Memory Research Research Articles

Preventive analgesia with oral tramadol and pregabalin for post-operative pain in breast surgical patients

Background & objective: Preventive analgesia is implied before the actual surgical insult occurs and it is aimed to reduce the neuro-humoral changes associated with surgical induced pain. Different methods have been used by the anesthesiologists for this purpose. We studied the effect of pre-emptive oral tramadol 50 mg and pregabalin 100 mg on post-operative pain, the requirement of rescue analgesics and the stay in post-anesthesia care unit (PACU) in breast cancer surgery patients. Methodology: A randomized double blinded, placebo-controlled trial, was conducted in the Department of Anesthesia, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore (Pakistan) after ethical approval by the hospital Scientific Review Committee and Institutional Review Board. Atotal of 30 patients, undergoing breast cancer surgery, were enrolled and randomly divided into two groups. Group A (study group) patients were given tramadol 50 mg and pregabalin 100 mg orally, and Group B (control group) received two soda mint tablets orally 30 min prior to induction of anesthesia. Standard monitoring was done and routine general anesthesia was administered with intubation. After recovery, Visual Analog Scale (VAS) scores and time to rescue analgesia, total morphine consumption, were recorded. Data was analyzed using SPSS v.20. P < 0.05 was considered significant. Results: The mean ages in Group A and B were 36.67 ± 9.50 y and 41.80 ± 12.43 y (P = 0.236). The differences in intra-operative morphine and rescue morphine use in both groups were not significant (P = 0.139 and 0.293, The rescue analgesic use and VAS scores in PACU were significantly different in both groups (P = 0.005 and P = 0.022, respectively). Total PACU stay in Group A was 79.33 ± 26.31 min and in Group B was 96.67 ± 34.98 min (P = 0.281). Tramadol use in the ward was not statistically equivalent (P = 0.300). Mean post-operative rescue morphine was 0.2 ± 0.775 mg/kg in control group as compared to placebo group was 1.4 ± 1.682 mg/kg, which was statistically significant (P = 0.02). VAS scores in PACU in both groups showed statistically differences, e.g., 1.33 ± 1.1 vs 2.70 ± 1.60 (P = 0.01). PACU stay time was also higher in the control group. Conclusion: The use of pre-emptive analgesia with oral tramadol 50 mg and pregabalin 100 mg 30 min before the surgery can reduce the requirement of peri operative opioid use, achieve better pain control and early recovery. Abbreviations: BMI- Basal Metabolic Rate; PACU- Post-Anesthesia Care Unit; PONV- Postoperative Nausea and Vomiting; VAS- Visual Analog Scale Key words: Analgesia, Preventive; Cancer Surgery; Opioids; Post-Anesthesia Care Unit; Pregabalin; Tramadol Citation: Usman A, Mehdi SR, Khan AA. Preventive analgesia with oral tramadol and pregabalin for post-operative pain in breast surgical patients. Anaesth. pain intensive care 2024;28(1):81−84; DOI: 10.35975/apic.v28i1.2374 Received: November 17, 2021; Reviewed: September 24, 2022; Accepted: July 06, 2023

Hypofractionated versus conventional fractionation external beam radiotherapy in intermediate and high risk localized prostate cancer

BackgroundProstate cancer is the second most common malignancy in men, and its incidence is increasing which is attributed to increased screening programs. The treatment options of intermediate and high risk prostate cancer include radical prostatectomy, radiotherapy and androgen deprivation therapy. Hypofractionated radiotherapy is becoming more popular lately due to better understanding of the radiobiology of prostate cancer and favorable logistics.ObjectiveTo compare the toxicity and efficacy of hypofractionated versus conventional fractionation external beam radiotherapy in patients with intermediate and high risk localized prostate cancer treated in Shaukat Khanum Memorial Hospital and Research Center, Lahore (SKMCH & RC).MethodologyWe retrospectively conducted this study on histopathologically confirmed 114 patients with prostate adenocarcinoma who underwent treatment from January 2013 till December 2018. These patients were treated with radical radiotherapy along with hormonal therapy as per indication. Data was collected from electronic hospital system and analyzed by SPSS version 23.Results114 patients were selected according to the inclusion criteria. Mean age was 68 years (61–75). 88% of patients had stage III-IVA disease at the time of diagnosis. Mean PSA and GS was 33 ± 39 SD and 7 ± 0.9 SD respectively. 89% (n = 102) received radiotherapy with 69% of patients receiving dose of 60 Gy in 20 fractions. Among patients who received hypofractionated dose, 86% (n = 61) of them were categorized as high risk and 14% (n = 10) were intermediate risk, whereas among conventional group 90% (n = 28) were high risk patients and 10% (n = 3) were of intermediate risk. In hypofractionated dose group, 14% (n = 10) developed grade 2 proctitis and 8% (n = 6) developed grade 2 cystitis, in contrast to conventional dose group in which only 3 patients (5%) developed grade 2 GI toxicity and 2 patients (2.9%) had grade 2 GU toxicity. However, these toxicities and their grade were clinically insignificant when compared with the dose groups (p = 0.11). 5 year overall survival for hypofractionated radiotherapy versus conventional dose was 100% and 90% respectively with 95% Cl and p value of 0.3 (clinically insignificant), whereas 5 year disease free survival was 100% and 75% for hypofractionation versus conventional EBRT respectively with 95% CI and p value of 0.04 (clinically significant).ConclusionHypofractionated radiotherapy in patients with intermediate and high risk localized prostate cancer has better disease free survival at the expense of higher risk for proctitis and cystitis but no difference in overall survival as compared to conventional dose of radiation.

Toward interpretable and generalized mitosis detection in digital pathology using deep learning.

The mitotic activity index is an important prognostic factor in the diagnosis of cancer. The task of mitosis detection is difficult as the nuclei are microscopic in size and partially labeled, and there are many more non-mitotic nuclei compared to mitotic ones. In this paper, we highlight the challenges of current mitosis detection pipelines and propose a method to tackle these challenges. Our proposed methodology is inspired from recent research on deep learning and an extensive analysis on the dataset and training pipeline. We first used the MiDoG'22 dataset for training, validation, and testing. We then tested the methodology without fine-tuning on the TUPAC'16 dataset and on a real-time case from Shaukat Khanum Memorial Cancer Hospital and Research Centre. Our methodology has shown promising results both quantitatively and qualitatively. Quantitatively, our methodology achieved an F1-score of 0.87 on the MiDoG'22 dataset and an F1-score of 0.83 on the TUPAC dataset. Qualitatively, our methodology is generalizable and interpretable across various datasets and clinical settings. In this paper, we highlight the challenges of current mitosis detection pipelines and propose a method that can accurately predict mitotic nuclei. We illustrate the accuracy, generalizability, and interpretability of our approach across various datasets and clinical settings. Our methodology can speed up the adoption of computer-aided digital pathology in clinical settings.

A systematic review and meta-analysis of how social memory is studied

Social recognition is crucial for survival in social species, and necessary for group living, selective reproduction, pair bonding, and dominance hierarchies. Mice and rats are the most commonly used animal models in social memory research, however current paradigms do not account for the complex social dynamics they exhibit in the wild. To assess the range of social memories being studied, we conducted a systematic analysis of neuroscience articles testing the social memory of mice and rats published within the past two decades and analyzed their methods. Our results show that despite these rodent’s rich social memory capabilities, the majority of social recognition papers explore short-term memories and short-term familiarity levels with minimal exposure between subject and familiar stimuli—a narrow type of social memory. We have identified several key areas currently understudied or underrepresented: kin relationships, mates, social ranks, sex variabilities, and the effects of aging. Additionally, reporting on social stimulus variables such as housing history, strain, and age, is limited, which may impede reproducibility. Overall, our data highlight large gaps in the diversity of social memories studied and the effects social variables have on social memory mechanisms.

Correlation of intra operative specimen imaging with final histopathology in breast conserving surgery for breast cancer.

To determine the effectiveness of specimen mammography in breast conserving surgery cases with respect to reduction in margin positivity rate, and to see whether the rate of secondary surgeries is decreased by intra-operative excision based on specimen mammography evaluation. The retrospective study was conducted at the Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan, and comprised data from January 2018 to December 2019 related to all female breast cancer patients who underwent mastectomy or breast conserving surgery with the involvement of specimen mammography. Sensitivity, specificity, positive predictive value and negative predictive value of specimen mammography were calculated. Data was analysed using SPSS 20. Of the 226 patients initially assessed, 65(28.7%) were excluded, and the final sample comprised 161(71.2%) women with mean age 46.71±10.47 years. The sensitivity, specificity, positive predictive value and negative predictive value of specimen mammography for the sample were 65.8%, 80.8%, 54% and 87.3%, respectively. Performing specimen mammography for intra-operative margin assessment in 12 patients was likely to spare one patient from re-excision. Intra-operative specimen mammography was found to be a reliable tool for assessing margin status.

Expression of PD-L1 clones (22C3 and 28-8) in hepatocellular carcinoma: a tertiary cancer care hospital experience

BackgroundHepatocellular carcinoma (HCC) is a highly aggressive and rapidly progressing form of cancer with a poor prognosis. Recent advances in the management of HCC focused on the novel immunotherapeutic modalities for patients with advanced disease. PD-L1 has emerged as a promising immunotherapeutic approach for HCC. The evaluation of PD-L1 expression aids in identifying patients who can derive maximum benefits from these therapies. This study aims to examine and compare the expression of PD-L1 using two clones (22C3 and 28-8) in HCC patients.MethodsForty-six patients with HCC were selected between 2005 and 2022 from the Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) in Lahore, Pakistan. The patients' formalin-fixed paraffin-embedded (FFPE) tissue samples were retrieved from the department of pathology to conduct immunohistochemical analysis. Moreover, the clinicopathological data of these patients were gathered from the hospital information system (HIS). To assess the relationship between variables, bivariate analysis was carried out using either the chi-square test or Fisher exact test when necessary.ResultsAmong the 46 tissue specimens analyzed, the presence of clone 22C3 was detected in 20 HCC patients, with 10 patients showing high expression (21.7%) and another 10 patients showing low expression (21.7%). 22C3 expression was not observed in 26 patients (56.5%). On the other hand, clone 28-8 was expressed in 10 patients, all of whom exhibited low expression (21.7%), while no expression of clone 28-8 was observed in 36 patients (78.3%). An association was found between the expression of 22C3 and 28-8 PD-L1 clones (p-value 0.01). Furthermore, upon closer examination, it was revealed that 12 cases exhibited positive results for 22C3 but negative results for 28-8. Interestingly, two cases displayed positive results for 28-8 but negative results for 22C3.ConclusionWe obserevd that the PD-L1 clones, 22C3 and 28-8, are comparable. If PD-L1 expression using 22C3 is negative, considering the use of 28-8 for evaluating expression in HCC patients may be beneficial. However, further validation in a larger cohort is necessary.

The central role of tilted anisotropy for field-free spin–orbit torque switching of perpendicular magnetization

The discovery of efficient magnetization switching upon device activation by spin Hall effect (SHE)-induced spin–orbit torque (SOT) changed the course of magnetic random-access memory (MRAM) research and development. However, for electronic systems with perpendicular magnetic anisotropy (PMA), the use of SOT is still hampered by the necessity of a longitudinal magnetic field to break magnetic symmetry and achieve deterministic switching. In this work, we demonstrate that robust and tunable field-free current-driven SOT switching of perpendicular magnetization can be controlled by the growth protocol in Pt-based magnetic heterostructures. We further elucidate that such growth-dependent symmetry breaking originates from the laterally tilted magnetic anisotropy of the ferromagnetic layer with PMA, a phenomenon that has been largely neglected in previous studies. We show experimentally and in simulation that in a PMA system with tilted anisotropy, the deterministic field-free switching exhibits a conventional SHE-induced damping-like torque feature, and the resulting current-induced effective field shows a nonlinear dependence on the applied current density. This relationship could be potentially misattributed to an unconventional SOT origin.

Exploring retro-cue effects on visual working memory: insights from double-cue paradigm.

In the realm of visual working memory research, the retro-cue paradigm helps us study retro-cue effects such as retro-cue benefit (RCB) and retro-cue cost (RCC). RCB reflects better performance with cued items, while RCC indicates poorer performance with uncued items. Despite consistent evidence for RCB, it's still uncertain whether it remains when previously uncued items are cued afterward. Additionally, research findings have been inconsistent. This study combines prior experiments by controlling the proportion of cue types and the number of memory items. Besides, using a CDA index to assess the status of items after the cue appeared. Results showed better performance under the double-cue condition (involving two cues pointing inconsistently with only the second cue being valid) compared to the neutral-cue condition, and better performance under the single-cue condition compared to double-cue. EEG data revealed that after the appearance of the second cue in the double-cue condition, there was a significant increase in CDA wave amplitude compared to the single-cue condition. Behavior results suggests that RCB occurs under double-cue but to a lesser extent than the single-cue. And EEG outcomes indicates that individuals did not remove the uncued item from their visual working memory after the first cue. Instead, they kept it in a passive state and then shifted it to an active state after the appearance of the second cue.

Reactivation of cytomegalovirus, human herpes virus, and Epstein-Barr virus infections after hemapoietic stem cell transplantation in children

Study objective: to evaluate frequency of CMV, HHV-6, and EBV reactivation in children within 60 days after HSCT.Materials and methods: The study was carried out in Raisa Gorbacheva Memorial Research Institute for Pediatric Oncology, Hematology, and Transplantation of the Pavlov First Saint Petersburg State Medical University We analyzed 95 medical records of pediatric patients who underwent HSCT in 2021. Pretransplant serostatus for CMV, EBV, HHV-6 was studied, as well as the frequency and timing of virus reactivation after transplantation. In the prospective part, 35 children aged from 1 to 17 years were enrolled. The pretransplant evaluation included detection of anti-CMV, anti-HHV-6, and anti-EBV IgM and IgG by ELISA, and blood PCR for viremia. DNA of herpes viruses was identified by quantitative blood PCR on the day of HSCT, and then 10, 20, 30 and 60 days after HSCT. The number of viral DNA copies was calculated per 105 cells. Statistical analysis was carried out using SPSS Statistics 22 software package.Results: On pre-transplant evaluation, 47 of 95 pediatric patients were tested for CMV with positive result in 36 children, 27 patients were tested for EBV and 17 were positive. HHV-6 DNA was detected in 3 of 25 patientsMostly, reactivation of herpes viruses occurred in the early period up to 60 days. HHV-6 reactivation was observed on average 25±4 days after transplantation, significantly earlier than for CMV and EBV.In a prospective study, reactivation of CMV, HHV-6, and EBV was revealed in 28 (80%) patients within 60 days of transplantation, with a maximum number of patients in 20 days after HSCT.A trend toward an increase in CMV and HHV-6 concentration in blood was observed on days 10 and 20 after HSCT, with a maximum viral load of HHV-6 and minimal EBV replicative activity. Clinically significant manifestations of herpesvirus infection were diagnosed in 19 (54.3%) patients.Conclusion: High seropositivity for CMV and EBV was revealed in children before transplantation. Herpes viruses reactivation occurs early in post-transplant period, on the 20th day after HSCT, HHV-6 in forms of mono- and mixed infection predominates with a trend toward increasing viral load.

Benefits of multinomial processing tree models with discrete and continuous variables in memory research: an alternative modeling proposal to Juola et al. (2019).

Signal detection theory (SDT) and two-high threshold models (2HT) are often used to analyze accuracy data in recognition memory paradigms. However, when reaction times (RTs) and/or confidence levels (CLs) are also measured, they usually are analyzed separately or not at all as dependent variables (DVs). We propose a new approach to include these variables based on multinomial processing tree models for discrete and continuous variables (MPT-DC) with the aim to compare fits of SDT and 2HT models. Using Juola et al.'s (2019, Memory & Cognition, 47[4], 855-876) data we have found that including CLs and RTs reduces the standard errors of parameter estimates and accounts for interactions among accuracy, CLs, and RTs that classical versions of SDT and 2HT models do not. In addition, according to the simulations, there is an increase in the proportion of correct model selections when relevant DV are included. We highlight the methodological and substantive advantages of MPT-DC in the disentanglement of contributing processes in recognition memory.

Музейные сувениры: память и забвение в современной культуре

The article is devoted to the study of museum souvenirs as indicators of the processes of cultural memory and oblivion. Based on the concepts of "memory research" by M. Halbwachs, Assmann’s self, the concept of habitus by P. Bourdieu and media studies by N. Luhmann, the representation of cultural heritage is considered in this case as a collective and personal event working to actualize and support certain ideological view, and its representation through certain marketing strategy, including souvenirs, should indicate the most valuable and important. The space of cultural memory includes both historical and cultural phenomena, as well as those associated with mythological and artistic systems; a separate issue is the transformation of ethnic or national traditions that fall into the sphere of consumption of souvenirs, therefore in some cases we are talking about "staged authenticity" or "constructed authenticity". Souvenirs become a marker of choice for both institutions and the user who has chosen a specific magnet or mug from the offered set. Over the last decade, within the framework of the event economy and new sensibility, consumers are increasingly paying attention to souvenirs with practical benefits; capable of expressing the individuality of the tourist himself; Artifacts marked as unique are becoming popular, "customization" of objects is in demand, as is the opportunity to make a souvenir yourself. A number of souvenirs over time lose their status as treasured travel items and become part of a person’s everyday culture. A separate issue is the devaluation of cultural values in the case of their presentation in the form of mass, standardized products. Souvenirs also demonstrate processes associated with "emergent" and "constructed authenticity", in which case they can be called a marker of certain trends in culture associated with the memory and forgetting of certain narratives and values.

How social memory works on social media: A methodological framework

Abstract Social media challenge several established concepts of memory research. In particular, the day-to-day mundane discourse of social media blur the essential distinction between commemorative and non-commemorative memory. We address these challenges by presenting a methodological framework that explores the dynamics of social memory on various social media. Our method combines top-down data mining with a bottom-up analysis tailored to each platform. We demonstrate the application of our approach by studying how the Holocaust is remembered in different corpora, including a dataset of 5.3 million Facebook posts and comments collected between 2015 and 2017 and a 5 million Tweets and Retweets dataset collected in 2021. We first identify the mnemonic agents initiating the discussion of the memory of the Holocaust and those responding to it. Second, we compare the macro-rhythms of Holocaust discourse on the two platforms, identifying peaks and mundane discussions that extend beyond commemorative occasions. Third, we identify distinctive language and cultural norms specific to the memorialization of the Holocaust on each platform. We conceptualize these dynamics as ‘Mnemonic Markers’ and discuss them as potential pathways for memory researchers who wish to explore the unique memory dynamics afforded by social media.

Clinicopathological Features and Treatment Outcomes of Male Breast Cancer in Pakistani Population: A 10-Year Retrospective Cross-Sectional Study.

Male breast cancer (MBC) accounts for 1% of global breast cancer cases. On account of its rarity, very few prospective clinical trials have been carried out on MBC. Pakistan has the highest incidence of breast cancer in Asia, but very limited data are available on MBC. The objective is to determine the clinicopathological characteristics and treatment patterns of MBC in Pakistani population. This is a retrospective cross-sectional study. A retrospective cross-sectional study carried out using the cancer database of Shaukat Khanum Memorial Cancer Hospital & Research Center. Men with a histologically proven breast cancer, stage 0 to III disease and requiring surgical intervention were included. The Kaplan-Meier curve and log-rank test were used for survival analysis. Sixty-eight patients with MBC were included with a median age at diagnosis of 55 years. Most patients were stage II (47.1%). Invasive ductal carcinoma (IDC) was the commonest type (89.7%). Estrogen receptor (ER), progesterone receptor (PR), and Her-2 receptor positivity were 92.6%, 86.8%, and 32.4%, respectively. Mastectomy was performed in 95.6% of the cases. Neoadjuvant and adjuvant chemotherapy was administered in 25 (36.8%) and 26 (38.2%) patients, respectively. Fifty-five (80.9%) patients received adjuvant radiotherapy. Most of the patients (89.7%) received tamoxifen. The 5-year overall and disease-free survival was 88.2% and 80.9%, respectively. Patients receiving neoadjuvant chemotherapy had a better overall and disease-free survival (P = .025). Male breast cancer occurs at a relatively earlier age in Pakistani population as compared with Western men. Mastectomy is the preferred surgical option for MBC on account of the advanced disease and delayed presentation. Neoadjuvant chemotherapy has a statistically significant effect on overall and disease-free survival, but in spite of these benefits, it remains underutilized.

Survival Outcomes in Malignancy-related Hypercalcemia: A Tertiary Care Single-center Experience.

Malignancy-related hypercalcemia is commonly observed in patients with advanced stages of cancer. It is intricately linked with an unfavorable prognosis among oncology patients. This study aimed to evaluate survival outcomes among individuals diagnosed with hypercalcemia associated with malignancy. This retrospective analysis of 173 cancer patients with hypercalcemia who sought treatment at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan, between July 2019 and June 2020. This cohort of patients underwent a longitudinal follow-up for 2.5 years. To assess survival outcomes, the Kaplan-Meier tool was used to construct survival curves and estimate the survival probability over time. The significance of potential survival factors was evaluated using the log-rank test. All patients exhibited elevated levels of calcium. At admission, the cohort demonstrated varying degrees of hypercalcemia severity attributable to malignancy: Mild hypercalcemia was observed in approximately 61.3% of patients, moderate hypercalcemia in 23.7%, and severe hypercalcemia in 15% of cases. Among the total sample, most patients were female (54.9%), with a median age of 54. The primary tumor site most frequently observed was in cases of breast cancer (35.3%), wherein the prevalent histological subtype was lobular/ductal invasive carcinoma (34.1%). Most of the patients (93.6%) had an Eastern Cooperative Oncology Group (ECOG) performance status (ECOG) >1. In addition, the median overall survival for patients diagnosed with hypercalcemia was 51 days. Notably, there was a significant association between survival factors, including the primary site of malignancy (P = 0.001), bone metastasis (P = 0.04), severity and symptoms of hypercalcemia (P = 0.001), altered mental state (P = 0.001), albumin levels (P = 0.001), and ECOG (P = 0.001). Malignancy-related hypercalcemia in patients with cancer is a significant predictor of an unfavorable prognosis. The aforementioned survival factors may have the potential to influence patient survival outcomes. Further studies on larger cohorts are warranted.

Cancer Statistics from the Shaukat Khanum Memorial Trust's Hospital-based Cancer Registry, Pakistan, 1994-2022: An Observational Study.

The Shaukat Khanum Memorial Trust has been operational, since February 1990. The first Shaukat Khanum Memorial Cancer Hospital and Research Center (SKMCH&RC) started functioning in Lahore on December 29, 1994. SKMCH&RC, Peshawar, started its operation in December 2015. The study aimed to give an overview of the cancer cases registered at SKMCH&RC over 28 years. This study comprised patient data entered into the hospital information system after registration at the centers affiliated with the trust. The malignancies were stratified according to sex and age category (children [≤18 years] and adults [>18 years]). Neoplasms of the breast, lower gastrointestinal (GI) tract, and lip and oral cavity were prevalent in all ages and both sexes combined; in adult females, neoplasms of the breast, ovary and uterine adnexa, and lip and oral cavity; in adult males, lower GI system, prostate, and lip and oral cavity; and in children, Hodgkin lymphoma, acute lymphoblastic leukemia, and non-Hodgkin lymphoma were predominant. Cases registered in a hospital-based registry are important. When combined with information from other facilities, they can estimate population-level statistics. This can improve cancer surveillance in the country for effective disease prevention, control, and management.

Impact of SSO-ASTRO Margin Guidelines on Re-excision Rate in Breast-conserving Surgery: A Single-center Experience.

Breast-conserving surgery (BCS) has been historically linked with a high rate of re-excision. To address this issue, the Society of Surgical Oncology (SSO) and the American Society for Radiation Oncology (ASTRO) developed consensus guidelines in 2014 to standardize practices and improve clinical outcomes for BCS patients. In our tertiary cancer care hospital, we assessed the impact of these guidelines on the re-excision rate following BCS. We conducted a retrospective study on breast cancer patients who underwent BCS at the Shaukat Khanum Memorial Cancer Hospital and Research Centre in Lahore, Pakistan. The study compared the re-excision rate before the implementation of the SSO-ASTRO consensus guidelines (November 2015-July 2017) and after the implementation (January 2018-August 2019). Margins were considered positive if "ink on tumor" was present and negative if "no ink on tumor" was present. Fisher's exact test or Chi-square test was used to compare the re-excision rates between the pre- and post-guideline periods. A total of 919 patients were identified, with 533 from the pre-guideline period and 386 from the post-guideline period. Of the 919 patients, 31 with ductal carcinoma in situ (DCIS) were excluded from the re-excision analysis because the guidelines were not implemented on the DCIS. Furthermore, the overall rate of re-excision in our data was 4.3%. The re-excision rate decreased from 71.1% to 28.9% (P ≤ 0.05) following the adoption of the guidelines. We observed a statistically significant decrease in the re-excision rate after implementing the SSO-ASTRO guidelines. Implementation of the SSO-ASTRO margin guidelines led to a notable decrease in the overall re-excision rate in our data set. These findings suggest that continued adherence to the guidelines may lead to a further reduction in the re-excision rate in the future.

PLANTAR, TRADUZIR, MINERAR: ANÍSIO TEIXEIRA (1935-1947)

ABSTRACT: We take Anísio Teixeira as a hub, from which we aim to design the configuration of networks, linking subjects and institutions. We choose the period from 1935 to 1947, scrutinizing the editorial work he carried out for Companhia Editora Nacional (CEN), based on documentation from the publisher’s collection at the Center for Memory and Historical Research of the History of UNIFESP; as well as documents about Anísio’s brief stay at UNESCO, form July 15, 1946 to February 15, 1947, existing at CPDOC-FGV and at the UNESCO Archives. The text is structured in two: in the first part, we highlight Anísio's work in CEN: in the second one, the focus shifts to his career at UNESCO. In both, it is the mobile web of networks that drives the writing, guided by an argument based on the transnational history of education. It is important to highlight that when we address the reflection to a transnational perspective, we are not neglecting the national space, nor placing Brazil in a peripheral position with respect to a supposed center that disseminates knowledge. On the contrary, we intend to reconfigure the territory based on the experiences of the subjects, the exchanges established, problematizing the confinement of physical borders in the organization of the educational field, in a time marked by the spread of authoritarian governments, war and reconstruction efforts on a global scale.

Local cultural memory of Ulytau: the sacralisation of the area by means of symbolic forms encoding

In the modern memory research, it is customary to distinguish the cultural and historical memory. Cultural memory is formed by the media-participants of the event, based on generational values, it has the ability to the constantly transformation. Whereas historical memory is a combination of knowledge and ideas about events in the past, accumulated through the information environment controlled by the authorities. Applying these theoretical developments to the analysis of nation-forming processes in Kazakhstan, in this research paper, we pay attention to to the practice of constructing sacred places of memory or special places of national worship. Considering that the toponym Ulytau gave the name to a new administrative entity, this is of interest how knowledge about the cultural landscape revitalizes in the Ulytau district. After all, within the Soviet period, it can be stated that much knowledge was literally displaced to the periphery of socio-humanities in Kazakhstan. Whereas from a certain period Ulytau is beginning to stay in the position as a special historical centre – a landmark value for cultural memory. In this regard, the research work based on the study of the processes of Ulytau transformation into a powerful modernization concept of cultural memory restoration carries out through the sacralisation of the area. The article completed within the framework of a dissertation research on the topic “Cultural landscape: research problems”.

Analysis of Memory Research Directions

Analysis of Memory Research Directions

Explorando a Complexa Relação entre Confi ança e Desempenho de Memória nas Práticas Jurídico-Criminais

The relationship between confi dence and accuracy has been the focus of memory research for over a century. As a result, several studies have indicated it as a dynamic, complex, and multifaceted relationship. Although the topic is controversial, confi dence is still commonly used in forensics as a predictor of memory accuracy. However, the literature shows that the interaction between confi dence and accuracy can be aff ected by various factors, making it diffi cult to establish direct and linear relationships between them. Therefore, the goal of this article is to discuss the specifi cities of such a complex interaction. To achieve this, we conducted a narrative review examining the main methods used to analyze the interaction between confi dence and accuracy, as well as the main variables that infl uence it. In addition, the article includes a theoretical discussion followed by a discussion of the practical implications in everyday legal-criminal practices, with a special focus on the Brazilian context. Although confi dence is still used as an indicator of the veracity of testimony, it is important to consider that this relationship is aff ected by several factors, highlighting the need for caution when interpreting accuracy and confi dence data.Keywords: Memory, confi dence, accuracy, recognition, eyewitness testimony