Perioperative standard oral nutrition supplements versus immunonutrition in patients undergoing colorectal resection in an Enhanced Recovery (ERAS) protocol

To compare immunonutrition versus standard high calorie nutrition in patients undergoing elective colorectal resection within an Enhanced Recovery After Surgery (ERAS) program. Despite progress in recent years in the surgical management of patients with colorectal cancer (ERAS programs), postoperative complications are frequent. Nutritional supplements enriched with immunonutrients have recently been introduced into clinical practice. However, the extent to which the combination of ERAS protocols and immunonutrition benefits patients undergoing colorectal cancer surgery is unknown. The SONVI study is a prospective, multicenter, randomized trial with 2 parallel treatment groups receiving either the study product (an immune-enhancing feed) or the control supplement (a hypercaloric hypernitrogenous supplement) for 7 days before colorectal resection and 5 days postoperatively. A total of 264 patients were randomized. At baseline, both groups were comparable in regards to age, sex, surgical risk, comorbidity, and analytical and nutritional parameters. The median length of the postoperative hospital stay was 5 days with no differences between the groups. A decrease in the total number of complications was observed in the immunonutrition group compared with the control group, primarily due to a significant decrease in infectious complications (23.8% vs. 10.7%, P=0.0007). Of the infectious complications, wound infection differed significantly between the groups (16.4% vs. 5.7%, P=0.0008). Other infectious complications were lower in the immunonutrition group but were not statistically significantly different. The implementation of ERAS protocols including immunonutrient-enriched supplements reduces the complications of patients undergoing colorectal resection

Between platonic love and internet pornography

The article sets out to show how an holistic approach in matters of sexuality is always more helpful than one-sided approaches. On the issue of internet pornography, the authors suggest that the recent anti-masturbation online movement ‘no fapping’ is based on wrong conclusions from insufficient evidence. We suggest that a holistic approach is called for, with emphasis on the embodied human. Abstinence or what is understood by ‘Platonic love’ is not a solution, according to Plato himself. From a phenomenological perspective, we suggest owning up to our strange bodies and habitualising sexual activity

Visual methodologies, sand and psychoanalysis: employing creative participatory techniques to explore the educational experiences of mature students and children in care

Social science research has witnessed an increasing move towards visual methods of data production. However, some visual techniques remain pariah sites because of their association with psychoanalysis; and a reluctance to engage with psychoanalytically informed approaches outside of therapy based settings. This paper introduces the method of ‘sandboxing’, which was developed from the psychoanalytical approach of the ‘world technique’. ‘Sandboxing’ provides an opportunity for participants to create three-dimensional scenes in sand-trays, employing miniature figures and everyday objects. Data is presented from two studies conducted in Wales, UK. The first, exploring mature students’ accounts of higher education, and the second, exploring the educational experiences of children and young people in public care. The paper argues that psychoanalytical work can be adapted to enable a distinctive, valuable and ethical tool of qualitative inquiry; and illustrates how ‘sandboxing’ engendered opportunities to fight familiarity, enabled participatory frameworks, and contributed to informed policy and practice

The sugar content of children’s and lunchbox beverages sold in the UK before and after the soft drink industry levy

Background: Childhood obesity is associated with an increased intake of sugary soft drinks and juice drinks. The aims of this study were (1) to report the sugar and energy content in commercial fruit juice (FJ), juice drinks (JD) and smoothies (S) specifically targeted at children in the UK, (2) to identify beverages liable for the Soft Drinks Industry Levy (SDIL) and (3) to compare the amount of sugar in these beverages before and after the levy. Methods: The beverages were retrieved using the online shopping tool my Supermarket, websites of nine major supermarket in the UK and manufacturers webpages. Comparisons of sugar content were taken before and after the introduction of the SDIL. Results: 131 FJJDS fulfilled the inclusion criteria. The mean sugar content of all the beverages was 6.3g±4.5/100mL. There was large variation in the sugar content from 0.1g/100mL to 15.2g/100mL, with smoothies found to contain the most sugar (11.55±1.62 g/mL). The beverages were reanalysed in September 2018 to determine their eligibility for the SDIL. Of the 131 products only 7 JD were eligible for the levy. Four of these beverages had reformulated their ingredients since the initial analysis resulting in a sugar content of <5g/100mL. Conclusions: The majority of the beverages targeted at children and children’s lunch boxes were not eligible for the SDIL. This study suggests the necessity to adapt the SDIL to include all FJJDS aimed at children as the total sugar content of these beverages are still above the recommended quantities for this age group

Intensive mobilities: figurations of the nomad in contemporary theory

The figure of the nomad, representing the virtues of freedom, mobility, and exploration, is a frequently occurring trope within contemporary continental philosophy and social theory, derived chiefly from the work of Gilles Deleuze and Félix Guattari. This paper will interrogate the concept of nomadism, firstly in the philosophy of these two foundational thinkers, and then subsequently in the feminist and posthumanist theorizations of Rosi Braidotti. Whilst accepting that Braidotti's challenges to sedentarist, essentialist metaphysical accounts of the transcendental subject are still politically relevant, it will be argued that the deployment of the nomadic figure—and more generally, the positing of an ontology of creative desire, or ‘becoming’—risks not only absolutizing the historical contingencies of the digitized, postindustrial society that it seeks to criticize, but actually reinforcing the unsustainable ideology of perpetual production upon which such a society is premised

Acute and Reproductive Effects of Align®, an Insecticide Containing Azadirachtin, on the Grape Berry Moth, Lobesia botrana

Azadirachtin, derived from the neem tree, Azadirachta indica A. Juss (Sapindales: Meliaceae), seems promising for use in integrated pest management programs to control a variety of pest species. A commercial formulation of azadirachtin, Align®, has been evaluated against different developmental stages of the European grape berry moth, Lobesia botrana Denis and Schiffermüller (Lepidoptera: Tortricidae). When administered orally, Align reduced the fecundity and fertility of adults treated with 1, 5, and 10 mg litre-1. At the highest doses, fecundity and fertility were zero, but longevity was not affected. An LC50 of 231.5 mg litre-1 was obtained when Align was sprayed on eggs less than 1 day old. Hatching of all egg classes was significantly reduced, and this reduction was more pronounced for eggs less than 24 h old. LC50 values of 2.1 mg litre-1 for first instars and 18.7 mg litre-1 for third instars were obtained when Align was present in the diet. Larvae reared on a diet containing different concentrations of Align did not molt into adults at the highest concentrations (0.3, 0.6, 1.2), and 50% molted at the lowest concentration (0.15). Phenotypic effects included inability to molt properly and deformities. The combination of acute toxicity and low, effective concentrations of Align observed in this study could lead to the inclusion of insecticides containing azadirachtin in integrated management programs against this pest

An artificial intelligence-based collaboration approach in industrial IoT manufacturing : key concepts, architectural extensions and potential applications

The digitization of manufacturing industry has led to leaner and more efficient production, under the Industry 4.0 concept. Nowadays, datasets collected from shop floor assets and information technology (IT) systems are used in data-driven analytics efforts to support more informed business intelligence decisions. However, these results are currently only used in isolated and dispersed parts of the production process. At the same time, full integration of artificial intelligence (AI) in all parts of manufacturing systems is currently lacking. In this context, the goal of this manuscript is to present a more holistic integration of AI by promoting collaboration. To this end, collaboration is understood as a multi-dimensional conceptual term that covers all important enablers for AI adoption in manufacturing contexts and is promoted in terms of business intelligence optimization, human-in-the-loop and secure federation across manufacturing sites. To address these challenges, the proposed architectural approach builds on three technical pillars: (1) components that extend the functionality of the existing layers in the Reference Architectural Model for Industry 4.0; (2) definition of new layers for collaboration by means of human-in-the-loop and federation; (3) security concerns with AI-powered mechanisms. In addition, system implementation aspects are discussed and potential applications in industrial environments, as well as business impacts, are presented

Dialectics and difference: against Harvey's dialectical post-Marxism

David Harvey`s recent book, Justice, nature and the geography of difference (JNGD), engages with a central philosophical debate that continues to dominate human geography: the tension between the radical Marxist project of recent decades and the apparently disempowering relativism and `play of difference' of postmodern thought. In this book, Harvey continues to argue for a revised `post-Marxist' approach in human geography which remains based on Hegelian-Marxian principles of dialectical thought. This article develops a critique of that stance, drawing on the work of Jacques Derrida, Gilles Deleuze and Felix Guattari. I argue that dialectical thinking, as well as Harvey's version of `post-Marxism', has been undermined by the wide-ranging `post-' critique. I suggest that Harvey has failed to appreciate the full force of this critique and the implications it has for `post-Marxist' ontology and epistemology. I argue that `post-Marxism', along with much contemporary human geography, is constrained by an inflexible ontology which excessively prioritizes space in the theory produced, and which implements inflexible concepts. Instead, using the insights of several `post-' writers, I contend there is a need to develop an ontology of `context' leading to the production of `contextual theories'. Such theories utilize flexible concepts in a multilayered understanding of ontology and epistemology. I compare how an approach which produces a `contextual theory' might lead to more politically empowering theory than `post-Marxism' with reference to one of Harvey's case studies in JNGD

The great ephemeral tattooed skin

The skin is always and already a series of planes which signify race, gender, age and such. Tattooing creates a new surface of potential significance upon the body. Tattooing can call into question concepts of volition in reference to the power to inscribe and define one’s subjectivity through one’s own skin, and the social defining of the subject. Skin is the involution or event between subject and object, will and cultural inscription, the social and the self. Feminism, particularly corporeal feminists, have attempted to think ways in which the female flesh may be recognized and self-defined without risking essentialism through reification of the meaning of ‘woman’s body’. Thinking the tattooed female body thus resonates with some of the risks and benefits feminism has found in theorizing a marginalized body. Using Deleuze, Guattari, Lyotard and other major influences on corporeal feminists this article explores ways in which significance is sought in skin and possible configurations of skin and world which challenge the desire to read the flesh as a legible incarnation of subjectivity

The ontological consequences of Copernicus: global being in the planetary world

This article argues that contemporary space exploration, in producing visual representations of the planetary Earth for terrestrial consumption, has engendered a shift in the way the Earth - as terra firma - is both experienced and conceived. The article goes on to suggest that this shift is a key, but still largely tacit presupposition, underlying contemporary discourses on globalization and cultural cosmopolitanization. However, a close reading of some of the texts that make up the canon of 20th-century European philosophy shows that this idea of a ‘deterritorialized’ planetary Earth challenges some basic presuppositions of that canon: especially its use of the pre-reflective experience of terra firma as a tropic site of intological and normative grounds. This article examines the way in which contemporary Western European philosophy - and intellectual culture generally - has responded to this challenge: and offers Deleuze and Guattari’s idea of the Earth as a ‘surface without territory’ as the most intellectually and ethically viable conception of the Earth in the age of ‘planetary deterritorialization’