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As Chairman of the Constitutional Court of Russia, Valery Zorkin has sought to legitimise State authoritarianism. He has done this through his jurisprudence and stewardship of the Court. Nowhere is this more visible than with the Courts approach to the executive’s foreign policy. This analysis will explore Zorkin’s views and impact upon the Constitutional Court, its relationship with the Presidency, and the extent to which Zorkin’s Court legitimises and reinforces Russia’s foreign policy.

ObjectivesPreventative coping is an underexplored aspect of coping behaviour. Specifically, coping is a key concern in stroke survivor accounts, but this has yet to be investigated with reference to secondary prevention.DesignSecondary analysis of a qualitative data set comprising semistructured interviews of 22 stroke survivors recruited from five general practices in the East of England. The topic guide included exploration of advice and support given by their doctor on medication and lifestyle. The interviews were coded using thematic analysis.ResultsThe accounts emphasised individual responsibility. Two key themes were identified, which foregrounded the role of self-concept for coping: (a) striving to be ‘good’, (b) appeal to ideas of ‘personality’. In the former, preventative behaviour was depicted in moralistic terms, with the doctor as an adjudicator. In the latter, participants attributed their coping behaviour to their personality, which might help or hinder these efforts.ConclusionsWe highlight that coping was characterised by survivors as something enacted by the individual self, and consider how constructions of self may impact preventative coping efforts.

To provide food security for a growing world population, it will be necessary to increase yields of staple crops such as wheat (Triticum aestivum L.). Yield is a complex, polygenic trait influenced by grain weight and number, which are negatively correlated with one another. Spikelet number is an important determinant of grain number, but allelic variants impacting its expression are often associated with heading date, constraining their use in wheat germplasm that must be adapted for specific environments. Identification and characterization of genetic variants affecting spikelet number will increase selection efficiency through their deployment in breeding programs. In this study, a quantitative trait locus (QTL) on chromosome arm 6BL for spikelet number was identified and validated using an association mapping panel, a recombinant inbred line population, and seven derived heterogeneous inbred families. The superior allele, QSn.csu-6Bb, was associated with an increase of 0.248 to 0.808 spikelets per spike across multiple environments that varied for mean spikelet number. Despite epistatic interactions between QSn.csu-6B and three other loci (WAPO-A1, VRN-D3, and PPD-B1), genotypes with a greater number of superior alleles at these loci consistently exhibit higher spikelet number. The frequency of superior alleles at these loci varies among winter wheat varieties adapted to different latitudes of the US Great Plains, revealing opportunities for breeders to select for increased spikelet number using simple molecular markers. This work lays the foundation for the positional cloning of the genetic variant underlying the QSn.csu-6B QTL to strengthen our understanding of spikelet number determination in wheat.

On 10th January 2021, the People’s Republic of China’s (PRC) enacted its first 5-year plan for the construction of a rule of law. Amongst its embellished statements of principle, the plan’s objective is to shape a ‘Chinese socialist rule of law’ by 2025, and achieve a fully formed version of by 2035. The official document carrying these policy goals is equally ambitious, and is the first of its kind in two respects. It is the first publically available document stating the principles, contents and procedures of a constitutional review by the all-powerful Standing Committee of the National People’s Congress. It is also the first public document calling for the enactment of a unified Chinese Administrative Law. The plan also reveals a deep commitment to “accelerate the construction of a legal system applicable outside the jurisdiction of our country.” This is both a significant development in contemporary Chinese globalism, and largely under-reported and under-explored by the West. Thus, the document is of paramount importance to understanding the Communist Party of China’s (CCP) future plans for both the domestic Chinese legal system, and future legal engagement with the rules-based international order. This article will offer a critical appraisal of the CCP’s plan, analysing its domestic and international implications. With a focus on Hong Kong, Macau, Taiwan, and the ‘Belt and Road Initiative’, this analysis concludes that the CCP’s plan for the rule of law signals a new consolidation of both legal justification for political ambition, and unbridled Chinese exceptionalism. &nbsp

The teacher's attention is focused on selected elements of Spanish culture which may be taught integrally with instructional materials found in the first-year Spanish texts "Entender y Hablar", "La Familia Fernandez", and "A-LM Spanish, Level One". Items are cross-referenced for 42 cultural concepts ranging from nicknames to streets, roads, and highways. The role of culture in foreign language teaching is elaborated with commentary on cultural phenomena and teaching methodology. Extensive linguistic examples and illustrations accompany discussion of each of the particular cultural concepts. The booklet serves as a supplement to traditional Spanish texts at all levels. (RL)

Although rare, Metaplastic Breast Carcinomas (MBC) account for significant global breast cancer mortality. This subgroup is extremely heterogeneous and by definition exhibits metaplastic change to squamous and/or mesenchymal elements, including but not limited to spindle, squamous, chondroid, osseous and rhabdomyoid elements. The WHO working group recognizes that the current classification is inadequate and in the interim, has suggested a purely descriptive classification. The mixed epithelial-mesenchymal morphology has led to speculation that MBC represent 'stem cell tumours'; in support of this, MBC have been shown to have a CD44+/CD24-/low phenotype. Clinically, patients present with tumours that are larger (higher stage), have increased likelihood of distant metastases at presentation and overall, have a reduced 5-year survival rate compared to Invasive Carcinoma-NST. Hence, this is a unique subtype with poor outcome but without a robust classification or understanding of the biology to aid clinical management. We present a detailed morphological, immunohistochemical and genomic analysis of a large series of MBC (n=347), as amassed through the Asia-Pacific MBC consortium. We consider our morphological dissection using the WHO subtyping guidelines and show that an increasing number of phenotypes in a mixed MBC (classified as WHO_1) significantly associates with a poor prognosis. Immunohistochemical analysis showed that a pure spindle (WHO_5) is significantly less likely to express vimentin, CK5/6, CK14, and CK19 than a mixed WHO_1 with spindle features. Similarly, a WHO_1 with chondroid features is less likely to express EGFR than WHO_1 with chondroid features and rhabdoid or osseous differentiation. Across the cohort, positivity for the AE1/3 antibody and a lack of EGFR expression both significantly associate with a better outcome. We report no significant association between patient age at diagnosis and breast cancer specific survival, nor between age and specific WHO MBC subtypes. We report a significant association between WHO_1 types and increasing tumour grade, and also between tumour size and grade, with tumour size being a highly significant prognostic indicator in this cohort. Our exome sequencing confirms a significant enrichment for TP53 and PTEN mutations in MBC, and intriguingly for concurrent mutations of TP53, PTEN and PIK3CA. A novel enrichment for NF1 mutations is also presented. In summary, we provide a thorough assessment of a large cohort of MBC, including morphology, survival, IHC and exome sequencing, and present our analysis contextualized by the WHO guidelines, extending the existing knowledge base of this rare tumour type. Citation Format: McCart Reed AE, Kalaw E, Nones K, Bettington M, Lim M, Bennett J, Johnstone K, Kutasovic JR, Kazakoff S, Xu QC, Saunus JM, Reid LE, Black D, Niland C, Ferguson K, Gresshoff I, Raghavendra A, Liu JC, Kalinowski L, Reid AS, Davidson M, Pearson JV, Yamaguchi R, Harris G, Tse G, Papadimos D, Pathmanathan R, Pathmanathan N, Tan PH, Fox S, O'Toole S, Waddell N, Simpson PT, Lakhani SR. Dissecting the heterogeneity of metaplastic breast cancer: A morphological, immunohistochemical and genomic analysis of a large cohort [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-08-03.

PURPOSE This study is to compare the accuracy of four different black-blood T2 mapping sequences in carotid vessel wall. METHODS Four different black-blood T2 mapping sequences were developed and tested through phantom experiments and 17 healthy volunteers. The four sequences were: 1) double inversion-recovery (DIR) prepared 2D multi-echo spin-echo (MESE); 2) DIR-prepared 2D multi-echo fast spin-echo (MEFSE); 3) improved motion-sensitized driven-equilibrium (iMSDE) prepared 3D FSE and 4) iMSDE prepared 3D fast spoiled gradient echo (FSPGR). The concordance correlation coefficient and Bland-Altman statistics were used to compare the sequences with a gold-standard 2D MESE, without blood suppression in phantom studies. The volunteers were scanned twice to test the repeatability. Mean and standard deviation of vessel wall T2, signal-to-noise (SNR), the coefficient of variance and interclass coefficient (ICC) of the two scans were compared. RESULTS The phantom study demonstrated that T2 measurements had high concordance with respect to the gold-standard (all r values >0.9). In the volunteer study, the DIR 2D MEFSE had significantly higher T2 values than the other three sequences (P 0.05). iMSDE 3D FSE had the highest SNR (P < 0.05) compared with the other three sequences. The 2D DIR MESE has the highest repeatability (ICC: 0.96, [95% CI: 0.88-0.99]). CONCLUSION Although accurate T2 measurements can be achieved in phantom by the four sequences, in vivo vessel wall T2 quantification shows significant differences. The in vivo images can be influenced by multiple factors including black-blood preparation and acquisition method. Therefore, a careful choice of acquisition methods and analysis of the confounding factors are required for accurate in vivo carotid vessel wall T2 measurements. From the settings in this study, the iMSDE prepared 3D FSE is preferred for the future volunteer/patient scans.

This study aimed to evaluate image quality and diagnostic performance of a recently developed navigated three-dimensional magnetic resonance cholangiopancreatography (3D-MRCP) with compressed sensing (CS) based on parallel imaging (PI) and conventional 3D-MRCP with PI only in patients with abnormal bile duct dilatation. This institutional review board-approved study included 45 consecutive patients [non-malignant common bile duct lesions (n = 21) and malignant common bile duct lesions (n = 24)] who underwent MRCP of the abdomen to evaluate bile duct dilatation. All patients were imaged at 3T (MR 750, GE Healthcare, Waukesha, WI) including two kinds of 3D-MRCP using 352 × 288 matrices with and without CS based on PI. Two radiologists independently and blindly assessed randomized images. CS acceleration reduced the acquisition time on average 5 min and 6 s to a total of 2 min and 56 s. The all CS cine image quality was significantly higher than standard cine MR image for all quantitative measurements. Diagnostic accuracy for benign and malignant lesions is statistically different between standard and CS 3D-MRCP. Total image quality and diagnostic accuracy at biliary obstruction evaluation demonstrates that CS-accelerated 3D-MRCP sequences can provide superior quality of diagnostic information in 42.5% less time. This has the potential to reduce motion-related artifacts and improve diagnostic efficacy.

The reserved set of audible alarm signals embodied within the global medical device safety standard, IEC 60601-1-8, is known to be problematic and in need of updating. The current alarm signals are not only suboptimal, but there is also little evidence beyond learnability (which is known to be poor) that demonstrates their performance in realistic and representative clinical environments. In this article, we describe the process of first designing and then testing potential replacement audible alarm signals for IEC 60601-1-8, starting with the design of several sets of candidate sounds and initial tests on learnability and localizability, followed by testing in simulated clinical environments. We demonstrate that in all tests, the alarm signals selected for further development significantly outperform the current alarm signals. We describe the process of collecting considerably more data on the performance of the new sounds than exists for the current sounds, which ultimately will be of use to end users. We also reflect on the process and practice of working with the relevant committees and other practical issues beyond the science, which also need constant attention if the alarms we have developed are to be included successfully in an updated version of the standard.

The purpose of this work is to evaluate the repeatability of a compressed sensing (CS) accelerated multi-contrast carotid protocol at 3 T. Twelve volunteers and eight patients with carotid disease were scanned on a 3 T MRI scanner using a CS accelerated 3-D black-blood multi-contrast protocol which comprises T 1w, T 2w and PDw without CS, and with a CS factor of 1.5 and 2.0. The volunteers were scanned twice, the lumen/wall area and wall thickness were measured for each scan. Eight patients were scanned once, the inter/intra-observer reproducibility of the measurements was calculated. In the repeated volunteer scans, the interclass correlation coefficient (ICC) for the wall area measurement using a CS factor of 1.5 in PDw, T 1w and T 2w were 0.95, 0.81, and 0.97, respectively. The ICC for lumen area measurement using a CS factor of 1.5 in PDw, T 1w and T 2w were 0.96, 0.92, and 0.96, respectively. In patients, the ICC for inter/intra-observer measurements of lumen/wall area, and wall thickness were all above 0.81 in all sequences. The results show a CS accelerated 3-D black-blood multi-contrast protocol is a robust and reproducible method for carotid imaging. Future protocol design could use CS to reduce the scanning time.

$\textit{Purpose:}$ Hepatic magnetic resonance elastography (MRE) is currently a breath-hold imaging technique. Patients with chronic liver disease can have comorbidities that limit their ability to breath-hold (BH) for the required acquisition time. Our aim was to evaluate whether stiffness measurements obtained from a navigator-triggered MRE acquisition are comparable to standard expiratory breath-hold, inspiratory breath-hold or free-breathing in healthy participants. $\textit{Materials and methods:}$ Twelve healthy participants were imaged using the four methods on a clinical 1.5 T MR system equipped with a product MRE system. Mean liver stiffness, and measurable area of stiffness (with a confidence threshold >95%) were compared between sequences using the concordance correlation coefficient. Repeatability of each sequence between two acquisitions was also assessed. $\textit{Results:}$ The standard BH expiratory technique had high concordance with the navigated technique (r = 0.716), and low concordance with the BH inspiration (r = 0.165) and free-breathing (r = 0.105) techniques. The navigator-triggered technique showed no statistical difference in measurable area of liver or in repeatability compared with the standard expiratory acquisition (p = 0.997 and p = 0.407 respectively). The free-breathing technique produced less measurable liver area and was less repeatable than the alternative techniques. The increase in acquisition time for navigator techniques was 3 min 6 s compared to standard expiratory breath-hold. $\textit{Conclusion:}$ Navigator-based hepatic MRE measurements are comparable to the reference standard expiratory breath-hold acquisition in healthy participants.

Purpose To develop a 3D black-blood T 2 mapping sequence with a combination of compressed sensing (CS) and parallel imaging (PI) for carotid wall imaging. Materials and methods A 3D black-blood fast-spin-echo (FSE) sequence for T 2 mapping with CS and PI was developed and validated. Phantom experiments were performed to assess T 2 accuracy using a Eurospin Test Object, with different combination of CS and PI acceleration factors. A 2D multi-echo FSE sequence was used as a reference to evaluate the accuracy. The concordance correlation coefficient and Bland-Altman statistics were calculated. Twelve volunteers were scanned twice to determine the repeatability of the sequence and the intraclass correlation coefficient (ICC) was reported. Wall-lumen sharpness was calculated for different CS and PI combinations. Six patients with carotid stenosis > 50% were scanned with optimised sequence. The T 2 maps were compared with multi-contrast images. Results Phantom scans showed good correlation in T 2 measurement between current and reference sequence (r = 0.991). No significant difference was found between different combination of CS and PI accelerations (p = 0.999). Volunteer scans showed good repeatability of T 2 measurement (ICC: 0.93, 95% CI 0.84–0.97). The mean T 2 of the healthy wall was 48.0 ± 9.5 ms. Overall plaque T 2 values from patients were 54.9 ± 12.2 ms. Recent intraplaque haemorrhage and fibrous tissue have higher T 2 values than the mean plaque T 2 values (88.1 ± 6.8 ms and 62.7 ± 9.3 ms, respectively). Conclusion This study demonstrates the feasibility of combining CS and PI for accelerating 3D T 2 mapping in the carotid artery, with accurate T 2 measurements and good repeatability.

A clear link between ulcerative colitis and the formation of dysplasia and neoplasia has been described. This increased risk remains even after subtotal colectomy and ileo-rectal anastomosis, necessitating life-long surveillance of the remaining ano-rectum. This case study highlights the importance in long-term follow up in this population, including proximal to the anastomosis as dysplastic changes can occur in the distal ileum. Resumo: Uma ligação clara entre colite ulcerativa e a formação de displasia e neoplasia tem sido descrita. Ese risco aumentado permanece mesmo após colectomia subtotal e ileo-retal, necesitando de uma vigilância ao longo da vida do ano-recto restante. Este caso de estudo realça a importância no acompanhamento a longo prado dessa população, incluindo áqueles próximos à anastomose já que podem ocorrer alteraçoes displásicas no íleo distal. Keywords: Ulcerative colitis, Colectomy, Follow-up, Neoplasms, Palavras-chave: Colite ulcerativa, Colectomia, Seguimento, Neoplasias

We present Polynomial in Temperature (PinT) decode weights, a novel approach to approximating functions with an ensemble of silicon neurons that increases thermal robustness. In mixed-signal neuromorphics, computing accurately across a wide range of temperatures is challenging because of individual silicon neurons’ thermal sensitivity. To compensate for the resulting changes in the neuron’s tuning-curves in the PinT framework, weights change continuously as a polynomial function of temperature. We validate PinT across a 38°C range by applying it to tuning curves measured for ensembles of 64 to 1936 neurons on Braindrop, a mixed-signal neuromorphic chip fabricated in 28-nm FDSOI CMOS. LinT, the Linear in Temperature version of PinT, reduces error by a small margin on test data, relative to an ensemble with temperature-independent weights. LinT and higher-order models show much greater promise on training data, suggesting that performance can be further improved. When implemented on-chip, LinT’s performance is very similar to the performance with temperature-independent decode weights. SpLinT and SpLSAT, the Sparse variants of LinT and LSAT, are promising avenues for efficiently reducing error. In the SpLSAT model, up to 90% of neurons on chip can be deactivated while maintaining the same function-approximation error.