Secondary Analysis of a James Lind Alliance Priority Setting Partnership to Facilitate Knowledge Translation in Degenerative Cervical Myelopathy (DCM): Insights from AO Spine RECODE-DCM

OBJECTIVES: To explore whether a James Lind Alliance Priority Setting Partnership could provide insights on knowledge translation within the field of degenerative cervical myelopathy (DCM). DESIGN: Secondary analysis of a James Lind Alliance Priority Setting Partnership process for DCM. PARTICIPANTS AND SETTING: DCM stake holders, including spinal surgeons, people with myelopathy and other healthcare professionals, were surveyed internationally. Research suggestions submitted by stakeholders but considered answered were identified. Sampling characteristics of respondents were compared with the overall cohort to identify subgroups underserved by current knowledge translation. RESULTS: The survey was completed by 423 individuals from 68 different countries. A total of 22% of participants submitted research suggestions that were considered \u27answered\u27. There was a significant difference between responses from different stakeholder groups (p CONCLUSIONS: Knowledge translation challenges exist within DCM. This practical approach to measuring knowledge translation may offer a more responsive assessment to guide interventions, complementing existing metrics

Drying colloidal systems: laboratory models for a wide range of applications

The drying of complex fluids provides a powerful insight into phenomena that take place on time and length scales not normally accessible. An important feature of complex fluids, colloidal dispersions and polymer solutions is their high sensitivity to weak external actions. Thus, the drying of complex fluids involves a large number of physical and chemical processes. The scope of this review is the capacity to tune such systems to reproduce and explore specific properties in a physics laboratory. A wide variety of systems are presented, ranging from functional coatings, food science, cosmetology, medical diagnostics and forensics to geophysics and art

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Representação em espaço de estados para a flexibilidade de roteamento Routing flexibility using state space representation

Este artigo descreve uma representação em espaço de estados para a flexibilidade de roteamento em sistemas de manufatura. A flexibilidade de roteamento é representada em três níveis de detalhamento, como segue: (i) grafo de precedências; (ii) grafo de transição de estados para a flexibilidade de seqüência; e (iii) grafo de transição de estados para a flexibilidade de roteamento. A terceira representação é a mais completa, sendo capaz de enumerar todas as possíveis rotas de uma peça no sistema de manufatura. Neste artigo ainda, será abordada a relação entre a representatividade e complexidade computacional para cada representação, auxiliando o processo de seleção do nível de representação mais adequado a um determinado contexto. A versatilidade desta representação permite que esta seja facilmente vinculada a outras ferramentas de análise e apoio, para o controle e projeto de sistemas flexíveis de manufatura, permitindo que estes sejam devidamente avaliados, compreendidos e mensurados. Por fim, a eficácia da representação é demonstrada por meio de sua aplicação em problemas de roteamento e mensuração da flexibilidade em sistemas de manufatura.<br>This paper describes a state space representation for routing flexibility in manufacturing systems. Routing flexibility is represented on three different levels, as follows: (i) Operations Precedence Graph; (ii) State Transition Graph of Manufacturing Operation Sequences; and (iii) State Transition Graph of Manufacturing Operation Routes. Each representation is able to represent routing flexibility in different degrees of detail. The third and most complete representation can enumerate all the possible manufacturing operation routes for a given part in the manufacturing system. Bounds for the computation of the representation levels are presented to help the user select the most suitable one for a given context. The versatility of this representation allows it to be linked easily with other analytical and support tools for the to design, operation, and control of flexible manufacturing systems, so that manufacturing flexibility can be properly measured, understood, and evaluated. The efficacy of the representation is demonstrated through its application to problems such as job route selection and routing flexibility measurement in manufacturing systems