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Psychonomic Bulletin & Review Jun 2024Affordances are opportunities for action for a given animal (or animals) in a given environment or situation. The concept of affordance has been widely adopted in the... (Review)
Review
Affordances are opportunities for action for a given animal (or animals) in a given environment or situation. The concept of affordance has been widely adopted in the behavioral sciences, but important questions remain. We propose a new way of understanding the nature of affordances; in particular, how affordances are related to one another. We claim that many - perhaps most - affordances emerge from non-additive relations among other affordances, such that some affordances are of higher order relative to other affordances. That is, we propose that affordances form a continuous category of perceiveables that differ only in whether and how they relate to other affordances. We argue that: (1) opportunities for behaviors of all kinds can be described as affordances, (2) some affordances emerge from relations between animal and environment, whereas most affordances emerge from relations between other affordances, and (3) all affordances lawfully structure ambient energy arrays and, therefore, can be perceived directly. Our concept of higher order affordances provides a general account of behavioral phenomena that traditionally have been interpreted in terms of cognitive processes (e.g., remembering or imagining) as well as behavioral phenomena that have traditionally been interpreted in terms of cultural rules, such as conventions, or customs.
PubMed: 38944659
DOI: 10.3758/s13423-024-02535-y -
American Journal of Surgery Jun 2024There has been tremendous effort to improve quality following colorectal surgery, including the proliferation of minimally invasive techniques, enhanced recovery...
BACKGROUND
There has been tremendous effort to improve quality following colorectal surgery, including the proliferation of minimally invasive techniques, enhanced recovery protocols, and surgical site infection prevention bundles. While these programs have demonstrated improved postoperative outcomes at the institutional level, it is unclear whether similar benefits are present on a national scale.
METHODS
American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Targeted Colectomy data from 2012 to 2020 were used to identify patients undergoing minimally invasive surgery (MIS) or open partial colectomy (CPT 44140, 44204) or low anterior resection (CPT 44145, 44207). Chronological cohorts as well as annual trends in 30-day postoperative outcomes including surgical site infection, venous thromboembolism, and length of stay were assessed using both univariable and multivariable regression analyses.
RESULTS
261,301 patients, 135,876 (52 %) female, with a median age of 62 (IQR 53-72) were included. Across all years, MIS partial colectomy was the most common procedure (37 %), followed by MIS low anterior resection (27 %), open partial colectomy (24 %), and open low anterior resection (12 %). MIS increased from 59 % in 2012-2014 to 66 % in 2018-2020 (p < 0.001). During this same period, postoperative length of stay decreased from a median of 5 days (IQR 4-7) in 2012-2014 to 4 days (IQR 3-6) in 2018-2020 (p < 0.001). Superficial surgical site infections decreased from 5.5 % in 2012-2014 to 2.9 % in 2018-2020 (p < 0.001). Deep surgical site infections similarly decreased from 1.1 % to 0.4 % between these periods (p < 0.001). Pulmonary embolism also decreased from 0.6 % to 0.5 % between periods (p = 0.02). 30-day mortality was unchanged at 1.7 % between 2012-2014 and 2018-2020 (p = 0.40). After adjustment for ACS NSQIP estimated probability of morbidity and mortality, undergoing a colectomy in 2020 compared to 2012 was associated with a 14 % decrease in postoperative length of stay (p < 0.001).
CONCLUSIONS
Between 2012 and 2020, significant improvements in postoperative outcomes after colectomy were observed in the United States. These results support the positive impact that the widespread adoption of quality improvement initiatives is having on colorectal patient care nationally.
PubMed: 38944622
DOI: 10.1016/j.amjsurg.2024.115808 -
Urologic Oncology Jun 2024Penile cancer (PeCa) is a rare disease. HPV infection, smoking, phimosis, and lichen sclerosus represent well-known associated risk factors.
BACKGROUND
Penile cancer (PeCa) is a rare disease. HPV infection, smoking, phimosis, and lichen sclerosus represent well-known associated risk factors.
OBJECTIVES
Primary aim of our study is to evaluate the incidence and risk factors of PeCa and to outline the adopted diagnostic and therapeutic approaches. Secondary aim is to investigate risk factors associated with aggressive disease and to identify the complications arising from its surgical treatment.
MATERIALS AND METHODS
We conducted a retrospective analysis using the PearlDiver™ Mariner database, from January 1, 2011, to December 31, 2021, identifying all patients diagnosed with PeCa and PeIN, evaluating comorbidities, risk factors, and social and economic conditions. We evaluated the imaging modalities employed for staging as well as the treatment strategies. Finally, we evaluated the most frequent complications associated with inguinal lymphadenectomy (ILND).
RESULTS
During the study period, 17,494 patients were diagnosed with PeCa and 5,965 with penile intraepithelial neoplasia (PeIN). US was the most frequently utilized imaging modality, followed by PET and PET/CT. Use of CT and MRI was around 5%. Surgical treatment was the predominant strategy, utilized in 31.3% of PeCa and 22.9% of PeIN. Wide Local Excision/Glansectomy emerged as the most common surgical procedures. MLR analysis identified smoking as a risk factor for metastatic PeCa (OR; 95% CI = 1.49; 1.379-1.609), HPV infections were associated with a 35% decrease in risk (OR; 95% CI = 0.65; 0.562-0.744) (all P < 0.001). Lichen sclerosus and phimosis were associated with a doubled risk of demolitive surgery. Approximately 40% of patients experienced complications associated with ILND.
CONCLUSION
Despite advances in PeCa management, there's no significant move toward more conservative treatments. Surgical treatments are still marked by high rates of complications, potentially affect the sexual and psychosocial health of patients. These issues may foster a tendency toward avoidance behaviors, contributing to a delayed clinical presentation and treatment.
PubMed: 38944595
DOI: 10.1016/j.urolonc.2024.05.013 -
Journal of Surgical Education Jun 2024This study aims to evaluate the instructional efficacy of a 3D Surgical Training System (3DSTS), which combines real surgical footage with high-definition 3D animations,...
OBJECTIVE
This study aims to evaluate the instructional efficacy of a 3D Surgical Training System (3DSTS), which combines real surgical footage with high-definition 3D animations, against conventional surgical videos and textbooks in the context of orthopedic proximal humerus fracture surgeries.
DESIGN
Before the experiment, 89 participants completed a pre-educational knowledge assessment. They were then randomized into 3 groups: the 3DSTS group (n = 30), the surgical video (SV) group (n = 29), and the textbook group (n = 30). After their respective teaching courses, all participants took a posteducational assessment and completed a perceived cognitive load test. The 3DSTS group also filled out a satisfaction survey. Once all assessments were finished, the SV and textbook groups were introduced to the 3DSTS course and subsequently completed a satisfaction survey. All statistical analyses were executed using IBM SPSS version 24 (IBM Corp., Armonk, NY). For data fitting normal distribution, we employed one-way analysis of variance (one-way ANOVA) and Tukey HSD tests, whereas, for non-normally distributed data, we used Kruskal-Wallis H tests and Dunn's tests. The significance level for all tests was set at p < 0.05.
SETTING
Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, P. R. China.
PARTICIPANTS
About 89 doctors who undergoing standardized residents training.
RESULT
The initial assessment scores among the three groups were comparable, showing no significant statistical difference. Post-education revealed a marked difference in the scores, with the 3DSTS group outperforming both the SV and textbook groups. Specifically, the 3DSTS group exhibited statistically greater improvement in areas such as procedural steps, and specialized surgical techniques compared to the SV and textbook groups. During the 3DSTS teaching process, participants reported the least perceived cognitive load and expressed strong satisfaction, highlighting that the instructional materials are well-prepared, and considering this teaching method superior and more innovative than previous courses they had encountered.
CONCLUSION
The 3D Surgical Training System, integrating real videos with 3D animations, significantly enhances orthopedic surgery education over conventional methods, providing improved comprehension, lower cognitive load, and standardized learning outcomes. Its efficacy and high participant satisfaction underscore its potential for broader adoption in surgical disciplines. This study is registered with ClinicalTrials. gov ID: ChiCTR2300074730.
PubMed: 38944585
DOI: 10.1016/j.jsurg.2024.05.015 -
The Surgical Clinics of North America Aug 2024While there has been great progress in the past few decades in the management of endocrine surgery disorders, with adoption of new technologies and approaches,... (Review)
Review
While there has been great progress in the past few decades in the management of endocrine surgery disorders, with adoption of new technologies and approaches, standardization of practice patterns, and guideline recommendations, unequal implementation of these improvement has led to differences in access and outcomes. Health disparities are well documented in this population; however, literature lacks discussion of strategies to decrease disparities. In this article, the authors will describe the current status of health care-related disparities in endocrine surgical care, and discuss opportunities for future investigation and issue an urgent call to action items.
Topics: Humans; Healthcare Disparities; Endocrine System Diseases; Endocrine Surgical Procedures; Health Services Accessibility; United States
PubMed: 38944509
DOI: 10.1016/j.suc.2024.02.017 -
The Surgical Clinics of North America Aug 2024Thyroidectomy is relatively safe and often can be done as a minimally invasive procedure. Although they may be associated with a learning curve, thoughtful use of... (Review)
Review
Thyroidectomy is relatively safe and often can be done as a minimally invasive procedure. Although they may be associated with a learning curve, thoughtful use of intraoperative adjuncts such as energy devices, recurrent laryngeal nerve monitoring, and parathyroid autofluorescence have the potential to make incremental improvements in the safety and efficiency of thyroid surgery. Perhaps many of these adjuncts may be of greatest benefit when used routinely by less experienced surgeons or selectively in higher-risk operations, although their adoption in practice continues to increase overall.
Topics: Humans; Thyroidectomy; Monitoring, Intraoperative; Thyroid Diseases; Recurrent Laryngeal Nerve Injuries; Thyroid Gland; Optical Imaging
PubMed: 38944497
DOI: 10.1016/j.suc.2024.02.006 -
Soins. Gerontologie 2024The emergence of social robots in gerontology has introduced new playful and reassuring media into nursing homes and geriatric wards. Despite promising results, their...
The emergence of social robots in gerontology has introduced new playful and reassuring media into nursing homes and geriatric wards. Despite promising results, their complexity hinders their widespread adoption. The Intelligent Interactive Care System aims to remedy these limitations by offering interactive therapeutic workshops. This study evaluates residents' involvement in these workshops within an adapted activity and care center, revealing a high level of involvement and satisfaction.
Topics: Humans; Aged; Robotics; Aged, 80 and over; Nursing Homes; Male; Female; Quality Improvement; Geriatrics
PubMed: 38944468
DOI: 10.1016/j.sger.2024.04.007 -
Bioresource Technology Jun 2024In this work, carbonization and subsequent activation procedures were adopted to synthesize waste shea butter shells into oxygen-rich interconnected porous activated...
In this work, carbonization and subsequent activation procedures were adopted to synthesize waste shea butter shells into oxygen-rich interconnected porous activated carbon (SAC_x, x is the mass ratio of KOH used for activation). The SAC_1.5 electrode material showed outstanding electrochemical performance with high specific capacitance (286.6F/g) and improved rate capability, owing to various synergistic effects originating from a high specific surface area (1233.5 m/g) and O-rich content. The SAC_1.5-based symmetric device delivered an impressive specific capacitance of 91.6F/g with a high energy density of 12.7 Wh/kg at 0.5 A/g. The device recorded 99.9 % capacitance retention after 10,000 charge-discharge cycles. The symmetric supercapacitor device successfully lit an LED bulb for more than 1 h, signifying the potential of bio-waste as an efficient carbon precursor for electrode material in practical supercapacitors. This work offers an efficient, affordable, and environmentally friendly strategy for potential renewable energy storage devices.
PubMed: 38944313
DOI: 10.1016/j.biortech.2024.131039 -
The Science of the Total Environment Jun 2024In the last decades, several studies have highlighted the significant impacts of the food sector. Therefore, enhancing sustainability within this sector has become of... (Review)
Review
In the last decades, several studies have highlighted the significant impacts of the food sector. Therefore, enhancing sustainability within this sector has become of paramount importance. A crucial step towards achieving this goal involves the definition and implementation of effective sustainability metric and measurements. In this regard, the adoption of multi-criteria decision analysis (MCDA) methods can be seen as one of the most suitable and promising approach to comprehensively capture the complex and broad-ranging effects of agricultural practices and food supply chains. In such context, a systematic review of the scientific literature on multi-criteria approaches and tools for measuring the sustainability of food supply chains (harvest and post-harvest stages) has been carried out, resulting in the selection and analysis of 42 articles. To delve into the selected articles, three main areas of focus have been identified. The first about MCDA methods and their features, revealing the most adopted methods for sustainability assessments of food supply chains. The second, focusing on the participatory approach, led to the definition of a stakeholder's engagement map, highlighting the typology of stakeholders involved, the reasons of their involvement and engagement methods. Lastly, the third focus is related to the analysis and classification of indicators adopted in each study and the sustainability dimensions to which they refer to. The results of the present review study provide a comprehensive overview of the essential aspects to be considered when developing a MCDA for sustainability assessment in the food sector, serving as a valuable resource for both scholars and practitioners.
PubMed: 38944301
DOI: 10.1016/j.scitotenv.2024.174235 -
International Journal of Biological... Jun 2024Recent advancements have transformed lignin from a byproduct into a valuable raw material for polymers, dyes, adhesives, and fertilizers. However, its structural... (Review)
Review
Recent advancements have transformed lignin from a byproduct into a valuable raw material for polymers, dyes, adhesives, and fertilizers. However, its structural heterogeneity, variable reactive group content, impurities, and high extraction costs pose challenges to industrial-scale adoption. Efficient separation technologies and selective bond cleavage are crucial. Advanced pretreatment methods have enhanced lignin purity and reduced contamination, while novel catalytic techniques have improved depolymerization efficiency and selectivity. This review compares catalytic depolymerization methodologies, highlighting their advantages and disadvantages, and noting challenges in comparing yield values due to variations in isolation methods and lignin sources. Recognizing "technical lignin" from pulping processes, the review emphasizes its diverse applications and the necessity of understanding its structural characteristics. Emerging trends focus on bio-based functional additives and nanostructured lignin materials, promising enhanced properties and functionalities. Innovations open possibilities in sustainable agriculture, high-performance foams and composites, and advanced medical applications like drug delivery and wound healing. Leveraging lignin's biocompatibility, abundance, and potential for high-value applications, it can significantly contribute to sustainable material development across various industries. Continuous research in bio-based additives and nanostructured materials underscores lignin's potential to revolutionize material science and promote environmentally friendly industrial applications.
PubMed: 38944064
DOI: 10.1016/j.ijbiomac.2024.133506