Surgical Issues for Operable Early-Stage Non–Small-Cell Lung Cancer

Surgical care for early stage non–small-cell lung cancer continuously evolves with new procedures, techniques and care pathways. The most obvious recent change was the transition to minimally invasive procedures, but numerous other aspects of care have also been refined to improve safety and tolerability. These care advancements are essential as we move into an era with increased early detection as a result of screening and greater indications for the use of adjuvant and neoadjuvant strategies.

Inter-Comparison of Particle and Gaseous Pollutant Emissions of a Euro 4 Motorcycle at Two Laboratories

The Euro 4 regulation, applicable since 2016 for L-category vehicles (i.e., two and three-wheelers, and mini cars) reduced the emission limits, but also introduced a new cycle, the WMTC (World Harmonized Motorcycle Test Cycle). The emission studies of Euro 4 motorcycles are limited, and most importantly there are no published studies comparing the results of different laboratories applying the new cycle. In this study we compared the particle and gaseous pollutants of one Euro 4 motorcycle measured in two laboratories in 2017 and 2020. The gaseous pollutant results had a variance (one standard deviation of the means) of 0.5% for CO2, 4–19% for CO, NOx, HC (hydrocarbons) and SPN (Solid Particle Number). The particulate matter mass results had higher variance of 50–60%. Additional tests with open configuration to mimic dilution at the tailpipe gave equivalent results to the closed configuration for the gaseous pollutants and SPN. The total particles (including volatiles) had significant differences between the two configurations, with the closed configuration giving higher results. The main conclusion of this study is that the new procedures have very good reproducibility, even for the SPN that is not regulated for L-category vehicles. However, the measurement of total particles needs attention due to the high sensitivity of volatile particles to the sampling conditions.

Using qualitative research methods to understand how surgical procedures and devices are introduced into NHS hospitals: the Lotus study protocol

IntroductionThe development of innovative invasive procedures and devices are essential to improving outcomes in healthcare. However, how these are introduced into practice has not been studied in detail. The Lotus study will follow a wide range of ‘case studies’ of new procedures and/or devices being introduced into NHS trusts to explore what information is communicated to patients, how procedures are modified over time and how outcomes are selected and reported.Methods and analysisThis qualitative study will use ethnographic approaches to investigate how new invasive procedures and/or devices are introduced. Consultations in which the innovation is discussed will be audio-recorded to understand information provision practice. To understand if and how procedures evolve, they will be video recorded and non-participant observations will be conducted. Post-operative interviews will be conducted with the innovating team and patients who are eligible for the intervention. Audio-recordings will be audio-recorded, transcribed verbatim and analysed thematically using constant comparison techniques. Video-recordings will be reviewed to deconstruct procedures into key components and document how the procedure evolves. Comparisons will be made between the different data sources.Ethics and disseminationThe study protocol has Health Research Authority (HRA) and Health and Care Research Wales approval (Ref 18/SW/0277). Results will be disseminated at appropriate conferences and will be published in peer-reviewed journals. The findings of this study will provide a better understanding of how innovative invasive procedures and/or devices are introduced into practice.

Potential New Treatments for Knee OA: A Prospective Review of Registered Trials

We aimed to evaluate potential new treatments for knee osteoarthritis (OA). The National Institute of Health ClinicalTrials.gov database was searched for “Osteoarthritis, Knee”. We found 565 ongoing interventional studies with a total planned enrollment of 111,276 subjects. Ongoing studies for knee OA represent a very small fraction of the registered clinical trials, but they are over a quarter of all knee trials and over two thirds of all OA studies. The most researched topic was arthroplasty, with aspects such as implant design changes, cementless fixation, robotic guidance, pain management, and fast track recovery. Intraarticular injections focused on cell therapies with mesenchymal stem cells sourced from adipose tissue, bone marrow, or umbilical cord. We could see the introduction of the first disease modifying drugs with an impact on knee OA, as well as new procedures such as geniculate artery embolization and geniculate nerve ablation.

Single-Anastomosis Procedures in Metabolic Surgery

The most effective long-term treatment for severe obesity is bariatric surgery with improvement or resolution of obesity-related comorbidities. Single-anastomosis procedures including single-anastomosis duodenoileal bypass and one-anastomosis gastric bypass are relatively new procedures that are gaining popularity worldwide. These surgical techniques are perceived to be less complex with a shorter learning curve in comparison to the standard biliopancreatic diversion with duodenal switch and Roux-en-Y gastric bypass; however, long-term outcomes and complications remain controversial. This article aims to review one-anastomosis procedures, evaluate their outcomes, and review potential complications.

Assessment of Color Discrimination of Different Light Sources

Light quality is a key parameter of building design, which is mainly defined by the perceived luminance and the color rendering. Nowadays, there is a wide variety of metrics that do not converge in the color rendition evaluation of current light sources. The obsolescence of the Color Rendering Index promoted the rise of new procedures to provide an accurate evaluation. However, the score provided by most of these metrics does not distinguish between color deviation and hue discrimination, giving a single value to assess the overall color perception allowed by a light source. In this context, a new study is proposed, based on the evaluation of seven different light sources, comparing the results of the most recent color rendering metrics and those observed using a Farnsworth–Munsell trial carried out with 115 participants. The results obtained show that there is a notable divergence between color rendition and hue discrimination, although there is a clear proportionality between both. Moreover, a clear relationship is observed between color discrimination and the correlative color temperature of light sources, providing a better hue distinction with cool light sources, even though the psychological preferences of the participants do not coincide with the optimal scenario for color discrimination.

Agile characteristics of employees and their role in risk management

Purpose of the study: In order to survive in the face of contemporary risks, organizations are forced to initiate the evolution of employee behavior towards developing agile traits. The article, based on the concept of agility and classification of agile employee characteristics defined in the literature, aims to present the theoretical model of the behavior of agile employees in the face of organizational risk. Methodology: The model presented in the article was developed on the basis of a critical analysis of the literature in the field of agile management and risk management. Main Findings: One of the possible reactions of modern enterprises to the emergence of organizational risk is promoting employee agility. An agile employee is able to effectively anticipate problems related to the occurrence of risk, has the ability to solve problems related to the occurrence of risk. Such an employee is able to implement innovative ideas and perform his duties effectively in stressful conditions, as well as propose new procedures or processes for his area of ​​work. Applications of this study: The presented model of agile behavior of employees in the face of organizational risk is of a utilitarian nature and can be implemented in the organizational culture of various entities, including small and medium-sized enterprises. Novelty/Originality of this Study: Research originality: The article allows for a better understanding of the need to develop agile traits in employees and the possibility of using them to eliminate or minimize risks. The article may be an inspiration for further research on the role of employee agility in the enterprise.

How to Determine the Dangerous Potential of Accidents to Domino Effect Detonation in a Hydrocarbon Processing Area?

The crude oil industry has been developed in recent decades due to the uses of this product, as well as its derivatives. One of the worst consequences phenomena that can occur in the process industry is the called domino effect. The domino effect or cascade effect occurs when an initiating event, such as a pool of fire or a vapor cloud explosion, causes a new number of accidents. Moreover, due to the importance of avoiding this phenomenon, the European Commission considers the domino effect analysis as mandatory for industrial facilities. There are methodologies in the specialized literature focused on quantifying the existing risks in the storage and processing of hydrocarbons. However, there is a tendency to develop new procedures that increase the risk perception of these accidents. In addition, it is necessary to develop a method that allows visualizing clearly and concisely the dangerous potential of fire and explosion accidents for the occurrence of the domino effect. Precisely, this research aims to predict the dangerous potential of fire and explosion accidents for the occurrence of the domino effect. For this purpose, a methodology consisting of three fundamental stages is developed. Finally, hydrocarbon storage and processing area is selected to apply the proposed methodology. Overall, the development of graphs that summarize information and show the dangerous potential regarding the escalation of fire and explosion accidents is vital in risk analysis. For the case study, the effectiveness of the same was demonstrated, since after its realization it was possible to increase the risk awareness of workers, technicians, and managers of the area taken as a case study.

Fear and Promise of the Unknown: How Losses Discourage and Promote Exploration

Many situations involving search, such as commuters trying out new routes or organizations testing new procedures, can subject the explorer to the potential for subjective losses – situations that are worse than the status quo. How does the potential for experiencing losses during the course of a search affect individuals’ appetite for exploration? In three incentivized studies, we manipulate search outcomes by presenting participants either with a gain-only environment or a gain-loss environment. The gain-loss environment offers identical relative incentives for exploration, but payoffs are shifted down and participants receive an initial endowment to offset the difference. In both conditions, participants engage in a novel search task in which they decide how to explore a one-dimensional environment, receiving payoffs based on their location in each period. Payoffs between neighboring options are correlated, and movement is restricted in each turn to immediately adjacent locations. We predict and find that participants are motivated to avoid losses, which increases exploration when they are incurring losses, but decreases exploration when they face the prospect of losses. We conclude that exploration is driven by hope of anticipated gains, constrained by fear of anticipated losses, and motivated by avoidance of experienced losses.