bluuebunny/crossref_metadata_2025 huggingface dataset:
P14.32 Patterns of invasion in Glioblastoma have unique radiological features, varied response to radiotherapy and long term outcomes
Authors: Uday Krishna A S , Nargund A , Santosh V , Mathew S , Thimmiah N , A A , V L
Published: September 2021

BACKGROUND

To assess the correlation of the three patterns of invasion of Glioblastoma (GB) with the respective MRI features, response to radiotherapy and disease free survival

MATERIAL AND METHODS

Histopathology of 62 patients with Glioblastoma who had undergone maximal safe resection (MSR)/ stereotactic biopsy (STB) & referred for adjuvant therapy was reviewed to assess the pattern of invasion. Three patterns were observed- single cell infiltration (pattern 1), perineuronal satellitosis (pattern 2) and vessel cooption (or perivascular spread, pattern 3), majority also had diffuse infiltration pattern in the background. The pre and post operative MRI scans were utilized for RT planning of 3DCRT/ IMRT/ VMAT, the modality decided by the treating oncologist. RT volumes were as per ESTRO-ACROP guidelines. Duration of radiotherapy- the Stupp regimen or a short course of hypofractionated radiotherapy (HFRT) (35Gy/10Fr- planned gap- completion of total dose) was based on the extent of resection (EOR) and KPS at the time of RT. Correlation of the pattern of invasion, MRI characteristics of each on the response to radiotherapy as assessed by RANO criteria and survival was analysed with the help of SPSS V21.

RESULTS

MRI findings after stratification of 62 patients, median age 43 years(18–70), M:F::42:20) into type 1:17, type 2:21 and type 3:24- patterns of invasion, were cortical tumours (subtle enhancement) close to SVZ, solid (+/- cystic) lesion in the eloquent cortex or large mass effect crossing the barriers respectively. OS of entire cohort at 1 year was 75%, with significant differences among groups (82% vs. 85% vs. 50%). Among pattern 1, those patients with IDH mutant (20%) & mean dose to C/L SVZ of 30Gy or more had longer DFS at 1 year (89% Vs. 38% & 85% vs. 0%, p<0.05). In pattern 2, EOR (gross total or near total resection Vs. only STB) showed a better DFS at 1 year (90% vs. 40%, p=0.095). In patients with pattern 3, 40% had post op KPS of <80 and 20% of them underwent HFRT who showed higher CR/PR rates compared to the conventional RT. HFRT in low KPS with m-MGMT showed higher local control at 6 months (100% Vs. 66%, p= 0.02).

CONCLUSION

Glioblastoma has three patterns of invasion with unique MRI features and aggressiveness for each. Identification of this may guide choice of adjuvant therapy, patterns of failure and therapy resistance
P14.36 Characterising Meningiomas in young patients under 40
Authors: Attia M , Mirkin Y , Hershkovitch R , Cohen Z R , Zibly Z , Zauberman J , Wohl A , Harnof S , Spiegelmann R , Hadani M , Furman O , Zach L
Published: September 2021

BACKGROUND

Meningiomas are the most common primary CNS tumor in adults, with a median age at diagnosis of 65 years and a female to male ratio of 2–3:1 (except in grade II, III meningiomas). Younger patients usually have a genetic background or history of prior radiation exposure. Based on population-level studies, approximately 80–85% of meningiomas are WHO grade I (benign), 15–18% grade II (atypical), and 1–3% grade III (anaplastic). This case series describes a single center experience of the presentation and pathology of meningiomas in patients under the age of 40.

MATERIALS AND METHODS

We reviewed the Sheba Medical Center Neurosurgery and radiotherapy databases containing patients who were operated on for meningioma between the years 2011–2020. Patients under 40 were selected and information from digital medical records was gathered on these patients, including pathology reports, surgical reports, clinical and radiological data, and the use of radiotherapy or medical treatments.

RESULTS

Of 600 patients in the database, 49 patients under 40 (8.3%) were identified and 54 tumors were reviewed (five patients were operated on for multiple meningiomas). 31 patients were female (63%); 2 were under 20 years old, 15 were age 20–29 and 32 were age 30–39 at first presentation. Seven patients had received prior radiation therapy for a childhood malignancy. 28 meningiomas were histology confirmed grade I (52%), 22 were grade II (41%), 2 were grade III (4%), and 2 (4%) were grade undetermined. 22 tumors were located in the skull base (41%) and 32 (59%) in the brain convexity. Of the skull base tumors, 16 were grade I, 5 were grade II, and one was grade III. Of the convexity tumors, 12 were grade I, 16 were grade II, and 2 were grade III. Median follow-up was 35 months, and longest follow-up time was 98 months. Six patients were treated with additional radiotherapy after surgery.

CONCLUSION

Our experience with meningioma patients under 40 revealed a different grade segregation than the older population, with younger patients showing a higher incidence of grade II tumors. These tumors are generally more aggressive, and require careful resection and consideration for post-surgical radiotherapy. Further validation with population based databases is required.
P14.54 Primary central nervous system lymphoma of the spinal cord: a LOC network cohort study
Authors: Valyraki N , Ahle G , Tabouret E , Houot R , Jardin F , Ghesquieres H , Choquet S , Moles M , Hoang-Xuan K , Houillier C
Published: September 2021

BACKGROUND

Primary central nervous system lymphoma (PCNSL) mainly affects the brain (>90% of the cases), Very little data can be found in the literature on PCNSL with spinal cord localization.

MATERIAL AND METHODS

We present a retrospective study based on the French LOC network database. We selected adult immunocompetentpatients, with a histological or cytological diagnosis of PCNSL, and a spinal cord localization at initial diagnosis.

RESULTS

Of the 2043 PCNSLof the LOC database newly diagnosed since 2011, 14 patients (9 men, median age 68, median Karnofsky performance status 50%)met the selection criteria. The median diagnostic delay was 82 days (min 15-max 1080) compared to 35 days in primary cerebral lymphomas. At diagnosis, walking was impossible in 7/14 patients and 5/14 had indwelling urinary catheter. On MRI, 100% had enlargement of the spinal cord with homogeneous contrast enhancement in 13/14 cases. Spinal cord lesions were unique in 9/14 patients and multiples in 5/14 patients. CSF IL10 level was increased in 6/7 patients. Brain lesions were found in 9/14 patients, located in the posterior fossa in 5/9 cases. The diagnosis was made either on a brain biopsy (N=6), a spinal cord biopsy or surgery (N=5) or the cytologic analysis of the CSF (N=3).4/5 patients had neurological sequel after spinal cord biopsy or surgery. All the patients were treated by high-dose methotrexate-based chemotherapy, followed by spinal cord irradiation (N=1) or autograft (N=2). There was an overall response rate of 71% (complete response in 8/14). 8/14 patients relapsed, 5 in the brain, 2 in the spinal cord, and 1 both in the spinal cord and in the brain. 2-year PFS and OS were 45% and 64%, respectively. Among the long-term responders, 50% remained in wheel chair, while only 10% could walk normally.

CONCLUSION

Considering the high risk of a spinal cord biopsy,the rarity of the disease, as well as the numerous differential diagnoses, the diagnosis of spinal cord lymphoma is difficult. Searching for other lymphomatous locations or assaying CSF IL10 may be helpful in this disease where delay in diagnosis is often prolonged et can cause irreversible handicap.
P14.56 Pattern of care of Brain Tumor patients in the last months of life: analysis of a cohort of 3045 patients in the Lazio region in the last 10 years
Authors: Pace A , Belleudi V , Pinarelli L , Villani V , Poggi F , Benincasa D , Davoli M
Published: September 2021

BACKGROUND

The final days of life of Brain Tumor patients (BT) present special challenges and often palliative care approach is underutilyzed. Several studies reported that BT patients in the last months of life receive frequent hospital readmissions and ER accesses as result of bad quality of End of Life care. Early integration of pallative care has been demonstrated to improve quality of care in advanced stage of disease and quality of death in cancer patients. With the aim to evaluate pattern of treatment and the rate of hospital readmission in the last months of life, we retrospectively analyzed a consecutive serie of BT patients discharged after a diagnosis of BT.

MATERIAL AND METHODS

Data regarding hospital readmission and treatment received in the last two months of life were collected from the Lazio Region Healthcare database. Adult patients discharged with diagnosis ICD-9 191.* between 1/1/2010 until 31/12/2019, were included in this study.

RESULTS

6672 patients were identified and 3045 who have died before 31/12/2019 were included (median age 67 y;M1700). In the last two month of life 42.6% received hospital reamission (4.6% intensive care unit) and 37.9% had ER accesses. 24.5% received chemotherapy and 12.1% radiotherapy. In the last 30 days 33% were readmitted in hospital and 24.2% were admitted in ER. 11.7% were treated with chemotherapy and 6% with radiotherapy.

CONCLUSION

Strategies to improve quality of care at the end of life and to decrease re-hospitalization and futile treatments are becoming increasingly important to improve quality of death and to reduce costs of Healthcare System.
P14.67 Long-term results of gamma knife radiosurgery for treatment of intracranial glomus jugulare tumors
Authors: Emad Eldin R M , Abdel Karim K M , El-Shehaby A M N , Reda W A , Nabeel A M , Tawadros S R
Published: September 2021

BACKGROUND

Glomus Jugulare tumors are benign but locally aggressive ones that represent a therapeutic challenge. Previous studies about the use of Gamma Knife Radiosurgery (GRS) in those tumors have documented good results that needed larger number of patients and longer follow up periods to be confirmed.

MATERIAL AND METHODS

Between August 2001 and December 2017, 70 patients with glomus jugulare tumors were treated at the Gamma Knife Center, Cairo. They were 46 females and 24 males. The mean age was 48 years (16–71 years). Nineteen of these patients were previously operated, 5 were partially embolized, 3 underwent embolization and subsequent surgery and 43 had gamma knife as their primary treatment. Volume-staged gamma knife radiosurgery was used in 10 patients and single-session in 60 patients, with a total of 86 sessions. The mean target volume was 12.7 cm3 (range 0.2 to 34.5 cm3). The mean tumor volume was 15.5 cm3 (range 0.2 to 105 cm3). The mean prescription dose was 14.5 Gy (range 12 to 18 Gy).

RESULTS

The mean follow up period was 60 months (range 18 to 206 months), and by the time of the data analysis, two of the patients were dead (66 and 24 months after GK treatment). The tumor control was 98.6% (69/70). Thirty-two tumors became smaller and 37 were unchanged. The symptoms improved in 36 patients, were stable in 32 patients, and worsened in 2 patients who developed a transient facial palsy and worsened hearing. Symptomatic improvement began before any reduction in tumor volume could be detected, where the mean time to clinical improvement was 7 months whereas the mean time to tumor shrinkage was 18 months.

CONCLUSION

This study about the long term follow up of the GKR for the intracranial glomus jugulare tumors confirmed that this is a highly effective and safe treatment. This data shows that the clinical improvement is not correlated with the radiological volume reduction.
P14.72 Involving patients and caregivers in the production of guidelines for palliative care in primary brain tumours: identification of intervention priorities
Authors: Pace A , Solari A , De Panfilis L , Lissoni B , Pronello E , Rudà R , Silvani A , Salmaggi A , Merli R , De Paula U , Bertocchi E , Verza M , Veronese S
Published: September 2021

BACKGROUND

Involving patients and caregivers is an important component of clinical guideline development. The three main Italian scientific associations for neurology, neuro-oncology and palliative care (SIN-AINO-SICP) recently appointed a joint task force (TF) of clinicians and researchers to develop specific guidance on palliative care of people with primary brain tumours, following the GRADE approach. To identify clinical questions meaningful to the patients and caregivers, a qualitative approach was used.

MATERIAL AND METHODS

Based on the existing literature and on consensus, the TF identified nine intervention areas, whose relevance was apprised by patients (via personal semi-structured interviews) and bereaved caregivers (via focus groups, FGs) from five tertiary neuro-oncology centres. Participants were prompted to provide their personal disease-related experience, and were asked to elicit the areas that mostly impacted their own lives. Interviews and FGMs were audio-recorded, transcribed and analysed using thematic analysis.

RESULTS

Twenty interviews and five FGs (28 caregivers) were completed between late 2020 and early 2021. Preliminary findings show that all the pre-specified areas were defined as important by participants. Most discussed topics were communication, organization and service satisfaction, cognitive and psychological issues, and advance care planning (ACP). Caregivers focused their discussions on the need for patient psychological support, difficulties experienced with symptoms control (e.g. epileptic seizures, behavioural changes), communication and organizational issues.

CONCLUSION

Participation of Italian patients with brain tumours and family caregivers was high and information-rich. All of the nine guideline intervention areas were considered important, communication, care organization, symptom control and ACP being the most discussed.
P14.74 Grade II and III pleomorfic xanthoastrocitoma: a monocentric, retrospective analysis
Authors: Gaviani P , Simonetti G , Farinotti M , Redaelli V , Botturi A , Pollo B , Legnani F , Pinzi V , Silvani A
Published: September 2021

BACKGROUND

Pleomorphic xanthoastrocytoma (PXA) represent an astrocytic neoplasm that is typically well circumscribed and can have a relatively favorable prognosis. Tumor progression to anaplastic PXA (WHO grade III), however, is associated with a more aggressive biologic behavior and worse prognosis. The factors that drive anaplastic progression are largely unknown. The activating BRAF mutation is a genetic alteration that could be present in both PXA and anaplastic PXA; Identification of the mutation can be important as BRAF V600E mutant protein could be targeted therapeutically by small molecule inhibitors of both RAF and MEK. The low frequency of these tumors has fostered heterogeneity of therapeutic approaches, particularly in adult patients. We performed a monocentric, retrospective study on adult patients with a PXA diagnosis treated by our Institution, in order to search for markers of diagnosis and prognosis.

MATERIAL AND METHODS

All consecutive patients older than 18 years with a histological diagnosis of a primary grade II and III pleomorphic xanthoastrocytoma operated and treated by our Institution from 2011 to 2021 were consecutively and retrospectively included in the study. All pathological diagnoses and PXA cases were reviewed according to the WHO classification. Histological and molecular characteristics, including BRAF mutation status, as well as clinical data, treatment modalities, and patient outcome were analyzed and described.

RESULTS

21 patients were included, 10 males and 11 females, with a median age of 40 years old (range 18–66). In 10 patients the histology showed an anaplastic PXA and in 11 patients a grade II tumor. Genetic features, including IDH status were available to all patients and BRAF mutation study was available in 8/10 anaplastic PXA. All patients underwent main surgery. Anaplastic features were associated with minimal PFS, whereas BRAF mutation tended to be associated with a better PFS.

CONCLUSION

Anaplastic features and BRAF mutation can lead to identify subgroups with distinct prognosis. These results should be validated in a larger and prospective study.
P14.79 Differentiation of treatment-related changes from tumor progression following brachytherapy in patients with WHO II and III gliomas using FET PET
Authors: Bauer E K , Werner J , Brunn A , Deckert M , Ruess D , Ruge M , Celik E , Fink G R , Langen K , Galldiks N
Published: September 2021

BACKGROUND

Following brachytherapy, the differentiation of radiation-induced changes (e.g., radiation necrosis) from actual tumor progression using MRI is challenging. To overcome this diagnostic uncertainty, we evaluated the diagnostic value of O-(2-[18F]-fluoroethyl)-L-tyrosine (FET) PET in glioma patients treated with brachytherapy.

MATERIAL AND METHODS

From 2006–2019, we retrospectively identified WHO grade II or III glioma patients (i) treated with brachytherapy using Iodine-125 seeds, (ii) equivocal or progressive MRI findings inside the radiation field, and (iii) additional FET PET imaging for diagnostic evaluation. Static FET PET parameters such as maximum and mean tumor-to-brain ratios (TBR) and dynamic FET PET parameters (i.e., time-to-peak, slope) were obtained. Diagnostic performances were calculated using receiver operating characteristic curve analyses and Fisher’s exact test. Diagnoses were confirmed histologically or clinicoradiologically.

RESULTS

Following brachytherapy, suspect MRI findings occurred after a median time of 33 months (range, 5–111 months). In 10 of 21 patients (WHO grade II, n=5; WHO grade III, n=16), treatment-related changes were diagnosed. The best diagnostic performance for identification of treatment-related changes was obtained using maximum TBRs (threshold <3.20; accuracy, 86%; sensitivity, 100%; specificity, 73%; P=0.007). Mean TBRs reached an accuracy of 76% (threshold <2.05; sensitivity, 89%; specificity, 64%; P=0.010). Dynamic PET parameters did not reach statistically significant results.

CONCLUSION

Our data suggest that static FET PET parameters add valuable diagnostic information to diagnose radiation-induced changes in glioma patients treated with brachytherapy.
P14.88 Management of primary CNS lymphomas. Experience of 32 cases
Authors: Simonyan A S , Lepsveridze L T , Simavonyan Z K , Davtyan A A , Mikhaylova A D , Tyurnikov V M , Gushcha A O
Published: September 2021

BACKGROUND

Lymphomas (primary and secondary) are rare tumors of the central nervous system. They can involve both the supratentorial areas and the posterior cranial fossa. Modern management of patients with suspected CNS lymphoma should include a stereotactic or navigation-guided biopsy and subsequently carrying out chemotherapy and, in rare cases, radiosurgery.

MATERIAL AND METHODS

We analyzed our experience of the diagnosis and treatment of PCNSL. Our work included 32 patients with PCNSL. The study did not include patients with suspected CNS lymphoma, according to MRI data, in whom the diagnosis was not confirmed after biopsy.

RESULTS

Thirty patients underwent biopsy (20 - navigation guided, 1 - open, 9 - “burr hole”) with preliminary intraoperative histological verification. Gross total resection was performed in 2 cases since, according to preoperative MRI data, it was assumed that the patient had glial tumors. Postoperative histological examination confirmed the diagnosis of CNS lymphoma in all cases. Subsequently, after detailed histological and immunohistochemical studies, 30 patients underwent intra-arterial chemotherapy or high-dose chemotherapy according to NCCN protocols. Palliative treatment was recommended in 2 cases due to acute deterioration of patients. In our work, we would like to present a diagnostic algorithm and treatment regimens used in the management of our patients.

CONCLUSION

In the treatment of CNS lymphomas, careful histological verification is required, which is possible if several key points are performed - discontinuation of dexamethasone at least 24 hours before the biopsy, MRI for intraoperative neuronavigation after discontinuation of dexamethasone, intraoperative preliminary histological verification. In our opinion, complete removal of the tumor is possible if there are no risks of developing a persistent neurological deficit. Various methods of opening the blood-brain barrier are currently used, which can significantly reduce the effective dosage of drugs and, accordingly, the side effects. Further research is needed to determine the dependence of the prognosis of the disease on the type of surgery (biopsy or resection).
P14.89 Papillary tumor of the pineal region: three cases from a single institution
Authors: Yorio F , Ujhelly I J , Calabrese B , Cervio A , Muggeri A
Published: September 2021

BACKGROUND

Papillary tumors of the pineal region are highly unusual lesions of unknown incidence. These are neuroepithelial tumors with papillary and solid areas. There is no standardized treatment because of the difficulty to make randomized prospective trials due to its rarity. We report three patients with papillary tumor of the pineal region.

MATERIAL AND METHODS

Retrospective review of the clinical records of patients with papillary tumor of the pineal region at a tertiary neurological center in Buenos Aires, Argentina was done between 2/2012-04/2021. Clinical characteristics, imaging, pathology, treatment and follow-up data were obtained.

RESULTS

Two patients were male and one female. All three patients were adults, two in the fourth decade of life and one in the seventh. Clinical presentation included headache along with either visual symptoms, gait disturbance, or both. Imaging workup included brain and spinal magnetic resonance imaging, finding expanding lesions in the pineal region, hyperintense in FLAIR/T2 sequences, with gadolinium enhancement in T1 with contrast sequence and variable degrees of hydrocephalus. Spinal lesions were not found in these patients. Cerebrospinal fluid cytology was negative in all cases. Tumor biopsy was the initial approach in all cases. Two patients underwent an initial third ventriculostomy procedure but all were submitted to a supracerebellar infratentorial approach for major resection. Posterior treatment included chemoradiotherapy with temozolomide. One patient had a distant recurrence after seven years with and remained with stable disease for two more years, and the other two patients are under control with no recurrence after 2 and 2.5 years respectively.

CONCLUSION

Papillary tumors in the pineal regions are aggressively treated as recurrence is very frequent regarding previous reports (> 70%). Total resection is the only predictive factor associated to better outcome, however, more information is needed in order to achieve treatment consensus.
P14.92 Combination of Tumor Treating Fields and CCNU chemotherapy as valuable option for the treatment of unresectable progressive glioblastoma: A case presentation
Authors: Mergen E , Landrock S , Chizzali B
Published: September 2021

BACKGROUND

Tumor Treating Fields (TTFields) are low intensity (1–3 V/cm) alternating electric fields with an intermediate frequency of 100–300 kHz. TTFields in addition to temozolomide (TMZ) after radiochemotherapy according to Stupp significantly increased progression-free survival (PFS), overall survival (OS) and long-term survival rates in patients with newly diagnosed glioblastoma (GBM) in the multicenter phase 3, EF-14 trial. Post-hoc analysis of the trial revealed that TTFields in combination with second-line therapy after first recurrence significantly prolonged OS compared to second-line therapy alone. We here report on a GBM patient with partial resection showing regressive volume of unresected, previously progressive tumor under combination therapy of TTFields and second-line CCNU chemotherapy.

MATERIAL AND METHODS

In November 2018, MRI of a 59-year-old female patient revealed a large heterogeneous space-occupying lesion in the left occipital region with clearly contrast-enhanced margin, perifocal edema and two smaller contrast-enhancing lesions in the splenium corporis callosi and right of the trigonum suboccipitale. While the tumor in the left occipital region was completely resected, lesions in the right hemisphere remained unresected. Histopathology identified MGMT-promoter methylated GBM. The patient received concomitant radiochemotherapy followed by adjuvant TMZ. However, after three cycles, the unresected tumor progressed, TMZ was exchanged by procarbazine/CCNU and TTFields therapy was initiated. After two cycles, chemotherapy was changed to only CCNU due to further progression while TTFields therapy was continued.

RESULTS

One year after diagnosis, MRI showed no contrast-enhancing tissue in the resection cavity and regressive perifocal edema while lesions in the right hemisphere remained stable. Under tolerable hematotoxicity CCNU was continued together with TTFields, to which the patient showed high adherence far beyond the suggested threshold of 75%. Control examination in February 2020 reported regressive tumor volume in the right hemisphere under CCNU/TTFields therapy. Until January 2021, the tumor regressed even further without the detection of new lesions. The patient is currently continuing CCNU together with TTFields, achieving an average usage of 84% over the last twelve months.

CONCLUSION

In the presented case, the combination of TTFields and CCNU was feasible and safe in progressive GBM. The patient showed radiological response and local tumor regression under the combination therapy, whereas the tumor had previously progressed under chemotherapy alone. In conclusion, the addition of TTFields to chemotherapy is a valuable treatment option to improve clinical and radiological outcome of patients with progressive GBM. This example of TTFields use in clinical practice encourages its use beyond tumor progression.
Sound Art as Locative Narrative
Authors: Whittaker Emma
Published: September 2021

Locative narrative is a form of mobile sound art that sites stories in diverse urban and rural situations. The live ambient sounds, particular to a street, building, or hilltop, are an essential element of the work. This chapter argues that these relations between sounds and things are multistable. This chapter first contextualizes locative narrative and then puts forward an experimental pragmatist framing of experience and perceiving, drawing upon the neuroscience term, multistability. A four-fold framework of multistability is introduced: (1) changing the relations to perceptual and imaginary objects; (2) influencing the value of belief; (3) influencing the value of fiction and the representation of perceptual objects; and (4) changing the relations to the experiences of perception and misperception. This theory is an important contribution to sound art because it demonstrates how changing the relations between sensory perception, language, and belief can reshape what is felt and experienced.
Echo’s Embrace
Authors: Crow Frances
Published: September 2021

This chapter seeks to bring together two relationships, the first, between science and art in the West during the period of modernity and the second between the fabric of sound-space and the rendering of Echo. Following the dis-articulation of sound-space pre-empted by Sabine’s equation for reverberation (and its adoption by the acoustic profession) I draw together the various traits of echo as mythic figure, as disembodied voice and as acoustic phenomenon to consider the re-articulation of sound-space through sound-art practice. This chapter offers to artists, acousticians, and architects an alternative mapping of the history of acoustics by drawing the reader’s attention to the work of Athanasius Kircher. I suggest that he is as much the father of the acoustic arts as Mersenne, his contemporary, is the father of the acoustic sciences.
Sonic sense
Authors: Voegelin Salomé
Published: September 2021

This chapter aims to set up the context for novel engagements in notions of sense, knowledge, and meaning via sound. Sound is introduced as material as well as concept, and listening is considered at once as strategy and as expanded method to engage and challenge existing notions of prehension, interpretation, and significance, and to query their rationale. The suggestion is that the sonic offers itself to experience not as meaning but as a challenge to the making of sense, and that consequently through listening we can reach a different sense, that is plural and includes what we did not expect to know. These ideas are developed by listening to Christof Migone’s work HitParade (NewYork) (2012), a group performance which sounds bodies, surfaces, and microphones through their shared rhythm, and to Jana Winderen’s The Wanderer (2015), a field recording of zooplankton and phytoplankton between the North Pole and the Equator.
Intimate Listening
Authors: Paterson Mark
Published: September 2021

Space and proximity are entangled in the idea of listening. First, I set up the relationship between intimacy and listening through Jean-Luc Nancy. Second, I consider highlights of nineteenth-century discoveries in the history of physiology and functional anatomy of the cochlea and the labyrinth of the inner ear, those spaces and chambers whose non-auditory function was determined only through painstaking experimentation. This leads to Michel Serres’ consideration of the interior and exterior noise of the body, including a proprioceptive hearing of intimate personal sounds through skin, bone, feet, and muscle, a bodily interior that resonates like boxes (boîtes). Third, I apply this shared intimacy of listening to a few examples of sound art that explore resonances across sensory modalities and bodily spaces, including the work of Jacob Kirkegaard, who employs the phenomenon of otoacoustic emission (OAE), and Adam Basanta.
Sound Art: Hearing in Particular
Authors: Drever John L.
Published: September 2021

Extoling and promoting listening is deeply ingrained in sound art practice and discourse, even on occasion its raison d’être, where listening is understood as a wholly congenial, benign activity. This can be seen through the routine use of affirmative tropes such as, through listening we: connect, locate, are embodied, discern, are immersed or enveloped. And through specific listening methods such as Deep Listening, we are offered ‘expand[ed] consciousness to the whole space/time continuum of sound/silences’ (Oliveros, 2005, p. xxiv). Refocusing from the act of listening to the audiological—the mechanisms related to the sense of hearing—from the findings of the author’s recent research, in particular his review on the noise impact of high-speed hand dryers (Drever, 2013), the author feels obliged to assert that the contrary is a reality for many—hearing, from time to time or incessantly: perturbs, isolates, excludes, disconnects, disembodies, and dislocates, hearing hurts! This will be familiar for those living with hyperacusis, misophonia, and phonophobia, but it can also be the case for those with particular hearing needs such as the partially sighted, hearing aid users or those with sensitive hearing such as infants and ASD. Bringing audiology into the sphere of sound art, this chapter recognizes a prevailing sensitization of hearing in the culture at large, and proposes a paradigm for situating hearing that diverges from a singular, idealized, symmetrical model of hearing, the auraltypical, that has predominated. In its place, we are beginning to enjoy a fluidity and openness to diverse forms of hearing and sensitive hearers in sound art, on embracing the emerging agenda of auraldiversity.
‘And I Listened to the Whistlings and Patterings Outside’
Authors: Carlyle Angus
Published: September 2021

The notion of the wild is one that has developed a richer currency in recent years, simultaneously enrolled as a branding device for leisure activities and employed to account for the potential planetary consequences of a shift towards the Anthropocene. Noting parallel amplifications of wild sound in both the philosophical concept of the sublime and in the literary genre known as nature writing, this chapter critically accounts for the ways in which creative sound practices have deployed listening and recording to manifest the spatial parameters of the wild. These sound art practices are shown to reveal tensions in terms of any strictly demarcated border between the wild and the cultivated, in terms of the technical assemblages that are taken to the wild and that render what is heard there audible, and in terms of the wild as a space that is to be accessed through solitary, silent and arduous effort.
Maternal Aggression
Authors: Ottesen Vibeke
Published: September 2021

This chapter explores evolutionary psychological (EP) perspectives on maternal aggression, focusing on physical aggression, both lethal and nonlethal. It argues that the psychological mechanisms underpinning such aggression held an adaptive function to our foremothers. If such mechanisms formerly did hold an adaptive function, then maternal aggression should not be expected to be a random event, nor necessarily caused by pathology. Rather, the risk factors and characteristic traits of maternal aggression should follow an ancestrally adaptive and evolutionary logic. In which case, it should be a predictable phenomenon on a societal level. And as the chapter presents, the theoretical understanding of maternal aggression that EP perspectives offer has allowed for the successful prediction of risk factors and characteristic traits for such aggression. The chapter reviews these risk factors and traits, along with the theoretical reasoning the predictions are based on and the cross-cultural empirical support for their existence.
Maternal Investment in Adolescent Daughters and Sons
Authors: Lewis Mary B. Eberly , Hoenig Trinity
Published: September 2021

This chapter reflects on maternal investment in adolescent daughters and sons. The focus of maternal investment necessarily changes as a function of the ontological maturity of adolescent sons and daughters. As most sexually mature youth continue to live with parents, mothers’ investments channel youth toward adaptive trajectories given the opportunities and constraints of the local ecology. The nature of childrearing shifts to a greater emphasis on preparing daughters and sons for socio-competitive success; that is, providing resources, particularly those that increase adult knowledge and skills, and protecting offspring from their own adventurousness while learning occurs. Through this focus, mothers facilitate the reproductive success of offspring.
Paternal Relationships With Sons and Daughters
Authors: Nikiforidis Lambrianos
Published: September 2021

This chapter examines paternal relationships with sons and daughters. Identity drives investment (and parental investment in particular), because people invest in that which aligns with their identity. And biological sex drives identity. These two ideas combined imply that a parent-offspring match in biological sex can influence parental favoritism in a systematic manner, an idea supported by recent empirical studies. This parental bias of concordant-sex favoritism can have broad implications, outside the context of the traditional family structure. In single parent or same-sex parent households, the consequences of this bias can be even stronger, because there would not be an opposite-direction bias from the other parent to even things out. This favoritism could have even broader ramifications, entirely outside the context of the family. On the one hand, whenever social norms dictate that men should control a family’s financial decisions, then sons may systematically receive more resources than daughters. This asymmetry in investment would then result in ever-increasing advantages that persist over time. On the other hand, if women are a family’s primary shoppers, this can manifest in subtle but chronic favoritism for daughters.
Politics and Parenting
Authors: Kerry Nicholas , Murray Damian R.
Published: September 2021

This chapter assesses how parenthood may functionally influence political attitudes. Becoming a parent is a keystone life event that has numerous psychological and physiological implications. There are several theoretical reasons to predict a functional relationship between parenthood (as well as individual differences in parenting motivation) and socially conservative attitudes, primarily related to an increased sensitivity to threat and a reduced interest in short-term mating. Moreover, initial work has found correlational, mediational, and experimental support for a functional and causal relationship between parenting and increased social conservatism and out-group prejudice. However, many unanswered questions remain, as do multiple fruitful avenues for future research.
Parental Influence and Sexual Selection
Authors: Apostolou Menelaos
Published: September 2021

This chapter addresses how the genetic relatedness between parents and their children results in the two parties having converging as well as diverging interests. In the domain of mating, these interests, along with other factors such as the trade-offs inherent in mating, give rise to an opportunity cost of free mate choice: Parents have much to lose if they allow their children to exercise choice freely. This opportunity cost provides a strong incentive to parents to influence their children’s mate choices. In preindustrial societies, parents manage to exercise direct control, which is predominantly manifested in the institution of arranged marriage. In postindustrial societies, parents exercise influence indirectly through manipulation. Ultimately, parental influence over mating gives rise to a sexual selection force, namely parental choice, which may be unique to the human species.
Cultural Perspectives on Parenting
Authors: Mesman Judi , Emmen Rosanneke A. G.
Published: September 2021

This chapter focuses on cultural influences on parenting, examining patterns across countries, but also within countries in different ethnic groups. Whereas forms vary, two broad functions of parenting practices can be consistently identified across cultural contexts: establishing a relational bond providing safety and security in infancy (commonly referred to as attachment), and transmitting culturally appropriate behavior, knowledge, and skills throughout the childhood years. The chapter then looks at the role of culture in ethnic minority parenting, which has unique features that are different from those in ethnic majority groups. It concludes by reflecting on the state of the research field of culture and parenting, and directions for the future. Given the high cultural diversity in many urban regions in the world where professionals deal with families from all over the world, and the frequent “export” of parenting interventions from the West to other parts of the world, the field would benefit enormously from investing in mixed-methods studies examining these processes in situations where cultures meet, and where it is not immediately clear which cultural norms should prevail.
Governmentality and Grand Strategy
Authors: Neal Andrew W.
Published: September 2021

This chapter explores the implications of Michel Foucault’s concept of “governmentality” for grand strategy. It argues that debates on governmentality and grand strategy share an interest in wider conditions and practices of government that extend beyond strategic decision-making. They also mirror each other in analyzing the rational frameworks that accompany and support practices of government and strategy. The chapter reflects on the work of Sir Basil Liddell Hart in this light, particularly his focus on conditions of strategic success beyond war fighting. The argument is that governmentality offers a way to critically engage with grand-strategic discourses and their historically situated assumptions about the nature and scope of government. The chapter concludes with a brief case study on the relationship between foreign development aid, grand strategy, and governmentality.
Material Sources of Grand Strategy
Authors: Ripsman Norrin M. , Kovac Igor
Published: September 2021

This chapter outlines material sources of grand strategy, such as the relative power of a state, the polarity of the international system, the regional balance of power, geography, and technology. It argues that these material factors, reflecting the material environment within which states interact, set the table for grand strategy construction and, therefore, have a profound impact on grand strategy, although they do not completely determine grand strategy. The material setting sets the parameters within which national leaders make decisions and prioritize goals within a given set of national institutions and in a particular cultural context. Furthermore, we provide concrete empirical examples of the mechanisms through which these factors impact state grand strategy.
Thucydides’ Legacy in Grand Strategy
Authors: Morley Neville
Published: September 2021

Thucydides is now a familiar name in the fields of politics, war, and strategy, but references to his work in discussions of grand strategy are usually superficial and sometimes problematic. He is treated as both ancient and modern, as an authoritative theorist whose views are then ignored in favor of the events of the war he described. This chapter explores the nature of Thucydides’ project, as a detailed narrative of past events that claims nevertheless to offer his readers a “possession for all time” as a guide to future developments. It surveys the various depictions of strategic thinking in his account, as presented in set-piece scenes of deliberation and debate—and explores how the broader narrative places the confident plans and expectations of war leaders, even Pericles, in question. His account emphasizes the absence of grand strategy in antiquity, above all the absence of the necessary institutional framework. It also raises important questions about the feasibility of any grand strategy, especially within a democracy, given the unpredictability of events and the poor track record of humans in anticipating them.
Grand Strategy and the Tools of Economic Statecraft
Authors: Early Bryan R. , Preble Keith
Published: September 2021

Economic statecraft provides great powers with a set of valuable tools they can employ in pursuing grand strategies, but the importance of its contribution is often overlooked. This chapter provides a conceptual framework for understanding how policymakers can leverage the tools of economic statecraft to achieve major objectives in pursuit of their grand strategies, including: bargaining, balancing, generating power and prosperity, signaling and norms promotion, and influencing nonstate actors. It then maps how economic sanctions, foreign aid, strategic commercial policy, and institutionalized economic cooperation can best contribute to the realization of these objectives. The analysis reveals that the flexibility of economic sanctions and foreign aid in achieving numerous objectives helps explain why great powers rely so heavily upon them.
Covert Action and Grand Strategy
Authors: Mitrovich Gregory
Published: September 2021

Throughout history, covert action has been a critically important instrument used by states to achieve their strategic aims without the use of military force. This chapter explores the little-known role that covert action played during the rise of the United States from the American Revolution to the First World War, as well their use by Great Britain and Germany to influence US foreign policy after the United States had become a great power. The chapter explores how covert operations aided US efforts to expand across North America and European covert missions to block America’s rise through exploiting divisions within US society and derailing American plans to expand its borders to the Pacific Ocean. The chapter then explores how prior to the First World War, Britain and Germany used covert psychological operations to sway American opinion to their respective sides. Once war broke out, these operations intensified as Britain sought to convince the United States to enter the conflict as their ally while German operations sought to encourage American neutrality. Once America entered the war, Germany switched to sabotaging American operations to derail US war production. The chapter concludes with a discussion of the future of covert action in the digital age and the role of cyberattacks in light of the Russian attack on the 2016 US presidential election.
Financing the Grand Strategy of Great and Rising Powers
Authors: Cappella Zielinski Rosella
Published: September 2021

How can great and rising powers finance their grand strategy? What enables and constrains a state’s ability to finance its grand strategic needs? Under what conditions are leaders able to implement their desired financial strategy? When considering the various means available for financing grand strategy, leaders are concerned with raising revenue to implement their grand strategy as well as staying in power. Financing grand strategy, however, presents an intertemporal dilemma for leaders: a politically costly fiscal sacrifice today for benefits accrued in the future. This chapter advances an analytical framework and offers illustrative examples to understand how leaders navigate this intertemporal dilemma. First, the chapter addresses the scope of the study: military spending of great and rising powers. Second, it presents the various financing options and addresses the short- and long-term political and economic costs of each. Third, it offers three variables that condition leader willingness to incur the short-term political costs of financing grand strategy: regime type, whether a state is a rising or great power, and the degree of clarity in the threat environment.
Grand Strategies of Declining Powers
Authors: MacDonald Paul K. , Parent Joseph M.
Published: September 2021

How do states deal with decline? Since Thucydides, various authors have tried to describe how falling states manage their declines and prescribe how they might do it better. Their arguments have run the gamut from “do nothing” to “change everything.” Although this might seem like a bewildering array of plausible alternatives, there are better and worse ways to go about choosing grand strategies of decline. This chapter lays out the dilemmas of decline as well as under-appreciated silver linings, and assesses how some states have succeeded in arresting, slowing, or reversing their declines while others have accelerated their declines or facilitated collapse. This chapter argues that the diverse descriptions in the literature derive from shifting structural conditions that encourage some policy combinations and discourage others. To make the case, it first elaborates the dilemmas of decline, assesses the policy options open to leaders in declining states, and examines the conditions that matter most. Next, it analyzes what grand strategic responses have been most common and which have tended to work. Finally, the chapter summarizes the literature and explores what remains to be known about states in decline.
Population Aging and Grand Strategy
Authors: Haas Mark L.
Published: September 2021

This chapter examines the effects of population aging on states’ grand strategies. Due to major reductions in fertility levels and significant increases in life expectancies over the course of the last century, a majority of countries are growing older, many at fantastic rates and extent. The number of seniors, both absolutely and as a share of states’ overall population, is reaching unprecedented levels. This worldwide demographic trend is likely to affect all dimensions of states’ grand strategies, including in the great powers, which are among the world’s oldest countries. Population aging is likely to reduce states’ military capabilities, push leaders to adopt more isolationist and peaceful foreign policies, reshape states’ core international interests to place greater emphasis on the advancement of citizens’ quality of life and the protection of particular ethnocultural identities, and increase the perceived threat posed by immigration and multicultural ideologies.