Literature Review on the Incidence of Primary Stapler Malfunction

2019 ◽  
Vol 27 (2) ◽  
pp. 229-234 ◽  
Author(s):  
Samwel Okoth Makanyengo ◽  
Dhan Thiruchelvam

Background. Surgical stapling devices are known for their reliability and convenience. A letter to health care professionals published by the US Food and Drug Administration in March 2019 highlighted the increasing number of adverse events associated with surgical staplers. Driven by a case of stapler malfunction during an elective laparoscopic sleeve gastrectomy, we performed a literature review to investigate the incidence of primary stapler malfunction. We also discuss the common types and an approach to its management. Methods. PubMed, MEDLINE, and EMBASE databases were searched for articles discussing surgical stapler malfunction. Twelve studies were selected that described the incidence and/or consequences of primary stapler malfunction. A narrative synthesis was performed. Results. From observational studies, the incidence ranged from 0.022% to 2.3%. A prospective survey reported that 86% of laparoscopic surgeons either had personal experience with or knew of surgeons who experienced stapler malfunction, implying a higher incidence. Underreporting has been an issue as manufacturers can get exemptions from public reporting. Significantly, higher malfunctions have been reported after exemptions were lifted. The most common types of stapler malfunction are stapler misfire and stapler locking. Major morbidity and mortality have been reported. Conclusion. Surgeons are increasingly reliant on technological innovations. Stapling failure occurs and it is imperative to be aware of this. Given the high volume of stapler use, a high percentage of surgeons are likely to encounter this problem in their career. It is important to have an approach to the prevention and management of this potentially catastrophic complication.

Author(s):  
Anne-Mette Nortvig ◽  
René B Christiansen

<p class="3">This literature review seeks to outline the state of the art regarding collaboration between educational institutions on Massive Open Online Courses (MOOCs) launched in Europe and in the US for the past 10 years. The review explores enablers and barriers that influence national institutional MOOC collaboration, and looks into how existing knowledge about institutional collaboration on e-learning can be used in MOOC collaboration. The review is based on a literature search in databases and on snowballing techniques. It concludes that collaboration on MOOCs can be advantageous in terms of ensuring quality and innovation in the common learning designs, and that—in order to succeed—such projects need strategic and institutional support from all partners involved. Moreover, the review points out barriers concerning the reluctance of individual institutions to engage in national collaboration due to fear of potential loss of their own national branding and the teachers’ hesitancy or passive resistance to new educational platforms and formats.</p>


2019 ◽  
Vol 19 (16) ◽  
pp. 1298-1368 ◽  
Author(s):  
Ankit Jain ◽  
Poonam Piplani

: Triazole is a valuable platform in medicinal chemistry, possessing assorted pharmacological properties, which could play a major role in the common mechanisms associated with various disorders like cancer, infections, inflammation, convulsions, oxidative stress and neurodegeneration. Structural modification of this scaffold could be helpful in the generation of new therapeutically useful agents. Although research endeavors are moving towards the growth of synthetic analogs of triazole, there is still a lot of scope to achieve drug discovery break-through in this area. Upcoming therapeutic prospective of this moiety has captured the attention of medicinal chemists to synthesize novel triazole derivatives. The authors amalgamated the chemistry, synthetic strategies and detailed pharmacological activities of the triazole nucleus in the present review. Information regarding the marketed triazole derivatives has also been incorporated. The objective of the review is to provide insights to designing and synthesizing novel triazole derivatives with advanced and unexplored pharmacological implications.


Author(s):  
Matthew A. Shadle

American Catholicism has long adapted to US liberal institutions. Progressive Catholicism has taken the liberal values of democratic participation and human rights and made them central to its interpretation of Catholic social teaching. This chapter explores in detail the thought of David Hollenbach, S.J., a leading representative of progressive Catholicism. Hollenbach has proposed an ethical framework for an economy aimed at the common good, ensuring that the basic needs of all are met and that all are able to participate in economic life. The chapter also looks at the US Catholic bishops’ 1986 pastoral letter Economic Justice for All, which emphasizes similar themes while also promoting collaboration between the different sectors of American society for the sake of the common good.


Author(s):  
Pete Dale

Numerous claims have been made by a wide range of commentators that punk is somehow “a folk music” of some kind. Doubtless there are several continuities. Indeed, both tend to encourage amateur music-making, both often have affiliations with the Left, and both emerge at least partly from a collective/anti-competitive approach to music-making. However, there are also significant tensions between punk and folk as ideas/ideals and as applied in practice. Most obviously, punk makes claims to a “year zero” creativity (despite inevitably offering re-presentation of at least some existing elements in every instance), whereas folk music is supposed to carry forward a tradition (which, thankfully, is more recognized in recent decades as a subject-to-change “living tradition” than was the case in folk’s more purist periods). Politically, meanwhile, postwar folk has tended more toward a socialist and/or Marxist orientation, both in the US and UK, whereas punk has at least rhetorically claimed to be in favor of “anarchy” (in the UK, in particular). Collective creativity and competitive tendencies also differ between the two (perceived) genre areas. Although the folk scene’s “floor singer” tradition offers a dispersal of expressive opportunity comparable in some ways to the “anyone can do it” idea that gets associated with punk, the creative expectation of the individual within the group differs between the two. Punk has some similarities to folk, then, but there are tensions, too, and these are well worth examining if one is serious about testing out the common claim, in both folk and punk, that “anyone can do it.”


Author(s):  
Nan-Hua Nadja Yang ◽  
Ana Carolina Bertassini ◽  
Jéssica Alves Justo Mendes ◽  
Mateus Cecílio Gerolamo

AbstractFor the transition towards a circular economy (CE), organisations have to be prepared to adapt to major changes. Thus, the concept and implementation of change management (CM) will be essential to an organisation’s success during this transformative period. Studies have shown that organisational CE barriers were more significant than individual CE barriers. To overcome such obstacles, the most appropriate set of managerial practices should be carefully considered. These barriers also have the potential to influence the agricultural sector, which seeks to adopt more sustainable ways of production. The goal of this paper is to propose a solution framework based on CM strategies to overcome organisational challenges posed by a CE, especially for agribusinesses. To accomplish this objectively, a systematic literature review and a content analysis were conducted. The common errors in CM within the implementation process and the main CE barriers were identified and classified. An in-depth analysis of the issue’s roots led to a solid understanding of how to tackle such CM problems. This paper presents an overview of organisational CE barriers verified in the agricultural context, the common errors in CM, and the correlation between these findings. The two areas were then combined in a matrix that shows the connection between common errors in CM errors and CE barriers. Based on this result, a solution framework called 3CE2CE was developed that provides a step-by-step guide on how organisations can successfully undergo transformation processes towards a CE with the principles of CM.


2019 ◽  
Vol 66 (1.2) ◽  
pp. 205-208 ◽  
Author(s):  
Masashi Kano ◽  
Toshihiko Nishisho ◽  
Ryo Miyagi ◽  
Fumio Chikugo ◽  
Eiji Kudo ◽  
...  

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Cheng KKF ◽  
S. A. Mitchell ◽  
N. Chan ◽  
E. Ang ◽  
W. Tam ◽  
...  

Abstract Background The aim of this study was to translate and linguistically validate the U.S. National Cancer Institute’s Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE™) into Simplified Chinese for use in Singapore. Methods All 124 items of the English source PRO-CTCAE item library were translated into Simplified Chinese using internationally established translation procedures. Two rounds of cognitive interviews were conducted with 96 cancer patients undergoing adjuvant treatment to determine if the translations adequately captured the PRO-CTCAE source concepts, and to evaluate comprehension, clarity and ease of judgement. Interview probes addressed the 78 PRO-CTCAE symptom terms (e.g. fatigue), as well as the attributes (e.g. severity), response choices, and phrasing of ‘at its worst’. Items that met the a priori threshold of ≥20% of participants with comprehension difficulties were considered for rephrasing and retesting. Items where < 20% of the sample experienced comprehension difficulties were also considered for rephrasing if better phrasing options were available. Results A majority of PRO-CTCAE-Simplified Chinese items were well comprehended by participants in Round 1. One item posed difficulties in ≥20% and was revised. Two items presented difficulties in < 20% but were revised as there were preferred alternative phrasings. Twenty-four items presented difficulties in < 10% of respondents. Of these, eleven items were revised to an alternative preferred phrasing, four items were revised to include synonyms. Revised items were tested in Round 2 and demonstrated satisfactory comprehension. Conclusions PRO-CTCAE-Simplified Chinese has been successfully developed and linguistically validated in a sample of cancer patients residing in Singapore.


1996 ◽  
Vol 3 (1) ◽  
pp. 34-43
Author(s):  
J.F. Gigot ◽  
J. Etienne ◽  
B. Lengele ◽  
P.J. Kestens

2015 ◽  
Vol 34 (4) ◽  
pp. S243
Author(s):  
J.C. Grimm ◽  
J. Magruder ◽  
A. Kilic ◽  
V. Valero ◽  
S.P. Dungan ◽  
...  

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