bluuebunny/crossref_metadata_2025 huggingface dataset:
Meningiomas after Radiotherapy for Tinea Capitis - Still No History
Authors: Pollak Lea , Walach Natalio , Gur Ruth , Schiffer Juana
Published: April 2018

Aims and background

To review the clinical, radiological and histological findings of 19 patients with radiation-induced intracranial meningiomas treated at our neurosurgical department between 1981 and 1996.

Method

The records of 18 patients with intracranial meningiomas who underwent low-dose radiation for tinea capitis in childhood, and of one patient irradiated for pituitary adenoma, were analyzed in respect of the previously reported features of postradiation meningiomas.

Results

The mean age of the patients with low-dose radiation-induced meningiomas was 58 years and the mean shortest onset latency was 48 years. The male to female ratio was 1.1:1. Forty-seven percent of patients presented with mental changes and/or focal neurological signs, 21% with signs of increased intracranial pressure and 26% with seizures. Calvarial location of the meningiomas was found in 54% of patients and in one patient the tumor arose from the skull base. Multiple tumors were present in 15% of patients and 29% of the meningiomas displayed malignant features on histological examination. A significantly lower meningioma recurrence rate was found in our series compared to the recurrence rate in the reported series of postradiation meningiomas. Five patients had a history of a second neoplasm other than meningioma.

Conclusion

Our series of low-dose radiation-induced meningiomas represents one of the largest of its kind in the English literature. The patients did not differ substantially in sex ratio, tumor localization, multiplicity and histological features from the previously reported postradiation meningioma patients, except for the significantly lower tumor recurrence rate. It would seem that over the next years we will be further witnessing the deleterious effects of low-dose radiation administered in childhood.
Gastrointestinal Stromal Tumors: A “Benign” Tumor with Hepatic Metastasis after 11 Years
Authors: Ballarini Carlo , Intra Mattia , Ceretti Andrea Pisani , Prestipino Francesco , Bianchi Filippo Maria , Sparacio Francesca , Berti Elisabetta , Perrone Silvia , Silva Franco
Published: April 2018

Gastrointestinal stromal tumors (GIST) constitue the largest category of primary non-epithelial neoplasms of the stomach and small bowel. They are characterized by a remarkable cellular variability and their malignant potential is sometimes difficult to predict. Very recent studies, using mitotic count and tumor size as the best determinants of biological behavior, divide GISTs into three groups: benign, borderline and malignant tumors. We report on a male patient who underwent a right hepatectomy for a large metastasis 11 years after the surgical treatment of an antral-pyloric gastric neoplasm, histologically defined as leiomyoblastoma and with clinical, morphological and immunohistochemical features of benignity (low mitotic count, tumor size < 5 cm, low cellular proliferation index). Histological and immunohistochemical analysis of the hepatic metastasis showed the cellular proliferation index (Ki-67) to be positive in 25% of neoplastic cells, as opposed to the primary gastric tumor in which Ki-67 was positive in only 5% of neoplastic cells. In conclusion, although modern immunohistochemical techniques are now available to obtain useful prognostic information, the malignant potential of GISTs is sometimes difficult to predict: neoplasms clinically and histologically defined as benign could metastasize a long time after oncologically correct surgical treatment. Therefore, benign GISTs also require consistent, long-term follow-up.
Continuing Medical Education in Radiation Oncology
Authors: Emiliani Ermanno
Published: April 2018

Continuing medical education (CME) has always been considered very important in modern medical practice. Physicians should not be left completly free to continuously educate themselves, but they should receive at least a minimal level of education accreditated by scientific and/or Government Institutions. The main goal of CME is to improve the quality of medical practice. In order to adequately define programs and contents of CME in radiation oncology, we must first identify the professional profile of the radiation oncologist: he is a physician engaged in the clinical practice of oncology, and in particular in the loco-regional cure of cancer by sophisticated technologies; he has the responsibility of diagnosis, treatment, follow-up and supportive care of cancer patients, collaborating within a multidisciplinary approach with the radiologist, the medical oncologist, the surgeon and the medical physicist. The european core curriculum in radiotherapy and the procedures employed in the daily practice could be models to develop postgraduate teaching and CME for the radiation oncologists in Italy. In fact, many countries, such as the USA, France, Belgium and the United Kingdom, have already developed accreditated programs of CME. Unfortunately, Italy still lacks this type of program. What is mostly needed to implement CME activities is a close cooperation between representatives of radiation oncology associations and Government Institutions to define laws, programs, an Accreditation Council, a minimum of formative credits, accreditated categories of education regulating CME, as well as the resources devoted to it.
Introducing Quality Assurance in Radiotherapy
Authors: Vitale Vito , Buconte Gerolama , Foppiano Franca , Franzone Paola , Guenzi Marina , Guglielmini Chiara , Maione Marina , Paoli Gabriella
Published: April 2018

Introducing a Quality Assurance methodology appears particularly useful in Radiation Oncology due to the complexity of the procedures involved and the heterogeneity of the standards adopted, if any, in the great majority of the Centers. There are two possible ways of evaluating quality in the Health Environment: a formal, Institutional certification, or a voluntary one obtained through a mechanism of peer review. The European Society for Therapeutic Radiology and Oncology (ESTRO) started in 1994 with the publication of a methodological Report intended to be adopted by the individual national Societies, and this paper is an invitation to do it.
Altered Fractionation in Radiotherapy
Authors: Valdagni Riccardo
Published: April 2018

Differences between late-responding (slowly proliferating) normal tissues and early-responding (rapidly proliferating) normal tissues and tumor cells and the event of tumor cell repopulation occurring during treatment have essentially led to the development of altered fractionation schemes. Altered fractionation regimens mainly refer to schedules utilising two or more (small dose) fractions per day for part of or for the entire treatment course. It must be underlined that a true standard or conventional fractionation regimen does not exist: no schedule is universally recognised as the standard of reference to be compared with. However, continental European and U.S. conventional regimens are the considered control arm with which the new experimental regimens have to be compared. For this reason they are generally recognised as the standards. The basic rationale for hyperfractionated or accelerated regimens respectively lies in the possibility (a) to deliver higher total doses reducing late-responding normal tissue damage, (b) to deliver total doses in a reduced overall treatment time to defeat tumor clonogen repopulation. Multiple fractions per day should not be delivered with interfraction intervals smaller than 6 hours. Clinical results of phase I-II and limited but convincing phase III randomised trials suggest that a therapeutic benefit can be achieved with new altered regimens.
Radiotherapy Combined with Other Treatments in Rectal Cancer
Authors: Valentini Vincenzo
Published: April 2018

Since the first reports in the late 1950's, a large amount of data have been collected. The analysis of the main evidence from the major randomized trials will be analyzed in this paper according to preoperative, postoperative and chemoradiation approaches. Fifteen randomized preoperative trials were reported; they have been grouped according to the fractionation schedule. In the hypofractionation group (5 Gy for fraction), all five studies that delivered 3-5 doses in one week had a significant improvement in local control and one of them also showed improvement in survival. Operative mortality was higher in the radiotherapy arm if inadequate techniques had been applied. In 3 out of 8 studies with conventional fractionation there was a significant improvement in local control, but no impact in survival was detected. No studies with total dose lower than 34 Gy had an improvement in local control. None of the six randomized postoperative studies showed an improvement in local control or survival. In all trials the local control rate was uniform; ranging from 76% to 84%. Toxicity was higher in the radiotherapy arm. One preoperative and five postoperative randomized studies that used chemoradiation were analyzed. One postoperative chemoradiation study showed a significant improvement in survival in comparison to the surgery arm, and another showed the same advantage compared to the postoperative arm. Protracted infusional administration of 5FU concomitant to radiotherapy showed better survival than bolus administration. No advantages were shown in using MeCCNU or Levamisole in two studies. Toxicity was high and related to the dose and the modality of administration of the drugs in order to adequately treat the different stages of rectal cancer, patients must be carefully selected in order to prescribe the most effective and the least toxic treatment for the individual stage; organ preservation should be an essential goal for its impact on quality of life, and the cost estimates should be taken into account.
Radio-Chemotherapy of Vulvar Cancer
Authors: Zucali Roberto , Raspagliesi Francesco , Kenda Rado , Lozza Laura , Tana Silvia , Valvo Francesca
Published: April 2018

Surgery alone, more or less demolitive, is the treatment of choice of vulvar cancers. Cure rates are high for early cancers only, while locally advanced tumors with or without inguinal adenopathies and recurrences have a bad prognosis. The excellent results of concurrent chemo-radiotherapy of anal cancers suggested to adopt the same approach for locally advanced vulvar cancers. The shrinkage of the tumor allowed surgery, often less demolitive than usual, and the pathological examination demonstrated an overall complete response in 40% of cases. Survival has been improved through this multidisciplinary approach. Patients not suitable for surgery obtained important remissions and an improved quality of life. Clinical experience at the Istituto Tumori of Milano is presented.
The Evolving Role of Radiation Therapy in the Optimal Multimodality Treatment of Childhood Cancer
Authors: Lombardi Fabrizio , Navarria Pierina , Gandola Lorenza
Published: April 2018

Childhood cancer is rare, representing only 1% of the total cancer problem. Of children diagnosed with cancer today, more than 70% are predicted to be long-term survivors. Essentially all pediatric cancers are treated by interdigitating radiation with surgical resection and systemic chemotherapy. The use of irradiation, important to achieve high rates of disease local control, must be always balanced against late effects specifically related to this treatment modality, principally growth retardation and second tumors induction. Using neuroblastoma, Wilms’ tumor and rhabdomyosarcoma as examples, the advances in the optimal multimodality treatment of childhood cancer and the evolution of the role of radiation therapy are discussed.
Recent Aspects in the Diagnosis and Prognosis of Bladder Cancer
Authors: Kontogeorgos George , Aninos Dionissios
Published: April 2018

Epidemiologic studies have stated the progressive increase of bladder tumors during the last decades. The aim of our review is to refer to factors implicated in bladder carcinogenesis (such as activated oncogenes, growth factors and chromosomal aberrations) and to resistance to drug uptake (i.e., multidrug resistance gene and P-glycoprotein). The review also provides information of diagnostic and prognostic significance, based on DNA analysis of transitional cancer cells. In addition to cytometric data, alternative counterings for estimation of the S-phase fraction, useful in indicating the biologic behavior of bladder cancer, are presented. Knowledge of such mechanisms results in a better approach to the diagnosis, prognosis and prevention of bladder carcinomas, especially those that do not respond to systemic intravesical chemotherapy. We have tried to mention all significant factors related to the development of bladder cancer. We conclude that the progress made in understanding the pathogenesis of bladder cancer has been significant. However, more studies are needed in order to introduce and adopt reliable criteria to accurately predict the clinical behavior.
Hospital-at-Home for Advanced Cancer Patients within the Framework of the Bologna Eubiosia Project: An Evaluation
Authors: Tanneberger Stephan , Pennuti Franco , Mirri Rossana , Panetta Achille , Mariano Paolo , Romano Domenico , Giordani Stefano , Martoni Andrea , Farabegoli Gildino
Published: April 2018

Aims and background

An evaluation of the Bologna Hospital-at-Home (BHH) was undertaken to examine the following aspects: 1) median daily costs of the BHH; 2) delivery of medical services; 3) patient satisfaction with the care received and frequency of requests for transfer to the alternative setting. Delivery of services and patient's satisfaction in the BHH were compared with data collected for a traditional hospital (Ospedale Sant'Orsola Malpighi, Bologna - OSM).

Methods

Our analysis was performed as a cost analysis considering two periods of time in 1992 and 1993/94. Included were direct and indirect costs; no intangible costs were found. The patient's perspective was selected for the analysis. The observational study examining delivery of service and quality of life of patients admitted to the two care settings, BHH and OSM, considered patient's clinical history and an interview conducted by the evaluation team 6 weeks after admission to either facility. Data included patient's characteristics, quantity of diagnostic and therapeutic measures, circumstances of life, satisfaction with the care received, and intention for transfer to the alternative setting of nursing. The statistical significance of our assumption of comparable care intensity and better patient quality of life in the BHH was tested by the Pearson Chi-square test.

Results

A survey was carried out of 236 patients treated in the BHH or the OSM. The setting of assistance did not influence the provision of services. The time of “talking to the doctor” was notably higher for BHH than for OSM patients. The analysis of satisfaction showed that 98% of the surveyed BHH patients believed it matched the actual needs. The quality of life was considered to be reduced/bad in 67% of the OSM patients but in only 51% of BHH patients. An opinion was also requested with regard to transfer to the alternative setting of nursing: 47% of OSM patients judged BHH care would be better than traditional hospital. The median daily costs in BHH reached 118,789 Lire (range, 108,569-129,027 Lire, depending on performance status).

Conclusions

Although the economic advantage of hospital-at-home care certainly is important, we would like to stress that better quality and dignity of life should be the main point supporting the idea of hospital-at-home care.
Progression from Nodular to Lymphangitic Subcutaneous Metastasis from Clear Cell Endometrial Carcinoma: Ct Findings
Authors: La Fianza Alfredo , Preda Lorenzo , Di Maggio Enrico Maria , Pedrazzoli Paolo , Tateo Saverio , Campani Rodolfo
Published: April 2018

Subcutaneous metastases from clear cell endometrial carcinoma are an uncommon event and tumor implantations are rarely found with diagnostic imaging techniques. The nodular form is the most frequent type of subcutaneous metastasis from genital system tumors, even though plaque-like and infiltrative forms have also been reported. We report the first case of subcutaneous metastasis from clear cell endometrial carcinoma whose progression from the early nodular to the lymphangitic infiltrative form was studied with computed tomography (CT). Differential diagnostic problems are discussed.
5-FLUOROURACILE E TUMORI DEL COLON-RETTO: IMPIEGO NELLA PRATICA CLINICA E PROGETTO “MISURA”
Authors: Labianca Roberto , Poletti Paola
Published: April 2018

5-fluorouracil, an antimetabolite inhibiting timidilate synthetase, is one of the most used drugs in the treatment of many solid tumor types. In particular it is still central in the treatment of colorectal cancer. Nevertheless 5-FU efficency is limited, this is due to the rapidity of its metabolism (T1/2 10 min). Many attempts have been done to increase its efficency: 1) combinations with other antitumor drugs have been tested, but no one showed improved response rates with respect to 5-FU alone; 2) use of biological modifiers such as folinic acid and methotrexate. They interact with the biological actions of 5-FU improving its therapeutic effects. These combinations appear to be more effective than 5-FU alone; 3) continuous infusion increases the percentage of susceptible tumor cells, it makes possible the use of a high intensity dose which is active in patients resistant to 5-FU administered as bolus-injection.

There are many schedules and methods of administration of 5-FU in the treatment of CRC, each of them showing different types of toxicities. This explains why there is the need to obtain a profile of 5-FU in clinical practice.

The project called MISURA is thought to give us this kind of information. It will be a collection of data regarding patients affected by colorectal cancer and treated with 5-FU. The collected information will be about diagnosis; ways of use, schedules, doses and tolerability of the drug; obtained responses. The aims of the study are: 1) to evaluate the use of 5-FU in clinical practice; 2) to collect data about the use of supportive therapy; 3) to know the effective incidence and prevalence of CRC in Italy. The study is retrospective, the sample consists of all patients from the oncological departments chosen to represent the national territory. The analysis of the data will be descriptive.
Ultrasound-Guided Fine-Needle Aspiration Biopsy for Breast Tumors: Needle Guide versus Freehand Technique
Authors: Hatada Takuya , Ishii Hiromitsu , Ichii Shigetoshi , Okada Kaoru , Yamamura Takehira
Published: April 2018

Background

We retrospectively studied whether a needle guide is necessary when performing ultrasound-guided fine-needle aspiration biopsy (US-FNAB) in patients with breast tumors.

Methods

A total of 47 patients (50 lesions) with breast tumors underwent US-FNAB with a needle guide and 127 patients (143 lesions) underwent the procedure without a needle guide (freehand biopsy). The diagnoses obtained by US-FNAB were compared with the surgical findings.

Results

The sensitivity of freehand biopsy for tumors <3 cm in diameter was significantly higher than that of the needle guide technique.

Conclusions

We recommend performing US-FNAB without a needle guide (freehand biopsy) in order to maximize the correct preoperative diagnosis rate, especially in patients with tumors <3 cm in diameter.
Pitfalls in Frozen Section Interpretation: A Retrospective Study of Palpable Breast Tumors
Authors: Cserni Gábor
Published: April 2018

Aims and background

The use of frozen sections for purposes of diagnosis is recognized to involve a degree of uncertainty. A retrospective study of breast specimen frozen section diagnoses was undertaken in order to analyse the major pitfalls.

Methods

Hard copy files from our archives relating to symptomatic (palpable) breast specimens obtained between 1983 and 1996 were reviewed.

Results

The review revealed 23 errors among the diagnoses on 2110 frozen specimens. Twenty-two of them were false-negative and 1 (a case of multiple intraductal papillomatosis with atypical ductal hyperplasia) was false-positive for malignancy. The factors contributing to the pitfalls were: 1) misinterpretation; 2) poor quality of the frozen sections (artifacts making the diagnosis difficult); 3) sampling errors during sectioning; 4) ignorance of the macroscopic features; 5) lesions difficult to interpret; 6) ductal carcinoma in situ as the only lesion in the specimen; and 7) sections not deep enough. Several of the factors sometimes occurred simultaneously.

Conclusions

Although the number of errors is relatively low, more stress should be placed on the preoperative diagnosis of breast lesions. Breast surgery frozen section should be used as rarely as possible for diagnostic purposes, despite the generally good diagnostic accuracy. However, it is reasonable to use frozen sections widely until the given preoperative diagnostic tools allow an appropriate preoperative workup, because it is the only way to keep histopathologists trained to interpret frozen sections.
Serum-Soluble E-Cadherin Fragments in Lung Cancer
Authors: Cioffi Michele , Gazzerro Patrizia , Di Finizio Bruno , Vietri Maria Teresa , Di Macchia Catia , Puca Giovanni Alfredo , Molinari Anna Maria
Published: April 2018

Aims and background

E-cadherin, also known as uvomorulin or cell-CAM 120/80, is one of the subclasses of cadherins, CA2+-dependent cell adhesion molecules. Several recent studies have suggested that loss of E-cadherin may be associated with tumor progression, such as in lung, gastric, hepatocellular, breast and prostatic carcinoma. Assessment of E-cadherin serum levels in lung cancer showed a relation to histologic type.

Methods and study design

Using an enzyme immunoassay, we determined E-cadherin serum levels in 79 patients affected with lung cancer (stage l–IV), 9 patients with breast cancer, 23 patients with different benign diseases, and 20 healthy patients.

Results

At a specificity level of 90%, E-cadherin diagnostic sensitivity was 66.6%, 47.6% and 43.7% in patients affected with squamous cell carcinoma, small cell carcinoma and adenocarcinoma, respectively.

Conclusions

Preliminary results suggest the use of serum E-cadherin as a prospective tumor marker.
Neutropenia following Perioperative Intraperitoneal Chemotherapy
Authors: Schnake Klaus J. , Sugarbaker Paul H. , Yoo Dal
Published: April 2018

Introduction

The purpose of this retrospective report was to evaluate clinical features associated with profound neutropenia in patients with peritoneal carcinomatosis who were treated with heated intraoperative intraperitoneal chemotherapy (HIIC) followed by early postoperative intraperitoneal chemotherapy (EPIC). Common clinical denominators for significant neutropenia were analyzed.

Materials and Methods

A retrospective study of all available clinical data of six patients with postoperative neutropenia out of a total of 242 was undertaken. All patients underwent cytoreductive surgery, HIIC with mitomycin C (n = 4) or cisplatin (n = 1) and EPIC with 5-fluorouracil (5-FU) for 4 (n = 1) or 5 (n = 5) days.

Results

All six patients presented with hematologic toxicity of WHO criteria grade 4; four of them died postoperatively. Two of the patients who died, and one who did not die, developed bowel perforations. Five patients had prior chemotherapy with 5-FU; three of them had toxic side effects. All patients were overweight, and three patients were anemic preoperatively. The neutropenia presented with fever, leukopenia and thrombocytopenia on postoperative days 10–15. The leukocyte count courses showed a pattern suggesting the 5-FU as the cause of leukopenia. There was no consistent warning signal for predicting severe neutropenia.

Discussion

Neutropenia following cytoreductive surgery combined with HIIC and EPIC has a high mortality (66%). Patients who are at special risk and should have a dose reduction include patients who had toxicities from prior chemotherapy, who present with obesity and anemia. The groups have an increased risk of developing postoperative profound neutropenia. This condition can result in a prohibitively high mortality and morbidity rate. Therefore, reduced doses of chemotherapy in selected patients are necessary to prevent this condition from developing.
Mitoxantrone, L-Leucovorin and 5-Fluorouracil: An Effective and Well Tolerated First-Line Treatment for Advanced Breast Cancer
Authors: Lorusso Vito , Mancarella Sergio , Catino Annamaria , Brandi Mario , Paradiso Angelo , Latorre Agnese , Mastria Antonella , De Mitrio Alessandra , Guida Michele , De Lena Mario
Published: April 2018

Aims and background

The combination of mitoxantrone plus leucovorin/fluorouracil in heavily pretreated patients with advanced breast cancer has shown significant activity and extremely good tolerability. The aim of this study was to evaluate the activity of this combination in patients not previously submitted to chemotherapy.

Methods

From May 1993 to December 1995 we treated 80 patients with advanced breast cancer with a combination of mitoxantrone, l-leucovorin and 5-fluorouracil. All patients had histologically or cytologically proven breast cancer, WHO performance status 0–3, normal hematological parameters and normal serum bilirubin. Prior chemotherapy for metastatic disease was not allowed, whereas adjuvant CMF (cyclophosphamide, methotrexate and 5-fluorouracil) or adjuvant anthracycline (doxorubicin or epirubicin) therapy was allowed; a single prior hormone treatment was permitted. Chemotherapy consisted of mitoxantrone 12 mg/m2 i.v. day 1, l-leucovorin 150 mg/m2 i.v. days 1, 2 and 3 and 5-fluorouracil 350 mg/m2 i.v. days 1, 2 and 3. The courses were repeated every 3 weeks.

Results

Objective response (CR + PR) was observed in 46/80 (57%) patients (95% CI, 46%–68%). Complete response (CR) was observed in 21/80 cases (26%). Response was observed in 14/24 (58%) patients with soft tissues as the dominant site of disease, in 22/34 (65%) patients with visceral involvement and in 10/22 (45%) of those with bone as the dominant site of disease. The median duration of response and survival was 9 months (range, 3–16) and 22 months (range, 2–48+), respectively. Toxicity was very manageable, with grade 4 leukopenia and thrombocytopenia in 6/80 (7.5%) and 1/80 (1.25%) patients, respectively, and negligible non-hematological toxicity.

Conclusions

The combination of mitoxantrone, 5-fluorouracil and high-dose l-leucovorin is a safe and effective regimen for first-line treatment of advanced breast cancer.
Orbital Pseudotumor: Case Report and Literature Review
Authors: Zurlo Alfredo , Sancesario Giuseppe , Bernardi Giorgio , Loasses Armando
Published: April 2018

The term orbital pseudotumor refers to a broad category of non-specific idiopathic inflammations of the orbit. This disease, which may affect any orbital structure, is one of the commonest causes of exophtalmus, occurring with a similar incidence in both sexes. The diagnosis is based on a combination of clinical, radiological and histopathological findings, after careful exclusion of specific systemic and local diseases. Many classification systems have been proposed and a range of therapeutic modalities, including surgery, steroids, immunosuppressive agents, and radiation therapy, have been employed by various authors in heterogeneous series of patients. This slowly proliferating disease, which usually presents with a long clinical history and high variability in clinical manifestations and prognosis, is difficult to manage with any of the available therapeutic options. The difficulties and controversies regarding the diagnostic and therapeutic management of these patients are addressed in an updated review of the literature and exemplified in our case report.
Actinomycin D Revisited in Testicular Cancer. A Case Report
Authors: Srinivas Sandy , Freiha Fuad S.
Published: April 2018

Background

Between 20–30% of patients with advanced germ cell tumors relapse or fail to achieve a complete response to conventional cisplatin based chemotherapy. Ifosphamide has been used very effectively in combination with cisplatin and etoposide (VIP) or in combination with cisplatin and vinblastine (VeIP). Actinomycin D with chlorambucil and methotrexate was widely used in the 1960s with complete responses in 20% of patients and long term survival of 6–10%. There exists no information on the use of actinomycin as a salvage in cisplatin refractory patients.

Methods and Results

One patient with metastatic germ cell tumor who failed chemotherapy with cisplatin and ifosphamide was successfully treated with an actinomycin D based regimen.

Conclusions

Actinomycin D is an active agent in testicular cancer and maybe used in patients refractory to platinum.
Exeunt Omnes? Survival, Pessimism and Time in the Work of John H. Herz
Authors: Stevens Tim
Published: April 2018

John H. Herz (1908-2005) is better known for his theorisation of the security dilemma than for his conviction that human survival is threatened by the conditions of late modernity. This article explores extinction and survival in his work to interrogate his persistent characterisation as an incorrigible pessimist. In his preoccupation with extinction, Herz would seem a first-rank pessimist, but his intellectual commitments belie this easy categorisation. Specifically, his appeals to interdisciplinary ‘survival research’ suggest a qualified pessimism that does not foreclose on the potential of humankind to overcome structural, political and normative obstacles. This is consistent with current understandings of pessimism within the broader realist tradition. Herz expressed an ‘open’ and ‘linear’ temporality that challenges cyclical and linear-progressive temporalities inherent to realism and liberalism, respectively. Herz articulates, therefore, a ‘productive pessimism’ that charts a different path for pessimist thought beyond its pejorative connotations. This article contributes to the literature on classical realism, to a growing interest in Herz’s intellectual legacy, and to the developing appreciation of time and temporality in International Relations theory and practice. It also provides a foundation for rethinking our assumptions about pessimism and international politics.
Age of Cannabis Use Onset and Adult Drug Abuse Symptoms: A Prospective Study of Common Risk Factors and Indirect Effects
Authors: Rioux Charlie , Castellanos-Ryan Natalie , Parent Sophie , Vitaro Frank , Tremblay Richard Ernest , Séguin Jean Richard
Published: April 2018

The present study examined 1) whether the associations between cannabis use (CU) age of onset and drug abuse by 28 y remain when controlling for risk factors in childhood, adolescence and early adulthood; and 2) the developmental pathways from early risk factors to drug abuse problems. Participants from a longitudinal sample of boys of low socioeconomic status ( N = 1,030) were followed from 6 to 28 y. We examined the self-reported CU onset between the ages of 13 and 17 y and drug abuse symptoms by 28 y. The odds of developing any drug abuse symptoms by 28 y were reduced by 31% for each year of delayed CU onset (OR = 0.69). Cannabis, alcohol and other drug frequency at 17 y mediated this association. Still, even when taking that frequency of use into account, adolescents who started using cannabis before 15 y were at a higher risk of developing drug abuse symptoms by age 28 y. Significant indirect effects were found from early adolescent delinquency and affiliation with deviant friends to drug abuse symptoms at 28 y through CU age of onset and substance use frequency at 17 y. The results suggest more clearly than before that prevention programs should aim at delaying CU onset to prevent or reduce drug abuse in adulthood. Furthermore, prevention programs targeting delinquency and/or affiliation with deviant friends in childhood or early adolescence could indirectly reduce substance abuse in adulthood without addressing substance use specifically.
The plight of indigenous peoples within the context of conflict mediation, peace talks and human rights in Mindanao, the Philippines
Authors: Candelaria Sedfrey M.
Published: April 2018

Republic Act 8371 or the Indigenous Peoples’ Rights Act of 1997 (IPRA) was passed by the Philippine Congress in order to address the concerns of the indigenous communities which had received marginal attention through the past decades. Indigenous communities have also been displaced from their lands due to armed conflicts between government soldiers and secessionist groups, particularly the Moro rebels and the communist-led New Peoples’ Army. The Philippines has been privy to peace initiatives with these two groups for some time now. Political circumstances, however, and legal impediments have periodically stalled the peace processes. It is the author’s intention to focus on the predicament of indigenous communities as they seek a strategic role in shaping the content of peace agreements being negotiated by the Philippine government with the rebel groups. How have the indigenous communities made an impression on the two peace processes through the years? And, have the indigenous peoples’ rights been sufficiently protected in the context of the peace agreements? The author will draw from his own insights on the peace processes and agreements which have been negotiated and even tested before the Supreme Court of the Philippines.
Retrospective Evaluation of Changes in Gait Patterns in Children and Adolescents With Cerebral Palsy After Multilevel Surgery
Authors: Steppacher Ramona , North David , Künzle Christoph , Lengnick Harald , Klima Harry , Mündermann Annegret , Wegener Regina
Published: April 2018

The purpose of this study was to retrospectively investigate changes in gait patterns after single-event multilevel surgery in children and adolescents with bilateral cerebral palsy. Three-dimensional instrumented pre- and postoperative gait data of 12 patients were compared to data of 12 healthy control subjects using principal component analysis to reduce the dimensionality of kinematic and kinetic gait data and detect gait differences. The differences between pre- and postoperative data and between postoperative data and data of control subjects were calculated using a linear mixed model. The results revealed 14 significant effects for pre- and postoperative waveforms and 11 significant effects for postoperative and control waveforms. Patients after single-event multilevel surgery walked with smaller internal foot progression angle throughout the gait cycle, lower knee flexion at initial swing, and earlier knee extension during terminal swing. Retained gait deviations included excessive pelvic tilt and internally rotated and flexed hips over the entire gait cycle. Contrary to our hypothesis, postoperative waveforms in the sagittal plane differed more from control waveforms than from preoperative waveforms. These results emphasize the importance of carefully planning further conservative therapy 2 years after single-event multilevel surgery.
Cryomilled zinc sulfide: A prophylactic for Staphylococcus aureus-infected wounds
Authors: Tran Phat L , Li Jianqiang , Lungaro Lisa , Ramesh Srikanthan , Ivanov Ilia N , Moon Ji-Won , Graham David E , Hamood Abdul , Wang James , Elfick Alistair PD , Rivero Iris V
Published: April 2018

Bacterial pathogens that colonize wounds form biofilms, which protect the bacteria from the effect of host immune response and antibiotics. This study examined the effectiveness of newly synthesized zinc sulfide in inhibiting biofilm development by Staphylococcus aureus ( S. aureus) strains. Zinc sulfide (ZnS) was anaerobically biosynthesized to produce CompA, which was further processed by cryomilling to maximize the antibacterial properties to produce CompB. The effect of the two compounds on the S. aureus strain AH133 was compared using zone of inhibition assay. The compounds were formulated in a polyethylene glycol cream. We compared the effect of the two compounds on biofilm development by AH133 and two methicillin-resistant S. aureus clinical isolates using the in vitro model of wound infection. Zone of inhibition assay revealed that CompB is more effective than CompA. At 15 mg/application, the formulated cream of either compound inhibited biofilm development by AH133, which was confirmed using confocal laser scanning microscopy. At 20 mg/application, CompB inhibited biofilm development by the two methicillin-resistant S. aureus clinical isolates. To further validate the effectiveness of CompB, mice were treated using the murine model of wound infection. Colony forming cell assay and in vivo live imaging results strongly suggested the inhibition of S. aureus growth.
Evaluation of the computer simulation model NTVPM for assessing military tracked vehicle cross-country mobility
Authors: Wong Jo Y , Jayakumar Paramsothy , Preston-Thomas Jon
Published: April 2018

In the United States and some other NATO (North Atlantic Treaty Organization) countries, the NATO Reference Mobility Model is currently used to evaluate military ground vehicle mobility. The module of the NATO Reference Mobility Model for predicting the cross-country performance of military vehicles is empirically based and was developed using test data collected decades ago. The NATO Reference Mobility Model has inherent limitations, such as the uncertainty whether its empirical relations can be extrapolated beyond the test conditions upon which they were derived or whether it can be used for evaluating new-generation military vehicles. This suggests that there is a need for the development of a physics-based model that takes into account the advancements in terramechanics and modelling/simulation techniques. This paper describes the results of a detailed evaluation of a physics-based model – the Nepean Tracked Vehicle Performance Model – for assessing military tracked vehicle cross-country performance. The performance of a notional tracked vehicle (an armoured personnel carrier) predicted by the latest version of the Nepean Tracked Vehicle Performance Model is compared with test data obtained on sandy terrain, muskeg and snow-covered terrain. The correlations between the predicted and measured performance are evaluated using the coefficient of correlation, coefficient of determination, root mean square deviation and coefficient of variation. The applications of the Nepean Tracked Vehicle Performance Model to predicting the maximum possible vehicle speed (speed-made-good) on a given terrain, the sensitivity of vehicle performance to variations in the values of terrain parameters and the mean maximum pressure are demonstrated. The results of this study indicate that the Nepean Tracked Vehicle Performance Model has potential to form the basis for the development of the next-generation cross-country performance assessment methodology for military tracked vehicles.
Minimum time overtaking problem of vehicle handling inverse dynamics based on interval mathematics
Authors: Zhao Youqun , Zhang Wenxin , Zhang Xinglong , Lin Fen
Published: April 2018

To analyze the influence of uncertain factors on minimum time overtaking, interval mathematics is used to describe the uncertainties, and the overtaking safety distance is calculated using interval analysis method. In addition, vehicle handling inverse dynamics is proposed in this paper. In this method, the driver-handling input can be obtained without the modeling of driver. The optimal control problem is first converted into a nonlinear programming problem based on Gauss pseudospectral method. Then sequential quadratic programming is applied to get the solution. The simulation results show that the overtaking behavior will be significantly different, if the drivers’ age groups or vehicles’ braking system parameters are different. Besides, the influence of different drivers’ estimate time is critical. The subjective judgments of the drivers are considered in this paper to realize the user-friendly design. This method may provide a reference for the research of unmanned vehicles and driving assistance system.
Numerical investigation of the split sliding guide vane for a variable nozzle turbine
Authors: Yang Dengfeng , Yang Ce , Hu Leon , Yi J James , Curtis Eric , Wooldridge Margaret S
Published: April 2018

The “swing” type guide vane has been widely used to control flow capacity in variable nozzle turbines. One disadvantage of these variable nozzle turbines is the drastic drop in stage efficiency that is caused by nozzle leakage flow when the engine operates at “low-end” conditions. In the present work, a novel split sliding guide vane has been proposed to improve turbine stage performance by mitigating the nozzle leakage flow. The design idea, geometry structure, and actuating method of split sliding guide vane are described in detail. A series of steady numerical simulations were performed on both baseline and split sliding guide vane turbines to verify the effectiveness of the split sliding guide vane, at three representative nozzle openings. Simulation results indicate that split sliding guide vane can effectively improve turbine peak efficiency up to 8% at 6% nozzle opening. In addition, unsteady simulations were also carried out to investigate the interaction between rotor and nozzle, and the aerodynamic loading fluctuations on rotor blades were compared between split sliding guide vane and base model.
Study on the order target of the sporty sound quality of the vehicle exhaust noise under acceleration
Authors: Yan Fuwu , Xiao Shenghao , Liu Zhien , Du Songze , Lu Chihua
Published: April 2018

Correlational studies of order noise sample tuning and subjective evaluation test of sound quality were conducted to achieve sporty sound quality and confirm the correlation between the auditory sense (subjective) and the order noise level (objective) of vehicle exhaust noise under acceleration. First, the frequency range and the order ingredient of sporty quality noise were confirmed by a study of ear-hearing subjective feeling on the basis of physiological acoustics. By using an order tuning software that was developed independently, the second, fourth, and sixth order noise A-weighting sound pressure level (dB(A)) of the exhaust noise of an objective vehicle were tuned segmentally into numerous sound samples. Furthermore, samples with high sporty sound quality were selected through subjective evaluation, and the A-weighting sound pressure level (dB(A)) distributions of the second, fourth, and sixth order noise of these samples were analyzed. Consequently, the relative size relations of the second, fourth, and sixth order noise of all the exhaust noise with sporty sound quality were determined. In addition, the curve distribution zones of the corresponding order noise were formed and the order quantitative target of the sporty sound quality was considered. Finally, four passenger vehicles with representative sound qualities (sporty, quiet, and characterless) on the market were selected as the benchmark vehicles; their order noise was objectively tested and their sound qualities subjectively evaluated. Meanwhile, the order noise objective test result was compared with the order target. Results showed that when the fourth and sixth order noise curves relative to the second order noise curves were within the order target zones at most of the engine speeds, the exhaust noise of the vehicle had considerable sporty sound quality; otherwise, it did not have such a sound. Therefore, the order target of the sporty sound quality was accurate and effective.
Analysis of the galloping behaviour of an electrified railway overhead contact line using the non-linear finite element method
Authors: Song Yang , Liu Zhigang , Wang Hongrui , Zhang Jing , Lu Xiaobing , Duan Fuchuan
Published: April 2018

Galloping of an electrified railway overhead contact line (also known as catenary galloping) is a large-amplitude wind-induced vibration under extreme conditions that is extremely detrimental to the railway infrastructure. This paper attempts to conduct a numerical simulation of catenary galloping and analyse its galloping behaviour. Computational fluid dynamics is utilized to calculate the aerodynamic coefficients of the contact wire with different classes of wear. The mechanism of catenary galloping is revealed by the Den Hartog theory. To describe the non-linear behaviour of catenary galloping, a non-linear finite element method is employed to establish the catenary model, which properly considers the geometrical non-linearity of the contact/messenger wire and the non-smooth non-linearity of droppers. Considering the effect of fluid-induced vibration, the self-excited forces acting on the contact wire are derived. Through several numerical examples, the galloping responses of the catenary are analysed with different tension classes and stochastic wind. The results demonstrate that the extreme wear of the contact wire caused by the long-term passage of pantograph can change the aerodynamic coefficients of the cross-sections of the contact wire and cause the system’s instability under steady wind load. It is concluded that upgrading the catenary tension class can effectively suppress catenary galloping. The stochastic wind only has small effect on the catenary galloping. The stochastic wind only has small effect on the catenary galloping.
Gesture segmentation and classification using affine speed and energy
Authors: Cifuentes Jenny , Pham Minh Tu , Boulanger Pierre , Moreau Richard , Prieto Flavio
Published: April 2018

The characterization and analysis of hand gestures are challenging tasks with an important number of applications in human–computer interaction, machine vision and control, and medical gesture recognition. Specifically, several researchers have tried to develop objective evaluation methods of surgical skills for medical training. As a result, the adequate selection and extraction of similarities and differences between experts and novices have become an important challenge in this area. In particular, some of these works have shown that human movements performed during surgery can be described as a sequence of constant affine-speed trajectories. In this article, we will show that affine speed can be used to segment medical hand movements and present how the mechanical energy computed in the segment is analyzed to compare surgical skills. The position and orientation of the instrument end effectors are determined by six video photographic cameras. In addition, two laparoscopic instruments are capable of measuring simultaneously the forces and torques applied to the tool. Finally, we will report the results of these experiments and present a correlation between the mechanical energy values, dissipated during a procedure, and the surgical skills.