Execution Plan Research Articles

CORPORATE GOVERNANCE, INVESTMENT STRATEGY, MACROECONOMIC VARIABLES AND FINANCIAL PERFORMANCE OF PENSION SCHEMES IN KENYA

<p>The study investigated the impact of corporate governance (CG), investment strategy (IS) and macroeconomic variables on the financial performance of pension schemes in Kenya, thereby addressing the key research question: What is the effect of CG, IS and macroeconomic variables on the financial performance of pension funds in Kenya? Qualitative, quantitative and correlational research designs were used to assess the effect of these factors on the financial performance of pension funds. Quantitative data on the annual return of pension funds and macroeconomic variables from 2012 to 2020, as well as qualitative data on CG indicators and IS, were used in the study. Return on investments proxied pension fund performance. Primary data was collected using survey questionnaires from the pension schemes from both the CG and IS indicators to develop both CG and IS indices. The findings show that CG, as well as IS and macroeconomic variables, impact pension funding differently. The effect of CG indicators on pension performance was positive and significant. The intervening effect of IS on the link between CG and pension performance was significant, while the moderating effect of macroeconomic variables was significant. The individual contribution of both CG indicators and macroeconomic factors on pension performance, nonetheless, varied. The main conclusion of the study is that pension fund financial performance is influenced by CG, IS and macroeconomic factors implying that there is a need to take into account the impact of these factors in the execution of investment plans of pension funds to ensure the generation of adequate funds for retirement benefits.</p><p> </p><p><strong>JEL: </strong>G23, G32, G34, E44, O55<strong></strong></p><p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0715/a.php" alt="Hit counter" /></p>

PROMOTING INNOVATIVE ACTIVITIES THROUGH ADVANCED MANAGEMENT AND FINTECH MODELS

Global economy is undergoing profound changes, impacting people's lives, businesses, and competitive landscapes. These shifts are driven by globalisation, continuous socio-economic development, the growing role of knowledge in the economy, and the intensified development and expansion of the European Union. In this evolving environment, new business models are becoming increasingly significant. Business and markets are no longer constrained by geographical boundaries. Products that were once confined to national markets are now exposed to international competition. With the removal of geographical restrictions, global markets for goods and services have essentially become operational around the clock. In response to these new challenges, companies adapt in different ways to new management and financial regulatory frameworks. To address the competitive challenges and increased competition, companies may choose to apply one or more business models that influence their overall performance. However, in the catering sector, particularly during the COVID-19 pandemic and quarantine periods, small and medium-sized enterprise managers have often neglected modern business management techniques, strategic planning, and company management. These elements are crucial for maintaining economic stability, forecasting future trends, addressing emerging issues, and safeguarding against factors that threaten business success and continuity. Recognising the increasing importance of strategic planning and management, alongside the need for scientific research and evidence-based recommendations, it has become essential to analyse a company's strategic position and its operational capabilities within this field. Every organisation must have a clear understanding of its current identity and future aspirations. For an organisation to grow and achieve its objectives successfully, it must employ advanced management methodologies and establish a well-defined strategy – a well-defined operational system. While setting goals can be straightforward, their realisation is significantly more complex. Once a company’s strategy is defined, it requires careful implementation. An action plan must be created to ensure the strategy's success, including budgeting, the development of an effective implementation mechanism, and tools for monitoring and evaluating the quality and progress of the plan. Employees responsible for specific strategy points and plan execution must be assigned. These are the next essential steps for the organisation. The key to success lies in responding swiftly to the ever-changing business environment and adjusting strategic directions and implementation measures as needed with a particular focus on strategic change management and the introduction of new, innovative management methodologies.

Exploring the dynamics of social roles in hospital evacuation: Factors, roles and behaviors

As a critical city facility of our society, it is important for hospitals to be resilient against emergencies for a health imperative and economic buoyancy. Understanding the evacuation behaviors of hospital roles and the corresponding influencing factors is essential for the accurate execution of emergency response plans and well-being. Therefore, this study aims to explore the dynamics of social roles in hospital evacuation by understanding the mediation effects of role evolution factors (i.e., responsibility, competence, and expectation of evacuation roles). Questionnaires on hospital roles, role evolution factors, and evacuation behaviors were designed and distributed, with a total of 324 responses from various hospital occupants. The common method variance analysis, internal consistency test, item analysis, and exploratory factor analysis consistently indicated good reliability and validity of the questionnaire. Chain mediation models of three prominent evacuation roles, namely leader, emergency responder, and follower were developed, with the three role evolution factors as mediating variables, evacuation behavior as the dependent variable, and hospital role as the independent variable. Findings indicated significant path effects of hospital roles and role evolutionary factors on leadership, emergency responding, and following behaviors. One-way ANOVA on egocentric behavior and hesitant behavior of hospital roles revealed that patients have a higher propensity for negative behaviors compared with hospital staff. In light of the findings, the subtle relationship between hospital roles, role evolution factors, and evacuation behaviors was revealed. Role-specific leadership training, role-based emergency response management, role-related following behavior guidance, and negative behavior reduction measures were proposed for improving hospital safety.

Dynamics of Saccade Trajectory Modulation by Distractors: Neural Activity Patterns in the Frontal Eye Field.

The sudden appearance of a visual distractor shortly before saccade initiation can capture spatial attention and modulate the saccade trajectory in spite of the ongoing execution of the initial plan to shift gaze straight to the saccade target. To elucidate the neural correlates underlying these curved saccades, we recorded from single neurons in the frontal eye field of two male rhesus monkeys shifting gaze to a target while a distractor with the same eccentricity appeared either left or right of the target at various delays after target presentation. We found that the population level of presaccadic activity of neurons representing the distractor location encoded the direction of the saccade trajectory. Stronger activity occurred when saccades curved toward the distractor, and weaker when saccades curved away. This relationship held whether the distractor was ipsilateral or contralateral to the recorded neurons. Meanwhile, visually responsive neurons showed asymmetrical patterns of excitatory responses that varied with the location of the distractor and the duration of distractor processing relating to attentional capture and distractor inhibition. During earlier distractor processing, neurons encoded curvature toward the distractor. During later distractor processing, neurons encoded curvature away from the distractor. This was observed when saccades curved away from distractors contralateral to the recording site and when saccades curved toward distractors ipsilateral to the recording site. These findings indicate that saccadic motor planning involves dynamic push-pull hemispheric interactions producing attraction or repulsion for potential but unselected saccade targets.

Water Access and Peace Transition Through Governance Regimes: A Cross-Case Study from Colombian Hydropower Industry

Hydroelectric power is part of the global energy transition policy, but its production in Colombia requires more collaborative solutions to social conflicts. This research aims to analyze watersheds’ governance as a collaborative framework using a cross-case study based on 53 interviews with the hydropower industry stakeholders in Colombia to describe issues, players, and tools in the context of conflict because of water access complications and violent struggle situations. The results exhibited water consumption complications and land use conflicts caused by the economic sectors of energy and agriculture. The identified transition to peace and the energy industry’s interdependency with the territory are favorable issues for a fairer energy transition to renewables. Governance regimes contribute more to planning and joint execution than evaluation in facing two significant challenges: (1) assessing the impact of the hydropower industry and (2) reducing the asymmetry between players. The research contributes to the energy transition policy with a comprehensive governance framework to better understand the interdependence between the hydropower industry and watersheds in conflict contexts.

The Relationship between Building Information Modeling (BIM) and Precast Concrete Structures

Due to the fact that a major part of the financial resources of each country is spent in the construction industry of that country, the effectiveness of governments from this industry, especially in developing countries, is very high. In recent years, it has been noticed in the world. Among the advantages of using the prefabricated industry, we can mention the production of parts in a short period of time, low cost and high quality. Currently, many projects undergo such changes that it is necessary to reduce the negative effects imposed on projects by using management techniques and tactics as well as the use of modern technologies. Among the negative effects imposed, we can mention things such as capital wastage (increase in cost), increase in construction time, and at the same time decrease in quality. At the same time, all construction management activities, based on the contract documents, depend on the two categories of plans and project specifications. In the traditional methods of construction management, various executive plans such as structural, architectural and facility plans are prepared separately but in coordination with each other. These maps are two-dimensional and even if three-dimensional maps are prepared from them, the system will not be able to identify mistakes, interferences and changes. The purpose of this article is to examine the relationship between building information modeling and precast concrete structures and the implementation of that system in precast concrete structures.

Tao: Improving Resource Utilization while Guaranteeing SLO in Multi-tenant Relational Database-as-a-Service

It is an open challenge for cloud database service providers to guarantee tenants' service-level objectives (SLOs) and enjoy high resource utilization simultaneously. In this work, we propose a novel system Tao to overcome it. Tao consists of three key components: (i) tasklet-based DAG generator, (ii) tasklet-based DAG executor, and (iii) SLO-guaranteed scheduler. The core concept in Tao is tasklet, a coroutine-based lightweight execution unit of the physical execution plan. In particular, we first convert each SQL operator in the traditional physical execution plan into a set of fine-grained tasklets by the tasklet-based DAG generator. Then, we abstract the tasklet-based DAG execution procedure and implement the tasklet-based DAG executor using C++20 coroutines. Finally, we introduce the SLO-guaranteed scheduler for scheduling tenants' tasklets across CPU cores. This scheduler guarantees tenants' SLOs with a token bucket model and improves resource utilization with an on-demand core adjustment strategy. We build Tao on an open-sourced relational database, Hyrise, and conduct extensive experimental studies to demonstrate its superiority over existing solutions.

Project approach to control system creating for modernizing traffic control at territorial communities’ reconstruction

The reform of urban planning activities has opened up opportunities to apply a modern approach to the strategic planning of territorial community development by developing and implementing the Concept of Integrated Territorial Development (CITD) of the territorial community, as well as sectoral plans for the implementation of specific CITD priorities. One of these priorities is the creation of a sustainable transportation system for the community that provides residents with high-quality transportation services, minimizes environmental harm, and ensures long-term socio-economic benefits. To achieve this, a Sustainable Urban Mobility Plan (SUMP) is developed and implemented, which includes, among other things, the modernization of traffic control. The full-scale military aggression against Ukraine has necessitated a reevaluation of the concept of sustainable mobility and the implementation of measures to adapt it to the requirements of military and post-war community recovery. The focus is now on the resilience of territorial communities to critical situations (shock events) related to military actions and ongoing threats from the aggressor. Particular attention must be given to large cities, which represent one of the strategic targets for the aggressor. The proposed article examines the peculiarities of implementing a traffic control management modernization project for the military and the post-war recovery of a territorial community in accordance with the principles of sustainable mobility. It justifies the need to develop a version of the SUMP that includes scenarios for the development of sustainable mobility tailored to the requirements of military and post-war recovery. Three main directions are proposed for the implementation of the road traffic management system's responsibilities in developing the transportation system of the territorial community: soft measures, hard measures, and measures to enhance the transportation resilience of the territorial community. The study concludes that there is a need to develop new indicators that characterize the transportation resilience of territorial communities. conducting a SWOT analysis of the strengths and weaknesses of communities and their mobility, considering the impacts of military aggression; adjusting existing SUMPs and developing new ones, particularly for large cities and border communities; adjusting the composition, structure, and functions of the traffic management system to ensure effective current mobility management in response to existing challenges and threats; implementing and providing technical support for the execution of traffic control schemes and traffic signal timing plans according to scenarios that address critical moments (shock events); applying methodologies for managing territorial infrastructure projects with a focus on digitizing traffic control processes.

Revisiting block deordering in finite-domain state variable planning

Plan deordering removes unnecessary ordering constraints between actions in a plan, facilitating plan execution flexibility and several other tasks, such as plan reuse, modification, and decomposition. Block deordering is a variant of plan deordering that encapsulates coherent actions into blocks to eliminate further ordering constraints from a partial-order plan (POP) and is useful in many applications (e.g., generating macro-actions and improving the overall plan quality). The existing block deordering strategy is formulated in propositional encodings. Finite-domain state variable encodings (e.g., SAS+ representation), in contrast with propositional encodings, can capture the internal structure and the behavior of state variables of a planning instance through concise constructs such as causal graphs (CGs) and domain transition graphs (DTGs). This work redefines the semantics of block deordering terminologies and related plan deordering concepts in finite domain representation (FDR). Our proposed semantics also resolves some limitations of the existing block semantics and further enhance plan flexibility. In addition, this work exploits block deordering to eliminate redundant actions from a POP. A comparative analysis is also performed on block deordering with various deordering/reordering techniques using explanation-based order generalization (EOG) and MaxSAT. Our experiments on the benchmark problems from International Planning Competitions (IPC) show that our FDR formalism of block deordering significantly improves the plan execution flexibility while maintaining good coverage and execution time.

IMPLEMENTASI DIGITAL MARKETING PADA BUMDES MEKAR SEJAHTERA DENGAN CRITICAL SUCCESS FAKTOR DAN VALUE CHAIN

The implementation of Digital Marketing in Village-Owned Enterprises (BUMDes) Mekar Sejahtera aims to improve marketing performance and business competitiveness through the implementation of Critical Success Factors (CSF) and Value Chain. The study identifies and analyzes the key elements that influence the successful implementation of digital marketing strategies, as well as integrating them in a structured framework. In this study, data collection was carried out using two types of data: primary data and secondary data. Primary data was obtained through direct interviews and surveys with managers of Mekar Sejahtera BUMDes, while secondary data was obtained through analysis of relevant literature and similar case studies from other BUMDes that have implemented digital marketing. The research method used in this study is a qualitative method, which is a research approach used to understand social phenomena in a deep and descriptive way, focusing on the meaning contained in it. The results of the study show that there are several important factors that greatly affect the success of digital marketing in BUMDes Mekar Sejahtera, including: adequate technological infrastructure, competent human resources, effective content management, and appropriate promotion strategies. In addition, the integration of the value chain, starting from raw material procurement, production, distribution, to customer service, also plays an important role in improving the efficiency and effectiveness of digital marketing. The implementation of good digital marketing can increase the visibility of BUMDes Mekar Sejahtera products, expand market reach, and increase sales. However, the challenges faced include budget constraints, resistance to change, and the need for ongoing training for managers. Therefore, strategic recommendations include the development of adequate digital infrastructure, increasing the capacity of human resources through training and mentoring, and strengthening collaboration with external parties such as the government and the private sector. This study concludes that the application of CSF and Value Chain in the development of digital marketing in BUMDes Mekar Sejahtera can have a significant positive impact, as long as it is carried out with careful planning and consistent execution. This research is expected to be a reference for other BUMDes in adopting effective and sustainable digital marketing strategies. Keywords: Critical Succes Factor, Value Chain, Digital Marketing.

Breaking the CO2 Gridlock: Can Renewables Lead the Way for the OECD?

The use of low-carbon energy in power grids is essential for minimizing negative effects on the environment. Energy consumption causes environmental damage to the OECD’s economy. This study aims to investigate the effect of energy consumption, population, and GDP on CO2 emissions using panel data from 17 OECD countries over the period 2000–2023. We use regression approaches, such as partial least squares and principal components, to study the effects of GDP, urban and total population, oil and nuclear use, renewable energy, and industrialization on CO2 emissions. The regression process in this study reduces the data to a two-dimensional representation using a stochastic model and estimation techniques. The findings of this empirical investigation indicate that the United States, Canada, France, Germany, Italy, Korea, Mexico, and the United Kingdom exhibit higher levels of primary energy consumption in comparison to value-added sectors, renewable–geothermal energy, and nuclear energy. We determined the effects of CO2 emissions, GDP, and energy consumption by considering these as the most significant elements. This has made it possible to reduce CO2 emissions by focusing one’s attention and energy on the development of novel technologies, the use of renewable energy sources, and the execution of strategic plans. Attracting increasing attention are technological shifts that deliver enormous quantities of clean energy to combat climate change. Findings from this study can help environmentalists and policymakers better understand the role of structural change and energy consumption processes in the globalization process.

The current role of CT in total knee arthroplasty.

Advanced 3D imaging and CT-based navigation have emerged as valuable tools to use in total knee arthroplasty (TKA), for both preoperative planning and the intraoperative execution of different philosophies of alignment. Preoperative planning using CT-based 3D imaging enables more accurate prediction of the size of components, enhancing surgical workflow and optimizing the precision of the positioning of components. Surgeons can assess alignment, osteophytes, and arthritic changes better. These scans provide improved insights into the patellofemoral joint and facilitate tibial sizing and the evaluation of implant-bone contact area in cementless TKA. Preoperative CT imaging is also required for the development of patient-specific instrumentation cutting guides, aiming to reduce intraoperative blood loss and improve the surgical technique in complex cases. Intraoperative CT-based navigation and haptic guidance facilitates precise execution of the preoperative plan, aiming for optimal positioning of the components and accurate alignment, as determined by the surgeon's philosophy. It also helps reduce iatrogenic injury to the periarticular soft-tissue structures with subsequent reduction in the local and systemic inflammatory response, enhancing early outcomes. Despite the increased costs and radiation exposure associated with CT-based navigation, these many benefits have facilitated the adoption of imaged based robotic surgery into routine practice. Further research on ultra-low-dose CT scans and exploration of the possible translation of the use of 3D imaging into improved clinical outcomes are required to justify its broader implementation.

Machine learning approaches to predict the execution time of the meteorological simulation software COSMO

AbstractPredicting the execution time of weather forecast models is a complex task, since these models are usually performed on High Performance Computing systems that require large computing capabilities. Indeed, a reliable prediction can imply several benefits, by allowing for an improved planning of the model execution, a better allocation of available resources, and the identification of possible anomalies. However, to make such predictions is usually hard, since there is a scarcity of datasets that benchmark the existing meteorological simulation models. In this work, we focus on the runtime predictions of the execution of the COSMO (COnsortium for SMall-scale MOdeling) weather forecasting model used at the Hydro-Meteo-Climate Structure of the Regional Agency for the Environment and Energy Prevention Emilia-Romagna. We show how a plethora of Machine Learning approaches can obtain accurate runtime predictions of this complex model, by designing a new well-defined benchmark for this application task. Indeed, our contribution is twofold: 1) the creation of a large public dataset reporting the runtime of COSMO run under a variety of different configurations; 2) a comparative study of ML models, which greatly outperform the current state-of-practice used by the domain experts. This data collection represents an essential initial benchmark for this application field, and a useful resource for analyzing the model performance: better accuracy in runtime predictions could help facility owners to improve job scheduling and resource allocation of the entire system; while for a final user, a posteriori analysis could help to identify anomalous runs.

The Goal after Tomorrow: Offline Goal Reasoning with Norms

Recent studies have focused on autonomous agents that select their own goals and then select actions to achieve these goals, using online Goal Reasoning (GR). GR agents can revise goals and plans at execution time if unexpected outcomes occur. However, for ethical or legal agent design, even the partial execution of an online plan may result in foreseeable norm violations. To prevent these violations, it is crucial to incorporate GR already at the planning phase. To this end, we design an offline GR system that can harbour normative systems or deontic logics for goal generation. Our main results include a characterization and comparison of the completeness classes for a variety of offline GR planners, and a discussion of the irreducibility of offline GR to pure planning methods.

Navigating Mergers and Demergers in the Technology Sector: A Guide to Managing Change and Integration

In the dynamic landscape of the technology sector, mergers and demergers have become pivotal events that significantly impact organizational structures, strategic directions, and operational efficiencies. This guide delves into the intricacies of navigating these complex transitions, focusing on managing change and ensuring effective integration. The technology sector's rapid evolution necessitates a nuanced understanding of how mergers and demergers can be strategically orchestrated to achieve desired outcomes while mitigating potential risks.The process of merging or demerging involves numerous challenges, including cultural integration, alignment of business processes, and harmonization of technological systems. Successful management of these transitions requires a comprehensive strategy that encompasses clear communication, meticulous planning, and robust execution. This guide outlines key strategies for managing change during these transformative periods, emphasizing the importance of leadership, stakeholder engagement, and the adoption of best practices.

Navigating Mergers and Demergers in the Technology Sector: A Guide to Managing Change and Integration

In the dynamic landscape of the technology sector, mergers and demergers have become pivotal events that significantly impact organizational structures, strategic directions, and operational efficiencies. This guide delves into the intricacies of navigating these complex transitions, focusing on managing change and ensuring effective integration. The technology sector's rapid evolution necessitates a nuanced understanding of how mergers and demergers can be strategically orchestrated to achieve desired outcomes while mitigating potential risks. The process of merging or demerging involves numerous challenges, including cultural integration, alignment of business processes, and harmonization of technological systems. Successful management of these transitions requires a comprehensive strategy that encompasses clear communication, meticulous planning, and robust execution. This guide outlines key strategies for managing change during these transformative periods, emphasizing the importance of leadership, stakeholder engagement, and the adoption of best practices.

Study of the technical parameters dynamics influence on operational performance of hydraulic single-bucket excavators

Introduction. The development of automobile and road construction is a priority in the Russian economy. Timely putting construction projects in commission increases the requirements for planning of execution mechanized works. The operation of transport and technological machines in construction processes for a long time leads to a decrease in their potential capabilities, including operational productivity. The purpose of the proposed article is to improve the method of calculating the performance of a single-bucket hydraulic excavator (EO), taking into account the operating time.Methods and materials. The performance calculation method takes into account the dynamics of the working pressure in the hydraulic system of the working equipment (GRO), the speed of rotation of the crankshaft (PMVC) from the operating time, regression dependencies were used to describe them. The parameters of the law of distribution of the random value of the working pressure in the hydraulic drive and the rate of its fall for the ‘development and recruitment of soil’ operation were also obtained.Results. Processing of the results of production experiments enables to establish the dependence of changes in the working pressure in the hydraulic system during development and gathering soil, as well as for all technological operations of the working cycle, the rotational frequency of the crankshaft of a single-bucket excavator engine on the operating time. The influence of the working pressure in the hydraulic drive, the rotational speed of the crankshaft of the excavator engine on the supply and hydraulic power, the duration of technological operations is studied. The calculation of the operational productivity of a single-bucket excavator is carried out taking into account the dynamics of parameters reflecting its change over operating time.Discussion and conclusions. It has been established that with an increase in operating time, the operating pressure in the hydraulic drive decreases by an average of 12.7-13.0%, and the decrease in the average operating speed of the crankshaft is 4%. The estimated value of the drop in the average hourly operating performance of the EO, taking into account the deterioration of the technical condition, is 55% in the operating time range from 0 to 10,000 operating hours for the Japanese EO ZX 330 model.

Multi-scale closed-loop coupled real-time water quantity optimization scheduling of cascade pumping station in water supply canal systems

Closed-loop control is an effective control method to deal with uncertain disturbance in water supply canal system (WSCS). However, previous researches mainly focus on closed-loop control with a single time scale, and it is difficult to solve the uncertainty problem with a long time dimension. In this paper, a multi-scale closed-loop coupled real-time scheduling framework is established and solved by considering both large and small scale closed-loop scheduling models, so as to improve the performance of real-time scheduling in a longer time dimension under uncertain perturbations. The framework is applied to the virtual simulation test of the Xuhong River WSCS of the east route of the South-to-North Water Diversion project under different water distribution disturbances. The results show that the closed-loop control method can update the system status regularly through rolling optimization, and effectively reduce the prediction error of water level and energy consumption. In the two water distribution disturbance scenarios, the proposed method reduces the average relative deviation of water supply plan execution by 3.4 % and 5.9 %, and the unit energy consumption of cascade pumping station operation by 1.7 kWh/104m3 and 1.5 kWh/104m3, respectively, compared with the single-scale closed-loop scheduling method. In addition, the proposed method can effectively deal with the uncertainty of water distribution disturbance in limited computing time, and can meet the requirements of real-time scheduling in a long time dimension under uncertain disturbance.

Barriers to the Integration of Building Information Modeling (BIM) in Modular Construction in Sub-Saharan Africa

The construction industry is constantly evolving through government policies, technologies, and innovative processes. BIM and modular construction are innovative concepts aimed at achieving sustainable smart cities by enhancing cost performance, efficiency, and sustainability. Despite growing global interest in their integration, there is a notable knowledge gap in sub-Saharan Africa. As a result, this research aims to explore the barriers to integrating BIM into modular construction in sub-Saharan Africa. The study adopted a non-experimental design, using a four-stage methodological framework. Initially, a literature review was carried out to conceptualize the study. Stage two involves a pilot survey to create an adequate data collection instrument. In the third stage, 81 registered companies were purposely selected, and data was collected through an online survey. Finally, the fourth stage uses descriptive and inferential techniques to make logical and informed conclusions. The top-ranked barriers are high initial costs, insufficient cross-field expertise, stakeholder collaboration problems, limited software interoperability, and skills shortages. Recommendations include early stakeholder collaboration, BIM execution plan development by modular companies, improved staff training, and increasing financial support from the government. Future research should explore country-specific barriers and case studies to aid the integration of the two innovative solutions in the region.

'Extended' restricted kinematic alignment results in decreased residual medial gap tightness among osteoarthritic varus knees during robotic-assisted total knee arthroplasty.

The aims of this study were: 1) to describe extended restricted kinematic alignment (E-rKA), a novel alignment strategy during robotic-assisted total knee arthroplasty (RA-TKA); 2) to compare residual medial compartment tightness following virtual surgical planning during RA-TKA using mechanical alignment (MA) and E-rKA, in the same set of osteoarthritic varus knees; 3) to assess the requirement of soft-tissue releases during RA-TKA using E-rKA; and 4) to compare the accuracy of surgical plan execution between knees managed with adjustments in component positioning alone, and those which require additional soft-tissue releases. Patients who underwent RA-TKA between January and December 2022 for primary varus osteoarthritis were included. Safe boundaries for E-rKA were defined. Residual medial compartment tightness was compared following virtual surgical planning using E-rKA and MA, in the same set of knees. Soft-tissue releases were documented. Errors in postoperative alignment in relation to planned alignment were compared between patients who did (group A) and did not (group B) require soft-tissue releases. The use of E-rKA helped restore all knees within the predefined boundaries, with appropriate soft-tissue balancing. E-rKA compared with MA resulted in reduced residual medial tightness following surgical planning, in full extension (2.71 mm (SD 1.66) vs 5.16 mm (SD 3.10), respectively; p < 0.001), and 90° of flexion (2.52 mm (SD 1.63) vs 6.27 mm (SD 3.11), respectively; p < 0.001). Among the study population, 156 patients (78%) were managed with minor adjustments in component positioning alone, while 44 (22%) required additional soft-tissue releases. The mean errors in postoperative alignment were 0.53 mm and 0.26 mm among patients in group A and group B, respectively (p = 0.328). E-rKA is an effective and reproducible alignment strategy during RA-TKA, permitting a large proportion of patients to be managed without soft-tissue releases. The execution of minor alterations in component positioning within predefined multiplanar boundaries is a better starting point for gap management than soft-tissue releases.