (KIT), Forschungszentrum 449, Eggenstein-Leopoldshafen, 76344, Baden-Württemberg, Germany.
| | - Marta Victoria
- Department of Mechanical and Production Engineering, Aarhus University, Inge Lehmanns Gade 10, Aarhus, 8000, Denmark
- Novo Nordisk Foundation CO2 Research Center, Gustav Wieds Vej 10, Aarhus, 8000, Denmark
| | - Tom Brown
- Department of Digital Transformation in Energy Systems, Faculty of Process Engineering, TU Berlin, Einsteinufer 25 (TA 8), Berlin, 10587, Berlin, Germany
- Institute for Automation and Applied Informatics (IAI), Karlsruhe Institute of Technology (KIT), Forschungszentrum 449, Eggenstein-Leopoldshafen, 76344, Baden-Württemberg, Germany
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27
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Li Z, Chen Y. Minimizing the makespan and carbon emissions in the green flexible job shop scheduling problem with learning effects. Sci Rep 2023; 13:6369. [PMID: 37076558 PMCID: PMC10115896 DOI: 10.1038/s41598-023-33615-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 04/15/2023] [Indexed: 04/21/2023] Open
Abstract
One of the most difficult challenges for modern manufacturing is reducing carbon emissions. This paper focuses on the green scheduling problem in a flexible job shop system, taking into account energy consumption and worker learning effects. With the objective of simultaneously minimizing the makespan and total carbon emissions, the green flexible job shop scheduling problem (GFJSP) is formulated as a mixed integer linear multiobjective optimization model. Then, the improved multiobjective sparrow search algorithm (IMOSSA) is developed to find the optimal solution. Finally, we conduct computational experiments, including a comparison between IMOSSA and the nondominated sorting genetic algorithm II (NSGA-II), Jaya and the mixed integer linear programming (MILP) solver of CPLEX. The results demonstrate that IMOSSA has high precision, good convergence and excellent performance in solving the GFJSP in low-carbon manufacturing systems.
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Affiliation(s)
- Zhi Li
- School of Economics and Management, Tiangong University, Tianjin, 300387, China.
| | - Yingjian Chen
- School of Economics and Management, Tiangong University, Tianjin, 300387, China
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28
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Levy BE, MacDonald M, Bontrager N, Castle JT, Draus JM, Worhunsky DJ. Evaluation of the learning curve for laparoscopic pyloromyotomy. Surg Endosc 2023:10.1007/s00464-023-09962-3. [PMID: 36922426 DOI: 10.1007/s00464-023-09962-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 02/12/2023] [Indexed: 03/17/2023]
Abstract
BACKGROUND Laparoscopic pyloromyotomy is the preferred surgical management of hypertrophic pyloric stenosis at most centers. We aimed to analyze the learning curve for laparoscopic pyloromyotomy using the experience of five fellowship-trained pediatric surgeons. METHODS A retrospective review of consecutive patients undergoing laparoscopic pyloromyotomy was performed. All cases were performed with general surgery residents. Cumulative sum (CUSUM) analysis for operating time was performed for up to the first 150 consecutive cases for individual surgeons. Outcomes were compared to identify different phases of the learning curve for operative competency. RESULTS A total of 414 patients were included in the analysis as not all surgeons had reached 150 cases at time of analysis. The mean operating time was 29.2 min for all cases across the 5 surgeons. CUSUM analysis for mean operating time revealed three phases of learning: Learning Phase (cases 1-16), Plateau Phase (cases 17-87), and a Proficiency Phase (cases 88-150). The mean operating time during the three phases was 34.1, 29.0, and 28.3 min, respectively (P = 0.005). There were no differences in complications, reoperations, length of stay, or readmissions across the three phases. CONCLUSION Three distinct phases of learning for laparoscopic pyloromyotomy were identified with no differences in outcomes across the phases. The operating time differed only for the Learning Phase, suggesting that some degree of proficiency occurs after 16 cases.
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Affiliation(s)
- Brittany E Levy
- Division of Pediatric Surgery, Department of Surgery, University of Kentucky and Kentucky Children's Hospital, 800 Rose Street, MS463A, Lexington, KY, 40536, USA
| | - Mia MacDonald
- Department of General Surgery, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Nicholas Bontrager
- Division of Pediatric Surgery, Department of Surgery, University of Kentucky and Kentucky Children's Hospital, 800 Rose Street, MS463A, Lexington, KY, 40536, USA
| | - Jennifer T Castle
- Division of Pediatric Surgery, Department of Surgery, University of Kentucky and Kentucky Children's Hospital, 800 Rose Street, MS463A, Lexington, KY, 40536, USA
| | - John M Draus
- Department of Surgery, Nemours Children's Health, Jacksonville, FL, USA
| | - David J Worhunsky
- Division of Pediatric Surgery, Department of Surgery, University of Kentucky and Kentucky Children's Hospital, 800 Rose Street, MS463A, Lexington, KY, 40536, USA.
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Angeles MA, Migliorelli F, León Ramírez LF, Ros C, Perissinotti A, Tapias A, Casanueva-Eliceiry S, Pahisa J, Torné A, Vidal-Sicart S, Del Pino M, Paredes P. Predictive factors of preoperative sentinel lymph node detection in intermediate and high-risk endometrial cancer. THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING : OFFICIAL PUBLICATION OF THE ITALIAN ASSOCIATION OF NUCLEAR MEDICINE (AIMN) [AND] THE INTERNATIONAL ASSOCIATION OF RADIOPHARMACOLOGY (IAR), [AND] SECTION OF THE SOCIETY OF... 2023; 67:37-45. [PMID: 32077670 DOI: 10.23736/s1824-4785.20.03246-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND In endometrial cancer (EC), sentinel lymph node (SLN) mapping has emerged as an alternative to systematic lymphadenectomy. Little is known about factors that might influence SLN preoperative detection. The aim of our study was to evaluate the clinical and technical variables that may influence on the success of SLN detection in preoperative lymphatic mapping in patients with intermediate and high-risk EC when performing transvaginal ultrasound-guided myometrial injection of radiotracer (TUMIR). METHODS Between March 2006 and March 2017, we prospectively enrolled patients with histologically confirmed EC with intermediate or high-risk of lymphatic involvement. All women underwent SLN detection by using TUMIR approach. After radiotracer injection, pelvic and abdominal planar and SPECT/CT images were acquired to obtain a preoperative lymphoscintigraphic mapping. Pattern of drainage was registered and analyzed to identify the factors directly involved in drainage. Sonographer learning curves to perform TUMIR approach were created following Cumulative Sum and Wright methods. Univariate and multivariate analyses were performed using logistic regression. RESULTS During study period, 123 patients were included. SLN preoperative detection rate was 70.7%. Age under 75 years at diagnosis (P<0.01), radiotracer injection above 4 mL -high-volume- (P<0.01), and tumoral size below 2 cm (P=0.04) were associated with higher SLN preoperative detection rate. Twenty-five procedures were necessary to attain an adequate performance in TUMIR approach. CONCLUSIONS The higher SLN preoperative detection rate in women with intermediate and high-risk endometrial cancer after TUMIR approach was related with younger age, smaller tumors and high-volume injection of radiotracer. Sonographers are required to perform 25 procedures before acquiring an expertise in radiotracer injection.
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Affiliation(s)
- Martina A Angeles
- Institute Clinic of Gynecology, Obstetrics, and Neonatology, Clinical Hospital of Barcelona, Barcelona, Spain - .,Department of Surgical Oncology, Claudius Regaud Institute, Cancer University Institute of Toulouse - Oncopole, Toulouse, France -
| | - Federico Migliorelli
- Department of Gynecology and Obstetrics, Centre Hospitalier Intercommunal des Vallées de l'Ariège, St Jean de Verges, France
| | | | - Cristina Ros
- Institute Clinic of Gynecology, Obstetrics, and Neonatology, Clinical Hospital of Barcelona, Barcelona, Spain
| | - Andrés Perissinotti
- Department of Nuclear Medicine, Clinical Hospital of Barcelona, Barcelona, Spain.,Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Barcelona, Spain
| | - Andrés Tapias
- Department of Nuclear Medicine, Clinical Hospital of Barcelona, Barcelona, Spain
| | | | - Jaume Pahisa
- Institute Clinic of Gynecology, Obstetrics, and Neonatology, Clinical Hospital of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Aureli Torné
- Institute Clinic of Gynecology, Obstetrics, and Neonatology, Clinical Hospital of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Sergi Vidal-Sicart
- Department of Nuclear Medicine, Clinical Hospital of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Marta Del Pino
- Institute Clinic of Gynecology, Obstetrics, and Neonatology, Clinical Hospital of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Pilar Paredes
- Department of Nuclear Medicine, Clinical Hospital of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine, University of Barcelona, Barcelona, Spain
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Warmerdam BWCM, Stevens M, van Rijswijk CSP, Eefting D, van der Meer RW, Putter H, Hamming JF, van der Vorst JR, van Schaik J. Learning Curve Analysis of Complex Endovascular Aortic Repair. Ann Vasc Surg 2023:S0890-5096(23)00057-2. [PMID: 36773932 DOI: 10.1016/j.avsg.2023.01.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 01/24/2023] [Accepted: 01/24/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND When introducing new techniques, attention must be paid to learning curve. Besides quantitative outcomes, qualitative factors of influence should be taken into consideration. This retrospective cohort study describes the quantitative learning curve of complex endovascular aortic repair (EVAR) in a nonhigh-volume academic center and provides qualitative factors that were perceived as contributors to this learning curve. With these factors, we aim to aid in future implementation of new techniques. METHODS All patients undergoing complex EVAR in the Leiden University Medical Center (LUMC) between July 2013 and April 2021 were included (n = 90). Quantitative outcomes were as follows: operating time, blood loss, volume of contrast, hospital stay, major adverse events (MAE), 30-day mortality, and complexity. Patients were divided into 3 temporal groups (n = 30) for dichotomous outcomes. Regression plots were used for continuous outcomes. In 2017, the treatment team was interviewed by an external researcher. These interviews were reanalyzed for factors that contributed to successful implementation. RESULTS Length of hospital stay (P = 0.008) and operating time (P = 0.010) decreased significantly over time. Fewer cardiac complications occurred in the third group (3: 0% vs. 2: 17% vs. 1: 17%, P = 0.042). There was a trend of increasing complexity (P = 0.076) and number of fenestrations (P = 0.060). No significant changes occurred in MAE and 30-day mortality. Qualitative factors that, according to the interviewees, positively influenced the learning curve were as follows: communication, mutual trust, a shared sense of responsibility and collective goals, clear authoritative structures, mutual learning, and team capabilities. CONCLUSIONS In addition to factors previously identified in the literature, new learning curve factors were found (mutual learning and shared goals in the operating room (OR)) that should be taken into account when implementing new techniques.
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Affiliation(s)
| | - Merieke Stevens
- Department of Technology and Operations Management, Rotterdam School of Management, Erasmus University, PA Rotterdam, the Netherlands
| | | | - Daniël Eefting
- Department of Surgery, Leiden University Medical Center, RC Leiden, the Netherlands
| | - Rutger W van der Meer
- Department of Radiology, Leiden University Medical Center, RC Leiden, the Netherlands
| | - Hein Putter
- Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, RC Leiden, the Netherlands
| | - Jaap F Hamming
- Department of Surgery, Leiden University Medical Center, RC Leiden, the Netherlands
| | | | - Jan van Schaik
- Department of Surgery, Leiden University Medical Center, RC Leiden, the Netherlands.
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Tsai PH, Berleant D, Segall RS, Aboudja H, Batthula VJR, Duggirala S, Howell M. Quantitative Technology Forecasting: A Review of Trend Extrapolation Methods. INTERNATIONAL JOURNAL OF INNOVATION AND TECHNOLOGY MANAGEMENT 2023. [DOI: 10.1142/s0219877023300021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Quantitative technology forecasting uses quantitative methods to understand and project technological changes. It is a broad field encompassing many different techniques and has been applied to a vast range of technologies. A widely used approach in this field is trend extrapolation. Based on the literature available to us, there has been little or no attempt made to systematically review the empirical evidence on quantitative trend extrapolation techniques. This study attempts to close this gap by conducting a systematic review of the technology forecasting literature addressing the application of quantitative trend extrapolation techniques. We identified 25 studies relevant to the objective of this research and classified the techniques used in the studies into different categories, among which the growth curves and time series methods were shown to remain popular over the past decade while the newer methods, such as machine learning-based hybrid models, have emerged in recent years. As more effort and evidence are needed to determine if hybrid models are superior to traditional methods, we expect a growing trend in the development and application of hybrid models to technology forecasting.
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Affiliation(s)
- Peng-Hung Tsai
- Department of Information Science, University of Arkansas at Little Rock, Little Rock, AR 72204 USA
| | - Daniel Berleant
- Department of Information Science, University of Arkansas at Little Rock, Little Rock, AR 72204 USA
| | - Richard S. Segall
- Department of Information Systems & Business Analytics, Arkansas State University, Jonesboro, AR 72467 USA
| | - Hyacinthe Aboudja
- Department of Computer Science, Oklahoma City, University Oklahoma City, OK 73106 USA
| | | | - Sheela Duggirala
- Department of Information Science, University of Arkansas at Little Rock, Little Rock, AR 72204 USA
| | - Michael Howell
- Department of Information Science, University of Arkansas at Little Rock, Little Rock, AR 72204 USA
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32
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Amavilah VH, Rodriguez Andres A. Technological knowledge progress: Were famous laws almost correct in developing and emerging economies? PLoS One 2023; 18:e0283107. [PMID: 37155692 PMCID: PMC10166483 DOI: 10.1371/journal.pone.0283107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 03/01/2023] [Indexed: 05/10/2023] Open
Abstract
Do the famous laws of the motion of technological progress like the Moore's Law, Wright's Law, Goddard's Law, and their derivatives explain the technological knowledge progress of developing and emerging economies? The aim of this paper is to investigate that question. For that purpose, we rationalize an existing framework (Nagy et al. 2013) and employ it on a panel data set of 66 developing and emerging market economies over the 1995-2017 period. Empirical evidence is mixed. Some of the results confirm a positive relationship between technological knowledge progress and the progress of time. Other instances indicate that the slow rate of learning delays the doubling time by 18 years. Yet other results predict that this group of countries will double its rate of progress in 4-5 years. The explanatory power varies across the laws, with most laws suggesting acceptance of the hypotheses that the included variables affect the technological knowledge progress while others recommending that we "do not accept" the hypothesis that in-situ scale and hence cumulative GDP per capita explain the technological knowledge progress of these countries. Practical policy implications, which this group of countries can use to assess and address constraints to the technological knowledge progress, are also discussed.
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Affiliation(s)
- Voxi Heinrich Amavilah
- Economics/Division of Behavioral and Social Sciences, Estrella Mountain College, Avondale, Arizona, United States of America
| | - Antonio Rodriguez Andres
- Department of Economics, Faculty of Management and Technology, German University in Cairo (GUC), New Cairo, Egypt
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Balas M, Kwok JM, Miguel A, Rai A, Rai A, Ahmed IIK, Schlenker MB. The Cataract Surgery Learning Curve: Quantitatively Tracking a Single Resident's Operative Actions Throughout Their Training. Am J Ophthalmol 2022; 249:82-89. [PMID: 36581189 DOI: 10.1016/j.ajo.2022.12.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 12/01/2022] [Accepted: 12/04/2022] [Indexed: 12/28/2022]
Abstract
PURPOSE To track operative phases of cataract surgery over a resident's training to measure action times and frequencies as a surrogate for competency and skill progression. DESIGN An n = 1 panel study. METHODS Cataract surgery video recordings performed by a single resident between 2021-2022 were collected. Only full-length videos of adequate quality without supervisor intervention were included. The start and end times of 19 distinct operative phases of cataract surgery were manually labeled by a trained annotator. Timeseries analysis was employed to measure the direction and magnitude of trends in the resident's surgical timing for each action across their first year of training. RESULTS The dataset comprised 100 videos spread across the resident's sixth to 760th cases. The median total time was 11.6 minutes (IQR 10.1-14.4 minutes), with overall speed increasing at a rate of 43.4 seconds for every 10 videos (95% CI 35.1, 52.7 seconds). Nine operative phases significantly decreased in time throughout training. The main incision, phacoemulsification, and hydrodissection had the greatest improvements in speed relative to their average procedural time. There was an average of 26.9 distinct operative actions (excluding idle periods) in each video (range 20-50). CONCLUSIONS This is the first study to quantitatively track operative times and frequencies across all relevant actions in cataract surgery and derive learning curves for each. Consistent with previous works, it was found that a basic level of surgical competency was achieved after performing 80 cases. In addition, results from this study indicated that the next level in skill advancement towards surgical finesse occurs after 300 cases.
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Affiliation(s)
- Michael Balas
- From the Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (M.B.)
| | - Jason M Kwok
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada (J.M.K., A.R., A.R., I.I.K.A., M.B.S.); Kensington Eye Institute, Toronto, Ontario, Canada (J.M.K., A.R., A.R., I.I.K.A., M.B.S.)
| | - Ana Miguel
- Department of Ophthalmology, Private Hospital of La Baie, Avranches, France (A.M.); Department of Ophthalmology, Central University Hospital of Caen, Caen, France (A.M.)
| | - Amrit Rai
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada (J.M.K., A.R., A.R., I.I.K.A., M.B.S.); Kensington Eye Institute, Toronto, Ontario, Canada (J.M.K., A.R., A.R., I.I.K.A., M.B.S.); Prism Eye Institute, Mississauga, Ontario, Canada (A.R., A.R., I.I.K.A., M.B.S.)
| | - Amandeep Rai
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada (J.M.K., A.R., A.R., I.I.K.A., M.B.S.); Kensington Eye Institute, Toronto, Ontario, Canada (J.M.K., A.R., A.R., I.I.K.A., M.B.S.); Prism Eye Institute, Mississauga, Ontario, Canada (A.R., A.R., I.I.K.A., M.B.S.)
| | - Iqbal Ike K Ahmed
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada (J.M.K., A.R., A.R., I.I.K.A., M.B.S.); Kensington Eye Institute, Toronto, Ontario, Canada (J.M.K., A.R., A.R., I.I.K.A., M.B.S.); Prism Eye Institute, Mississauga, Ontario, Canada (A.R., A.R., I.I.K.A., M.B.S.)
| | - Matthew B Schlenker
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada (J.M.K., A.R., A.R., I.I.K.A., M.B.S.); Kensington Eye Institute, Toronto, Ontario, Canada (J.M.K., A.R., A.R., I.I.K.A., M.B.S.); Prism Eye Institute, Mississauga, Ontario, Canada (A.R., A.R., I.I.K.A., M.B.S.).
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Learning curve of the Krackow suture technique for the repair of Achilles tendon rupture. Arch Orthop Trauma Surg 2022; 142:3747-3754. [PMID: 34661712 DOI: 10.1007/s00402-021-04213-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/03/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Knowledge on the learning curve for the repair of Achilles tendon rupture is limited. The aim of this study was to quantify the learning curve for the Krackow suture technique for the repair of Achilles tendon rupture and to identify the correlation between the cumulative volume of cases and clinical outcome measures. MATERIALS AND METHODS A total of 226 cases of Achilles tendon repair using the Krackow suture technique were reviewed. Each surgery was independently performed by four surgeons who started a foot and ankle specialty career after fellowship training. After logarithmic transformation of the operative time and cumulative volume of cases, a linear regression analysis was performed to determine the best-fit linear equations to predict the required time for the Krackow suture technique according to the cumulative volume of cases. The correlation between the cumulative volume of cases and clinical outcome measures was analyzed using Pearson correlation coefficients. Receiver operating characteristic curves were constructed to determine the minimum number of cases with an operative time shorter than the average in the first 30 cases. RESULTS In all four surgeons, significant log-linear correlations were observed between the operative time and cumulative volume of cases. The best-fit linear equations showed estimated learning rates of 90%, 87%, 92%, and 86% for each of the four surgeons, indicating that the necessary operative time decreased by 10%, 13%, 8%, and 14%, respectively, when the cumulative volume of cases had doubled. The minimum number of cases with an operative time shorter than the average was 9 (91% sensitivity and 59% specificity). The clinical outcome measures at 6 and 12 months postoperatively were available for one surgeon; however, no correlation was found with the cumulative volume of cases. CONCLUSION The learning rate for the Krackow suture technique for the repair of Achilles tendon rupture was approximately 89%, indicating that the required operative time can decrease by up to 11% when the cumulative volume of cases doubles. Therefore, it is important to rapidly accumulate surgical experience during the early phase of training.
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Isolan GR, Monteiro J, Vaz MAS, Lavinsky J, de Araújo RL, Santis G, Figueiredo EG, Buffon V, Ribas Filho CAP, Ribas Filho JM, Malafaia O. The Learning Curve in Skull Base Surgery Part 1–From Historical-Philosophical Concepts to Microsurgical Lab Training. ARQUIVOS BRASILEIROS DE NEUROCIRURGIA: BRAZILIAN NEUROSURGERY 2022. [DOI: 10.1055/s-0042-1758220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
AbstractThe learning curve reflects surgeons' experience in managing several patients with the same disease. In skull base surgery, the professional's place on the curve could be related to the number of times the same procedure was performed. Where does curve begin? What amount of training is necessary prior to its application in surgical settings? What were the results of the first few skull base tumor surgeries performed by a surgeon who goes on to produce excellent results, and how is reflected in the start of their learning curve? The only way for neurosurgeons to improve their results from the start is with prior training in the microsurgery laboratory. This learning technique is essential to maximize the chance of success of a neurosurgical procedures, minimizing the morbidity rate to which patients are subjected by less experienced neurosurgeons. This article is divided in two parts, and its purpose is to show how training in the microsurgical laboratory fits into the construction of knowledge about skull base surgery, based on authors' experience and reflections. This first part discusses the technical, psychological, and philosophical aspects of medical knowledge, primarily addressing those training in skull base surgery, the principles of some selected philosophical currents, and their influence on the development of current medical knowledge.
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Affiliation(s)
- Gustavo Rassier Isolan
- The Center for Advanced Neurology and Neurosurgery (CEANNE), Brazil
- Evangelical Mackenzie University of Paraná, Bigorrilho, Curitiba, PR, Brazil
- The Center for Neurotology and Acoustic Neuroma (CNNA), Porto Alegre, Brazil
| | - Jander Monteiro
- The Center for Advanced Neurology and Neurosurgery (CEANNE), Brazil
| | | | - Joel Lavinsky
- The Center for Advanced Neurology and Neurosurgery (CEANNE), Brazil
- The Center for Neurotology and Acoustic Neuroma (CNNA), Porto Alegre, Brazil
- Lavinsky Clinic, Porto Alegre, Brazil
| | - Ricardo Lopes de Araújo
- Department of Neurological Surgery, Laboratory of Surgical Innovations for Skull Base Microneurosurgery, Weill Cornell Medical College, New York, NY, USA
| | - Giuseppe Santis
- The Center for Advanced Neurology and Neurosurgery (CEANNE), Brazil
| | | | - Viviane Buffon
- The Center for Advanced Neurology and Neurosurgery (CEANNE), Brazil
- Evangelical Mackenzie University of Paraná, Bigorrilho, Curitiba, PR, Brazil
| | | | | | - Osvaldo Malafaia
- Evangelical Mackenzie University of Paraná, Bigorrilho, Curitiba, PR, Brazil
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Vanella S, Bottazzi EC, Farese G, Murano R, Noviello A, Palma T, Godas M, Crafa F. Minimally invasive colorectal surgery learning curve. World J Gastrointest Endosc 2022; 14:731-736. [PMID: 36438877 PMCID: PMC9693684 DOI: 10.4253/wjge.v14.i11.731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/01/2022] [Accepted: 10/31/2022] [Indexed: 11/14/2022] Open
Abstract
The learning curve in minimally invasive colorectal surgery is a constant subject of discussion in the literature. Discordant data likely reflects the varying degrees of each surgeon’s experience in colorectal, laparoscopic or robotic surgery. Several factors are necessary for a successful minimally invasive colorectal surgery training program, including: Compliance with oncological outcomes; dissection along the embryological planes; constant presence of an expert tutor; periodic discussion of the morbidity and mortality rate; and creation of a dedicated, expert team.
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Affiliation(s)
- Serafino Vanella
- Department of General and Oncology Surgery, A.O.R.N. San Giuseppe Moscati, Avellino 83100, Italy
| | - Enrico Coppola Bottazzi
- Department of General and Oncology Surgery, A.O.R.N. San Giuseppe Moscati, Avellino 83100, Italy
| | - Giancarlo Farese
- Department of General and Oncology Surgery, A.O.R.N. San Giuseppe Moscati, Avellino 83100, Italy
| | - Rosa Murano
- Department of General and Oncology Surgery, A.O.R.N. San Giuseppe Moscati, Avellino 83100, Italy
| | - Adele Noviello
- Department of General and Oncology Surgery, A.O.R.N. San Giuseppe Moscati, Avellino 83100, Italy
| | - Tommaso Palma
- Department of General and Oncology Surgery, A.O.R.N. San Giuseppe Moscati, Avellino 83100, Italy
| | - Maria Godas
- Department of General and Oncology Surgery, A.O.R.N. San Giuseppe Moscati, Avellino 83100, Italy
| | - Francesco Crafa
- Department of General and Oncology Surgery, A.O.R.N. San Giuseppe Moscati, Avellino 83100, Italy
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Svarts A, Anders T, Engwall M. Volume creates value: The volume-outcome relationship in Scandinavian obesity surgery. Health Serv Manage Res 2022; 35:229-239. [PMID: 35125029 PMCID: PMC9574905 DOI: 10.1177/09514848211048598] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study establishes the relationship between surgical volume and cost and quality outcomes, using patient-level clinical data from a national quality registry for bariatric surgery in Sweden. Data include patient characteristics with comorbidities, surgical and follow-up data for patients that underwent gastric bypass or gastric sleeve operations between 2007 and 2016 (52,703 patients in 51 hospitals). The relationships between surgical volume (annual number of bariatric procedures) and several patient-level outcomes were assessed using multilevel, mixed-effect regression models, controlling for patient characteristics and comorbidities. We found that hospitals with higher volumes had lower risk of intraoperative complications as well as complications within 30 days post-surgery (odds ratios per 100 procedures are 0.78 and 0.87, respectively, p<0.01). In addition, higher-volume hospitals had substantially shorter procedure time (17 min per 100 procedures, p<0.01) and length of stay (0.88 incidence-rate ratio per 100 procedures p<0.01). Our results support the claim that increased surgical volume significantly improves quality. Further, the results strongly suggest that increased volume leads to lower cost per surgery, by reducing cost drivers such as procedure time and length of stay.
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Affiliation(s)
- Anna Svarts
- Department of Industrial Economics
and Management, KTH
Royal Institute of Technology,
Stockholm, Sweden
| | - Thorell Anders
- Department of Clinical
Sciences,
Karolinska Institutet, Danderyd
Hospital, Stockholm, Sweden
- Department of
Surgery, Ersta Hospital, Stockholm,
Sweden
| | - Mats Engwall
- Department of Industrial Economics
and Management, KTH
Royal Institute of Technology,
Stockholm, Sweden
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The impact of monetary incentives and regulatory focus on worker productivity and learning in order picking. INTERNATIONAL JOURNAL OF OPERATIONS & PRODUCTION MANAGEMENT 2022. [DOI: 10.1108/ijopm-11-2021-0730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeIn manual order picking systems, temporary workers are often employed to handle demand peaks. While this increases flexibility, it may hamper productivity, as they are usually unfamiliar with the processes and may have little experience. It is important for managers to understand how quickly inexperienced workers arrive at full productivity and which factors support workers in improving their productivity. This paper aims to investigate how learning improves the performance of order pickers, and how their regulatory focus (RF) and monetary incentives, as management actions, influence learning.Design/methodology/approachData was collected in two case studies in controlled field-lab experiments and statistically analysed. This allowed evaluating the validity of hypotheses through an ANOVA, the calculation of correlation coefficients and the application of regression models.FindingsA monetary incentive based on total order picking time and pick errors has a positive influence on order picking time, but not on pick quality. The incentive influences initial productivity, but not the learning rate. A dominant promotion-oriented RF increases the effect of the incentive on initial productivity, but it does not impact worker learning.Practical implicationsThis study contributes to behavioral and human-focused order picking management and supports managers in setting up work plans and developing incentive systems for learning and productivity enhancement, considering worker RF.Originality/valueThis work is among the few to empirically investigate the effect of monetary incentives on learning in interaction with RF. It is the first study to investigate these concepts in an order picking scenario.
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Tan G, Yu X. Arc entropy of uncertain sets and its applications. JOURNAL OF INTELLIGENT & FUZZY SYSTEMS 2022. [DOI: 10.3233/jifs-220564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
As an important tool to measure the degree of difficulty of predicting the realization of an uncertain set, entropy theory of uncertain set has been investigated by many scholars. In order to measure the uncertainty associated with some uncertain sets, this paper first proposes the arc entropy for an uncertain set. Then a computational arc entropy formula via inverse membership function is introduced to calculate the arc entropy more quickly, and some properties of arc entropy are studied. Furthermore, some applications are also provided to illustrate the superiority of the arc entropy.
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Affiliation(s)
- Guimei Tan
- Library, Liaocheng University, Liaocheng, China
| | - Xichang Yu
- Liaocheng Vocational and Technical College, Liaocheng, China
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Choe C, Byun M, Lee H, Lim H. Techno-economic and environmental assessments for sustainable bio-methanol production as landfill gas valorization. WASTE MANAGEMENT (NEW YORK, N.Y.) 2022; 150:90-97. [PMID: 35810729 DOI: 10.1016/j.wasman.2022.06.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 06/17/2022] [Accepted: 06/28/2022] [Indexed: 06/15/2023]
Abstract
With the regular increase in global solid waste, landfilling is intensively used for waste disposal. However, landfill gas (LFG) produced as a byproduct during waste decomposition in the landfills is a serious problem since it leads to damage to the eco-systems. Accordingly, it has been highlighted to convert LFG into other value-added chemicals. In this study, LFG utilization was studied in terms of conversion into methanol (MeOH) by considering different scenarios of LFG utilization. Techno-economic analysis and environmental assessment were performed to identify the economic feasibility and environmental impact of each case. From the economic analysis, bio-MeOH production costs of 879.16, 724.52, and 1,130.74 $ ton-1 for case 1, 2, and 3 was estimated with the economic infeasibility, while substantial cost reduction through projected cost analysis can lead to economic competitiveness (449.52 $ ton-1 for case 2 and 595.76 $ ton-1 for case 3). In sequence, the quantitative environmental impacts in terms of climate change impact were 2.360, 0.835, and 0.605 kg CO2-eq kg MeOH-1 for cases 1, 2, and 3, respectively. Based on the results of two analyses, a multi-criteria decision analysis was conducted to investigate the acceptable case of bio-MeOH production in the economic and environmental aspects. It can be concluded that the most feasible case depends on decision-makers if only economic and environmental criteria were considered. Therefore, dry reforming and membrane separation of LFG have considerable potential for bio-MeOH production in terms of LFG utilization for high weighting of economic and environmental aspects, respectively.
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Affiliation(s)
- Changgwon Choe
- School of Energy and Chemical Engineering, Ulsan National Institute of Science and Technology, 50 UNIST-gil, Eonyang-eup, Ulju-gun, Ulsan 44919, Republic of Korea
| | - Manhee Byun
- School of Energy and Chemical Engineering, Ulsan National Institute of Science and Technology, 50 UNIST-gil, Eonyang-eup, Ulju-gun, Ulsan 44919, Republic of Korea
| | - Hyunhee Lee
- School of Energy and Chemical Engineering, Ulsan National Institute of Science and Technology, 50 UNIST-gil, Eonyang-eup, Ulju-gun, Ulsan 44919, Republic of Korea
| | - Hankwon Lim
- School of Energy and Chemical Engineering, Ulsan National Institute of Science and Technology, 50 UNIST-gil, Eonyang-eup, Ulju-gun, Ulsan 44919, Republic of Korea.
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Basso L, Pietroletti R, Micarelli A, Bicaj A, Costi U, Crocetti D, D'Ermo G, Gallo G. The impact of experience on recurrence rates after biopsy punch excision for pilonidal disease. Colorectal Dis 2022; 24:984-991. [PMID: 35344244 PMCID: PMC9541250 DOI: 10.1111/codi.16126] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/15/2022] [Accepted: 03/19/2022] [Indexed: 02/08/2023]
Abstract
AIM We present the outcomes and the recurrences of 848 patients with pilonidal disease (PD) treated by biopsy punch excision (BPE) and we weigh our results against progressively obtained operative experience. BPE is a modified 'merged' version of both the Bascom 'pit picking' procedure and the Gips procedure. It employs biopsy punches of different calibre, depending on whether treatment is in the natal cleft (calibre as small as possible) or lateral (larger calibre punches or even small incision). Sometimes this procedure is referred to as the Bascom-Gips procedure. METHODS In all, 848 consecutive patients with PD were treated from January 2011 until December 2016 (sex 622 [73.4%] men and 226 [26.6%] women; median age 26.2 years, mean age 24.6 ± 28.99 [range 14-55] years, men 25.1 years, women 24.8 years). Of these 848 patients, 287 were operated in 2011-2012, 301 in 2013-2014 and 260 in 2015-2016. The recurrence rates were recorded 12, 24 and 60 months after surgery both cumulatively and by examining the outcomes of the three biennia individually (years of treatment 2011-2012 or group A, 2013-2014 or group B, 2015-2016 or group C). RESULTS The mean operating time was 34 ± 24.45 min. Postoperative complications included early (<24 h; n = 22 or 2.6%) and delayed (>24 h; n = 26 or 3.1%) postoperative bleeding. Postoperative fluid collections (<2 weeks) occurred in 83/848 patients (9.8%) and included haematoma (n = 25) and seroma (n = 58). Full recovery was obtained after a mean of 21 ± 12.72 days and work/school/university activities were resumed after a mean of 4 ± 12.02 days. Twelve-, 24- and 60-month follow-ups were possible in 725 (85.5%), 682 (80.4%) and 595 (70.2%) patients out of 848. An overall significant (ꭓ2 = 16.87, P = 0.0002) difference was found in the recurrence rates: 59 recurrences/725 patients (or 8.1%) after 1 year, 89 recurrences/682 patients (or 13.0%) after 2 years and 98 recurrences/595 (or 16.4%) after 5 years. However, when subgrouping patients in three 24-month subsets, the recurrence rates showed a steady and progressive decrease in the three biennia 2011-2012 (group A), 2013-2014 (group B) and 2015-2016 (group C) at 12-, 48- and 60-month follow-ups. Recurrences after 12 months were 29/225 (12.9%), 19/285 (6.7%) and 11/215 (5.1%) (ꭓ2 = 8.53, P = 0.014) in groups A, B and C respectively; after 24 months, 36/226 (15.9%), 31/242 (12.8%) and 22/214 (10.2%) (ꭓ2 = 2.38, P = 0.30 N.S.) in groups A, B and C respectively; after 60 months, 38/194 (19.5%), 36/215 (16.7%) and 24/186 (12.9%) (ꭓ2 = 2.23, P = 0.32) in groups A, B and C respectively. CONCLUSIONS BPE is an effective, disease-targeted, minimally invasive and inexpensive way to treat PD. Its results are influenced by the experience of the team involved, especially regarding early recurrences/failure of surgery. At least 5-year follow-ups are needed to ascertain the outcome of surgery for PD.
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Affiliation(s)
- Luigi Basso
- ‘Pietro Valdoni’ Department of Surgery, Faculty of Medicine and Dentistry, Policlinico ‘Umberto I’‘Sapienza’ University of RomeRomeItaly
| | - Renato Pietroletti
- Surgical Coloproctology, ‘Val Vibrata’ HospitalL'Aquila UniversityTEItaly
| | - Alessandro Micarelli
- ITER Center for Balance and Rehabilitation Research (ICBRR)RomeItaly
- Eurac Research, Institute of Mountain Emergency MedicineBolzanoItaly
| | - Agreta Bicaj
- ‘Pietro Valdoni’ Department of Surgery, Faculty of Medicine and Dentistry, Policlinico ‘Umberto I’‘Sapienza’ University of RomeRomeItaly
| | - Umberto Costi
- ‘Pietro Valdoni’ Department of Surgery, Faculty of Medicine and Dentistry, Policlinico ‘Umberto I’‘Sapienza’ University of RomeRomeItaly
| | - Daniele Crocetti
- ‘Pietro Valdoni’ Department of Surgery, Faculty of Medicine and Dentistry, Policlinico ‘Umberto I’‘Sapienza’ University of RomeRomeItaly
| | - Giuseppe D'Ermo
- ‘Pietro Valdoni’ Department of Surgery, Faculty of Medicine and Dentistry, Policlinico ‘Umberto I’‘Sapienza’ University of RomeRomeItaly
| | - Gaetano Gallo
- Unit of General Surgery and Surgical Oncology, Department of Medicine, Surgery and NeurosciencesUniversity of SienaSienaItaly
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Doublet T, Nosrati M, Kentros CG. Social Learning of a Spatial Task by Observation Alone. Front Behav Neurosci 2022; 16:902675. [PMID: 35910679 PMCID: PMC9325960 DOI: 10.3389/fnbeh.2022.902675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 06/10/2022] [Indexed: 11/16/2022] Open
Abstract
Interactions between conspecifics are central to the acquisition of useful memories in the real world. Observational learning, i.e., learning a task by observing the success or failure of others, has been reported in many species, including rodents. However, previous work in rats with NMDA-receptor blockade has shown that even extensive observation of an unexplored space through a clear barrier is not sufficient to generate a stable hippocampal representation of that space. This raises the question of whether rats can learn a spatial task in a purely observed space from watching a conspecific, and if so, does this somehow stabilize their hippocampal representation? To address these questions, we designed an observational spatial task in a two-part environment that is nearly identical to that of the aforementioned electrophysiological study, in which an observer rat watches a demonstrator animal to learn the location of a hidden reward. Our results demonstrate that rats do not need to physically explore an environment to learn a reward location, provided a conspecific demonstrates where it is. We also show that the behavioral memory is not affected by NMDA receptor blockade, suggesting that the spatial representation underlying the behavior has been consolidated by observation alone.
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Social Sustainability in Production Planning: A Systematic Literature Review. SUSTAINABILITY 2022. [DOI: 10.3390/su14138198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Sustainable production includes economic, environmental, and social aspects. However, social sustainability has received less attention, especially compared to the economic aspects. Next to technical and organizational measures, social improvements within supply chains can also be achieved through suitable production planning. Within production planning, production programs are determined, and the assignment of available resources (e.g., employees) is specified. Thus, the utilization and workload of employees are defined. This systematic literature review investigates to what extent such employee-related social aspects are reflected in production planning and discusses whether economic aspects dominate them. For this, a Scopus database search was carried out and 76 identified approaches were analyzed and categorized regarding the occurring employee-related social aspects and their implementation. Thus far, the approaches mainly consider single aspects on single planning levels. A consideration of a broad set of aspects along the entire production planning has rarely been studied. In particular, health and safety aspects are considered on the levels of assembly line balancing and job rotation. However, their impact is primarily determined by the specific settings of the decision-maker. To support decision-makers, only a few studies have investigated the effects based on real application scenarios. Further potential might be an extended modeling of social and economic interdependencies and a consideration of employee-related social aspects in medium- to long-term production planning.
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Magdy M, Abdel-Monem M, El Dash K. Float loss impact on project cost. INTERNATIONAL JOURNAL OF CONSTRUCTION MANAGEMENT 2022. [DOI: 10.1080/15623599.2020.1740960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Dutt N, Lawrence M. Learning to Manage Breadth: Experience as Repetition and Adaptation. ORGANIZATION SCIENCE 2022. [DOI: 10.1287/orsc.2021.1482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We examine how experience-induced adaptations that affect the breadth of an ongoing activity affect performance. The research on organizational learning suggests that accumulating experience, both from repetition and adaptation at the activity level, improves outcomes. Yet, findings on the effects of increasing breadth—the number of different processes making up an activity—are mixed. Greater breadth exposes organizations to diverse activities. It also generates an additional need for coordination that may undermine performance. We examine the joint effect of experience and breadth on waste reduction for U.S. manufacturing facilities managing their toxic waste from 1991 to 2014. These facilities manage toxic waste on a chemical by chemical basis. We find a detrimental effect of breadth on performance that is highest for facilities with low experience; however, this effect is moderated by experience with the waste management activity. Because most facilities manage toxic waste from several chemicals, we also see spillovers—in terms of both learning benefits and the costs of increasing breadth. When a facility expands waste management breadth anywhere, performance decreases for the focal chemical. Yet, this spillover effect of breadth decreases for activities where the facility has accrued more experience. Our research clarifies when facilities should consider adding breadth to a routine activity and why performance in the proximate period may falter as the organization learns and improves in the longer term.
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Affiliation(s)
- Nilanjana Dutt
- Bocconi University, 20136 Milan, Italy
- Invernizzi Center for Research on Innovation, Organization, Strategy and Entrepreneurship (iCRIOS), 20136 Milan, Italy
| | - Megan Lawrence
- Owen Graduate School of Management, Vanderbilt University, Nashville, Tennessee 37203
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Interaction of Consumer Heterogeneity and Technological Progress in the US Electric Vehicle Market. ENERGIES 2022. [DOI: 10.3390/en15134722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Electric Technology Vehicles (ETVs: hybrid, electric, and plug-in hybrid) may reach price parity with incumbent internal combustion vehicles (ICEVs) in the near future. Climate policy for transportation will depend on the degree to which consumers prefer ETVs, and price parity is a key factor. In this study, we explore the interaction between future cost reductions and the economically motivated adoption of ETVs. We construct a model of the U.S. personal vehicle market accounting for heterogenous use and vehicle preferences, in which adoption induces cost reductions that increase future market share. Model results indicate that price parity is reached for most consumers in a number of cost scenarios, but not with constant ICEV costs and modest ETV cost declines. A price parity future suggests that government support could be temporary and phased out after a successful market transition. However, if ETVs continue to be more expensive than ICEVs, then lasting government support is needed. Heterogeneity is essential to understanding the market transition: treating consumers as heterogeneous results in an ETV market share 23% higher than assuming average consumers. Future work can clarify ETV support policy by resolving uncertainty in cost trajectories and modeling dynamic and heterogenous consumer markets.
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Lu Q, Yang W, Zhou C, Wang N. Analyzing entry strategies for co-opetitive supply chains with the learning effect. JOURNAL OF MODELLING IN MANAGEMENT 2022. [DOI: 10.1108/jm2-11-2021-0266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This study aims to investigate whether the contract manufacturer (CM) should take the first-mover advantage in the end-product without supplying core components to the original equipment manufacturer (OEM) immediately, or should fully squeeze the benefit of the learning effect through an amplified production quantity by letting the OEM enter the end-product market early.
Design/methodology/approach
The authors propose a two-period model for a supply chain consisting of a CM and an OEM where the CM has four alternative entry strategies concerning it competition to the OEM in the end-product market. For each strategy, the authors derive the equilibrium solutions of the two firms using a backward approach. Comparison leads to the CM’s final choices among the four strategies.
Findings
For both CM and OEM, the monopoly and the first-entry strategies will be dominated by either the post-entry or the simultaneous-entry strategy, and thus, their preferred strategy is chosen from the latter two. Regarding the two firms choices between the post- and simultaneous-entry strategy, the CM prefers the post-entry strategy when the OEMs brand premium is at a moderate level, whereas the OEM prefers the post-entry strategy when its brand premium is low, and the learning effect can amplify the interval for the CMs adopting the post-entry strategy as well as changes the interval for the OEMs preference related to the two strategies.
Originality/value
This paper is the first one to explore the optimal strategy for a CM to maximize its profit in a co-opetitive supply chain situation with a CM and an OEM. The authors believe that our paper contributes to both literature and the market.
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Chatenet M, Pollet BG, Dekel DR, Dionigi F, Deseure J, Millet P, Braatz RD, Bazant MZ, Eikerling M, Staffell I, Balcombe P, Shao-Horn Y, Schäfer H. Water electrolysis: from textbook knowledge to the latest scientific strategies and industrial developments. Chem Soc Rev 2022; 51:4583-4762. [PMID: 35575644 PMCID: PMC9332215 DOI: 10.1039/d0cs01079k] [Citation(s) in RCA: 329] [Impact Index Per Article: 109.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Indexed: 12/23/2022]
Abstract
Replacing fossil fuels with energy sources and carriers that are sustainable, environmentally benign, and affordable is amongst the most pressing challenges for future socio-economic development. To that goal, hydrogen is presumed to be the most promising energy carrier. Electrocatalytic water splitting, if driven by green electricity, would provide hydrogen with minimal CO2 footprint. The viability of water electrolysis still hinges on the availability of durable earth-abundant electrocatalyst materials and the overall process efficiency. This review spans from the fundamentals of electrocatalytically initiated water splitting to the very latest scientific findings from university and institutional research, also covering specifications and special features of the current industrial processes and those processes currently being tested in large-scale applications. Recently developed strategies are described for the optimisation and discovery of active and durable materials for electrodes that ever-increasingly harness first-principles calculations and machine learning. In addition, a technoeconomic analysis of water electrolysis is included that allows an assessment of the extent to which a large-scale implementation of water splitting can help to combat climate change. This review article is intended to cross-pollinate and strengthen efforts from fundamental understanding to technical implementation and to improve the 'junctions' between the field's physical chemists, materials scientists and engineers, as well as stimulate much-needed exchange among these groups on challenges encountered in the different domains.
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Affiliation(s)
- Marian Chatenet
- University Grenoble Alpes, University Savoie Mont Blanc, CNRS, Grenoble INP (Institute of Engineering and Management University Grenoble Alpes), LEPMI, 38000 Grenoble, France
| | - Bruno G Pollet
- Hydrogen Energy and Sonochemistry Research group, Department of Energy and Process Engineering, Faculty of Engineering, Norwegian University of Science and Technology (NTNU) NO-7491, Trondheim, Norway
- Green Hydrogen Lab, Institute for Hydrogen Research (IHR), Université du Québec à Trois-Rivières (UQTR), 3351 Boulevard des Forges, Trois-Rivières, Québec G9A 5H7, Canada
| | - Dario R Dekel
- The Wolfson Department of Chemical Engineering, Technion - Israel Institute of Technology, Haifa, 3200003, Israel
- The Nancy & Stephen Grand Technion Energy Program (GTEP), Technion - Israel Institute of Technology, Haifa 3200003, Israel
| | - Fabio Dionigi
- Department of Chemistry, Chemical Engineering Division, Technical University Berlin, 10623, Berlin, Germany
| | - Jonathan Deseure
- University Grenoble Alpes, University Savoie Mont Blanc, CNRS, Grenoble INP (Institute of Engineering and Management University Grenoble Alpes), LEPMI, 38000 Grenoble, France
| | - Pierre Millet
- Paris-Saclay University, ICMMO (UMR 8182), 91400 Orsay, France
- Elogen, 8 avenue du Parana, 91940 Les Ulis, France
| | - Richard D Braatz
- Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - Martin Z Bazant
- Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
- Department of Mathematics, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
| | - Michael Eikerling
- Chair of Theory and Computation of Energy Materials, Division of Materials Science and Engineering, RWTH Aachen University, Intzestraße 5, 52072 Aachen, Germany
- Institute of Energy and Climate Research, IEK-13: Modelling and Simulation of Materials in Energy Technology, Forschungszentrum Jülich GmbH, 52425 Jülich, Germany
| | - Iain Staffell
- Centre for Environmental Policy, Imperial College London, London, UK
| | - Paul Balcombe
- Division of Chemical Engineering and Renewable Energy, School of Engineering and Material Science, Queen Mary University of London, London, UK
| | - Yang Shao-Horn
- Research Laboratory of Electronics and Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - Helmut Schäfer
- Institute of Chemistry of New Materials, The Electrochemical Energy and Catalysis Group, University of Osnabrück, Barbarastrasse 7, 49076 Osnabrück, Germany.
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The Science Behind the Learning Curve. Indian J Surg 2022. [DOI: 10.1007/s12262-022-03452-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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