The centenary of Viktor Mikhailovich Zhdanov

The article is devoted to the outstanding Soviet scientist - virologist VM Zhdanov. V.M. Zhdanov first USSR stimulated studies of HIV infection. His studies on the classification of viruses are highly appreciated in the world, and he was invited to become a member of the International Committee on Taxonomy of Viruses. VM Zhdanov focused on the fight against polio, and the incidence of paralytic polio has been reduced to a minor problem. In a memorial conference in honor of Viktor Zhdanov virologists attended from 30 countries.Статья посвящена выдающемуся советскому ученому - вирусологу В.М. Жданову, который внес важный вклад в профилактику инфекционных заболеваний, особенно, по ликвидации оспы в мире. В.М. Жданов первым в СССР стимулировал исследования ВИЧ-инфекции. Его исследования по классификации вирусов высоко оценены в мире, и он был приглашен стать членом Международного комитета по таксономии вирусов. В.М. Жданов сосредоточил свое внимание на борьбе с полиомиелитом, и заболеваемость паралитическим полиомиелитом была сокращена до незначительной проблемы. В мемориальной конференции в честь Виктора Жданова приняли участие вирусологи из 30-ти стран мира.Стаття присвячена видатному радянському вченому - вірусологу В.М. Жданову, який вніс важливий внесок у профілактику інфекційних захворювань, особливо, з ліквідації віспи в світі. В.М. Жданов першим в СРСР стимулював дослідження ВІЛ-інфекції. Його дослідження з класифікації вірусів високо оцінені в світі, і він був запрошений стати членом Міжнародного комітету з таксономії вірусів. В.М. Жданов зосередив свою увагу на боротьбі з поліомієлітом, і захворюваність паралітичним поліомієлітом була скорочена до незначної проблеми. У меморіальній конференції на честь Віктора Жданова взяли участь вірусологи з 30-ти країн світу

Study on preventing and combating hate speech in times of crisis

Crises are testing grounds for societies and for their democratic institutions. They can either threaten or reinforce societal cohesion; weaken or consolidate the capacity of governments and elected bodies to respond to voters’ concerns; and suppress or stimulate the reaction of civil society organizations toward new needs and forms of marginalization. Regarding discrimination, crises can intensify hatred and hate speech targeting specific individuals or groups deemed responsible for the crisis, but they can also be aggravated by hate speech when a certain group has been singled out as a threat or an enemy. Hate speech in times of crisis may build on existing discriminatory or hate narratives, but also trigger, and evolve from, new narratives disseminated to respond to such crises. European countries have experienced several crises in the last few years, which have impacted the production, dissemination, and reception of hate speech. The COVID-19 pandemic (“a pandemic of hate” to quote the United Nations Secretary-General António Guterres) has globally boosted dynamics of social conflict, polarisation, and radicalization; saw a huge increase in hate speech against individuals and groups (such as Chinese and people of Asian descent, migrants and refugees, and national minorities); revamped antisemitism (via conspiracy theories); intertwined hateful narratives; and intersected grounds of discrimination. Roma and Travellers have also been particularly affected by hate speech in several European countries for both enduring systemic discrimination and for more contextual causes, such as forced marginalization and isolation during lockdowns, and for being singled out as potential plague-spreaders. The full-scale military aggression of the Russian Federation against Ukraine in February 2022 has fostered violent, dehumanizing rhetoric and hate speech both in the countries and – more generally – across Europe, opposing the Russian Federation and “The West” and disseminating hatred against Ukraine, Ukrainian nationals, and refugees from Ukraine through disinformation campaigns. Nationalistic hate speech has triggered and is fuelling the conflict and its circulation also represents a challenge to the media sector and to internet intermediaries, which are asked to disentangle hateful narratives and provide the public with objective information about the Russian Federation’s aggression. At the same time, the war of aggression against Ukraine has also had a negative impact on communities using Russian as their main language, including outside of Ukraine and the Russian Federation. The arrivals of migrants and refugees have been labeled in political discourse and by the media as "crises” in the last few years to create a consistent narrative that sees the rise of mixed migration movements to European countries as a cause of uncertainty, threat, and ongoing emergency to states and societies. This coupled with increasing anti-migrant hate speech since the arrival of a large number of refugees from Syria in 2015, together with the fear of contagion and border control during the pandemic has further consolidated a xenophobic discourse, and migrants and refugees remain one of the major targets of hate speech across the continent. Finally, terrorist attacks have fuelled xenophobic feelings, and terror attacks themselves are equally fuelled by intolerance: for example, the attack fomented by homophobia that occurred in the Slovak Republic in 2022. Hatred against Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) persons – and in particular against transgender people – is on the rise all over Europe, which calls for effective institutional interventions to prevent and combat LGBTI-phobia at all levels. Due to such crises, new challenges have emerged for the different actors involved in monitoring, analyzing, preventing, and combating hate speech. From the very definition of hate speech which has confronted new complexities, the urgency of increasing public awareness of disinformation, which is particularly misleading and disruptive in times of crisis, to the need to better work with social media platforms (to get access to data, and foster collaboration with law enforcement) and to create inter-institutional cooperation involving those targeted by hate speech, stakeholders are expressing their concerns and setting their priorities, with the aim of making their approaches more comprehensive. Much has already been done – by various actors and at various levels – to address hate speech in times of crisis, and promising practices across the continent have been tested, such as the implementation of legal measures to combat hate speech, coordinated campaigns online and offline by law enforcement and networks of stakeholders, education and counter-speech initiatives and some actions in support of those targeted by hate speech. However, much still needs to be done, as this report shows, and comprehensive strategies still need to be designed, implemented, and assessed to better tackle hate speech in times of crisis. The recommendations to enhance the fight against hate speech in times of crisis include assessing and amending legal frameworks, as well as reinforcing law enforcement measures. Collaboration among stakeholders needs to be strengthened, including a focus on the role and competencies of specific actors such as media, national human rights institutions, and equality bodies. Making public awareness and information campaigns a priority and providing support to those targeted by hate speech also appear as crucial measures to prevent and combat hate speech in times of crisis. Importantly, it should be recognized that it can be difficult to amend legal frameworks or make substantial policy or practical changes quickly in times of crisis. Therefore, it is essential to take steps to prepare good conditions of social cohesion in ordinary times to ensure a greater level of resilience to discriminatory and hateful speech in times of crisis. In this respect, it is suggested that member states and stakeholders closely follow the recommendations presented in the Recommendation CM/Rec(2022)16 of the Committee of Ministers to member States on combating hate speech

Minimally invasive complete response assessment of the breast after neoadjuvant systemic therapy for early breast cancer (micra trial) : interim analysis of a multicenter observational cohort study

Background The added value of surgery in breast cancer patients with pathological complete response (pCR) after neoadjuvant systemic therapy (NST) is uncertain. The accuracy of imaging identifying pCR for omission of surgery, however, is insufficient. We investigated the accuracy of ultrasound-guided biopsies identifying breast pCR (ypT0) after NST in patients with radiological partial (rPR) or complete response (rCR) on MRI. Methods We performed a multicenter, prospective single-arm study in three Dutch hospitals. Patients with T1-4(N0 or N +) breast cancer with MRI rPR and enhancement <= 2.0 cm or MRI rCR after NST were enrolled. Eight ultrasound-guided 14-G core biopsies were obtained in the operating room before surgery close to the marker placed centrally in the tumor area at diagnosis (no attempt was made to remove the marker), and compared with the surgical specimen of the breast. Primary outcome was the false-negative rate (FNR). Results Between April 2016 and June 2019, 202 patients fulfilled eligibility criteria. Pre-surgical biopsies were obtained in 167 patients, of whom 136 had rCR and 31 had rPR on MRI. Forty-three (26%) tumors were hormone receptor (HR)-positive/HER2-negative, 64 (38%) were HER2-positive, and 60 (36%) were triple-negative. Eighty-nine patients had pCR (53%; 95% CI 45-61) and 78 had residual disease. Biopsies were false-negative in 29 (37%; 95% CI 27-49) of 78 patients. The multivariable associated with false-negative biopsies was rCR (FNR 47%; OR 9.81, 95% CI 1.72-55.89; p = 0.01); a trend was observed for HR-negative tumors (FNR 71% in HER2-positive and 55% in triple-negative tumors; OR 4.55, 95% CI 0.95-21.73; p = 0.058) and smaller pathological lesions (6 mm vs 15 mm; OR 0.93, 95% CI 0.87-1.00; p = 0.051). Conclusion The MICRA trial showed that ultrasound-guided core biopsies are not accurate enough to identify breast pCR in patients with good response on MRI after NST. Therefore, breast surgery cannot safely be omitted relying on the results of core biopsies in these patients

Neoadjuvant Therapy in Early Breast Cancer:Treatment Considerations and Common Debates in Practice

Neoadjuvant treatment offers a number of benefits for patients with early breast cancer, and is an important option for consideration by multidisciplinary teams. Despite literature showing its efficacy, the use of neoadjuvant therapy varies widely. Here we discuss the clinical evidence supporting the use of neoadjuvant therapy in early stage breast cancer, including patient selection, monitoring response, surgery and radiotherapy considerations, with the aim of assisting multidisciplinary teams to determine patient suitability for neoadjuvant treatment

Residual cancer burden after neoadjuvant chemotherapy and long-term survival outcomes in breast cancer : a multicentre pooled analysis of 5161 patients

Background Previous studies have independently validated the prognostic relevance of residual cancer burden (RCB) after neoadjuvant chemotherapy. We used results from several independent cohorts in a pooled patient-level analysis to evaluate the relationship of RCB with long-term prognosis across different phenotypic subtypes of breast cancer, to assess generalisability in a broad range of practice settings. Methods In this pooled analysis, 12 institutes and trials in Europe and the USA were identified by personal communications with site investigators. We obtained participant-level RCB results, and data on clinical and pathological stage, tumour subtype and grade, and treatment and follow-up in November, 2019, from patients (aged ≥18 years) with primary stage I–III breast cancer treated with neoadjuvant chemotherapy followed by surgery. We assessed the association between the continuous RCB score and the primary study outcome, event-free survival, using mixed-effects Cox models with the incorporation of random RCB and cohort effects to account for between-study heterogeneity, and stratification to account for differences in baseline hazard across cancer subtypes defined by hormone receptor status and HER2 status. The association was further evaluated within each breast cancer subtype in multivariable analyses incorporating random RCB and cohort effects and adjustments for age and pretreatment clinical T category, nodal status, and tumour grade. Kaplan-Meier estimates of event-free survival at 3, 5, and 10 years were computed for each RCB class within each subtype. Findings We analysed participant-level data from 5161 patients treated with neoadjuvant chemotherapy between Sept 12, 1994, and Feb 11, 2019. Median age was 49 years (IQR 20–80). 1164 event-free survival events occurred during follow-up (median follow-up 56 months [IQR 0–186]). RCB score was prognostic within each breast cancer subtype, with higher RCB score significantly associated with worse event-free survival. The univariable hazard ratio (HR) associated with one unit increase in RCB ranged from 1·55 (95% CI 1·41–1·71) for hormone receptor-positive, HER2-negative patients to 2·16 (1·79–2·61) for the hormone receptor-negative, HER2-positive group (with or without HER2-targeted therapy; p<0·0001 for all subtypes). RCB score remained prognostic for event-free survival in multivariable models adjusted for age, grade, T category, and nodal status at baseline: the adjusted HR ranged from 1·52 (1·36–1·69) in the hormone receptor-positive, HER2-negative group to 2·09 (1·73–2·53) in the hormone receptor-negative, HER2-positive group (p<0·0001 for all subtypes). Interpretation RCB score and class were independently prognostic in all subtypes of breast cancer, and generalisable to multiple practice settings. Although variability in hormone receptor subtype definitions and treatment across patients are likely to affect prognostic performance, the association we observed between RCB and a patient's residual risk suggests that prospective evaluation of RCB could be considered to become part of standard pathology reporting after neoadjuvant therapy