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BACKGROUND: IGTS is a rare phenomenon of paradoxical germ cell tumor (GCT) growth during or following treatment despite normalization of tumor markers. We sought to evaluate the frequency, clinical characteristics and outcome of IGTS in patients in 21 North-American and Australian institutions. METHODS: Patients with IGTS diagnosed from 2000-2017 were retrospectively evaluated. RESULTS: Out of 739 GCT diagnoses, IGTS was identified in 33 patients (4.5%). IGTS occurred in 9/191 (4.7%) mixed-malignant GCTs, 4/22 (18.2%) immature teratomas (ITs), 3/472 (0.6%) germinomas/germinomas with mature teratoma, and in 17 secreting non-biopsied tumours. Median age at GCT diagnosis was 10.9 years (range 1.8-19.4). Male gender (84%) and pineal location (88%) predominated. Of 27 patients with elevated markers, median serum AFP and Beta-HCG were 70 ng/mL (range 9.2-932) and 44 IU/L (range 4.2-493), respectively. IGTS occurred at a median time of 2 months (range 0.5-32) from diagnosis, during chemotherapy in 85%, radiation in 3%, and after treatment completion in 12%. Surgical resection was attempted in all, leading to gross total resection in 76%. Most patients (79%) resumed GCT chemotherapy/radiation after surgery. At a median follow-up of 5.3 years (range 0.3-12), all but 2 patients are alive (1 succumbed to progressive disease, 1 to malignant transformation of GCT). CONCLUSION: IGTS occurred in less than 5% of patients with GCT and most commonly after initiation of chemotherapy. IGTS was more common in patients with IT-only on biopsy than with mixed-malignant GCT. Surgical resection is a principal treatment modality. Survival outcomes for patients who developed IGTS are favourable.
As the deficit model's failure leaves scientists searching for more effective communicative approaches, science communication scholars have begun promoting narrative as a potent persuasive tool. Narratives can help the public make choices by setting out a scientific issue's contexts, establishing the stakes involved, and offering potential solutions. However, employing narrative for persuasion risks embracing the same top-down communication approach underlying deficit model thinking. This essay explores the parallels between movie censorship and the current use of narrative to influence public opinion by examining how the Hays Office and the Catholic Legion of Decency responded to science in movies. I argue that deploying narratives solely as public relations exercises demonstrates the same mistrust of audiences that provided the foundation of movie censorship. But the history of movie censorship reveals the dangers of using narrative to remove the public's agency and to coerce them towards a preferred position rather than fostering their ability to come to their own conclusions.
This study explored the partnership between universities and local primary schools to deliver a classroom-based paediatric communication impairment service provided by undergraduate speech pathology students. It aimed to understand how partnerships work to facilitate programme replication.
The partners included universities sending students on rural clinical placement, local host academic units and primary schools who worked together to provide paediatric speech and language services in primary schools in three sites in Australia. Rural and remote communities experience poorer health outcomes because of chronic workforce shortages, social disadvantage and high Aboriginality, poor access to services and underfunding.
The study was in twofold: qualitative analysis of data from interviews/focus group with the partners in the university and education sectors, and quantitative social network analysis of data from an electronic survey of the partners.
Factors supporting partnerships were long-term, work and social relationships, commitment to community, trust and an appetite for risk-taking. We postulate that these characteristics are more likely to exist in rural communities.
Following the 2016 U.S. election, researchers and policymakers have become intensely concerned about the dissemination of “fake news,” or false news stories in circulation (Lazer et al., 2017). Research indicates that fake news is shared widely and has a pro-Republican tilt (Allcott and Gentzkow, 2017). Facebook now flags dubious stories as disputed and tries to block fake news publishers (Mosseri, 2016). While the typical misstatements of politicians can be corrected (Nyhan et al., 2017), the sheer depth of fake news’s conspiracizing may preclude correction. Can fake news be corrected?
In the mid-twentieth century film studios sent their screenplays to Hollywood's official censorship body, the Production Code Administration (PCA), and to the Catholic Church's Legion of Decency for approval and recommendations for revision. This article examines the negotiations between filmmakers and censorship groups in order to show the stories that censors did, and did not, want told about pregnancy, childbirth and abortion, as well as how studios fought to tell their own stories about human reproduction. I find that censors considered pregnancy to be a state of grace and a holy obligation that was restricted to married women. For censors, human reproduction was not only a private matter, it was also an unpleasant biological process whose entertainment value was questionable. They worried that realistic portrayals of pregnancy and childbirth would scare young women away from pursuing motherhood. In addition, I demonstrate how filmmakers overcame censors’ strict prohibitions against abortion by utilizing ambiguity in their storytelling. Ultimately, I argue that censors believed that pregnancy and childbirth should be celebrated but not seen. But if pregnancy and childbirth were required then censors preferred mythic versions of motherhood instead of what they believed to be the sacred but horrific biological reality of human reproduction.
Ferromagnetic resonance investigations on Ni nanowires are reported. The angular dependence of the resonance line position is analyzed within a thermodynamic approach that includes shape anisotropy (ellipsoids of revolution), magnetocrystalline anisotropies (cubic and uniaxial), and dipole–dipole interactions. The results are supported by hysteresis loops, obtained on the same sample.
A transducer that can act as a highly sensitive and reliable universal sensor capable of detecting and continuously monitoring changes in the physical, chemical and biological domains is a potentially useful scientific tool. The Thin Film Bulk Acoustic Wave Resonator (FBAR) is a microwave device that is becoming increasingly recognised as a universal transduction platform with the added advantage of potential integration into CMOS architecture and array-like formats. This work shows preliminary results on FBAR where a continuous monitoring arrangement demonstrated the capability of FBAR to respond to changes in physical parameters such as temperature and light levels, the work goes on further to show the ability of FBAR to respond to changes in humidity in a gas flow and can have sensitivity increased with the addition of hygroscopic polymers on its surface and finally how FBAR can be adapted to act as a biosensor in the form of an immunosensor with sensitivity some orders of magnitude greater than traditional lower frequency bulk acoustic wave platforms.
Inherited disorders of mitochondrial oxidative phosphorylation are the most common group of inborn errors of metabolism and cause a wide range of clinical presentations. Mitochondrial DNA encodes 13 protein subunits required for oxidative phosphorylation plus 22 transfer RNAs and two ribosomal RNAs, and mutations in most of these genes cause human disease. Nuclear genes encode most of the protein subunits and all other proteins required for mitochondrial biogenesis and mitochondrial DNA replication and expression. Mutations in 64 nuclear genes and 34 mitochondrial genes are now known to cause mitochondrial disease and many novel mitochondrial disease genes await discovery. The genetic complexity of oxidative phosphorylation means that maternal, autosomal recessive, autosomal dominant and X-linked modes of inheritance can occur, along with de novo mutations. This complexity presents a challenge in planning efficient molecular genetic diagnosis of patients with suspected mitochondrial disease. In some situations, clinical phenotype can be strongly predictive of the underlying genotype. However, more often this is not the case and it is usually helpful, particularly with pediatric patients, to determine whether the activity of one or more of the individual oxidative phosphorylation enzymes is deficient before proceeding with mutation analysis. In this review we will summarize the genetic bases of mitochondrial disease and discuss some approaches to integrate information from clinical presentation, laboratory findings, family history, and imaging to guide molecular investigation.
In March 1856, Alexander II (1855–81) visited the Grand Duchy of Finland, and laid before the Senate a five-point programme of reform, designed to revive trade and stimulate the economy. This marked the beginning of a hectic period in which public life in Finland would escape from the narrow, cramped confines of the first five decades of imperial Russian rule, and the firm contours of a modern state would begin to take shape. The new emperor's visit took place at the end of a war which had revealed the necessity of modernisation throughout his sprawling domains. The Grand Duchy of Finland was thus not alone in going through the turmoil of change, which was ultimately to threaten the continued existence of favoured autonomous regions within an empire striving for uniformity and administrative centralisation.
Alexander II had probably less freedom than his namesake fifty years earlier to experiment in reform within the framework of an established political and legal system. In the first instance, as the emperor occasionally reminded his advisors on Finnish affairs, unrest at home occasioned by the emancipation of the peasantry in 1861 and the growing threat of revolt in the Polish lands compelled him to exercise caution. He also had to take account of the still tense international situation after the conclusion of the Crimean War in 1856, and of an emerging Russian nationalism that expressed critical opinions about Finland's status.
Between the accession of Erik XIV in 1560 and the death of Karl X (1654-60), hardly a year passed when Sweden was not at war. Five major wars were fought against Denmark during this hundred-year period, with Sweden gradually gaining the upper hand and acquiring territory to the south and west that has remained Swedish to the present day. In the east, Sweden succeeded in expanding a bridgehead in northern Estonia acquired in 1561 to embrace most of Estonia and Livonia by 1629. The virtual collapse of the Muscovite state following the death of Boris Godunov in 1605 enabled Sweden to push back the Finnish frontier to the shores of lake Ladoga and to establish a land bridge to the Estonian territories through the acquisition of Ingria. The entry of Sweden into the Thirty Years War in 1629 and the astonishing victories that carried Gustav II Adolf and his forces deep into the Catholic heartland of Germany marked an entirely new phase. Sweden was now able to command lavish French subsidies and make war ‘pay for itself’ by a variety of methods from forced contributions to outright extortion. Its battles were fought by polyglot armies; the men conscripted back home constituted only a small minority of the Swedish forces fighting in Germany. More territory, this time on the north German coast, was acquired in the final peace settlement in 1648. Within seven years, Sweden was once more enmeshed in war, its armies drawn deep into Poland in a bewildering series of marches and battles, and twice flung against the old enemy, Denmark.
Finland can fairly lay claim to have been one of the big success stories of the modern age. The transformation of what less than a century ago was a poor agrarian land on the northern periphery of Europe into one of the most prosperous states of the European Union today is a remarkable story, but is by no means an uneventful one. The gaining of independence from Russia in 1918 was accompanied by a bitter civil war which left its scars upon the body politic of Finland for decades. Finland fought three wars between 1939 and 1945, twice against the Soviet Union and once against Germany, and suffered grievous loss of life in addition to almost a tenth of its territory. The political history of the independent republic was for much of the twentieth century conflict-ridden and far removed from the image of consensual stability and good European membership that is projected today. The reinvention of Finland over the past two decades as a confident and assertive Eurostate, no longer in the shadow of the Soviet Union, has also been paralleled by a re-evaluation of the nation's history and identity. In particular, Finland's recent past has come under severe scrutiny, as part of what may be seen as a purging process not dissimilar to the examination in eastern European countries of ‘blank spots’ in the recent past.
The physical contours of northern Europe, including the 338,145 sq.km. of land and water that constitute the present-day republic of Finland, were essentially shaped in the aftermath of the great Ice Age. The retreating mass of ice scoured the crystalline bedrock of the Fenno-Scandian shield, leaving in its wake thousands of shallow lakes, eskers and drumlins, and a deeply indented coastline that is still emerging from the sea as the land recovers from the tremendous compression of the glaciers. Only in the far north of Finland does the land rise above a thousand metres. To the east, the Maanselka ridge is a watershed for the rivers that run westwards into the Gulf of Bothnia and eastwards into the White Sea. The great lake systems of central and eastern Finland are separated from the coastal regions by a further series of ridges running in a south-eastward direction towards the south coast. Almost a quarter of the surface area of this inland region is covered by water, and a further 20 per cent is classified as wetland, mostly bogs and morasses. With all but a tiny tip of land lying north of the sixtieth parallel (Oslo and the Shetland Islands lie on this latitude, Stockholm slightly further south), Finland can claim to be the most northerly of all the countries of mainland Europe, stretching over a thousand kilometres from the northern shores of the Baltic towards the Arctic Sea.