From Crisis to Compensation: Reinventing Identity and Place in the Sideshow and the Laboratory

Examining the ambivalent place of the sideshow and the laboratory within Victorian culture and its reimaginings, this essay explores the contradiction between the narratively orchestrating role and peripheral location of the sideshow in Leslie Parry’s Church of Marvels (2015) and the laboratory in NBC’s Dracula (2013–2014), reading these neo-Victorian spaces as heterotopias, relational places simultaneously belonging to and excluded from the dominant social order. These spaces’ impacts on individual identity illustrate this uneasy relationship. Both the sideshow and the laboratory constitute sites of resignification, emerging as “crisis heterotopias” or sites of passage: in Parry’s novel, the sideshow allows the Church twins to embrace their unique identities, surpassing the limitations of their physical resemblance; in Dracula, laboratory experiments reverse Dracula’s undead condition. Effecting reinvention, these spaces reconfigure the characters’ senses of belonging, propelling them to places beyond their confines, and thus projecting the latter’s heterotopic qualities onto the city. Potentially harmful, yet opening up urban space to include identities which are considered aberrant, these relocations envision the city as a “heterotopia of compensation”: an alternative, possibly idealized, space that reifies the sideshow’s and the laboratory’s attempts to achieve greater extroversion and visibility for their liminal occupants, thus fostering neo-Victorianism’s outreach efforts to support the disempowered.

On the origin of the Uruguayan voseo

This article is dedicated to the origin of the phenomenon of voseo in the Uruguayan Spanish. Description is given to the evolution of the use of pronoun ‘vos’ and the corresponding verb forms in the Old Spanish and classical Spanish language, as well as to specificity of the development of the forms of voseo in Latin America (namely the process hybridization of the paradigm). Special attention is given to the spread of this linguistic phenomenon in the Río de la Plata, which includes the territory of modern Uruguay, in the context of the history of colonization. The author examines the theory of the two “norms” (urban and rural) to clarify the correlation between ‘tú’ and ‘vos’ in the Uruguayan Spanish of the XVIII – XXI centuries. This article is first within the Russian Spanish studies to examine the forms of address in the Uruguayan Spanish from the diachronic perspective, as up to the present it has rarely become the focus of attention of the Soviet and Russian philology. The following conclusions are formulated: 1) the key factor in wide spread occurrence of voseo in the Spanish language of America lies in the specificity of assimilation of the Spanish language by autochthonous and mixed population; 2) unlike Spain and some regions of America, the forms ‘vos’ prevalent Río de la Plata with the beginning of colonization have not been displaced by the form ‘tú’ due ti peripheral location of the territory and remoteness from cultural centers of the empire; 3) at the same time, the presence of tuteo was more noticeable in the cities, which led to the formation of two “norms” in the region – rural, characterized by voseo; and urban tuteo, which was oriented towards Pyrenean norm.

Prevalence of Delta-Like Protein 3 in a Consecutive Series of Surgically Resected Lung Neuroendocrine Neoplasms

Delta-like protein 3 (DLL3) is a protein of the Notch pathway, and it is a potential therapeutic target for high-grade lung neuroendocrine tumors (NETs), i.e., small cell lung carcinoma (SCLC) and large cell neuroendocrine carcinoma (LCNEC). However, DLL3 prevalence in lung NETs and its association with clinicopathological characteristics and prognosis remained unclear. We analyzed the immunohistochemical expression of DLL3 and its prognostic role in a consecutive series of 155 surgically resected lung NETs, including typical carcinoid (TC), atypical carcinoid (AC), LCNEC, and SCLC patients. The DLL3 expression was categorized as high (>50% positive tumor cells) or low (<50%). In addition, tumors were categorized by H-score (i.e., percentage of positive cells by staining intensity, ≥150 vs. <150). DLL3 staining was positive in 99/155 (64%) samples, and high DLL3 expression was frequently observed in high-grade tumors. In detail, 46.9% and 75% of SCLC and 48.8% and 53.7% of LCNEC specimens showed a high DLL3 expression by using H-score and percentage of positive tumor cells, respectively. Regarding low-grade NETs, only 4.9% and 12.2% TCs and 19.5% and 24.4% ACs had high DLL3 expression considering H-score and percentage of positive tumor cells, respectively. High DLL3 expression was associated with advanced American Joint Committee on Cancer (AJCC) stage, peripheral location, and chromogranin A expression in high-grade tumors (p < 0.05). In low-grade NETs, high DLL3 expression was associated with female sex, peripheral location, a higher number of mitoses, higher Ki-67 index, presence of necrosis, and pleural infiltration (p < 0.05). No association was observed between high DLL3 expression and overall survival (OS) and disease-free survival (DFS) in high-grade NETs, whereas high DLL3 expression was associated with lower DFS in ACs (p = 0.01). In conclusion, our study demonstrated a high prevalence of DLL3 expression in high-grade lung NET patients and its association with aggressive clinicopathological features. These findings confirm that DLL3 could represent a useful biomarker for target therapy in high-grade tumors. Our results also suggest that the DLL3 expression could identify a subset of AC tumors with more aggressive behavior, thus providing the basis for new therapeutic options in this group of patients.

Science, urban space, and early phonography in Barcelona, 1898–1914

The chapter focuses on the gabinetes fonográficos active in Barcelona from 1898 onward. It aims to analyze why Barcelona’s early recording industry remained more precarious and less successful than that in Madrid, and advances two reasons: the failure of the Barcelona gabinetes to position themselves within local discourses around science, technology, modernity, and Catalan national identity; and their increasingly peripheral location in the developing urban space of Barcelona. The chapter then discusses how Barcelona eventually came to lead the Spanish recording industry after the advent of the gramophone, with a subsidiary of Gramophone and a new generation of record shops opening in the city.

Application of a second opinion ultrasound in Breast Imaging Reporting and Data System 4A cases: can immediate biopsy be avoided?

Objective The probability of malignancy in women who are diagnosed with a Breast Imaging Reporting and Data System (BI-RADS) 4A score is low. Application of a second opinion ultrasound (SOUS), which is low in cost and minimally invasive, may lower the biopsy rate for patients who fall into this category. This study aimed to apply SOUS to patients with a BI-RADS score of 4A and predict the pathological results of a biopsy. Methods One hundred seventy-eight patients were analyzed. Univariate and multivariate analyses were performed to screen for predictive factors that are associated with malignancy. Categorical alteration of downgraded, unchanged, or upgraded was made after SOUS results. Changes in category were compared with biopsies to determine their predictive value of benignancy or malignancy. Results Independent factors associated with malignancy were age (>50 years), tumor size (≥20 mm), margin (not circumscribed), orientation (not parallel), and peripheral location, and an upgraded categorical alteration from SOUS. Downgraded categorical alterations were associated with benignancy. Conclusions In BI-RADS 4A cases, a biopsy is recommended when independent factors are associated with malignancy. A downgraded result from an SOUS examination is a protective factor, supporting the likelihood of benignancy in these patients.

Clinical and CT characteristics of Xpert MTB/RIF-negative pulmonary tuberculosis

Purpose To determine the diagnostic accuracy of the Xpert MTB/RIF assay in patients with smear-negative pulmonary tuberculosis (TB) and to assess clinical and CT characteristics of Xpert-negative pulmonary TB. Material and methods We retrospectively reviewed the records of 1,400 patients with suspected pulmonary TB for whom the sputum Xpert MTB/RIF assay was performed between September 1, 2014 and February 28, 2020. Clinical and CT characteristics of smear-negative pulmonary TB patients with negative Xpert MTB/RIF results were compared with positive results. Results Of 1,400 patients, 365 (26.1%) were diagnosed with pulmonary TB and 190 of 365 patients (52.1%) were negative for sputum acid-fast bacilli. The diagnosis of pulmonary TB was based on a positive culture, positive Xpert MTB/RIF or the clinical diagnoses of patients treated with an anti-TB medication. The sensitivity, specificity, positive predictive and negative predictive values of sputum Xpert MTB/RIF for smear-negative pulmonary TB were 41.1%, 100%, 100%, and 90.1%, respectively. Finally, 172 patients with smear-negative pulmonary TB who underwent chest CT within 2 weeks of diagnosis were included to compare Xpert-positive (n = 66) and Xpert- negative (n = 106) groups. Patients with sputum Xpert-negative TB showed lower positive rates for sputum culture (33.0% vs. 81.8%, p<0.001) and bronchoalveolar lavage culture (53.3% vs. 84.6%, p = 0.042) than in Xpert-positive TB. Time to start TB medication was longer in patients with Xpert-negative TB than in Xpert-positive TB (11.3±16.4 days vs. 5.0±8.7 days, p = 0.001). On chest CT, sputum Xpert-negative TB showed significantly lower frequency of consolidation (21.7% vs. 39.4%, p = 0.012), cavitation (23.6% vs. 37.9%, p = 0.045), more frequent peripheral location (50.9% vs. 21.2 p = 0.001) with lower area of involvement (4.3±4.3 vs. 7.6±6.4, p<0.001). Multivariate analysis revealed peripheral location (odds ratios, 2.565; 95% confidence interval: 1.157–5.687; p = 0.020) and higher total extent of the involved lobe (odds ratios, 0.928; 95% confidence interval: 0.865–0.995; p = 0.037) were significant factors associated with Xpert MTB/RIF-negative TB. Regardless of Xpert positivity, more than 80% of all cases were diagnosed of TB on chest CT by radiologists. Conclusion The detection rate of sputum Xpert MTB/RIF assay was relatively low for smear negative pulmonary TB. Chest CT image interpretation may play an important role in early diagnosis and treatment of Xpert MTB/RIF-negative pulmonary TB.

Frequency of complications and risk factors associated with computed tomography guided core needle lung biopsies

BACKGROUND: Although transthoracic needle biopsy (TTNB) is an effective method for diagnosis of lung tumors, it has some complications. It is crucial to know the frequency and severity of the complications of TTNB and its risk factors in order to avoid them. OBJECTIVES: Evaluate the complications and risk factors of computed tomography guided core needle lung biopsies (CT-CNLB). DESIGN: Prospective evaluation of complications. SETTING: Single center in Turkey. PATIENTS AND METHODS: For CT-CNLBs performed between October 2017 and March 2018, the complications of biopsies were noted and classified as major and minor based on guidelines of the Society of Interventional Radiology. MAIN OUTCOME MEASURES: The complications and risk factors for complications were evaluated. SAMPLE SIZE: 123 adult patients. RESULTS: The most common complications were pulmonary hemorrhage (30.9%) and pneumothorax (22%). Increased overall pulmonary hemorrhage was observed with underlying emphysema ( P =.022), non-peripheral location of the lesion ( P <.001), increased needle pathway ( P <.001), fissure penetration ( P =.011), increased number of pleura penetrations ( P =.024), prolonged needle time across pleura ( P =.037), and decreased lesion size ( P =.033). The pneumothorax rate increased with non-peripheral location of the lesion ( P <.007), fissure penetration ( P =.021), prolonged needle time across the pleura (P=.013), and decreased lesion size ( P =.002). In the logistic regression analyses for he two most common complications, the only risk factor for both alveolar hemorrhage and pneumothorax was a non-peripheral location of the lesion ( P <.001, OR=14.7, 95% CI=3.9–55.4 for alveolar hemorrhage) and ( P =.001, OR=156.2, 95% CI =7.34–3324.7 for pneumothorax). CONCLUSION: Most common complications of CT-CNLB were pneumothorax and pulmonary alveolar hemorrhage with a 5.7% major complication rate. Choosing the shortest possible trans-pulmonary needle pathway minimizes the risk of complications. LIMITATIONS: Limited number of patients, absence of rare complications as death, air embolism, and needle tract seeding. CONFLICT OF INTEREST: None.

A role for Dynlt3 in melanosome movement, distribution, acidity and transfer

Skin pigmentation is dependent on cellular processes including melanosome biogenesis, transport, maturation and transfer to keratinocytes. However, how the cells finely control these processes in space and time to ensure proper pigmentation remains unclear. Here, we show that a component of the cytoplasmic dynein complex, Dynlt3, is required for efficient melanosome transport, acidity and transfer. In Mus musculus melanocytes with decreased levels of Dynlt3, pigmented melanosomes undergo a more directional motion, leading to their peripheral location in the cell. Stage IV melanosomes are more acidic, but still heavily pigmented, resulting in a less efficient melanosome transfer. Finally, the level of Dynlt3 is dependent on β-catenin activity, revealing a function of the Wnt/β-catenin signalling pathway during melanocyte and skin pigmentation, by coupling the transport, positioning and acidity of melanosomes required for their transfer.

The Russian Empire (1453–1917)

The construction of a mighty empire and impressive high culture in a region uniquely far from the centers of global trade and culture was a great achievement. Elements of Eurasian empire and European military-fiscal state merged in the tsarist polity. This polity’s success rested on a powerful “sacred” monarchy that dominated the church and forged a close alliance with the landowning nobility while preserving a massive “state peasantry” whose surplus went to the crown alone. As with the English, French, and Spanish, Russia’s peripheral location in Europe facilitated the conquest of non-European territories. The Industrial and French revolutions posed great challenges to Russia’s geopolitical security and social order, as well as to the regime’s legitimacy. Though these challenges (e.g., nationalism) were faced by most empires, in the Russian case factors that had been essential to previous success (autocracy, serfdom, Westernized elites) contributed to undermining the regime’s legitimacy by 1900.

In-field stereotactic body radiotherapy (SBRT) reirradiation for pulmonary malignancies as a multicentre analysis of the German Society of Radiation Oncology (DEGRO)

Data of thoracic in-field reirradiation with two courses of stereotactic body radiotherapy (SBRT) is scarce. Aim of this study is to investigate feasibility and safety of this approach. Patients with a second course of thoracic SBRT and planning target volume (PTV) overlap were analyzed in this retrospective, multicenter study. All plans and clinical data were centrally collected. 27 patients from 8 centers have been amenable for evaluation: 12 with non-small-cell lung cancer, 16 with metastases, treated from 2009 (oldest first course) to 2020 (latest second course). A median dose of 38.5 Gy to the 65%-isodose over a median of 5 fractions was prescribed in the first course and 40 Gy in 5 fractions for the second SBRT-course. Median PTV of the second SBRT was 29.5 cm3, median PTV overlap 22 cm3. With a median interval of 20.2 months between the two SBRT-courses, 1-year OS, and -LCR were 78.3% and 70.3% respectively. 3 patients developed grade 1 and one grade 2 pneumonitis. No grade > 2 toxicity was observed. Peripheral location and dose were the only factors correlating with tumor control. A second SBRT-course with PTV overlap appears safe and achieves reasonable local control.