bluuebunny/crossref_metadata_2025 huggingface dataset:
The management of asymptomatic radiological anastomotic leakage following anterior resection
Authors: Rabie Mohamed , Parry Laura , Sadien Iannish , Kapur Sandeep , Stearns Adam , Shaikh Irshad
Published: January 2022

Background

The evidence to guide the management of asymptomatic radiologically‐detected anastomotic leakages (ARAL) following anterior resection (AR) with diverting ileostomy is deficient. This study describes the outcomes of managing ARAL one of the UK teaching hospitals.

Method

The study included all patients diagnosed with ARAL following AR during 8 years period (2012–2020). The following data were retrospectively collected: patient demographics, surgical indication, anastomotic technique, tumour staging, neoadjuvant therapy, how ARAL was managed, the outcomes and duration to heal and ileostomy reversal.

Results

A total of 35 patients (M = 24) who developed ARAL during the study period were included. In 32 patients, AR was performed for rectal cancer. All patients with ARAL were treated conservatively and in 31 (89%) patients, there was complete resolution of the leakage within a median duration of 6 months. Covering loop ileostomies were reversed in 26 (74%) patients with a median interval to reversal of 10 months.

Conclusion

Most asymptomatic radiologically‐detected anastomotic leakages after anterior resection heal with conservative treatment in the presence of a covering loop ileostomy with an expected average delay of 6 months for the leakage to heal before covering ileostomies can be reversed.
Laparoscopic mesh removal for mesh infection related to pararectal incision of previous appendectomy after laparoscopic total extraperitoneal inguinal hernia repair: A case report
Authors: Mikamori Manabu , Kinjo Ayaka , Nakahara Yujiro , Iwamoto Kazuya , Hyuga Satoshi , Naito Atsushi , Ohtsuka Masahisa , Furukawa Kenta , Moon Jeongho , Imasato Mitsunobu , Asaoka Tadafumi , Kishi Kentaro , Mizushima Tsunekazu
Published: January 2022

A 67‐year‐old man with a history of appendectomy 40 years ago underwent single‐incision laparoscopic surgery for total extraperitoneal inguinal hernia repair. Postoperatively, the pararectal incisional scar obtained from the appendectomy was infected; thus, antibiotic therapy and drainage were performed. However, the infection persisted. After 5 postoperative months, the mesh was laparoscopically removed at a sufficient distance from the infected site. No enterocutaneous fistula was observed. After 1 year and 10 months, no recurrence of hernia or infection was observed. Thus, laparoscopic mesh removal is feasible. Infection of a 40‐year‐old incision rarely results in mesh infection. Therefore, in pararectal incision, the extent of mesh coverage should be considered; if the overlap is large, changing the technique by not covering the incision may be necessary.
Initial entry via the left upper quadrant with an optical trocar in laparoscopic bariatric surgery
Authors: Amiki Manabu , Ishiyama Yasuhiro , Harada Tatsunosuke , Mochizuki Ichitaro , Tomizawa Yuki , Ito Shingo , Oneyama Masataka , Hara Yoshiaki , Narita Kazuhiro , Tachimori Yuji , Goto Manabu , Sekikawa Koji , Kuba Motoko
Published: January 2022

Introduction

Laparoscopic bariatric surgery (BS) is not readily performed in Japan. To facilitate safe initial access to the abdominal cavity, we insert an optical viewing trocar at a unique site in the left upper quadrant (LUQ). Herein, we describe the technique, its advantages, and outcomes.

Materials and Surgical Technique

Briefly, the optical trocar is inserted just below the left subcostal margin, 8 cm from the midline. On insertion, layers of the abdominal wall are visualized on the monitor. Depending on the angle of insertion, five, seven, or eight layers are seen.

Discussion

In assessing our initial entry technique, used in 21 obese patients undergoing laparoscopic sleeve gastrectomy, we found median insertion time to be 25 seconds. There were no related complications. In nearly all (20/21) patients, the abdominal wall was visualized as seven layers: subcutaneous fat, anterior rectus sheath, rectus abdominis muscle, posterior rectus sheath, transverse abdominis muscle, transversalis fascia, and peritoneum. Understanding the layers of the abdominal wall visualized during optical trocar insertion in the LUQ will provide for safe and rapid initial entry in patients undergoing laparoscopic BS and can further the widespread acceptance of laparoscopic BS.
Retroperitoneoscopy‐Assisted Dismembered Pyeloplasty With Single‐Site Plus One Port in Older Children With Congenital Hydronephrosis
Authors: Tanabe Kazuya , Nakamura Shigeru , Hyuga Taiju , Kubo Taro , Kawai Shina , Nakai Hideo
Published: January 2022

Introduction

This study aimed to clarify the advantage of retroperitoneoscopy‐assisted dismembered pyeloplasty with single‐site plus one port (RPSPO) for pediatric congenital hydronephrosis in patients aged ≥7 years.

Methods

We retrospectively compared a group of patients aged ≥7 years (study group) with patients aged <7 years (comparison group), who underwent RPSPO between August 2015 and August 2018, in terms of preoperative patient characteristics, intra‐ and perioperative results, and postoperative results.

Results

The study group consisted of eight patients. The median body weight at surgery was 27 kg (20–38 kg). The median age at surgery was 102.5 m (87–139 m). The severity of hydronephrosis on the affected side graded by the Society for Fetal Urology grade was grade 3 in one case and grade 2 or less in all other cases. All patients underwent a 99mTc‐MAG3 renogram. Comparison between the two groups showed significant differences in body weight at surgery (p = 0.003), age (p < 0.001), and preoperative hydronephrosis grade (p = 0.007), but the median length of the skin incision was 20 mm in both groups, with no significant difference (p = 1.000). Redo pyeloplasty was not required in any patient in either group.

Conclusion

RPSPO is an advantageous procedure for older children because it allows precise ureteropelvic neoanastomosis under direct vision and the same wound size as in younger children.
Modelling the association between biomarkers and clinical outcome: An introduction to nonlinear joint models
Authors: Kerioui Marion , Bertrand Julie , Bruno René , Mercier François , Guedj Jérémie , Desmée Solène
Published: January 2022

Nonlinear joint models are a powerful tool to precisely analyse the association between a nonlinear biomarker and a time‐to‐event process, such as death. Here, we review the main methodological techniques required to build these models and to make inferences and predictions. We describe the main clinical applications and discuss the future developments of such models.
Colombian Foreign Policy and the Spanish Civil War, 1936–1939 (Blakemore Prizewinner for 2020)
Authors: Eaton Charlotte
Published: January 2022

The Spanish civil war saw two different Liberal presidencies in Colombia. Contrary to common belief, they did not follow a unified policy towards Spain but instead faced different parameters for action which shaped their response. These policies, in turn, illuminate both the internal dynamics of the two administrations and how they conceived of Colombia's position on the world stage. By providing the national, international and wider structural contexts, this article will therefore use the Spanish conflict to shine a spotlight on the Santos and López governments and the development of Colombian foreign policy during the late 1930s.
Decision‐making experiences of health professionals in withdrawing treatment for children and young people: A qualitative study
Authors: Abdin Shanara , Heath Gemma , Neilson Susan , Byron‐Daniel James , Hooper Nic
Published: January 2022

Objective

To explore factors that influence professionals in deciding whether to withdraw treatment from a child and how decision making is managed amongst professionals as an individual and as a team.

Study Design

Semi‐structured interviews were conducted with a purposive sample of health professionals working at a UK Children's Hospital, with children with life‐limiting illnesses whose treatment has been withdrawn. Data were transcribed verbatim, anonymized and analysed using a thematic framework method.

Results

A total of 15 participants were interviewed. Five interrelated themes with associated subthemes were generated to help understand the experiences of health professionals in decision making on withdrawing a child's treatment: (1) understanding the child's best interests, (2) multidisciplinary approach, (3) external factors, (4) psychological well‐being and (5) recommendations to support shared decision making.

Conclusion

A shared decision‐making approach should be adopted to support professionals, children and their families to make decisions collectively.
Application of non‐pharmaceutical interventions in camps following the onset of COVID‐19
Authors: Garst Barry A. , Dubin Alexsandra , Gaslin Tracey
Published: January 2022

Background

As the COVID‐19 pandemic emerged in the United States in the spring and summer of 2020, many organizations serving children and youth immediately faced significant operational and healthcare challenges. Centers for Disease Control and Prevention guidance for the safe operation of youth programmes emphasized the importance of non‐pharmaceutical interventions (NPIs), yet few studies have examined NPI usage in summer programmes such as camps.

Method

This sequential explanatory mixed‐methods study explored the utilization of NPIs among camp healthcare providers who completed an online questionnaire followed by one‐on‐one interviews.

Results

The study findings indicated that camps consistently used a core set of NPIs to maintain and protect the health of camp participants, including screening, cohorting, hand hygiene, sanitizing practices, ventilation and physical distancing. The study findings further identified specific practices of camp healthcare providers that made NPI utilization possible, as exemplified in the emergent themes of wellness promotion; health awareness and modelling; and camp health service mobilization.

Conclusion

NPI usage benchmarks from this study, as well as effective practices for NPI utilization, can inform the application of NPIs and other health‐promoting practices across diverse formal and informal youth settings.
Investigation of the effect of laser technology on the colouring and patterning possibilities in polyacrylonitrile socks
Authors: Atav Rıza , Köksal Daban Sevda , Çetin Erdoğan
Published: January 2022

The aim of the current study was to determine the effect of laser treatment on basic dye uptake and the fastness values of acrylic socks. To achieve this, laser treatments were applied to acrylic socks at different resolutions (10, 20 and 30 dpi) over various pixel times (80, 100 and 120 µs) before dyeing. To support the findings obtained, tests and analyses, such as Yellowness Index, Fourier Transform–infrared analysis, scanning electron microscopy, scanning electron microscopy with energy dispersive X‐ray spectroscopy, and bursting strength, were also applied to untreated and treated fabric samples. It was found that treatment with laser did not have a significant effect on the basic dye uptake of fibres; nevertheless, the samples treated with laser were dyed slightly lighter than the untreated sample. Furthermore, it was determined that the samples treated at 30 dpi started to melt and the fabric was damaged considerably, but the fabrics treated at 10 and 20 dpi were not affected at all. Another result obtained regarding the use of laser technology in acrylic socks is that if some areas of acrylic socks are not treated with laser, while some other areas are treated with laser at 20 dpi for 100 µs, it is possible to obtain patterns containing two different shades of the same colour on the socks.
Interaction between ischemic time and donor age under the new donor heart allocation system: Effect on post‐transplant survival
Authors: Nordan Taylor , Mahrokhian Shant H. , Liang Caroline J. , Ortoleva Jamel P. , Critsinelis Andre C. , Chen Frederick Y. , Couper Gregory S. , Kawabori Masashi
Published: January 2022

Background

Ischemic time (IT) under the new heart transplant (HTx) allocation system has increased compared to the old system. We investigated the effect of IT and donor age on post‐HTx survival.

Methods

The United Network for Organ Sharing (UNOS) database was analyzed to identify adult HTx between October 2015 and August 2020. Recipients were stratified by donor age, transplantation era, and IT. Kaplan‐Meier and log‐rank tests were used to compare 180‐day post‐HTx mortality. Cox proportional hazards modeling and propensity score matching were performed to adjust for confounders.

Results

Under the new system (N = 3654), IT≥4 h led to decreased survival compared to IT < 4 h (91.4% vs. 93.7%; P = .02), although this decrease was undetectable among those with donors ≥39 years old (90.4% vs. 91.1%; P = .73). IT≥4 h led to decreased survival with donors < 39 years old (91.7% vs. 94.6%; P < .01). Under the old system (N = 5987), IT≥4 h resulted in decreased survival (89.8% vs. 93.9%; P < .01), including with donors ≥39 years old (86.9% vs. 92.4%; P < .01).

Conclusions

IT≥4 h remains a risk for post‐HTx mortality under the new system. However, the magnitude of this effect is blunted when donor age is ≥39 years, likely secondary to increased allocation of these organs to lower status, more stable recipients.
Inoperable duodenal ampullary carcinoma: Can endoscopic radiofrequency ablation therapy be a promising palliative treatment in the future?
Authors: Iwasaki Eisuke
Published: January 2022

This Editorial refers to the article by M.X. Xia et al., p 587‐595 of this issue.
Amoebic colitis rapidly diagnosed by endocytoscopy
Authors: Miyaguchi Kazuya , Tsuzuki Yoshikazu , Imaeda Hiroyuki
Published: January 2022

Watch a video of this article.
A detailed radiographic description and correlated magnetic resonance imaging findings of an infrequently identified articular indentation of the articular margin of the distal phalanx
Authors: Frietman S. K. , Aert C. D. M. Van , ter Braake F. , Compagnie E. , De Heer N.
Published: January 2022

Background

Equine veterinarians frequently obtain lateromedial radiographs of the feet. During assessment, one infrequently encounters a triangular‐shaped articular indentation of the articular surface of the distal phalanx (P3). To the authors’ knowledge, there are no detailed radiographic or MRI descriptions of this specific articular indentation in the literature so far.

Objectives

The main purpose of this study was to give a detailed morphological description of this radiographical identified articular indentation.

Study design

Descriptive study.

Methods

All LM and DP radiographs of the feet of horses presented at our hospital between August 2016 and August 2019 were retrospectively reviewed for presence of an articular indentation. Following selection, patient information, patient history, clinical findings, MRI‐finding and surgical details were retrieved. In total, 30 horses were included of which 12 underwent magnetic resonance imaging. Radiographs and MRI results were evaluated for the precise location, shape and extent of the articular indentation and for signs of degenerative joint disease of the DIPJ.

Results

Four different indentation types were identified radiographically. Concomitant low field MRI proved to be a useful and excellent imaging modality for evaluation of this rare articular indentation and its surrounding subchondral bone. MRI findings were various and ranged from slight subchondral contour deviations to obvious OCLL (Osseous Cyst Like Lesions). Furthermore, MRI identified some additional indentation related OCLLs that were not noted on plain radiographs.

Main limitations

The limited number of horses that were included and the absence of complementary histopathology.

Conclusions

Articular indentations are typically identified in the third quarter of the articular margin of P3 and may have underlying OCLLs. Since OCLLs are known to be a potential cause of future unsoundness, careful radiographic assessment is advised if an indentation is encountered. If needed, Standing Low‐Field MRI can give additional and detailed information.
PD‐L1 in circulating exosomes of Merkel cell carcinoma
Authors: Zanella Anaïs , Vautrot Valentin , Aubin François , Avoscan Laure , Samimi Mahtab , Garrido Carmen , Gobbo Jessica , Nardin Charlée
Published: January 2022

Exosomes, as potential circulated biomarkers, have recently become a topic of interest in the field of oncology. Immune checkpoint molecule PD‐L1 has recently been detected in circulating exosomes from cancer patients. The purpose of this work was to evaluate PD‐L1 levels in circulating exosomes (Exo‐PD‐L1) isolated from patients’ plasma suffering from Merkel cell carcinoma (MCC). We conducted a prospective bicentric cohort study. PD‐L1 was analysed in circulating exosomes from plasma samples of patients suffering from MCC stage I to IV (according to the AJCC 8). Exosomes from 34 patients corresponding to 66 samples were analysed. PD‐L1 was identified in circulating exosomes of MCC patients. Exo‐PD‐L1 levels of MCC patients were similar to healthy donors and lower than other cancers such as melanoma. Exo‐PD‐L1 levels tended to be higher in MCC patients with distant metastases. Furthermore, Exo‐PD‐L1 levels did not significantly vary over the course of the disease whatever the disease course or the response to treatment. This study assessed the presence of PD‐L1 in circulating exosomes of MCC patients. The low levels of Exo‐PD‐L1 and small changes over the course of the disease may be due to the metastatic dissemination of MCC, which is mainly through the skin and lymph nodes rather than blood. PD‐L1 was identified in circulating exosomes of MCC patients and tends to be higher in advanced disease. This preliminary study is a proof of concept of PD‐L1 detection in circulating exosomes of MCC patients.
Off‐target inhibition of NGLY1 by the polycaspase inhibitor Z‐VAD‐fmk induces cellular autophagy
Authors: Needs Sarah H. , Bootman Martin D. , Grotzke Jeff E. , Kramer Holger B. , Allman Sarah A.
Published: January 2022

The polycaspase inhibitor Z‐VAD‐fmk acts as an inhibitor of peptide: N‐glycanase (NGLY1), an endoglycosidase which cleaves N‐linked glycans from glycoproteins exported from the endoplasmic reticulum (ER) during ER‐associated degradation (ERAD). Both pharmacological N‐glycanase inhibition by Z‐VAD‐fmk and siRNA‐mediated knockdown (KD) of NGLY1 induce GFP‐LC3‐positive puncta in HEK 293 cells. The activation of ER stress markers or induction of reactive oxygen species (ROS) is not observed under either condition. Moreover, Ca2+ handling is unaffected when observing release from intracellular stores. Under conditions of pharmacological NGLY1 inhibition or NGLY1 KD, upregulation of autophagosome formation without impairment of autophagic flux is observed. Enrichment of autophagosomes by immunoprecipitation (IP) and mass spectrometry‐based proteomic analysis reveals comparable autophagosomal protein content. Gene ontology analysis of proteins enriched in autophagosome IPs shows overrepresentation of factors involved in protein translation, localization and targeting, RNA degradation and protein complex disassembly. Upregulation of autophagy represents a cellular adaptation to NGLY1 inhibition or KD, and ATG13‐deficient mouse embryonic fibroblasts (MEFs) show reduced viability under these conditions. In contrast, treatment with pan‐caspase inhibitor, Q‐VD‐OPh, does not induce cellular autophagy. Therefore, experiments with Z‐VAD‐fmk are complicated by the effects of NGLY1 inhibition, including induction of autophagy, and Q‐VD‐OPh represents an alternative caspase inhibitor free from this limitation.

Enzymes

Peptide:N‐glycanase1, Peptide‐N(4)‐(N‐acetyl‐beta‐glucosaminyl)asparagine amidase [EC:3.5.1.52].
Changes in elements and magnetic properties of Sendai Bay sediments caused by the 2011 Tohoku‐oki tsunami
Authors: Abe Hirokuni , Kawamura Noriko , Ishikawa Naoto , Kogiso Tetsu
Published: January 2022

Nearshore marine sediments deposited along island arcs can preserve evidence of past disaster events, such as tsunamis. Evidence of a tsunami that occurred off the Pacific coast of Tohoku, Japan, on March 11, 2011, was likely preserved in marine sediments. Using geochemical and rock magnetic analyses, this study aimed to investigate tsunami records preserved in marine sediments in Sendai Bay, located west of the epicenter of the 2011 Tohoku earthquake. We collected sediment samples at five stations (S‐1, S‐2, S‐3, S‐4, and S‐5) in Sendai Bay from 2002 to 2014. We compared the samples collected before and after the tsunami. We established that the silt component increased, while that of fine sand decreased at stations S‐3, S‐4, and S‐5 in the 2011 sediment sample. Notably, the concentrations of terrestrial and industrial metallic elements (Cu, Zn, and Pb) and total nitrogen, carbon, and sulfur amounts increased, while the magnetic susceptibility and isothermal remanent magnetization values decreased after the tsunami. We also found that Ti‐poor magnetite increased in the 2011 samples, indicating tsunami‐mediated changes. The study area experienced a large typhoon 6 months after the tsunami, leading to flooding. The elevation in the total organic carbon and total nitrogen ratio in the 2012 sample suggested that terrestrial organic matter was supplied by the flood.
Geochemistry and Sr–Nd isotopes of the Late Mesozoic lamprophyres in the Chaohu area, eastern China: Petrogenesis and tectonic implications
Authors: Chen Mo , Li Longming , Kan Tianxiang , Liu Hang , Zhao Xilin , Li Jiahao , Han Xu
Published: January 2022

Late Mesozoic lamprophyres are widespread in the Chaohu area of the Lower Yangtze region, eastern China. These mantle‐derived rocks are of great significance for understanding the characteristics of mantle source and tectonic environment of eastern China during the Late Mesozoic. The lamprophyres from the Chaohu area can be divided into two types. The type‐I lamprophyres have low SiO2 (43.8–44.5 wt.%) and TiO2 (1.06–1.14 wt.%), high MgO (13.5–17.5 wt.%) and high contents of compatible elements, and are enriched in LREE and LILE but depleted in HFSE. They have high initial 87Sr/86Sr (0.70767–0.70904) and negative εNd (t) (−4.8 to −4.4). The type‐II lamprophyres are characterized by low contents of SiO2 (43.0–45.4 wt.%), high TiO2 (1.74–2.55 wt.%), MgO (9.17–15.4 wt.%), and compatible elements. They are also enriched in LREE and LILE but depleted in HFSE. They show enriched Sr‐Nd isotopic compositions with initial 87Sr/86Sr values (0.70773–0.70886) and εNd (t) values (−8.6 to −7.8). The type‐I lamprophyres show higher Mg# and MgO contents but significant lower TiO2 than the type‐II lamprophyres. In addition, the type‐I lamprophyres have relatively similar initial 87Sr/86Sr ratios but higher εNd(t) values than the type‐II lamprophyres. The difference of geochemical characteristics between the type‐I and type‐II lamprophyres may be caused by different degrees of partial melting of an amphibole‐bearing garnet lherzolite mantle. The lithospheric mantle was metasomatised by the fluids caused by the rollback of the Paleo‐Pacific plate subduction during the Late Cretaceous.
A realist evaluation of weighted modalities as an alternative to pro re nata medication for mental health inpatients
Authors: Dawson Suzanne , Oster Candice , Scanlan Justin , Kernot Jocelyn , Ayling Barry , Pelichowski Katarzyna , Beamish Amelia
Published: January 2022

Implementing psychosocial approaches into mental health inpatient settings continues to be challenging. This is despite mental health policies prioritizing trauma‐informed and recovery‐orientated care approaches. This study reports on an interdisciplinary project that implemented and examined the uptake of weighted modalities in a psychiatric inpatient rehabilitation setting. While over‐reliance on pro re nata (PRN) medication in these settings has been reported, weighted modalities are a sensory approach that can be self‐initiated by consumers as an alternative to use of PRN to manage distress and agitation. A mixed‐methods realist approach was used to determine what works, for whom, and in what circumstances weighted modalities were offered by clinicians and used by consumers. Additionally, we were interested in determining whether there was an associated change in PRN use during the trial. Data included in‐depth interviews with consumers (n = 12) and clinicians (n = 11), and extraction of PRN medication use preceding, throughout, and following implementation. Statistical analysis revealed a significant increase in PRN rates in the first 3 months of implementation (mean difference from baseline = 29.5,P = 0.047) but a significant decrease in the second three‐month period following implementation (mean difference from baseline = −30.7,P = 0.036). Qualitative findings highlighted the key components of successful implementation as being environmental restructuring (availability/accessibility and visibility of weighted modalities) and social influences. Strategies to enhance these components are discussed.
Contemporary perceptions and meanings of ‘the medical model’ amongst NHS mental health inpatient clinicians
Authors: Barnes Georgina L. , Haghiran Maryam Z. , Tracy Derek K.
Published: January 2022

Debates within health care and public spheres have, at times, created a seeming ‘divide’ between biological and psychosocial determinants and management of mental health difficulties. The phrase ‘medical model’ is often held up as an example and is sometimes used pejoratively to infer over‐reliance on biology and medication. Our objective was to explore inpatient mental health clinicians’ perceptions of the definition and the application of a ‘medical model’ in contemporary mental health care. In this qualitative study, eighteen clinicians working in adult inpatient teams participated in three mixed focus groups. Data were analysed using framework analysis. Three core themes were identified: (i) power of a ‘medical model’ and authority of the medic; (ii) responsibility within, and reliance on, a ‘medical model’; and (iii) integrated models of contemporary mental health care. Subthemes arose around organisational culture and low resources affecting the power of a ‘medical model’ and the value of multidisciplinary and person‐centred approaches. The findings highlight the importance of recognising inter‐professional dynamics and power gradients in mental health teams and organisations, as we begin to move towards more integrated models of collaboration and distributed leadership within the NHS.
Die Aktualität der positivistischen Methode ‐ am Beispiel Thomas Mann
Authors: Dierks Manfred
Published: January 2022

Das derzeit prinzipielle Problem, wie theoretisch neu fundierte Methoden die Ergebnisse einer wissenschaftslogisch anders reflektierten »älteren« Literaturwissenschaft sich nutzbar machen könnten, wird an einem Beispiel aus der Thomas‐Mann‐Forschung angesprochen.

Verf. stellt zu Hartmut Böhmes sozialpsychologischer Interpretation von Murió und der Zauberer (Orbis Litterarum 1975, H. 4) fest, daß diese Interpretation um eine entscheidende Erkenntnisdimension verkürzt bleibt, weil sie Thomas Manns primäre Gedankenmodelle außer acht läßt. Dies wird in drei Schritten unternommen:

Das den Ereignissen im Mario tatsächlich unterlegte Strukturierungs‐ und Deutungsmodell Thomas Manns wird nach seiner Entstehung im Werk rekonstruiert.

Die Novelle wird in dieser Hinsicht neu interpretiert.

Es wird dabei nachgewiesen, inwiefern eine rein sozialpsycho logische Textanalyse sich in der Einschätzung Thomas Manns verfehlt. Dieser steht in entscheidender Differenz zum symbolisch unterliegenden Ich‐Erzähler, seine eigenen Deutungsmuster bleiben stabil.
Fully dense ZrB2 ceramics by borothermal reduction with ultra‐fine ZrO2 and solid solution
Authors: Xu Liang , Guo Wei‐Ming , Liu Qiu‐Yu , Zhang Yan , Wu Li‐Xiang , You Yang , Lin Hua‐Tay
Published: January 2022

The effects of ZrO2 particle size (55 nm and 113 nm) and borothermal reduction routes (borothermal reduction with water‐washing (BRW) and in situ 5 mol% TaB2 solid solution, BRS) on synthesis and densification of ZrB2 were investigated. Irrespective of reduction routes, the use of finer ZrO2 powders as raw materials resulted in finer ZrB2 powders. Compared to the powders derived from BRS, the powders derived from BRW had smaller particle size with higher oxygen content, especially the powders synthesized with finer ZrO2. Irrespective of ZrO2 particle size, the oxygen contents of ZrB2 powders prepared by the BRS route were similar. Because of the high oxygen content, the ZrB2 ceramics synthesized by BRW with finer ZrO2 demonstrated the lowest relative density (90.5%), which resulted in the lowest Vickers’ hardness (14.2 ± 0.9 GPa). Due to the low oxygen content and small particle size of ZrB2 powders, fully dense ZrB2 ceramics (relative density: 99.6%) with highest Vickers’ hardness (16.0 ± 0.2 GPa) were achieved by BRS with finer ZrO2 powders.
Synthesis of Na ion‐electron mixed conductor Na3Zr2Si2PO12 by doping with transition metal elements (Co, Fe, Ni)
Authors: Luo Jing , Zhao Gaolei , Qiang Wenjiang , Huang Bingxin
Published: January 2022

NASICON solid electrolyte Na3Zr2Si2PO12 (NZSP) exhibits high chemical stability and can be utilized as cladding materials of cathodes to improve battery cycle stability. However, the electronic conductivity of NZSP is extremely low (∼10−9 S cm−1), which will hinder the electron conduction of cathode materials. To address this issue, the electronic conductivity of NZSP is improved by doping with transition metal elements (Co, Fe, Ni). Co‐doped NZSP has an electronic conductivity of 5.03 × 10−6 S cm−1. On the other hand, the ionic conductivity of doped samples remains stable, even slightly increased. The mechanical properties of pristine and doped samples are characterized with a micro indenter, which is also a key parameter for coating materials.
Barium‐doped Sr2Fe1.5Mo0.5O6‐δ perovskite anode materials for protonic ceramic fuel cells for ethane conversion
Authors: Fan Yun , Xi Xiuan , Li Jun , Wang Qi , Xiang Kun , Medvedev Dmitry , Luo Jing‐Li , Fu Xian‐Zhu
Published: January 2022

Protonic ceramic ethane fuel cells fed by hydrocarbon fuels are demonstrated to be effective energy conversion devices. However, their practical application is impeded by a lack of anode materials combining excellent catalytic activity with good chemical stability and anti‐carbon deposition properties. In this work, in which Sr2Fe1.5Mo0.5O6‐δ (SFM) double perovskite oxide is used as the matrix framework, catalytic activity toward H2 and C2H6 oxidation is systematically investigated using Ba‐doping. It is found that the concentration of the oxygen vacancy is gradually improved with increased Ba content to significantly enhance catalytic activity toward H2 and C2H6 oxidation. From the series studied, Ba0.6Sr1.4Fe1.5Mo0.5O6‐δ exhibits the highest catalytic activity, while the power densities of the electrolyte‐supported Ba0.6SFM/BaCe0.7Zr0.1Y0.2O3‐δ (BCZY)/La0.58Sr0.4Co0.2Fe0.8O3‐δ (LSCF)‐Sm0.2Ce0.8O2‐δ (SDC) single cell reach 205 and 138 mW cm–2 at 750°C in H2 and C2H6, respectively. The ethane conversion rate of the experimental cell is shown to reach 38.4%, while simultaneously maintaining ethylene selectivity at 95%. Furthermore, the single cell exhibits no significant attenuation during stable operation for 20 h, as well as demonstrating excellent anti‐coking performance. The proposed results suggest that Ba0.6Sr1.4Fe1.5Mo0.5O6‐δ represents a promising anode material for efficient hydrocarbon‐related electrochemical conversion to realize the coproduction of ethylene and power in protonic ceramic ethane fuel cells.
The impact of competitive integrated employment on economic, psychological, and physical health outcomes for individuals with intellectual and developmental disabilities
Authors: Taylor Joshua , Avellone Lauren , Brooke Valerie , Wehman Paul , Inge Katherine , Schall Carol , Iwanaga Kanako
Published: January 2022

Background

Although competitive integrated employment (CIE) has been established as a goal of employment research, policy, and practice for individuals with intellectual and developmental disabilities, the secondary benefits of CIE are rarely discussed.

Aims

The purpose of this systematic review was to analyze and synthesise research related to the association between CIE and improved economic, psychological health, and physical health outcomes for individuals with intellectual and developmental disabilities.

Materials & Methods

Our review searched peer‐reviewed literature from seven electronic databases and screened 1110 peer‐reviewed articles based on inclusion criteria established following PRISMA guidelines.

Results

Our search procedures produced a final sample of 17 studies.

Discussion

Implications of these findings for future research, policy, and practice are provided.

Conclusion

Our findings showed strong evidence associated with economic outcomes of CIE, moderate associated with psychological health outcomes, and limited evidence related to physical health outcomes.
Effect of electrolyzed water and carbon dioxide microbubbles on removal of diazinon and diazoxon
Authors: Kobayashi Fumiyuki , Aoki Hitoshi , Kamagata Junichi , Odake Sachiko
Published: January 2022

Effect of electrolyzed water (EW) produced from sodium chloride solution in a single vessel and carbon dioxide microbubbles (CO2MB) on decomposition of diazinon and its oxidized product, diazoxon, was investigated. Furthermore, these removal by the EW with CO2MB from broccoli‐attached diazinon was examined. Diazinon was oxidized to diazoxon by EW, and the oxidative effect increased with increasing EW concentration from 0.1 to 0.6 mol L−1 or electrolyzing time from 1 to 10 min. However, EW concentration more than 0.2 mol L−1 was required to reduce diazoxon. The effect of EW on the decomposition of diazoxon increased with increasing EW concentration, electrolyzing time or reaction time from 10 to 60 min but decreased by generating CO2MB. Furthermore, diazinon concentration in broccoli was significantly decreased by treatment with deionized water or EW for 10 min, and the removal effect was continued by generating CO2MB in EW until 60 min. The diazoxon concentration in broccoli treated by EW decreased after increased up to 30 min, and the removal effect was increased by generating CO2MB. Also, the pH and available chlorine concentration (ACC) of the EW increased with increasing EW concentration or electrolyzing time but decreased and almost unchanged by generating CO2MB, respectively. Therefore, it was revealed that EW had a decomposition effect on diazinon and diazoxon and that CO2MB promoted the effect of EW on the removal of these pesticides in broccoli. Additionally, the decomposition effect of EW on diazinon and diazoxon was suggested to be influenced by high pH and ACC.

Practical Application

The EW produced from NaCl solution in a single vessel is a safer technique easy to be used than that from HCl. In addition, CO2MB has no harmful effects on the human body. This study demonstrated that the EW was effective for decomposing diazinon, an organophosphorus insecticide, and diazoxon, its oxidized product, and that the removal of these pesticides in broccoli by the EW could be more effectively achieved by generating CO2MB. Therefore, the use of EW with CO2MB can be expected to remove pesticides from fruits and vegetables at food factory.
Immune profile by multiplexed immunohistochemistry associated with recurrence after chemoradiation in rectal cancer
Authors: Hong Seung Wook , Lee Seohyun , Kim Yun Jae , Ahn Soyeon , Park In Ja , Hong Seung‐Mo , Hwang Sung Wook , Park Sang Hyoung , Yang Dong‐Hoon , Ye Byong Duk , Byeon Jeong‐Sik , Yang Suk‐Kyun , Kim Jaeil , Kim Sang‐Yeob , Myung Seung‐Jae
Published: January 2022

Background and Aim

Evidence has emerged that a pretreatment immune profile in rectal cancer is associated with response to chemoradiotherapy (CRT) and recurrence after CRT. However, few studies have evaluated the immune profile differences after CRT regarding recurrence and nonrecurrence.

Methods

We included patients with advanced rectal cancer treated with CRT and surgery with recurrence within 1 year in a recurrence group. After sex and age matching with the recurrence group, patients with no recurrence for 3 years after CRT were included in a nonrecurrence group. We extracted the immune profile, including CD3 and CD8, from the surgical specimen after CRT using multispectral fluorescence immunohistochemistry and compared the two groups.

Results

The immune profiles of 65 patients with rectal cancer were assessed; 30 were included in the recurrence group and 35 were included in the nonrecurrence group. CD3+ and CD8+ T lymphocyte densities were significantly higher in the nonrecurrence group than in the recurrence group (CD3+; P < 0.001, CD8+; P = 0.003) in the primary tumor. Consistent results were found in epithelial and stromal cells. Compared with the recurrence group, the distinct profiles of co‐expressed immune markers in the nonrecurrence group were revealed (CD3+CD8+, P = 0.001; CD3+CD8+PD‐L1−, P = 0.001; CD3+CD8+ FOXP3− PD‐L1−, P = 0.001).

Conclusions

Vigorous CD3+ and CD8+ T cell priming post‐CRT was prominent in the nonrecurrence group compared with that of the recurrence group. This finding suggests that differences in immune profiles may have clinical significance even after CRT.
Randomized field trial comparing the efficacy of florfenicol and oxytetracycline in a natural outbreak of calf pneumonia using lung reaeration as a cure criterion
Authors: Jourquin Stan , Bokma Jade , De Cremer Lieze , van Leenen Katharina , Vereecke Nick , Pardon Bart
Published: January 2022

Background

Respiratory infections are the main indication for antimicrobial use in calves. Optimal treatment duration currently is unknown, but shorter duration would likely decrease selection for antimicrobial resistance.

Hypothesis/Objectives

Determine differences in cure rate and healing time between animals treated with florfenicol and oxytetracycline in a natural outbreak of respiratory disease using reaeration observed on thoracic ultrasound examination as healing criterion.

Animals

Commercial farm housing 130, 3 to 9 month old Belgian blue beef calves.

Methods

Randomized clinical trial during an outbreak of respiratory disease. Metaphylactic treatment was initiated, randomly treating animals with either florfenicol or oxytetracycline. Ultrasonographic follow‐up was done the first day and every other day for a 14‐day period. At the individual animal level, treatment was discontinued when reaeration of the lungs occurred. Differences in cure rate and healing time were determined.

Results

Of the 130 animals studied, 67.7% developed a lung consolidation ≥0.5 cm. The mean ultrasonographic healing time was 2.5 days in the florfenicol group compared to 3.1 days in the oxytetracycline group (P = .04). After single treatment, 80.6% and 60.3% had no consolidations in the florfenicol and oxytetracycline groups, respectively (P = .01). A Mycoplasma bovis strain was genetically and phenotypically determined to be susceptible to both antimicrobials.

Conclusions and Clinical Importance

Ultrasonographic lung reaeration shows potential as a cure criterion to rationalize antimicrobial use for outbreaks of pneumonia. In our study, florfenicol resulted in a faster cure and higher reduction in antimicrobial usage than did oxytetracycline.
Formal Jests: the Sonata‐Form Scherzo in Mendelssohn's Mature Chamber Music
Authors: TAYLOR BENEDICT
Published: January 2022

One of the most striking aspects of Mendelssohn's scherzi is his unusual propensity for sonata form in this movement type. Yet in referencing sonata construction, the composer frequently appears to be playing against its norms, taking delight in confounding expectations in the movement's formal twists and turns, as if this ambiguous and ever‐shifting relation were itself a crucial part of the aesthetic quality of the music. The present article examines the manipulations of form present in the sonata‐orientated scherzi of Mendelssohn's mature chamber works from the period 1837–45: those of the String Quartets Op. 44 Nos 2 and 3 and the Piano Trios Op. 49 and Op. 66. In doing so, it makes several significant contributions to current debates about sonata form. First, while continuing the incursion of Formenlehre into the nineteenth century, it brings discussion of sonata form round to address a movement type – the scherzo – not normally considered in recent discussions. Second, the interaction between different formal types posited by these movements has numerous similarities with the dialogic approach foregrounded by James Hepokoski and Warren Darcy's sonata theory. The playful ambiguities suggested by Mendelssohn's scherzi seem particularly suited to a theory in which formal meaning is understood to arise from the productive tension between expectation and realisation, abstract generic norm and particular instantiation. Still, much of Mendelssohn's subtle manipulation of form occurs on the smaller‐scale level of syntax, and one of this study's final implications concerns the interrelation between top‐down, intentional models and bottom‐up, generative approaches to form.
The impact of ABCDE bundle implementation on patient outcomes: A nationwide cohort study
Authors: Frade‐Mera María Jesús , Arias‐Rivera Susana , Zaragoza‐García Ignacio , Martí Joan Daniel , Gallart Elisabet , San José‐Arribas Alicia , Velasco‐Sanz Tamara Raquel , Blazquez‐Martínez Eva , Raurell‐Torredà Marta
Published: January 2022

Background

The ABCDE bundle is a set of evidence‐based practices to systematically reduce the risks of sedation, delirium, and immobility in intensive care patients. Implementing the bundle improves clinical outcome.

Aims and Objectives

To investigate the association between patient outcomes and compliance with bundle components ABC (analgosedation algorithms), D (delirium protocol), and E (early mobilization protocol).

Design

A Spanish multicentre cohort study of adult patients receiving invasive mechanical ventilation (IMV) for ≥48 h until extubation.

Methods

The primary outcome was pain level, cooperation to permit Medical Research Council Scale administration, patient days of delirium, and mobility. The secondary outcome was cumulative drug dosing by IMV days. Tertiary outcomes (ICU days, IMV days, bed rest days, ICU mortality, ICUAW) and independent variables (analgosedation, delirium, early mobilization protocols) were also studied.

Results

Data were collected from 605 patients in 80 ICUs and 5214 patient days with IMV. Two‐thirds of the ICUs studied applied no protocols. Pain was not assessed on 83.6% of patient days. Patient cooperation made scale administration feasible on 20.7% of days. Delirium and immobility were found on 4.2% and 69.9% of days, respectively. Patients had shorter stays in ICUs with bundle protocols and fewer days of IMV in ICUs with delirium and mobilization bundle components (P = 0.006 and P = 0.03, respectively). Analgosedation protocols were associated with more opioid dosing (P = 0.02), and delirium and early mobilization protocols with more propofol (P = 0.001), dexmedetomidine (P = 0.001), and lower benzodiazepine dosing (P = 0.008).

Conclusions

The implementation rate of ABCDE bundle components was very low in our Spanish setting, but when implemented, patients had a shorter ICU stay, more analgesia dosing, and lighter sedation.

Relevance to clinical practice

Applying some but not all the bundle components, there is increased analgesia and light sedation drug use, decreased benzodiazepines, and increased patient cooperation and mobility, resulting in a shorter ICU stay and fewer days of IMV.
Into great silence: Pierre Péju’s La Petite Chartreuse, a contemporary tale of secular pilgrimage
Authors: Ponnou‐Delaffon Erin Tremblay
Published: January 2022

La Petite Chartreuse (2002), penned by the prolific yet understudied novelist and essayist Pierre Péju, charts an unlikely relationship in the wake of a devastating accident. As he walks the Massif de la Chartreuse in the shadow of the Carthusian Grande Chartreuse, a solitary bookseller searches inner depths and mountainous heights before confronting his eponymous young victim’s death—and his own. Informed by the hermeneutical relationship between tale and travel, this chapter reads the novel as a contemporary conte (as theorized by Péju himself), as well as a secular pilgrimage (informed, notably, by Thomas Merton). I contend that Péju’s secular antihero, within (rather than in spite of) physically circumscribed conditions, paradoxically scales spiritual heights epitomized by these two wayfaring narrative traditions. His tale offers a defense and illustration of reading in the face of modernity’s acceleration and dematerialization, challenges contemporary unease before suffering, and belies personal and narrative expectations like progress and harmonious closure. Ultimately, I suggest that Péju plots a profoundly humanistic voyage unto death, as he defamiliarizes the very terrain of these travel genres.
Spermidine enhances the survival of Streptococcus pyogenes M3 under oxidative stress
Authors: Banerji Rajashri , Iyer Parvati , Saroj Sunil D.
Published: January 2022

Streptococcus pyogenes, a host‐restricted gram‐positive pathogen during infection, initially adheres to the epithelia of the nasopharynx and respiratory tract of the human host, followed by disseminating to other organs and evading the host immune system. Upon phagocytosis, S. pyogenes encounters oxidative stress inside the macrophages. The role of polyamines in regulating various physiological functions including stress resistance in bacteria has been reported widely. Since S. pyogenes lacks the machinery for the biosynthesis of polyamines, the study aimed to understand the role of extracellular polyamines in the survival of S. pyogenes under oxidative stress environments. S. pyogenes being a catalase‐negative organism, we report that its survival within the macrophages and H2O2 is enhanced by the presence of spermidine. The increased survival can be attributed to the upregulation of oxidative stress response genes such as sodM, npx, and mtsABC. In addition, spermidine influences the upregulation of virulence factors such as sagA, slo, and hasA. Also, spermidine leads to a decrease in hydrophobicity of the cell membrane and an increase in hyaluronic acid. This study suggests a role for extracellular spermidine in the survival of S. pyogenes under oxidative stress environments. Recognizing the factors that modulate S. pyogenes survival and virulence under stress will assist in understanding its interactions with the host.