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Tonio Andrade's The Gunpowder Age is a big book. It spans roughly 800 years, in both China and Europe. Its boldest claims concern China, but Andrade delves into European history as well, making it a challenge for any one scholar to assess his evidence and arguments. Because China specialists would want to know how historians specializing in European warfare and in Western science and technology evaluate Andrade's challenges to received wisdom, the Journal of Chinese History’s editor and editorial board invited historians outside the China field to contribute to a joint review. We succeeded in recruiting a distinguished panel, all of whom have written extensively on these issues: David Parrott, author of such books as The Business of War: Military Enterprise and Military Revolution in Early Modern Europe; Philip Hoffman, author most recently of Why Did Europe Conquer the World?; Stephen Morillo, author of War in World History, among other books; and Ian Inkster, author of Science and Technology in History: An Approach to Industrial Development, among other books. This introduction provides an overview of the discussion so far, and a few additional observations from a historian who has also tried his hand at Sino-European comparisons.
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.
OBJECTIVES/SPECIFIC AIMS: The 2 primary objectives were to (i) insure that Scholars can effectively communicate the translational impact of their research to a lay audience and (ii) assess the benefits and efficacy of having community, as well as faculty members, judge the translational impact of KL2 Scholar’s poster presentations. An explicit secondary goal was to further the engagement of community members in CTSI-sponsored translational research. METHODS/STUDY POPULATION: CTSI’s Education, Community Engagement, Discovery and Translation, and Translational Workforce Development Cores created the translational impact questions and evaluation sheets. The Community Engagement and Office of Discovery and Translation recruited community judges from their respective networks and they were assigned to relevant studies. Scholars were provided with the judges scoring template in advance. After the Research Poster Session, the KL2 Scholars evaluated the quality of their presentations and the impact of having feedback from Community Judges. The Community Judges evaluated their perceived “added value” to the research presentations and their interactions with the Scholars. Both Scholars and judges completed evaluations of the poster presentation and judging process, performed on a 5-point Likert scale. RESULTS/ANTICIPATED RESULTS: KL2 Scholars felt that the community impact judges provided valuable feedback on their research (3.8/5) and were satisfied overall with the poster session (3.4/5). In evaluating their own presentations, Scholars tended to rate themselves higher (4.2–4.6/5) on the clarity of their translational impact presentations than the community judges rated the Scholars (4.1–4.2/5). Scholars also rated themselves somewhat higher in the quality of their dealing with any ethical issues and their dissemination plan (4.0/5) than the community judges (3.8/5). Judges were very positive and felt they brought value to the experience (4.2–4.4/5). DISCUSSION/SIGNIFICANCE OF IMPACT: Community judges added qualitative value to the Scholar presentations based on the Scholar and community judge evaluations and based on comparison based on prior year poster sessions. Documenting the degree of impact of the combination of this proscribed poster format and community-judging process awaits future assessment of Scholar presentations before and after the next annual poster presentation.
Nancy Dorian's foundational work on the loss of Gaelic in the East Sutherland communities continues to provide important insights into the nature of the process of language change in situations of obsolescence. In this article I look at a subset of Dorian's data from the perspective of current syntactic theory, and argue that the connected loss of such apparently different constructions as objects of non-finite verbs, inalienable possessive structures, and a range of passives, and the concomitant restructuring of the grammar, all follow from the interaction between a reduction in agreement features on a functional head and the broad syntactic ecology of the language. This approach makes sense of why these apparently disparate constructions all undergo the particular kinds of change that are seen, changes which are mysterious from the perspective that an obsolescing language should alter to become more like the dominant language (in this case English) which is replacing it.
Fontan survivors have depressed cardiac index that worsens over time. Serum biomarker measurement is minimally invasive, rapid, widely available, and may be useful for serial monitoring. The purpose of this study was to identify biomarkers that correlate with lower cardiac index in Fontan patients.
Methods and results
This study was a multi-centre case series assessing the correlations between biomarkers and cardiac magnetic resonance-derived cardiac index in Fontan patients ⩾6 years of age with biochemical and haematopoietic biomarkers obtained ±12 months from cardiac magnetic resonance. Medical history and biomarker values were obtained by chart review. Spearman’s Rank correlation assessed associations between biomarker z-scores and cardiac index. Biomarkers with significant correlations had receiver operating characteristic curves and area under the curve estimated. In total, 97 cardiac magnetic resonances in 87 patients met inclusion criteria: median age at cardiac magnetic resonance was 15 (6–33) years. Significant correlations were found between cardiac index and total alkaline phosphatase (−0.26, p=0.04), estimated creatinine clearance (0.26, p=0.02), and mean corpuscular volume (−0.32, p<0.01). Area under the curve for the three individual biomarkers was 0.63–0.69. Area under the curve for the three-biomarker panel was 0.75. Comparison of cardiac index above and below the receiver operating characteristic curve-identified cut-off points revealed significant differences for each biomarker (p<0.01) and for the composite panel [median cardiac index for higher-risk group=2.17 L/minute/m2 versus lower-risk group=2.96 L/minute/m2, (p<0.01)].
Higher total alkaline phosphatase and mean corpuscular volume as well as lower estimated creatinine clearance identify Fontan patients with lower cardiac index. Using biomarkers to monitor haemodynamics and organ-specific effects warrants prospective investigation.
Ediacara-type fossils are found in a diverse array of preservational styles, implying that multiple taphonomic mechanisms might have been responsible for their preservational expression. For many Ediacara fossils, the “death mask” model has been invoked as the primary taphonomic pathway. The key to this preservational regime is the replication or sealing of sediments around the degrading organisms by microbially induced precipitation of authigenic pyrite, leading toward fossil preservation along bedding planes. Nama-style preservation, on the other hand, captures Ediacaran organisms as molds and three-dimensional casts within coarse-grained mass flow beds, and has been previously regarded as showing little or no evidence of a microbial preservational influence. To further understand these two seemingly distinct taphonomic pathways, we investigated the three-dimensionally preserved Ediacaran fossil Pteridinium simplex from mass flow deposits of the upper Kliphoek Member, Dabis Formation, Kuibis Subgroup, southern Namibia. Our analysis, using a combination of petrographic and micro-analytical methods, shows that Pteridinium simplex vanes are replicated with minor pyrite, but are most often represented by open voids that can be filled with secondary carbonate material; clay minerals are also found in association with the vanes, but their origin remains unresolved. The scarcity of pyrite and the development of voids are likely related to oxidative weathering and it is possible that microbial activities and authigenic pyrite may have contributed to the preservation of Pteridinium simplex; however, any microbes growing on P. simplex vanes within mass flow deposits were unlikely to have formed thick mats as envisioned in the death mask model. Differential weathering of replicating minerals and precipitation of secondary minerals greatly facilitate fossil collection and morphological characterization by allowing Pteridinium simplex vanes to be parted from the massive hosting sandstone.
Mobile health (mHealth) technology can play a critical role in improving disaster victim tracking, triage, patient care, facility management, and theater-wide decision-making.
To date, no disaster mHealth application provides responders with adequate capabilities to function in an austere environment.
The Operational Medicine Institute (OMI) conducted a qualitative trial of a modified version of the off-the-shelf application iChart at the Fond Parisien Disaster Rescue Camp during the large-scale response to the January 12, 2010 earthquake in Haiti.
The iChart mHealth system created a patient log of 617 unique entries used by on-the-ground medical providers and field hospital administrators to facilitate provider triage, improve provider handoffs, and track vulnerable populations such as unaccompanied minors, pregnant women, traumatic orthopedic injuries and specified infectious diseases.
The trial demonstrated that even a non-disaster specific application with significant programmatic limitations was an improvement over existing patient tracking and facility management systems. A unified electronic medical record and patient tracking system would add significant value to first responder capabilities in the disaster response setting.
Callaway DW, Peabody CR, Hoffman A, Cote E, Moulton S, Baez AA, Nathanson L. Disaster mobile health technology: lessons from Haiti. Prehosp Disaster Med. 2012;27(2):1-5.