Annual Review of Constitution-Building: 2020

International IDEA’s Annual Review of Constitution-Building Processes: 2020 provides a retrospective account of constitutional reform processes around the world and from a comparative perspective, and their implications for national and international politics. This eighth edition covers events in 2020 and includes chapters on the impact of the Covid-19 pandemic and emergency legal frameworks on constitutionalism and constitution-building worldwide; the impact of the pandemic on attempted executive aggrandizement in Central African Republic, Hungary and Sri Lanka; the impact of the pandemic on peace- and constitution-building processes in Libya, Syria and Yemen; gender equality in constitution-building and peace processes, with a particular focus on Chile and Zimbabwe; constitutional amendments to enhance the recognition of customary law in Samoa and Tonga; and the establishment, functioning and outputs of the French Citizens’ Convention for Climate. Writing at the mid-way point between the instant reactions of the blogosphere and academic analyses that follow several years later, the authors provide accounts of ongoing political transitions, the major constitutional issues they give rise to, and the implications of these processes for democracy, the rule of law and peace.

Do Oncologic Outcomes From Head and Neck Versus Truncal and Extremity Melanoma Differ? A Single-Institution Single-Subspecialty Experience

Background Outcomes are thought to be worse in head and neck (H&N) melanoma patients. However, definitive evidence of inferior outcomes in H&N melanoma in the modern era is lacking. We sought to ascertain whether H&N melanomas carry a worse prognosis than melanomas of other sites. Methods All patients who underwent excision for primary melanoma by fellowship-trained surgical oncologists at a single institution from 2014 to 2020 were queried from the electronic medical record. Patients who had AJCC eighth edition stage I-III disease were included. Results Of 1127 patients, 28.7% had primary H&N melanoma. H&N patients were more likely to be male, older, and present with more advanced AJCC stage. Median follow-up was 20.0 months (IQR 26.4). On multivariable analyses controlling for other variables, H&N melanoma was associated with worse RFS. Notably, H&N melanoma was not associated with worse MSS, DMFS, or OS on univariate or multivariable analyses. Among patients who recurred, H&N patients were significantly more likely to recur locally compared to non-H&N patients. On subgroup analysis, scalp melanoma was also associated with worse RFS compared to patients with melanoma in locations other than the scalp. When patients with scalp melanoma were excluded from analysis, non-scalp H&N RFS was not significantly different from the non-H&N group on univariate or multivariable analyses. Discussion In this series from a high-volume tertiary referral center, the differences in rates and sites of recurrence between H&N and non-H&N melanoma do not impact melanoma-specific or overall survival, suggesting that H&N melanoma patients should be treated similarly with respect to regional and systemic therapies.

The Integration of the Pre-Treatment Neutrophil-to-Lymphocyte Ratio in the Eighth Edition of the AJCC Staging System for Nasopharynx Cancer

ObjectiveThe present study aimed to evaluate the role of integrating the pretreatment neutrophil-to-lymphocyte ratio (NLR) into the eighth edition of the AJCC staging system for nasopharynx cancer in an endemic region.MethodsBetween May 2007 and December 2012, a total of 713 cases with NPC were retrospectively analyzed. The separation ability in terms of overall survival (OS), local failure-free survival (LFFS), distant metastasis-free survival (DMFS), and failure-free survival (FFS) was evaluated. The discriminatory ability was assessed using Harrell’s concordance index (c-index). Recursive partitioning analysis (RPA) was conducted and incorporated with pretreatment NLR.ResultsWhen integrated with NLR, the separate and discriminatory abilities for N classifications were improved in terms of OS and DMFS, but not for T categories. By using Recursive partitioning analysis, five subgroups were generated. Compared with the overall stage, the integration of NLR could not enhance the separate and discriminatory abilities. However, patients in the RPA 4 group gained significant benefits in terms of OS (HR 0.390 (95%CI 0.212-0.716), P = 0.002) and FFS (HR 0.548 (95%CI 0.314-0.958), P = 0.032) from the additional adjuvant chemotherapy after concurrent chemoradiotherapy.ConclusionThe integration of NLR into the 8th edition of the AJCC staging system could enhance the separation and discriminatory abilities for N classifications, but not for T categories. In addition, patients in the RPA 4 group could benefit from the addition of adjuvant chemotherapy to concurrent chemoradiotherapy.

Preface for the Proceedings of the 8th International Building Physics Conference

Menghao Qin1 and Carsten Rode1 1Department of Civil Engineering, Technical University of Denmark, Lyngby, 2800, Denmark Emails: [email protected] [email protected] The 8th International Building Physics Conference (IBPC 2021) took place online during August 25-27, 2021. IBPC 2021 was organized by the Technical University of Denmark in cooperation with Aalborg University, Aarhus University, University of Southern Denmark, and Lund University. More than 370 participants from 37 countries worldwide attended the conference. IBPC 2021 is the eighth edition of the official triennial conference of the International Association of Building Physics (IABP). The IBPC 2021 unites researchers, practitioners, educators, and students from the construction sector worldwide. We meet to exchange new research and innovative technologies and to discuss current and future challenges and sustainable solutions within building physics. This year, IBPC was held as a virtual meeting due to the impact of COVID-19 and the limitations on the entry and exit. IBPC 2021 used PheedLoop and Zoom as the platform holding the online conference. There were 170 oral presentations and 100 poster presentations were arranged during the three-day conference. Every presentation was about 15 minutes, including 3 minutes for the Q&A part. Authors made their presentations on the topics covering all aspects of building physics. Though the authors and speakers couldn’t communicate face to face, the passion for involvement wasn’t affected. Papers have been gathered through a call issued in August 2020. We received around 420 submissions from 45 countries. We employed a single-blind peer-review process involving scholars of various fields related to Building Physics as reviewers. At the end of the reviewing process, 248 papers were accepted for the conference proceedings - Journal of Physics: Conference Series. Here we would like to thank all the scientific committee members who made great efforts on paper reviewing. The appreciation also goes to other organizing committee members, program chairs, keynote/invited speakers, session chairs and all the authors. Thanks for their understanding and support in this special time. We hope all the participants had a wonderful time during the conference and got fruitful inspiration from the presentations delivered by speakers and authors. Given the high-quality works done by authors, reviewers, and other committee members, we are confident that the IBPC 2021 proceedings capture the current state of the research in the related fields and hope it will motivate some of you in the longer term. We are looking forward to seeing you again in IBPC 2024. List of titles Chairs, Organizing committee, Scientific committee are available in this Pdf.

Which classification system defines best prognosis of mucinous neoplasms of the appendix with peritoneal dissemination: TNM vs PSOGI?

AimsSeveral classification systems are used for pseudomyxoma peritonei. The four-tiered classification system proposed by Peritoneal Surface Oncology Group International (PSOGI) and the two-tiered proposed by the eighth edition of the American Joint Committee on Cancer (AJCC) result from evolution in terminology and pathological insight. The aim is to evaluate the impact of PSOGI and eighth edition of the AJCC classifications on survival.MethodsPathological slides were reviewed from a prospectively maintained database including patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for an appendiceal mucinous neoplasm with peritoneal dissemination between January 2009 and December 2019. Patients were reclassified according to PSOGI and AJCC eighth edition criteria. Survival analysis evaluated the impact of each classification system on overall survival (OS) and disease-free survival (DFS) while the concordance-index evaluated their predictive power.Results95 patients were identified; 21.1% were reclassified as acellular mucin, 55.8% as low-grade mucinous carcinoma peritonei, 8.4% as high-grade MCP (HGMCP) and 14 as HGMCP with signet ring cells. Median OS was not reached, 5-year OS and DFS were 86.1% and 51.5%, respectively. Multivariate analysis revealed significant associations with OS (PSOGI: HR 10.2, p=0.039; AJCC: HR 7.7, p=0.002) and DFS (PSOGI: HR 12.7, p=0.001; AJCC: HR 3.7, p<0.001). The predictive capacity of both classification systems was unacceptable for OS and DFS (concordance-index values <0.7).ConclusionsBoth classification systems behaved similarly when stratifying our series into prognostic groups. The PSOGI classification provides better histopathological description, but histology alone is insufficient for adequate patient prognostication.

Radiomic Features Associated With HPV Status on Pretreatment Computed Tomography in Oropharyngeal Squamous Cell Carcinoma Inform Clinical Prognosis

PurposeThere is a lack of biomarkers for accurately prognosticating outcome in both human papillomavirus-related (HPV+) and tobacco- and alcohol-related (HPV−) oropharyngeal squamous cell carcinoma (OPSCC). The aims of this study were to i) develop and evaluate radiomic features within (intratumoral) and around tumor (peritumoral) on CT scans to predict HPV status; ii) investigate the prognostic value of the radiomic features for both HPV− and HPV+ patients, including within individual AJCC eighth edition-defined stage groups; and iii) develop and evaluate a clinicopathologic imaging nomogram involving radiomic, clinical, and pathologic factors for disease-free survival (DFS) prediction for HPV+ patients.Experimental DesignThis retrospective study included 582 OPSCC patients, of which 462 were obtained from The Cancer Imaging Archive (TCIA) with available tumor segmentation and 120 were from Cleveland Clinic Foundation (CCF, denoted as SCCF) with HPV+ OPSCC. We subdivided the TCIA cohort into training (ST, 180 patients) and validation (SV, 282 patients) based on an approximately 3:5 ratio for HPV status prediction. The top 15 radiomic features that were associated with HPV status were selected by the minimum redundancy–maximum relevance (MRMR) using ST and evaluated on SV. Using 3 of these 15 top HPV status-associated features, we created radiomic risk scores for both HPV+ (RRSHPV+) and HPV− patients (RRSHPV−) through a Cox regression model to predict DFS. RRSHPV+ was further externally validated on SCCF. Nomograms for the HPV+ population (Mp+RRS) were constructed. Both RRSHPV+ and Mp+RRS were used to prognosticate DFS for the AJCC eighth edition-defined stage I, stage II, and stage III patients separately.ResultsRRSHPV+ was prognostic for DFS for i) the whole HPV+ population [hazard ratio (HR) = 1.97, 95% confidence interval (CI): 1.35–2.88, p &lt; 0.001], ii) the AJCC eighth stage I population (HR = 1.99, 95% CI: 1.04–3.83, p = 0.039), and iii) the AJCC eighth stage II population (HR = 3.61, 95% CI: 1.71–7.62, p &lt; 0.001). HPV+ nomogram Mp+RRS (C-index, 0.59; 95% CI: 0.54–0.65) was also prognostic of DFS (HR = 1.86, 95% CI: 1.27–2.71, p = 0.001).ConclusionCT-based radiomic signatures are associated with both HPV status and DFS in OPSCC patients. With additional validation, the radiomic signature and its corresponding nomogram could potentially be used for identifying HPV+ OPSCC patients who might be candidates for therapy deintensification.

Contextualizing Disability

The interconnection of language and societal context is demonstrated through the Library of Congress Subject Headings surrounding disability. This study examines and compares how language encapsulates contemporary understandings of disability in the second edition (1919) and eighth edition (1975). Created and published during the so-called “Progressive Era,” the second edition emphasizes Victorian beliefs in the correspondence of morality with participation in the labour force and genetic fitness (i.e., conformity to physical and psychological norms). The language of this context further marginalized persons with disabilities. In contrast, the eighth edition marks the growing respect for and autonomy of people with disabilities, with language related to the civil rights movement, medical advances, and the replacement of ableist terms such as “Deaf and dumb” with neutral terms or self-definitions, such as “Deaf.” This evolution demonstrates the positive effects when we as librarians accept our social responsibility to eschew marginalizing language and instead use language that affirms minority identities.