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(1) Background: Oncological gastrectomy requires complex multidisciplinary management. Clinical pathways (CPs) can potentially facilitate this task, but evidence related to their use in managing oncological gastrectomy is limited. This study evaluated the effect of a CP for oncological gastrectomy on process and outcome quality. (2) Methods: Consecutive patients undergoing oncological gastrectomy before (n = 64) or after (n = 62) the introduction of a CP were evaluated. Assessed parameters included catheter and drain management, postoperative mobilization, resumption of diet and length of stay. Morbidity, mortality, reoperation and readmission rates were used as indicators of outcome quality. (3) Results: Enteral nutrition was initiated significantly earlier after CP implementation (5.0 vs. 7.0 days, p < 0.0001). Readmission was more frequent before CP implementation (7.8% vs. 0.0%, p = 0.05). Incentive spirometer usage increased following CP implementation (100% vs. 90.6%, p = 0.11). Mortality, morbidity and reoperation rates remained unchanged. (4) Conclusions: After implementation of an oncological gastrectomy CP, process quality improved, while indicators of outcome quality such as mortality and reoperation rates remained unchanged. CPs are a promising tool to standardize perioperative care for oncological gastrectomy
The last decade has seen a sharp increase in the number of scientific publications describing physiological and pathological functions of extracellular vesicles (EVs), a collective term covering various subtypes of cell-released, membranous structures, called exosomes, microvesicles, microparticles, ectosomes, oncosomes, apoptotic bodies, and many other names. However, specific issues arise when working with these entities, whose size and amount often make them difficult to obtain as relatively pure preparations, and to characterize properly. The International Society for Extracellular Vesicles (ISEV) proposed Minimal Information for Studies of Extracellular Vesicles (“MISEV”) guidelines for the field in 2014. We now update these “MISEV2014” guidelines based on evolution of the collective knowledge in the last four years. An important point to consider is that ascribing a specific function to EVs in general, or to subtypes of EVs, requires reporting of specific information beyond mere description of function in a crude, potentially contaminated, and heterogeneous preparation. For example, claims that exosomes are endowed with exquisite and specific activities remain difficult to support experimentally, given our still limited knowledge of their specific molecular machineries of biogenesis and release, as compared with other biophysically similar EVs. The MISEV2018 guidelines include tables and outlines of suggested protocols and steps to follow to document specific EV-associated functional activities. Finally, a checklist is provided with summaries of key points.
Several translation scholars have recognised translation as a form of discourse mediation or discourse presentation (see, for example, Mossop 1998). In line with this, "universals" of translation have also been re-framed in the larger context of discourse mediation, as mediation universals rather than something strictly translationspecific (Ulrych 2009). In the present article, this line of enquiry is developed by comparing some of the alleged universals of translation, namely standardization and explicitation, with insights from literary and narratological studies on the nature of discourse presentation. The notion of reportive or interpretative interference (Sternberg 1982) and Fludernik’s (1993) claim that all represented discourse is typical and schematic in nature seem to bear curious resemblance to the notion of standardization or normalization, posited as a possible universal of translation (Mauranen & Kujamäki 2004). Drawing on the results of my earlier research (Kuusi 2011), I present examples of free indirect discourse (FID) used in Dostoevsky’s novel Crime and Punishment with their translations into Finnish. Analyzing the translations, I demonstrate how in
translations, the narratological and literary-theoretical notions of reportive interference and typification/schematization coincide with the translation-theoretical notions of explicitation and standardization.