Marginalia as Message:Affordances for Reader-to-Reader Communication

Purpose – The purpose of this paper is to investigate readers’ annotations in library books and attitudes towards marginalia among library users. In particular, the study discusses how marginalia function as reader-to-reader communication. Design/methodology/approach – The study used data collected from both public library and university library collections, as well as a user survey conducted among library users. The empirical results are discussed in relation to theories of affordances, in order to understand what characterizes the socio-physical realm within which marginalia exist (RQ1), and what specific conditions make marginalia possible as a communicative act between readers (RQ2). Findings – The study suggests that marginalia in library books are mainly by-products of reading/studying processes. The user survey depicts an overall picture of ambiguous attitudes towards marginalia. It is argued that marginalia seen as communication rely heavily on the proximity of the context and the permanence of the physical medium. Three distinctive categories are proposed for classifying marginalia according to their relationship with the text: embedded; evaluative; extratextual. In spite of being an often unwanted communication, marginalia thus still function as an additional layer to the main message of the primary text. Research limitations/implications – The findings are indicative pointing to follow-up studies that may further validate them. The study contributes to a referential frame for future studies on the subject. Originality/value – The study addresses factual and communicative aspects of marginalia less covered in previous research, thus providing a basis for further research also in relation to designing affordances for annotations in e-books. </jats:sec

Promising role of preoperative neutrophil-to-lymphocyte ratio in patients treated with radical nephroureterectomy.

Several retrospective studies with small cohorts reported neutrophil-to-lymphocyte ratio (NLR) as a prognostic marker in upper tract urothelial carcinoma (UTUC) following radical nephroureterectomy (RNU). We aimed at validating the predictive and prognostic role of NLR in a large multi-institutional cohort. Preoperative NLR was assessed in a multi-institutional cohort of 2477 patients with UTUC treated with RNU. Altered NLR was defined by a ratio &gt;2.7. Logistic regression analyses were performed to assess the association between NLR and lymph node metastasis, muscle-invasive and non-organ-confined disease. The association of altered NLR with recurrence-free survival (RFS) and cancer-specific survival (CSS) was evaluated using Cox proportional hazards regression models. Altered NLR was observed in 1428 (62.8 %) patients and associated with more advanced pathological tumor stage, lymph node metastasis, lymphovascular invasion, tumor necrosis and sessile tumor architecture. In a preoperative model that included age, gender, tumor location and architecture, NLR was an independent predictive factor for the presence of lymph node metastasis, muscle-invasive and non-organ-confined disease (p &lt; 0.001). Within a median follow-up of 40 months (IQR 20-76 months), 548 (24.1 %) patients experienced disease recurrence and 453 patients (19.9 %) died from their cancer. Compared to patients with normal NLR, those with altered NLR had worse RFS (0.003) and CSS (p = 0.002). In multivariable analyses that adjusted for the effects of standard clinicopathologic features, altered NLR did not retain an independent value. In the subgroup of patients treated with lymphadenectomy in addition to RNU, NLR was independently associated with CSS (p = 0.03). In UTUC, preoperative NLR is associated with adverse clinicopathologic features and independently predicts features of biologically and clinically aggressive UTUC such as lymph node metastasis, muscle-invasive or non-organ-confined status. NLR may help better risk stratify patients with regard to lymphadenectomy and conservative therapy

Environmental Aspects of Historical Ferromanganese Tailings in the Šibenik Bay, Croatia

The former manganese ferroalloy plant and the remaining tailings are affecting the quality of the environment in Šibenik Bay, Croatia, even though industrial activities ceased more than 25 years ago. This study has revealed that the main manganese mineral phases present in the recently collected tailings, as well as in the dust collected on the roof of the plant during the production period, are bustamite and Mn-oxides. The same type of Mn mineral phases was also found in recently collected sediments from Šibenik Bay. Detailed chemical and phase analyses (XRD, BCR sequential analysis, aqua regia and lithium borate fusion) of the dust sample revealed high manganese values (24.1%), while granulometric analysis showed that 50% of the particles are smaller than PM2.5. The influence of the tailings is visible in the sediment, but the concentrations of the potentially toxic elements determined by the sequential BCR analysis are within the legal limits. Some higher values (20.3 g/kg Mn, 595 mg/kg Pb and 494 mg/kg Zn) are detected in the tailings, which are still exposed to weathering and as such should be additionally monitored. On the other hand, this material contains a considerable number of elements that could be considered lucrative (∑ REE up to 700 mg/kg, Mn up to 23 g/kg, Fe up to 37 g/kg and Al up to 25 g/kg), opening the possibility of reuse and recovery

What a difference 15 years can make!

En sammenligning af litteraturlister fra 40 specialer med 15 års mellemrum

Lithology as a factor for the distribution of metals in stream sediments associated with sediment-hosted Cu deposits: a case study from the Alta-Kvænangen tectonic window, northern Norway

The Kåfjord area in northern Norway hosts numerous Cu deposits that were subjected to mining activities back in the nineteenth century. Relicts of the historical mining activity are still visible at several abandoned mines and associated mine waste disposal sites that may represent an environmental threat. The area was subjected to mining activities during the nineteenth century and abandoned mines and associated mine waste disposal sites still may represent a significant environmental threat. The Cu mineralization, found within the Paleoproterozoic Alta-Kvænangen Tectonic Window, primarily occurs as epigenetic sulfide-quartz-carbonate hydrothermal veins that crosscut the Kvenvik volcano-sedimentary complex and the overlying Storviknes sedimentary sequence. This study aims to determine the geochemical composition of stream sediments associated with the sediment-hosted Cu deposits and examine the role of host lithologies in the dispersion of elements associated with the deposits. Sediments from two streams and a river in the Kåfjord area were analyzed using phase and element analyses (aqua regia chemistry), complemented by a seven-step sequential extraction procedure. Results from Annaselva stream, draining Cu occurrences in the carbonate sediments of the Storviknes sequence, showed a significant positive correlation of Cu with mobile chalcophile elements (Pb, Zn, Ni, Tl, Hg, Ag, Sb, Bi) and lithophile elements (Sr, Ca, Ba, Al, K). In contrast, Brakkelva stream, draining the mafic volcanics of the Kvenvik complex, exhibited no statistically significant correlations between Cu and any of the analyzed elements. Møllneselva River, draining both lithologies, showed a strong Cu-Sc correlation, with principal component analysis indicating limited distinction between lithology-derived elements. These results did not completely align with statistical analysis outcomes highlighting the challenges of statistical data interpretation using a limited number of samples

Current Disease Management of Primary Urethral Carcinoma

Context: Primary urethral cancer (PUC) is a rare cancer entity. Owing to the low incidence of this malignancy, the main body of literature consists mainly of case reports, making evidence-based management recommendations difficult. Objective: To review reported disease management strategies of PUC and their impact on oncological outcomes. Evidence acquisition: A systematic research was performed according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement using Medline, Scopus, and Web of Science, to find studies of the past 10yr including ≥20 patients, and investigating treatment strategies and their impact on outcomes of the three most frequent histologies: urothelial carcinoma, adenocarcinoma, and squamous cell carcinoma. Evidence synthesis: In localized PUC, penis-sparing surgery can be performed in males, while in females, complete urethrectomy with surrounding tissue is advised to minimize recurrence due to positive margins. Radiotherapy (RT) has worse survival and recurrence rates, as well as more adverse effects, than surgery, limiting its use in genital-preserving therapy. Locally advanced PUC should be treated with multimodal therapy, as monotherapies result in inferior recurrence and survival rates. Extent of surgery is still undecided, favoring radical cyst(oprostat)ectomy with total urethrectomy (RCU). Lymph node involvement is a predictor of survival, highlighting the role of lymph node dissection for disease control and staging. RT can improve survival in combination with surgery and/or chemotherapy (CHT). Neoadjuvant platinum-based CHT can improve overall and recurrence-free survival. At recurrence, salvage therapy with surgery and/or CHT can improve survival. Superficial urothelial carcinoma of the prostatic urethra can be treated with transurethral resection. Stromal invasion often features concomitant bladder cancer with a poor prognosis and requires RCU with or without systemic preoperative CHT. Conclusions: PUC is a rare malignancy with an often poor natural course, requiring a stage- and gender-specific risk-based treatment strategy. The role of systematic perioperative CHT and the extent of surgery are becoming more important. Patient summary: In this review, we looked at the treatment options for primary urethral cancer. We found that while an organ-confined disease can be managed with local resection, growth beyond the organ border makes a combination of different treatment modalities, such as surgery and systematic chemotherapy, necessary to improve outcomes

Prognostic value of T1 substaging on oncological outcomes in patients with non-muscle-invasive bladder urothelial carcinoma : a systematic literature review and meta-analysis

Purpose To evaluate the prognostic value of substaging on oncological outcomes in patients with T (or pT1) urothelial carcinoma of the bladder. Methods A literature search using PubMed, Scopus, Web of Science, and Cochrane Library was conducted on March 2019 to identify relevant studies according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. The pooled disease recurrence (DR) and disease progression (DP) rate in T1(or pT1) patients were calculated using a fixed or random effects model. Results Overall 36 studies published between 1994 and 2018 including a total of 6781 bladder cancer patients with T1(or pT1) stage were selected for the systematic review and meta-analysis. Twenty-nine studies reported significant association between tumor infiltration depth or muscularis mucosa (MM) invasion and oncological outcomes. Totally 12 studies were included in the meta-analysis. MM invasion (T1a/b/c [or pT1a/b/c] or T1a/b [or pT1a/b] substaging system) was associated with DR (pooled HR: 1.23, 95%CI: 1.01–1.49) and DP (pooled HR: 2.61, 95%CI: 1.61–4.23). Tumor infiltration depth (T1 m/e [or pT1 m/e] substaging system) was also associated with DR (pooled HR: 1.49, 95%CI: 1.11–2.00) and DP (pooled HR: 3.29, 95%CI: 2.39–4.51). Conclusions T1(or pT1) substaging in patients with bladder cancer is of prognostic value as it is associated with oncologic outcomes. Inclusion of this factors into the clinical decision-making process of this heterogeneous tumor may improve outcomes, while avoiding over- and under-treatment for T1(or pT1) bladder cancer

Oncologic and Safety Outcomes for Endoscopic Surgery Versus Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma: An Updated Systematic Review and Meta-analysis

We systematically reviewed the literature and summarized oncologic and safety outcomes for endoscopic management (EM) compared to radical nephroureterectomy (RNU) for patients with upper tract urothelial carcinoma (UTUC). Studies comparing oncologic and/or safety results for EM versus RNU in patients with UTUC were included in our review. Overall, 13 studies met the criteria, and five studies were included in a meta-analysis using adjusted hazard ratios (HRs) for overall survival (OS), cancer-specific survival (CSS), and bladder recurrence-free survival (BRFS). EM was associated similar OS (HR 1.27, 95% confidence interval [CI] 0.75–2.16), CSS (HR 1.37, 95% CI 0.99–1.91), and BRFS (HR 0.98, 95% CI 0.61–1.55) to RNU, while 28–85% of patients treated with EM experienced upper tract recurrence across the studies. EM required more interventions with a higher cumulative risk of complications and lower likelihood of renal preservation. In summary, EM for low-grade UTUC had comparable survival outcomes to RNU at the cost of higher local recurrence rates resulting in a need for long-term rigorous surveillance and repeated interventions

Intravesical Therapy in Patients with Intermediate-risk Non–muscle-invasive Bladder Cancer: A Systematic Review and Network Meta-analysis of Disease Recurrence

Context Patients with intermediate-risk non–muscle-invasive bladder cancer (NMIBC) may pose a clinical dilemma without an agreed evidence-based decision tree for personalized treatment. Objective To perform a systematic review and network meta-analysis (NMA) to summarize available evidence on the oncologic outcomes of intravesical therapy in patients with intermediate-risk NMIBC. Evidence acquisition The MEDLINE, EMBASE, and ClinicalTrials.gov databases were searched in October 2020 according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. Studies were deemed eligible if they reported on oncologic outcomes in patients with intermediate-risk NMIBC treated with transurethral resection of bladder tumor with and without intravesical chemotherapy or bacillus Calmette-Guérin (BCG) immunotherapy. Evidence synthesis Twelve studies were included in a qualitative synthesis (systematic review); three were deemed eligible for a quantitative synthesis (NMA). An NMA of five different regimens was conducted for the association of treatment with the 5-yr recurrence risk. Chemotherapy with maintenance was associated with a lower likelihood of 5-yr recurrence than chemotherapy without maintenance (odds ratio [OR] 0.51, 95% credible interval [CI] 0.26–1.03). Immunotherapy, regardless of whether a full- or reduced-dose regimen, was not associated with a significantly lower likelihood of 5-yr recurrence when compared with chemotherapy without maintenance (OR 0.90, 95% CI 0.39–2.11 vs OR 0.93, 95% CI 0.40–2.19). Analysis of the treatment ranking revealed that chemotherapy with maintenance had the lowest 5-yr recurrence risk (P score 0.9666). Conclusions Our analysis indicates that chemotherapy with a maintenance regimen confers a superior oncologic benefit in terms of 5-yr recurrence risk compared to chemotherapy without maintenance in patients with intermediate-risk NMIBC. Regardless of the dose regimen, immunotherapy with BCG does not appear to be superior to chemotherapy in patients with intermediate-risk NMIBC in term of disease recurrence. However, owing to the lack of comparative studies, there is an unmet need for well-designed, large-scale trials to validate our findings and generate robust evidence on disease recurrence and progression. Patient summary A maintenance schedule of chemotherapy reduces the rate of long-term recurrence of bladder cancer that has not invaded the bladder muscle. Chemotherapy inserted directly into the bladder and immunotherapy without maintenance schedules seem to have limited benefit in preventing cancer recurrence