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Efforts to theorise pragmatic variation in (new) varieties of English have primarily been made in the area of Variational Pragmatics (VarPra) (Barron and Schneider, 2009; Schneider, 2021) and Postcolonial Pragmatics (PP) (Anchimbe and Janney, 2017; Anchimbe, 2018). In this contribution, we will illustrate how criticism voiced in PP can be addressed within a VarPra framework. Taking the pragmatics of Namibian English as our primary research object, we will present an ethnographically grounded and data-driven approach to the investigation of speech acts and related concepts, following principles laid down in Constructivist Grounded Theory (Charmaz, 2006, 2014; Charmaz and Thornberg, 2020). We will detail the development of a research tool specifically designed for the Namibian context, describing how a Discourse Completion Task (DCT) questionnaire was devised in close cooperation with Namibian research partners and the Community of Practice under investigation, thereby avoiding ethno-centrist bias and guaranteeing ecological validity. This centrally includes a systematic and synergistic combination of quantitative and qualitative research methods, allowing us to adhere to the principles of contrastivity and comparability central to VarPra while properly taking into account the emic perspective of the post-colonial language community in question. We believe that the methodology proposed could function as a blueprint for systematically introducing pragmatic inquiry into World Englishes (WE) research. • This project uses Pragmatic Profiling to characterise Namibian English pragmatics. • It synergistically combines qualitative and quantitative empirical methods. • It thereby ensures ecological validity for Variational Pragmatics research. • Language users' emic perspective is combined with quantitative speech act analysis. • This is exemplarily demonstrated for Namibian English Responses to Thanks. [ABSTRACT FROM AUTHOR]

Cardiovascular CT is required for planning transcatheter aortic valve implantation (TAVI). To compare image quality, suitability for TAVI planning, and radiation dose of photon-counting CT (PCCT) with that of dual-source CT (DSCT). Retrospective study on consecutive TAVI candidates with aortic valve stenosis who underwent contrast-enhanced aorto-ilio-femoral PCCT and/or DSCT between 01/2022 and 07/2023. Signal-to-noise (SNR) and contrast-to-noise ratio (CNR) were calculated by standardized ROI analysis. Image quality and suitability for TAVI planning were assessed by four independent expert readers (two cardiac radiologists, two cardiologists) on a 5-point-scale. CT dose index (CTDI) and dose-length-product (DLP) were used to calculate effective radiation dose (eRD). 300 patients (136 female, median age: 81 years, IQR: 76–84) underwent 302 CT examinations, with PCCT in 202, DSCT in 100; two patients underwent both. Although SNR and CNR were significantly lower in PCCT vs. DSCT images (33.0 ± 10.5 vs. 47.3 ± 16.4 and 47.3 ± 14.8 vs. 59.3 ± 21.9, P <.001, respectively), visual image quality was higher in PCCT vs. DSCT (4.8 vs. 3.3, P <.001), with moderate overall interreader agreement among radiologists and among cardiologists (κ = 0.60, respectively). Image quality was rated as "excellent" in 160/202 (79.2%) of PCCT vs. 5/100 (5%) of DSCT cases. Readers found images suitable to depict the aortic valve hinge points and to map the femoral access path in 99% of PCCT vs. 85% of DSCT (P < 0.01), with suitability ranked significantly higher in PCCT vs. DSCT (4.8 vs. 3.3, P <.001). Mean CTDI and DLP, and thus eRD, were significantly lower for PCCT vs. DSCT (22.4 vs. 62.9; 519.4 vs. 895.5, and 8.8 ± 4.5 mSv vs. 15.3 ± 5.8 mSv; all P <.001). PCCT improves image quality, effectively avoids non-diagnostic CT imaging for TAVI planning, and is associated with a lower radiation dose compared to state-of-the-art DSCT. Radiologists and cardiologists found PCCT images more suitable for TAVI planning. [ABSTRACT FROM AUTHOR]

Multimodal therapy regimens became the standard of care for patients with esophageal cancer, whereas surgical resection remains at the center of curative treatment modalities. Current guidelines provide no recommendations on the extent of the oral resection margin, especially in the era of neoadjuvant therapy. Therefore, this study aimed to evaluate the relationship between the oral tumor-free resection margin and overall survival. Retrospective study with 382 1:1 propensity-matched patients out of 660 patients, operated between 2013 and 2019, with an Ivor-Lewis-esophagectomy for adenocarcinoma and squamous cell carcinoma of the esophagus or esophagogastric junction after neoadjuvant therapy. Independent pathologists measured the oral resection margin after formalin fixation. The mean oral tumor-free resection margin was 37.2 ± 0.6 mm. The ideal cut-off for survival differences was determined for 33 mm. Patients with an oral resection margin of more than 33 mm had a better median overall survival (≤33 mm: 45.0 months, 95% confidence interval: 22.4–67.6 months, >33 mm: not reached, P =.005). An oral resection margin of more than 33 mm proved to be an independent favorable prognostic factor for patients' overall survival in multivariate Cox regression analyses (P =.049). This study analyzed a patient cohort retrospectively after curative intended Ivor-Lewis-esophagectomy after neoadjuvant therapy. An oral resection margin of more than 33 mm is a factor for improved overall survival. Therefore, a minimum resection margin of 34 mm after fixation could be suggested. [ABSTRACT FROM AUTHOR]

Mandibular reconstruction is a complex surgical procedure that aims to restore form and function. This procedure becomes necessary in cases where significant bone loss or defects occur due to medication-related osteonecrosis or severe cases of osteomyelitis, tumor resection, or congenital abnormalities. In the last decades, advancements in surgical techniques, materials, and technologies have greatly improved the outcomes of mandibular reconstruction. Nevertheless, complications such as the subsequent formation of large soft tissue wounds regularly occur after the successful treatment of these bone defects. These wounds occur as a result of the relative movements that naturally happen between the implant and the soft tissue, causing the soft tissue to wear away. However, the factors that promote or delay wear have not yet been conclusively clarified. In this work, a test bench was developed and evaluated to simulate naturally occurring movements between implant materials and soft tissue. Then, this test bench was used to compare the wear behavior of linear titanium plates with the behavior of titanium plates encased with bone cement (Palacos®) in a preliminary study. The friction coefficients for different movement patterns of the two surgical techniques were measured and the wear on the abdominal skin of pigs was examined. The results revealed that encasing the titanium plates with bone cement has advantages in terms of friction coefficients and wear for certain movement patterns. [ABSTRACT FROM AUTHOR]

In this paper the construction of C k basis functions on meshes with hanging nodes for hp -finite element methods is proposed. The construction is limited to axis-parallel, rectangular meshes, which can, however, be of any dimension. The basis functions are composed by using hierarchical tensor product shape functions which are defined on patches of so-called constraining nodes and combine univariate Hermite interpolation polynomials and Gegenbauer polynomials. The paper discusses how to integrate the constructed C k basis functions into the assembling process of stiffness matrices and load vectors by using connectivity matrices. Numerical examples illustrate the applicability of the proposed concept. [ABSTRACT FROM AUTHOR]

Many pediatric urology conditions affect putatively normal tissues or appear too commonly to be based solely on specific DNA mutations. Understanding epigenetic mechanisms in pediatric urology, therefore, has many implications that can impact cell and tissue responses to settings, such as environmental and hormonal influences on urethral development, uropathogenic infections, obstructive stimuli, all of which originate externally or extracellularly. Indeed, the cell's response to external stimuli is often mediated epigenetically. In this commentary, we highlight work on the critical role that epigenetic machinery, such as DNA methyltransferases (DNMTs), Enhancer of Zeste Polycomb Repressive Complex 2 Subunit (EZH2), and others play in regulating gene expression and cellular functions in three urological contexts. Animal and cellular constructs were used to model clinical pediatric uropathology. The hypertrophy, trabeculation, and fibrosis of the chronically obstructed bladder was explored using smooth muscle cell models employing disorganised vs. normal extracellular matrix (ECM), as well as a new animal model of chronic obstructive bladder disease (COBD) which retains its pathologic features even after bladder de-obstruction. Cell models from human and murine hypospadias or genital tubercles (GT) were used to illustrate developmental responses and epigenetic dependency of key developmental genes. Finally, using bladder urothelial and organoid culture systems, we examined activity of epigenetic machinery in response to non uropathogenic vs. uropathogenic E.coli (UPEC). DNMT and EZH2 expression and function were interrogated in these model systems. Disordered ECM exerted a principal mitogenic and epigenetic role for on bladder smooth muscle both in vitro and in CODB in vivo. Key genes, e.g., BDNF and KCNB2 were under epigenetic regulation in actively evolving obstruction and COBD, though each condition showed distinct epigenetic responses. In models of hypospadias, estrogen strongly dysregulated WNT and Hox expression, which was normalized by epigenetic inhibition. Finally, DNA methylation machinery in the urothelium showed specific activation when challenged by uropathogenic E.coli. Similarly, UPEC induces hypermethylation and downregulation of the growth suppressor p16INK4A. Moreover, host cells exposed to UPEC produced secreted factors inducing epigenetic responses transmissible from one affected cell to another without ongoing bacterial presence. Microenvironmental influences altered epigenetic activity in the three described urologic contexts. Considering that many obstructed bladders continue to display abnormal architecture and dysfunction despite relief of obstruction similar to after resection of posterior valves or BPH, the epigenetic mechanisms described highlight novel approaches for understanding the underlying smooth muscle myopathy of this crucial clinical problem. Similarly, there is evidence for an epigenetic basis of xenoestrogen on development of hypospadias, and UTI-induced pan-urothelial alteration of epigenetic marks and propensity for subsequent (recurrent) UTI. The impact of mechanical, hormonal, infectious triggers on genitourinary epigenetic machinery activity invite novel avenues for targeting epigenetic modifications associated with these non-cancer diseases in urology. This includes the use of deactivated CRISPR-based technologies for precise epigenome targeting and editing. Overall, we underscore the importance of understanding epigenetic regulation in pediatric urology for the development of innovative therapeutic and management strategies. [Display omitted] [ABSTRACT FROM AUTHOR]

The efficacy and safety of enhanced recovery after surgery (ERAS) protocols for patients undergoing total knee arthroplasty (TKA) have been generally proven. Previous studies investigating patients undergoing simultaneous bilateral TKA (SBTKA) focused on complications, mortality, and pain and did not examine patients' functional limitations. Therefore, the aim of this study was to investigate to what extent patients undergoing SBTKA are able to meet functional discharge criteria originally designed for their counterparts undergoing unilateral TKA (UTKA) in an ERAS setting. All patients who received primary SBTKA between June 2015 and December 2018 were included in this retrospective analysis. For comparison, UTKA patients were matched 1:1 to SBTKA patients using Propensity Score Matching based on age, gender, and BMI. The times to achieving the rehabilitation checkpoints of walking 150 m, walking a flight of stairs, and 90° knee flexion were evaluated. 63 (SBTKA group) and 64 (UTKA group) patients were included. Due to the Propensity-Score-Matching there were no differences regarding age, gender, and BMI. The mean length of stay (LOS) was 9.1 days in the SBTKA and 7.6 days in the UTKA group (p = 0.003). On average, it took SBTKA patients 5.4 days to achieve an uninterrupted walking distance of at least 150 m, while it took UTKA patients 4.1 days (p < 0.001). Mean time to walking a flight of stairs was 6.3 days for SBTKA patients and 4.7 days for UTKA patients (p < 0.001). 90° flexion was achieved after 4.1 days by SBTKA patients and 3.5 days by UTKA patients (p = 0.241). The vast majority of SBTKA patients were able to achieve functional discharge criteria within their inpatient stay when allowed about 30% extra time. Therefore, functional discharge criteria in ERAS protocols designed for UTKA can be considered appropriate for SBTKA patients. Therapeutic Level III. [ABSTRACT FROM AUTHOR]

Fractures of the mandibular condyle account for a significant proportion of mandibular fractures. The specific functional loads require particular specifications for the implant design used for open reduction and internal fixation of such fractures. The clinical and radiographic outcomes in patients treated using a single rhombic 3D condylar fracture plate for open reduction and internal fixation at a single institution, and who fulfilled the inclusion and exclusion criteria, are presented. The primary outcome variables were: occlusion, maximum interincisal distance and mandibular excursion at 1, 3, and 6 months postoperatively, and radiographic measurements for mandibular height and gonion angle. In total, 263 patients were included, of whom 173 (65.8%) were male and 90 (34.2%) female. The mean age was 40.4 ± 18.9 years. There was satisfactory occlusion in 98.9% of patients at the 6-month follow-up, and a significant improvement in all parameters for mandibular excursion (p < 0.001), with a reduced ramus height and an increase in the gonion angle on the fractured side. Excellent clinical and radiographic results were achieved using the rhombic-shaped implant, deeming it appropriate for the osteosynthesis of mandibular condyle fractures. [ABSTRACT FROM AUTHOR]