Ideal Stage Research Articles

Stories from Smithfield: Markets and the Narration of London

Throughout London’s history, marketplaces have not only been integral to its economy but also to how the city was imagined. Drawing on a diverse range of archives and sources—from tabloid journalism and film, through to oral history and photography—this article examines the ‘narration of London’ at one of the city’s most famous market sites, Smithfield. It focuses upon three moments when London’s meat market came to be seen as emblematic of the city’s story: as an ‘anvil’ for modernisation in the mid-nineteenth century; as an ‘insider’s’ account of the commercial empire in the early twentieth century; and as the last remnant of a ‘London lost’ on the eve of a new millennium. This article argues that the narrative power of the marketplace lies in its capacity for temporal rupture and connection—an ideal stage for dramatising the relationship between urban past and present. It shows how starkly and stereotypically gendered representations of Smithfield’s male workforce became one important means of understanding and articulating urban change.

On the path to extinction: Helix godetiana Kobelt, 1878, the only threatened Helix species in Greece

Land snails and the Aegean Archipelago offer an intriguing combination for studying biodiversity, biogeography and ecology. A region with high environmental and temporal heterogeneity and a tri-continental biotic influence and a group of organisms with low active dispersal abilities, high endemism, as well as the particularity to leave shells as traces of past presence, set an ideal stage for testing biodiversity patterns and exploring multisource threats, especially in the era of the ongoing biodiversity crisis. In this study, we examine Helix godetiana, a large-sized, threatened and endemic land snail of the central and south Aegean Islands. The species has been extirpated from 22 of the 32 islands where it was historically present. We identify potential drivers of its extinction, as Helix godetiana faces several threats across its current range, including competitive exclusion by Cornu aspersum, a species with continuing expansion in the Aegean and climate change disrupting its unusual breeding cycle, which occurs in late spring. Our findings shed light on potentially major, yet previously unexplored, threats on endemic molluscs of the Aegean Islands, a European biodiversity hotspot.

Insular infraorbital neurovascular pedicle labial salivary gland transplantation for the treatment of severe dry eye disease: an IDEAL stage 0, 1 and 2a study

ObjectivesTo address the lack of nerve and blood supply after labial salivary gland transplantation (LSGT) resulting in glandular atrophy. We designed a modified LSGT, called insular infraorbital neurovascular pedicle LSGT,...

Physiological and harvestable maturity of seeds in finger millet [Eleusine coracana (L.) Gaertn.

Identification of correct stage of physiological maturity (PM) and ideal stage of harvestable maturity (HM) of seeds in finger millet is important for production of quality seed. The earliest date of appearance of seed setting was considered as the first stage of harvest and subsequently eight harvests were made at weekly intervals. The seeds harvested at different intervals during two late post-rainy seasons of 2019 and 2020 were evaluated. The study revealed the seed PM at 37 DAA (days after anthesis) during the first year for the variety VL347. The next harvest at 44 DAA reduced the seed yield, vigour and storability traits significantly indicating suitable stage of HM at 40 DAA. More or less similar, the second year results also confirmed these stages of PM and HM in VL347. In case of VR936, maximum seed quality reached at harvest stage of 48 DAA, however it was non-significant at 41 DAA for most of these traits, and further the seed yield reduced significantly with later harvest at 48 DAA. These observations indicated the appropriate stage of PM at 41 DAA and possible HM at 44 DAA in VR936. Also, the predictions based on polynomial regression model (II order) more or less closely confirmed these stages of PM in VL347 and VR936. The morphological indices observed at PM and HM stages were that most of the plants and ears appeared in brown to dark-brown and the seeds in brown to copper color. The black layer depression developed at hilum region of seed that was prominently visible at PM stage. These indicators help to judge the right stage of crop harvest for quality seed production in finger millet.

Temporal Stages of Burnout: How to Design Prevention?

Burnout, a major concern defined most commonly in the literature with a symptoms-based classification, can also be described as a temporal process with various stages experienced by workers, each composed of unique characteristics and challenges. This intricate process of burnout emphasizes pivotal moments, such as engagement and enthusiasm with a high job ideal (Stage 0), weakening of the ideal (Stage 1), protective withdrawal (Stage 2) and confirmed burnout (Stage 3). Through an opinion review, the objective of this article is to examine which prevention level, and more specifically which prevention actions, can be developed at each stage of this temporal process of burnout. The review criteria allow for the integration of both individual- and organization-focused interventions, ranging from early organizational-level strategies (primary prevention) to clinical consultations addressing the erosion of professional ideals (secondary prevention), as well as psychoeducational sessions aimed at promoting worker well-being. In conclusion, the article underscores the need for a holistic approach, combining organization-focused interventions with individual-focused interventions. Through a comprehensive review, this research provides insights into evidence-based practices, identifies gaps in current research, and offers guidance for future interventions for better support of workers facing burnout.

Impact of season and maturity stage on biochemical parameters of Averrhoa carambola fruits

The nutritional quality of fruits can be affected by changes in physiological indicators during fruit ripening, which is why it is important to identify the stage of maturity and the appropriate season for harvesting. Based on this observation, this study was carried out to evaluate the influence of the two different seasons and the stage of maturity on the nutritional parameters of Averrhoa Carambola. The results showed a significant effect (p<0.0001) of the two seasons and maturity stage on the biochemical parameters of A. carambola fruits. Ash contents and pH were significantly high in rainy seasons and at the ripe stage. Their values ​​were respectively (6.80±0.59%) and (3.54±0.27). Moisture and titratable acidity concentrations decreased significantly during maturation while total sugars, reducing and non-reducing sugars, and total soluble solids increased significantly during maturation. vitamin C and phenolic compounds were more abundant in the dry season and at the green stage. The values ​​were Vitamin C (15,869.64±0.03 mg/g), polyphenols (30.92±0.03 mg GAE/mg), flavonoids (30.59±0.28 mg EQ/g) and tannins (21-.02±0.01 mg GAE/g). This study suggests that there are differences in the biochemical parameters of starfruit between seasons depending on the maturity stage. The data provided useful information on the season and ideal stage of maturity for harvesting and their use in food products.

Non-invasive vagus nerve stimulation to reduce ileus after colorectal surgery: randomized feasibility trial and efficacy assessment (IDEAL Stage 2B).

Ileus is characterized by a period of intestinal dysmotility after surgery, leading to vomiting and constipation. In preclinical models, vagus nerve stimulation reduces intestinal inflammation and prevents smooth muscle dysfunction, accelerating the return of gut function. This study explored the feasibility of a definitive trial of non-invasive vagus nerve stimulation (nVNS) along with an early assessment of efficacy. A multicentre, randomized feasibility trial (IDEAL Stage 2B) of self-administered nVNS was performed. Patients undergoing colorectal surgery were randomized to nVNS or sham before and after surgery. Feasibility outcomes comprised assessments of recruitment, compliance, blinding and attrition. Clinical outcomes were measures of intestinal function and adverse events. All participants were followed up for 30 days. Interviews with patients and health professionals explored barriers to feasibility and perspectives around implementation. In all, 125 patients were approached about the study and 97 (77.6%) took part. Across all randomized groups, the median compliance to treatment was 19 out of 20 stimulations (interquartile range 17-20). The incidence of adverse events was similar across groups. In this unpowered feasibility study, the time taken for the return of gut function (such as first passage of stool) was similar between nVNS and sham treatments. According to interviews, patients were highly motivated to use the device because it provided them with an opportunity to engage actively in their care. Health professionals were highly driven to tackle the problem of ileus. Powered assessments of clinical efficacy are required to confirm or refute the promise of nVNS, as already demonstrated in preclinical models. This feasibility study concludes that a definitive randomized assessment of the clinical benefits of nVNS is desired and feasible.

This is the first in‐human trial and prospective case series of a novel single‐port robotic system for gynaecological surgery: An IDEAL stage 2a study

AbstractBackgroundThe Shurui® system (SR‐ENS‐600) is a novel fully integrated single‐port robotic system with bioinspired serpentine surgical manipulators and a camera.MethodsThis was a single‐centre prospective case‐series study according to the IDEAL stage 2a guidelines to evaluate the feasibility, safety and potential efficacy of the Shurui® system for gynaecological surgeries and to improve the operating process.ResultsTen patients with a gradient of surgical difficulty who had indications for laparoscopic surgery and who volunteered to participate in a clinical trial were enrolled in the study. All 10 subjects successfully completed the procedure without converting to other procedures. No serious complications were reported at the 3‐month follow‐up. Subjects recover faster after surgery and are highly satisfied with the incision.ConclusionsGynaecological single‐site laparoscopic surgery with the Shurui® system was technically feasible for well‐selected patients with minimal alterations in technique. Further prospective multicenter large‐sample studies are necessary.Registration numberChiCTR2300075431. URL: https://www.chictr.org.cn/showproj.html?proj=189995.

Assessment of Sugarcane Varieties at Various Maturity Levels Using Physical Properties

The objective of the study was to extract sugarcane juice, identify the ideal stage of maturity and assess its acceptability using sensory analysis. From Rudrur, Regional Sugarcane and Rice Research Station in Nizamabad provided the sugarcane cultivars Co86032, 85R186 and 83R23 for the study which was carried out in 2021–2022. These types were gathered in the eighth, tenth and twelve months of maturity. The findings showed that physical characteristics like sucrose in brix% and juice obtained grew more prominent as one aged. Thus, for sensory examination 12thmonth maturity stage was chosen. Out of all the varieties that were evaluated the experimental sample SCR2-83R23 showed better acceptability than the experimental sample SCR1-85R186 and control SCO-Co86032. Because of improved sweetness, a deeper flavor profile and superior overall juice obtained are important components of consumer choice and sensory pleasure the SCR2-83R23 variant is probably more widely accepted.

PE066 IDEAL stage 2 implementation of the Medtronic Hugo™ Robotic-Assisted Surgery (RAS) for upper tract urological procedures

PE066 IDEAL stage 2 implementation of the Medtronic Hugo™ Robotic-Assisted Surgery (RAS) for upper tract urological procedures

PE042 IDEAL stage 2 implementation of the Medtronic Hugo™ Robotic-Assisted Surgery (RAS) in radical prostatectomy: Comparative study from the first UK centre

PE042 IDEAL stage 2 implementation of the Medtronic Hugo™ Robotic-Assisted Surgery (RAS) in radical prostatectomy: Comparative study from the first UK centre

Evaluation of the suitability of using ArtiSential in various renal surgery: IDEAL stage 1 study

BackgroundArtiSential, a new articulating laparoscopic instruments, addresses the limited movement associated with conventional laparoscopic instruments. This study was conducted to assess the clinical effectiveness of ArtiSential in detailed steps of various renal surgery.MethodsThis study was approved by the Institutional Review Board of our institution and registered on the Clinical Research Information Service site of the Korea Disease Control and Prevention Agency. Participants meeting all inclusion and exclusion criteria were included in the clinical trial and underwent renal surgery. The clinical effectiveness of ArtiSential was assessed in terms of the feasibility and objective and subjective parameters across 9 detailed steps.ResultsOf the 15 potential candidates enrolled from October 2021 to November 2021, 1 patient dropped out due to anaphylaxis from an anesthetic agent, and 14 patients underwent laparoscopic surgery using ArtiSential. Of the 14 patients, 2 patients were converted to laparoscopic surgery using straight-shaped instruments due to the ischemia time exceeding 30 min, and 1 patient due to excessive bleeding. The feasibility for most steps was more than 90%, except the renorrhaphy step. The median total operation time and ischemia time were 161 and 23 min, respectively. The median estimated blood loss was 58.5 mL. Two cases of venous injury occurred during renal pedicle dissection step. The accuracy of the procedure judged by reviewers and usability judged by the operator were acceptable in all steps. The surgeon’s quantitatively measured stress score was the highest during renorrhaphy step.ConclusionsLaparoscopic surgery using ArtiSential is feasible for most steps except the renorrhaphy step. The difficulty of performing renorrhaphy is attributed to prolonged ischemia time, which could be addressed by overcoming the learning curve.Trial registrationClinical Research Information Service site of the Korea Disease Control and Prevention Agency, KCT0006532. Registered 03/09/2021, https://cris.nih.go.kr/cris/search/detailSearch.do?seq=24071.

Minimally Invasive transCervical oEsophagectomy (MICE) for oesophageal cancer: prospective cohort study (IDEAL stage 2A).

Minimally invasive transcervical oesophagectomy is a surgical technique that offers radical oesophagectomy without the need for transthoracic access. The aim of this study was to evaluate the safety and feasibility of the minimally invasive transcervical oesophagectomy procedure and to report the refinement of this technique in a Western cohort. A single-centre prospective cohort study was designed as an IDEAL stage 2A study. Patients with oesophageal cancer (cT1b-4a N0-3 M0) who were scheduled for oesophagectomy with curative intent were eligible for inclusion in the study. The main outcome parameter was the postoperative pulmonary complication rate and the secondary outcomes were the anastomotic leakage, recurrent laryngeal nerve palsy, and R0 resection rates, as well as the lymph node yield. In total, 75 patients underwent minimally invasive transcervical oesophagectomy between January 2021 and November 2023. Several modifications to the surgical technique were registered, evaluated, and implemented in the context of IDEAL stage 2A. A total of 12 patients (16%) had postoperative pulmonary complications, including pneumonia (4 patients) and pleural effusion with drainage or aspiration (8 patients). Recurrent laryngeal nerve palsy was observed in 33 of 75 patients (44%), with recovery in 30 of 33 patients (91%). A total of 5 of 75 patients (7%) had anastomotic leakage. The median number of resected lymph nodes was 29 (interquartile range 22-37) and the R0 resection rate was 96% (72 patients). Introducing minimally invasive transcervical oesophagectomy for oesophageal cancer in a Dutch institution is associated with a low rate of postoperative pulmonary complications and a high rate of temporary recurrent laryngeal nerve palsy.

EFFECT OF BAP ALONG WITH 2.4, D ON THE INDUCTION OF SHOOTS FORMATION ON POTATO CULTIVAR ARIZONA IN VITRO

This examination delves into the many-sided transaction between two key development controllers, BAP (6-benzylaminopurine) and 2,4-Dichlorophenoxyacetic acid (2,4-D), exploring their aggregate effect on shoot induction in the in vitro development of the esteemed potato cultivar Arizona. The study is fastidiously designed to unwind the nuanced effect of these controllers on shoot commencement inside a controlled lab setting.Potato micropropagation stands as a fundamental feature of horticultural advancement, and the feeling of proficient shoot development fills in as a crucial stage in this cycle. The exceptional development attributes of Cultivar Arizona provide an ideal stage for assessing the synergistic impacts of BAP and 2,4-D on the commencement and multiplication of shoots. By carefully noticing and measuring the reaction of potato explants to fluctuating focuses and mixes of BAP and 2,4-D, this study expects to discern ideal conditions conducive to enhanced shoot development. Through detailed analysis and observation, the research seeks to contribute valuable insights into refining in vitro cultivation methodologies for potato propagation, aiming at elevating efficiency and yield.

Impact of thermodynamics and kinetics on the carbon capture performance of the amine-based CO2 capture system

Solvent-based CO2 capture is a commonly employed post-combustion technique in processes involving absorber-stripper columns. This study focused on computer simulations with equilibrium- and rate-based modeling of CO2 capture using the amine solvents 2-amino-2-methyl-1-propanol (AMP), diethanolamine (DEA), and methyl diethanolamine (MDEA) and thermodynamic methods involving electrolyte NRTL models. The objective of this study was to understand the impacts of rate-based modeling, the type of amine, and thermodynamic methods on carbon capture. Within this study, the amine-based CO2 capture process from coal-power plant flue gas was studied using Aspen Plus modeling. Simulations were also conducted to determine the impact of thermodynamics and kinetics on the CO2 capture performance of the system. The results were analyzed on the basis of captured CO2 according to the solvents and models. The equilibrium approach was mostly invalid because of the oversimplified ideal stage assumptions through the column. The lowest carbon capture capacity was obtained with MDEA, while DEA yielded the best results. A sensitivity analysis with rate-based modeling showed the significant impact of the inlet CO2 composition. The amine-based CO2 capture process simulation included solution chemistry, electrolyte thermodynamics, rigorous transport property modeling, reaction kinetics, and rate-based multistage simulation, which could be applicable to different solvent systems.

The Importance of Stage Scheduling in Dance Creation - - Taking Far Mountain is Not Far Away as an Example

Stage scheduling is to schedule the stage, schedule the position of the actors on the stage, also known as scene scheduling. In order to better show the central idea and connotation of the work, it is necessary to design and arrange the actors on the stage, which is called stage scheduling in drama. This paper mainly describes what is stage scheduling, stage scheduling methods and stage scheduling in the role and application of dance choreography. The basic content of dance creation is innovation and thinking ability. In order to achieve a more ideal stage effect, the application of stage scheduling in dance creation is indispensable. There are two main functions of stage scheduling: action scheduling and lyrical scheduling. Action scheduling is mainly targeted to the actor s action scheduling, commonly used in opera or slightly small plot singing. The lyrical scheduling mainly refers to the scheduling that has no action connection with the performer, which is mainly formulated for the needs of the atmosphere. Stage scheduling is mainly a means to make the stage resonate with the audience.

Об информационном воздействии юридического голосования на правовые отношения

The article analyzes one of the main functions of legal voting, namely the informational function. The author proposed and examined in detail a staged model of informational impact of legal voting on the legal relations that develop on issues of collective adoption of legally significant decisions. It is concluded that this function is one of the most important functions of the considered legal phenomenon, and its practical implementation involves the consecutive passage of four stages. At the same time, the ideal stage model does not assume optional stages, considering each of them as a mandatory one. In practice, the third stage, namely the perception of collectively made legally significant decision, understanding its meaning, by the persons interested in the results of the voting procedure can fail to occur due to objective and subjective factors.

Prospective development study of the Versius Surgical System for use in transoral robotic surgery: an IDEAL stage 1/2a first in human and initial case series experience

PurposeTransoral robotic surgery is well established in the treatment paradigm of oropharyngeal pathology. The Versius Surgical System (CMR Surgical) is a robotic platform in clinical use in multiple specialities but is currently untested in the head and neck. This study utilises the IDEAL framework of surgical innovation to prospectively evaluate and report a first in human clinical experience and single centre case series of transoral robotic surgery (TORS) with Versius.MethodsFollowing IDEAL framework stages 1 and 2a, the study evaluated Versius to perform first in human TORS before transitioning from benign to malignant cases. Iterative adjustments were made to system setup, instrumentation, and technique, recorded in accordance with IDEAL recommendations. Evaluation criteria included successful procedure completion, setup time, operative time, complications, and subjective impressions. Further evaluation of the system to perform four-arm surgery was conducted.Results30 TORS procedures were successfully completed (15 benign, 15 malignant) without intraoperative complication or conversion to open surgery. Setup time significantly decreased over the study period. Instrumentation challenges were identified, urging the need for TORS-specific instruments. The study introduced four-arm surgery, showcasing Versius’ unique capabilities, although limitations in distal access were observed.ConclusionsTORS is feasible with the Versius Surgical System. The development of TORS-specific instruments would benefit performance and wider adoption of the system. 4-arm surgery is possible however further evaluation is required. Multicentre evaluation (IDEAL stage 2b) is recommended.

New robotic platform for transoral robotic surgery: an IDEAL stage 0 study

ObjectivesThis study aims to assess the feasibility to perform transoral robotic surgery (TORS) with a new robotic platform, the Versius Surgical System (CMR Surgical, UK) in a preclinical cadaveric setting...

The ClearPoint Prism® Laser Ablation System: A New Platform for Laser Interstitial Thermal Therapy (LITT) in Neuro-Oncology

BACKGROUND AND OBJECTIVES: Laser interstitial thermal therapy (LITT) has advanced the surgical treatment of brain cancer. However, technical constraints in the first-generation laser ablation systems limit the full potential of this technology. The ClearPoint Prism® Laser Ablation System was developed to overcome many of these limitations, including a larger ablation window, a faster refresh rate for magnetic resonance thermometry, and integration with an MRI-compatible stereotactic system. This system was US Food and Drug Administration–cleared for neurosurgical use in 2022. METHODS: As an IDEAL Stage 1 study, we prospectively followed the first 3 patients who underwent LITT using the ClearPoint Prism® Laser Ablation System in the United States to establish feasibility and safety of this technology platform. RESULTS: Three patients underwent procedures involving MRI-guided needle biopsy followed by LITT. The radial error of stereotaxis relative to the intended target ranged from 0.8 to 1.6 mm (with a median of 1.0 mm). Definitive diagnosis was achieved in all cases. The average time required to establish the trajectories was 98.7 ± 16.6 minutes. The average time required to perform the biopsy and LITT was 110 ± 19.3 minutes. These times are not statistically different from our published results for comparable procedures using other available LITT systems. The average LITT time required to achieve ablation of >1 cm radius was 49 seconds (range: 29-133 seconds). There were no procedural complications. All patients were discharged home by postoperative day 3. The postoperative MRIs demonstrated expected ablation findings consistent with intraoperative thermometric assessment. With a median follow-up of 219 days (range: 185-259 days), there were no 30-day readmission, 90-day emergency visits, or wound complications. CONCLUSION: In this study, we introduced the design rationale for the ClearPoint Prism® Laser Ablation System, theoretical considerations for its technical merits relative to other existing systems, and to share our initial experience.