Twenty Years On: RECIST as a Biomarker of Response in Solid Tumours an EORTC Imaging Group – ESOI Joint Paper

Response evaluation criteria in solid tumours (RECIST) v1.1 are currently the reference standard for evaluating efficacy of therapies in patients with solid tumours who are included in clinical trials, and they are widely used and accepted by regulatory agencies. This expert statement discusses the principles underlying RECIST, as well as their reproducibility and limitations. While the RECIST framework may not be perfect, the scientific bases for the anticancer drugs that have been approved using a RECIST-based surrogate endpoint remain valid. Importantly, changes in measurement have to meet thresholds defined by RECIST for response classification within thus partly circumventing the problems of measurement variability. The RECIST framework also applies to clinical patients in individual settings even though the relationship between tumour size changes and outcome from cohort studies is not necessarily translatable to individual cases. As reproducibility of RECIST measurements is impacted by reader experience, choice of target lesions and detection/interpretation of new lesions, it can result in patients changing response categories when measurements are near threshold values or if new lesions are missed or incorrectly interpreted. There are several situations where RECIST will fail to evaluate treatment-induced changes correctly; knowledge and understanding of these is crucial for correct interpretation. Also, some patterns of response/progression cannot be correctly documented by RECIST, particularly in relation to organ-site (e.g. bone without associated soft-tissue lesion) and treatment type (e.g. focal therapies). These require specialist reader experience and communication with oncologists to determine the actual impact of the therapy and best evaluation strategy. In such situations, alternative imaging markers for tumour response may be used but the sources of variability of individual imaging techniques need to be known and accounted for. Communication between imaging experts and oncologists regarding the level of confidence in a biomarker is essential for the correct interpretation of a biomarker and its application to clinical decision-making. Though measurement automation is desirable and potentially reduces the variability of results, associated technical difficulties must be overcome, and human adjudications may be required.

Gamifying Online News in a Senior Online Community: Insights from Designing and Assessing the Readers’ Experience

Aging audiences and the shift of news consumption to an online paradigm have led to the need of finding strategies to engage aging readers with online news by assessing their news consumption habits and identifying the potential for digital platforms to assist the reader’s journey, i.e., the activities performed from access to the information to the relatedness and shareability of the news content. It is well established that the use of game elements and game thinking within the context of a community can capture the user’s attention and lead to behavioral engagement toward repetitive tasks. However, information about the design implications of socially gamified news to the aging reader’s experience is still lacking. Using a development research approach, we implemented a prototype that socially gamifies news to support the aging reader experience based on a pre-assessment survey with 248 participants about their news consumption habits and motivations. We then validated the prototype with six market-oriented representatives of Portuguese newspapers and eleven adults aged 50 and over. A model for onboarding a reader’s 6-step journey (read, react, discuss, share, relate and experience) within the context of a Senior Online Community using gamification is proposed. The game elements used can inform the design of a much more personalized experience of consuming news and news behavioral engagement.

The relationship between Artistic Time and Space in Natalie Sarott’s “Golden Friut”

The article discusses the peculiarities of the relationship between time and space in Natalie Sarott's novel "Golden Fruit" (1963), a representative of the French "New Novel" of the twentieth century: Non-linearity, asymmetry, syncretism, avoidance of story lines, rapid interruption of time, alternation, "intense" immobility, inertia of time, simultaneous expressions of repetition, "immobilization-freezing" of the present, reflected in each other.The “rapid interruption” on time conveyed by the semicolon and the techniwue of substituting grammatical forms of different tenses will make the reader experience the uniformity of the past, present and future and the inconsistent circular interchange.

Preoperative measurement of the hiatal surface with MDCT: impact on surgical planning

Objective To evaluate the accuracy and reproducibility of hiatal surface area (HSA) measurement on dedicated multidetector computed tomography (MDCT) acquisition, in patients, previously subjected to laparoscopic sleeve gastrectomy (LSG), and affected by gastroesophageal reflux disease (GERD). Intraoperative HSA measurement was considered the reference standard. Methods Fifty-two candidates for laparoscopic hiatal hernia repair were prospectively included in the study. MDCT images were acquired during swallowing of oral iodinated contrast media and during strain. Measurements were performed by nine readers divided into three groups according to their experience. Results were compared with intraoperative measurements by means of Spearman correlation coefficient. Reproducibility was evaluated with intra- and interreader agreement by means of weighted Cohen’s kappa and intraclass correlation coefficient (ICC). Results Significant differences between MDCT and intraoperative HSA measurements were observed for swallowing imaging for less experienced readers (p = 0.037, 0.025, 0.028 and 0.019). No other statistically significant differences were observed (p > 0.05). The correlation between HSA measured intraoperatively and on MDCT was higher for strain imaging compared to swallowing (r = 0.94—0.92 vs 0.94—0.89). The overall reproducibility of MDCT HSA measurement was excellent (ICC of 0.95; 95% CI 0,8993 to 0,9840) independently of reader’s experience Conclusion HSA can be accurately measured on MDCT images. This method is reproducible and minimally influenced by reader experience. The preoperative measurement of HSA has potential advantages for surgeons in terms of correct approach to hiatal defects in obese patient.

A modularity analysis helps improving the structure of the International Code of Zoological Nomenclature

Background In a recent work I transformed a complex and integrated text like the International Code of Zoological Nomenclature into a network of interconnected parts of text. This new approach allowed understanding that a continuous body of text cannot accurately reflect the true structure of the Code, and provided a scientific methodology to identify a priori parts that could be affected by future revisions. In this next step, I investigate further the structure of the Code, seeking to use the network in order to identify the various conceptual communities grouping the various articles and other text items of the Code. Methods Using the first version of the network of the Code, I perform a comprehensive modularity analysis in two rounds: the first round aims to identify the fewest and largest communities or modules for the entire network, whereas the second round identifies the sub-modules within each larger module. The potential conflicts between the current structure of the Code and the module composition are evaluated with a parcellation analysis. Results The optimal modularity search identified 10 different modules in the entire network of varying size (ranging from 75 to 200 nodes). Each module can be further divided into smaller modules, that all-together allow describing the 65 conceptual groups of text items in the Code. Parcellation analysis revealed that two-thirds of the current chapters of the Code are in excellent or good accordance with the recovered conceptual modules, whereas the current composition of six chapters is in serious conflict with the conceptual structure of the Code. Discussion Judging only the composition and not the order of appearance of the Articles in the Chapters of the Code, I show that in many cases the current structure of the Code is found to correspond quite well to the concepts presented therein. The most important conflict is found on the provisions related to the various groups of names governed by the Code: family-, genus-, and species-group names. Currently, these provisions are spread out in different Articles in different Chapters, along the entire length of the Code. The modularity analysis suggests that re-organizing the Code in chapters that will deal with all aspects related to a given group (e.g., chapters including information on name formation, availability, typification, and validity for a given group), could potentially improve reader experience and, consequently, the applicability of the Code.

Pink Floyd’s Time: an aural metanarrative exploring time through form, lyric, and musical arrangement

The inability of language to capture the essence of time is a crisis that has been expressed by philosophers starting from St. Augustine to Paul Ricoeur. Appearing on their seminal album, Dark Side of the Moon, Pink Floyd’s Time is a profound artistic attempt which transcends this language barrier by using music to bring the listeners to a more direct confrontation with time; doing so by juxtaposing time as calibrated and as experienced through the music and the lyrics, and by making the reader experience time-based affects such as impatience, expectation, monotony, and such. As a direct function of song, time is experienced as musical time in the song, thereby ensuring that the listener’s confrontation with time is immersive, with lyrics that describe the nature of experienced and calibrated time working synchronously with the music to complete the image. In the context of its release in 1974, the 6:52 minute song was in engagement with the concept of time as well, in that it was among the pioneering ones which redefined radio broadcast time beyond the standard 3 minutes afforded to popular music tracks, with the commercially preferred listener span in mind. The matter of time thus becomes a multi-layered formal engagement in the song, at the level of lyric, recording, music and listening, thereby making possible an image of time that is polished and rounded. These aural, lyrical and production-based concepts will be addressed and expanded upon to show how Pink Floyd’s Time functions as a metanarrative in how it uses and invokes the elements of time to talk about time.