Development of intraindividual value structures in middle childhood: A multicultural and longitudinal investigation.

OBJECTIVE: We examined changes in value interrelations during middle childhood. In line with the Personal Values Theory, we expected a value system, with individuals similarly valuing related motivations, and setting priorities between conflicting motivations. We hypothesized this system to develop dynamically during middle childhood as children deepen their understanding of their own values. METHOD: Using unfolding analysis, we estimated intraindividual value structure coherence, that is, the extent to which the interrelations among a child's values are similar to the hypothesized interrelations. Cross-Cultural Study 1 (N = 4615, 6-12-year-old children) included children from 12 countries. Cross-Sequential Study 2 (N = 629, 6-10-year-old children at Time 1) included three annual measurements. RESULTS: In Study 1, we found a curvilinear association between age and intraindividual value structure coherence: Children's values were more coherent at ages 9-10 than before or after. Study 2 confirmed this pattern of within-individual development. CONCLUSIONS: We propose that development in coherence with the theoretical value structure offers insight into children's understanding of values as well as changes in value priorities.

Evolution of endoscopic vacuum therapy for upper gastrointestinal leakage over a 10-year period: a quality improvement study.

BACKGROUND: Endoscopic vacuum therapy (EVT) is an effective treatment option for leakage of the upper gastrointestinal (UGI) tract. The aim of this study was to evaluate the clinical impact of quality improvements in EVT management on patients' outcome. METHODS: All patients treated by EVT at our center during 2012-2021 were divided into two consecutive and equal-sized cohorts (period 1 vs. period 2). Over time several quality improvement strategies were implemented including the earlier diagnosis and EVT treatment and technical optimization of endoscopy. The primary endpoint was defined as the composite score MTL30 (mortality, transfer, length-of-stay > 30 days). Secondary endpoints included EVT efficacy, complications, in-hospital mortality, length-of-stay (LOS) and nutrition status at discharge. RESULTS: A total of 156 patients were analyzed. During the latter period the primary endpoint MTL30 decreased from 60.8 to 39.0% (P = .006). EVT efficacy increased from 80 to 91% (P = .049). Further, the need for additional procedures for leakage management decreased from 49.9 to 29.9% (P = .013) and reoperations became less frequent (38.0% vs.15.6%; P = .001). The duration of leakage therapy and LOS were shortened from 25 to 14 days (P = .003) and 38 days to 25 days (P = .006), respectively. Morbidity (as determined by the comprehensive complication index) decreased from 54.6 to 46.5 (P = .034). More patients could be discharged on oral nutrition (70.9% vs. 84.4%, P = .043). CONCLUSIONS: Our experience confirms the efficacy of EVT for the successful management of UGI leakage. Our quality improvement analysis demonstrates significant changes in EVT management resulting in accelerated recovery, fewer complications and improved functional outcome.

Cumulative semantic interference is blind to morphological complexity and originates at the conceptual level.

When naming a sequence of pictures of the same semantic category (e.g., furniture), response latencies systematically increase with each named category member. This cumulative semantic interference effect has become a popular tool to investigate the cognitive architecture of language production. However, not all processes underlying the effect itself are fully understood, including the question where the effect originates from. While some researchers assume the interface of the conceptual and lexical level as its origin, others suggest the conceptual-semantic level. The latter assumption follows from the observation that cumulative effects, namely cumulative facilitation, can also be observed in purely conceptual-semantic tasks. Another unanswered question is whether cumulative interference is affected by the morphological complexity of the experimental targets. In two experiments with the same participants and the same material, we investigated both of these issues. Experiment 1, a continuous picture naming task, investigated whether morphologically complex nouns (e.g., kitchen table) elicit identical levels of cumulative interference to morphologically simple nouns (e.g., table). Our results show this to be the case, indicating that cumulative interference is unaffected by lexical information such as morphological complexity. In Experiment 2, participants classified the same target objects as either man-made or natural. As expected, we observed cumulative facilitation. A separate analysis showed that this facilitation effect can be predicted by the individuals' effect sizes of cumulative interference, suggesting a strong functional link between the two effects. Our results thus point to a conceptual-semantic origin of cumulative semantic interference.

Endoscopic Management of Large Leakages After Upper Gastrointestinal Surgery.

Background: Endoscopic vacuum therapy (EVT) is an evidence-based option to treat anastomotic leakages of the upper gastrointestinal (GI) tract, but the technical challenges and clinical outcomes of patients with large defects remain poorly described. Methods: All patients with leakages of the upper GI tract that were treated with endoscopic negative pressure therapy at our institution from 2012-2021 were analyzed. Patients with large defects (>30 mm) as an indicator of complex treatment were compared to patients with smaller defects (control group). Results: Ninety-two patients with postoperative anastomotic or staplerline leakages were identified, of whom 20 (21.7%) had large defects. Compared to the control group, these patients required prolonged therapy (42 vs. 14 days, p < 0.001) and hospital stay (63 vs. 26 days, p < 0.001) and developed significantly more septic complications (40 vs. 17.6%, p = 0.027.) which often necessitated additional endoscopic and/or surgical/interventional treatments (45 vs. 17.4%, p = 0.007.) Nevertheless, a resolution of leakages was achieved in 80% of patients with large defects, which was similar compared to the control group (p = 0.42). Multiple leakages, especially on the opposite side, along with other local unfavorable conditions, such as foreign material mass, limited access to the defect or extensive necrosis occurred significantly more often in cases with large defects (p < 0.001). Conclusions: Overall, our study confirms that EVT for leakages even from large defects of the upper GI tract is feasible in most cases but comes with significant technical challenges.

Early disruption of photoreceptor cell architecture and loss of vision in a humanized pig model of usher syndromes.

Usher syndrome (USH) is the most common form of monogenic deaf-blindness. Loss of vision is untreatable and there are no suitable animal models for testing therapeutic strategies of the ocular constituent of USH, so far. By introducing a human mutation into the harmonin-encoding USH1C gene in pigs, we generated the first translational animal model for USH type 1 with characteristic hearing defect, vestibular dysfunction, and visual impairment. Changes in photoreceptor architecture, quantitative motion analysis, and electroretinography were characteristics of the reduced retinal virtue in USH1C pigs. Fibroblasts from USH1C pigs or USH1C patients showed significantly elongated primary cilia, confirming USH as a true and general ciliopathy. Primary cells also proved their capacity for assessing the therapeutic potential of CRISPR/Cas-mediated gene repair or gene therapy in vitro. AAV-based delivery of harmonin into the eye of USH1C pigs indicated therapeutic efficacy in vivo.

On the lexical representation(s) of compounds: A continuous picture naming study.

The lexical representation of compound words in speech production is still under debate. While most studies with healthy adult speakers suggest that a single lemma representation is active during compound production, data from neuropsychological studies point toward multiple representations, with activation of the compound's constituent lemmas in addition to the compound's lemma. This study exploits the cumulative semantic interference effect to investigate the lexical representation of compounds in speech production. In a continuous picture naming experiment, category membership was established through the compounds' first constituents (category animals: zebra crossing, pony tail, cat litter …), while the compounds themselves were not semantically related. Moreover, pictures depicting the compounds' first constituents (zebra, pony, cat …) were presented as a control condition. As expected, naming latencies within categories increased linearly with each additionally named category member when producing monomorphemic words, which is interpreted as increasing interference during lexical selection. Importantly, this cumulative semantic interference effect was also observed for compounds. This indicates that the lemmas of the compounds' first constituents were activated during compound production, causing interference due to their semantic relationship and thereby hampering the production of the whole compound. The results are thus in line with the multiple-lemma representation account (Marelli et al., 2012). We argue that the apparent contradiction between results of previous studies with healthy adult speakers and our current study can be explained by the different experimental paradigms used. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Impact of Borderline Resectability in Pancreatic Head Cancer on Patient Survival: Biology Matters According to the New International Consensus Criteria.

BACKGROUND: International consensus criteria (ICC) have redefined borderline resectability for pancreatic ductal adenocarcinoma (PDAC) according to three dimensions: anatomical (BR-A), biological (BR-B), and conditional (BR-C). The present definition acknowledges that resectability is not just about the anatomic relationship between the tumour and vessels but that biological and conditional dimensions also are important. METHODS: Patients' tumours were retrospectively defined borderline resectable according to ICC. The study cohort was grouped into either BR-A or BR-B and compared with patients considered primarily resectable (R). Differences in postoperative complications, pathological reports, overall (OS), and disease-free survival were assessed. RESULTS: A total of 345 patients underwent resection for PDAC. By applying ICC in routine preoperative assessment, 30 patients were classified as stage BR-A and 62 patients as stage BR-B. In total, 253 patients were considered R. The cohort did not contain BR-C patients. No differences in postoperative complications were detected. Median OS was significantly shorter in BR-A (15 months) and BR-B (12 months) compared with R (20 months) patients (BR-A vs. R: p = 0.09 and BR-B vs. R: p < 0.001). CA19-9, as the determining factor of BR-B patients, turned out to be an independent prognostic risk factor for OS. CONCLUSIONS: Preoperative staging defining surgical resectability in PDAC according to ICC is crucial for patient survival. Patients with PDAC BR-B should be considered for multimodal neoadjuvant therapy even if considered anatomically resectable.

Prognostic impact of simultaneous venous resections during surgery for resectable pancreatic cancer.

BACKGROUND: The aim of this study was to evaluate the prognostic impact of simultaneous venous resection during pancreaticoduodenectomy (PD) for pancreatic adenocarcinoma (PDAC) that was preoperatively staged resectable according to NCCN guidelines. METHODS: A retrospective analysis of 153 patients who underwent PD for PDAC was performed. Patients were divided into standard PD and PD with simultaneous vein resection (PDVR). Groups were compared to each other in terms of postoperative morbidity and mortality, disease free (DFS) and overall survival (OS). RESULTS: 114 patients received PD while 39 patients received PDVR. No differences in terms of postoperative morbidity and mortality between both groups were detected. Patients in the VR group presented with a significantly shorter OS in the median (13 vs. 21 months, P = 0.011). In subgroup analysis, resection status did not influence OS in the PDVR group (R0 13 vs. R1 12 months, P = 0.471) but in the PD group (R0 23 vs. R1 14 months, P = 0.043). PDVR was a risk factor of OS in univariate but not multivariable analysis. CONCLUSION: PDVR for PDAC preoperatively staged resectable resulted in significantly shorter OS regardless of resection status. Patients who require PDVR should be considered for adjuvant chemotherapy in addition to other oncological indications.

Cruciate ligament degeneration and stifle joint synovitis in 56 dogs with intact cranial cruciate ligaments: Correlation of histological findings and numbers and phenotypes of inflammatory cells with age, body weight and breed.

The majority of dogs with ruptured cranial cruciate ligaments (crCLs) have inflammatory changes of the stifle joint suggesting that synovitis is an important factor which is involved in the development of degenerative ligament changes. Detailed information is not available concerning the possible occurrence of inflammatory changes in the stifle joint synovium of dogs with macroscopically intact crCLs and its correlation with presence and severity of degenerative changes of the crCLs. Therefore, the purpose of this study was to examine post mortem tissue samples of 56 dogs with non-ruptured crCLs histologically for the presence of inflammatory and degenerative changes of the stifle joint synovium and cruciate ligaments, respectively. In 25/56 (44.6%) dogs, histology showed that both lymphoplasmacytic synovitis and degenerative alterations of the crCLs were present. In these dogs, there was a significant positive statistical correlation between the severity of synovitis and degenerative crCL lesions. The results suggest that synovitis in the stifle joints of dogs with non-ruptured crCLs is a frequent event and probably is involved in the development of degenerative lesions occurring in canine crCLs. Also, the severity of crCL degeneration in these 25 dogs was significantly correlated with their age and body weight. In 2/56 (3.6%) cases, only lymphoplasmacytic synovitis was found in the absence of degenerative crCL lesions. In 15/56 (26.8%) dogs, only degenerative lesions of the crCLs without synovitis were present. Statistically, a significant correlation was found between the severity of degenerative alterations and age and body weight of these dogs. Phenotyping of inflammatory cells by immunohistochemistry showed that the synovium of dogs which histologically had lymphoplasmacytic synovitis was infiltrated with CD3+ T lymphocytes, CD79+ B lymphocytes, major histocompatibility class II antigen (MHC class II)+ cells and macrophages expressing CD163 or S100/A8/S100A9 (calprotectin), while tartrate-resistant acid phosphatase (TRAP)+ cells were absent. Quantification and statistical evaluation of inflammatory cell types in the inflamed synovium revealed that the numbers of lymphocytic cells and macrophages were significantly correlated with the severity of synovitis. These findings indicate that, besides T and B lymphocytes, both pro- and anti-inflammatory macrophages play a role in the development of degenerative crCL alterations.

Values in families with young children: Insights from two cultural milieus in Germany.

Are children's value priorities different from their parents' generation? We present data from the youngest children's sample that has been included in a comprehensive family study of values so far: Our study is based on self-reported values of 127 six- to eleven-year-old German children (M = 7.89, SD = 1.35) and their mothers and fathers. We further took into account two potentially interacting developmental variables that have been suggested in the literature: (a) family members' gender and (b) cultural milieu (we looked specifically at families with Turkish immigration background and families without immigration background). While values of self-transcendence, self-enhancement and openness to change did not differ significantly between the two generations, children found conservation significantly more important than their parents. This contrasts with findings from previous studies with older participants. We discuss to what extent this effect may be unique to this developmental stage of middle childhood that had not been covered by previous research. Females valued conservation more than males, and conservation was more important in families with as compared to families without Turkish immigration background. There was neither a gender × generation nor a cultural milieu × generation interaction.

Parent-child value similarity in families with young children: The predictive power of prosocial educational goals.

Value transmission from one generation to the next is a key issue in every society, but it is not clear which parents are the most successful in transmitting their values to their children. We propose parents' prosocial educational goals as key predictors of parent-child value similarity. Accordingly, we hypothesized that the more parents wanted their children to endorse values of self-transcendence (helping, supporting, and caring for others) and the less parents wanted their children to endorse the opposing values of self-enhancement (striving for power and achievement), the higher would be parent-child overall value similarity. Findings from two studies of families - Study 1: 261 Swiss families, children aged 7-9 years; Study 2: 157 German families, children aged 6-11 years - confirmed this hypothesis. The effect was even stronger after controlling for values that prevail in the Swiss and German society, respectively. We integrate evidence from this study of values in families with young children with existing findings from studies with adolescent and adult children, and we discuss potential pathways from parents' educational goals to parent-child value similarity.

Brief report: Into the wild? How a film can change adolescents' values.

In adolescence, behavior and attitudes are constantly rethought and value priorities are established. Still, there is hardly any research addressing how values are shaped throughout this sensitive period. We employed an experimental design, testing whether adolescents' values can be influenced by exposure to a film. In our study, 154 German adolescents (80 females, ages 13-15) were randomly assigned to an experimental group that watched excerpts from the film "Into the wild" or to a control group. Value change was assessed in a pre-post-test design with a one-week interval. As hypothesized, values changed in the direction of those displayed by the film's protagonist: Universalism values increased significantly and conformity values decreased significantly as compared to the control group. Our findings suggest that single exposure to a film may initiate value change, indicating that not only major live events, but also everyday experiences significantly affect adolescents' values.

Cross-cultural evidence of value structures and priorities in childhood.

We broaden the developmental focus of the theory of universals in basic human values (Schwartz, 1992, Advances in Experimental Social Psychology) by presenting supportive evidence on children's values from six countries: Germany, Italy, Poland, Bulgaria, the United States, and New Zealand. 3,088 7-11-year-old children completed the Picture-Based Value Survey for Children (PBVS-C, Döring et al., 2010, J. Pers. Assess., 92, 439). Grade 5 children also completed the Portrait Values Questionnaire (PVQ, Schwartz, 2003, A proposal for measuring value orientations across nations. Chapter 7 in the Questionnaire Development Package of the European Social Survey). Findings reveal that the broad value structures, sex differences in value priorities and pan-cultural value hierarchies typical of adults have already taken form at this early age. We discuss the conceptual implications of these findings for the new field of children's basic values by embedding them in the recent developmental literature.

Assessing values at an early age: the Picture-Based Value Survey for Children (PBVS-C).

In this article, we introduce the Picture-Based Value Survey for Children (PBVS-C): a new assessment instrument that was developed within the conceptual framework of Schwartz's (1994) theory of universal human values. In the article, we describe the development of the PBVS-C with a specific focus on children's cognitive-developmental background (Harter, 1999; La Greca, 1990) and first applications. Multidimensional Scaling analyses in 2 samples of 8- to 12-year-old children (N= 267, N= 421, respectively) revealed highly differentiated structural patterns that closely correspond to Schwartz's theory. We discuss these findings and the potentials and limitations of the new instrument with respect to future directions of values research.