bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Factors Associated With Circumferential Resection Margin Positivity in Rectal Cancer: A Binational Registry Study
Authors: Warrier Satish K. , Kong Joseph Cherng , Guerra Glen R. , Chittleborough Timothy J. , Naik Arun , Ramsay Robert G. , Lynch A. Craig , Heriot Alexander G. 
Published: March 2018

BACKGROUND:
Rectal cancer outcomes have improved with the adoption of a multidisciplinary model of care. However, there is a spectrum of quality when viewed from a national perspective, as highlighted by the Consortium for Optimizing the Treatment of Rectal Cancer data on rectal cancer care in the United States.

OBJECTIVE:
The aim of this study was to assess and identify predictors of circumferential resection margin involvement for rectal cancer across Australasia.

DESIGN:
A retrospective study from a prospectively maintained binational colorectal cancer database was interrogated.

SETTINGS:
This study is based on a binational colorectal cancer audit database.

PATIENTS:
Clinical information on all consecutive resected rectal cancer cases recorded in the registry from 2007 to 2016 was retrieved, collated, and analyzed.

MAIN OUTCOME MEASURES:
The primary outcome measure was positive circumferential resection margin, measured as a resection margin ≤1 mm.

RESULTS:
A total of 3367 patients were included, with 261 (7.5%) having a positive circumferential resection margin. After adjusting for hospital and surgeon volume, hierarchical logistic regression analysis identified a 6-variable model encompassing the independent predictors, including urgent operation, abdominoperineal resection, open technique, low rectal cancer, T3 to T4, and N1 to N2. The accuracy of the model was 92.3%, with an receiver operating characteristic of 0.783 (p < 0.0001). The quantitative risk associated with circumferential resection margin positivity ranged from <1% (no risk factors) to 43% (6 risk factors).

LIMITATIONS:
This study was limited by the lack of recorded long-term outcomes associated with circumferential resection margin positivity.

CONCLUSIONS:
The rate of circumferential resection margin involvement in patients undergoing rectal cancer resection in Australasia is low and is influenced by a number of factors. Risk stratification of outcome is important with the increasing demand for publicly accessible quality data. See Video Abstract at http://links.lww.com/DCR/A512.
A Novel Closure Technique for Complex Abdominal Wounds
Authors: Aydinli H. Hande , Peirce Colin , Aytac Erman , Remzi Feza H. 
Published: March 2018

INTRODUCTION:
Abdominal wound closure is a challenge in patients undergoing colorectal surgery with a complex history of multiple abdominopelvic operations. Loss of domain of the abdominal fascia because of prior laparotomies precludes the use of simple, everyday abdominal wound closure techniques. Furthermore, ongoing intra-abdominal sepsis, with or without a concurrent entero- or colocutaneous fistula, increases the risk of postoperative morbidity and mortality in this patient population. We propose an abdominal wound closure technique for patients with multiple previous complex operations and subsequent ongoing abdominopelvic sepsis.

TECHNIQUE:
Following completion of the intra-abdominal component of the operation, the abdominal wall fascial edges are identified and mobilized to allow for a smooth skin closure. The skin is brought together with a small amount of subcutaneous tissue in the abdominal wound line and sutured with a 1.0 Prolene stitch by using the vertical mattress technique. For both wound edges, a dental roll is inserted between the entry and exit points of the suture, with the suture material placed above and over the dental roll, and thus the dental roll is incorporated within the stitch when it is tied down. These stitches and dental rolls are placed along the length of the wound. No mesh is utilized, and the technique achieves skin closure with development of a subsequent ventral hernia.

RESULTS:
Good postoperative short-term and long-term overall outcomes were achieved in 14 patients who underwent complex abdominal wound closure. Two patients required further late operative intervention because of the incarceration of the known ventral hernia (at 34 and 120 months postoperatively).

CONCLUSIONS:
Complex abdominal wound closure in this setting is safe and feasible to achieve a healthy abdominal wall closure and enable healing by primary intention after colorectal surgery.
Draining Setons as Definitive Management of Fistula-in-Ano
Authors: Daodu Oluwatomilayo O. , O’Keefe Julia , Heine John A. 
Published: March 2018

BACKGROUND:
The ideal management for fistula-in-ano would resolve the disease while preserving anal continence.

OBJECTIVE:
The purpose of this study was to determine the efficacy of draining seton alone in achieving resolution or significant amelioration of symptoms for patients with fistula-in-ano.

DESIGN:
This was a retrospective case series involving chart review and telephone interviews. A single colorectal surgeon performed surgeries between June 1, 2005, and June 30, 2014.

SETTINGS:
The study was conducted by a single surgeon in a large urban city.

PATIENTS:
Patient ≥18 years of age presenting with fistula-in-ano of cryptoglandular origin were included.

MAIN OUTCOME MEASURES:
Resolution of symptoms or significant symptom improvement requiring no additional surgical management and rate of recurrence were measured.

RESULTS:
A total of 76 patients (53 men) met the inclusion criteria. Mean age was 45 years (range, 19–73 y). The average time to seton removal was 36.6 weeks (range, 6.0–188.0 wk). Mean follow-up was 63 months (range, 7–121 mo). Fifty-seven patients (75%) were reached for telephone interview. Fifty-six patients (73.7%) had complete symptom resolution, and 14 (18.4%) had significant amelioration of symptoms with no additional surgical management required. Six (7.9%) had persistent severe symptoms. Five (7.1%) had a recurrence after seton removal. Rates of symptom resolution and recurrence were similar between patients whose setons were removed before or after 26 weeks (median time of seton removal) from the time of placement. Twenty-one patients (27.6%) required 1 or more additional operative procedures before planned seton removal to unroof a collection and/or replace the seton, and this represented the most significant risk factor for failure of resolution or improvement or recurrence (relative risk = 7.0).

LIMITATIONS:
This study was retrospective and represents a single surgeon experience.

CONCLUSIONS:
Placement of draining seton alone is a viable treatment option for definitive symptomatic management of fistula-in-ano. Because draining setons are sphincter and function preserving, their use should be considered as primary management for fistula-in-ano. See Video Abstract at http://links.lww.com/DCR/A552.
Murder by Pushing
Authors: Ferguson Claire , Sutherland Tiffany 
Published: March 2018

AbstractThe difficulty in classifying manner of death in falls from a height provides offenders an opportunity to avoid detection by having a homicide appear otherwise. Twelve fall homicides were qualitatively examined. Results showed that most homicidal falls occurred at remote outdoor locations, were planned by offenders who were in controlling intimate relationships with the victim, and were motivated by gain. Homicide was established using inconsistencies in offender's statements and the physical evidence, inappropriate postoffense behavior, evidence of planning, and improbable alleged victim behavior. Fall homicides pose unique challenges for investigators and may negatively impact on the criminal justice process.
The Use of Smartphones as a Digital Security Blanket: The Influence of Phone Use and Availability on Psychological and Physiological Responses to Social Exclusion
Authors: Hunter John F. , Hooker Emily D. , Rohleder Nicolas , Pressman Sarah D. 
Published: March 2018

ABSTRACT

Objective
Mobile phones are increasingly becoming a part of the social environment, and when individuals feels excluded during a socially stressful situation, they often retreat to the comfort of their phone to ameliorate the negativity. This study tests whether smartphone presence does, in fact, alter psychological and physiological responses to social stress.

Methods
Participants (N = 148, 84% female, mean age = 20.4) were subjected to a peer, social-exclusion stressor. Before exclusion, participants were randomized to one of the following three conditions: (1) phone-present with use encouraged, (2) phone-present with use restricted, or (3) no phone access. Saliva samples and self-report data were collected throughout the study to assess salivary alpha amylase (sAA), cortisol, and feelings of exclusion.

Results
Participants in both phone-present conditions reported lower feelings of exclusion compared with individuals who had no access to their phone (F(2,143) = 5.49, p = .005). Multilevel modeling of sAA responses revealed that the individuals in the restricted-phone condition had a significantly different quadratic trajectory after the stressor compared with the phone use (ϒ = −0.12, z = −2.15, p = .032), and no-phone conditions (ϒ = −0.14, z = −2.64, p = .008). Specifically, those in the restricted-phone condition showed a decrease in sAA after exclusion, those in the no-phone condition showed a gradual increase, and phone users exhibited little change. Cortisol responses to the stressor did not vary by condition.

Conclusions
Taken together, these results suggest that the mere presence of a phone (and not necessarily phone use) can buffer against the negative experience and effects of social exclusion.
Experience of Nurses Caring for Patients With Neurogenic Bowel Dysfunction
Authors: Todd Claire , Woodward Sue 
Published: March 2018

PURPOSE:
The purpose of this study was to explore the experience and perceptions of nurses providing bowel care to patients after spinal cord injury.

DESIGN:
Qualitative study using thematic analysis of semistructured interviews.

SUBJECTS AND SETTING:
Eleven RNs who provided bowel care to patients following spinal cord injury and were deemed competent to do so by their employer were invited to participate. The study setting was a large, London NHS Trust providing acute hospital care to a population of around 1 million people.

METHODS:
Semistructured interviews were digitally audio-recorded and transcribed verbatim. Analysis of data was undertaken using Braun and Clark's 6 stages of thematic analysis.

RESULTS:
Four main themes emerged: (1) unpleasantness of task; (2) perceived patient experience; (3) motivation and avoidance; and (4) barriers to care. There was stoic acceptance of the unpleasant nature of bowel care for the nurse, but unpleasantness for patients was not as readily acknowledged. Perceived patient experience ranged from descriptions of positive aspects of comfort and continence to negative aspects of embarrassment and discomfort. Nurses were motivated by the medical need for bowel care but often saw it as low priority due to the unpleasant nature and displayed avoidance tactics. The barriers concerned inadequate training, the taboo nature of bowel care, and potential sexual interpretations of care.

CONCLUSION:
Nurses described bowel care as unpleasant but accepted its physiologic need and importance. The standardization of bowel care training and increasing the numbers of nurses trained in bowel care may decrease stigma surrounding provision of care. Study findings suggest that male nurses' experience may differ from female nurses' experience, but this result requires further investigation.
Study on tumor cell RNA cross-anticancer mechanism in non-tumor mice experimental model
Authors: Xu Qiwang 
Published: March 2018

ABSTRACTTo report the experiments of fractal structure and self-similar function in biological coupled oscillation brings life system waving growth in life organism. At the same time by self-organization the system openness come into being to maintain stability features of growth survival. From this, the orderly oscillation of tumor cell RNA was recognized that this process could lead to system sequentiality openness. According to waving growth of basic research the procedure could be sure to turn into a model as out of control of growing in tumor. Then in complete contrast that derived from the same component which have cross resistance effect. It shows that its biological behavior is converted as only a single physical power to play action by inactivated processing. Subsequent further confirms the essential roles whether essential roles link up with recovery of physiological function. The result in that it could exhibit feature of anticancer owing to be endowed tissue embryonization response. So that it also exerts preventing on senile chronic diseases. In theory, the concept of this tissue response in life organism closely link up with the single physical power of RNA component so as to bring up specific procedure of growing and subsisting that deal with keeping life vigor generalized explanatory.
A dual sRNA inStaphylococcus aureusinduces a metabolic switch responding to glucose consumption
Authors: Bronesky D. , Desgranges E. , Corvaglia A. , François P. , Caballero C.J. , Prado L. , Toledo-Arana A. , Lasa I. , Moreau K. , Vandenesch F. , Marzi S. , Romby P. , Caldelari I. 
Published: March 2018

ABSTRACTPathogenic bacteria must rapidly adapt to ever-changing environmental signals or nutrient availability resulting in metabolism remodeling. The carbon catabolite repression represents a global regulatory system, allowing the bacteria to express genes involved in carbon utilization and metabolization of the preferred carbon source. InStaphylococcus aureus, regulation of catabolite repressing genes is mediated by the carbon catabolite protein A (CcpA). Here, we have identified a CcpA-dependent small non-coding RNA, RsaI that is inhibited by high glucose concentrations. RsaI represses the translation of mRNAs encoding a major permease of glucose uptake, the FN3K enzyme that protects proteins against damages caused by high glucose concentrations, and IcaR, the transcriptional repressor of exopolysaccharide production. Besides, RsaI regulates the activities of other sRNAs responding to the uptake of glucose-6 phosphate or NO. Finally, RsaI inhibits the expression of several enzymes involved in carbon catabolism pathway, and activates genes involved in energy production, fermentation and NO detoxification when the glucose concentration decreases. This multifunctional RNA provides a signature for a metabolic switch when glucose is scarce and growth is arrested.
Phosphorylation by CK2 Regulates MUS81/EME1 in Mitosis and After Replication Stress
Authors: Palma Anita , Pugliese Giusj Monia , Murfuni Ivana , Marabitti Veronica , Malacaria Eva , Rinalducci Sara , Minoprio Anna , Sanchez Massimo , Mazzei Filomena , Zolla Lello , Franchitto Annapaola , Pichierri Pietro 
Published: March 2018

ABSTRACTThe MUS81 complex is crucial for preserving genome stability through the resolution of branched DNA intermediates in mitosis. However, untimely activation of the MUS81 complex in S-phase is dangerous. Little is known about the regulation of the human MUS81 complex and how deregulated activation affects chromosome integrity. Here, we show that the CK2 kinase phosphorylates MUS81 at Serine 87 in late-G2/mitosis, and upon mild replication stress. Phosphorylated MUS81 interacts with SLX4, and this association promotes the function of the MUS81 complex. In line with a role in mitosis, phosphorylation at Serine 87 is suppressed in S-phase and is mainly detected in the MUS81 molecules associated with EME1. Loss of CK2-dependent MUS81 phosphorylation contributes modestly to chromosome integrity, however, expression of the phosphomimic form induces DSBs accumulation in S-phase, because of unscheduled targeting of HJ-like DNA intermediates, and generates a wide chromosome instability phenotype. Collectively, our findings describe a novel regulatory mechanism controlling the MUS81 complex function in human cells. Furthermore, they indicate that, genome stability depends mainly on the ability of cells to counteract targeting of branched intermediates by the MUS81/EME1 complex in S-phase, rather than on a correct MUS81 function in mitosis.
An intelligent computation system for precise assembly of large laser optics
Authors: Wang Hui , Zhang Zheng , Xiong Zhao , Liu Tianye , Long Kai , Quan Xusong , Yuan Xiaodong 
Published: March 2018

Purpose
It is a huge technical and engineering challenge to realize the precise assembly of thousands of large optics in high power solid-state laser system. Using the 400-mm aperture-sized transport mirror as a case, this paper aims to present an intelligent numerical computation methodology for mounting performance analysis and modeling of large optics in a high-power laser system for inertial confinement fusion (ICF).

Design/methodology/approach
Fundamental principles of modeling and analysis of the transport mirror surface distortion are proposed, and a genetic algorithm-based computation framework is proposed to evaluate and optimize the assembly and mounting performance of large laser optics.

Findings
The stringent specifications of large ICF optics place very tight constraints upon the transport mirror’s assembly and mounts. The operational requirements on surface distortion [peak-to-valley and root mean square (RMS)] can be met as it is appropriately assembled by the close loop of assembly-inspection-optimization-fastening. In the end, the experimental study validates the reliability and effectiveness of the transport mirror mounting method.

Originality/value
In the assembly design and mounting performance evaluation of large laser optics, the whole study has the advantages of accurate evaluation and intelligent optimization on nano-level optical surface distortion, which provides a fundamental methodology for precise assembly and mounting of large ICF optics.
Sleep signal controlled footless domino circuit for low leakage current
Authors: Pandey Amit Kumar , Gupta Tarun Kumar , Verma Pawan Kumar 
Published: March 2018

Purpose
This paper aims to propose a new sleep signal controlled footless domino circuit for reducing the subthreshold and gate oxide leakage currents.

Design/methodology/approach
In the proposed circuit, a P channel MOSFET (PMOS) sleep switch transistor is inserted between the power supply and the output node. The sleep transistor, the source of the pull-down network, and the source of the N channel MOSFET (NMOS) transistor of the output inverter are controlled by this additional sleep signal to place the footless domino circuit in a low leakage state.

Findings
The authors simulate the proposed circuit by using HSPICE in 45-nm CMOS technology for OR and AND logic gates such as OR2, OR4, OR8, AND2 and AND4 at 25°C and 110°C. The proposed circuit reduces leakage power consumption as compared to the existing circuits.

Originality/value
The proposed circuit significantly reduces the total leakage power consumption up to 99.41 and 99.51 per cent as compared to the standard dual-threshold voltage footless domino circuits at 25°C and 110°C, respectively, and up to 93.79 and 97.98 per cent as compared to the sleep control techniques at 25°C and 110°C, respectively. Similarly, the proposed circuit reduces the active power consumption up to 26.76 and 86.25 per cent as compared to the standard dual-threshold voltage and sleep control techniques footless domino circuits at 25°C and 110°C, respectively.
University governance: insights from England and Greece
Authors: Saiti Anna , Abbott Ian , Middlewood David 
Published: March 2018

PurposeThe purpose of this paper is to investigate and assess the role played by university governance in the effectiveness and efficiency of the higher education system through literature analysis and the management evaluation method of Organization and Methods (the O and M technique) and argue for a more radical change in, and greater scrutiny of, university governance so as to improve the efficiency and effectiveness of university operations and thus yield a more optimal satisfaction of social needs.Design/methodology/approachThe paper employs the O and M technique in order to investigate and assess the role played by university governance in the effectiveness and efficiency of the higher education system.FindingsThe “objective” is education and knowledge and there is no room for experimentation in the system. The higher education sector does not need experiments to develop further. Rather, it deserves cautious, creative and innovative consideration and needs a very distinctive treatment of national problems. No matter the policy orientation of the system, higher education policy makers should not forget that higher education has a tremendous influence on peoples’ attitudes and beliefs so the focus should be on the actual knowledge on social responsibility and on the commitment of higher education to serve social interests and needs.Research limitations/implicationsThe analysis developed in this study would benefit from a deeper exploration by investigating more numerous and diverse examples from the international arena of higher education.Originality/valueThis study acts as a complement to previous research on higher education governance since it develops further the analysis and the understanding of university governance. By using as examples two countries with different orientation in their higher education system (mainly due to differences in cultural and ideological perceptions) and keeping in mind that there is no ideal model for university governance, this study could enlighten decision makers in any country to develop a more effective and constructive model of university governance that would serve societal interests more effectively.
Teacher self-efficacy and students’ ratings
Authors: Lev Smadar , Tatar Moshe , Koslowsky Meni 
Published: March 2018

Purpose
Extensive theoretical and empirical work has yielded abundant knowledge regarding teacher self-efficacy (TSE). Recent research has found significant correlations between TSE and students’ ratings, as an indicator for teaching effectiveness. The purpose of this paper is to test the relationship between TSE and students’ ratings of their school teacher (SRST) in the context of school level and teacher role.

Design/methodology/approach
Data were collected from 111 teachers and their 2,490 students attending junior- and senior-high schools. Teachers reported on their personal efficacy beliefs at the beginning of the school year, whereas students rated their teachers at the end of the year.

Findings
Teacher role and school level moderated the relationship between STE and SRST: the relationship between TSE and SRST is higher among homeroom classes than subject matter classes, and among junior high classes as compared to senior high classes.

Research limitations/implications
The research is based on small number of classes, which precluded more sophisticated analyses. Future research should consider additional personal and/or contextual variables to better understand the association between teacher and students perceptions.

Originality/value
This study is a first exploration of the ways teachers perceive their ability to enhance student performance vis-à-vis their students’ views of their teaching functioning.