Early versus the traditional start of oral intake following esophagectomy for esophageal cancer: a systematic review and meta-analysis.

BACKGROUND: Nil by mouth is considered the standard of care during the first days following esophagectomy. However, with the routine implementation of enhanced recovery after surgery, early oral intake is more likely to be the preferred mode of nutrition following esophagectomy. The present study aims to evaluate the safety and effectiveness of early oral intake following esophagectomy for esophageal cancer. METHODS: Comprehensive literature searches were conducted using PubMed, Web of Science, Embase, and Cochrane Library. Weighted mean differences (WMD) and odds ratios (OR) with 95% confidence intervals (CI) were calculated as the effect sizes for continuous and dichotomous variables, respectively. RESULTS: Fourteen studies with a total of 1947 patients were included. Length of hospital stay (WMD = - 3.94, CI: - 4.98 to - 2.90; P < 0.001), the time to first flatus (WMD = - 1.13, CI: - 1.25 to - 1.01; P < 0.001) and defecation (WMD = - 1.26, CI: - 1.82 to - 0.71; P < 0.001) favored the early oral intake group. There was no statistically significant difference in mortality (OR = 1.23, CI: 0.45 to 3.36; P = 0.69). Early oral intake also did not increase the risk of pneumonia and overall postoperative complications. CONCLUSIONS: Current evidence indicates early oral intake following esophagectomy seems to be safe and effective. It may be the preferred mode of nutrition following esophagectomy. However, more high-quality studies are still needed to further validate this conclusion.

The Mediating Role of Job Competence between Safety Participation and Behavioral Compliance.

The effective improvement of employee behavioral compliance and safety performance is an important subject related to the sustainable development of the construction industry. Based on data from a Chinese company (n = 290), this study used a partial least squares-structural equation model to clarify the relationship among safety participation, job competence, and behavioral compliance. Empirical analysis found that: (1) safety participation had a significant positive impact on employees' behavioral compliance; and (2) job competence played a partial mediating role between safety participation and behavioral compliance. By selecting two new perspectives of safety participation and job competence, this study derived new factors affecting behavioral compliance, constructed a new theory about safety management, and conducted an in-depth discussion on improving behavioral compliance theoretically. Practically, the research put forward a new decision-making model, deconstructed the mechanism between safety participation and behavioral compliance, and provided new guiding strategies for improving employee behavioral compliance.

Stable, precisely controlled, and switchable thulium-doped fiber laser based on cascaded mode interference filters.

This research experimentally demonstrates a switchable, single-wavelength, thulium-doped fiber laser based on the cascading of a multimode-single-mode-multimode (MSM) fiber filter and a two-mode fiber (TMF) filter. When the MSM fiber filter suffers from bending, the blue-shift of the output spectrum can be obtained. A switchable lasing wavelength output is realized by bending the MSM fiber filter to cover different channels of the TMF filter. The output wavelength can be switched from 1982.54 to 1938.81 nm with an optical signal-to-noise ratio of higher than 40 dB. The wavelength interval of the switchable output is an integral multiple of the wavelength interval of the TMF filter. The stability of the output wavelength was tested within 60 min, and the wavelength shift and output power fluctuation were found to be less than 0.01 nm and 0.31 dB, respectively, which demonstrates a stable output performance.

[Treatment of depression fractures of posterolateral tibial plateau through a modified anterolateral approach].

OBJECTIVE: To study the therapeutic effects of posterolateral depression fractures of the tibial plateau through a modified anterolateral approach. METHODS: From February 2011 to January 2012,13 patients with posterolateral depression fractures of the tibial plateau were treated through a modified anterolateral approach. There were 8 males and 5 females, ranging in age from 28 to 59 years old (49.2 years old on average). Data from patients were collected retrospectively as follows: X-ray, time of fracture healing and the complications of fracture healing. The patients were evaluated both clinically and radiologically according to the Rasmussen score system. RESULTS: All the patients were followed up, and the duration ranged from 6 to 18 months (mean 13.7 months). All the patients got bony union. The average radiographic bony union time was 15.1 weeks (ranged, 11 to 17 weeks). No case of secondary articular depression was found. No complications such as malunion or joint stiffness were found. But 1 patient had superficial infection and 1 patient had common peroneal nerve injury. According to the Rasmussen score system,the mean radiological score was 16.50 ± 0.67 (ranged, 13 to 18), and the mean functional score was 25.20 ± 2.21 (ranged, 13 to 30). The mean range of knee motion was (125.3 ± 9.3)° (ranged, 0° to 135°). CONCLUSION: Treatment of depression fractures of posterolateral tibial plateau with a modified anterolateral approach is a safe method with effective exposure, due to its stable fixation and relatively good outcome with minimal soft-tissue complications. It is regarded as an ideal procedure for depression fractures of posterolateral tibial plateau.

Treatment of depression fractures of posterolateral tibial plateau through a modified anterolateral approach / 中国骨伤

<p><b>OBJECTIVE</b>To study the therapeutic effects of posterolateral depression fractures of the tibial plateau through a modified anterolateral approach.</p><p><b>METHODS</b>From February 2011 to January 2012,13 patients with posterolateral depression fractures of the tibial plateau were treated through a modified anterolateral approach. There were 8 males and 5 females, ranging in age from 28 to 59 years old (49.2 years old on average). Data from patients were collected retrospectively as follows: X-ray, time of fracture healing and the complications of fracture healing. The patients were evaluated both clinically and radiologically according to the Rasmussen score system.</p><p><b>RESULTS</b>All the patients were followed up, and the duration ranged from 6 to 18 months (mean 13.7 months). All the patients got bony union. The average radiographic bony union time was 15.1 weeks (ranged, 11 to 17 weeks). No case of secondary articular depression was found. No complications such as malunion or joint stiffness were found. But 1 patient had superficial infection and 1 patient had common peroneal nerve injury. According to the Rasmussen score system,the mean radiological score was 16.50 ± 0.67 (ranged, 13 to 18), and the mean functional score was 25.20 ± 2.21 (ranged, 13 to 30). The mean range of knee motion was (125.3 ± 9.3)° (ranged, 0° to 135°).</p><p><b>CONCLUSION</b>Treatment of depression fractures of posterolateral tibial plateau with a modified anterolateral approach is a safe method with effective exposure, due to its stable fixation and relatively good outcome with minimal soft-tissue complications. It is regarded as an ideal procedure for depression fractures of posterolateral tibial plateau.</p>

catena-Poly[[[tetra-aqua-praseo-dym-ium(III)]-di-µ-nicotinato-κO:N;κO:N-disilver(I)-di-µ-nicotinato-κN:O;κN:O] perchlorate monohydrate].

In the title compound, {[Ag(2)Pr(C(6)H(4)NO(2))(4)(H(2)O)(4)]ClO(4)·H(2)O}(n), the Pr(III) atom, lying on a twofold rotation axis, has a distorted square-anti-prismatic coordination geometry, defined by four O atoms from four nicotinate (nic) ligands and four water mol-ecules. The Ag(I) atom is coordinated in an almost linear fashion by two pyridyl N atoms from two nicotinate ligands. The linear coordination is augmented by weak inter-actions with three O atoms from one perchlorate anion, one uncoordinated water mol-ecule and one carboxyl-ate group. Two Pr atoms link two {Ag(nic)(2)}(+) units into a ring, which is further extended into an infinite zigzag chain by sharing the Pr atoms. These chains are further connected into a three-dimensional network via weak Ag⋯O inter-actions, O-H⋯O hydrogen bonds, Ag⋯Ag inter-actions [3.357 (2) Å] and π-π inter-actions between the pyridyl rings [centroid-centroid distance = 3.685 (4) Å].

Poly[penta-aqua-tetra-kis(µ(2)-nicotinato-κN:O)(perchlorato-κO)lanthanum(III)disilver(I)].

In the title complex, [Ag(2)La(C(6)H(4)NO(2))(4)(ClO(4))(H(2)O)(5)](n), the La(III) atom, lying on a twofold rotation axis, is eight-coordinated by four O atoms from four nicotinate (nic) ligands and four water mol-ecules in a distorted square-anti-prismatic coordination geometry. The Ag(I) atom is coordinated in an almost linear fashion by two pyridyl N atoms of two nic ligands. The linear coordination is augmented by weak inter-actions with one O atom from a half-occupied ClO(4) (-) anion and a water mol-ecule lying on a twofold axis. Two Ag(nic)(2) units connect two La atoms, forming a cyclic unit. These units are further extended into an infinite zigzag chain. The chains are bridged by the disordered perchlorate ions via weak Ag-O [2.678 (2) Å] inter-actions. O-H⋯O hydrogen bonds, weak Ag⋯Ag [3.3340 (15) Å] inter-actions and π-π inter-actions between the pyridyl rings [centroid-centroid distance = 3.656 (2) Å] lead to a three-dimensional network.