bluuebunny/crossref_metadata_2025 huggingface dataset:
Dynamical Complexities of a Discrete Ivlev-Type Predator-Prey System
Authors: Rana Sarker Md. Sohel
Published: February 2023

In this study, we examine a discrete predator-prey system from the following two perspectives: (i) the functional response is of the Ivlev type and (ii) the prey growth rate is of the Gompertz type. We define the stability requirement for feasible fixed points. We demonstrate algebraically that if the bifurcation (control) parameter rises over its threshold value, the system encounters flip and Neimark–Sacker (NS) bifurcations in the vicinity of the interior fixed point. We explicitly establish the existence requirements and direction of bifurcations via the center manifold theory. Analytical findings are validated by numerical simulations, which are used to highlight the occurrence of instability and chaotic dynamics in the system. In order to regulate the chaotic trajectories that exist in the system, we adopt a feedback control approach.
Pro-Poor Hydraulic Governmentality: Sustainable Water Management and Local Livelihoods in Mekong Delta
Authors: Zhu Jinsheng Jason , Liu Zhiyong
Published: February 2023

This article considers and adds empirical nuances to the recent conceptualization of pro-poor water management. Using the concept of pro-poor hydraulic governmentality along the Vietnam-Cambodia border of Thường Phước commune, we argue that water management is linked to local rural livelihoods in a complex and dynamic pro-poor mechanism. While certain policies organize local populations according to cost-effectiveness ignoring local customs, the practicalities of dealing with such constraints are much more ambivalent. This article demonstrates the structural pro-poor complexity among sand excavation, riverbank landslides, water management, local livelihoods, and populace resettlement. The government’s resettlement plans and the perceptions of residents of these plans are intertwined with a wider political, economic, social, and cultural significance in the context of strong institutional power in Vietnam. Limitations and future research agenda are also indicated in the discussion and conclusion section.
Relationship between Platelet-to-Lymphocyte Ratio and Lymphocyte-to-Monocyte Ratio with Spontaneous Preterm Birth: A Systematic Review and Meta-analysis
Authors: Peng Liang , Cao Baodi , Hou Fangpeng , Xu Baolin , Zhou Hong , Liang Luyi , Jiang Yu , Wang Xiaohui , Zhou Jingjian
Published: February 2023

Background. Spontaneous preterm birth is one of the most common pregnancy complications in obstetric clinical practice, and its etiology is complex. The problems of low survival and high morbidity rates of premature infants need to be solved urgently. The platelet-to-lymphocyte ratio (PLR) and lymphocyte-to-monocyte ratio (LMR) are two novel biomarkers of inflammation, and several studies have linked PLR and LMR to spontaneous preterm birth. These systematic review and meta-analysis are aimed at analyzing the relationship between PLR and LMR in patients with spontaneous preterm birth to provide new ideas for the early prevention and treatment of spontaneous preterm births. Methods. Cochrane Library, EMBASE, PubMed, and China National Knowledge Infrastructure databases were inspected to gather PLR and LMR in patients with spontaneous preterm birth, all from the database to February 2022. Interstudy heterogeneity was evaluated using Cochran’s

Q

test and

I

2

statistic. Differences in PLR and LMR between patients with spontaneous preterm birth and full-term controls were evaluated by computing standardized mean differences and 95% confidence intervals. Publication bias and sensitivity analyses were also performed. Results. Nine studies were included in the meta-analysis based on the inclusion and exclusion criteria. The meta-analysis showed that serum PLR values were remarkably larger for patients with spontaneous preterm birth than for full-term controls (

SMD
=
0.49

, 95% CI: 0.13 to 0.84,

P
=
0.007

), whereas the difference between serum LMR in patients with spontaneous preterm birth and full-term controls was not statistically significant (SMD: 0.35, 95% CI: -0.18, 0.88,

P
=
0.199

). The results of Begg’s and Egger’s tests revealed that the publication bias of the meta-analysis was not significant. The outcomes of the sensitivity analysis showed that the individual studies did not influence the meta-analysis results. Conclusions. Current evidence shows that PLR is strongly associated with spontaneous preterm birth, whereas LMR is not. PLR has a certain clinical value in diagnosing and treating spontaneous preterm births, and our research will provide strong theoretical support for clinical work. In the future, it will be necessary to further explore the reasons for the increased PLR in the serum of patients with spontaneous preterm birth and other mechanisms inducing spontaneous preterm birth.
Tissue-Specific Metabolic Profiling of Mungbean (Vigna radiata L.) Genotypes with Different Seed Coat Colors
Authors: Jeon Seyoung , Kim Byeong Cheol , Ha Jungmin
Published: February 2023

Mungbean (Vigna radiata L.) is one of the major legume crops containing high carbohydrate and protein contents. In this study, the total phenolic and flavonoid contents and ABTS/DPPH radical scavenging activity of whole sprouts and seed coats were evaluated by using 10 mungbean genotypes with diverse seed coat colors and origins. Qualitative/quantitative analysis of individual secondary metabolites was performed with ultrahigh performance liquid chromatography (UPLC). Overall, 23 polyphenols, including flavonoids, phenylpropanoids, and anthocyanins, were identified. Depending on genotypes, significant variations in the contents of each phytochemical were identified before/after germination. The results indicate that the specific pathways of phenolic compounds, including chlorogenic acid, coumestrol, genistein, and glycitein, are activated by sprouting in mungbean. The neo/chlorogenic acid contents had tissue specificity, even though it was isomeric. The anthocyanin contents were higher in green and yellow mungbeans than in black mungbeans. These findings in this study will provide valuable information to improve the food quality of mungbean sprouts with high polyphenolic contents.
Value‐Added Service for Fashion Product Supply Chain with Overseas Warehouse Logistics Outsourcing
Authors: Mou Jinjin , Wang Shuyun
Published: February 2023

To quickly respond to consumer demand, more and more fashion product cross‐border e‐commerce (CBEC) retailers outsource international logistics to an integrated overseas warehouse logistics provider (OWLP). Due to the scarcity of integrated OWLP, this paper investigates the effect of the Stackelberg game, where the OWLP dominated the supply chain, and the cooperative game where the retailer and the OWLP are consistent with the interests, on pricing, and the comprehensive value‐added service (VAS) strategy for a fashion product and explores the effect of demand coefficient factors on decision‐making policy and supply chain performance through sensitivity analysis. It is found that the VAS level increases in the decrease of price coefficient a and the service cost coefficient k, in the increase of the service level coefficient b, and sales cycle coefficient T. By adopting the VAS cost‐sharing contract, and not only the total profit of the cooperative game is greater than that of the Stackelberg game but also the win‐win cooperation between e‐commerce retailer and OWLP is realized.
Modeling Electric Vehicle’s Battery Module using Computational Homogenization Approach
Authors: Shinde Shantanu R. , Song Yihan , Sahraei Elham
Published: February 2023

Numerical simulations of heterogeneous structures like battery modules of electric vehicles are challenging due to the various length scales involved in it. Even with the latest computing technology, it is impossible to simulate the crash scene of the full vehicle resolving all length scales. Such hurdles have prevented manufacturers to understand the mechanical response of battery packs in vehicle crash scenarios. In this work, the problem of multiple length scales was solved using the RVE technique based on homogenization theory. An appropriate representative volume element was identified, and a 3D FE model was developed. Classical first-order boundary conditions were used in this research work. The RVE was subjected to several macroscopic deformations, and its response was obtained. The homogenized material properties were computed from the obtained responses, and a material model available in LS-Dyna’s material library was selected and calibrated to describe the nonlinear multiaxial behavior of the homogenized battery module at the macroscale. For validation, the USABC Crush and Drop Tests were simulated for the detailed and homogenized battery modules. The main output of this research is a robust and computationally efficient tool enabling satisfactory integration of a battery pack model to the vehicle for crash simulations, eliminating the need to simulate micro details at macro length scales. This approach significantly reduced the computational cost. For example, for a Drop Test simulation, the homogenized model reduced the simulation time from 40 hours (detailed model) to about 3 minutes, while maintaining a high precision (

R

2

=
0.9871

) in predicting the load-displacement response. The system level modeling will enable the stakeholders to perform efficient optimization and safety evaluation for full-scale crashworthiness of electric vehicles.
Desmoid Tumor and Implant-Based Breast Reconstruction
Authors: Kilmartin Catherine , Westover Clinton , Raghavan Shyam , Dillon Patrick M. , Campbell Chris A.
Published: February 2023

Desmoid tumors are rare locally aggressive myelodysplastic tumors that are usually abdominally based. They account for 0.2% of breast tumors. Certain factors like prior surgery, familial adenomatous polyposis, pregnancy, and high estrogen states are associated with chest wall desmoid tumor occurrence. We present a patient with a history of intraductal carcinoma of the left breast who underwent mastectomy with implant-based reconstruction who had a desmoid tumor of the breast detected during workup for cardiac transplantation for chemotherapy-induced heart failure. The tumor was originally thought to be recurrent breast cancer during workup with imaging obscured by the implant. Excisional biopsy demonstrated a desmoid tumor with a positive deep margin requiring rib resection, synthetic mesh, and pectoralis major flap reconstruction. Breast desmoid tumors are reactive malignancies that have been diagnosed after prior breast implant surgery but without an established risk associated with breast implants. Excision with microscopically negative margins and chest wall reconstruction when indicated is the current established treatment protocol; however, recent paradigm shifts include “watchful waiting” and medical management among treatment strategies.
The Role of Host in the Spectrum of Outcomes in Family Clusters of Hepatitis Infection: From Asymptomatic to Hepatocellular Carcinoma
Authors: Noverati Nicholas , Nguyen Anh , Chalikonda Divya , Halegoua-DeMarzio Dina , Hann Hie-Won
Published: February 2023

Hepatitis B virus infections are prevalent worldwide, but the outcomes of infection vary greatly from host to host. In many endemic regions, vertical transmission from mother to child is most common. In this transmission setting, virus genotype and shared patient genetics make for an interesting comparison of outcome of chronic hepatitis B infection. This case series demonstrates four family clusters which display disparate outcomes among family members with hepatitis B virus infections, further stressing the role of host and non-genetic factors in the natural history of the disease. Many host factors have been theorized, from epigenetic mechanisms to the role of chronic stress, but more research is needed to better understand those at higher risk of feared complications such as hepatocellular carcinoma and cirrhosis.
Patient with Mosaic Turner Syndrome and a Derivative X Chromosome with a Variant Triple X Diagnosis in Fetus: A Case Report
Authors: Haggerty Abigail , Spaulding Joanna , Fisher Sara , Byers Benjamin , Mahoney Nicolle , Nelson Marilu , Althof Pamela , Dave Bhavana
Published: February 2023

Although Turner syndrome is most often sporadic, multigenerational recurrence has been reported more often in the offspring of women with mosaic or variant forms of Turner syndrome. We present a case in which natural conception in a woman with identified 45,X/46,XX mosaicism resulted in a fetus with a gain of a derivative X chromosome. The unexpected fetal finding prompted further cytogenetic evaluation of the patient and subsequent identification of an additional cell line with the same derivative X chromosome, not observed in the initial study. To our knowledge, this is the first case in which further investigation of an abnormal noninvasive prenatal screen resulted in the identification of both maternal and fetal sex chromosome abnormality. We discuss the discordant finding, similar cases, and potential phenotype with respect to skewed X inactivation. We also highlight the use of multiple testing methodologies to characterize the serendipitous identification of a derivative X chromosome.
Behavioral Improvements following Lesion Resection for Pediatric Epilepsy: Pediatric Psychosurgery?
Authors: Dang Huy , Khan Abdul Basit , Gadgil Nisha , Sharma Himanshu , Trandafir Cristina , Malbari Fatema , Weiner Howard L.
Published: February 2023

Introduction: Resection of brain lesions associated with refractory epilepsy to achieve seizure control is well accepted. However, concurrent behavioral effects of these lesions such as changes in mood, personality, and cognition and the effects of surgery on behavior have not been well characterized. We describe 5 such children with epileptogenic lesions and significant behavioral abnormalities which improved after surgery. Case Descriptions: Five children (ages 3–14 years) with major behavioral abnormalities and lesional epilepsy were identified and treated at our center. Behavioral problems included academic impairment, impulsivity, self-injurious behavior, and decreased social interaction with diagnoses of ADHD, oppositional defiant disorder, and autism. Pre-operative neuropsychiatric testing was performed in 4/5 patients and revealed low-average cognitive and intellectual abilities for their age, attentional difficulties, and poor memory. Lesions were located in the temporal (2 gangliogliomas, 1 JPA, 1 cavernoma) and parietal (1 DNET) lobes. Gross total resection was achieved in all cases. At mean 1-year follow-up, seizure freedom (Engel 1a in 3 patients, Engel 1c in 2 patients) and significant behavioral improvements (academic performance, attention, socialization, and aggression) were achieved in all. Two patients manifested violence pre-operatively; one had extreme behavior with violence toward teachers and peers despite low seizure burden. Since surgery, his behavior has normalized. Conclusion: We identified 5 patients with severe behavioral disorders in the setting of lesional epilepsy, all of whom demonstrated improvement after surgery. The degree of behavioral abnormality was disproportionate to epilepsy severity, suggesting a more complicated mechanism by which lesional epilepsy impacts behavior. We propose a novel paradigm in which lesionectomy may offer behavioral benefit even when seizures are not refractory. Thus, behavioral improvement may be an important novel goal for neurosurgical resection in children with epileptic brain lesions.
Studies in Australian Mantodea: New synonyms, notes on distributions, and an updated checklist
Authors: CONNORS MATTHEW G.
Published: February 2023

Despite recent advances in Mantodean systematics that have resolved many historical problems within the order, the Australian fauna still contains many erroneously recorded or incorrectly placed species. An investigation of these problematic species and related taxa necessitated a number of taxonomic changes: Exparoxypilus Beier is a new synonym of Paraoxypilus Saussure, Paraoxypilus verrauxii Wood-Mason and Exparoxypilus africanus Beier are new synonyms of Paraoxypilus verreauxii Saussure, Pthersigena Hinton is a new synonym of Phthersigena Stål, Austromantis alboterminata Sjöstedt is a new synonym of Austromantis albomarginata Sjöstedt, Deiphobe australiana Giglio-Tos is a new synonym of Coenomantis kraussiana Saussure, Notomantis Tindale is a new synonym of Pseudomantis Saussure, Hierodula dimorpha Werner is a new synonym of Pseudomantis albofimbriata (Stål), Notomantis chlorophana Tindale is a new synonym of Pseudomantis hartmeyeri Werner, Pseudomantis papua (Werner) comb. nov. is transferred from Hierodula, Orthodera marginata (Saussure) is reinstated as a valid species, and Ciulfina liturgusa Giglio-Tos and Orthodera gunnii Le Guillou are considered nomina dubia. In addition, notes are provided on the nomenclature, systematics, distribution, and ecology of several other Australian taxa, and a synonymic checklist of Australian Mantodea is provided. Finally, the origins and diversification of the Australian fauna are discussed in light of these and other recent changes.
An enigma of Handianus Ribaut, 1942 (Hemiptera: Cicadellidae: Deltocephalinae: Athysanini): identical host preferences and male calling signals in two morphologically distinctive sympatric species
Authors: TISHECHKIN DMITRI YU.
Published: February 2023

Handianus eurotiae and H. fartilis distinctly differ in the forewing venation and the male genitalia shape, but have strongly overlapping ranges, do not differ in ecological preferences, feed on the same host plant, Krascheninnikovia ceratoides, and produce almost identical male calling signals. They were never found in the same biotope, although the mechanism of such vicariation is not clear. According to Mayr’s biological species concept, such taxa are good species, but Paterson’s species recognition concept is inapplicable in this case. Similar examples in Orthoptera and Auchenorrhyncha are considered.
The worldwide occurrence of Sceliphron caementarium (Drury, 1773) outside its native range, with new records (Hymenoptera: Sphecidae)
Authors: CECCOLINI FILIPPO
Published: February 2023

Sceliphron caementarium (Drury, 1773) is a Nearctic mud-dauber wasp, accidentally introduced in various parts of the world. All literature records of its distribution outside its native range are summarized and many new records are provided, showing the quick spreading of this species. The countries and the islands in which Sceliphron caementarium occurs are summarized and ordered chronologically according to the date of the first record. The occurrence of the species is first recorded for Argentina, Oman, mainland Spain, the small country of San Marino and the archipelagos of Azores, Canary Islands, and Cayman Islands. Moreover, overall 56 new regions in several countries and 14 new islands are added to those from which the species was previously known. In Russia, the first record of the species is backdated to 2019.
1. The Functions and Role of Modern Education Systems
Authors: Gomendio Montserrat , Wert José Ignacio
Published: February 2023

Chapter 1 provides a brief introduction of the role played by governments in the development of public education systems in different countries, of when universal access was achieved, and a description of the shift from concentrating on constructing education systems (building schools and hiring teachers) to improving quality (student performance) and efficiency. While the interests of governments and most stakeholders are well-aligned during the first phase, major conflicts of interest emerge during the second phase. This is followed by a brief description of the current demands on education systems and the challenges they face. Finally, we describe the questions addressed in the book.
Physics-Informed Deep Neural Network for Backward-in-Time Prediction: Application to Rayleigh–Bénard Convection
Authors: Hammoud Mohamad Abed El Rahman , Alwassel Humam , Ghanem Bernard , Knio Omar , Hoteit Ibrahim
Published: February 2023

Backward-in-time predictions are needed to better understand the underlying dynamics of physical fluid flows and improve future forecasts. However, integrating fluid flows backward in time is challenging because of numerical instabilities caused by the diffusive nature of the fluid systems and nonlinearities of the governing equations. Although this problem has been long addressed using a nonpositive diffusion coefficient when integrating backward, it is notoriously inaccurate. In this study, a physics-informed deep neural network (PI-DNN) is presented to predict past states of a dissipative dynamical system from snapshots of the subsequent evolution of the system state. The performance of the PI-DNN is investigated using several systematic numerical experiments and the accuracy of the backward-in-time predictions is evaluated in terms of different error metrics. The proposed PI-DNN can predict the previous state of the Rayleigh–Bénard convection with an 8-time-step average normalized
error of less than 2% for a turbulent flow at a Rayleigh number of 105.
Ocean Surface Warming Pattern Inhibits El Niño–Induced Atmospheric Teleconnections
Authors: Hao Xin , Wang Huijun , Zhou Botao , Li Jiandong , Wei Jiangfeng , Han Tingting
Published: February 2023

The ocean surface temperature has warmed dramatically over most of the globe in recent decades, which shows the west warmed faster than the east (“La Niña–like” warming) in the equatorial Pacific. It differs from the simulated “El Niño–like” warming in existing studies that discussed the El Niño–induced teleconnection response to global warming. Some studies have indicated that El Niño teleconnections are sensitive to the ocean surface warming patterns, but the mechanisms are still elusive. Here, reanalysis data and numerical experiments were analyzed to investigate how winter El Niño atmospheric teleconnections respond to the historical ocean surface warming. We show that the inhibited effect of the El Niño on the North African winter climate through the suppressed Walker circulation over Atlantic–Africa–Indian Ocean sectors under the ocean surface warming matches the observed changes. Also, the model reproduces the observed weakening of the El Niño–induced Pacific–North American wave and its suppressed downstream propagation in the ocean surface warming scenario because of the reduction in contributions of the vortex stretching to the El Niño–induced wave sources in the subtropical jet streams. Our findings demonstrate the important role of ocean surface warming patterns in the projections of the El Niño–induced atmospheric teleconnection.
Ideological Presuppositions in Media Coverage of Corporation Tax Policy in the UK and Ireland: A Critical Discourse Analysis
Authors: Graham Ciara , O’Rourke Brendan K.
Published: February 2023

This paper argues that the state’s capacity to tax corporations in order to fund itself is reaching crisis proportions. Following decades of trade liberalization, deregulation, and globalization, large multinational companies have been able to take advantage of tax competition between states in order to avoid taxation and offset their obligations. This crisis, arguably, has been facilitated by state actors and exacerbated by non-state actors: we explore the ways in which multi-national corporations (MNCs) manipulate their capital, assets, and supply chains to minimize their tax burdens; and we further consider the ways in which media narratives construct this issue and whether they challenge the practice or intensify it. Discourse surrounding taxation plays a huge part in what is considered acceptable. While the old adage that “death and taxes” cannot be avoided, it has become clear that large companies, helped by a tax avoidance industry do indeed manage to do just that. Discourse analysis reveals the ways in which ideology can be used to manage consensus around this potentially controversial subject and this paper seeks to explicate that by examining the frames, presuppositions and discursive formations present within the discourse structure. The argument is developed through a comparative case study research design demonstrating the different policy-based, economic and historical contexts of the two jurisdictions which offer some insight and explanation of the distinctive ideological discursive formations that are present within the discourses.
Organizational and Institutional Response to the COVID-19 Pandemic
Authors: Schulz Jeremy , Robinson Laura , Ruiu Maria Laura , Williams Apryl
Published: February 2023

This issue of American Behavioral Scientist deals with the various ways in which different kinds of organizations cope with the manifold challenges brought about by the COVID-19 pandemic. Together, these articles map the challenges and opportunities encountered by a variety of organizations in a major public health crisis. The first section of the issue takes up the theme of adaptive crisis response in relation to two different kinds of organizations. This section begins with a comprehensive overview of U.S. nonprofit organizations’ responses to the COVID-19 pandemic. The second article expands on the theme of communication practices in organizations using digital communication platforms which facilitate constructive forms of disagreement or “creative conflict.” Both of these articles indicate the potential positive outcomes of entrepreneurial organizational response. In the next section, we turn to organizational responses hampered by digital inequalities. The first article addresses digital inequalities and eLearning during the pandemic in the country of Pakistan. The next article also uses a digital inequalities framework to probe infrastructural inadequacies faced by the criminal justice system in terms of hindrances to external communication for incarcerated populations during the pandemic. This pair of articles underscores the importance of infrastructure as a necessary element of successful crisis response. The third section of the issue continues with case studies of carceral institutions with the first article offering insight into strategies used by incarcerated people to generate a sense of normality despite pandemic disruptions. Finally, the issue closes with an article revealing the delicate balancing act which rural U.S. law enforcement carried out when competing imperatives made it extremely difficult to manage public health and public safety simultaneously.
Intraoperative Parathyroid Hormone Monitoring Is of Limited Usefulness in Guiding Autotransplantation in Reoperative or Subtotal Parathyroidectomy for Primary Hyperparathyroidism
Authors: Richards Bradley A. , Vierkant Robert A. , Dy Benzon M. , Foster Trenton R. , McKenzie Travis J. , Lyden Melanie L.
Published: February 2023

Introduction

Patients with primary hyperparathyroidism (1HPT) undergoing reoperative or subtotal parathyroidectomy (PTX) may undergo autotransplantation (ATX) when the viability of remaining tissue is unknown. This study aims to identify whether intraoperative parathyroid hormone levels (IOPTH) can determine ATX candidacy.

Methods

Patients with 1HPT who underwent PTX with ATX at our institution were identified. IOPTH and PTH values within 24 h, 2-4 weeks, and >1 month postoperative were analyzed. Patients were classified as either a candidate for ATX (low PTH after 2-4 weeks) or not a candidate based on postoperative PTH (normal PTH after 2-4 weeks). Associations of ATX candidate status with demographic and clinical attributes were studied.

Results

268 had a reoperative (49%) or subtotal PTX with ATX. 151 had data for PTH analysis, and 21 (14%) were identified as candidates for ATX. The mean % decline in IOPTH from baseline to 20 min post-excision was 51% in noncandidates vs 73% in candidates (P = .002). The mean change in IOPTH from baseline to final was 52% in noncandidates and 83% in candidates (P = .009). A decrease in IOPTH from baseline to 20 min post-excision of 23.4% or greater or a final PTH of 52 pg/mL or less would be an indication for ATX. Of the 21 who needed an ATX, it failed in 10.

Conclusion

Parathyroid ATX is frequently unnecessary, and the viability is less than expected. While candidates for ATX have a greater IOPTH % decline at all points during surgery and a lower final IOPTH, the clinical practicality of using IOPTH to determine ATX candidacy is limited.
The Use of Sequential Surveys to Shorten Implementation Time for Healthcare System-Level Enhanced Recovery After Surgery (ERAS) Pathways
Authors: Adams Ursula C. , Moulthrop Amy J. , Malay Brendan , Straube Lacey E. , McNaull Peggy P. , McGinigle Katharine L. , Phillips Michael R.
Published: February 2023

Background

Enhanced Recovery After Surgery (ERAS) pathways improve healthcare quality, safety, and cost-effectiveness. We hypothesized that the RAND Method (a hybrid Delphi approach), involving anonymous sequential surveys and face-to-face meetings, would allow for more rapid agreement and initiation of new ERAS pathways.

Methods

Using the ERAS Society guidelines for cesarean section as a baseline, our institution’s ERAS Leadership Team (ELT) compiled published literature and institutional practices to design a 32-component survey that was sent to obstetricians, nurse midwives, anesthesiologists, pharmacists, and nurses. Components that did not reach 90% consensus were included in a second survey the following week, and meetings were held to review results. At the conclusion of this process, time to agreement was retrospectively compared to the colorectal ERAS pathway process at this institution.

Results

ERAS pathway components were compiled and reviewed by 121 stakeholders at 7 hospitals using iterative surveys with review meetings over a 13-week period. Survey response rates were 61% and 50% in the initial and follow-up surveys, respectively. There was agreement on 28/32 and 32/32 items on the initial and follow-up surveys. Using the RAND Method, time to agreement decreased by 54.1% (24 vs 13 weeks) compared to prior system-wide efforts to standardize the colorectal surgery ERAS pathway.

Discussion

With rapidly expanding healthcare systems, effective methods to gain consensus and adopt ERAS pathways are critical to implementation of ERAS guidelines. We demonstrate that the RAND Method allows for a transparent and efficient means of agreement across a diverse group of clinicians practicing in several settings.
Effect of Smoking History on 30-Day Morbidity Following Bariatric Surgery
Authors: Fuentes Nicolas , Reyes Jose A. , Souferi Benjamin , Khan Ayda , Kuo Yen-Hong , Bates Andrew T. , Davis John M. , Gadaleta Dominick , Pechman David M.
Published: February 2023

Introduction

Smoking and postoperative complications are well documented across surgical specialties. Preoperative smoking cessation is frequently recommended by surgeons. In this study, we assessed to what degree documented smoking history increased a patient’s risk of postoperative complications.

Methods

The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database for the years 2015-2018 was used. Patients were included if they underwent primary sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (LRYGB). Patients with a documented smoking history were assigned to the “SH” cohort and patients without smoking history were assigned to the “NSH” cohort. Patients without documentation regarding smoking history, missing variables, younger than 18, with prior surgery, or lost to follow-up were excluded. 30-day morbidity and mortality data were assessed. Multiple logistic regression analysis was made based on all available patient characteristics and perioperative factors, continuous variables were analyzed using Student’s t-test and categorical variables were compared using the chi-square test.

Results

After evaluation of 760,076 patients on the MBSAQIP database, 650,930 patients underwent non-revisional bariatric surgery, including 466,270 SG and 184,660 LRYGB. Of the total patients included in the study, 44,606 patients were assigned to the SH cohort and 479,601 were assigned to the NSH cohort. 4628 of patients did not have documented smoking status. Within 30 days SH patients had higher rates of readmission (4.2% vs 3.7%, P < .0001), reoperation (1.3% vs 1.1%, P < .0001), unplanned intubation (.2% vs .1%, P = .0212), and unplanned ICU admission (.7% vs .0.6%, P = .0022).

Conclusion

SH patients undergoing bariatric surgery were at significantly increased risk of readmission and reoperation within 30 days of procedure. In addition, SH patients were more likely to have unplanned intubation and unplanned ICU admission. Given the higher rates of complications in smoking patients, this study would suggest that preoperative smoking cessation in patients prior to primary bariatric surgery might be beneficial. Further study is warranted to compare short-term cessation vs long-term cessation preoperatively, which was not assessed in our study.
Short- and Long-Term Outcomes of the Minimal Proximal Resection Margin in Total Gastrectomy for Siewert II Adenocarcinoma of the Esophagogastric Junction
Authors: Guo Wei , Hao Jinguo , Mei Xianghuang , Wang Yangyang , He Zhipeng , Su Shi , Zhang Ke , Guan Xiaoqi , Yang Jingcheng , Lv Jiake
Published: February 2023

Objective

This study aimed to investigate the feasibility of the minimal proximal resection margin (PRM) in total gastrectomy (TG) for Siewert II adenocarcinoma of the esophagogastric junction (AEG).

Methods

This study finally included 178 Siewert II advanced AEG patients who underwent TG from January 2017 to September 2020. According to the PRM length, patients were divided into 20-25 mm group and 30-35 mm group. Intraoperative, short-, and long-term postoperative outcomes were compared between two groups.

Results

The PRM of the 20-25 mm group had significantly less operation time compared with the PRM of the 30-35 mm group ( P < .001), but the amount of blood loss, management of the diaphragmatic crura, and the incidence of positive resection margin were not significantly different between two groups (P > .05). In short-term postoperative outcomes, first gas-passing time, gastric-tube removal time, start time of diet, hospitalization, postoperative complications, and body weight loss were similar between two groups (P > .05). During the follow-up, the 3-year overall survival rates and the recurrence rates were not significantly different between the PRM of 20-25 mm and 30-35 mm groups (81.2% vs 83.5%, P = .695; 18.8% vs 15.5%, P = .812, respectively).

Conclusion

With less operation time and more preserved esophagus, the minimal PRM length of 20-25 mm could be an appropriate option in TG for patients with Siewert II advanced AEG.
Effect of Antiplatelet and Anticoagulant Agents on Outcomes Following Emergent Surgery for Traumatic Brain Injuries
Authors: Bazzi Rola , Sharp Victoria , Hecht Jason
Published: February 2023

Purpose

Traumatic brain injury (TBI) is the largest cause of death from injury in the United States. This study utilized the Michigan Trauma Quality Improvement Program (MTQIP) database to determine the effect that antiplatelets and anticoagulants (AP/AC) have on outcomes following emergent surgery for TBI patients.

Basic Procedures

Patients were included with age ≥18 years, maximum head/neck abbreviated injury score (AIS) ≥2, and underwent a neurosurgical procedure within 24 hours. Patients were excluded if they had an AIS ≥3 in other body region or no signs of life at initial evaluation.

Main Findings

Within the 1,932 patients analyzed, 139 (8.74%) were in the warfarin with or without (+/-) aspirin cohort, 101 (6.35%) in the direct oral anticoagulants (DOAC) +/− aspirin cohort, 169 (10.62%) in the clopidogrel +/− aspirin cohort, and 1,182 (74.29%) in the no AP/AC cohort (control group). After controlling for demographic and clinical characteristics, no significant difference in mortality rates was observed in the treatment groups ( P > 0.05). However, our subgroup analysis did reveal a significantly higher mortality rate within the warfarin and aspirin subgroup when compared to the control group (odds ratio [OR], 2.368; confidence interval [CI], 1.306-4.294, P = 0.005). With regards to hospital complications, there was a significant increase in this outcome within the DOAC +/− aspirin (OR, 1.825; CI, 1.143-2.915, P = 0.012) and clopidogrel +/− aspirin (OR, 1.82; CI, 1.244-2.663, P=0.002) groups.

Conclusion

Patients on AP/AC who experience a TBI requiring an emergent operation do not have an increased risk of mortality compared to patients not on AP/AC.
Reintervention Rate After Pigtail Catheter Insertion Compared to Surgical Chest Tubes
Authors: Mortman Keith D. , Tanenbaum Mira T. , Cavallo Kathryn M. , Kelley Devon , Bonitto Stephano S. , Sadur Alana , Amdur Richard , Sarin Shawn , Napolitano Michael A.
Published: February 2023

Background

Prior studies suggest similar efficacy between large-bore chest tube (CT) placement and small-bore pigtail catheter (PC) placement for the treatment of pleural space processes. This study examined reintervention rates of CT and PC in patients with pneumothorax, hemothorax, and pleural effusion.

Methods

This retrospective study examined patients from September 2015 through December 2020. Patients were identified using ICD codes for pneumothorax, hemothorax, or pleural effusion. Use of a pigtail catheter (≤14Fr) or surgical chest tube (≥20Fr) was noted. The primary outcome was overall reintervention rate within 30 days of tube insertion. Patients who died with a pleural drainage catheter in place, unrelated to complications from chest tube placement, were excluded.

Results

There were 1032 total patients in the study: 706 CT patients and 326 PC patients. The PC group was older with more comorbidities and more likely to have effusion as the indication for pleural drainage. Patients with PC were 2.35 times more likely to have the tube replaced or repositioned ( P < .0001), 1.77 times more likely to require any reintervention ( P = .001) and 2.09 times more likely to remain in the hospital >14 days ( P < .0001) compared to patients with CT.

Conclusion

PCs have a significantly higher reintervention rate compared to CT for the treatment of pneumothorax, hemothorax, and pleural effusion. Although PC are believed to cause less pain and tissue trauma, they do not necessarily drain the pleural space as well as CT. Decisions on which method of draining the chest should be made on a case-by-case basis.
Spirituality in Surgery-A Double-Edged Scalpel
Authors: Marterre Buddy , Hinshaw Daniel B. , Shinall Myrick C.
Published: February 2023

Investigating, respecting, and working with surgical patients’ spiritualities is as critical a skill as the proficient technical performance of operations. When spirituality is ignored, sacred patient values remain undiscovered, authentic trust is hindered, and healthy shared decision-making processes suffer. These are instances when the other edge of the spiritual scalpel comes back to cut us as surgeons, but more importantly, upon withdrawal of spiritual understanding, it deeply injures our patients and their families. Spiritual screening, spiritual history taking, engaged, active listening, and big-picture prognostic truth-telling while promoting hope are critical skills for efficacious whole-person surgical care and the healing of our surgical patients’ suffering—in all aspects of their humanity. These skills require surgeon introspection and vulnerability, however, as well as regular practice, and can be quite difficult; frequently leading to understandable discomfort, particularly when the surgeon does not share the patient’s spiritual orientation or religious commitments. This literature-based essay addresses all of these issues, providing surgeons with a variety of new spiritual tools for their holistic armamentarium to promote healing, rather than further injury.
Non-Invasive Assessment of Endothelial Shear Stress in Myocardial Bridges Using Coronary Computed Tomography Angiography
Authors: Giannopoulos Andreas A. , Bolt Basil , Benz Dominik C. , Messerli Michael , Von Felten Elia , Patriki Dimitri , Gebhard Catherine , Pazhenkottil Aju P. , Gräni Christoph , Kaufmann Philipp A. , Buechel Ronny R. , Gaemperli Oliver
Published: February 2023

Myocardial bridging (MB) is a segment of coronary arteries with an intramural course, typically spared from atherosclerosis, while the adjacent proximal segment is reported to be atherosclerosis-prone, a phenomenon contributed to local endothelial shear stress (ESS). We aimed to describe the ESS milieu in coronaries with MBs combining coronary computed tomography angiography with computational fluid dynamics and to investigate the association of atherosclerosis presence proximal to MBs with hemorheological characteristics. Patients ( n = 36) were identified and 36 arteries with MBs (11 deep and 25 superficial) were analyzed. ESS did not fluctuate 5 mm proximally to MBs vs 5 mm within MBs (0.94 vs 1.06 Pa, p = .56). There was no difference when comparing ESS in the proximal versus mid versus distal MB segments (1.48 vs 1.37 vs 1.9 Pa, p = ns). In arteries with plaques ( n = 12), no significant ESS variances were observed around the MB entrance, when analyzing all arteries ( p = .81) and irrespective of morphological features of the bridged segment (deep MBs; p = .65, superficial MBs; p = .84). MBs are characterized by homogeneous, atheroprotective ESS, possibly explaining the absence of atherosclerosis within bridged segments. The interplay between ESS and atherosclerosis is potentially not different in arteries with MB compared with arteries without bridges.
Local electrical conductivity of carbon black/PDMS nanocomposites subjected to large deformations
Authors: Moronkeji Oluwadara E , Das Debashish , Lee Sunho , Chang Kelly M , Chasiotis Ioannis
Published: February 2023

The full-field microscale electrical behavior of polydimethylsiloxane (PDMS) matrix composites with 12 wt% (below the electrical percolation threshold) and 20 wt% (above the electrical percolation threshold) carbon black (CB) nanoparticles was obtained with the aid of Conductive Atomic Force Microscopy (C-AFM) as a function of uniaxial tensile strain. A comparison between the macroscale and the microscale 2D strain fields showed that 25 × 25 μm2 specimen domains can serve as a representative surface element (RSE) to describe the macroscale mechanical response under finite deformations. The same surface domain size was shown to serve as RSE for the local electrical behavior of CB/PDMS nanocomposites at small and large strains. The transverse specimen contraction due to the Poisson’s effect increased the through-thickness conductivity of 12 wt% CB specimens, with a rapid increase in the total electric current measured at the scale of the RSE taking place above 23% uniaxial true strain. The locally dominant tunneling conductance in the undeformed specimen state transitioned to a combination of Ohmic (linear local current-voltage (I–V) characteristics) and tunneling (parabolic local I–V characteristics) at 35% uniaxial true strain. In comparison, the local I–V characteristics of undeformed PDMS composites with 20 wt% CB were a combination of Ohmic (contributing the majority of the total current) and tunneling. Upon application of 35% uniaxial true strain the vast majority of local conduction sites became Ohmic, while the total electric current at the scale of the RSE increased relatively linearly with applied strain.
Investigating the mechanical properties and morphology of novalac phenolic resin nanocomposite/hybrid short fibers carbon and glass reinforced with silica nanoparticles
Authors: Jahangiri Ali Asghar , Rostamiyan Yasser
Published: February 2023

The purpose of this research is to make a nanocomposite with combined fibers in order to achieve two integrated mechanical characters including strength and plastic deformation in an optimal way. Novalac type phenolic resin (PF), short fibers carbon (CF) and glass (GF) and silica (SiO2) nanoparticles were used for making. The results showed that with the hybrid of carbon and glass fibers (CGF) in the composite, the ultimate strength and Plastic deformation increased compared to the samples without a combination, and it was modified as an optimal sample. Also, the results showed that the composite sample with hybrid fibers with 2 wt% SiO2 nanoparticles increased the tensile strength by 25%, the bending strength by 48% and the buckling strength by 37%. From the X-ray diffraction and EDX tests, the dispersion of nanoparticles in the composite was determined, and the SEM images showed that with the presence of SiO2 nanoparticles, The amount of adhesion and penetration between resin and fibers has increased. One of the main applications of hybrid nanocomposite can be mentioned portable light structures on land, sea and air, sports goods and orthopedic equipment.
Who Persists and Who Desists? A Prospective Study of Prescription Stimulant Misuse in College Graduates
Authors: Holt Laura J. , Langdon Susan W. , Feinn Richard S.
Published: February 2023

Prescription stimulant misuse (PSM) has been studied extensively in college populations, but few studies have examined how PSM changes after graduation. We used a longitudinal design to follow individuals at risk for PSM 2 years after college graduation to document PSM prevalence, motives, and predictors of PSM persistence. Participants from two small, private colleges completed online surveys focused on intrapersonal, interpersonal, and sociocultural predictors of PSM. Overall, PSM declined over time. Lack of premeditation, perceived peer norms, positive expectancies, media exposure, and other substance use were associated with continued PSM; however, only lack of premeditation, descriptive norms, and other substance use predicted PSM in a multivariate model. This preliminary study suggests dispositional and behavioral risk factors may help to explain why PSM persists after college. Interventions that enhance decision-making skills, correct misperceptions about peers’ PSM, and reduce polysubstance use may be effective in curbing PSM in college graduates.
Hidden from history: Carriage cleaners in the United Kingdom from 1849 to COVID-19
Authors: Winterson Julia
Published: February 2023

The story of carriage cleaners has been sadly neglected in the history of railway workers. The work has low pay, it is sometimes unpleasant, and it is also physically tough. This panorama paper explores some of the literature surrounding the history of carriage cleaners from the earliest records in the nineteenth century, through the two world wars, up to the early days of privatisation. The focus is on female carriage cleaners, exploring the reasons why their work has been hidden from history and putting forward an argument as to why more attention should be drawn to it. Despite its low pay and poor working conditions, cleaning work is found at an important nexus of the railway economy, ensuring that the spaces of railway travel remain sanitary and functional. Given their importance for the operation of the railway transport system, it is surprising that cleaners remain largely invisible.
A Symposium to Mark the Publication, by New York University Press, of Ian O’Donnell's Prison Life: Pain, Resistance, and Purpose
Authors: Gido Rosemary , Jeffreys Derek S. , Behan Cormac , Edgar Kimmett , Schmidt Bethany E. , Mesko Gorazd , Stohr Mary K. , Rubin Ashley T.
Published: February 2023

Recognizing the major scholarly contributions to criminology by the noted Irish criminologist, Ian O’Donnell, The Prison Journal invited seven contemporary corrections and punishment scholars to offer insights into O’Donnell’s new book, Prison Life: Pain, Resistance, and Purpose. Offering contextually rich descriptions of prisoner life, the text features four case study prisons—H Blocks, Northern Ireland; Eastham Unit, Texas; Isir Bet, Ethiopia; and ADX Florence, Colorado, in pivotal time periods and through an individual's custodial career in each institution. The symposium discussants focus on O’Donnell's conceptual framework—the degree of prison integration, system and staff regulation, and legitimacy—and how these reflect the key interactions between punishment and society across time and culture.