Reference Point Research Articles

Transformation risk and associated survival outcome of marginal zone lymphoma: A nationwide study.

Histological transformation into an aggressive B-cell lymphoma indicates a poor survival outcome for patients with indolent marginal zone lymphoma (MZL), which has been less studied. Large-scale data with long-term follow-up to investigate MZL transformation is limited. Here, by reporting a US-Nationwide cohort of 30,619 MZL patients diagnosed between 2000 and 2019, we found that transformation occurred in 2.08% (N = 624) of MZL cases, with the transformation incidence of 3.1 per 1,000 person-years. Advanced Ann Arbor stage, nodal MZL (NMZL) and splenic MZL (SMZL) were associated with an elevated risk of transformation. Certain subtype-specific characteristics, such as non-gastric extra-nodal MZL (vs. gastric, HR, 1.51, 95%CI 1.13-2.04; p = 0.006), and receiving splenectomy for SMZL (HR, 2.04, 95%CI 1.28-3.26; p = 0.003), also indicated a higher risk of transformation. Besides, transformation independently increased the overall mortality risk (HR, 1.38, 95%CI 1.24-1.53, p < 0.001), especially the higher lymphoma-caused mortality risk (HR, 3.21, 95%CI 2.81-3.67, p < 0.001). Transformation was also associated with a higher percentage of lymphoma-caused deaths. The post-transformation prognostic analyses demonstrated that female gender and age ≥ 65 years independently affected patients' mortalities. These findings, based on the largest cohort to date, contribute to a better understanding of transformed MZL, and provide valuable reference points for guidelines and patient counseling.

Mutuality between nurses and patients with chronic illnesses: A cross-sectional descriptive study.

Mutuality is a process in which the patient participates and is involved in decision-making and care interventions. The aim of this study was to measure mutuality in the relationship between nurses and chronic illness patients. This study had a cross-sectional design; the sample included 249 patients and 249 nurses. Mutuality was measured with the Nurse-Patient Mutuality in Chronic Illness scale. Patients had higher scores in almost all items (p < 0.001). Patients demonstrate high reciprocity towards nurses and the ability to express and share their emotions. Patients consider nurses their point of reference and share with them their health goals. Nurses show more difficulty in being mutual with the patient, especially in the aspects related to the sharing of emotions, objectives, and planning. The egalitarian relationship score was low in both patients and nurses. These findings are important to consider at clinical, educational, organisational, and policy levels. Nurse education and organisation must push towards respect for the wishes of patients, the possibility of expressing their choices, and their involvement in the care plan. In clinical practice, it is necessary to put the patients more at the centre, involving them in the identification of objectives and in making decisions.

Buying a Wealthy Dream: Determinants of Rural Residents' Lottery Purchase Behavior in China.

The expansion of illicit lottery activities has caused significant harm to both agricultural production and the livelihood of rural residents. An analysis of the factors that influence rural residents' participation in underground lotteries can provide crucial insight for regulating the lottery industry's development. This study examines the present state of rural residents' participation in underground lotteries, investigates the factors that impact their participation using the Double-Hurdle model, and further employs the ISM model to evaluate the correlations and hierarchical structure among the factors, using field survey data collected from 603 rural residents in S Province, China. The findings reveal that 53.07% of the respondents have participated in underground lotteries. Risk preference, information acquisition, social networks, age, education, family burden, percentage of agricultural labor, agricultural business scale, and household income significantly affect whether residents purchase lotteries (WPL). All factors, except the percentage of agricultural labor and agricultural business scale, also significantly impact underground lottery spending (LS). Among the significant influencing factors, rural residents' risk preference is the direct surface factor, whereas agricultural business scale, household income, information acquisition, and social networks are the middle indirect factors, and residents' age, education, family burden, and percentage of agricultural labor are the deep-rooted factors. It is recommended to regulate the lottery industry's development can be achieved by enhancing entertainment and cultural activities, expanding economic opportunities, enhancing rural education, increasing law awareness, and improving the public welfare lottery business model. The conclusions offer a valuable reference point for the standardized development of the lottery industry and the promotion of social stability in rural areas.

A Dataset of Benthic Species from Mesophotic Bioconstructions on the Apulian Coast (Southeastern Italy, Mediterranean Sea)

Marine bioconstructions are complex habitats that represent a hotspot of biodiversity. Among Mediterranean bioconstructions, those thriving on mesophotic bottoms on southeastern Italian coasts are of particular interest due to their horizontal and vertical extension. In general, the communities that develop in the Mediterranean twilight zone encompassed within the first 30 m of depth are better known, while relatively few data are available on those at greater depths. By further investigating the diversity and structure of mesophotic bioconstructions in the southern Adriatic, we can improve our understanding of Mediterranean biodiversity while developing effective conservation strategies to preserve these habitats of particular interest. The dataset reported here comprises records of benthic marine taxa from algae and invertebrate mesophotic bioconstructions investigated at six sites along the southern Adriatic coast of Italy, at depths between approximately 25 and 65 m. The dataset contains a total of 1718 records, covering 11 phyla and 648 benthic taxa, of which 580 were recognized at the species level. These data could provide a reference point for further investigations with descriptive or management purposes, including the possible assessment of mesophotic bioconstructions as refuges for shallow-water species.

ORGANIZATIONAL CAPITAL AND EMPLOYEES’ COUNTERPRODUCTIVE WORK BEHAVIOUR IN THE NIGERIAN PUBLIC HEALTH SECTOR

This study was carried out with the view to assessing the impact of organizational capital on employees’ counterproductive work behaviour among some public healthcare organizations in Nigeria using Bayelsa state as a reference point. The study used a sample of two hundred and forty-three (243) employees of the selected organizations and data obtained were analyzed using both descriptive and inferential statistical tools. Specifically, the regression results indicated an insignificant but positive influence of organization capital on employees’ counterproductive work behaviour in public healthcare organizations. On the basis of the findings, it was recommended among others that organizations should regularly assess and monitor employee behaviour including counterproductive work behaviour via appropriate performance management systems and employee feedback mechanisms; this would allow organizations to identify early warning signs and take proactive measures to address any emerging issues.&#x0D; Keywords: Human Capital, Intellectual Capital, Public Health, Stress Facilitation Theory, Structural Capital, Work Overload.

Opinion, uptake and current practice of robot-assisted upper gastrointestinal and oesophagogastric surgery in the UK: AUGIS national survey results.

The uptake of upper gastrointestinal (GI) robotic surgery in the United Kingdom (UK), and Europe more widely, is expanding rapidly. This study aims to present a current snapshot of the practice and opinions of the upper GI community with reference to robotic surgery, with an emphasis on tertiary cancer (oesophagogastric) resection centres. An electronic survey was circulated to the UK upper GI surgical community via national mailing lists, social media and at an open-invitation conference on robotic upper GI surgery in January 2023. The survey included questions on surgeons' current practice or planned adoption (if any) of robotics at individual and unit level, and their opinions on robotic upper GI surgery in general. Priority ranking and Likert-scale response options were used. In total, 81 respondents from 43 hospitals were included. Thirty-four resectional centres responded, including 30 of 31 (97%) recognised upper GI cancer centres in England. Respondents reported performing robotic surgery in 21 of 34 (61.8%) resectional centres, with a median of 65 procedures per centre performed at the time of the survey (range 0-500, interquartile range 93.75). Every centre without a robotic programme expressed a desire or had active plans to implement one. Respondents ranked surgeon ergonomics as the most important reason for pursuing robotics, followed by improvements in patient outcomes and oncological efficacy. Robotic upper GI practice is nascent but rapidly growing in the UK with plans for uptake in almost all tertiary centres. There is growing opinion that this is likely to become the predominant surgical approach in future with benefits to both patients and surgeons. This snapshot offers a point of reference to all stakeholders in upper GI surgery.

From Social Minority to Children’s Rights in Colombia

Abstract This article reviews the institutional concepts associated with child protection in Bogota, Colombia, from the 16th century to the present, and studies how these concepts merged with the neoliberal discourse at the beginning of the 21st century in the care practices that are carried out. The article shows how state institutions in charge of child protection base their activities on ideological representations that involve techniques of control, surveillance and punishment of domestic units, which are presented as dysfunctional insofar as the children are seen as vulnerable. The article concludes that this exercise perpetuates social and spatial segregation in the city to legitimise the governance of child care. Ethnographic work carried out in the period between 2012 and 2017 in the Centro Único de Recepción de Niños (Unique Child Reception Centre) in Bogotá, is taken as a point of reference for the analysis.

Generosity of old‐age pensions for the self‐employed—A typology of European welfare states

AbstractResearch on pension generosity has so far used employees in standard employment as the reference point, ignoring nonstandard forms of employment such as the self‐employed. Moreover, as one of the major concepts of welfare state analysis, generosity has not been considered in research on the old‐age security of the self‐employed. Hence, there is a ‘missing link’ between the two strands in the literature. This paper aims to close this research gap by analysing the differences between 12 European welfare states regarding the generosity of old‐age pensions for the self‐employed. Based on the degree of strictness of access and benefit level, a typology is developed that results in four types of generosity: high generosity, low generosity, basic security and selective generosity.

Jak chrześcijaństwo stworzyło cywilizację techniczną w „zaczarowanym [jeszcze] świecie”?

This text highlights the underestimated contribution of broadly understood Christianity to the development of technological civilization. This would not have been possible without an entirely new understanding of the concept of human freedom brought about by the Christian faith. This new understanding of freedom, completely different from the one in the ancient theocratic system, by recognizing the role of the human person, led to the liberation of creativity in the areas of economic initiative and technological ingenuity. In the modern era, economic freedom became a subject of moral reflection for the Church. This work provides numerous examples of technical and economic innovation carried out by believers and discusses the necessity of developing a moral science that is adequate to new challenges. The reference point for the presented considerations is Max Weber’s concept of the “disenchantment of the world” and its interpretation by Franz-Xavier Kaufmann.

Review of the research on the scrubbing of fission products in liquid metal pool

In recent times, the risk assessment and design optimization of advanced fourth-generation nuclear reactors have garnered significant global scholarly attention. Specifically, researchers worldwide have been focusing on the comprehensive analysis of the scrubbing process of radioactive fission product aerosols within the reactor containment pool under severe accident scenarios. This study delves into the historical progression of investigating the pool scrubbing phenomenon, which dates back to the mid-20th century. International efforts have encompassed various aspects, including assessing the migration behavior of radioactive nuclides within molten metal environments, conducting sensitivity analyses to gauge the impact of diverse variables on pool scrubbing, formulating models for analyzing the pool scrubbing process, and conducting relevant experimental validations. Drawing upon an extensive body of literature, this article presents a synthesized overview of research into the pool scrubbing process of fission product aerosols, focusing on three principal dimensions: model elucidation, experimental investigations, and computational simulations. The insights provided herein serve as a consolidated reference point for forthcoming endeavors in this domain of research.

French political symbolism and identity construction

The present study examines how the language of political symbolism operates within the framework of identity construction. It focusses on the themes of sovereignty during the 2022 French presidency of the European Union and the national presidential election campaign. On the basis of Conceptual Metaphor Theory, it suggests that, apart from purely linguistic features, extra-linguistic factors are also essential in order to convey a global view of symbolic rhetoric. The analysis is conducted according to an overall 6-tier model of figurative origins involving the parameters of personal background, political context, cultural history, reference, conceptual metaphor and linguistic metaphor. By applying the parameters of the model, it is proposed that the core of political argumentation in the corpus analysis is based on national symbols and the conceptual mapping they embody. The basic hypothesis of the model assumes that a politician attempts to portray the symbolisation of unity in accordance with his or her political background and personal biography. A political narrative is thereby created within the current political context using predominant symbols in cultural history. An over-riding factor is the role of referential points which may determine divergence in conceptual mapping. These features then lead to the construction of conceptual metaphors which can take on a particularly hyperbolic structure in the ensuing linguistic metaphors. The implications of the study highlight the important role of symbolism in political debate, its interaction with conceptual metaphor, the relevance of extra-linguistic factors portrayed by the 6-tier model, the link between cultural history and hyperbolic linguistic structures and political divergence in similar symbols.

Optimising high-throughput sequencing data analysis, from gene database selection to the analysis of compositional data: a case study on tropical soil nematodes

Optimising high-throughput sequencing data analysis, from gene database selection to the analysis of compositional data: a case study on tropical soil nematodes

Managerial Mental Accounting and Downstream Project Decisions

Project leaders are responsible for planning, controlling, and revising projects. As a project unfolds, the leader evaluates the project’s progress by comparing ongoing costs and scope to a baseline plan and considers potential revisions. We offer a general model of managerial mental accounting, which includes loss aversion, reference point updating, and narrow framing, and examine how it impacts downstream decisions. Our model predicts insufficient adjustments of project scope and cost at revision, resulting in reduced financial profit. We show that the choice of measure to quantify the project progress—planned, actual, or earned—affects the updating of reference points, and hence the downstream decisions. Thus, progress measures could be wisely employed to mitigate insufficient adjustments. It turns out that measuring progress via planned scope is often advantageous, whereas utilizing earned value for cost is never advisable. This paper was accepted by David Simchi-Levi, behavioral economics and decision analysis. Supplemental Material: The online appendix is available at https://doi.org/10.1287/mnsc.2021.02929 .

Evaluation of the Anatomical Reference Point in Posterior Minimally Invasive Atlantoaxial Spine Surgery: A Cadaveric Anatomical Study.

Minimally invasive atlantoaxial surgery offers the benefits of reduced trauma and quicker recovery. Previous studies have focused on feasibility and technical aspects, but the lack of comprehensive safety information has limited its availability and widespread use. This study proposes to define the feasibility and range of surgical safety using the intersection of the greater occipital nerve and the inferior border of the inferior cephalic oblique as a reference point. Dissection was performed on 10 fresh cadavers to define the anatomical reference point as the intersection of the greater occipital nerve and the inferior border of the inferior cephalic oblique muscle. The study aimed to analyze the safety range of minimally invasive atlantoaxial fusion surgery by measuring the distance between the anatomical reference point and the transverse foramen of the axis, the distance between the anatomical reference point and the superior border of the posterior arch of the atlas, and the distance between the anatomical reference point and the spinal canal. Measurements were compared using Student's t test. The point where the occipital greater nerve intersects with the inferior border of the inferior cephalic oblique muscle was defined as the anatomical marker for minimally invasive posterior atlantoaxial surgery. The distance between this anatomical marker and the transverse foramen of the axis was measured to be 9.32 ± 2.04 mm. Additionally, the distance to the superior border of the posterior arch of the atlas was found to be 21.29 ± 1.93 mm, and the distance to the spinal canal was measured to be 11.53 ± 2.18 mm. These measurement results can aid surgeons in protecting the vertebral artery and dura mater during minimally invasive posterior atlantoaxial surgery. The intersection of the greater occipital nerve with the inferior border of the inferior cephalic oblique muscle is a safe and reliable anatomical landmark in minimally invasive posterior atlantoaxial surgery.

Magnetic Field Analysis and Development of Disk Axial–Radial Hybrid Excitation Generator for Range Extenders in Extended-Range Electric Vehicles

Magnetic Field Analysis and Development of Disk Axial–Radial Hybrid Excitation Generator for Range Extenders in Extended-Range Electric Vehicles

Modified versus three-level technique of retroperitoneal laparoscopic adrenalectomy for all patients with adrenal lesions ≤ 6cm: a retrospective, case-controlled study.

The modified three-level technique for retroperitoneal laparoscopic adrenalectomy (RLA) has proven beneficial in the treatment of adrenal lesions in patients with BMI≥25 Kg/m2. This paper aims to summarize our institution's seven-year experience using this technique for all patients with Adrenal Lesions ≤ 6cm. Between January 2016 and December 2022. The patients underwent laparoscopic adrenal surgery were categorized into Zhang's technique (ZT) (Three-level Technique) group and modified technique (MT) group. The fundamental characteristics and perioperative data were analyzed, with statistical significance set at p<0.05. In total, 731 patients were stratified into two groups: ZT (n=448) and MT (n=283). Statistically significant distinctions were not detected between the two groups regarding sex, BMI, tumor location, tumor size, tumor type, or American Society of Anesthesiologists (ASA) score (p>0.05). The MT group demonstrated superior outcomes compared to the ZT group in terms of operative time, estimated blood loss, drainage volume, diet recovery time, complication rates, and postoperative hospitalization duration (p<0.05). 17 (4.34%) in the ZT group required unplanned adrenalectomy, while there was none in MT group (P<0.05). MT retroperitoneal laparoscopic adrenalectomy has demonstrated its benefits in the treatment of adrenal lesions across all patients with adrenal lesions ≤ 6cm, serving as a valuable point of reference for the surgical management of adrenal diseases. We have made modifications to the classic retroperitoneal laparoscopic adrenalectomy and achieved superior surgical outcomes, resulting in a procedure known as modified retroperitoneal laparoscopic adrenalectomy. This technique is suitable for both obese individuals and the general population with adrenal lesions ≤ 6cm.

Networks, ownership and productivity does firm age play a moderating role?

Purpose The purpose of this study is to investigate whether and how inter-firm cooperation and firm age moderate the relationship between family ownership and productivity.Design/methodology/approachWe first estimate the total factor productivity (TFP) of a large sample of Italian firms observed over the period 2010–2018 and then apply a Poisson random effects model.FindingsTFP is, on average, higher for non-family firms (non-FFs) than for FF. Furthermore, inter-organizational cooperation and firm age mitigate the negative effect of family ownership. In detail, it is found that belonging to a network acts as a moderator in different ways according to firm age. Indeed, young FFs underperform non-FF peers, although the TFP gap decreases with age. In contrast, the benefits of a formal network are high for older FFs, suggesting that an age-related learning process is at work.Practical implicationsThe study provides evidence that FFs can outperform non-FFs when they move away from Socio-Emotional Wealth-centered reference points and exploit knowledge flows arising from high levels of social capital. In the case of mature FFs, networking is a driver of TFP, allowing them to acquire external resources. Since FFs often do not have sufficient in-house knowledge and resources, they must be aware of the value of business cooperation. While preserving the familiar identity of small companies, networks grant FFs the competitive and scale advantages of being large.Originality/valueDespite the wide but ambiguous body of research on the performance gap between FFs and non-FFs, little is known about the role of FFs’ heterogeneity. This study has proven successful in detecting age as a factor in heterogeneity, specifically to explain the network effect on the link between ownership and TFP. Based on a representative sample, the study provides a solid framework for FFs, policymakers and academic research on family-owned companies.

Vision‐based robust missing and loosened bolt detection for splice plate joints

SummaryVision‐based bolt defect detection methods based on feature changes have been reported. However, the robustness of key feature extraction and bolt detection requires improvement. This paper proposes a robust missing and loose bolt defect detection approach. The key features—reference points for perspective correction and the straight lines of the bolt edges—are extracted from the masks obtained by semantic segmentation models. The true and false bolt discrimination approach based on the mask shape can help improve bolt object detection accuracy. Overlapping between the bolt bounding boxes in the reference and detection images indicates missing bolts. The rotation angles reveal loosened bolts. The proposed approach was tested on fabricated bolted joint specimens and a steel railway bridge. The results suggest that these improvements ensure defect detection accuracy, with a miss rate of only 1% for missing bolt detection. Moreover, a loosened bolt with only 3° rotation is successfully detected. This approach has promising potential applicability in automatically detecting bolt defects in large steel structures.

Robust Two-Layer Control of DC Microgrids With Fluctuating Constant Power Load Demand

This paper proposes a cascaded control structure for the regulation of DC Microgrids (MG). It is well-known that the negative impedance characteristics of a constant power load (CPL) adversely affect the stability of the network, and can cause problems such as voltage collapse or damage the electronic components. To mitigate this, we propose a two-layer control structure, where at the inner layer, the proposed controller achieves fast tracking of the supplied reference points and ultimate boundedness of the trajectories in a desired set. The outer layer generates the inner layer reference points, accounts for system constraints, and introduces robustness of the voltage dynamics to unknown perturbations of the CPL demand. For the first time, an investigation of the nonlinear geometric behaviour of the CPL is carried out to derive necessary conditions that ensure boundedness of the network dynamics and feasible regulation to a desired equilibrium set. Finally, Control Lyapunov functions are formulated to prove the stability and estimate the region of attraction of the closed loop dynamics. A simulated scenario of a meshed MG network is presented to confirm the validity of the results.

Separable Representations for Duration and Distance in Virtual Movements.

To navigate through the environment, humans must be able to measure both the distance traveled in space, and the interval elapsed in time. Yet, how the brain holds both of these metrics simultaneously is less well known. One possibility is that participants measure how far and how long they have traveled relative to a known reference point. To measure this, we had human participants (n = 24) perform a distance estimation task in a virtual environment in which they were cued to attend to either the spatial or temporal interval traveled while responses were measured with multiband fMRI. We observed that both dimensions evoked similar frontoparietal networks, yet with a striking rostrocaudal dissociation between temporal and spatial estimation. Multivariate classifiers trained on each dimension were further able to predict the temporal or spatial interval traveled, with centers of activation within the SMA and retrosplenial cortex for time and space, respectively. Furthermore, a cross-classification approach revealed the right supramarginal gyrus and occipital place area as regions capable of decoding the general magnitude of the traveled distance. Altogether, our findings suggest the brain uses separate systems for tracking spatial and temporal distances, which are combined together along with dimension-nonspecific estimates.