[Accreditation and dedication in coloproctology is associated with good perioperative care]. / La acreditación y dedicación en coloproctología se asocian a buenos cuidados perioperatorios.

UNLABELLED: Complex data analysis methods require optimisation techniques such as evolutionary algorithms in order to generate reliable results. The objective of this study is to analyse the relationships of particular perioperative care in colorectal surgery (CRS) with surgeon epidemiological data, performing partition grouping to look for significant relationships. METHODS: Data were used from a survey of members of Spanish coloproctology associations on perioperative care in colorectal surgery, and analysing the responses associated with mechanical bowel preparation (MBP), nasogastric intubation (NGI), drainages (D), and early feeding (EF), over the existing scientific evidence (SE) which shows that the first ones are unnecessary and the importance of the last one. We applied a variant of particle swarm optimization (PSO), to group data conglomerates, optimising variables with statistical grouping criteria. RESULTS: A total of 130 surveys were analysed, finding 2 clear groups which included 21.5% and 78.5% of the sample, respectively. Sixty eight per cent of the surgeons in Group A belonged to the European Board in Coloproctology, compared to none in Group B, and the former performed 80% of the coloproctology activity, compared to 60% of the rest. A responded homogeneously to questions on MBP, NGI, D and EF, those of group A following the SE, while the others did it randomly and without following it. Age, work position or academic range were not significant in the grouping. CONCLUSIONS: The evolutionary algorithm was shown to be able to identify groups according to the use of perioperative care in CRS. Accreditation and dedication was associated with behaviour based on the SE.

A risk evaluation framework for the best maintenance strategy: The case of a marine salt manufacture firm.

This paper intends to contribute with a multi-criteria decision-making (MCDM) framework to support risk evaluation for maintenance activities carried out on critical systems in industry. We propose to first select the best maintenance strategy tailored to companies' requirements and systems' features, and second to perform a risk prioritisation aimed at highlighting priorities of intervention. The Analytic Network Process (ANP) is suggested to select the maintenance policy representing the best trade-off considering the complex and varied interdependencies amongst a diversity of clustered elements characterising the system. Then, the main risks related to the interventions associated to the selected maintenance policy are ranked using the ELimination Et Choix Traduisant la REalité III (ELECTRE III) method, using the same criteria weighted by the previous ANP application. This hybrid MCDM framework is applied to a core subsystem of a real-world marine salt manufacture firm.

Intraocular pressure in myopic patients after Worst-Fechner anterior chamber phakic intraocular lens implantation.

PURPOSE: To assess intraocular pressure measured with a Goldmann tonometer over a period of 1 year after implantation of a Worst-Fechner anterior chamber phakic intraocular lens to correct myopia of -7.00 D or more. METHODS: We performed a prospective, non-masked study of 100 patients (100 myopic eyes) who had a Worst-Fechner phakic intraocular lens implanted to correct myopia of -7.00 D or greater. Central corneal Goldmann tonometry was performed before surgery and 1, 3, 6, and 12 months after surgery. The influence of different variables was assessed. RESULTS: IOP showed a significant increase of a mean 2.1 mmHg at 3 months after surgery (P=.001). There was not a statistically significant difference between IOP before surgery and 6 months after PIOL implantation (P=.244) or 1 year after surgery (P=.845). In one eye, the lens was explanted 11 months after surgery because of the presence of ocular hypertension. No variables studied showed a statistically significant difference from before to after surgery. CONCLUSIONS: Worst-Fechner anterior chamber phakic intraocular lens implantation led to a slight transitory increase of intraocular pressure during the first 3 months after surgery, but returned to preoperative levels by 6 months after implantation.