bluuebunny/crossref_metadata_2025 huggingface dataset:
Cholangiocarcinoma: Advocate an Aggressive Operative Approach with Adjuvant Chemotherapy
Authors: Kelley S.T. , Bloomston M. , Serafini F. , Carey L.C. , Karl R.C. , Zervos E. , Goldin S. , Rosemurgy P. , Rosemurgy A.S.
Published: November 2022

Cholangiocarcinoma presents many challenges. Prognosis is thought to be determined by conventional predictors of survival; margin status, pathologic criteria, stage, and comorbid disease. Ninety-four patients, 57 males and 37 females, underwent resections for cholangiocarcinoma between 1989 and 2000. Thirty-two patients (34%) had distal tumors, 10 had midduct lesions, and 52 had proximal/intrahepatic lesions. Thirty-four patients underwent pancreaticoduodenectomies, 23 bile duct resections alone, and 37 bile duct and concomitant hepatic resections. Tumor location did not influence mean survival (distal, 28 months ± 23; midduct, 28 months ± 21; and proximal, 31 months ± 36). Operation undertaken did not alter survival (bile duct resection, 30 months ± 37; pancreaticoduodenectomy, 27 months ± 23; and concomitant bile duct/hepatic resection, 32 months ± 32). TNM stage failed to predict survival: 5 stage I (29 months ± 22), 12 stage II (41 months ± 33), 12 stage HI (33 months ± 19), and 64 stage IV (27 months ± 32). Tumor size did not influence survival: T1–2 (32 months ± 33) versus T3–4 lesions (29 months ± 25). Mean survival with negative margin (n = 67) was 34 months ± 33, whereas microscopically positive (n = 13, 23.9 months ± 25) or grossly positive (n = 14, 20.4 months ± 20) margins were predictive of significantly shorter survival ( P < 0.03). Adjuvant treatment (n = 41) was associated with significantly longer survival (40.5 months ± 36) than those who received no further therapy (n = 53; 24 months ± 24) ( P = 0.05). TNM stage, tumor size, operation undertaken, and location were not associated with duration of survival after resection. Margin status was associated with duration of survival, though extended survival is possible even with positive margins. Advanced stage should not preclude aggressive resection. Without specific contraindications, an aggressive operative approach is advocated followed by adjuvant therapy.
A Novel Intestinal Anastomotic Device in a Porcine Model
Authors: Park Adrian E. , Adrales Gina L. , Mckinlay Roderick , Knapp Charles
Published: November 2022

The purpose of this study was to evaluate a novel, intraluminally deployed anastomotic device (AD). A survival study was conducted in 18 farm pigs. One early subject was excluded and replaced due to premature expiration. Six animals were placed in 1 of 3 cohorts, with euthanasia and AD explantation planned at 2, 4, and 6 weeks. A distal small intestinal side-side [functional end-end] anastomosis using the AD was performed via midline laparotomy. Fluoroscopy with double-contrast dilute barium and burst pressure measurements were performed in 4 animals in each group. Two animals in each cohort underwent fluoroscopy without contrast and resection for histology. Mucosal healing, inflammation, anastomotic alignment of the muscularis propria, and fibrosis were graded on a 4-point scale. All animals survived to the date of planned euthanasia except the excluded subject, who expired from causes unrelated to the device. Normal weight gain was seen in all. Sixteen of 18 devices sloughed prior to extraction without evidence of injury or obstruction during the survival period or at necropsy. Filling pressures of >200 mm Hg were reached; no leakage was seen. Mucosal healing and continuity were graded good to excellent at 2 weeks and excellent at 4 and 6 weeks. Inflammation improved with time, with moderate change at 2 weeks and mild at 6 weeks. Anastomotic fibrosis was mild at 2 weeks, mild to minimal at 4 weeks, and minimal at 6 weeks. The anastomotic alignment was 100 per cent except in 1 animal at 2 weeks with >50 per cent but <100 per cent alignment. The AD resulted in a stable, functional anastomosis without narrowing. All tested anastomoses withstood supraphysiologic insufflation pressures without evidence of disruption. The applicability of this novel device will be explored for use in other gastrointestinal and biliary anastomoses using minimally invasive deployment techniques.
Regulation of Tumor Necrosis Factor-α Production in the Isolated Rat Heart Stimulated by Bacterial Lipopolysaccharide or Reactive Oxygen
Authors: Jennings G. Russell , Castresana Manuel R. , Newman Walter H.
Published: November 2022

Reperfusion after cardiopulmonary bypass causes induction of reactive oxygen species (ROS), elevated plasma levels of bacterial lipopolysaccharide (LPS), and production of tumor necrosis factor-α (TNF) by the heart. Nuclear factor-κB (NF-κB) regulates the expression of TNF. Because NF-κB is activated by both LPS and ROS, we hypothesized that an inhibitor of NF-κB, pyrrolidine dithiocarbamate (PDTC), would block release of TNF from the heart stimulated by these two agents. With Institutional animal care and use committee (IACUC) approval, rat hearts were perfused Langendorf style. LPS was infused and ROS were generated with a hypoxanthine/xanthine oxidase system. PDTC was added to the perfusion buffer. Other hearts were treated with forskolin in order to elevate cyclic AMP. Timed collections of coronary effluent were made for the determination of coronary flow and measurement of TNF. LPS stimulated TNF release to a maximum of 2247 ± 133 pg/min at 150 minutes. PDTC inhibited LPS-stimulated TNF release. For instance, at 150 minutes, LPS-stimulated TNF release was 449 ± 49 pg/min with 100μM PDTC and was 70 ± 65 pg/mL with 250μM PDTC ( P < 0.05 vs LPS alone). ROS stimulated TNF release was 1494 ± 130 pg/min at 150 minutes and was not affected by PDTC. Forskolin almost completely blocked TNF release stimulated by LPS or ROS. These data are consistent with the notion that inhibitors of NF-κB block cytokine production stimulated by some agents but not others.
A Retrospective Study of Nosocomial Pneumonia in Postoperative Patients Shows a Higher Mortality Rate in Patients Receiving Nasogastric Tube Feeding
Authors: Bullock Timothy K. , Waltrip Todd J. , Price Shaun A. , Galandiuk Susan
Published: November 2022

Pneumonia remains a significant cause of morbidity and mortality in surgical patients. Though most studies have focused on pneumonia in trauma or special respiratory intensive care units (ICU), we examine postoperative ventilator-associated pneumonia in patients undergoing elective operations. We hypothesized that a study of multiple clinical variables would disclose factors influencing morbidity and mortality in these patients. We conducted a retrospective review of 1969 patients who underwent elective general, cardiac, and general thoracic procedures during a 6-month period in a private teaching hospital. A total of 77 patients (3.9%) developed postoperative ventilator-associated pneumonia. Thirty-eight (49%) patients had a history of smoking and 27 (35%) had chronic obstructive pulmonary disease (COPD). Among these 77 patients, 20 (26%) experienced recurrent pneumonia. The overall mortality rate for patients developing pneumonia was 34 per cent. At diagnosis of pneumonia, 33 patients were receiving enteral nutrition through nasogastric feeding tubes, whereas 41 received no enteral feeding. The method of nutritional intake was not known in 3 patients. The feeding/nonfeeding groups were similar in age and underlying disease, differing significantly only in the higher number of smokers in the patients not receiving enteral nutrition ( P = 0.03). To our surprise, the mortality rate from all causes was higher ( P = 0.018) in the patients who received tube feedings through soft, nasogastric feedings (33%) than in those not enterally fed (17%). Parenteral nutrition, COPD, number of ventilator days, and the location of the tip of the feeding tube did not correlate with mortality. The mortality rate from all causes was higher in patients with postoperative pneumonia who received tube feedings, despite similar underlying medical illnesses. Enteral feeding of postoperative surgical patients has many desirable effects, but prospective studies should address harmful effects, such as presumed aspiration and related pneumonia.
Stent-Graft Repair for Acute Traumatic Thoracic Aortic Rupture
Authors: Neuhauser B. , Czermak B. , Jaschke W. , Waldenberger P. , Fraedrich G. , Perkmann R.
Published: November 2022

Traumatic rupture of the thoracic aorta is potentially life-threatening and leads to death in 75 to 90 per cent of cases at the time of injury. In high-risk patients, as traumatic injuries of the aorta combine with multiple associated injuries, endoluminal repair is now reported as a promising therapeutic strategy with encouraging results. This study determined the outcome of patients with traumatic thoracic aortic injury treated endovascularly during the past 7 years at our institution. Thirteen patients, 11 males and 2 females (mean age, 39 years; range, 19–82), with traumatic rupture of the otherwise unremarkable descending aorta (10 acute, 3 chronic), out of a series of 64 endovascular thoracic stent-graft procedures, were treated by implantation of Talent (n = 8), Vanguard (n = 5), and Excluder (n = 2) self-expanding devices between January 1996 and August 2003. The immediate technical success rate was 92 per cent (12/13). One patient showed a proximal endoleak type I, which was treated successfully by an additional stent-graft procedure. Secondary success rate was 100 per cent. The mortality rate was 0 per cent. Two additional stent-graft procedures were performed due to type I endoleaks after 18 and 28 months. There was no other intervention-related morbidity or mortality during the mean follow-up time of 26.4 months (range, 6–86). Endovascular stent-graft repair of traumatic thoracic aortic injuries is a safe, effective, and low-morbidity alternative to open thoracic surgery and has promising midterm results.
Reoperative Fundoplications are Effective Treatment for Dysphagia and Recurrent Gastroesophageal Reflux
Authors: Rosemurgy Alexander S. , Arnaoutakis Dean J. , Thometz Donald P. , Binitie Odion , Giarelli Natalie B. , Bloomston Mark , Goldin Steve G. , Albrink Michael H.
Published: November 2022

With wide application of antireflux surgery, reoperations for failed fundoplications are increasingly seen. This study was undertaken to document outcomes after reoperative fundoplications. Sixty-four patients, 26 men and 38 women, of average age 55 years ± 15.6 (SD), underwent reoperative antireflux surgery between 1992 and 2003. Fundoplication prior to reoperation had been undertaken via celiotomy in 27 and laparoscopically in 37. Both before and after reoperative antireflux surgery, patients scored their reflux and dysphagia on a Likert Scale (0 = none, 10 = continuous). Reoperation was undertaken because of dysphagia in 16 per cent, recurrent reflux in 52 per cent (median DeMeester Score 52), or both in 27 per cent. Failure leading to reoperation was due to hiatal failure in 28 per cent, wrap failure in 19 per cent, both in 33 per cent, and slipped Nissen fundoplication in 20 per cent. Laparoscopic reoperations were completed in 49 of 54 patients (91%); 15 had reoperations undertaken via celiotomy. Eighty-eight per cent of reoperations were Nissen fundoplications. With reoperation, Dysphagia Scores improved from 9.5 ± 0.7 to 2.6 ± 2.8, and Reflux Scores improved from 9.1 ± 1.4 to 1.8 ± 2.7. Seventy-nine per cent of patients with reflux prior to reoperation, 100 per cent with dysphagia, and 74 per cent with both noted excellent or good outcomes after reoperation. We conclude that failure after fundoplication occurs. Reoperations reduce the severity of dysphagia and reflux, thus salvaging excellent and good outcomes in most. Laparoscopic reoperations are generally possible. Reoperative fundoplications are effective treatment for dysphagia and recurrent gastroesophageal reflux, and their application is encouraged.
Interpersonal stress mediates the relationship between childhood trauma and depressive symptoms: Findings from two culturally different samples
Authors: Fung Hong Wang , Lam Stanley Kam Ki , Chien Wai Tong , Hung Suet Lin , Ling Henry Wai-Hang , Lee Vincent Wan Ping , Wang Edward KS
Published: November 2022

Objective:

Childhood trauma is associated with adulthood depressive symptoms, but very few studies explored potential social and interpersonal mediators behind this association. This study made the first attempt to test the potential mediating effects of interpersonal stress in the associations between childhood betrayal and non-betrayal trauma and depressive symptoms.

Method:

We analyzed data in a sample of English-speaking adults from diverse backgrounds (from 19 different countries, mainly from Western countries) ( N = 468). We then replicated and compared the results with those in another convenience sample of Chinese-speaking younger adults with different cultural backgrounds and mental health status ( N = 205).

Results:

The results in both samples indicated that (1) childhood betrayal trauma had a stronger relationship with depressive symptoms than childhood non-betrayal trauma and that (2) interpersonal stress was a significant mediator in the relationship between childhood betrayal trauma and depressive symptoms, even when childhood non-betrayal trauma was included as a covariate. The indirect effect of childhood non-betrayal trauma on depressive symptoms through interpersonal stress was not consistent in two samples.

Conclusions:

Our findings point to the importance of taking social and interpersonal contexts into account when investigating, preventing and managing depression in trauma-exposed populations. Early social interventions such as family interventions, interpersonal skills training and building social resources may have the potential to change the trajectory of the development of mental health problems in trauma survivors.
Effect of particles morphology on the effective elastic properties of bio–composites reinforced by seashells: Numerical investigations
Authors: Ben–Ltaief Nada , NGuyen Franck , Kanit Toufik , Imad Abdellatif , Bel–Hadj–Ali Nizar
Published: November 2022

Seashell waste, mainly composed of calcium carbonate and made of a complex microstructure, has been increasingly used as a bio–filler for composite materials, in a crushed or powdered state. Seashell particles present various sizes and shapes which in turn could affect the mechanical properties of the composites. The main aim of this work is to investigate the effect of particles size and shape and inter–phase properties on the overall elastic properties of bio–composite reinforced by seashell particles. For that purpose, a morphological study based on particles size measurement and shape analysis, was first carried out in order to identify the morphological distribution of seashell particles. Seashell particles were classified into six diameters and six types of shape. Afterwards, a numerical homogenization based on finite element and representative elementary volume is used to compute the effective elastic properties of bio–composites, which include bulk modulus, shear modulus, and Young’s modulus. We assumed a perfect bond at the polyester/seashell particle inter–phase. Then we incorporate an inter–phase surrounding the seashell particles by considering variable properties (thickness, number of layers). In the present work, the calculations are carried out for two types of microstructures according to particles shapes. Several microstructure configurations were considered by varying particles sizes and volume fractions 6.6, 13.7, 21.4, 25.5, and 29.8%. The results showed that adding seashell particles significantly improves the effective elastic properties of polyester composite and that the morphology of seashell particles and the inter–phase structure has a negligible effect on the effective elastic properties of bio–composite. As for inter–phase thickness, it could have a considerable effect on the effective elastic properties of bio–composites.
Novel Genetic Determinants of Dental Maturation in Children
Authors: Grgic O. , Prijatelj V. , Dudakovic A. , Vucic S. , Dhamo B. , Trajanoska K. , Monnereau C. , Zrimsek M. , Gautvik K.M. , Reppe S. , Shimizu E. , Haworth S. , Timpson N.J. , Jaddoe V.W.V. , Jarvelin M.-R. , Evans D. , Uitterlinden A.G. , Ongkosuwito E.M. , van Wijnen A.J. , Medina-Gomez C. , Rivadeneira F. , Wolvius E.B.
Published: November 2022

Dental occlusion requires harmonious development of teeth, jaws, and other elements of the craniofacial complex, which are regulated by environmental and genetic factors. We performed the first genome-wide association study (GWAS) on dental development (DD) using the Demirjian radiographic method. Radiographic assessments from participants of the Generation R Study (primary study population, N1 = 2,793; mean age of 9.8 y) were correlated with ~30 million genetic variants while adjusting for age, sex, and genomic principal components (proxy for population stratification). Variants associated with DD at genome-wide significant level ( P < 5 × 10−8) mapped to 16q12.2 ( IRX5) (lead variant rs3922616, B = 0.16; P = 2.2 × 10−8). We used Fisher’s combined probability tests weighted by sample size to perform a meta-analysis ( N = 14,805) combining radiographic DD at a mean age of 9.8 y from Generation R with data from a previous GWAS ( N2 = 12,012) on number of teeth (NT) in infants used as proxy of DD at a mean age of 9.8 y (including the ALSPAC and NFBC1966). This GWAS meta-analysis revealed 3 novel loci mapping to 7p15.3 ( IGF2BP3: P = 3.2 × 10−8), 14q13.3 ( PAX9: P = 1.9 × 10−8), and 16q12.2 ( IRX5: P = 1.2 × 10−9) and validated 8 previously reported NT loci. A polygenic allele score constructed from these 11 loci was associated with radiographic DD in an independent Generation R set of children ( N = 703; B = 0.05, P = 0.004). Furthermore, profiling of the identified genes across an atlas of murine and human stem cells observed expression in the cells involved in the formation of bone and/or dental tissues (>0.3 frequency per kilobase of transcript per million mapped reads), likely reflecting functional specialization. Our findings provide biological insight into the polygenic architecture of the pediatric dental maturation process.
Race, Toxic Exposures, and Environmental Health: The Contestation of Lupus among Farmworkers
Authors: Adams Alison E. , Saville Anne , Shriver Thomas E.
Published: November 2022

Extant research has established that low-wage workers of color are at higher risk for occupational exposures. While the medical sociology literature regarding contested illness provides insights into the dynamics surrounding workplace exposures, some environmental illnesses such as lupus have gotten scant analytical attention. This is a significant gap because women of color, who are more likely to hold these high-risk jobs, are disproportionately affected by the disease. We examine a case of pesticide exposure among Black women farmworkers in Florida. We investigate how race and occupation intersect to shape lived experiences with toxics and what role race plays in the process of contesting exposures and illness. Our data include in-depth interviews (N = 36), media coverage, and archival materials. Our findings indicate that race-related factors played an important part in shaping the farmworkers’ experiences with exposures, illness, and interaction with elite actors.
Safe, supported, and empowered
Authors: White Annie M. , Weiss John Kenneth
Published: November 2022

Many effective strategies exist to keep students safe, supported, and engaged in school. Restorative practice (RP) is a powerful approach for achieving these goals as it elevates student voice and can strengthen school climate. Annie M. White and John Kenneth Weiss share findings from an initiative through which high school student-faculty teams learned strategies to use RP practices and incorporate student voice to improve school climate. After two years, students gained the confidence to work for school change. They offer implementation recommendations, including prioritizing relationship-building, reaching a critical mass, and providing structure for engagement. Ultimately, they found that student voice and engagement may be key to improving school climate.
The fraught connection between state and school
Authors: Labaree David F.
Published: November 2022

Public schooling in the 19th century cultivated in students a shared sense of identity as citizens with a common culture. However, posits David Labaree, U.S. schools are less effective than they used to be at serving this purpose, making their value to the nation-state open to questioning. Labaree considers three common functions that public schools serve for the state — legitimacy, economic productivity, and civic community — and questions how well schools serve, or even undermine, these purposes. Schools rely on the state for support, but that support is in danger if systems of schooling promote division and are not perceived as promoting a common good.
On Leadership: Expectations and exceptions
Authors: Starr Joshua P.
Published: November 2022

It’s not always easy to balance high expectations with the need to make exceptions when students are struggling. The pandemic has made educators and the public more aware of how social-emotional needs can affect students’ ability to learn, but students still need to meet some academic standards. Joshua Starr suggests that knowing students personally and using data to understand students’ stories can help educators attend to student needs in ways that also support their academic development.
Policy Solutions: The policy of school policing
Authors: Collins Jonathan E.
Published: November 2022

More than half of U.S. schools have no police presence on their campuses. Jonathan E. Collins proposes that all school buildings be free of police. School resource officers (SROs), he writes, do more harm than good. An alternate policy that would remove SROs from schools involves the framework of the community policing model. This model focuses on engaging students in full and deep discussions and problem-solving that reveals what students think of school safety and the root cause of school violence.
Designing Teaching for Transfer in English for Academic Purposes
Authors: Jeon Heon
Published: November 2022

Transfer of learning is an important goal of English for Academic Purposes (EAP) education where multilingual students learn knowledge and skills of academic literacy to use in other contexts of writing. Despite the importance of learning transfer in EAP, it does not often take place without mindful teaching for transfer. EAP teachers should make active efforts to help students shape the habit of transfer thinking and experience successful transfer while taking EAP courses. This action research aims at promoting learning transfer by designing and implementing pedagogical tools guided by the notion of high road transfer: (a) transfer guideline, (b) transfer feedback, (c) transfer journals, and (d) transfer imagination activity. The teaching for transfer innovation lasted over the 16-week semester in the target course where multilingual students, who use English as a second/foreign language, learned skills (e.g., how to design PowerPoint slides using different modes of communication, critical reading, source-use skills, synthesizing, finding sources, revising, editing, and reference style) and knowledge of writing (e.g., multimodality and rhetorical situation). Each pedagogical tool was implemented in the classroom so that students maintain their awareness of the importance of learning transfer while taking the target course. Overall, the teaching for the transfer project had positive impacts on articulating what students learn from the target course, leading to actual transfer of learning to other contexts of writing. Future pedagogical directions for promoting learning transfer in EAP are discussed.
Maximizing Probable Oil Field Profit: Uncertainties on Well Spacing
Authors: MacKay J.A. , Lerche I.
Published: November 2022

The influence of uncertainties in field development costs, well costs, lifting costs, selling price, discount factor, and oil field reserves are evaluated for their impact on assessing probable ranges of uncertainty on present day worth PDW, oilfield lifetime τ2/3, optimum number of wells OWI, and the minimum (n-) and maximum (n+) number of wells to produce a PDW ≥ 0. The relative importance of different factors in contributing to the uncertainties in PDW, τ2/3, OWI, n- and n+ is also analyzed.

Numerical illustrations indicate how the maximum PDW depends on the ranges of parameter values, drawn from probability distributions using Monte Carlo simulations.

In addition, the procedure illustrates the relative importance of contributions of individual factors to the total uncertainty, so that one can assess where to place effort to improve ranges of uncertainty; while the volatility of each estimate allows one to determine when such effort is needful.
Utility of combined gadoxetic acid and ferumoxytol-enhanced liver MRI for preoperative detection of colorectal cancer liver metastases: a pilot study
Authors: Carney Benjamin W , Gholami Sepideh , Fananapazir Ghaneh , Sekhon Simran , Lamba Ramit , Loehfelm Thomas W , Wilson Machelle D , Corwin Michael T
Published: November 2022

Background

Colorectal cancer (CRC) is the second-leading cause of cancer-related death worldwide and resection of CRC metastases confined to the liver is the treatment of choice when feasible. Ferumoxytol is an off-label contrast agent that opacifies vasculature and may be helpful in distinguishing metastases from small hemangiomas and blood vessels on gadoxetic acid-enhanced magnetic resonance imaging (MRI).

Purpose

To compare the diagnostic accuracy of MRI using a standard gadoxetic acid protocol and a combined gadoxetic acid/ferumoxytol protocol in patients with suspected colorectal hepatic metastases.

Material and Methods

In this institutional review board-approved, single-institution, retrospective study, eight patients underwent gadoxetic acid-enhanced liver MRI, supplemented with additional T1-weighted ferumoxytol enhanced sequences. Two radiologists in consensus identified all metastases using all available sequences, which served as the reference standard. Two different radiologists reviewed each exam twice, once using the standard protocol and once with additional ferumoxytol sequences. The detection rate was estimated as the predicted probability of a metastasis along with the 95% confidence interval (CI) using hierarchical logistic regression models.

Results

A total of 49 metastases were identified. The mean diameter was 10 mm, measured in greatest axial dimension (median=7 mm; range=2–70 mm). Readers 1 and 2 had detection rates of 69.6% (95% CI = 48.2–85.0) and 53.1% (95% CI = 35.2–70.3) for gadoxetic acid alone and 98.0% (95% CI = 86.3–99.7) and 83.5% (95% CI = 59.3–94.7) for combined protocol.

Conclusion

In this preliminary investigation, adding ferumoxytol-enhanced sequences to gadoxetic acid liver MRI protocol increased the detection rate of CRC hepatic metastases and may aid in preoperative decision making.
Ultrasound-guided perineal laser ablation versus prostatic arterial embolization for benign prostatic hyperplasia: two similar short-term efficacies
Authors: Cai Huaijie , Zhu Conghui , Fang Jianhua
Published: November 2022

Background

There are many ways to treat prostatic hyperplasia; these are currently more inclined to minimally invasive treatment. We mainly compared the differences between two treatment methods， ultrasound-guided transperineal laser ablation (US-TPLA) and prostatic artery embolization (PAE).

Purpose

To evaluate the efficacy and safety of US-TPLA and PAE in the treatment of benign prostatic hyperplasia (BPH).

Material and Methods

The clinical information for 40 patients with BPH admitted to our hospital between June 2018 and January 2021 were retrospectively analyzed. The changes in International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), postvoid residual (PVR), prostate volume (PV), and the incidence of complications were compared between groups.

Results

The IPSS ( P < 0.001; P < 0.001), QoL ( P < 0.001; P < 0.001), Qmax ( P < 0.001; P < 0.001), PVR ( P < 0.001; P < 0.001), and PV ( P < 0.001; P < 0.001) at three and six months after US-TPLA and PAE improved with respect to those before surgery. There was no significant difference in IPSS ( P = 0.235; P = 0.151), QoL ( P = 0.527; P = 0.294), Qmax ( P = 0.776; P = 0.420), PVR ( P = 0.745; P = 0.607), and PV ( P = 0.527; P = 0.573) between the groups at three and six months after surgery. No serious complications occurred in either group.

Conclusion

US-TPLA and PAE seem to have a similar short-term efficacy. The efficacy of the two procedures is comparable, and neither is associated with serious complications. US-TPLA and PAE are both effective complementary measures for the treatment of BPH.
Laparoscopic natural orifice specimen extraction, a minimally invasive surgical technique for mid-rectal cancers: Retrospective single-center analysis and single-surgeon experience of selected patients
Authors: Muhammad Shan , Gao YiBo , Guan Xu , QingChao Tang , Fei Shao , Wang Guiyu , Chen Yinggang , Liu Zheng , Jiang Zheng , Kaur Kavanjit , Tatiana Kamchedalova , Ul Ain Qurat , Wang Xishan , He Jie
Published: November 2022

Objective

To evaluate the feasibility, safety, and short-term outcomes of middle rectal resection followed by transanal specimen extraction.

Methods

Forty-four patients with small mid-rectal tumors underwent laparoscopic rectal resection followed by transanal specimen extraction.

Results

The procedure was successful in all patients without intraoperative conversion or additional access. The mean operation time was 182.7 minutes (range, 130–255 minutes), the mean blood loss was 26.5 mL (range, 5–120 mL), the mean postoperative exhaust time was 31.3 hours (range, 16–60 hours), and the mean length of hospital stay was 9.5 days (range, 8–19 days). One patient developed anastomotic leakage, which was treated by intravenous antibiotics and daily pelvic cavity flushes through the abdominal drainage tube. No infection-related complications or anal incontinence were observed. The mean tumor size was 2.1 cm (range, 1.6–3.2 cm), the mean number of harvested lymph nodes was 16.5 (range, 6–31), and the mean follow-up time was 8.5 months (range, 2–16 months). By the last follow-up, no signs of recurrence had been found in any patient.

Conclusion

The combination of standard laparoscopic proctectomy and transanal specimen extraction could become a well-established strategy for selected patients.
The metabolic phenotype of the patient influences the reduction in carotid intima-media thickness achieved following metabolic surgery
Authors: Melchor-López Alberto , Suárez-Cuenca Juan Antonio , Banderas-Lares Diana Zaineff , De la Peña-Sosa Gustavo , Salamanca-García Moisés , Vera-Gómez Eduardo , Hernández-Patricio Alejandro , Gutiérrez-Buendía Juan Ariel , Zamora-Alemán Carlos Ramiro , Alcaráz-Estrada Sofía Lizeth , Ortiz-Fernández Moisés , Montoya-Ramírez Jesús , Felipe Gaytán-Fuentes Omar , Escamilla-Tilch Mónica , Pineda-Juárez Juan Antonio , Antonio Téllez-González Mario , Rodríguez-Arellano Martha Eunice , Contreras-Ramos Alejandra , Hernández-Muñoz Rolando Efraín , Gutiérrez-Salinas José , García Silvia , Mondragón-Terán Paul
Published: November 2022

Objectives

To determine whether metabolic phenotype is associated with the change in carotid intima-media thickness (CIMT) in patients undergoing bariatric /metabolic surgery (BMS).

Methods

We performed a case-control study of BMS candidates who had metabolically unhealthy obesity (MUO) or metabolically healthy obesity (MHO). We measured the change in CIMT during the 9 months following BMS. The plasma tumor necrosis factor-α, interleukin-1β, adiponectin, leptin, nitric oxide (NO), vascular endothelial growth factor A (VEGF-A), and malondialdehyde concentrations were determined, adipocyte area was measured histologically, and adipose tissue area was estimated using computed tomography.

Results

Fifty-six patients (mean age 44.5 years, mean body mass index 44.9 kg/m2, 53% women, and 53% had MUO) were studied. Nine months following BMS, the MUO phenotype was not associated with a significant reduction in CIMT, and that of the MHO group was larger. In addition, fewer participants achieved a 10% reduction in CIMT in the MUO group. A CIMT reduction was associated with lower VEGF-A and NO in the MUO group, while that in the MHO group was associated with a higher NO concentration.

Conclusion

The metabolic phenotype of patients may influence their change in CIMT following BMS, probably through circulating vasodilatory and pro-inflammatory molecules.
Putting practice under the microscope: The perceived uses and limitations of slow instrumental music practice
Authors: Allingham Emma , Wöllner Clemens
Published: November 2022

Practicing slowly is a commonly used, intuitive approach to music learning, and is widely considered the bedrock of musical skill acquisition. Yet, little is known about the different approaches and techniques musicians use when practicing slowly. This study investigated instrumental musicians’ perspectives on the uses, limitations, and specific techniques of slow music practice, through qualitative thematic analysis of responses to an online questionnaire. Generally, slow practice was perceived as a useful, and often necessary, part of learning. Furthermore, we identified four perceived functions of slow practice. They were managing information load; building a foundation for motor learning; creative and critical problem-solving; and regulating emotional, mental, and perceptual states. We propose a possible underlying mechanism of these functions: reduction of extrinsic cognitive load and stimulation of germane cognitive processes. Respondents also perceived potential technical-practical and emotional-cognitive malfunctions of slow practice, as well as possible strategic pitfalls of using slow practice. Specific techniques of slow practice included the use of tempo organization methods and strategies to complement slow practice. This provided insight into how biomechanical differences between slow and fast playing might be bridged. Findings have implications for music education and understanding the psychology of musical skill acquisition.
Cooperation Leads Change: Subordinate Moqi, Leader-member Exchange, and Change-oriented Behaviors among Chinese Workers
Authors: Wu Bingqing , Alikaj Albi , Akinlade Ekundayo , Zheng Xingshan
Published: November 2022

This paper developed and tested a theoretical model linking subordinates’ moqi with their supervisor with change-oriented behaviors—specifically, creativity and taking charge—via leader–member exchange (LMX). Using a sample of 189 matched subordinate–supervisor dyads from 22 firms in China, a hierarchical modeling analysis showed that, as hypothesized, subordinate moqi with the supervisor positively affected employees’ creativity and taking charge. Additionally, LMX mediated the relationship between subordinate moqi with the supervisor and employees’ creativity and taking charge. This paper contributes to the current understanding of leadership from a followership perspective and its influence on change-oriented behaviors.
Millennial entrepreneurial persistence under harsh contextual environments in Iran
Authors: Bagheri Afsaneh , Zhu Ying
Published: November 2022

Millennial Iranian entrepreneurs, as an emerging business class, face new realities rarely seen in other countries due to the harsh and uncertain contextual environment. As young and dynamic entrepreneurs, they want to build independent careers by developing new start-up businesses to address the social and economic needs of the masses and, at the same time, to earn an income to ensure their economic survival. However, given the difficult business environment with domestic challenges and international embargos, these entrepreneurs find themselves faced with many problematic issues. Therefore, this research is based on the concept of entrepreneurial persistence for survival and aims to investigate how Iranian millennial entrepreneurs develop businesses in a difficult contextual environment. A new conceptual framework and a number of propositions for future research have been offered in this study on the basis of the findings. Implications for policy and practices are also discussed with the focus on possible policy reform, better entrepreneurial education as well as other incentives to support millennial entrepreneurs.
Relationship between stress due to COVID-19 pandemic, telecommuting, work orientation and work engagement: Evidence from India
Authors: Chidambaram Vijayabanu , Ramachandran Gayathri , Chandrasekar Therasa , Parayitam Satyanarayana
Published: November 2022

The purpose of the present study is to examine the effect of stress induced by coronavirus (COVID-19), telecommuting, and work orientation on work engagement among employees in the Information Technology (IT) sector. Using a structured survey instrument, data were collected from 285 respondents from four cosmopolitan cities in the southern part of India—Chennai, Coimbatore, Tiruchirappalli, and Madurai using a structured instrument. The hierarchical regression results reveal that (i) stress induced by COVID-19 was negatively related to work engagement, (ii) work orientation is positively associated with work engagement, and (iii) telecommuting is positively associated with work engagement. The results also reveal that (i) telecommuting weakened the relationship between stress induced by COVID-19 and work engagement and (ii) strengthened the positive relationship between work orientation and work engagement. These results are consistent with Job Demands and Resources (JDR), Conservation of Resources Theory (COR), and Career Construction Theory (CCT). The study highlights the importance of telecommuting as a strategic move on the part of the companies to reduce stress and enhance work engagement. Considering the global pandemic situation, employees in the IT sector would find it comfortable to work from their homes and contribute their best for the success of organizations. The present study also suggests ways for the organizations to promote work engagement and remain committed to performing during stressful situations like a global pandemic. The theoretical and practical implications are discussed.
Hypocritical leaders who do not walk their talk: An in-depth field study
Authors: Henkel Thomas G , Ade Ann Marie
Published: November 2022

This research aimed to explore the factors related to leaders who do not walk their talk and the resulting hypocritical behavior negatively impacting an organization and its employees. A convenience sampling of 305 professional employees attending an advanced leadership educational program voluntarily revealed their personal experiences with hypocritical leaders that did not walk their talk. The findings identified leaders who do not walk their talk regarding the top six most frequently cited interview responses. It is with the expectation that organizations can use the results from this qualitative study to develop, identify and understand leaders who do not walk their talk and initiate action to resolve the damaging effects of such undesirable hypocritical behavior.
Nitrogen dynamics in the Critical Zones of China
Authors: Li Si-Liang , Liu Xin , Yue Fu-Jun , Yan Zhifeng , Wang Tiejun , Li Songjing , Liu Cong-Qiang
Published: November 2022

Nitrogen dynamics at ecosystem levels profoundly impact the Earth’s surface system due to their environmental and ecological significance. Exploring the sources and transformation of nitrogen in various Critical Zones is vital to understanding biogeochemical cycles and sustainable development. This study summarized nitrogen characteristics in soil profiles and nitrogen dynamics in diverse terrestrial ecosystems based on data from typical Critical Zones of China. The results indicated that nitrogen accumulates in the deep soils of cropland ecosystems due to intensive fertilizer applications, which potentially harms soil functions and water quality. Therefore, it is necessary and meaningful to take adequate measures to alleviate nitrogen accumulation in deep soils. Additionally, surplus nitrogen transported into groundwater and riverine systems from soil has emerged as an important issue for environmental management. There are serious nitrogen pollution issues in many river water and groundwater areas, which could be addressed by reducing the fast leaching and considerable nitrogen accumulation in the vadose zone. Systematic and long-term observational studies are needed to achieve the ultimate goal of ecological conservation and high-quality development. Therefore, future research should consider monitoring and evaluating ecosystems based on the long-term Critical Zone Observatories networks to advance appropriate environmental management strategies that adapt to nature’s rules and strengthen the ecosystem service function for sustainable development.
Crashworthiness of embedded composite structures coupling carbon fiber reinforced plastic tubes and aluminum honeycombs
Authors: Xie Suchao , Liu Zinan , Zhang Jing , Zheng Shiwei
Published: November 2022

The crashworthiness of embedded composite structures that couple carbon fiber reinforced plastic tubes and aluminum honeycomb (CFRP-AH) was assessed through quasi-static compression tests and finite element simulation. Experimental results show that CFRP tubes tilt, when the AH fits with the CFRP tubes is not tight enough. With an increasing number of embedded CFRP tubes, the CFRP-AH composite structures are found to have a larger mean crush force (MCF) and specific energy absorption (SEA). Among the four experimental groups, CFRP-AH composite structures in Group S3, which used a larger size of CFRP tube, are found to have significantly improved energy-absorbing performance, and SEA of S3-t25 is improved by 576% compared with that of the pure AH S3-t0 without tubes. The S2 group’s CFRP tube is tilted, which used a smaller size, and the structure is improved to obtain the NS2 structure, so that only tearing deformation occurs in the AH-CFRP structure’s CFRP tube. The SEA of NS2-t25 was improved by 29.70% over S2-t25 and 22.83% over S3-t25, which has the best energy absorption characteristics among the filled tube structures.
How to Address the Health of Home Care Workers: A Systematic Review of the Last Two Decades
Authors: Gebhard Doris , Herz Michael
Published: November 2022

Making home care a healthy workplace is a societal concern but research on specific interventions is still scarce. The aim of this systematic review was to provide an initial overview of interventions addressing home care workers’ health. All (quasi-) experimental studies, presenting any intervention among home care employees, and reporting any outcome related to occupational health, safety, or well-being were included. PsycArticles, Medline, PubMed, and Web of Science were searched from January 2000 to February 2022. From 16,345 publications, 18 studies with 2432 participants were included and assessed with the Joanna Briggs Institute Critical Appraisal Tools. Organizational and training/educational approaches were found in five studies each, a behavioral approach in one, and seven studies presented a combined approach. Due to methodological limitations and the heterogeneity of interventions, the existing studies are insufficient to inform new programs, but emphasize the need for tailored approaches, integrated concepts, and participatory intervention development.
Process planning of cylindrical printing for a novel 2T2R-type rotary 3D printer and an initial feasibility investigation
Authors: Zhao Donghua , Zhu Gaohan , He Jiapeng , Han Youcheng , Guo Weizhong
Published: November 2022

Due to solid freeform fabrication (SFF)’s manufacturing capability, additive manufacturing (AM) or 3D printing, is developing rapidly and has received much attention, leading to various aerospace, military and robotics applications. Slicing and path planning are two critical steps of AM, determining the manufactured part’s geometric accuracy and mechanical performance to a large extent. Many research works focus on the detailed strategies and algorithms of slicing and path planning. However, instead of 3D printing, most available studies concentrate only on 2.5D printing, where slicing and printing along the Z direction and filling 2D contours in the XY plane are applied. Although multi-direction and curved layer slicing have been proposed, little attention has been paid to path planning on the curved layers, especially tool path generation for the revolving parts requiring supports, such as screw conveyors and the propeller or fan. Hence, the primary purpose of this paper is to propose a novel cylindrical slicing strategy (a type of curved layer slicing) based on the triangle mesh model for curved layer Material Extrusion (CLMEX). It could be learned that the support structure is necessary for cases with traditional bottom-up printing, while supportless printing may be feasible with cylindrical slicing. Besides, a preliminary experiment is conducted to illustrate the proposed method and validate its feasibility based on a novel 2T2R-type rotary Material Extrusion (MEX) 3D printer designed in the authors’ previous research. This early-stage work generally intends to investigate the process planning and show the initial feasibility of cylindrical printing using a novel 2T2R-type rotary 3D printer. This research provides process designers with a novel and feasible slicing method for multi-axis 3D printers having a rotary build platform.
Corrosion and wear behaviors of brick powder reinforced aluminum composites manufactured by stir casting
Authors: Jha Vinit Kumar , Singh Shubham Kumar , Shukla Sarvagya , Sharma Rajul , Ji Gopal
Published: November 2022

Aluminum 6061 (Al6061) possesses good mechanical properties, strength, hardness, and corrosion resistance. However, the properties of Al6061 can be sufficiently raised by making composites. Metal matrix composites (MMCs) are well known for their high strength and corrosion resistance. However, these properties depend on the reinforcement materials added to the metal matrix. In the present work, Al6061-based MMCs have been manufactured by stir casting. In these MMCs, brick powders are used as reinforcement materials. Four MMCs have been developed by varying concentration and size of brick powders: MMC1, 2 h ball milled and 1% by weight; MMC2, 2 h ball milled and 7% by weight; MMC3, 4 h ball milled and 1% by weight; and MMC4, 4 h ball milled and 7% by weight. The successful formation of MMCs is examined by field emission scanning electron microscopy, energy-dispersive X-ray spectroscopy, and X-ray powder diffraction. The corrosion and wear resistance of the manufactured MMCs have been investigated by electrochemical measurements and a pin-on disc tribometer. Based on the results of both tests, MMCs can be ranked as MMC4 > MMC3 > MMC2 > MMC1. The reason for improved behavior can be quoted as an enhancement in overall hardness and interaction of reinforced material with the matrix. To support this statement, the Vickers hardness of Al6061 and the developed composites have also been measured.
Metachronal wave form analysis on cilia-driven flow of non-Newtonain Phan–Thien–Tanner fluid model: A physiological mathematical model
Authors: Sher Akbar Noreen , Akhtar Salman
Published: November 2022

The Phan–Thien–Tanner non-Newtonian model of fluid flow is considered to mathematically model the cilia governed flow inside the human body. The collective action of cilia generates a rhythmic motion in form of metachronal wave traveling along the wall of channel. We have utilized the necessary assumptions to non-dimensionalize this complex problem and the exact solutions are obtained for the cilia governed flow problem. The graphical results are also incorporated to further discuss these solutions in detail. The wavy movements developed due to rhythmic actions of cilia are clearly evident in pressure gradient graphs. Further, a parabolic flow pattern is also observed in this ciliated channel flow problem. Streamlines disclose the trapping phenomenon and the multiple pumping regions can be seen in intrigued pressure rise graphical solutions.