Multidisciplinary Context Research Articles

Carcinoma colon masquerading as bleeding per vagina.

Isolated vaginal metastasis from colorectal cancer is a rare entity with very few reports in the literature. Here we report a patient who presented with bleeding per vagina from a vaginal mucosal lesion. Biopsy of the vaginal lesion indicated a metastatic adenocarcinoma from a colorectal primary. Further workup of the patient with colonoscopy and Positron emission tomography (PET CT) indicated a primary in the sigmoid colon. As the patient had a single site of metastasis, she was planned for definitive management. The colonic primary, as well as the vaginal deposit were managed surgically. Further, the patient received adjuvant chemotherapy as well as adjuvant external beam radiation to the site of the vaginal lesion. Vaginal metastases from colorectal primary are usually part of systemic dissemination with multiple metastatic sites and hence has poor prognosis. When the patient presents with an isolated metastasis in the vagina., the survival appears reasonable as per the few reports available in the literature. Due to the rarity of the presentation, there are no standard treatment guidelines available. Surgical management, radiation and adjuvant chemotherapy have been used in varying combinations in the reports available in the literature. To conclude, vaginal metastasis should be included in the differential diagnosis of patients presenting with vaginal bleeding, especially with a history of colorectal carcinoma. Available limited evidence suggests that isolated vaginal metastasis from colorectal cancer that is amenable to local surgical resection has a reasonable outcome. Hence, isolated vaginal metastasis should be treated with curative intent in a multidisciplinary context like other sites of oligometastatic disease.

SYRMEP beamline: state of the art, upgrades and future prospects

SYRMEP is the hard X-ray imaging beamline of Elettra synchrotron offering X-ray full-field techniques, micro-computed tomography (microCT) and phase-contrast modality in the energy range 10–40 keV. The beamline operates in a multidisciplinary research context spanning from biomedical applications to botany, from zoology to food technology and cultural heritage, from materials engineering to geology and earth science. Thanks to the flexibility of SYRMEP setup, in situ experiments can be performed as well, novel imaging methods can be developed and implemented in a synergical manner with interested users and collaborators. SYRMEP peculiar wide beam together with the long sample-to-detector distance enables multiscale phase-contrast studies with optimized contrast and spatial resolution on rather large specimens, such as human lung phantoms. This is particularly relevant in view of future clinical lung imaging foreseen in the framework of Elettra 2.0 program. Here, the current beamline features and recent upgrades are illustrated, an overview of the imaging methods routinely offered to SYRMEP users’ community is presented, and the outlook for the new beamline SYRMEP-Life Science (SYRMEP-LS) is reported.

The interdisciplinary field of Sleep Medicine-time for dentists to sink their teeth into it!

Sleep Medicine has evolved into a highly multidisciplinary field over the last few decades, involving respiratory physicians, neurologists, cardiologists, ENT surgeons, psychiatrists and psychologists to name a few. It is within this highly multidisciplinary context that we have seen an increasing role for dentists in the recognition, diagnosis and management of select sleep disturbances and disorders. Over the last couple of decades, this growing role for dentists has seen the informal emergence of a new interdisciplinary field of Dental Sleep Medicine-a field that bridges medicine and dentistry as it pertains to the diagnosis and management of sleep disorders. This article describes this new field in terms of its history, the evolving scope of practice for dentists, the implications for education and training, and the importance of multidisciplinary care that optimises outcomes for patients.

Multidisciplinary learning assessment in Finland – a phenomenographic approach on teachers’ perceptions

ABSTRACT Multidisciplinary learning (ML) contexts have become an integral part of teaching. Since the 2014 curriculum reform in Finland, certain aspects of learning assessment have changed in Finnish basic education. These educational policy reforms and their practical implementation have increased national and international interest in the Finnish curriculum and its approach to learning assessment. This paper explores Finnish primary school (students aged 7–12) teachers’ (PST) perceptions of the significance of learning assessment in basic education, particularly regarding multidisciplinary learning modules. This study implements a phenomenographic research design based on semi-structured interviews (n = 15). The qualitative analysis resulted in five hierarchical outcome categories reflecting the primary school teachers’ perception of significance of learning assessment in a multidisciplinary learning context. The results indicate that primary school teachers’ perceptions of the significance of learning assessment can influence both the variety of assessment, and the teacher/student roles in the design and implementation of assessment. The qualitative findings of this study deepen our understanding of the role of learning assessment in multidisciplinary learning and teaching and support the further development of teacher education in the field of learning assessment. Interactive, comprehensive assessment strengthens quality learning by making learning visible and steering learning towards its goals.

Conceptual dimensions of conceptions of teaching problem-solving

AbstractStudies over the past three decades have shown the alignment between teachers' conceptions and approaches to teaching. However, little attention has been given to exploring skill-oriented teaching conceptions and approaches, such as problem-solving (PS). Although teachers' views, beliefs, and understanding of problem-solving have been studied to a certain extent, there has not been a common conceptual ground to study the conceptions of teaching problem-solving in a wider and multidisciplinary context. Therefore, this review article aims to assemble and provide conceptual clarity to the elements teaching problem-solving might constitute to create the foundation for future study. Positing that the way teachers conceive ‘problem’ in instruction, the process of problem-solving, and their role inform the approaches they take to teach PS, this paper provides conceptual grounding and reasoning of each element. To conclude, the paper might be a valuable resource for scholars starting to examine the same topic, as it provides overviews of seminal papers and essential insights into the topic, demonstrating the importance of studying conceptions of teaching problem-solving.

Orthodontic bonding in special circumstances

This clinical paper provides an in-depth exploration of advanced techniques for bonding orthodontic attachments under special circumstances. Challenges arise when bonding brackets to non-enamel surfaces, such as dental restorations, and in conditions such as amelogenesis imperfecta, which affect enamel integrity. Distinct approaches required for bonding to different restorative materials, including glassy ceramics, zirconia, resin composites and metals, are outlined. Moreover, we describe strategies to manage bonding in conditions including amelogenesis imperfecta, hypodontia and microdontia in a multidisciplinary context.

Palliative Thoracic Radiotherapy in the Era of Modern Cancer Care for NSCLC.

Palliative thoracic radiotherapy provides rapid and effective symptom relief in approximately two-thirds of NSCLC patients treated. In patients with poor performance status, the degree of palliation appears unrelated to the radiation dose or fractionation schedule. Conversely, in patients with good performance status, higher radiation doses administered over longer periods have shown modest survival benefits. These findings stem from studies conducted before the advent of immunotherapy and targeted therapy in clinical practice. Currently, there are no large prospective studies specifically dedicated to palliative radiotherapy conducted in this new treatment era. Modern radiotherapy technologies are now widely available and are increasingly used for palliative purposes in selected patients, reflecting the expanded array of therapeutic options for disseminated NSCLC and improved prognosis. Some traditional tenets of palliative thoracic radiotherapy, such as the improvement of overall survival with a protracted radiation schedule and the use of simple, cost-effective radiation techniques for palliative purposes, may no longer hold true for patients receiving immunotherapy or targeted therapy. The application of IMRT or SBRT in the context of palliative radiotherapy for NSCLC is not yet sufficiently explored, and this is addressed in this review. Moreover, new risks associated with combining palliative radiotherapy with these systemic treatments are being explored and are discussed within the context of palliative care. The optimal timing, doses, fractionation schedules, and treatment volumes for radiotherapy combined with immunotherapy or targeted therapy are currently subjects of investigation. In emergencies, radiotherapy should be used as a life-saving measure without delay. However, for other indications of palliative thoracic radiotherapy, decisions regarding doses, timing relative to systemic treatments, and treatment volumes should be made in a multidisciplinary context, considering the patient's prognosis, anticipated outcomes, and access to potentially effective treatments. We still lack robust data from prospective studies on this matter. This review examines and discusses available evidence on the use of palliative thoracic radiotherapy within the framework of modern treatment strategies for NSCLC.

HYPERTHYROIDISM AND GRAVES' DISEASE: OPHTHALMOLOGICAL MANIFESTATIONS AND SURGICAL TREATMENT.

Introduction: Hyperthyroidism, characterized by the excessive production of hormones by the thyroid gland, can lead to various systemic complications, including ophthalmological manifestations such as Graves' Orbitopathy (GO). Graves' Disease, one of the main causes of hyperthyroidism, is often associated with these ocular complications, which include ocular protrusion, diplopia, and periorbital swelling. Surgical treatment, including total or subtotal thyroidectomy, emerges as an option to control the progression of hyperthyroidism and improve associated ophthalmological symptoms. **Objective**: To analyze the ophthalmological manifestations of hyperthyroidism and Graves' Disease, as well as evaluate the effectiveness of surgical treatment in managing these complications. **Methodology**: The review followed the PRISMA checklist to ensure rigor and transparency. Searches were conducted in PubMed, Scielo, and Web of Science databases using five descriptors: "Hyperthyroidism," "Graves' Disease," "Graves' Orbitopathy," "Surgical Treatment," and "Ophthalmological Manifestations." Inclusion criteria encompassed articles published in the last 10 years, studies focused on surgical treatment for GO, and works explicitly addressing the ophthalmological manifestations of Graves' Disease. Exclusion criteria included studies that did not discuss surgical treatment, non-peer-reviewed articles, and publications older than a decade. **Results**: The analysis revealed that Graves' Orbitopathy frequently manifests with symptoms such as ocular protrusion, diplopia, and periorbital edema, significantly impacting patients' quality of life. Thyroidectomy proved effective in reducing hormone levels, resulting in symptomatic improvements for many patients. However, outcomes varied, and surgical intervention was not always associated with complete resolution of ophthalmological manifestations. **Conclusion**: Surgical treatment of hyperthyroidism and Graves' Disease can provide significant relief from ophthalmological manifestations, though it does not guarantee complete resolution of symptoms. Surgery should be considered within a multidisciplinary context, taking into account the severity of ocular symptoms and response to conservative treatment. The review highlighted the need for integrated treatment strategies to optimize outcomes for patients with ophthalmological complications associated with hyperthyroidism and Graves' Disease.

Exploring the Collaboration Skills among Architecture Students: A Quantitative Study in North Cyprus

This research investigates the collaboration competencies among architecture students at Eastern Mediterranean University, in North Cyprus, highlighting the necessity for curricular enhancements to foster teamwork skills essential for professional practice. A structured questionnaire was administered to 77 final-year students, evaluating their knowledge, abilities, and experiences in collaborative settings. Factor analysis revealed twelve key components of collaboration, indicating moderate skill levels overall. Notably, students excelled in work quality, self-reflection, and time management yet exhibited deficiencies in team learning, role adaptability, and equitable idea contribution. This study identified five critical dimensions of teamwork: interpersonal facilitation, collaborative leadership, engagement contribution, active listening, and transparent information exchange. A strong correlation emerged between students’ perceived readiness for collaborative work and their self-rated leadership and interpersonal skills. Comparative analysis showed distinct collaboration skill sets between international and domestic students and across different academic years. These insights emphasize the imperative for architectural education to progressively incorporate specific learning activities and interventions to cultivate teamwork competencies systematically. The development of such skills is vital for preparing graduates to effectively navigate and lead within the multidisciplinary contexts they will face. Recommendations include curriculum redesign to integrate explicit teamwork instruction, faculty development programs, and fostering an educational culture that consistently values collaboration. Future studies should investigate effective pedagogical strategies for nurturing collaboration skills and examine how individual variances affect the acquisition of these critical abilities.

Revisiting organizational culture in healthcare: Heterogeneity as a resource

Aligning culture to be similar across work units is a common organizational tactic, but its appropriateness for the multidisciplinary context of healthcare is far from certain. Variation in perceptions of culture across large health systems may serve a functional purpose in delivering high quality care and ameliorating job stress; however, past research in healthcare has focused on culture as the average set of values and norms (i.e., cultural content) rather than on (dis)agreement about values and norms among organizational members (i.e., cultural structure). This survey-based study examines both cultural content (averages among individuals) and structure (distances between individuals) in departments of a large U.S. healthcare organization (total sample = 26,314 workers, response rate = 84%). We used linear models to associate four commonly used culture measures with outcome measures (perceived care quality, intent to stay, and manageable job stress). We found substantial heterogeneity in perceptions for multiple culture types. We found curvilinear relationships between heterogeneity for all culture types and outcomes, suggesting that heterogeneity promotes positive outcomes up to a certain point after which the positive effect declines. For research, our findings point to the importance of studying culture in healthcare with greater focus on heterogeneity; for practice, this study highlights how culturally-focused efforts to improve care quality and worker experience in healthcare should be more precise about balancing cultural alignment and heterogeneity.

Next-level precision medicine: why the theragnostic approach is the future.

Theragnostics represents one of the most innovative fields of precision medicine with a huge potential in the field of oncology in the next years. The use of a pair of selective radiopharmaceuticals for cellular receptors, used for diagnostic and therapeutic purposes (PRRT), finds applications in the Neuroendocrine tumors and metastatic Castration-Resistant prostate cancer (mCRPC) thanks, respectively, to somatostatin receptor agonists and PSMA-based peptides. Further evolutions of theragnostics will be possible to the radioimmunoconjugates used both in the diagnostic (Immuno-PET) and in the therapeutic fields (radioimmunotherapy). It is evident that in the "omics-era," theragnostics could become a necessary method, not only in order to improve our knowledge of tumor biology, but also, to find more and more targeted therapies in a multidisciplinary context and in a tailor-based approach.

Evaluation of Calcarenite Degradation by X-ray Photoelectron Spectroscopy Analysis inside the Rupestrian Church of San Pietro Barisano (Matera, Southern Italy)

We report on the XPS analysis of degraded surfaces inside San Pietro Barisano, the rupestrian church carved into the calcarenite rock of ancient Matera, which has been a UNESCO World Heritage Site since 1993. As reported in previous works, the “Sassi” district and the park of rupestrian churches were available as open laboratories for the National Smart Cities SCN_00520 research project dedicated to the sustainable recovery of this remarkable architectural heritage. In that context, XPS functionality was shown to reside in the possibility of analyzing surfaces by feasible sampling, acquiring spectra without any preliminary sample treatment, and processing data using a well-established curve fitting procedure. The obtained results allowed us to identify the degradation products of the investigated surfaces, thus contributing to defining a diagnostic framework for subsequent actions. Accordingly, the samples here considered, collected from the internal wall surfaces of the church, were all analyzed in comparison with the reference calcarenite, and the XPS results were evaluated as a function of local environmental factors and the historical context of the church itself. The final aim was to provide, for each sample, the most representative indicator(s) of biotic and/or abiotic degradation for reliable use, in a multidisciplinary context, in planning care interventions for building heritage.

Clival Metastases: Single-Center Retrospective Case Series and Literature Review.

Background/Objectives: Clivus metastases from distant neoplasms are uncommon occurrences both in clinical practice and the neurosurgical literature. Surgical management is debated, particularly about the role of surgery and the preferable approach. The aim of this study was to report our surgical experience and review the concerning literature. Methods: Our institutional registry was retrospectively reviewed, and patients who underwent surgical treatment for clival metastasis from 1998 to 2023 were included. A PRISMA systematic review of the literature was performed. Results: Four patients were enrolled, and all of them underwent an endoscopic endonasal approach (EEA). Three presented with cranial nerve (CN) VI palsy. The aim of surgery was biopsy in all cases. No complications were reported. Mean overall survival (OS) was 6 ± 1 months. The systematic review retrieved 27 papers reporting 39 patients who underwent the surgical treatment of clivus metastases. Most of them (79.5%) presented with CN palsies, and EEA was the preferred approach in 92.3% of the cases, to perform a biopsy in most patients (59%). Two hemorrhagic complications (5.1%) were reported, and the mean OS was 9.4 ± 5.6 months. Conclusions: Clival metastases are uncommonly observed, in most cases, during advanced stages of oncological disease. The aim of surgery should be the confirmation of diagnosis and symptomatic relief, balancing the risk-benefit ratio in a multidisciplinary context. EEA is the approach of choice, and it should be carried out in experienced tertiary skull base centers.

Optimizing outcomes in symptomatic spinal metastases from non-small cell lung cancer: Evaluating the role of salvage surgical intervention in a multidisciplinary context – A Narrative Review

Background: Lung cancer, a leading cause of cancer-related mortality worldwide, often metastasises to the spine, resulting in significant morbidity and complex treatment challenges. The management of spinal metastatic disease from lung cancer necessitates a multidisciplinary approach, given the array of potential interventions including surgery, radiation therapy, chemotherapy, and supportive care. The selection of appropriate therapeutic strategies is influenced by multiple factors, including disease staging, patient health status, and symptomatology. Aim: This review article aims to explore the current landscape of surgical intervention for spinal metastases from lung cancer, evaluating its role, efficacy, and the criteria for patient selection within the context of multidisciplinary care. Additionally, it seeks to provide an overview of the existing treatment modalities, highlighting the importance of a tailored approach based on individual patient needs. Methods: An extensive review of the literature was conducted, focusing on studies, clinical trials, and meta-analyses published on the treatment of spinal metastases in lung cancer patients. Special attention was given to works discussing the surgical outcomes, prognostic factors, and the evolution of treatment protocols over recent decades. Results: Surgical treatment for spinal metastases from lung cancer is beneficial for select patients, particularly those without prior systemic treatments and those in good overall health. The decision to pursue surgery should be made within a multidisciplinary team, taking into account the patient’s specific situation and potential to benefit from the intervention. Research advancements and technological innovations continue to refine surgical techniques and improve patient outcomes. Conclusion: While the role of surgery in treating spinal metastatic disease from lung cancer is limited, it remains a critical option for appropriately selected patients. Future research should aim to further define and expand the criteria for surgical candidacy, enhancing the precision of patient selection and tailoring of treatment strategies. Emphasis on a multidisciplinary approach is essential for optimising outcomes and advancing care for patients with this challenging condition.

Pragmatic critical realism and Mixed methods in Inter-disciplinary Research—Management and Information systems

Mixed methods research traditionally follows one paradigm based on established typologies. However, this study deviates from conventional research paradigms by combining two paradigms in one study. Specifically, it employs a critical realist method to analyze data, complemented by a pragmatist approach. This combination allows for the exploration of various phenomena in multidisciplinary research, such as cyber risk management, which intersects with management and information systems. By delving into the causal mechanisms underlying observed social and organizational phenomena, the pragmatic critical realism (PCR) approach, in conjunction with mixed methods research (MMR), offers a valuable framework for understanding the study's findings. Importantly, PCR has not been widely discussed or adopted in a multidisciplinary context for examining mixed data and advancing theory using MMR. This approach can be applied to multidisciplinary research in different contexts, enabling a deeper understanding of research participants' perspectives, the observable events resulting from those perspectives, and their causal relationships. The study systematically reviews the literature on pragmatism and critical realism in the field of management and information system; compares and combines these two research paradigms to identify common ground and explore their potential for developing a new framework to address interdisciplinary research questions. As a result, a new multiparadigm conceptual model has been established that integrates pragmatism and critical realism, making an original contribution to the field of mixed methods research. The study suggests that academics and researchers in management and information systems should broaden their use of methodologies and embrace interdisciplinary thinking in order to advance theoretical debates within their discipline.

How to facilitate NHS professionals to recognise and use skills gained from global health engagement when back in the UK workforce? A participatory action research project to design, pilot and evaluate a series of online leadership workshops

ObjectivesLeadership knowledge and skills are known to be developed by health professionals during global health experiences overseas. However, volunteers struggle to recognise and use these new skills on return to...

Artists’ books as a qualitative research methodology in multidisciplinary contexts

This practitioner piece outlines a novel method for practice-based research centred on the production of artists’ books. There is growing evidence for the benefits of artists publishing as an alternative route to disseminating academic research (see Bodman, ‘Towards a community of artists’ books’, 2019; Taylor, ‘The artist’s book as collaborative art practice’, 2017; Vieth, ‘The artist’s book challenges academic convention’, 2006). However, there is only limited research to help understand how the unique qualities of the artist’s book as a medium – and the processes and methods used in its creation – can be positioned to scaffold a process of mediating knowledge and hierarchies of practices. The insights from the study have significant benefits beyond art and design where they can be useful in STEAM (Science, Technology, Engineering, Arts and Mathematics) contexts, especially where this involves diverse multidisciplinary groups and specialist/non-specialist participants. The research focused on designing a practice-based method which positions the artist’s book edition as a visual verbatim facsimile. The project’s initiating concept and conceptual anchor centred on the etymology of the prefix ‘re’. As a facsimile, each iterative edition revisits, reuses and reassembles, making visible the traces of individual interpretations and interventions as well as the technologies and materials deployed in the process of collaboration. As shown through the study, the method proposed offers an inclusive collaborative process where progressively more complex relationships are formed and synthesized through subsequent editions. A series of four iterative editions were developed through the study, each following a cyclical method involving three phases: (1) transcription and documentation; (2) constellation and translation; and (3) publication.

Adrenalectomy for Metastasis: The Impact of Primary Histology on Survival Outcome.

Adrenalectomy is commonly considered a curative treatment in case of adrenal gland as site of metastasis. In the present study, we evaluated the impact of primary tumor histology on survival outcomes after a minimally invasive adrenal mastectomy for a solitary metachronous metastasis. From May 2004 to August 2020, we prospectively collected data on minimally invasive adrenalectomies whose pathological examination showed a metastasis. All patients only received metastasectomies that were performed with curative intent, or to achieve non-evidence of disease status. Adjuvant systemic therapy was not administered in any case. Cancer-specific survival (CSS) was assessed using the Kaplan-Meier method. Univariable and multivariable Cox regression analyses were applied to identify independent predictors of CSS. Out of 235 laparoscopic and robotic adrenalectomies, the pathologic report showed metastases in 60 cases. The primary histologies included 36 (60%) renal cell carcinoma (RCC), 9 (15%) lung cancer, 6 (10%) colon cancer, 4 (6.7%) sarcoma, 3 (5%) melanoma and 2 (3.3%) bladder cancer. RCC displayed significantly longer survival rates with a 5-year CSS of 55.9%, versus 22.8% for other histologies (log-rank p = 0.01). At univariable analysis, disease-free interval (defined as the time from adrenalectomy to evidence of disease progression) < 12 months and histology were predictors of CSS (p = 0.003 and p < 0.001, respectively). At multivariable Cox analysis, the only independent predictor of CSS was primary tumor histology (p = 0.005); patients with adrenal metastasis from colon cancer and bladder cancer showed a 5.3- and 75.5-fold increased risk of cancer death, respectively, compared to patients who had RCC as primary tumor histology. Oncological outcomes of adrenal metastasectomies are strongly influenced by primary tumor histology. A proper discussion of the role of surgery in a multidisciplinary context could provide optimal treatment strategies.

Expanded Terminological List in Astronomy and Space Sciences from English to Romanian

In the field of astronomy and its broader scientific context of space sciences, the English and Romanian languages use terms and sentences on various levels of specialization and therefore, accessibility for the general public as well as for the scientists. The flow of scientific data and information is generated in both languages, which raises the subsequent need of a correct equivalence in specific translations from English to Romanian and vice-versa. In this respect, this study discusses in a multi-disciplinary context a list of terms and expressions translated from English to Romanian that are nowadays used in the fields of astronomy and space sciences. In these scientific areas, the authors of this article considered the English language as being more specific than Romanian and therefore, they aimed to deconstruct the scientific meaning behind each of these specialized English language entries, and point out through additional comments, the rationality of the translation choice they have made, according to the thinking, the ways of expressing and converging ideas in both languages.

Introducing Entropy into Organizational Psychology: An Entropy-Based Proactive Control Model.

This paper provides a systematic review of the transfer and quantification of the concept of entropy in multidisciplinary fields and delves into its future applications and research directions in organizational management psychology based on its core characteristics. We first comprehensively reviewed the conceptual evolution of entropy in disciplines such as physics, information theory, and psychology, revealing its complexity and diversity as an interdisciplinary concept. Subsequently, we analyzed the quantification methods of entropy in a multidisciplinary context and pointed out that their calculation methods have both specificity and commonality across different disciplines. Subsequently, the paper reviewed the research on how individuals cope with uncertainty in entropy increase, redefined psychological entropy from the perspective of organizational management psychology, and proposed an "entropy-based proactive control model" at the individual level. This model is built around the core connotation of entropy, covering four dimensions: learning orientation, goal orientation, change orientation, and risk taking. We believe that psychological entropy, as a meta structure of individuals, can simulate, explain, and predict the process of how individuals manage and control "entropy" in an organizational environment from a dynamic perspective. This understanding enables psychological entropy to integrate a series of positive psychological constructs (e.g., lean spirit), providing extensive predictive and explanatory power for various behaviors of individuals in organizations. This paper provides a new direction for the application of the concept of entropy in psychology, especially for theoretical development and practical application in the field of organizational management.