Revealing climatic and groundwater impacts on the spatiotemporal variations in vegetation coverage in marine sedimentary basins of the North China Plain, China.

The North China Plain (NCP) is one of the three great plains in China and also serves as a vital region for grain, cotton, and oil production. Under the influence of regional hydrothermal changes, groundwater overexploitation, and seawater intrusion, the vegetation coverage is undergoing continuous alterations. However, a comprehensive assessment of impacts of precipitation, temperature, and groundwater on vegetation in marine sedimentary regions of the NCP is lacking. Heilonggang Basin (HB) is located in the low-lying plain area in the east of NCP, which is part of the NCP. In this study, the HB was chosen as a typical area of interest. We collected a series of data, including the Normalized Difference Vegetation Index (NDVI), precipitation, temperature, groundwater depth, and Total Dissolved Solids (TDS) from 2001 to 2020. Then the spatiotemporal variation in vegetation was analyzed, and the underlying driving mechanisms of vegetation variation were explored in this paper. The results show that NDVI experiences a rapid increase from 2001 to 2004, followed by stable fluctuations from 2004 to 2020. The vegetation in the HB has achieved an overall improvement in the past two decades, with 76% showing improvement, mainly in the central and eastern areas, and 24% exhibiting deterioration in other areas. From 2001 to 2020, NDVI correlates positively with precipitation, whereas its relationship with temperature fluctuates between positive and negative, and is not statistically significant. There is a threshold for the synergistic change of NDVI and groundwater depth. When the groundwater depth is lower than 3.8 m, NDVI increases sharply with groundwater depth. However, beyond this threshold, NDVI tends to stabilize and fluctuate. In the eastern coastal areas, NDVI exhibits a strong positive correlation with groundwater depth, influenced by the surface soil TDS controlled by groundwater depth. In the central regions, a strong negative correlation is observed, where NDVI is primarily impacted by soil moisture under the control of groundwater. In the west and south, a strong positive correlation exists, with NDVI primarily influenced by the intensity of groundwater exploitation. Thus, precipitation and groundwater are the primary driving forces behind the spatiotemporal variability of vegetation in the HB, while in contrast, the influence of temperature is uncertain. This study has elucidated the mechanism of vegetation response, providing a theoretical basis for mitigating adverse factors affecting vegetation growth and formulating rational water usage regulations in the NCP.

Location and extent of cavernous transformation of the portal vein dictates different visceral side revascularization in Meso-Rex bypass.

BACKGROUND: As an emerging standard of care for portal vein cavernous transformation (PVCT), Meso-Rex bypass (MRB) has been complicated and variated. The study aim was to propose a new classification of PVCT to guide MRB operations. METHODS: Demographic data, the extent of extrahepatic PVCT, surgical methods for visceral side revascularization, intraoperative blood loss, operating time, changes in visceral venous pressure before and after MRB, postoperative complications and the condition of bypass vessels after MRB were extracted retrospectively from the medical records of 19 patients. RESULTS: The median age of the patients (13 males and 6 females) was 32.5 years, while two patients were underage. Causes of PVCT can be summarized as follows: thrombophilia such as dysfunction of antithrombin III or proteins C; secondary to abdominal surgeries; secondary to abdominal infection or traumatic intestinal obstruction, and unknown causes. Intraoperatively, the median operation time was 9.5 h (7-13 h), and the intraoperative blood loss was 300 mL (100-1,600 mL). Ten cases used autologous blood vessels while 10 used allogeneic blood vessels. The vascular anastomosis was divided into the following types according to the site and approach: Type (T) 1-PV pedicel type, T2-confluence type, T3-major visceral vascular type; and T4-collateral visceral vascular type. Furthermore, the visceral venous pressure before and after MRB dropped significantly from 36 cmH2O (28-44) to 24.5 cmH2O (15-31) (P < 0.01). Postoperatively, one patient had delayed wound healing, two developed biochemical pancreatic fistulae, one experienced lymphatic leakage, the former caused by heat damage of the pancreatic tissues, the latter by cutting lymphatic vessels in the mesentery or removing the local lymph nodes during the process of separating the superior mesenteric vein, and one was re-operated on for an intervening intestinal fistulae. Postoperative enhanced CT scans revealed a significant improvement in abdominal varix in the patients with patent bypass, and at the 1-year postoperative follow-up, enhanced CT scans of six patients showed that the long axis of the spleen was reduced by ≥ 2 cm. CONCLUSIONS: MRB can effectively reduce visceral venous pressure in patients with PVCT. It is feasible to determine the PVCT type according to the extent of involvement and to choose individualized visceral side revascularization performances.

Improving Safety Performance of Construction Workers through Learning from Incidents.

Learning from incidents (LFI) is a process to seek, analyse, and disseminate the severity and causes of incidents, and take corrective measures to prevent the recurrence of similar events. However, the effects of LFI on the learner's safety performance remain unexplored. This study aimed to identify the effects of the major LFI factors on the safety performance of workers. A questionnaire survey was administered among 210 construction workers in China. A factor analysis was conducted to reveal the underlying LFI factors. A stepwise multiple linear regression was performed to analyse the relationship between the underlying LFI factors and safety performance. A Bayesian Network (BN) was further modelled to identify the probabilistic relational network between the underlying LFI factors and safety performance. The results of BN modelling showed that all the underlying factors were important to improve the safety performance of construction workers. Additionally, sensitivity analysis revealed that the two underlying factors-information sharing and utilization and management commitment-had the largest effects on improving workers' safety performance. The proposed BN also helped find out the most efficient strategy to improve workers' safety performance. This research may serve as a useful guide for better implementation of LFI practices in the construction sector.

Are you a water saver? Discovering people's water-saving intention by extending the theory of planned behavior.

Saving water is a common responsibility of all humanity, which is essential for achieving sustainable use of global water resources. The aim of this study is to discover the determinants of an individual's intention to save water. Based on the theory of planned behavior, a novel comprehensive framework has been developed by extending environmental concern, perceived risk, and information publicity. Partial least squares structural equation modeling was used to perform an empirical analysis with data from questionnaire of 265 residents in Jinan, the famous Chinese "Spring City". The findings indicate that residents have a strong environmental concern and water-saving intention with mean values of 6.78 and 6.67, respectively. Attitude and information publicity are the most important antecedents of water-saving intention, followed by subjective norms and perceived behavioral control. Environmental concern and perceived risk indirectly affect the intention to save water through attitude, subjective norms, and perceived behavioral control. The role of environmental concern is more important than the role of perceived risk. Interestingly, a high level of information publicity may strengthen the impact of attitude on water-saving intention but weaken the impact of perceived behavioral control. This study strongly supplements current knowledge on water-saving behavior. Moreover, these findings provide insights for policymakers to motivate people to save water.

Modified Meso-Rex bypass with umbilical vein recanalization and intra-operative stenting.

PURPOSE: The aim of the study was to evaluate the usefulness of a novel modified Meso-Rex bypass surgical technique with umbilical vein recanalization and intra-operative stenting to treat portal vein cavernous transformation. METHODS: In total, 13 portal vein cavernous transformation patients underwent Meso-Rex bypass surgery, consisting of bypass grafts between the superior mesenteric vein (SMV) and the recess of Rex as well as through the ligamentum teres hepatis without stent implantation (Group A, n = 9) and umbilical vein recanalization with intra-operative stent implantation (Group B, n = 4). RESULTS: In Group A, the bypass diameter was 0-6 mm (median 3 mm) and blood flow velocity 25-115 cm/s (median 72 cm/s) 1 month after Meso-Rex bypass surgery, with open bypass times of 0-67 months (median 6 months); 6 patients in this group developed postoperative Meso-Rex bypass occlusions. A patient in Group A treated with ligamentum teres hepatis recanalization needed a thrombectomy and stent implantation during a second surgery 2 days after the Meso-Rex bypass, because of bypass thrombosis and umbilical vein stenosis. In Group B, the average modified Meso-Rex bypass diameter was 5.5-6.5 mm (median 6 mm), and the bypass vessels remained open in all patients, with blood flow rates of 45-100 cm/s (median 76.5 cm/s) 1 month after the modified Meso-Rex bypass, up to the endpoint (15-33 months, median 24 months). The rate of bypass occlusions in Group A and Group B were 22.2% and 0%, 30.0% and 0%, and 55.6% and 0% at 1 month, 3 months, and 1 year, respectively, after bypass surgery. CONCLUSIONS: Our novel modified Meso-Rex bypass approach for portal vein cavernous transformation treatment was effective with excellent long-term bypass patency.

Decision-making interaction among stakeholders regarding construction and demolition waste recycling under different power structures.

The market power and competition scenario of recycling enterprises and landfills may change in the future due to the environmental pressure caused by landfills and the environmental potential of construction and demolition waste (C&DW) recycling. In this context, how these changes will affect the economic performance of enterprises and the environmental performance of the whole society remains unclear, along with how the willingness to pay and the environmental awareness of contractors will affect the pricing decisions of recycling enterprises and landfills. This study investigates the charging and recycling problem under different power structures in the reverse supply chain of C&DW, which is composed of waste generators (construction contractors) and two disposers (recycling enterprises and landfills). The interactive decisions of three stakeholders are discussed and the optimal charge fee, profit, and recycling ratio are obtained. Results indicate the following (i) The environmental preference of contractors directly increases the charge fee of recycling enterprises, and indirectly increases the charge fee of landfills. (ii) An increase in contractors' environmental preference will reduce the recycling ratio of C&DW and increase landfill and illegal dumping ratios. (iii) From the perspective of environmental benefits, illegal dumping and recycling ratios experience the worst scenario in the Recycling-Stackelberg game model and the best scenario in Nash game model because recycling enterprises take advantage of their dominant market position and set higher charges than those that contractors can afford. This theoretical study bridges the research gap on the effects of the market power on the environmental and economic performance of stakeholders in the field of C&DW management. The findings also help policy makers understand the behavior of stakeholders under different power structures to formulate the most effective intervention strategies.

Augmented Reality-Assisted Pancreaticoduodenectomy with Superior Mesenteric Vein Resection and Reconstruction.

INTRODUCTION: Pancreaticoduodenectomy (PD) with superior mesenteric vein (SMV) reconstruction are often required to achieve complete (R0) resection for pancreatic head cancer (PHC) with tumor invasion of the SMV. Augmented reality (AR) technology can be used to assist in determining the extent of SMV involvement by superimposing virtual 3-dimensional (3D) images of the pancreas and regional vasculature on the surgical field. MATERIALS AND METHODS: Three patients with PHC and tumor invasion of the SMV underwent AR-assisted PD with SMV resection and reconstruction following preoperative computed tomography scanning. Preoperative imaging data were used to reconstruct 3D images of anatomical structures, including the tumor, portal vein (PV), SMV, and splenic vein (SV). Using AR software installed on a smart phone, the reconstructed 3D images were superimposed on the surgical field as viewed in a smart phone display to provide intermittent navigational assistance to the surgeon in identifying the boundaries of PHC tumor invasion for resection of the vessels involved. RESULT: All patients successfully completed the operation. Intraoperative AR applications displayed virtual images of the pancreas, SMV, bile duct, common hepatic artery (CHA), and superior mesenteric artery (SMA). Two patients required end-to-end anastomosis for reconstruction of the SMV. One patient required allogenic vascular bypass to reconstruct the SMV-PV juncture with concomitant reconstruction of the SV-SMV confluence by end-to-side anastomosis of the SV and bypass vessel. Postoperative pathology confirmed R0 resections for all patients. CONCLUSION: AR navigation technology based on preoperative CT image data can assist surgeons performing PD with SMV resection and reconstruction.

Uncovering people's mask-saving intentions and behaviors in the post-COVID-19 period: Evidence from China.

The COVID-19 pandemic has caused a surge in the demand for medical masks over the past few months. Many countries and regions have experienced a shortage of masks and raw materials, as well as soaring prices. Understanding mask-saving behavior is an important way to help improve medical resource sustainability and respond to the outbreak. This study integrates the theory of planned behavior and normative activation to propose a new comprehensive theoretical framework, which aims to reveal people's mask-saving intentions (MSI) and behaviors in the post-pandemic period. Using the partial least squares structural equation modeling method, a total of 1057 questionnaires randomly collected from China were measured and empirically analyzed. Results indicate the following: (i) Reducing the frequency of going-out is the main approach to saving masks in China, and the majority of people reuse a mask from two to five times. (ii) Personal norms, subjective norms, attitudes and perceived behavioral control all have significant positive effects on MSI; awareness of consequences and ascription of responsibility also indirectly affect MSI through personal norms. (iii) As for extended factors, environmental concerns, perceived risk and information publicity positively affect MSI, but supply chain performance does not have a significant role. (iv) Excessive information publicity may weaken the impact of personal norms, subjective norms and perceived risk on MSI. Given the above findings, some insightful management implications are proposed.

Risk factors for new-onset diabetes mellitus after distal pancreatectomy.

INTRODUCTION: Several previous studies have reported the incidence of new-onset diabetes mellitus (NODM) after pancreatectomy. Nevertheless, the results were inconsistent. The true rate of NODM after distal pancreatectomy (DP) is still unknown. RESEARCH DESIGN AND METHODS: The aim of this study was to investigate the incidence of and the risk factors for NODM after DP. This study enrolled patients who underwent DP between January 2004 and February 2016 at Peking Union Medical College Hospital. Patients with preoperative diabetes mellitus or diagnosed with pancreatic cancer were excluded. The primary outcome was NODM. RESULTS: A total of 485 patients were enrolled. The median (IQR) of follow-up duration was 30.95 (9.26-180.30) months. The accumulative incidence of NODM was 8.9% at postoperative 6 months, 14.0% at postoperative year one, 22.3% at year three, 27.1% at year five, and 35.5% at year ten. Multivariate analysis showed that the risk of postoperative NODM was positively correlated with age (HR 1.029 (1.013-1.045), p<0.001), preoperative body mass index (BMI) (HR 1.042 (1.003-1.083), p=0.001), operative blood loss (HR 1.0003 (1.0002-1.0010), p<0.001), and length of resected pancreas (HR 1.079 (1.013-1.148), p=0.017). Moreover, concomitant splenectomy (HR 2.001 (1.202-3.331), p=0.008) was associated with significantly higher risk of postoperative NODM. CONCLUSION: NODM incidence increased with postoperative time progression. Age, BMI, surgical blood loss, length of resected pancreas and splenectomy were independent risk factors for NODM after DP. TRIAL REGISTRATION NUMBER: NCT03030209.

Investigating the Relationship between Work-To-Family Conflict, Job Burnout, Job Outcomes, and Affective Commitment in the Construction Industry.

This study explored the effects of work-to-family conflict on job burnout and job outcomes in the construction industry, focusing on the moderating effects of affective commitment. Based on the conservation of resources theory, a theoretical model introducing affective commitment as a moderating variable was established. A structured questionnaire survey was then implemented among construction professionals in China. A total of 376 valid responses were obtained. Structural equation modeling was used to analyze the valid data. The results revealed the following: (i) work-to-family conflict has a significant positive impact on job burnout, but a significant negative impact on job satisfaction and job performance; (ii) job burnout negatively affects job satisfaction and job performance; (iii) affective commitment negatively moderates the effects of work-to-family conflict on job burnout. This study provides a reference for construction companies to manage work-to-family conflict and job burnout of employees, while also improving their affective commitment and job outcomes.

Work-Family Conflict and Job Outcomes for Construction Professionals: The Mediating Role of Affective Organizational Commitment.

This study developed and tested a model, which involves the effects of work-family conflicts on job satisfaction and job performance of construction professionals, with a focus on the mediating role of affective organizational commitment. A structured questionnaire survey was conducted among construction professionals in China, resulting in 317 valid responses. The results, generated from structural equation modelling, revealed two interrelated dimensions of work-family conflicts, work's interfering with family life and family life's interfering with work. We found these two types of work-family conflicts directly, negatively affected affective organizational commitments and job satisfaction but not job performance. Additionally, affective organizational commitment positively affected job satisfaction and job performance, and mediated the effects of work-family conflicts on job satisfaction. This study advances our understanding of how or why work-family conflicts produce dysfunctional effects on employees' job outcomes in the context of construction projects.

CTC phenotyping for a preoperative assessment of tumor metastasis and overall survival of pancreatic ductal adenocarcinoma patients.

BACKGROUND: The evaluation for surgical resectability of pancreatic ductal adenocarcinoma (PDAC) patients is not only imaging-based but highly subjective. An objective method is urgently needed. We report on the clinical value of a phenotypic circulating tumor cell (CTC)-based blood test for a preoperative prognostic assessment of tumor metastasis and overall survival (OS) of PDAC patients. METHODS: Venous blood samples from 46 pathologically confirmed PDAC patients were collected prospectively before surgery and immunoassayed using a specially designed TU-chip™. Captured CTCs were differentiated into epithelial (E), mesenchymal and hybrid (H) phenotypes. A further 45 non-neoplastic healthy donors provided blood for cell line validation study and CTC false positive quantification. FINDINGS: A validated multivariable model consisting of disjunctively combined CTC phenotypes: "H-CTC≥15.0 CTCs/2ml OR E-CTC≥11.0 CTCs/2ml" generated an optimal prediction of metastasis with a sensitivity of 1.000 (95% CI 0.889-1.000) and specificity of 0.886 (95% CI 0.765-0.972). The adjusted Kaplan-Meier median OS constructed using Cox proportional-hazard models and stratified for E-CTC < 11.0 CTCs/2 ml was 16.5 months and for E-CTC ≥ 11.0 CTCs/2 ml was 5.5 months (HR = 0.050, 95% CI 0.004-0.578, P = .016). These OS results were consistent with the outcome of the metastatic analysis. INTERPRETATION: Our work suggested that H-CTC is a better predictor of metastasis and E-CTC is a significant independent predictor of OS. The CTC phenotyping model has the potential to be developed into a reliable and accurate blood test for metastatic and OS assessments of PDAC patients. FUND: National Natural Science Foundation of China; Zhejiang Province Science and Technology Program; China Scholarship Council.

Role Stress, Job Burnout, and Job Performance in Construction Project Managers: The Moderating Role of Career Calling.

This study aims to explore the influence of role stress (role ambiguity and role conflict) on job burnout and job performance in construction project managers in the Chinese construction industry. Based on the JD-R (Job Demands Resources) model, this study introduces career calling as the moderating variable, in order to develop a theoretical model. The theoretical model is then tested with structural equation modeling. This work uses data from 191 owners, contractors, subcontractors, and supervisors in the Chinese construction industry. The results indicate that: (i) role ambiguity has a negative and significant effect on job burnout and job performance; (ii) role conflict has a negative effect on job burnout, but has a non-significant influence on job performance; (iii) job burnout has a negative impact on job performance; (iv) career calling negatively moderates the relationship between role ambiguity and job burnout, and positively moderates the relationship between role conflict and job performance. Furthermore, the results also show that career calling can positively moderate the effect of role conflict on job burnout. This study expands the existing body of knowledge by reasonably controlling role stress and appropriately introducing career calling. In addition, the study provides some suggestions relevant to construction project management.

Impacts of Lean Construction on Safety Systems: A System Dynamics Approach.

Lean construction has been viewed as an effective management approach for reducing the occurrence of no-value or destructive activities, such as wasting resources and safety-related accidents. However, few studies have systematically addressed how and to what extent lean construction practices influence construction safety. To bridge this gap, a conceptual model is developed and validated using a system dynamics approach. The construction system in this model comprises four sub-systems (i.e., environment system, equipment system, management system, and employee system). Data were collected from 448 projects in China. Simulations were conducted to determine the correlations between five types of lean tools and the four construction sub-systems. The results show that: (a) 5S management has significant positive impacts on the control of key locations and facilities at construction sites, and contributes to the mitigation of environmental impacts; (b) visual management can significantly improve safety compliance and safety management; (c) just-in-time management has significantly positive influences on the safety facilities layout and formulation of the safety plan; and (d) the Last Planner® System and conference management are effective in improving safety training and the implementation of the safety plan. These findings provide new insights into the use of lean construction for improving construction safety through the implementation of a targeted lean approach.

Job Burnout, Work-Family Conflict and Project Performance for Construction Professionals: The Moderating Role of Organizational Support.

Construction professionals are prone to work-family conflict and job burnout, which in turn can affect project performance during implementation of delivery. To cope with this, a questionnaire survey was undertaken with construction professionals in the Chinese construction industry and 373 valid responses were received. A theoretical model introducing organizational support as a moderating variable was developed and tested with structural equation modeling. The results showed that there is a positive correlation between work-family conflict and job burnout for construction professionals. Involving organizational support can alleviate the impact of work-family conflict on professionals' job burnout. Meanwhile, both work-family conflict and job burnout have negative effects on project performance. Therefore, an atmosphere and culture of humanized management should be established within the construction enterprises. Additionally, organizational incentives such as regulations and rules should be formulated assisting employees achieve work-family balance. Such incentives could contribute to the construction industry and improve project performance. Furthermore, this study provides a new theoretical perspective for the management of job burnout and work-family conflict in the construction industry, complementing the existing body of knowledge.

Prognostic significance of circulating tumor microemboli in patients with pancreatic ductal adenocarcinoma.

The significance of circulating tumor microemboli (CTMs) in patients with pancreatic ductal adenocarcinoma (PDAC) is still unknown. Thus, the present study used a epithelial cellular adhesion molecule independent subtraction and immunostaining-fluorescence in situ hybridization (SET-iFISH) platform to enumerate circulating tumor cells (CTCs) and CTMs in a total of 86 peripheral blood samples from 19 patients with PDAC. The associations between CTCs and CTMs with clinicopathologic factors and prognoses were analyzed. Prior to treatment, CTCs were detected in all 19 patients, and CTMs were detected in 4 patients with different tumor-node-metastasis (TNM) stages. A total of 85 of the 86 peripheral blood samples had cytokeratin 18-negative CTCs. The number of CTCs and CTMs were significantly associated with tumor size and vascular invasion. Patients with CTMs had poorer overall survival and disease-free survival when compared with those without CTMs (7.3 vs. 25.40 months, P=0.001; and 1.80 vs. 18.97 months, P=0.037). The presence of CTMs in the peripheral blood prior to surgery was predictive of poor prognosis in PDAC patients. CTMs could be detected in patients of different TNM stage (II, III and IV). Surgery did not benefit patients with CTMs, thus, surgeons should take greater consideration when assessing the requirements for surgery in patients with CTMs.

Work-Family Conflict, Perceived Organizational Support and Professional Commitment: A Mediation Mechanism for Chinese Project Professionals.

Projects are characterized by long working hours, complex tasks and being a kind of temporary organization. As such, work-family conflict is particularly prominent for project employees. This research examined whether and how work-family conflict affects professional commitment among Chinese project professionals. Research hypotheses were developed to explore the relationship between work-family conflict, professional commitment to the project and the mediating effects of perceived organizational support. Data were collected from 327 project managers or professionals working in construction enterprises in China; data were analyzed using structural equation modeling, applying the bootstrapping method. Results showed that there were three dimensions of work-family conflict: time-based conflict, strain-based conflict and behavior-based conflict. There were two dimensions of perceived organizational support: emotional support and instrumental support. The study also tested the negative effect of work-family conflict on professional commitment and the positive effect of perceived organizational support on professional commitment. Specifically, time-based conflict and emotional support had positive effects on professional commitment. Perceived organizational support had a total mediating effect between work-family conflict and professional commitment. The strain-based conflict dimension of work-family conflict had negative impacts on professional commitment through perceived emotional support and instrumental support. Overall, our findings extend a better understanding of work-family conflict and professional commitment in the project setting and verify the importance of social support in balancing work and family and improving employee mobility.