The Evolution of Geotech Reginald Hammah, Thamer Yacoub, Alison McQuillan, John Curran / Reginald Hammah, Thamer Yacoub, Alison McQuillan, John Curran
2021, 2022, 2021-11-23
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This publication includes 82 technical papers presented at Rocscience International Conference (RIC) 2021, held online on April 20 and 21, 2021. Rocscience created this event to bring geotechnical ...academics, researchers and practitioners together to exchange ideas as part of celebrating 25 years of the company’s existence. The papers in these proceedings were from keynotes, panel discussions and papers, selected after careful review of over 100 technical submissions delivered at RIC 2021. The technical papers were grouped into sessions based on their subject areas. The conference aimed to stimulate discussions that could help the industry work towards overcoming geotechnical engineering limitations today. It also sought to foster creative thinking that will advance the current states of the art and practice. The keynote addresses, panel discussions and technical presentations tried to examine geotechnical problems and situations from fresh perspectives. RIC 2021 hopes that the proceedings will continue to enrich our thinking and contribute to achieving a critical mass of change in our practices and approaches. We look forward to significant improvements in our industry.
In his "Letter to Raleigh," Edmund Spenser describes his project using the strange and provocative term analysis. This essay explores three ways in which the Ramist ideas closely associated with this ...term can inform our understanding of The Faerie Queene. First, since analysis recalls Ramism's ideal of analytical method, organization of matter in a descent from the most general principles to the more special and obscure, the poem might be approached as an analysis of virtue ethics, with concepts sequenced and divided methodically. Second, the "Letter" excuses out-of-order poetry by the second or imperfect method, crypsis. Spenser's disclaimer about his "method" as poet historical does not necessarily abnegate logic: we may consider that by puzzling, cryptical features we are alerted to a hidden order, so that an analysis of virtue becomes a pleasing analysis. Third, analysis might refer not just to the poet's project but to readerly exercise. In analyzing the virtue-knights' efforts at invention and judgment, we exercise our own. Ramist commentary on these senses of analysis is represented by William Temple, Abraham Fraunce, Gabriel Harvey, and Ramus himself. Readerly analytical exercise is illustrated by the parallel failures of logic of the Redcrosse Knight and Artegall.
Applying a next-generation sequencing assay targeting 145 cancer-relevant genes in 40 colorectal cancer and 24 non-small cell lung cancer formalin-fixed paraffin-embedded tissue specimens identified ...at least one clinically relevant genomic alteration in 59% of the samples and revealed two gene fusions, C2orf44-ALK in a colorectal cancer sample and KIF5B-RET in a lung adenocarcinoma. Further screening of 561 lung adenocarcinomas identified 11 additional tumors with KIF5B-RET gene fusions (2.0%; 95% CI 0.8-3.1%). Cells expressing oncogenic KIF5B-RET are sensitive to multi-kinase inhibitors that inhibit RET.
Feedback on students' work is, probably, one of the most important aspects of learning, yet students' report, according to the National Union of Students (NUS) Survey of 2008, unhappiness with the ...feedback process. Students were unhappy with the quality, detail and timing of feedback. This paper examines the benefits of using audio, as opposed to written, feedback in an attempt to overcome student criticisms. Using the Audacity audio software MP3 feedback files were created and sent to 60 students either via a VLE or email. The students were asked to complete an online survey on audio feedback. Twenty-six students responded. The results were, generally, very positive. The use of audio feedback seemed to have overcome the problems reported by the NUS survey. Students are at least 10 times more likely to open audio files compared to collecting written feedback. The paper concludes with reflections, and advice, on introducing audio feedback.
Coronavirus Disease 2019 (COVID-19), caused by the novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has affected over 30 million globally to date. Although high rates of venous ...thromboembolism and evidence of COVID-19-induced endothelial dysfunction have been reported, the precise aetiology of the increased thrombotic risk associated with COVID-19 infection remains to be fully elucidated. Therefore, we assessed clinical platelet parameters and circulating platelet activity in patients with severe and nonsevere COVID-19. An assessment of clinical blood parameters in patients with severe COVID-19 disease (requiring intensive care), patients with nonsevere disease (not requiring intensive care), general medical in-patients without COVID-19, and healthy donors was undertaken. Platelet function and activity were also assessed by secretion and specific marker analysis. We demonstrated that routine clinical blood parameters including increased mean platelet volume (MPV) and decreased platelet:neutrophil ratio are associated with disease severity in COVID-19 upon hospitalisation and intensive care unit (ICU) admission. Strikingly, agonist-induced ADP release was 30- to 90-fold higher in COVID-19 patients compared with hospitalised controls and circulating levels of platelet factor 4 (PF4), soluble P-selectin (sP-selectin), and thrombopoietin (TPO) were also significantly elevated in COVID-19. This study shows that distinct differences exist in routine full blood count and other clinical laboratory parameters between patients with severe and nonsevere COVID-19. Moreover, we have determined all COVID-19 patients possess hyperactive circulating platelets. These data suggest abnormal platelet reactivity may contribute to hypercoagulability in COVID-19 and confirms the role that platelets/clotting has in determining the severity of the disease and the complexity of the recovery path.
Abstract Background The primary goals of the Children's Cancer Group 99703 study were to assess the feasibility and tolerability of—as well as the response rate to—a novel dose-intensive chemotherapy ...regimen. Methods Between March 1998 and October 2004, 92 eligible patients were enrolled. Following biopsy/resection, patients received three identical cycles of Induction chemotherapy (vincristine, cyclophosphamide, etoposide, and cisplatin) administered every 21-28 days. Patients without tumor progression then received three consolidation cycles of marrow-ablative chemotherapy (thiotepa and carboplatin) followed by autologous hematopoietic cell rescue. Results The maximum tolerated dose of thiotepa was 10 mg/kg/day × 2 days per cycle. The toxic mortality rate was zero during induction and 2.6% during consolidation. Centrally evaluated response rates to induction and consolidation in evaluable patients with residual tumor were 73.3% and 66.7%, respectively. Disease progression rates on induction and consolidation were 4%. Five-year event-free survival and overall survival were 43.9 ± 5.2% and 63.6 ± 5% respectively. Gross total resection versus less than gross total resection were the only significant outcome comparisons: 5-year maximum tolerated dose and overall survival of 54.4 ± 7% versus 28.9 ± 7% ( P = 0.0065) and 75.9 ± 8% versus 48.7 ± 8% ( P = 0.0034), respectively. The 5-year maximum tolerated dose for localized (M0) versus metastatic (M1+) medulloblastoma was 67.5 ± 9.5% versus 30 ± 14.5% ( P = 0.007). The 5-year maximum tolerated dose and overall survival for desmoplastic medulloblastoma patients versus other medulloblastoma were 78.6 ± 11% versus 50.5 ± 12% ( P = 0.038) and 85.7 ± 9.4% versus 60.6 ± 11.6% ( P = 0.046), respectively. Conclusions This phase I dose-escalation study of marrow-ablative thiotepa regimen determined a maximum tolerated dose that had acceptable toxicity. Overall survival data justify this strategy for current Children's Oncology Group studies.
Ileus following abdominal surgery is a common postoperative complication. It is a source of considerable morbidity to patients and prolongs hospital stay. There is limited evidence to support the use ...of coffee to promote resolution of post-operative ileus.
We performed a systematic review, a risk of bias assessment, and meta-analysis of randomised controlled trials that compared the effect of coffee consumption with control intervention on gastrointestinal motility after abdominal surgery. We searched PubMed, EMBASE, CINAHL, ISI Web of Science, clinicaltrials.gov, Cochrane Library, CENTRAL, WHO ICTRP, and Google Scholar, from inception to 24th February 2018.
Data from seven studies were extracted (606 patients). 31% were men. 69% were women. 342 underwent colorectal resection, 114 gynaecological resection and 150 elective caesarean section.
Estimates from meta-analysis revealed that coffee consumption reduced time to defecation by 14.8 h (95% CI: −11.9, −17.7) after colorectal resection and 17.8 h (95% CI: −13.6, −22.0) after gynaecological resection, but had no significant effect after caesarean section. Coffee also reduced time to first bowel sound, and time to tolerance of solid food, but not time to first reported flatus. No measures of ileus were increased by coffee consumption. Complications and length of hospital stay were similar for coffee and control groups. Coffee was well-tolerated with no adverse effects. Cost was low.
Risk of bias was moderate or high across studies. Assessed with GRADE criteria, there is low to moderate quality evidence that coffee accelerates postoperative recovery of gastrointestinal function after colorectal and gynaecological surgery.
CRD42018087962.
Although urothelial carcinoma (UC) of the urinary bladder generally portends a favorable prognosis, metastatic tumors often follow an aggressive clinical course. DNA was extracted from 40 μm of ...formalin-fixed, paraffin-embedded (FFPE) sections from 35 stage IV UCs that had relapsed and progressed after primary surgery and conventional chemotherapy. Next-generation sequencing (NGS) was performed on hybridization-captured, adaptor ligation-based libraries for 3320 exons of 182 cancer-related genes plus 37 introns from 14 genes frequently rearranged in cancer to at an average sequencing depth of 1164 × and evaluated for all classes of genomic alterations (GAs). Actionable GAs were defined as those impacting the selection of targeted anticancer therapies on the market or in registered clinical trials. A total of 139 GAs were identified, with an average of 4.0 GAs per tumor (range 0–10), of which 78 (56%) were considered actionable, with an average of 2.2 per tumor (range 0–7). Twenty-nine (83%) cases harbored at least one actionable GA including: PIK3CA (9 cases; 26%); CDKN2A/B (8 cases; 23%); CCND1 (5 cases; 14%); FGFR1 (5 cases; 14%); CCND3 (4 cases; 11%); FGFR3 (4 cases; 11%); MCL1 (4 cases; 11%); MDM2 (4 cases; 11%); EGFR (2 cases, 6%); ERBB2 (HER2/neu) (2 cases, 6%); NF1 (2 cases, 6%) and TSC1 (2 cases, 6%). Notable additional alterations included TP53 (19 cases, 54%) and RB1 (6 cases; 17%). Genes involved in chromatin modification were altered by nonsense mutation, splice site mutation or frameshift indel in a mutually exclusive manner in nearly half of all cases including KDM6A (10 cases; 29%) and ARID1A (7 cases; 20%). Comprehensive NGS of 35 UCs of the bladder revealed a diverse spectrum of actionable GAs in 83% of cases, which has the potential to inform treatment decisions for patients with relapsed and metastatic disease.
Micropapillary urothelial carcinoma (MPUC) is a rare and aggressive form of bladder cancer. We conducted genomic analyses next-generation sequencing (NGS) of MPUC and non-micropapillary urothelial ...bladder carcinomas (non-MPUC) to characterize the genomic landscape and identify targeted treatment options.
DNA was extracted from 40 μm of formalin-fixed paraffin-embedded sections from 15 MPUC and 64 non-MPUC tumors. Sequencing (NGS) was performed on hybridization-captured, adaptor ligation-based libraries to high coverage for 3,230 exons of 182 cancer-related genes plus 37 introns from 14 genes frequently rearranged in cancer. The results were evaluated for all classes of genomic alteration.
Mutations in the extracellular domain of ERBB2 were identified in 6 of 15 (40%) of MPUC: S310F (four cases), S310Y (one case), and R157W (one case). All six cases of MPUC with ERBB2 mutation were negative for ERBB2 amplification and Erbb2 overexpression. In contrast, 6 of 64 (9.4%) non-MPUC harbored an ERBB2 alteration, including base substitution (three cases), amplification (two cases), and gene fusion (one case), which is higher than the 2 of 159 (1.3%) protein-changing ERBB2 mutations reported for urinary tract cancer in COSMIC. The enrichment of ERBB2 alterations in MPUC compared with non-MPUC is significant both between this series (P < 0.0084) and for all types of urinary tract cancer in COSMIC (P < 0.001).
NGS of MPUC revealed a high incidence of mutation in the extracellular domain of ERBB2, a gene for which there are five approved targeted therapies. NGS can identify genomic alteration, which inform treatment options for the majority of MPUC patients.
Background Primary cesarean deliveries are a major contributor to the large increase in cesarean delivery rates in the United States over the past 2 decades and are an essential focus for the ...reduction of related morbidity and costs. Studies have shown that primary cesarean delivery rates among low-risk women in the United States vary 3-fold across hospitals and are not explained by differences in patient case-mix. However, the extent to which maternal vs hospital characteristics contribute to this variation remains poorly understood because previous studies were limited in scope and did not assess the influence of factors such as maternal ethnicity subgroups or prepregnancy obesity. Objective We assessed the contribution of individual- and hospital-level risk factors to the hospital variation in primary cesarean delivery rates among low-risk women in Florida. Study Design Our population-based retrospective cohort study used Florida’s linked birth certificate and hospital discharge records for the period of 2004-2011. The study population was comprised of 412,192 nulliparous, singleton, vertex, live births with labor at 37-40 weeks gestation in 122 nonmilitary delivery hospitals. Data were analyzed with logistic mixed-effects regression with cesarean delivery as the outcome. This approach provided adjusted risk estimates at an individual and hospital level and the estimated percent of hospital variation statewide that was explained by these factors. Results The primary cesarean delivery rate in the study population was 23.9%, with hospital-specific estimates that ranged from 12.8-47.3%. Leading risk factors for cesarean delivery were maternal age ≥35 years (adjusted relative risk, 2.22), prepregnancy obesity (body mass index, ≥30 kg/m2 ; adjusted relative risk, 1.73), medical risk conditions (adjusted relative risk, 1.72), labor induction (adjusted relative risk, 1.52), and delivery in hospitals located in Miami-Dade County (adjusted relative risk, 1.73). Hospital geographic location was a significant effect modifier for prepregnancy obesity, medical conditions, and labor induction ( P < .05), with a tendency towards lower adjusted relative risks for these factors in Miami-Dade County relative to other Florida regions. Conversely, Miami-Dade County had an increased prevalence of higher-risk ethnic subgroups, such as Cuban or Puerto Rican mothers, and also substantially higher adjusted relative risks that were associated with practice-related factors, such as delivery during weekday hours. Whereas hospital geographic location contributed to 39.6% of the observed variation statewide, the estimated contribution of maternal ethnicity ranged from 1.6-15.7% among Florida regions. Conclusions Hospital geographic location contributes to hospital variation in primary cesarean delivery rates among low-risk women in Florida. In contrast to previous studies, our findings suggest that individual level risk factors such as maternal ethnicity also contribute to some of this variation, with differing extent by region. These individual factors likely interact with practice factors and add to the variation. This study was limited by not including maternal Bishop score before induction or obstetrics provider in the analysis. These were not available on the dataset but likely contribute to the variation. Our findings suggest potential issues to consider in quality improvement efforts, such as the need for future qualitative research that focuses on mothers in higher-risk ethnic subgroups and providers in high-rate hospitals, particularly those in Miami-Dade County. These studies may help to identify potential cultural differences in maternal beliefs and expectations for delivery and maternal reasons for differences in obstetrics practices.
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