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2%) and our disease-free survival rate was 70.5%. Recurrence occurred in 14 (9.6%) of all patients. Conclusion In conclusion, although laparoscopic gastrectomy is a reliable and feasible method for gastric cancer, the standardization of laparoscopic surgery is required in clinics.In this article, I present the concept of "birthing consciousness," a psychophysical altered state of women that can occur during natural and undisturbed birth. Streptozocin I demonstrate that this altered state of consciousness (ASC) has phenomenological and cognitive features of hypofrontality; thus, birthing consciousness probably shares a similar brain mechanism to that postulated by the transient-hypofrontality theory (THT). I argue that until recently (with the advent of modern medical intervention), in evolutionary terms, women lacking the proclivity for this specific brain mechanism had a lower chance of reproducing successfully. Hence, I suggest a general and preliminary hypothesis concerning THT Birthing consciousness is one example of an adaptive pain-induced ASC associated with transient hypofrontality.Propagandists often compare members of stigmatized out-groups to nonhuman entities such as rats, lice, and snakes. Drawing on these horrifying descriptions, the dehumanization hypothesis proposes that out-group members are viewed as less than human and that being viewed as less than human renders them vulnerable to harm. I offer seven challenges to the dehumanization hypothesis. I argue that, even in supposedly prototypical examples of extreme dehumanization, out-group members are not treated like nonhuman entities. Furthermore, although out-group members may be denied some human qualities and states, they are attributed others. I also argue that there is reason to doubt the hypothesized causal connection between being viewed as less than human and being at risk of harm-some nonhuman organisms are treated with great care, and some groups are harmed because of how their uniquely human qualities are perceived. I close by offering an alternative account of why out-group members are sometimes referred to as nonhuman entities.Machine learning (i.e., data mining, artificial intelligence, big data) has been increasingly applied in psychological science. Although some areas of research have benefited tremendously from a new set of statistical tools, most often in the use of biological or genetic variables, the hype has not been substantiated in more traditional areas of research. We argue that this phenomenon results from measurement errors that prevent machine-learning algorithms from accurately modeling nonlinear relationships, if indeed they exist. This shortcoming is showcased across a set of simulated examples, demonstrating that model selection between a machine-learning algorithm and regression depends on the measurement quality, regardless of sample size. We conclude with a set of recommendations and a discussion of ways to better integrate machine learning with statistics as traditionally practiced in psychological science.Introduction Carbapenem-resistant Enterobacteriaceae (CRE) represents an urgent threat worldwide. We aimed to investigate the frequency of carbapenem-resistant Klebsiella pneumoniae and Escherichia coli in Iran. Materials and Methods PubMed/Medline, Embase, Scopus, Web of Sciences, and Iranian databases were searched to find potentially relevant articles. Statistical analyses were performed using STATA version 14. Results Forty-nine studies fulfilled the inclusion criteria. The pooled rates of resistance to carbapenem in K. pneumoniae and E. coli were 24.0% (95% confidence interval [CI] 18.0-31.0) and 5.0% (95% CI 2.0-8.0), respectively. blaOXA-48 gene was the most common cause of carbapenem resistance in K. pneumoniae and E. coli. Conclusions CRE is prevalent in Iran, which confers the importance of strength prevention and control measures.BACKGROUND Psychological distress is highly prevalent among patients with metastatic colorectal cancer. AIMS To perform an economic evaluation of a combined screening and treatment program targeting psychological distress in patients with metastatic colorectal cancer in comparison with usual care. DESIGN Societal costs were collected alongside a cluster randomized controlled trial for 48 weeks. A total of 349 participants were included. SETTING Participants were recruited from oncology departments at 16 participating hospitals in the Netherlands. METHODS Outcome measures were the Hospital Anxiety and Depression Scale and quality-adjusted life-years. Missing data were imputed using multiple imputation. Uncertainty was estimated using bootstrapping. Cost-effectiveness planes and cost-effectiveness acceptability curves were estimated to show uncertainty surrounding the cost-effectiveness estimates. Sensitivity analyses were performed to check robustness of results. RESULTS Between treatment arms, no significant re, widespread implementation cannot be recommended.BACKGROUND Informal caregivers of palliative patients show higher levels of depression and distress compared with the general population. Fegg's (2013) existential behavioural therapy was shortened to two individual 1-h sessions (short-term existential behavioural therapy). AIM Testing the effectiveness of sEBT on psychological symptoms of informal caregivers in comparison with active control. DESIGN Randomised controlled trial. SETTING/PARTICIPANTS Informal caregivers of palliative in-patients. METHODS The primary outcome was depression; secondary outcomes were anxiety, subjective distress and minor mental disorders, positive and negative affect, satisfaction with life, quality of life and direct health care costs. General linear mixed models allow several measurements per participant and change over time. Reasons for declining the intervention were investigated by Rosenstock's Health Belief Model. RESULTS Overall inclusion rate was 41.0%. Data of 157 caregivers were available (63.1% females; mean age 54.6 years, standard deviation (SD) 14.1); 127 participants were included in the main analysis. Participation in sEBT or active control was not significantly associated with post-treatment depression. Outcomes showed prevailingly significant association with time of investigation. Self-efficacy, scepticism of benefit of the intervention, belief of better coping alone and support by family and friends were significant factors in declining participation in the randomised controlled trial. CONCLUSION Inclusion rate was tripled compared with a previously evaluated longer EBT group intervention. By shortening the intervention, inclusion rate was traded for effectiveness and the intervention could not impact caregivers' psychological state. Early integration of sEBT and combination of individual and group setting and further study of the optimal length for caregiver interventions are suggested.Background Recently, the minimally invasive surgical approach has been available for performing liver resections (LRs) with laparoscopic and robotic techniques. The robotic approach for LRs seems to overcome several laparoscopic limitations, which is a valid alternative when performed in high volume and specialized centers. Laparoscopic difficulty score systems (DSSs) should serve to guide the surgeon's choice in the best surgical approach to adopt for every single patient, giving the possibility to switch to the open approach when needed. To this day, no specific robotic difficulty scores exist. link2 The aim of our study was to verify the feasibility of applying these scores and related updates on robotic LRs performed in our Institute. Materials and Methods Out of a total of 683 LRs performed from June 2010 to July 2019, 60 were performed through using a mini invasive approach and of these 18 were performed robotically. The Ban DSS and subsequently the modified Iwate DSS were applied to our cases. Results Based on our findings, applying the DSS we divided our series into two groups a low difficulty level group (1-3) made up of 5 patients, and an intermediate difficulty level group (4-6) consisting of 13 patients. Average Ban DSS and subsequently updated score system results were 4.6 ± 1.5 points (range 2-6) for both scores. Conclusions Difficulties were encountered in applying the score when simultaneous multiple wedge resections were performed. The laparoscopic DSS is applicable to robotic LRs with some limitations due to the peculiarity of the two different minimally invasive approaches. A specific robotic difficulty rating score could be necessary to include these elements.Introduction Thoracoscopic repair of esophageal atresia and tracheo-esophageal fistula (EA/TEF) is challenging. We addressed this by designing a fully synthetic simulator of the procedure and described the design process and how its content validity was assessed. Methods An iterative design and assessment of content validity was undertaken in three stages. Data were collected from participants who trialed the model and completed a survey of their experience (adapted from Barsness et al.). Results The model was trialed by participants of varying experience. Each design refinement improved the model's fidelity and validity. link3 For the last iteration of the simulator, the observed averages (out of a maximum of 5) were value as a training tool 4.8, relevance 4.6, physical attributes 4.5, realism of material 4.25, realism experience 4.17, and ability to perform tasks 3.77. Conclusion An iterative design process based on end-user feedback has led to a synthetic simulator that has achieved a high level of content validity. This model has advantages over other EA/TEF simulators in that it is relatively inexpensive and does not use animal tissue, thus removing ethical and procurement issues. It was rated highly for its value and relevance to training.A probiotic is considered a live microbial feed supplement that has beneficial effects on the host. In this study, the probiotic property by which strain HS-08 increased intestinal acetate levels and enhanced IgA secretion, which may result in strengthening of the mucosal immune system.BACKGROUND Liraglutide was administered to patients with type 2 diabetes, and its effects on estimated glomerular filtration rate (eGFR) slopes and albuminuria were retrospectively evaluated. METHODS This study included 568 patients with type 2 diabetes who received liraglutide therapy (up to 0.9 mg/day) >1 year and were followed-up for a maximum of 2 years before and 7 years after treatment. The decline in renal function was estimated as the slope of the individual linear regression line of eGFR over the follow-up time. Spot urine samples were collected to measure albuminuria, which were calculated using creatinine levels. In addition, HbA1c, body weight, blood pressure, and heart rate were monitored. RESULTS The mean liraglutide treatment period was 3.1 ± 2.0 years. The mean baseline eGFR slope (mL/min/1.73m2/year) was -2.75 ± 6.04. After liraglutide treatment, the mean eGFR slope significantly improved (-1.42 ± 4.30, P less then 0.01). This effect appeared more pronounced for baseline eGFRs less then 45 mL/min/1.73 m2. Albuminuria, HbA1c, body weight, and systolic blood pressure levels were significantly reduced after treatment with liraglutide for 1 year, whereas diastolic blood pressure and heart rates were increased. CONCLUSIONS Patients treated with liraglutide experienced a significantly slower annual decline in kidney function. The benefit appeared more pronounced in patients with the development and progression of diabetic kidney disease. These results suggest that the benefits of liraglutide on kidney function identified in clinical trials appear to be well generalizable to clinical practice.
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