bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors of pathologic response to preoperative chemotherapy and concurrent radiotherapy for locally advanced breast cancer
Authors: Venkitaraman R. , Ramanan S. G. , Rajalekshmy K. R. , Sagar T. G. , Shanta V.
Published: August 2020

e11545

Background: Combined modality treatment is essential for acheiving optimal results in the management of locally advanced breast cancer (LABC). Neoadjuvant chemoradiotherapy is considered a promising approach for LABC. Pathologic complete response to neoadjuvant treatment for LABC predicts prolonged survival. Aim: To determine the rate of pathologic complete response (pCR) after neoadjuvant chemotherapy and radiotherapy for locally advanced breast cancer and to identify the predictors of pCR. Methods: Female patients with noninflammatory LABC received neo-adjuvant chemotherapy with concurrent radiotherapy, and then underwent mastectomy and axillary clearance. The pathologic response was analysed with respect to the baseline clinical factors and the receptor status on immunohistochemical studies of the initial biopsy specimen. Results: Of the 296 patients included in the study, 286 underwent mastectomy. Ninety-two (31 %) patients achieved a pCR. The significant predictor of a pCR was Oestrogen receptor negative status (p = 0.025), while progesterone receptor negative status (p=0.069 ), HER2 status (p= 0.62), age (p= 0.074), stage (p=0.6), grade (p=0.86), type of chemotherapy (p=0.37) and number of cycles of chemotherapy (p = 0.23) did not predict for pathologic response. Clinical complete response predicted for a pathologic complete response (p=0.0001). Conclusions: Neoadjuvant concurrent chemoradiotherapy results in good pathologic complete response rates in LABC. High pathologic compete response rates are achieved in patients with endocrine receptor negative disease, with neoadjuvant chemoradiotherapy, which might result in improved outcome in this high risk subset of patients.

No significant financial relationships to disclose.
Correlating MRI, mammogram, and ultrasonography( USG): Which study most accurately predicts breast cancer size?
Authors: Silva J. , Martinez-Velasco A.
Published: August 2020

e11549

Purpose: Assessment of tumor size in patients with breast cancer is based on radiologic assessment when pathology measurements are equivocal and it is also considered when neoadjuvant therapy is used. Tumor size is measured as the largest dimension or for multifocal disease, as the largest dimension of the largest focus. However, wide variation exists between measurements obtained by different imaging methods. The purpose of this study was to compare the currently used imaging methods for determining breast tumors’ size. Accurate assessment influences the choice of oncologic treatment and predicts the prognosis of a patient. Methods: We conducted a study of 46 patients with breast cancer with no prior treatment. All women had preoperative MRI, USG and mammographic assessment of tumor size. Measurements were compared to the pathologic tumor size of the surgical specimen. Results: The greatest tumor diameter measured was within 3 mm of the pathologic tumor size in 43.4% of patients measured by MRI, 32.6% of patients measured by USG, and 36.9% of patients measured by mammogram. In average, MRI overestimated tumor size by 0.35 cm (95% confidence interval [95% CI], - 0.11 - 0.81 p = NS, whereas US underestimated it by -0.82 cm (95%CI, -1.01 - -0.63; p <0.001). Mammogram underestimated it by - 0.65 cm (95% CI, -0.96 - -0.33; p < 0.001). MRI measurement of the actual tumor size showed a significant correlation (r = 0.36, 95%, 0.06 - 0.61 p = 0.02) and confirms more accuracy in determining tumor size. Conclusions: In this study, magnetic resonance imaging is superior to conventional methods for assessing pathological dimensions. Both mammography and USG have a tendency to underestimate tumor size. The use of magnetic resonance imaging would help in the accurate assessment of the tumor size influencing the choice of oncologic treatment and better predicting the prognosis of the patient.

No significant financial relationships to disclose.
Lymphedema following irradiation in breast cancer: A cross-sectional study
Authors: Goyal S. , Puri T. , Sharma D. N. , Julka P. K. , Rath G. K.
Published: August 2020

e11569

Background: Nearly 15–30% of breast cancer patients (pts) face lymphedema (LE) following locoregional therapy, incidence being higher with surgery (Sx) & radiotherapy (RT) combination than with Sx alone. We intended to study the incidence of post-RT LE and associated symptoms. Method: We evaluated 104 unilateral breast cancer pts who had completed curative therapy (Sx + RT + chemotherapy ± hormone therapy HT), with a minimum follow up of 6 months. Besides demographic & treatment details, symptoms associated with LE and objective measurements of upper limb circumference were recorded using an indigenous questionnaire. Results: Median age was 45 years (range 28–65). Chest wall or breast RT was delivered using medial & lateral tangential portals (Cobalt-60 unit) in 88 pts & with 12 MeV electrons in 18 pts. Of all pts, 77 were given supraclavicular & axillary RT. HT was given to 72 pts. Pathological stages were: T1/2- 73, T3/4- 27, Tx-4; N0–44, N1–25, N2/3–33, Nx-2. Arm swelling was reported by 68 pts (mild-40, moderate-28). Other symptoms included reduced range of motion (mild-52, moderate-24), fatigue (48), pain (28), numbness (20), infections (12), shoulder droop (12) and local tenderness (8). Forty-four pts reported having psychological stress (mild-40, moderate-4). Nearly 60% had symptoms mandating change in physical activity (mild-56, moderate-8). Dominant hand was involved in 57 pts. Shoulder exercises were advised in 84 pts; compliance was poor in 16, average in 32, & good in 36. Only 36 pts were advised compression garments, compliance being poor in 28, average in 4 & good in 4. Objective measurements revealed a difference of ≥3 cm in 27 pts in mid-arm circumference (MAC) (median 5.5 cm, maximum 8 cm) & 34 pts in forearm circumference (FAC) (median 3.5, maximum 7 cm). There was no significant association between MAC or FAC with age, stage, body surface area, basal metabolic index, Sx type, chemotherapy or HT. Perceived LE and objective measurements correlated well. MAC difference >3 cm was seen in 28.5% (22/77) pts who received axillary RT and in 18.5% (5/27) of those who received only local RT. Conclusions: LE, with its associated complications, is often understudied in breast cancer survivors. Revision of Sx and RT policies (e.g., omission of axillary dissection & RT in selected pts) may help minimise LE.

No significant financial relationships to disclose.
A novel histopathological evaluation method for predicting the outcome of non-small cell lung cancer treated by neoadjuvant therapy
Authors: Yamane Y. , Ishii G. , Goto K. , Kojima M. , Nakao M. , Shimada Y. , Nishiwaki Y. , Nagai K. , Ochiai A.
Published: August 2020

e11574

Background: Chemotherapy, chemoradiotherapy, or radiotherapy is sometimes used to treat non-small cell lung cancer (NSCLC) before surgical resection (neoadjuvant therapy). However, no histopathological evaluation method for predicting the outcome of NSCLC treated by neoadjuvant therapy has been fully assessed. The purpose of this study was to assess a novel histopathological evaluation method for predicting the outcome of NSCLC patients who received neoadjuvant therapy followed by surgical resection. Methods: We reviewed the histopathology of the tumors of 61 NSCLC patients who received neoadjuvant chemotherapy, chemoradiotherapy, or radiotherapy and identified the histological features produced by neoadjuvant therapy by comparing them with the histopathological features of the tumors in 138 NSCLC cases treated by surgery without neoadjuvant therapy. We also measured the area of residual tumor (ART) on the maximum cut surface of the tumors and analyzed the relationships between the histological features, ART, and the outcome. Results: The proportions of cases with the histological features “cholesterin clefts,” “foreign body reactive giant cells,” “stromal hyalinosis,” and “cancer cells more than 50% of which contained a bizarre nucleus” were significantly higher in the neoadjuvant therapy group than in the surgery alone group. However, the presence of none of these features except “stromal hyalinosis” had any significant effect on survival in the neoadjuvant therapy group. Although pathological T factor (ypT) and N factor (ypN) had no significant effect on overall survival, smaller ART (≤400 mm2) and absence of pleural invasion (p(-)) were predictors of a outcome (p=0.004 and p=0.001, respectively). Conclusions: Smaller ART (≤400 mm2) and p(-) predict a better outcome of NSCLC in patients who receive neoadjuvant therapy. We concluded that ART is a novel histopathological parameter for predicting the outcome of NSCLC patients who receive neoadjuvant therapy followed by surgical resection.

No significant financial relationships to disclose.
Incidence of peripheral neuropathy in high-risk early-stage breast cancer patients receiving dose-dense paclitaxel in central Pennsylvania
Authors: Barochia A. C. , Cream L. , Harvey H. , Sivik J.
Published: August 2020

e11595

Background: Paclitaxel (P) is an important part of chemotherapy regimens for early breast cancer. Breast cancer survivors may be left with iaotrogenic peripheral neuropathy which can affect their quality of life. Methods: We conducted a retrospective, IRB approved, medical chart review to determine the rate of peripheral neuropathy in a tertiary care practice in central Pennsylvania. Patients had biopsy proven, newly diagnosed, high risk breast cancer. Patients were treated with a standard dose dense (DD) regimen where 4 cycles of adriamycin (A) 60 mg/m2/cyclophosphamide (C) 600 mg/m2 were followed by four cycles of paclitaxel (P) 175 mg/m2 every 2 weeks (Citron et al) between 7/2006 to7/2008 at Penn State Cancer Institute. All patients who received dose dense chemotherapy by a single provider were included (n=23). No peripheral neuropathy (PN) was reported before initiating paclitaxel, but 3 of 23 patients had type II diabetes. Electronic medical charts were reviewed and data was abstracted to analyze incidence of peripheral neuropathy. These data were compared to reported published data. Results: 22 pts received dose dense AC followed by P chemotherapy. 100% completed 4 cycles of AC and 87% complete 4 cycles of P. Overall, 82% developed neuropathy (32% with grade 1, 41 % with grade 2, 9 % with grade 3). Almost 30% of patients required gabapentin for control of neuropathic pain. 35% of patients with PN had symptoms persisting >3 months after chemotherapy. Conclusions: A considerable percentage of high risk, early breast cancer patients treated with AC followed by DD paclitaxel developed at least mild neurotoxicity. Rates of Grade 3 neurotoxicity were much higher (9%) than the previous CALGB-9741 study (4%). This may be related to regional pharmacogenomic differences. Although dense dose paclitaxel has been shown to improve disease free survival, PN affects most patients treated with paclitaxel and for some patients can have a prolonged impact on their quality of life. Future studies should attempt identify which patients are at risk for severe peripheral neuropathy.

No significant financial relationships to disclose.
Effect of endocrine therapy with tamoxifen on hormone receptor status in patients with breast cancer
Authors: Djahansouzi S. , Rostock V. , Niederacher D. , Rein D. , Rath W. , Bender H.
Published: August 2020

e11598

Background: Endocrine therapy (ET) of patients with hormone receptor (HR)-positive breast cancer (BC) is thought to adversely affect the HR status of the tumor with time. In order to evaluate this, a study was undertaken comparing the HR status of patients with estrogen receptor (ER)-positive BC prior to adjuvant tamoxifen (Tam) therapy and after progression. Methods: A retrospective analysis of all BC patients presented to the unit between 1999 to 2004 with an initial stage I-III ER-positive BC, who received Tam between 6 and 60 month and went on to develop progressive disease in the form of local recurrence or distant metastasis. Progression was confirmed by tumor biopsy and analysis of the HR status. All patients were evaluated for ER and progesterone receptor (PR) status using immunohistochemistry as well as tumor grading prior to Tam therapy and after relapse. Results: 67 eligible patients with ER-positive BC were recorded. All patient and tumor characteristics, including age, tumor size, histology and adjuvant therapy were similar as published elsewhere. 82% were initially PR-positive. The mean duration of Tam administration of 20mg po was 40.7±19.9 month. The mean duration to progression was calculated at 54.9±34.6 month. After relapse, 70.1% of tumors retained a positive ER status and only 53% showed positive PR expression. Using the nonparametric McNemar's test, a highly significant reduction (p< 0.001) of both HR was the result of Tam administration. Conclusions: our data suggests that progression under ET shows a trend towards loss of HR status (ER as well as PR). Therefore, this data is a useful tool for the clinician in evaluating the effectiveness of further ET in patients with progressive BC without having been able to confirm the present HR status through biopsy. Furthermore, as opposed to common belief, the reduction in positive ER tumors showed no correlation with tumor grading.

No significant financial relationships to disclose.
Importance of genetic heterogeneity in curing adult acute leukemia (AL)
Authors: Bloomfield Clara D.
Published: August 2020

s1

Forty-five years ago adult AL was incurable. Since then we have discovered the striking heterogeneity of AL and its importance in selecting therapy, resulting in cure of increasing numbers of patients. Publication of the French-American-British classification 34 years ago resulted in acceptance that morphology and cytochemistry separated AL into two different diseases, acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL), that required separate treatment. During the next 15–20 years the importance of cytogenetics in dissecting ALL and AML into entities requiring different therapies became widely accepted, resulting in 2001 in their first incorporation into the World Health Organization (WHO) classification of AL. Over the last 10 years, discovery of molecular abnormalities within cytogenetic groups has further increased our ability to selectively treat and increasingly cure AL. The most striking example of increased curability of AL is acute promyelocytic leukemia, in which targeted therapy combined with chemotherapy has increased survival from a 2-week median to an 80% cure rate. Recognition of increased sensitivity of a genetic subtype of AML to high-dose cytarabine (HiDAC) has increased the cure rate of core-binding factor (CBF) AML from <10%–25% to 55%–60%. Recent discovery of the adverse impact of KIT mutations in CBF AML may allow the addition of tyrosine kinase inhibitors to HiDAC to substantially further increase cure. Among adult de novo AML 40%–45% are cytogenetically normal (CN); the striking molecular heterogeneity of CN-AML is now being recognized and promises to allow individualized approaches that improve substantially upon the current cure rate of 40%. In adult ALL the major adverse subgroup has a Philadelphia chromosome (PH+). New molecularly targeted approaches are allowing remissions in over 90% of PH+ elderly patients and appear likely to substantially cure an increasing fraction of younger PH+ adults. New approaches to studying the leukemia genome and epigenome should improve our understanding of AL heterogeneity, identify new therapeutic targets, and allow the cure of most patients.
Cancer genomes and their implications for understanding and managing cancer
Authors: Vogelstein Bert
Published: August 2020

s1a

Research over the past 25 years has shown that cancer is, in essence, a genetic disease. In the past three years, it has become possible to determine the sequence of nearly all the 21,000 protein-encoding genes in the human genome. The results of such sequencing in 68 tumors of the breast, colon, pancreas, or brain have led to new insights about the nature and diversity of the genetic alterations responsible for initiation and progression of tumors. The pathogenesis of solid tumors can best be understood as the cumulative result of alterations in approximately a dozen pathways that each regulate the balance between cell birth and cell death. The challenge for basic science is to understand these pathways in more detail. The challenge for clinical science is to devise approaches to use this new and extensive genetic information to improve diagnosis and therapy. Examples of how these challenges might be achieved in the future will be presented.
Geriatric oncology: The ultimate personalized cancer care
Authors: Extermann Martine
Published: August 2020

s2a

In many aspects, geriatric oncology is the quintessential expression of ASCO's 2009 theme: personalizing cancer care (PCC). PCC has two aspects: the tumor and the patient. Major efforts are conducted to identify mechanisms in an individual tumor that could be targeted more effectively by therapies. This research generates huge amounts of data, which creates a challenge in selecting the best therapeutic targets. As senescence has aspects that both prevent and favor cancer, we could take advantage of basic aging research to identify more effectively which mechanisms are key, and which are epiphenomena. Increasingly recognized also is the role of the microenvironment and macroenvironment—the patient—in influencing cancer prognosis and treatment tolerance. Here again, we can learn much from older patients. Seventy-five-year-olds are much more diverse than 25-year-olds. This provides higher sensitivity to detect patient-related factors. The last decade of work in geriatric oncology has demonstrated that geriatric instruments improve prognostic assessment beyond classic oncology predictors. Tantalizing data show that a geriatric intervention might even improve significantly the survival of patients with cancer. We now have screening tools simple enough to be used in oncology practice. In the same way that we are moving away from, for example, lumping all non-small cell lung cancers together, we are moving away from considering the patient condition as a relatively neutral background summarized by an ECOG Performance Status. Older patients also have remarkably diverse life experiences and patterns of functioning. This has enabled significant learning about individualizing the prediction of treatment tolerance and of willingness to undertake it. Geriatric oncology is an ideal terrain to explore end points such as the maintenance of independence and personal goals by cancer survivors. As the world population ages, we are progressing toward providing cancer care tailored to both the tumor and the older cancer patient.
Classification of Thyroid Dysfunction in Pregnant Women Differs by Analytical Method and Type of Thyroid Function Test
Authors: Andersen Stine Linding , Christensen Peter Astrup , Knøsgaard Louise , Andersen Stig , Handberg Aase , Hansen Annebirthe Bo , Vestergaard Peter
Published: August 2020

Context

Physiological alterations challenge the assessment of maternal thyroid function in pregnancy. It remains uncertain how the reference ranges vary by week of pregnancy, and how the classification of disease varies by analytical method and type of thyroid function test.

Design

Serum samples from Danish pregnant women (n = 6282) were used for the measurement of thyrotropin (TSH), total and free thyroxine (T4), total and free 3,5,3′-triiodothyronine (T3), and T-uptake using “Method A” (Cobas 8000, Roche Diagnostics). TSH and free T4 were also measured using “Method B” (ADVIA Centaur XP, Siemens Healthineers).

Main Outcome Measures

Pregnancy week- and method-specific reference ranges were established among thyroid antibody–negative women (n = 4612). The reference ranges were used to classify maternal thyroid function, and results were compared by analytical method and type of thyroid function test.

Results

The reference ranges for TSH showed a gradual decrease during pregnancy weeks 4 to 14, a gradual increase was observed for total T4, total T3, and T-uptake, whereas free T4 and free T3 showed less variation. When TSH and free T4 were used, Method A classified 935 (14.9%) with abnormal thyroid function, Method B a total of 903 (14.4%), and the methods agreed on 554 individuals. When TSH and total T4 were used, 947 (15.1%) were classified with abnormal thyroid function, and classifications by either total T4 or free T4 agreed on 584 individuals.

Conclusions

Even when pregnancy week- and method-specific reference ranges were established, the classification of maternal thyroid dysfunction varied considerably by analytical method and type of thyroid function test.
Casting Shadows at Chesney Wold: Empty-House-Time and Realism in the British Novel
Authors: Strout Laura
Published: August 2020

What insights into literary realism can be found by dwelling in the empty rooms and abandoned spaces of Bleak House, a novel more often read for its representation of overcrowded environments? Traveling between and imaginatively inhabiting empty houses of Charles Dickens's and Virginia Woolf's construction, this article proposes empty-house-time as a distinctive narrative chronotope, one that nineteenth- and twentieth-century British writers use to investigate the processes of realist fiction, especially its affective dimensions. Taking the character-less built environment as a figure for the novel form, the article shows that the chromatic present that characterizes narratives of spaces like Chesney Wold when the Dedlocks are absent throws into flux boundaries between the fictional and the real, the reader and the world of the text, and different modes of imagining. It opens up continuums along which strategies of realist characterization and world-building are dramatized and interrogated. Most powerfully, empty-house-time reveals how affects associated with imagining the world going on without you shape encounters with fiction. Identifying the vital, ongoing existence of unoccupied rooms in Dickens's writing can in turn revitalize studies of the relationship between Victorian and modernist novels and theories of realism. This article concludes by turning to the Ramsays’ abandoned coastal home in To the Lighthouse, in which Woolf, like Dickens, links an interrogation of realist fictionality to a historically specific reimagining of the household.
“They’re Not Alone”: An Oral History of the Pennsylvania Faculty Strike of 2016
Authors: Mantler Gordon , Riedner Rachel
Published: August 2020

In 2016, more than five thousand faculty members and coaches in the Association of Pennsylvania State College and University Faculties successfully struck in the union’s first ever such action in thirty-five years as an official bargaining agent. Two faculty members active in the union reflect on their experience in a wide-ranging interview about how years of careful, often painstaking organizing made such a success possible. The strike was the product of both ten years of increasingly acrimonious negotiations and considerable tactical work by a new generation of union members who learned a number of lessons from the process, including the necessary work of persuading faculty members that they, too, were workers.
Apolipoprotein E expression pattern in human induced pluripotent stem cells during in vitro neural induction
Authors: Lee Hyunah , Nowosiad Paulina , Dutan Polit Lucia M. , Price Jack , Srivastava Deepak P. , Thuret Sandrine
Published: August 2020

Apolipoprotein E (APOE) is a multifunctional protein that plays significant roles in important cellular mechanisms in peripheral tissues and is as well expressed in the central nervous system, notably by adult neural stem cells (NSCs) in the hippocampus. Evidence from animal studies suggest that APOE is critical for adult NSC maintenance. However, whether APOE has the potential to play a similar role in human NSCs has not been directly investigated. To address this question, we conducted a focused study characterising APOE gene and protein expression in an in vitro model of neural differentiation utilising human induced pluripotent stem cells. We found that APOE gene expression was dramatically decreased as the cells became more differentiated, indicating that APOE expression levels reflect the degree of cellular differentiation during neural induction. Furthermore, qualitative analysis results of immunocytochemistry showed that intracellular localisation of APOE protein becomes more pronounced as neural differentiation progresses. Taken together, our findings suggest a potential role for APOE in human NSC maintenance and justify further investigations being carried out to understand whether changes in APOE levels can directly impact the neurogenic capacity of human stem cells.
Genomic evidence of multiple SARS-CoV-2 introductions into Morocco
Authors: Chaouni Bouchra , Allali Imane , Sehli Sofia , Rhalem Wajih , Idrissi Azami Abdellah , Habib Nihal , Hamdi Salsabil , Wakrim Lahcen , Bakkali Abderrahmane , Mahmoud Mustapha , Bouguenouch Laila , Al Idrissi Najib , Bakri Youssef , Amzazi Saaïd , Barrijal Said , Ghazal Hassan
Published: August 2020

Background: The recent emergence of a novel coronavirus (SARS-CoV-2) has caused serious public health concerns due to its rapid dissemination worldwide. A total of 8,931 positive cases had been reported in Morocco by the 16th of June 2020.

Methods: To better understand the SARS-CoV-2 pandemic in this North African country, we analyzed the complete genome sequences of the virus related to Morocco by constructing a phylogenetic tree and creating a variant network using the available Moroccan and other sequences in dedicated databases.

Results: Phylogenetic and variant network analyses of SARS-CoV-2 strains from early patients with COVID-19 in Morocco showed multiple spatiotemporal introductions from Italy (ten), France (seven), Spain (one) and Portugal (one). This is consistent with the assumption that the early infections in Morocco were imported, mainly from Europe. The 17 virus strains form two independent phylogenetic clusters and provide evidence for early community-based transmission following the initial introductions of the virus. We then catalogued 13 novel mutations in the SARS-CoV-2 isolates from Moroccan patients. Interestingly, the recurrent missense variant A>G at position 23,403 in the spike gene, known to be associated with virus severity, has been identified in all Moroccan isolates.

Conclusions: These primary findings testify of the importance of the genomic surveillance strategies as a means of understanding the virus spread dynamics, counteracting the pandemic outbreak, and drawing useful lessons for dealing with any future emerging infectious pathogens.
Effect of riboflavin supplementation on blood pressure and possible effect modification by the MTHFR C677T polymorphism: a randomised trial in rural Gambia
Authors: Jobe Modou , Ward Mary , Sonko Bakary , Muhammad Abdul Khalie , Danso Ebrima , McNulty Helene , Prentice Andrew M
Published: August 2020

Introduction: Emerging evidence links a functional polymorphism in the methylenetetrahydrofolate reductase (MTHFR) gene (rs1801133) with hypertension in adults. This variant reduces the affinity of MTHFR for its cofactor flavin-adenine dinucleotide (FAD) which is derived from riboflavin. Previous work has demonstrated a blood pressure (BP)-lowering effect of riboflavin in Irish adults with the MTHFR 677TT variant. We hypothesize that the almost-universal severe riboflavin deficiency seen in rural Gambia mimics the BP phenotypic effect of the TT variant and exacerbate the effect of the CT variant. We will test this in a randomised, placebo-controlled trial, whether intervention with riboflavin can decrease BP in adults in rural Gambia.

Methods: This is a phase 2 recall-by-genotype randomised single-blind placebo-controlled riboflavin supplementation trial. We will use the Keneba biobank to recruit approximately 102 individuals aged between 18-70, previously genotyped for the MTHFR C677T polymorphism and identified as carrying the T allele; these individuals will be age- and sex-matched to a similar number of homozygotes for the C allele. The participants will be randomised to a 16-week supplementation trial of 5 mg/day riboflavin or placebo, supplied every 14 days. The primary outcome, BP, will be measured at baseline and at weeks 8 and 16. Blood samples, collected at baseline and week 16, will be analysed for riboflavin, homocysteine, red cell folate, cobalamin (vitamin B12) and pyridoxine (vitamin B6).

Discussion: The study will evaluate the role of riboflavin supplementation in BP control within a population with high levels of riboflavin deficiency and will test a possible gene-nutrient interaction with the MTHFR C677T polymorphism. If improvements in BP are observed in this study, and proven in subsequent large-scale interventions, riboflavin could offer a cost-effective, safe and accessible option for the  prevention and control of hypertension in this population.

Trial registration: ClinicalTrials.gov Identifier NCT03151096. Registered on 12 May 2017.
Ewolucja kryteriów podziału gramatycznego leksemów (relatory a spójniki)
Authors: Grochowski Maciej
Published: August 2020

The Evolution of Criteria for a Grammatical Classification of Lexemes (Relative Pronouns vs Conjunctions)

The paper discusses the evolution of the part-of-speech classification of Polish lexemes, and presents the changes in the criteria used to distinguish relative pronouns and conjunctions. The characterization has been based on important works in the field of theoretical Polish grammar, including textbooks, from the beginning of the 20th to the beginning of the 21st century. The author distinguishes two breakthroughs in the history of grammar, the first caused by the influence on research into grammar of the connotation theory, and the other by the influence of the metatext theory.
Zagadnienie motywacji w gniazdowym opisie słowotwórstwa gwarowego (na przykładzie gwary orawskiej)
Authors: Kurdyła Tomasz
Published: August 2020

The Question of Motivation in Nest-Oriented Description of Dialectal Word Formation (Using the Example of the Orava Dialect)

The paper discusses word formation’s most important notion, i.e. the motivation, in respect to nestoriented descriptions. The first part presents the difficulties which arise in the traditional, as well as in the nest-oriented description of word formation of general Polish (mutual motivation, multiple motivations, indirect and direct motivation, base and accompanying motivation, equivalent motivation). In the second part, these problems of motivation, resulting from the specificity of dialectal material, are being discussed. This part also formulates methodological suggestions about the creation of certain nests which are more difficult to analyse. The final part tackles the question of mutual dependence between the model of word formation, and the speaker’s word formation intuition (awareness, competence).
Obraz społeczności wiejskiej zakrzepły w nazwach synów i córek
Authors: Kurek Halina
Published: August 2020

The Image of Rural Community Preserved in the Names of Sons and Daughters. Tradition and Change (Based on the Villages of the Dukla Region in the Low Beskids)

The goals of the present article are to reconstruct the linguistic image of the rural community of the Dukla region, preserved in the names of sons and daughters living in the 20th and 21st centuries; as well as to present the direction and rate of changes that take place in this dialect in the formation of analysed anthroponyms. The analysis of the material reveals a dynamic image of the rural community which undergoes significant changes in consequent generations. The names of descendants from the beginning of the 20th century preserved the image of a traditional village that kept true to the fathers’ traditions. The names of further generations of sons and daughters expose a community which, gradually but visibly, loses its language and culture. This refers also to the descendants’ names created with word formation that were consistently removed from the analysed dialect at the turn of the 20th and 21st centuries. As a result, the next generations will probably use the syntactic structure: name + preposition od ‘to’ + gen. sg. of the personal name.
Niechciani obcy – imigranci w świetle komentarzy internetowych
Authors: Winiarska Justyna
Published: August 2020

Unwanted Aliens – Immigrants in the Light of Internet Comments

The article deals with comments published in the Internet as a reaction to remarks made by foreigners. Subject’s utterances are treated as a way of his (her) self-presentation and presentation of held values. The author uses methodology of cognitive linguistic and concept of linguistic image of the world. The article shows that when Polish Internet users encounter aliens they use stigmatization and stereotypes, feel threatened and display their aversion.
Rozważania nad koncepcją historii językoznawstwa polskiego
Authors: Miodunka Władysław T.
Published: August 2020

Reflections on the Conception of the History of Polish Linguistics

The author explains his reason for taking up the topic by recalling his discussions with prof. Mirosław Skarżyński and encouraging him to prepare a publication in which he would present his conception of the history of Polish linguistics. Prof. Skarżyński will not write this paper any more, so this author decided to present his own reflections on the matter. He begins with the first grammar of Polish, Polonicae grammatices institutio, published in 1568 by a Frenchman Piotr Statorius-Stojeński, for foreigners who wish to learn the language. He presents the work against the European background, and shows that it belongs to the great European movement of the 16th century, of preparing descriptions of contemporary languages. This author proposes that the publication of Statorius’ grammar, and of Jan Mączyński’s Latin-Polish dictionary (1564), can be considered the actual beginnings of Polish linguistics. In relation to S. Urbańczyk who tied those beginnings to year 1751, this author moves the date nearly 200 years back. He also refers to the opinions of historians of science. The paper concludes with remarks on the place of applied linguistics and glottodidactics in Polish linguistics.
Początki językoznawstwa polonistycznego na Uniwersytecie Poznańskim
Authors: Pihan-Kijasowa Alicja
Published: August 2020

The Origins of Polish Language Studies at Poznań University

Linguistic studies on the Polish language and literature were first conducted at the Faculty of Philosophy of Poznań University (established in 1919). Studies on literary theory were pursued in the Department of History of Polish Literature, whereas linguistic studies in the Department of Slavic Philology and Indo-European Linguistics. Initially, these studies were supervised by scholars who came from the Jagiellonian University in Cracow: Mikołaj Rudnicki and Tadeusz Lehr-Spławiński, as well as Stanisław Dobrzycki who was active in two fields, theory of literature and linguistics. It was only in 1922 that the Department of the Polish Language was established thanks to the efforts of Edward Klich, who also came from Cracow. At first, Polish language studies at Poznań University concentrated on two fields: onomastics (with components of etymology), and dialectology. More comprehensive research was conducted since the establishment of the Department of the Polish Language which was joined by a new generation of linguists, including graduates of Poznań University.
Metajęzykowe działania na tekście osoby dwujęzycznej
Authors: Ligara Bronisława
Published: August 2020

Metalinguistics Operations on a Bilingual Person’s Text

The paper presents the traces of metalinguistic operations reflected in the process of translation into Polish (L2) performed by Zygmunt Krasiński, of two audiences in 1857 and 1858, that the Polish- -French bilingual author had with Emperor Napoleon III. Both audiences concerned the so-called Polish cause, la cause polonaise. They constituted a spoken discourse co-created by both participants of those communicative events, and their common code was the French language (L1). Napoleon III demanded strictly confidential audiences, however Krasiński, thanks to his outstanding bilingual competence, transferred the spoken discourse he memorized in extenso in L1, into the sphere of the Polish language (L2). The translations of the audiences, written down in statu nascendi, reveal the process of emergence of the target text in the genre of linguistic mediation. This process included the act of consolidating in Krasiński’s memory of a series of replies uttered in L1, and then the act of their translation, recording in L2 in the form of a text that is semantically equivalent to source dialogues. The translation of Napoleon III’s words, foreign words, and the auto-translation of Krasiński’s own words reflect metalinguistic operations which result from his bilingualism, i.e. from the fact that both French and Polish were his first languages. Metalinguistic operations result from interpretative relations that can occur between two languages which both inhabit the mind of a bilingual person, so that one language becomes the metalanguage for the other one. Krasiński realized the translations exactly as bilingual speech which contains explicit traces of his metalinguistic operations. They take the form of code switching, double language thinking, interference, and negotiation of common meanings in the situation where linguistic units of L1 and L2 differ. The translation of the audiences shows translation as a special type of Krasiński’s communication with the Polish national community: the transcript made them available to Polish recipients who did not know the French language. Simultaneously, Krasiński’s translation excluded from among potential recipients the speakers of French, as Polish was a language unknown to French elites in the 19th century, and in a sense was a secret language for them.
Effect of Complex Korean Medicine Treatment on Sacral Insufficiency Fracture: A Case Report
Authors: Jung Ga Hyeon , Lee Hyun , Ryu Hwa Yeon , Kang Jae Hui
Published: August 2020

Sacral insufficiency fractures (SIF) are a common, but often underdiagnosed source of lower back pain without apparent trauma. This report presents the clinical outcome of a 75-year-old female with SIF, and an underlying medical history of osteoporosis and rheumatoid arthritis. She was treated non-operatively, in-hospital, with Korean medicine. Patient progress was assessed using the numerical rating scale and selfreported symptoms. Post-treatment, the numerical rating scale score for pain in her hip decreased from 7 to 2. At admission, the patient was unable to sit, and could only walk 3 m with assistance. At discharge, she could sit for longer than 1 hour and walk further than 200 m unassisted. On the follow-up visit, the patient was asymptomatic, and x-ray scans showed ossification of the sacral and pubic fractures. These results suggest that, Korean medicine can effectively reduce pain and aid rehabilitation in patients with SIF, without the need for surgery.
A Study of the Initial Dose of Sweet Bee Venom for the Treatment of Patients with Lower Back Pain
Authors: Lee Kwang Ho
Published: August 2020

Sweet bee venom (SBV) causes less hypersensitivity reactions compared with whole bee venom. To determine the appropriate SBV initial dose for pharmacopuncture treatment of lower back pain, the initial dose, and the dose which caused hypersensitivity were retrospectively reviewed between January 1st, 2017 and December 31st, 2019. There were 523 first-visit patients who received SBV pharmacopuncture for lower back pain and 41 showed hypersensitivity. No systemic reactions were observed and localized reactions were not severe. Hypersensitivity was observed during the first (7 cases), and fifth treatments (8 cases). An initial SBV (10%) volume of 0.1 mL was used in 2 cases, 0.2 mL in 6 cases, 0.6 mL in 41 cases, and 1.2 mL in 474 cases. The hypersensitivity rate during the first and fifth treatment was 1.34% and 1.53%, respectively. As a result, 1.2 mL of SBV was considered the acceptable initial dose. However, for safer treatment, we recommend limiting the initial dose of SBV to 0.5 mL.
The changing face of reoperative parathyroidectomy: a single-centre comparison of 147 parathyroid reoperations
Authors: Camenzuli C , DiMarco AN , Isaacs KE , Grant Y , Jackson J , Alsafi A , Harvey C , Barwick TD , Tolley N , Palazzo FF
Published: August 2020

Introduction

Reoperative parathyroidectomy for persistent and recurrent primary hyperparathyroidism is dependent on radiology. This study aimed to compare outcomes in reoperative parathyroidectomy at a single centre using a combination of traditional and newer imaging studies.

Materials and methods

Retrospective case note review of all reoperative parathyroidectomies for persistent and recurrent primary hyperparathyroidism over five years (June 2014 to June 2019; group A). Imaging modalities used and their positive predictive value, complications and cure rates were compared with a published dataset spanning the preceding nine years (group B).

Results

From over 2000 parathyroidectomies, 147 were reoperations (101 in group A and 46 in group B). Age and sex ratios were similar (56 vs 62 years; 77% vs 72% female). Ultrasound use remains high and shows better positive predictive value (76% vs 57 %). 99mTc-sestamibi use has declined (79% vs 91%) but the positive predictive value has improved (74% vs 53%). 4DCT use has almost doubled (61% vs 37%) with better positive predictive value (88% vs 75%). 18F-fluorocholine positron emission tomography-computed tomography and ultrasound-guided fine-needle aspiration for parathyroid hormone are novel modalities only available for group A. Both carried a positive predictive value of 100%. Venous sampling with or without angiography use has decreased (35% vs 39%) but maintains a high positive predictive value (86% vs 91%). Cure rates were similar (96% vs 100%). Group A had 5% permanent hypoparathyroidism, 1% permanent vocal cord palsy and 1% haematoma requiring reoperation. No complications for group B.

Conclusion

Optimal imaging is key to good cure rates in reoperative parathyroidectomy. High-quality, non-interventional imaging techniques have produced a shift in the preoperative algorithm without compromising outcomes.
PROMs in total knee replacement: analysis of negative outcomes
Authors: Begum F , Panagiotidou A , Park C , Ashdown T , El-Tawil S
Published: August 2020

Introduction

NHS England uses the Oxford Knee Score (OKS) as part of patient-reported outcome measures (PROMs) to evaluate ‘health gains’ following total knee replacement. Policy makers use this to guide healthcare funding and resource allocation. Our study aims to undertake a qualitative and quantitative analysis of OKS among patients who experienced a negative outcome after a total knee replacement at our centre.

Materials and methods

Between April 2017-March 2018, 19 of 189 (10%) patients had a worsened OKS at our centre. We retrospectively and prospectively reviewed 14 of these patients. Structured telephone interviews with a repeat OKS were carried out in September 2019 (18–29 months post-operation).

Results

Eight patients were female and the total age range was 57–95, mean average 75.6 (SD 9.9 years). Of 48 (higher scores meaning better outcomes), the average preoperative OKS was 24.2 and the average postoperative OKS at 6 months was 19.4 (decrease of 20%). The average postoperative OKS at 18–29 months was 35.6 (an increase of 83.5% from 6 months).

Discussion

The OKS was developed and validated over 20 years ago in Oxford. In our study, four patients asked for clarification of questions 4, 6 and 10 owing to ambiguous language. All 14 patients who had negative OKS outcomes had positive outcomes when retested after 18 months, depicting ‘health gains’ not conveyed in PROMs analysis.

Conclusion

The OKS needs to be revalidated on current patient groups for accurate and reliable data. Further prospective studies should be undertaken on larger cohorts to understand the recovery course and whether PROMs should be carried out later.
Designs toward synchronization of optical limit cycles with coupled silicon photonic crystal microcavities
Authors: Takemura Naotomo , Takiguchi Masato , Notomi Masaya
Published: August 2020

A driven high-Q Si microcavity is known to exhibit limit cycle oscillation originating from carrier-induced and thermo-optic nonlinearities. We propose a novel nanophotonic device to realize synchronized optical limit cycle oscillations with coupled silicon (Si) photonic crystal (PhC) microcavities. Here, coupled limit cycle oscillators are realized by using coherently coupled Si PhC microcavities. By simulating coupled-mode equations, we theoretically demonstrate mutual synchronization (entrainment) of two limit cycles induced by coherent coupling. Furthermore, we interpret the numerically simulated synchronization in the framework of phase description. Since our proposed design is perfectly compatible with current silicon photonics fabrication processes, the synchronization of optical limit cycle oscillations will be implemented in future silicon photonic circuits.
Multipole interplay controls optical forces and ultra-directional scattering
Authors: Kiselev Andrei , Achouri Karim , Martin Olivier J. F.
Published: August 2020

We analyze the superposition of Cartesian multipoles to reveal the mechanisms underlying the origin of optical forces. We show that a multipolar decomposition approach significantly simplifies the analysis of this problem and leads to a very intuitive explanation of optical forces based on the interference between multipoles. We provide an in-depth analysis of the radiation coming from the object, starting from low-order multipole interactions up to quadrupolar terms. Interestingly, by varying the phase difference between multipoles, the optical force as well as the total radiation directivity can be well controlled. The theory developed in this paper may also serve as a reference for ultra-directional light steering applications.
Ultrawideband terahertz absorber with a graphene-loaded dielectric hemi-ellipsoid
Authors: Zhong Renbin , Yang Long , Liang Zekun , Wu Zhenhua , Wang Yiqin , Ma AnChen , Fang Zheng , Liu Shenggang
Published: August 2020

We herein present a high-performance ultrawideband terahertz absorber with a silicon hemi-ellipsoid (SHE) on a monolayer graphene that is separated by a dielectric spacer from a bottom metal reflector. The constitution of the absorber, which includes dielectric-mode structures and unstructured monolayer graphene, can minimize undesired optical losses in metals and avoid graphene processing. The absorber achieved an ultrawide absorption bandwidth from 2 THz to more than 10 THz with an average absorption of 95.72%, and the relative bandwidth is 133%. The excellent absorption properties are owing to the presence of graphene and the shape morphing of the SHE, in which multiple discrete graphene plasmon resonances (GPRs) and continuous multimode Fabry–Perot resonances (FPRs) can be excited. By coupling the GPRs and FPRs, the absorption spectrum is extended and smoothed to realize an ultrawideband absorber. The incident angular insensitivity within 50° of the absorber is discussed. The results will shed light on the better performance of terahertz trapping, imaging, communication and detection.