WorldWideScience

Sample records for cancer controversies part

  1. PET in cancer screening: a controversial imaging

    International Nuclear Information System (INIS)

    Su Minggang; Tan Tianzhi

    2012-01-01

    Malignancy has been one of the most dangerous threats to human health. Early diagnosis and treatment are key factors for improving prognosis. Cancer screening is an important way to detect early stage cancer and precancerous lesion. PET has been used increasingly in cancer screening in accordance with the requirement of the public. Though a great number of data show that PET can find some subclinical malignancy, yet as a cancer screening modality, PET is still controversial in contemporary medical practice. The aim of this article is to review the application status and existing problem of PET in cancer screening, and to offer some recognition and view about cancer srceening. (authors)

  2. Breast cancer radiotherapy: controversies and prospectives

    Institute of Scientific and Technical Information of China (English)

    YU Jin-ming; WANG Yong-sheng

    2008-01-01

    @@ Despite consensus on breast cancer radiotherapy, there are still some controversies over post-mastectomy radiotherapy (PMRT) in patients with 1-3 positive lymph nodes, accelerated partial breast irradiation (APBI), appropriate sequence of radiotherapy, chemotherapy and hormonal treatment, and radiotherapy after preoperative systemic therapy.

  3. Controversial Issues in Thyroid Cancer Management.

    Science.gov (United States)

    Tuttle, R Michael

    2018-04-13

    The lack of prospective randomized clinical trials for most management topics in differentiated thyroid cancer force us to make management recommendations based on retrospective observational data which is often incomplete, subject to selection bias, and conflicting. Therefore, it is not surprising that many aspects of thyroid cancer management remain controversial and not well defined. This review will examine the controversies surrounding three important topics in thyroid cancer management: (1) the option of thyroid lobectomy as initial therapy for thyroid cancer, (2) the proper use of preoperative neck imaging to optimize the completeness of the initial surgical procedure, and (3) the selective use RAI therapy as remnant ablation, adjuvant treatment or treatment of known persistent/recurrent disease. As thyroid cancer management moves toward a much more risk adapted approach to personalized management recommendations, clinicians and patients must balance the risks and benefits of the potential management options to arrive at a management plan that is optimized based on both patient preferences/values and the philosophy/experience of the local disease management team. Copyright © 2018 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

  4. Management of endometrial cancer: issues and controversies.

    Science.gov (United States)

    Bogani, G; Dowdy, S C; Cliby, W A; Ghezzi, F; Rossetti, D; Frigerio, L; Mariani, A

    2016-01-01

    Although endometrial cancer (EC) is the most common gynecologic cancer in developed countries, several aspects of its management are still controversial. In particular, the need to perform lymphadenectomy represents an important matter of discussion. Because of the discordant results in the literature, it is still not possible to draft any definitive conclusions regarding the therapeutic value of lymph node dissection. The present review discusses the role of lymphadenectomy in the setting of EC, risk factors for lymphatic spread, identification of patients at risk for lymph node dissemination, and the current evidence for adjuvant therapies in patients with positive nodes. Reasons for the difficulty in demonstrating any therapeutic value of pelvic and para-aortic lymphadenectomy are also discussed.

  5. Progress and controversies in developing cancer vaccines

    Directory of Open Access Journals (Sweden)

    Speiser Daniel E

    2005-04-01

    Full Text Available Abstract Immunotherapy has become a standard approach for cancer management, through the use of cytokines (eg: interleukin-2 and monoclonal antibodies. Cancer vaccines hold promise as another form of immunotherapy, and there has been substantial progress in identifying shared antigens recognized by T cells, in developing vaccine approaches that induce antigen-specific T cell responses in cancer patients, and in developing new technology for monitoring immune responses in various human tissue compartments. Dramatic clinical regressions of human solid tumors have occurred with some cancer vaccines, but the rate of those responses remains low. This article is part of a 2-part point:counterpoint series on peptide vaccines and adoptive therapy approaches for cancer. The current status of cancer vaccination, and associated challenges, are discussed. Emphasis is placed on the need to increase our knowledge of cancer immunobiology, as well as to improve monitoring of cellular immune function after vaccination. Progress in both areas will facilitate development of effective cancer vaccines, as well as of adoptive therapy. Effective cancer vaccines promise to be useful for treatment and prevention of cancer at low cost and with low morbidity.

  6. Silica and lung cancer: a controversial issue.

    Science.gov (United States)

    Pairon, J C; Brochard, P; Jaurand, M C; Bignon, J

    1991-06-01

    The role of crystalline silica in lung cancer has long been the subject of controversy. In this article, we review the main experimental and epidemiological studies dealing with this problem. Some evidence for a genotoxic potential of crystalline silica has been obtained in the rare in vitro studies published to date. In vivo studies have shown that crystalline silica is carcinogenic in the rat; the tumour types appear to vary according to the route of administration. In addition, an association between carcinogenic and fibrogenic potency has been observed in various animal species exposed to crystalline silica. An excess of lung cancer related to occupational exposure to crystalline silica is reported in many epidemiological studies, regardless of the presence of silicosis. However, most of these studies are difficult to interpret because they do not correctly take into account associated carcinogens such as tobacco smoke and other occupational carcinogens. An excess of lung cancer is generally reported in studies based on silicosis registers. Overall, experimental and human studies suggest an association between exposure to crystalline silica and an excess of pulmonary malignancies. Although the data available are not sufficient to establish a clear-cut causal relationship in humans, an association between the onset of pneumoconiosis and pulmonary malignancies is probable. In contrast, experimental observations have given rise to a pathophysiological mechanism that might account for a putative carcinogenic potency of crystalline silica.

  7. Low-level radiation: The cancer controversy

    International Nuclear Information System (INIS)

    Stewart, A.M.

    1990-01-01

    According to early studies it would be safe to assume there are no late effects of radiation apart from cancer, no lasting selective effects of the early deaths of A-bomb victims, and no cancer risk at low dose levels (below 20 rad). The nuclear establishment had good reason to believe that a potentially dangerous situation had been completely defused, and optimists were still free to regard daily exposure to background radiation as a benign influence. For several years the only indication to the contrary was the Oxford survey's finding on prenatal X-rays. But today we face the possibility that there are other late effects of radiation besides cancer; and the possibility that the selection effects of the two nuclear explosions are still reflected in death rates among survivors and are the reason why no cancer effects have been found at low dose levels. If these possibilities are confirmed, we may one day realize how fortunate it was that the Oxford survey findings put a brake on the enthusiasms of nuclear power advocates. Otherwise, we might never have pressed for direct studies of the effects of low doses of radiation. 7 refs

  8. Breast cancer screening controversies: who, when, why, and how?

    Science.gov (United States)

    Chetlen, Alison; Mack, Julie; Chan, Tiffany

    2016-01-01

    Mammographic screening is effective in reducing mortality from breast cancer. The issue is not whether mammography is effective, but whether the false positive rate and false negative rates can be reduced. This review will discuss controversies including the reduction in breast cancer mortality, overdiagnosis, the ideal screening candidate, and the optimal imaging modality for breast cancer screening. The article will compare and contrast screening mammography, tomosynthesis, whole-breast screening ultrasound, magnetic resonance imaging, and molecular breast imaging. Though supplemental imaging modalities are being utilized to improve breast cancer diagnosis, mammography still remains the gold standard for breast cancer screening. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Radiotherapy in prostate cancer. Innovative techniques and current controversies

    International Nuclear Information System (INIS)

    Geinitz, Hans

    2015-01-01

    Examines in detail the role of innovative radiation techniques in the management of prostate cancer, including IMRT, IGRT, BART, and modern brachytherapy. Explores a range of current controversies in patient treatment. Intended for both radiation oncologists and urologists. Radiation treatment is rapidly evolving owing to the coordinated research of physicists, engineers, computer and imaging specialists, and physicians. Today, the arsenal of ''high-precision'' or ''targeted'' radiotherapy includes multimodal imaging, in vivo dosimetry, Monte Carlo techniques for dose planning, patient immobilization techniques, intensity-modulated radiotherapy (IMRT), image-guided radiotherapy (IGRT), biologically adapted radiotherapy (BART), quality assurance methods, novel methods of brachytherapy, and, at the far end of the scale, particle beam radiotherapy using protons and carbon ions. These approaches are like pieces of a puzzle that need to be put together to provide the prostate cancer patient with high-level optimized radiation treatment. This book examines in detail the role of the above-mentioned innovative radiation techniques in the management of prostate cancer. In addition, a variety of current controversies regarding treatment are carefully explored, including whether prophylactic treatment of the pelvic lymphatics is essential, the magnitude of the effect of dose escalation, whether a benefit accrues from hypofractionation, and what evidence exists for the superiority of protons or heavy ions. Radiotherapy in Prostate Cancer: Innovative Techniques and Current Controversies is intended for both radiation oncologists and urologists with an interest in the up-to-date capabilities of modern radiation oncology for the treatment of prostate cancer.

  10. Controversies in the management of tongue base cancer.

    LENUS (Irish Health Repository)

    O'Neill, J P

    2012-01-31

    BACKGROUND: Tongue base cancer is one of the most lethal head and neck cancers. There is considerable controversy in the management of this disease with wide variation of opinion within the literature. METHODS: We discuss the presentation, diagnostic and therapeutic strategies which exist in the literature. Articles were reviewed from 1970 to 2007 within the Medline, Pubmed and Cochrane libraries. CONCLUSIONS: Smokers with a history of persistent unilateral neck pain, even in the absence of clinical signs warrant MRI neck imaging. Tongue base cancer organ preservation therapeutic strategies, radiation and concomitant platinum based chemotherapy, currently optimise oncologic and quality of life outcomes.

  11. Controversies in breast cancer: adjuvant and neoadjuvant therapy.

    Science.gov (United States)

    Montemurro, Filippo; Redana, Stefania; Valabrega, Giorgio; Aglietta, Massimo

    2005-06-01

    Initial randomised studies of chemotherapy and endocrine therapy showed that systemic treatments had a substantial impact on the survival of women with early breast cancer. The original assumption was that the efficacy of these treatments was limited to those patients presenting with more adverse prognostic features. Subsequently, meta-analyses of randomised trials revealed that the benefits of chemotherapy and endocrine therapy are not mutually exclusive and extend to all the prognostic subgroups. However, the absolute benefit varies according to baseline characteristics such as tumour stage and other biological factors. Over the last 10 years, considerable progress has been made with the introduction of new drugs into the adjuvant and neoadjuvant treatment of women with breast cancer. Taxanes and third-generation aromatase inhibitors are providing proof of additional benefits compared with standard reference treatments. In parallel, research on the biology of breast cancer is establishing novel prognostic and predictive factors, which may allow better treatment tailoring. Currently, however, women with early breast cancer and their doctors face the difficult task of making therapeutic decisions often based on early results from positive studies. In a disease where follow up is crucial to fully assess the benefit and long-term toxicities of an intervention, current knowledge leaves unanswered questions that generate debate and controversy. This review will summarise recent results from randomised trials of adjuvant and neoadjuvant therapy in women with early breast cancer and focus on the current controversies.

  12. Radiotherapy in prostate cancer. Innovative techniques and current controversies

    Energy Technology Data Exchange (ETDEWEB)

    Geinitz, Hans [Krankenhaus der Barmherzigen Schwestern, Linz (Austria). Dept. of Radiation Oncology; Linz Univ. (Austria). Medical Faculty; Roach, Mack III [California Univ., San Francisco, CA (United States). Dept. of Radiation Oncology; Van As, Nicholas (ed.) [The Institute of Cancer Research, Sutton Surrey (United Kingdom)

    2015-04-01

    Examines in detail the role of innovative radiation techniques in the management of prostate cancer, including IMRT, IGRT, BART, and modern brachytherapy. Explores a range of current controversies in patient treatment. Intended for both radiation oncologists and urologists. Radiation treatment is rapidly evolving owing to the coordinated research of physicists, engineers, computer and imaging specialists, and physicians. Today, the arsenal of ''high-precision'' or ''targeted'' radiotherapy includes multimodal imaging, in vivo dosimetry, Monte Carlo techniques for dose planning, patient immobilization techniques, intensity-modulated radiotherapy (IMRT), image-guided radiotherapy (IGRT), biologically adapted radiotherapy (BART), quality assurance methods, novel methods of brachytherapy, and, at the far end of the scale, particle beam radiotherapy using protons and carbon ions. These approaches are like pieces of a puzzle that need to be put together to provide the prostate cancer patient with high-level optimized radiation treatment. This book examines in detail the role of the above-mentioned innovative radiation techniques in the management of prostate cancer. In addition, a variety of current controversies regarding treatment are carefully explored, including whether prophylactic treatment of the pelvic lymphatics is essential, the magnitude of the effect of dose escalation, whether a benefit accrues from hypofractionation, and what evidence exists for the superiority of protons or heavy ions. Radiotherapy in Prostate Cancer: Innovative Techniques and Current Controversies is intended for both radiation oncologists and urologists with an interest in the up-to-date capabilities of modern radiation oncology for the treatment of prostate cancer.

  13. Physician-patient discussions of controversial cancer screening tests.

    Science.gov (United States)

    Dunn, A S; Shridharani, K V; Lou, W; Bernstein, J; Horowitz, C R

    2001-02-01

    Screening mammography for younger women and prostate-specific antigen (PSA) measurement have controversial benefits and known potential adverse consequences. While providing informed consent and eliciting patient preference have been advocated for these tests, little is known about how often these discussions take place or about barriers to these discussions. We administered a survey to medical house staff and attending physicians practicing primary care. The survey examined physicians' likelihood of discussing screening mammography and PSA testing, and factors influencing the frequency and quality of these discussions. For the three scenarios, 16% to 34% of physicians stated that they do not discuss the screening tests. The likelihood of having a discussion was significantly associated with house staff physicians' belief that PSA screening is advantageous; house staff and attending physicians' intention to order a PSA test, and attending physicians' intention to order a mammogram; and a controversial indication for screening. The most commonly identified barriers to discussions were lack of time, the complexity of the topic, and a language barrier. Physicians report they often do not discuss cancer screening tests with their patients. Our finding that physicians' beliefs and intention to order the tests, and extraneous factors such as time constraints and a language barrier, are associated with discussions indicates that some patients may be inappropriately denied the opportunity to choose whether to screen for breast and prostate cancer.

  14. Physician–Patient Discussions of Controversial Cancer Screening Tests

    Science.gov (United States)

    Dunn, Andrew S.; Shridharani, Kanan V.; Lou, Wendy; Bernstein, Jeffrey; Horowitz, Carol R.

    2016-01-01

    Background Screening mammography for younger women and prostate-specific antigen (PSA) measurement have controversial benefits and known potential adverse consequences. While providing informed consent and eliciting patient preference have been advocated for these tests, little is known about how often these discussions take place or about barriers to these discussions. Methods We administered a survey to medical house staff and attending physicians practicing primary care. The survey examined physicians’ likelihood of discussing screening mammography and PSA testing, and factors influencing the frequency and quality of these discussions. Results For the three scenarios, 16% to 34% of physicians stated that they do not discuss the screening tests. The likelihood of having a discussion was significantly associated with house staff physicians’ belief that PSA screening is advantageous; house staff and attending physicians’ intention to order a PSA test, and attending physicians’ intention to order a mammogram; and a controversial indication for screening. The most commonly identified barriers to discussions were lack of time, the complexity of the topic, and a language barrier. Conclusions Physicians report they often do not discuss cancer screening tests with their patients. Our finding that physicians’ beliefs and intention to order the tests, and extraneous factors such as time constraints and a language barrier, are associated with discussions indicates that some patients may be inappropriately denied the opportunity to choose whether to screen for breast and prostate cancer. PMID:11165455

  15. Cigarette smoking and lung cancer: a continuing controversy.

    Science.gov (United States)

    Burch, P R

    1982-09-01

    During the late 1950s Sir Ronald Fisher questioned the already popular, but in his view precipitate, causal interpretation of the association between smoking and lung cancer. His pungently expressed views began a controversy that has smouldered and sometimes flared ever since. The most recent attack on Fisher's constitutional hypothesis was launched by Reif and in this paper I consider the validity of his criticisms. A range of evidence shows that it is not yet possible to distinguish between constitutional and causal-plus-constitutional interpretations although recent studies indicate that a pure causal hypothesis is incapable of explaining the full association as observed in Western populations. Unfortunately, errors of diagnosis and death certification still impede the rigorous testing of adequately formulated hypotheses.

  16. Asbestos and cancer: epidemiological and public health controversies.

    Science.gov (United States)

    Huncharek, M

    1994-01-01

    This paper discusses many of the currently controversial issues surrounding asbestos health effects and their relationship to cancer risk assessment and risk management. The major conclusions reached from this analysis are: (1) All asbestos fiber types are carcinogenic and pose a threat to human health. Therefore, all fiber types should be regulated similarly. (2) The health risks associated with indoor asbestos exposure are uncertain. Available data show that some groups, such as building maintenance personnel (among others), may contract asbestos-related diseases secondary to indoor exposure. Clearly, additional research is needed to accurately determine the extent and nature of disease risk under these conditions. (3) Controlled use has proved an elusive goal. Limited information from underdeveloped countries parallels the experience of Western industrialized nations. Efforts by the Canadian government to establish markets for asbestos in these areas should be opposed. (4) Finally, asbestos-related cancer risk is no longer confined to asbestos industry workers. Asbestos-related mesothelioma has been documented in a wide variety of occupational and nonoccupational settings, highlighting the need for continued surveillance to minimize potential health risks.

  17. The World Congress on Controversies in Breast Cancer (CoBRA in Melbourne, Australia

    Directory of Open Access Journals (Sweden)

    Ilana Rabinoff-Sofer

    2015-03-01

    Full Text Available The World Congress on Controversies in Breast Cancer (CoBRA will take place October 22-24, 2015 in Melbourne, Australia.CoBRA is a concept congress dealing with controversial topics in breast cancer in the format of debates and discussions, allowing ample time for speaker-participant interaction.CLICK HERE for more information

  18. Controversies in the handling of Cancer of breast

    International Nuclear Information System (INIS)

    Martinez, Alvaro; Perez, Carlos

    1999-01-01

    The handling of the breast Cancer is based on three fundamental pillars that are: the surgery, the radiotherapy and the chemotherapy, at the moment the controversy rests in that moment in that it should be given the radiotherapy and the shortcomings of the same one in the treatment. It is important then to clarify which is the ideal moment to begin the radiotherapy, for what the patients can be divided in two groups: 1 - Those to those who are made conservative surgery and later radiotherapy in the breast. 2 - those to who that are practiced radical mastectomy and later radiotherapy. In the conservative surgery there is more impact in the delay and local control of the tumor while in the other ones (second group) there is not a significant impact. The best study is that of the U. of Harvard that includes but of 200 patients to those that were given initial chemotherapy and another group with initial radiotherapy that then received chemotherapy. When the radiotherapy took a long time for 16 weeks or more, there was more fail in the breast, being but high the recurrence incidence. If the patient had intraductal tumor or with positive margins, they were more frequent the fault. In the patients with radiotherapy and later chemotherapy, had but metastasis incidence, for what it concludes that if there are as much positive margin as tumor extensive, first the radiotherapy it should be administered and later the chemotherapy

  19. Current state and controversies in fertility preservation in women with breast cancer.

    Science.gov (United States)

    Taylan, Enes; Oktay, Kutluk H

    2017-06-10

    On average, over 25000 women are diagnosed with breast cancer under the age of 45 annually in the United States. Because an increasing number of young women delay childbearing to later life for various reasons, a growing population of women experience breast cancer before completing childbearing. In this context, preservation of fertility potential of breast cancer survivors has become an essential concept in modern cancer care. In this review, we will outline the currently available fertility preservation options for women with breast cancer of reproductive age, discuss the controversy behind hormonal suppression for gonadal protection against chemotherapy and highlight the importance of timely referral by cancer care providers.

  20. Imaging Management of Breast Density, a Controversial Risk Factor for Breast Cancer.

    Science.gov (United States)

    Falcon, Shannon; Williams, Angela; Weinfurtner, Jared; Drukteinis, Jennifer S

    2017-04-01

    Breast density is well recognized as an independent risk factor for the development of breast cancer. However, the magnitude of risk is controversial. As the public becomes increasingly aware of breast density as a risk factor, legislation and notification laws in relation to breast density have become common throughout the United States. Awareness of breast density as a risk factor for breast cancer presents new challenges for the clinician in the approach to the management and screening of women with dense breasts. The evidence and controversy surrounding breast density as a risk factor for the development of breast cancer are discussed. Common supplemental screening modalities for breast cancer are also discussed, including tomosynthesis, ultrasonography, and magnetic resonance imaging. A management strategy for screening women with dense breasts is also presented. The American College of Radiology recognizes breast density as a controversial risk factor for breast cancer, whereas the American Congress of Obstetricians and Gynecologists recognizes breast density as a modest risk factor. Neither organization recommends the routine use of supplemental screening in women with dense breasts without considering additional patient-related risk factors. Breast density is a poorly understood and controversial risk factor for the development of breast cancer. Mammography is a screening modality proven to reduce breast cancer-related mortality rates and is the single most appropriate tool for population-based screening. Use of supplemental screening modalities should be tailored to individual risk assessment.

  1. The Controversial Clinicobiological Role of Breast Cancer Stem Cells

    Directory of Open Access Journals (Sweden)

    Claudia Casarsa

    2008-01-01

    Full Text Available Breast cancer remains a leading cause of morbidity and mortality in women mainly because of the propensity of primary breast tumors to metastasize. Growing experimental evidence suggests that cancer stem cells (CSCs may contribute to tumor progression and metastasis spread. However, despite the tremendous clinical potential of such cells and their possible therapeutic management, the real nature of CSCs remains to be elucidated. Starting from what is currently known about normal mammary stem/progenitor cells, to better define the cell that originates a tumor or is responsible for metastatic spread, this review will discuss experimental evidence of breast cancer stem cells and speculate about the clinical importance and implications of their evaluation.

  2. Enteral versus parenteral nutrition in cancer patients: evidences and controversies.

    Science.gov (United States)

    Cotogni, Paolo

    2016-01-01

    The debate over the use of enteral nutrition (EN) and parenteral nutrition (PN) is an old but evergreen and hot topic. Since many years, studies comparing EN and PN have been a pivotal 'leitmotif' in the published literature on artificial nutrition (AN). Actually, there is a background misunderstanding in this debate; specifically, that EN and PN are competitors in the choice of the route for delivering nutrition support in cancer patients. Conversely, EN and PN have specific indications and contraindications. This review has the purpose to discuss the indications and complications as well as pros and cons of EN and PN in cancer patients, the crucial role of nutrition support in oncology patients during anticancer treatments and throughout the course of disease, and, finally, the role of AN in advanced cancer patients. In summary, we have no evidence-based data able to definitively indicate the optimal method for delivering AN in cancer patients. EN and PN have to be considered equally effective in maintaining or improving nutritional status in cancer patients. Besides, this review strongly supports the recommendation that a baseline nutritional assessment should be carried out by a healthcare professional expert in AN for all cancer patients at the time of diagnosis or anticancer treatment plan, taking the nutritional status, estimated duration of AN, AN-related potential benefits and possible complications into consideration on an individual basis. Moreover, the patient symptoms, performance status, estimated life expectancy, and mainly, will or preferences have to be evaluated and incorporated into the nutrition support plan before the definitive choice of the route for delivering nutrients is decided. Finally, applying a decision-making process tailored to patient needs-regardless of whether receiving or not anticancer treatment-allows to choose reasonably the optimal nutritional support strategy.

  3. Controversial role of mast cells in skin cancers.

    Science.gov (United States)

    Varricchi, Gilda; Galdiero, Maria R; Marone, Giancarlo; Granata, Francescopaolo; Borriello, Francesco; Marone, Gianni

    2017-01-01

    Cancer development is a multistep process characterized by genetic and epigenetic alterations during tumor initiation and progression. The stromal microenvironment can promote tumor development. Mast cells, widely distributed throughout all tissues, are a stromal component of many solid and haematologic tumors. Mast cells can be found in human and mouse models of skin cancers such as melanoma, basal and squamous cell carcinomas, primary cutaneous lymphomas, haemangiomas and Merkel cell carcinoma. However, human and animal studies addressing potential functions of mast cells and their mediators in skin cancers have provided conflicting results. In several studies, mast cells play a pro-tumorigenic role, whereas in others, they play an anti-tumorigenic role. Other studies have failed to demonstrate a clear role for tumor-associated mast cells. Many unanswered questions need to be addressed before we understand whether tumor-associated mast cells are adversaries, allies or simply innocent bystanders in different types and subtypes of skin cancers. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Postoperative radiotherapy for lung cancer: Is it worth the controversy?

    OpenAIRE

    Billiet, Charlotte; Peeters, Stephanie; Decaluwe, Herbert; Vansteenkiste, Johan; Mebis, Jeroen; De Ruysscher, Dirk

    2016-01-01

    Introduction: The role of postoperative radiation therapy (PORT) in patients with completely resected non-small cell lung cancer (NSCLC) with pathologically involved mediastinal lymph nodes (N2) remains unclear. Despite a reduction of local recurrence (LR), its effect on overall survival (OS) remains unproven. Therefore we conducted a review of the current literature. Methods: To investigate the benefit and safety of modern PORT, we identified published phase III trials for PORT. We investiga...

  5. Brain imaging before primary lung cancer resection: a controversial topic.

    Science.gov (United States)

    Hudson, Zoe; Internullo, Eveline; Edey, Anthony; Laurence, Isabel; Bianchi, Davide; Addeo, Alfredo

    2017-01-01

    International and national recommendations for brain imaging in patients planned to undergo potentially curative resection of non-small-cell lung cancer (NSCLC) are variably implemented throughout the United Kingdom [Hudson BJ, Crawford MB, and Curtin J et al (2015) Brain imaging in lung cancer patients without symptoms of brain metastases: a national survey of current practice in England Clin Radiol https://doi.org/10.1016/j.crad.2015.02.007]. However, the recommendations are not based on high-quality evidence and do not take into account cost implications and local resources. Our aim was to determine local practice based on historic outcomes in this patient cohort. This retrospective study took place in a regional thoracic surgical centre in the United Kingdom. Pathology records for all patients who had undergone lung resection with curative intent during the time period January 2012-December 2014 were analysed in October 2015. Electronic pathology and radiology reports were accessed for each patient and data collected about their histological findings, TNM stage, resection margins, and the presence of brain metastases on either pre-operative or post-operative imaging. From the dates given on imaging, we calculated the number of days post-resection that the brain metastases were detected. 585 patients were identified who had undergone resection of their lung cancer. Of these, 471 had accessible electronic radiology records to assess for the radiological evidence of brain metastases. When their electronic records were evaluated, 25/471 (5.3%) patients had radiological evidence of brain metastasis. Of these, five patients had been diagnosed with a brain metastasis at initial presentation and had undergone primary resection of the brain metastasis followed by resection of the lung primary. One patient had been diagnosed with both a primary lung and a primary bowel adenocarcinoma; on review of the case, it was felt that the brain metastasis was more likely to have

  6. Controversies about cervical cancer screening: A qualitative study of Roma women's (non)participation in cervical cancer screening in Romania.

    Science.gov (United States)

    Andreassen, Trude; Weiderpass, Elisabete; Nicula, Florian; Suteu, Ofelia; Itu, Andreea; Bumbu, Minodora; Tincu, Aida; Ursin, Giske; Moen, Kåre

    2017-06-01

    Romania has Europe's highest incidence and mortality of cervical cancer. While a free national cervical cancer-screening programme has been in operation since 2012, participation in the programme is low, particularly in minority populations. The aim of this study was to explore Roma women's (non)participation in the programme from women's own perspectives and those of healthcare providers and policy makers. We carried out fieldwork for a period of 125 days in 2015/16 involving 144 study participants in Cluj and Bucharest counties. Fieldwork entailed participant observation, qualitative interviewing and focus group discussions. A striking finding was that screening providers and Roma women had highly different takes on the national screening programme. We identified four fundamental questions about which there was considerable disagreement between them: whether a free national screening programme existed in the first place, whether Roma women were meant to be included in the programme if it did, whether Roma women wanted to take part in screening, and to what degree screening participation would really benefit women's health. On the background of insights from actor-network theory, the article discusses to what degree the programme could be said to speak to the interest of its intended Roma public, and considers the controversies in light of the literature on patient centred care and user involvement in health care. The paper contributes to the understanding of the health and health-related circumstances of the largest minority in Europe. It also problematizes the use of the concept of "barriers" in research into participation in cancer screening, and exemplifies how user involvement can potentially help transform and improve screening programmes. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  7. Controversies in external beam and high dose rate brachytherapy of oesophageal cancer

    International Nuclear Information System (INIS)

    Sur, R.K.; Levin, V.C.; Malas, Simon; Donde, Bernard

    1994-01-01

    Various controversies in the treatment of oesophageal carcinoma with external beam radiotherapy and high dose rate intracavitary irradiation have been reviewed. Conflicting results from different parts of the world has made it difficult to optimize the radiation dose that may give the best results. More studies and longer follow-up are needed before a definite conclusion can be made on the optimization of dose. (author). 18 refs., 2 tabs

  8. The relationship between total testosterone levels and prostate cancer: a review of the continuing controversy.

    Science.gov (United States)

    Klap, Julia; Schmid, Marianne; Loughlin, Kevin R

    2015-02-01

    on total testosterone measurements. One of 18 series of low total testosterone and prostate cancer adhered to published guidelines while none of 17 showing a relationship of high total testosterone to prostate cancer and only 1 of 10 that identified no relationship between total testosterone and prostate cancer adhered to measurements recommended in the guidelines. In 11 studies the risk of exogenous testosterone was examined in patients with a prostate cancer history. Many studies were limited by small cohort size and brief followup. However, overall this literature suggests that the risk of exogenous testosterone replacement in patients with prostate cancer appears to be small. The relationship between total testosterone and prostate cancer has been an area of interest among physicians for decades. Conflicting results have been reported on the relationship between total testosterone and subsequent prostate cancer. Much of this controversy appears to be based on conflicting study designs, definitions and methodologies. To date no prospective study with sufficient power has been published to unequivocally resolve the issue. The preponderance of studies of the safety of exogenous testosterone in men with a prostate cancer history suggests that there is little if any risk. However, because the risk has not proved to be zero, the most prudent course is to follow such men with regular prostate specific antigen measurements and digital rectal examinations. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  9. Controversies surrounding human papilloma virus infection, head & neck vs oral cancer, implications for prophylaxis and treatment.

    Science.gov (United States)

    Campisi, Giuseppina; Giovannelli, Lucia

    2009-03-30

    Head & Neck Cancer (HNC) represents the sixth most common malignancy worldwide and it is historically linked to well-known behavioural risk factors, i.e., tobacco smoking and/or the alcohol consumption. Recently, substantial evidence has been mounting that Human Papillomavirus (HPV) infection is playing an increasing important role in oral cancer. Because of the attention and clamor surrounding oral HPV infection and related cancers, as well as the use of HPV prophylactic vaccines, in this invited perspective the authors raise some questions and review some controversial issues on HPV infection and its role in HNC, with a particular focus on oral squamous cell carcinoma. The problematic definition and classification of HNC will be discussed, together with the characteristics of oral infection with oncogenic HPV types, the frequency of HPV DNA detection in HNC, the location of HPV-related tumours, the severity and prognosis of HPV-positive HNC, the diagnosis of oral HPV infection, common routes of oral infection and the likelihood of oro-genital HPV transmission, the prevention of HPV infection and novel therapeutic approaches.

  10. Investigation into the controversial association of Streptococcus gallolyticus with colorectal cancer and adenoma

    International Nuclear Information System (INIS)

    Abdulamir, Ahmed S; Hafidh, Rand R; Mahdi, Layla K; Al-jeboori, Tarik; Abubaker, Fatimah

    2009-01-01

    The seroprevalence of IgG antibodies of Streptococcus gallolyticus subspecies gallolyticus, CIP 105428, was evaluated to investigate the controversial association of S. gallolyticus with colorectal carcinoma and adenoma in attempt to investigate the nature of such association if any, by exploring the mRNA expression of NF-κB and IL-8. Moreover, the serological behavior of S. gallolyticus IgG antibodies was compared to that of an indicator bacterium of bowel, Bacteroides fragilis. ELISA was used to measure IgG antibodies of S. gallolyticus and B. fragilis in sera of 50 colorectal cancer, 14 colorectal adenoma patients, 30 age- and sex- matched apparently healthy volunteers (HV) and 30 age- and sex- matched colonoscopically-proven tumor-free control subjects. NF-κB and IL-8 mRNA expression was evaluated in tumorous and non-tumorous tissue sections of carcinoma and adenoma patients in comparison with that of control subjects by using in situ hybridization assay. Colorectal cancer and adenoma patients were associated with higher levels of serum S. gallolyticus IgG antibodies in comparison with HV and control subjects (P < 0.05) while no similar association was found with serum IgG antibodies of B. fragilis (P > 0.05). ELISA cutoff value for the seropositivity of S. gallolyticus IgG was calculated from tumor-free control group. The expression of NF-κB mRNA was higher in tumorous than non-tumorous tissue sections of adenoma and carcinoma, higher in carcinoma/adenoma sections than in control subjects, higher in tumorous sections of carcinoma than in adenoma patients, and higher in S. gallolyticus IgG seropositive than in seronegative groups in both tumorous and non-tumorous sections (P < 0.05). IL-8 mRNA expression in tumorous sections of adenoma and carcinoma was higher than in non-tumorous sections, higher in carcinoma/adenoma than in control subjects, and higher in S. gallolyticus IgG seropositive than in seronegative groups in tumorous rather than non

  11. Computational Controversy

    NARCIS (Netherlands)

    Timmermans, Benjamin; Kuhn, Tobias; Beelen, Kaspar; Aroyo, Lora

    2017-01-01

    Climate change, vaccination, abortion, Trump: Many topics are surrounded by fierce controversies. The nature of such heated debates and their elements have been studied extensively in the social science literature. More recently, various computational approaches to controversy analysis have

  12. Still controversial

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    1986-10-15

    It is some sixty years since the existence of the neutrino was controversially postulated by the controversial Wolfgang Pauli. Today, the neutrino remains controversial. At the Berkeley Conference, summarizer Steve Weinberg kept the spotlight on these enigmatic particles during a considerable portion of his talk.

  13. Still controversial

    International Nuclear Information System (INIS)

    Anon.

    1986-01-01

    It is some sixty years since the existence of the neutrino was controversially postulated by the controversial Wolfgang Pauli. Today, the neutrino remains controversial. At the Berkeley Conference, summarizer Steve Weinberg kept the spotlight on these enigmatic particles during a considerable portion of his talk

  14. Current state and controversies in fertility preservation in women with breast cancer

    OpenAIRE

    Taylan, Enes; Oktay, Kutluk H

    2017-01-01

    On average, over 25000 women are diagnosed with breast cancer under the age of 45 annually in the United States. Because an increasing number of young women delay childbearing to later life for various reasons, a growing population of women experience breast cancer before completing childbearing. In this context, preservation of fertility potential of breast cancer survivors has become an essential concept in modern cancer care. In this review, we will outline the currently available fertilit...

  15. Controversies surrounding Human Papilloma Virus infection, head & neck vs oral cancer, implications for prophylaxis and treatment

    OpenAIRE

    Campisi, G.; Giovannelli, L.

    2009-01-01

    Head & Neck Cancer (HNC) represents the sixth most common malignancy worldwide and it is historically linked to well-known behavioural risk factors, i.e., tobacco smoking and/or the alcohol consumption. Recently, substantial evidence has been mounting that Human Papillomavirus (HPV) infection is playing an increasing important role in oral cancer. Because of the attention and clamor surrounding oral HPV infection and related cancers, as well as the use of HPV prophylactic vaccines, in this in...

  16. Plutonium controversy

    International Nuclear Information System (INIS)

    Richmond, C.R.

    1980-01-01

    The toxicity of plutonium is discussed, particularly in relation to controversies surrounding the setting of radiation protection standards. The sources, amounts of, and exposure pathways of plutonium are given and the public risk estimated

  17. Plutonium controversy

    Energy Technology Data Exchange (ETDEWEB)

    Richmond, C.R.

    1980-01-01

    The toxicity of plutonium is discussed, particularly in relation to controversies surrounding the setting of radiation protection standards. The sources, amounts of, and exposure pathways of plutonium are given and the public risk estimated. (ACR)

  18. Computational Controversy

    OpenAIRE

    Timmermans, Benjamin; Kuhn, Tobias; Beelen, Kaspar; Aroyo, Lora

    2017-01-01

    Climate change, vaccination, abortion, Trump: Many topics are surrounded by fierce controversies. The nature of such heated debates and their elements have been studied extensively in the social science literature. More recently, various computational approaches to controversy analysis have appeared, using new data sources such as Wikipedia, which help us now better understand these phenomena. However, compared to what social sciences have discovered about such debates, the existing computati...

  19. Adjuvant chemotherapy for stage II colon cancer: influence of care structures' characteristics on a controversial clinical practice.

    Science.gov (United States)

    Alter, Eléonore; Phelip, Jean-Marc; Guilhot, Jean-Noel; Matysiak, Michel; Vermorel, Michel; Roblin, Xavier

    2007-11-01

    Adjuvant chemotherapy for stage II colon cancer is a controversial practice and is not recommended by the French Consensus Conference outside of therapeutic trial. To assess, within a well-defined population, the influence of hospital characteristics in this practice. In the Rhône-Alpes region (10% of the French population), 534 patients presenting with colon cancer stage II were operated on in 81 hospitals in the year 2000. The influence of hospital characteristics on the use of adjuvant chemotherapy was assessed using a multivariate logistic regression. Overall, 19.5% of patients received adjuvant chemotherapy. Younger age, T4 tumour, hospital volume lower than 20 colon cancer surgeries [odds ratio (OR) 2.96; Pclinical complications at diagnosis were independently associated with higher rates of chemotherapy. On the other hand, a number of examined lymph nodes lower than recommendations did not have any influence on chemotherapy use. Hospital characteristics had independently influenced the practice of adjuvant chemotherapy in stage II colon cancer. The more important institutional factor was the hospital procedure volume. The decisions of the multidisciplinary committees appeared at times paradoxical; a more comprehensive evaluation of this practice is needed.

  20. Contemporary management of locally advanced rectal cancer: Resolving issues, controversies and shifting paradigms.

    Science.gov (United States)

    Nacion, Aeris Jane D; Park, Youn Young; Kim, Nam Kyu

    2018-02-01

    Advancements in rectal cancer treatment have resulted in improvement only in locoregional control and have failed to address distant relapse, which is the predominant mode of treatment failure in rectal cancer. As the efficacy of conventional chemoradiotherapy (CRT) followed by total mesorectal excision (TME) reaches a plateau, the need for alternative strategies in locally advanced rectal cancer (LARC) has grown in relevance. Several novel strategies have been conceptualized to address this issue, including: 1) neoadjuvant induction and consolidation chemotherapy before CRT; 2) neoadjuvant chemotherapy alone to avoid the sequelae of radiation; and 3) nonoperative management for patients who achieved pathological or clinical complete response after CRT. This article explores the issues, recent advances and paradigm shifts in the management of LARC and emphasizes the need for a personalized treatment plan for each patient based on tumor stage, location, gene expression and quality of life.

  1. [Population-based breast cancer screening: certainties, controversies, and future perspectives].

    Science.gov (United States)

    Apesteguía Ciriza, Luis; Pina Insausti, Luis Javier

    2014-01-01

    Population-based breast cancer screening programs based on mammography must maintain a high level of quality, so the results must be constantly monitored. Although most authors consider that these programs have decreased the mortality due to breast cancer by about 30%, others claim that the mortality has decreased by only about 12% due to errors in the randomization of patients, because the rate of advanced tumors has hardly decreased and because adjuvant treatment also improves survival. Other criticisms focus on overdiagnosis and overtreatment. We believe that despite the unquestionable value of mammographic screening, we should be open to certain changes such as the stratification of patients by their level of risk and the introduction of complementary techniques like tomosynthesis, ultrasonography, and magnetic resonance imaging in selected cases. Copyright © 2012 SERAM. Published by Elsevier Espana. All rights reserved.

  2. Controversies in using urine samples for prostate cancer detection: PSA and PCA3 expression analysis

    Directory of Open Access Journals (Sweden)

    S. Fontenete

    2011-12-01

    Full Text Available PURPOSE: Prostate cancer (PCa is one of the most commonly diagnosed malignancies in the world. Although PSA utilization as a serum marker has improved prostate cancer detection it still presents some limitations, mainly regarding its specificity. The expression of this marker, along with the detection of PCA3 mRNA in urine samples, has been suggested as a new approach for PCa detection. The goal of this work was to evaluate the efficacy of the urinary detection of PCA3 mRNA and PSA mRNA without performing the somewhat embarrassing prostate massage. It was also intended to optimize and implement a methodological protocol for this kind of sampling. MATERIALS AND METHODS: Urine samples from 57 patients with suspected prostate disease were collected, without undergoing prostate massage. Increased serum PSA levels were confirmed by medical records review. RNA was extracted by different methods and a preamplification step was included in order to improve gene detection by Real-Time PCR. RESULTS: An increase in RNA concentration with the use of TriPure Isolation Reagent. Despite this optimization, only 15.8% of the cases showed expression of PSA mRNA and only 3.8% of prostate cancer patients presented detectable levels of PCA3 mRNA. The use of a preamplification step revealed no improvement in the results obtained. CONCLUSION: This work confirms that prostate massage is important before urine collection for gene expression analysis. Since PSA and PCA3 are prostate specific, it is necessary to promote the passage of cells from prostate to urinary tract, in order to detect these genetic markers in urine samples.

  3. Controversial roles played by toll like receptor 4 in urinary bladder cancer; A systematic review.

    Science.gov (United States)

    Afsharimoghaddam, Amin; Soleimani, Mohammad; Lashay, Alireza; Dehghani, Mahdi; Sepehri, Zahra

    2016-08-01

    Urinary bladder cancer (UBC) is a prevalent human cancer. The main mechanisms which lead to eradication or progression the disease has yet to be clarified. Toll like receptor (TLR) 4 is a membrane receptor which is expressed either on immune cells or tumor cells. This review article was aimed to clear the main mechanisms played by TLR4 and its related intracellular pathways on outcome of UBC. PubMed, Scopus and Google scholar databases have been used for searching related research articles which have evaluated the roles played by TLR4 and its related intracellular pathways on outcome of UBC. Collected information from the related articles revealed that TLR4 either participates in induction of immune responses against UBC or development of the malignancy. There are limited investigations regarding the genetic variations of TLR4 in UBC. According to the results it seems that TLR4/ligands interaction outcome is dependent on several factors including TLR4 ligand doses, interaction of TLR4 with its ligands on immune cells or tumor cells, and other TLRs/ligand interaction simultaneously. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Dose-response relationship for elective neck irradiation of head and neck cancer - facts and controversies

    International Nuclear Information System (INIS)

    Suwinski, R.; Maciejewski, B.; Withers, H.R.

    1998-01-01

    The aim of this study is to assign dose-response relationship for subclinical neck metastases of squamous cell head and neck cancer based on extensive survey of 24 data sets collected from the literature. Neck relapse rates (NRR) without and after elective (ENI) or preoperative irradiation were estimated for each site and stage of primary tumor and the reduction in neck relapse rate was calculated. An average NRR without ENI was 22% (12-35% ) and only 2.5% (0-1 0%) after the ENI with total dose of 46- 50 Gy which gives high reduction rate in the risk of neck recurrences being on the average 89% and 42% (0-46%) after preoperative irradiation using 22-30 Gy. Dose response curve for elective and preoperative irradiation have shown that 50 Gy in 2 Gy fraction reduces the incidence of neck relapses in the NO patients by more than 90% and only by less than 50% after total doses lower than 30 Gy. No correlation between the risk of neck metastases without ENI and the reduction in neck relapses after ENI was found. (authors)

  5. Caffeine controversies.

    Science.gov (United States)

    Gentle, Samuel J; Travers, Colm P; Carlo, Waldemar A

    2018-04-01

    Caffeine use in preterm infants has endured several paradigms: from standard of care to possible neurotoxin to one of the few medications for which there is evidence of bronchopulmonary dysplasia (BPD) risk reduction. The purpose of the review is to analyze this dynamic trajectory and discuss controversies that still remain after decades of caffeine use. Following concerns for caffeine safety in preterm infants, a large randomized controlled trial demonstrated a reduction in BPD and treatment for patent ductus arteriosus. The lower rate of death or neurodevelopmental impairment noted at 18-21 months was not statistically different at later timepoints; however, infants in the caffeine group had lower rates of motor impairment at 11-year follow-up. The time of caffeine therapy initiation is now substantially earlier, and doses used are sometimes higher that previously used, but there are limited data to support these practices. Caffeine therapy for apnea of prematurity (AOP) remains one of the pillars of neonatal care, although more evidence to support dosing and timing of initiation and discontinuation are needed.

  6. Plutonium controversy

    International Nuclear Information System (INIS)

    Gofman, J.W.

    1976-01-01

    If the world chooses to seek a solution to the energy dilemma through nuclear energy, the element plutonium will become an article of commerce to be handled in quantities of thousands of tonnes annually. Plutonium is a uniquely potent inhalation carcinogen, the potential induction of lung cancer dwarfing other possible toxic effects. For reasons to be presented here, it is the author's opinion that plutonium's carcinogenicity has been very seriously underestimated. If one couples the corrected carcinogenicity with the probable degree of industrial containment of the plutonium, it appears that the commercialization of a plutonium-based energy economy is not an acceptable option for society. Sagan's statement that ''the experience of 30 years supports the contention that plutonium can be used safely'' is manifestly indefensible. No meaningful epidemiological study of plutonium-exposed workers for that 30-year period has ever been done. Since thousands of those possibly exposed have left the industry and are not even available to follow-up, it is doubtful that any meaningful study of ''the experience of 30 years'' will ever be accomplished

  7. Chernobylsk: a 'cloud' crosses... the facts and the controversies

    International Nuclear Information System (INIS)

    Lerouge, B.

    2008-01-01

    Twenty years after the Chernobylsk accident the effects are detailed by specialists, in radiobiology to judge the eventual sanitary injuries. It is a critical analysis that is made in this work, at the light of todays knowledge. The first part treats the question of communication, faults, late, silent. The second part is the time of controversy, the contamination in France, the radiation doses in France, thyroid cancers, the controversy of low doses effects, the controversy of sanitary consequences in USSR. The third part concerns the modernization of the nuclear world, the radiobiology, the public opinion. In annexes are: radioactivity, serious accidents, radiation doses (concepts and units), radiation protection and standards, the scientific bases of radiation protection, the figured conclusions of Chernobylsk forum, the European contamination map. (N.C.)

  8. Weak value controversy

    Science.gov (United States)

    Vaidman, L.

    2017-10-01

    Recent controversy regarding the meaning and usefulness of weak values is reviewed. It is argued that in spite of recent statistical arguments by Ferrie and Combes, experiments with anomalous weak values provide useful amplification techniques for precision measurements of small effects in many realistic situations. The statistical nature of weak values is questioned. Although measuring weak values requires an ensemble, it is argued that the weak value, similarly to an eigenvalue, is a property of a single pre- and post-selected quantum system. This article is part of the themed issue `Second quantum revolution: foundational questions'.

  9. Mapping Wind Energy Controversies

    DEFF Research Database (Denmark)

    Munk, Anders Kristian

    As part the Wind2050 project funded by the Danish Council for Strategic Research we have mapped controversies on wind energy as they unfold online. Specifically we have collected two purpose built datasets, a web corpus containing information from 758 wind energy websites in 6 different countries......, and a smaller social media corpus containing information from 14 Danish wind energy pages on Facebook. These datasets have been analyzed to answer questions like: How do wind proponents and opponents organize online? Who are the central actors? And what are their matters of concern? The purpose of this report...

  10. Controversies in hormone replacement therapy

    Directory of Open Access Journals (Sweden)

    A. Baziad

    2001-09-01

    Full Text Available Deficiency of estrogen hormone will result in either long-term or short-term health problems which may reduce the quality of life. There are numerous methods by which the quality of female life can be achieved. Since the problems occuring are due to the deficiency of estrogen hormone, the appropriate method to tackle the problem is by administration of estrogen hormone. The administration of hormone replacement therapy (HRT with estrogen may eliminate climacteric complaints, prevent osteoporosis, coronary heart disease, dementia, and colon cancer. Although HRT has a great deal of advantage, its use is still low and may result in controversies. These controversies are due to fact that both doctor and patient still hold on to the old, outmoded views which are not supported by numerous studies. Currently, the use of HRT is not only based on experience, or temporary observation, but more on evidence based medicine. (Med J Indones 2001; 10: 182-6Keywords: controversies, HRT

  11. Management of early-stage non-small cell lung cancer using stereotactic ablative radiotherapy: Controversies, insights, and changing horizons

    International Nuclear Information System (INIS)

    Louie, Alexander V.; Palma, David A.; Dahele, Max; Rodrigues, George B.; Senan, Suresh

    2015-01-01

    The use of stereotactic ablative radiotherapy (SABR) for early-stage non-small cell lung cancer is growing rapidly, particularly since it has become the recommended therapy for unfit patients in current European and North American guidelines. As three randomized trials comparing surgery and SABR closed prematurely because of poor accrual, clinicians are faced with a dilemma in individual patient decision-making. Radiation oncologists, in particular, should be aware of the data from comparative effectiveness studies that suggest similar survival outcomes irrespective of local treatment modality. The necessity of obtaining a pathological diagnosis, particularly in frail patients prior to treatment remains a challenge, and this topic was addressed in recent European recommendations. Awareness of the high incidence of a second primary lung cancer in survivors, as well as other competing causes of mortality, is needed. The challenges in distinguishing focal scarring from recurrence after SABR also need to be appreciated by multidisciplinary tumor boards. With a shift in focus toward patient-centered decision-making, clinicians will need to be aware of these new developments and communicate effectively with patients, to ensure that treatment decisions are reflective of patient preferences. Priorities for additional research in the area are proposed

  12. Bladder cancer: overview and disease management. Part 1: non-muscle-invasive bladder cancer.

    Science.gov (United States)

    Anderson, Beverley

    2018-05-10

    Part 1 of this two-part article provides an overview of bladder cancer and discusses its management. Since publication of a previous article entitled 'Understanding the role of smoking in the aetiology of bladder cancer' ( Anderson, 2009 ), the author has received many requests for an update. This article provides an overview of bladder cancer and its current management practices, underlining the continued role of smoking as the predominant risk factor in the disease's development. The management of bladder cancer is governed by specific guidelines. Management of non-muscle-invasive cancers, including surgical intervention with transurethral resection, and intravesical therapy using chemotherapy and immunotherapy agents, is discussed. Cystectomy (removal of the bladder), is sometimes necessary. Treatments are effective in reducing tumour recurrence, but the effects of the risks and side-effects on the individual's quality of life can be significant. The prevalence of bladder cancer, and the nature of its management make this cancer one of the most expensive for the NHS to treat. The effectiveness of health promotional strategies in increasing peoples' awareness of their risk of developing the disease, and in enabling them to change long-term health behaviours is discussed. The role of the multidisciplinary team is explored, along with that of the uro-oncology cancer nurse specialist. Part 2 will consider the management of muscle-invasive and metastatic bladder cancer.

  13. The nuclear controversy

    International Nuclear Information System (INIS)

    Walske, C.; Dobkin, R.A.

    1984-01-01

    The article deals with the nuclear controversy, especially in the United States. To a certain extent the nuclear debate has become heavily politicised. Public opinion and anti-nuclear groups are mentioned as well as nuclear disarmament

  14. Controversies and consensus in the innovation access for cancer therapy in the European countries: on the subject of metastatic prostate cancer.

    Science.gov (United States)

    Oudard, S; Courbon, F

    2017-02-01

    Innovative cancer therapies and advances in drug development have created new hopes for patients and health providers. The purpose of this article was to evaluate the discrepancies in the assessment of the magnitude of benefit of four new drugs (abiraterone acetate, enzalutamide, cabazitaxel, radium-223 dichloride) for the treatment of metastatic castration-resistant prostate cancer (mCRPC). The comparison was done among three European countries (UK, Germany and France) and Canada, according to the statement of each country and to the European Society of Medical Oncology (ESMO) Magnitude of Clinical Benefit Scale. Whereas those drugs are authorized by the European Medical Agency, one can observed that clear discrepancies in the magnitude of benefit assessment exist between selected countries, as well as between national pricing evaluation agencies and ESMO. However, price setting and reimbursement decisions remain national responsibility with differences in assessment of the medical value of new treatment across countries, leading to a heterogeneous accessibility to cancer treatments. In conclusion, several procedures have to be implemented to overcome the patchwork of administrative assessments. Among them, the assessment of medical value should be based on independent statements of learned societies, and the harmonization of access to cancer therapy in Europe has to be driven by a common European reimbursement and pricing policy. © The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. American Association for Emergency Psychiatry Task Force on Medical Clearance of Adult Psychiatric Patients. Part II: Controversies over Medical Assessment, and Consensus Recommendations

    Directory of Open Access Journals (Sweden)

    Michael P. Wilson

    2017-05-01

    Full Text Available Introduction: The emergency medical evaluation of psychiatric patients presenting to United States emergency departments (ED, usually termed “medical clearance,” often varies between EDs. A task force of the American Association for Emergency Psychiatry (AAEP, consisting of physicians from emergency medicine, physicians from psychiatry and a psychologist, was convened to form consensus recommendations for the medical evaluation of psychiatric patients presenting to U.S.EDs. Methods: The task force reviewed existing literature on the topic of medical evaluation of psychiatric patients in the ED and then combined this with expert consensus. Consensus was achieved by group discussion as well as iterative revisions of the written document. The document was reviewed and approved by the AAEP Board of Directors. Results: Eight recommendations were formulated. These recommendations cover various topics in emergency medical examination of psychiatric patients, including goals of medical screening in the ED, the identification of patients at low risk for co-existing medical disease, key elements in the ED evaluation of psychiatric patients including those with cognitive disorders, specific language replacing the term “medical clearance,” and the need for better science in this area. Conclusion: The evidence indicates that a thorough history and physical examination, including vital signs and mental status examination, are the minimum necessary elements in the evaluation of psychiatric patients. With respect to laboratory testing, the picture is less clear and much more controversial.

  16. American Association for Emergency Psychiatry Task Force on Medical Clearance of Adult Psychiatric Patients. Part II: Controversies over Medical Assessment, and Consensus Recommendations.

    Science.gov (United States)

    Wilson, Michael P; Nordstrom, Kimberly; Anderson, Eric L; Ng, Anthony T; Zun, Leslie S; Peltzer-Jones, Jennifer M; Allen, Michael H

    2017-06-01

    The emergency medical evaluation of psychiatric patients presenting to United States emergency departments (ED), usually termed "medical clearance," often varies between EDs. A task force of the American Association for Emergency Psychiatry (AAEP), consisting of physicians from emergency medicine, physicians from psychiatry and a psychologist, was convened to form consensus recommendations for the medical evaluation of psychiatric patients presenting to U.S.EDs. The task force reviewed existing literature on the topic of medical evaluation of psychiatric patients in the ED and then combined this with expert consensus. Consensus was achieved by group discussion as well as iterative revisions of the written document. The document was reviewed and approved by the AAEP Board of Directors. Eight recommendations were formulated. These recommendations cover various topics in emergency medical examination of psychiatric patients, including goals of medical screening in the ED, the identification of patients at low risk for co-existing medical disease, key elements in the ED evaluation of psychiatric patients including those with cognitive disorders, specific language replacing the term "medical clearance," and the need for better science in this area. The evidence indicates that a thorough history and physical examination, including vital signs and mental status examination, are the minimum necessary elements in the evaluation of psychiatric patients. With respect to laboratory testing, the picture is less clear and much more controversial.

  17. Energy, controversies and prospects

    International Nuclear Information System (INIS)

    Bertholet, J.-L.; Garbely, M.; Lachal, B.; Romerio, F.; Weber, W.

    2003-01-01

    The energy debate raises deep controversies, as discussions on climate change or electricity markets' deregulation show. In this context, it is very difficult for the citizen to express himself in referendums and for the decision maker to slice between various options. Experts themselves deliver controversial evaluations and interest groups can benefit from them to suggest their own solution. This book enables to get a better insight and better understand energy-related controversies and the environmental and socio-economic impacts of energy. It deals with topics as complex and politically extreme as the exhaustion of fossil fuels, climate change, ionising radiations, renewable energy sources, energy consumption in Southern countries and the reorganisation of electricity markets. It starts with an article on the precaution principle and it ends with a glance on the future, devoted to education in the field of efficient energy use [fr

  18. Obstetric controversies in thyroidology

    Directory of Open Access Journals (Sweden)

    Ambika Gopalakrishnan Unnikrishnan

    2013-01-01

    Full Text Available It is well known that thyroid disorders commonly affect women. The care of pregnant women affected by thyroid disease is an important clinical challenge for endocrinologists. Hypothyroidism is the commonest problem, and maternal hypothyroxinemia has been linked to adverse feto-maternal outcomes. This article would discuss the controversy regarding first-trimester thyroid hormone deficiency and fetal brain development. Certain obstetric controversies in the management of hyperthyroidism in pregnancy, including the indications of TSH receptor antibody measurements and fetal thyroid status monitoring would also be discussed.

  19. Sexual Orientation, Controversy, and Science.

    Science.gov (United States)

    Bailey, J Michael; Vasey, Paul L; Diamond, Lisa M; Breedlove, S Marc; Vilain, Eric; Epprecht, Marc

    2016-09-01

    SummaryOngoing political controversies around the world exemplify a long-standing and widespread preoccupation with the acceptability of homosexuality. Nonheterosexual people have seen dramatic surges both in their rights and in positive public opinion in many Western countries. In contrast, in much of Africa, the Middle East, the Caribbean, Oceania, and parts of Asia, homosexual behavior remains illegal and severely punishable, with some countries retaining the death penalty for it. Political controversies about sexual orientation have often overlapped with scientific controversies. That is, participants on both sides of the sociopolitical debates have tended to believe that scientific findings-and scientific truths-about sexual orientation matter a great deal in making political decisions. The most contentious scientific issues have concerned the causes of sexual orientation-that is, why are some people heterosexual, others bisexual, and others homosexual? The actual relevance of these issues to social, political, and ethical decisions is often poorly justified, however. © The Author(s) 2016.

  20. Adjuvant vaginal brachytherapy as a part of management in early endometrial cancer.

    Science.gov (United States)

    Kellas-Ślęczka, Sylwia; Wojcieszek, Piotr; Białas, Brygida

    2012-12-01

    Endometrial cancer is the most frequent cancer of female genital tract. Metro- and menorrhagia or postmenopausal bleeding results in its early presentation. It allows radical treatment. However, controversies remain on surgery coverage or adjuvant therapies in early endometrial women cancer. Optimal management should minimize intervention instead of aggressive approach, as showed by recent studies. There is a role for brachytherapy as an adjuvant irradiation. Crucial publications including PORTEC-1, GOG 99, MRC ASTEC, ASTEC/EN.5, PORTEC-2 or Italian lymphadenectomy trial are discussed. Moreover, there is attention paid on adjuvant vaginal brachytherapy analyses for the past fifteen years.

  1. Controversies in Obesity Treatment

    Directory of Open Access Journals (Sweden)

    Majid Karandish

    2015-06-01

    Full Text Available The markedly high prevalence of obesity contributes to the increased incidence of chronic diseases, such as diabetes, hypertension, sleep apnea, and heart disease. Because of high prevalence of obesity in almost all countries, it has been the focus of many researches throughout the world during the recent decades. Along with increasing researches, new concepts and controversies have been emerged. The existing controversies on the topic are so deep that some researches argue on absolutely philosophical questions such as “Is obesity a disease?” or “Is it correct to treat obesity?” These questions are based on a few theories and real data that explain obesity as a biological adaptation and also the final results of weight loss programs. Many people attempt to lose weight by diet therapy, physical activity and lifestyle modifications. Importantly, weight loss strategies in the long term are ineffective and may have unintended consequences including decreasing energy expenditure, complicated appetite control, eating disorders, reducing self-esteem, increasing the plasma and tissue levels of persistent organic pollutants that promote metabolic complications, and consequently, higher risk of repeated cycles of weight loss and weight regain. In this review, major paradoxes and controversies on obesity including classic obesity paradox, pre-obesity; fat-but-fit theory, and healthy obesity are explained. In addition, the relevant strategies like “Health at Every Size” that emphasize on promotion of global health behaviors rather than weight loss programs are explained.

  2. Cartography of architectural controversies

    DEFF Research Database (Denmark)

    Lotz, Katrine

    2009-01-01

    on the visual materials and documents produced during the process, and interviews with architects, clients and engineers, I describe the continuous efforts to establish and strengthen architectural motives, and how they eventually gain the ability to align other motives and other actors. I suggest...... that employing the visualising methods of the recent development of Actor-Network-Theory called ‘Cartography of Controversies' might contribute to trans-disciplinary efforts to develop analytic understanding of the conflicting human purposes and power-struggles at stake in the be-coming of architecture....

  3. How science makes environmental controversies worse

    International Nuclear Information System (INIS)

    Sarewitz, Daniel

    2004-01-01

    I use the example of the 2000 US Presidential election to show that political controversies with technical underpinnings are not resolved by technical means. Then, drawing from examples such as climate change, genetically modified foods, and nuclear waste disposal, I explore the idea that scientific inquiry is inherently and unavoidably subject to becoming politicized in environmental controversies. I discuss three reasons for this. First, science supplies contesting parties with their own bodies of relevant, legitimated facts about nature, chosen in part because they help make sense of, and are made sensible by, particular interests and normative frameworks. Second, competing disciplinary approaches to understanding the scientific bases of an environmental controversy may be causally tied to competing value-based political or ethical positions. The necessity of looking at nature through a variety of disciplinary lenses brings with it a variety of normative lenses, as well. Third, it follows from the foregoing that scientific uncertainty, which so often occupies a central place in environmental controversies, can be understood not as a lack of scientific understanding but as the lack of coherence among competing scientific understandings, amplified by the various political, cultural, and institutional contexts within which science is carried out. In light of these observations, I briefly explore the problem of why some types of political controversies become 'scientized' and others do not, and conclude that the value bases of disputes underlying environmental controversies must be fully articulated and adjudicated through political means before science can play an effective role in resolving environmental problems

  4. The words of controversy about climate change

    International Nuclear Information System (INIS)

    Chetouani, Lamria

    2007-01-01

    The author analyses the rhetorical staging of controversies which occur in France about climate change, and more particularly about the greenhouse effect. In a first part, she makes a distinction between four registers of controversy: on responsibilities, on consequences and extent of the phenomenon, on solutions, and on spatio-temporal projections of the greenhouse effect. She shows that debates are structured by an opposition between optimism and pessimism. In a second part, based on a lexicological analysis, she highlights the important oppositions between scientific speeches and political speeches, independent speeches and technocratic speeches, and so on, with unexpected aspects. It appears that controversy goes largely beyond the scientific debate, and incorporates crossed interventions of economic, political and social concern

  5. Exxon Valdez controversy revived

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    Four years after its occurrence rocked the petroleum industry and revitalized the US environmental movement, the Exxon Valdez tanker oil spill off Alaska continues to stir controversy. Conflicting reports abound over whether there is long term damage to the Prince William Sound ecosystem resulting from the March 24, 1989, spill. Government scientists at recent conferences disclosed studies they contend show long term, significant damage to the sound. Exxon this month launched a counteroffensive, disclosing results of studies it funded that it claims show no credible scientific evidence of long term damage. At the same time, the company blasted as flawed the government's data on assessing environmental damage to the sound and charged that test samples from the sound were mishandled. Meantime, Prince William Sound still shows lingering effects from the Exxon Valdez oil spill. But recovery has been so rapid that there is more controversy over how to use $900 million in natural resource recovery funds that Exxon paid than over how badly species are suffering. The paper describes Exxon's studies; faulty data; lingering damage; and an update on tanker safety

  6. The breast implant controversy.

    Science.gov (United States)

    Cook, R R; Harrison, M C; LeVier, R R

    1994-02-01

    The breast implant issue is a "bad news/good news" story. For many women with implants, the controversy has caused a fair degree of anxiety which may or may not be resolved as further information becomes available. It has also taken its toll on Dow Corning. Whole lines of medical products have been eliminated or are being phase out. The development of new medical applications has been terminated. As a consequence, employees have lost their jobs. What the effect will be on the biomedical industry as a whole remains to be seen (11). While silicones have been an important component in various medical devices, it is likely that other materials can be used as replacements. However, suppliers of non-silicone materials are also reevaluating their role in this market. For example, Du Pont, the nation's largest chemical company, has determined that the unpredictable and excessive costs of doing business with manufacturers of implantable medical devices no longer justifies the unrestricted sale of standard raw materials into this industry. Other companies are quietly following suit. On the up side, it is possible that the research being driven by this controversy will result in a greater understanding of the immunologic implications of xenobiotics, of the importance of nonbiased observations, of the need for ready access to valid data sets, and of the opportunity for valid scientific information to guide legal decisions. Only time will tell.

  7. Adolescent varicocoele management controversies.

    Science.gov (United States)

    Serefoglu, E C; Saitz, T R; La Nasa, J A; Hellstrom, W J

    2013-01-01

    Varicocoele is defined as excessive dilatation of the pampiniform venous plexus of the spermatic cord. Varicocoele frequently appears during early puberty and is recognized to be the most common surgically correctable cause of male infertility. However, the actual incidence in adolescents, pathophysiology and the association with male factor infertility all remain somewhat controversial. The most accurate diagnostic technique for identifying young men who will benefit from surgical treatment has yet to be established. Observations of testicular asymmetry and deteriorating semen quality helped establish current guidelines and recommendations for surgical treatment. Further studies, comparing observation with surgical intervention, are needed to refine the current indications for varicocoele repair in the adolescent male. © 2012 American Society of Andrology and European Academy of Andrology.

  8. Siting controversial facilities

    International Nuclear Information System (INIS)

    Baird, R.D.; Blacker, P.B.

    1985-01-01

    There is often significant difficulty involved with siting controversial facilities. The social and political problems are frequently far more difficult to resolve than the technical and economic issues. The tendancy for most developing organizations is to address only technical issues in the search for a technically optimal site, to the exclusion of such weighting considerations as the social and political climate associated with potential sites--an approach which often imperils the success of the project. The site selection processes currently suggested is summarized and two contemporary examples of their application are cited. The difference between developers' real objectives and the objectives they have implicitly assumed by adopting the recommended approaches without augmentation are noted. The resulting morass of public opposition is attributed to the failure to consider the needs of individuals and groups who stand to be negatively impacted by the development. A comprehensive implementation strategy which addresses non-technical consideration in parallel with technical ones is presented and evaluated

  9. Controversies in gestational diabetes.

    Science.gov (United States)

    Nolan, Christopher J

    2011-02-01

    Gestational diabetes mellitus (GDM) and controversy are old friends. However, several major studies in the field have clarified some of the main issues. There is now no doubt that hyperglycaemia, at levels less than those that occur in overt diabetes, is associated with adverse pregnancy outcomes, such as large-for-gestational age infants, neonatal hyperinsulinism, neonatal hypoglycaemia and pre-eclampsia. We also have evidence now that a standard approach to GDM with diagnosis at 24-28 weeks, dietary advice, self-monitoring of blood glucose and insulin therapy as needed reduces these adverse perinatal outcomes. Unknown, however, is if this same approach is effective at reducing long-term risks of metabolic syndrome, type 2 diabetes and cardiovascular disease in both the mothers and babies. For example, could our management strategies miss critical time points of fuel-mediated injury to the foetus important for the baby's long-term metabolic health? The implications of a recent international consensus statement on new diagnostic criteria for GDM are discussed, as well as issues relating to the timing of diagnosis. The potential place for a risk calculator for adverse outcomes in GDM pregnancy that takes into account glycaemic and non-glycaemic risk factors is considered. Such a tool could help stratify GDM women to different levels of care. Ongoing issues relating to maternal glycaemic and foetal growth targets, and the use of oral hypoglycaemic agents in GDM are discussed. To resolve some of the remaining controversies, further carefully designed randomised controlled trials in GDM with long-term follow-up of both mothers and babies are necessary. Copyright © 2010 Elsevier Ltd. All rights reserved.

  10. Storytelling as part of cancer rehabilitation to support cancer patients and their relatives.

    Science.gov (United States)

    la Cour, Karen; Ledderer, Loni; Hansen, Helle Ploug

    2016-01-01

    Previous research on psychosocial support for cancer-related concerns has primarily focused on either patients or their relatives, although limited research is available on how patients and their relatives can be supported together. The aim of this article is to explore the use of storytelling as a part of a residential cancer rehabilitation intervention for patients together with their relatives, with a specific focus on their management of cancer-related concerns. Ten pairs participated in the intervention and data were generated through ethnographic fieldwork, including participant observations, informal conversations and follow-up interviews conducted one month after completing the intervention. Analysis was performed drawing on narrative theory combined with social practice theory. The results demonstrate that the use of storytelling and metaphors intertwined with other course activities, such as dancing and arts & crafts, provided the patients and their relatives with strategies to manage cancer-related concerns, which they were later able to apply in their everyday lives. The study results may be useful to other professionals in clinical practice for rehabilitation purposes for addressing issues of fear and worry.

  11. The Price Elasticity of Specialty Drug Use: Evidence from Cancer Patients in Medicare Part D.

    Science.gov (United States)

    Jung, Jeah Kyoungrae; Feldman, Roger; McBean, A Marshall

    2017-12-01

    Specialty drugs can bring substantial benefits to patients with debilitating conditions, such as cancer, but their costs are very high. Insurers/payers have increased patient cost-sharing for specialty drugs to manage specialty drug spending. We utilized Medicare Part D plan formulary data to create the initial price (cost-sharing in the initial coverage phase in Part D), and estimated the total demand (both on- and off-label uses) for specialty cancer drugs among elderly Medicare Part D enrollees with no low-income subsidies (non-LIS) as a function of the initial price. We corrected for potential endogeneity associated with plan choice by instrumenting the initial price of specialty cancer drugs with the initial prices of specialty drugs in unrelated classes. We report three findings. First, we found that elderly non-LIS beneficiaries with cancer were less likely to use a Part D specialty cancer drug when the initial price was high: the overall price elasticity of specialty cancer drug spending ranged between -0.72 and -0.75. Second, the price effect in Part D specialty cancer drug use was not significant among newly diagnosed patients. Finally, we found that use of Part B-covered cancer drugs was not responsive to the Part D specialty cancer drug price. As the demand for costly specialty drugs grows, it will be important to identify clinical circumstances where specialty drugs can be valuable and ensure access to high-value treatments.

  12. CONTROVERSIAL ASPECTS REGARDING TAX EVASION

    Directory of Open Access Journals (Sweden)

    Mircea-Constantin SINESCU

    2018-05-01

    Full Text Available Throughout the paper, we have highlighted some controversial aspects regarding the crime of tax evasion, referring to some important decisions of the High Court of Cassation and Justice and also of the Bucharest Court of Appeal. Debating upon the impunity provision stated by art. 10 of Law no. 241/2005, the study also sheds light upon the issue of the perspective of the judicial organs regarding the juridical regime of the tax due for dividends. The main focus of the paper leads to the situations when there is legal ground for the tax due for dividends to be considered part of the damage caused by tax evasion crime. The study includes a short analysis of some relevant provisions of the Romanian Fiscal Code and also some aspects deriving from decisions issued by the Administrative and Tax Litigation Chamber of The High Court of Cassation and Justice concerning the legal regime of dividends. Consequently, the authors are presenting both perspectives of the interpretation of the issue regarding the tax due for dividends to be considered part of the damage caused by tax evasion crime, resulting from two decisions of the two Criminal Sections of The Bucharest Court of Appeal, also arguing in favour of the most solid interpretation among them

  13. Teen Addiction. Current Controversies Series.

    Science.gov (United States)

    Winters, Paul A., Ed.

    The Current Controversies series explores social, political, and economic controversies that dominate the national and international scenes today from a variety of perspectives. Recent surveys have shown that, after years of decline, drug use among teenagers has increased during the 1990s, and that alcohol and tobacco use have remained…

  14. Nurse experiences as cancer survivors: part II--professional.

    Science.gov (United States)

    Picard, Carol; Agretelis, Joan; DeMarco, Rosanna F

    2004-05-01

    To uncover dimensions of nurses' professional experiences of cancer survivorship. Interpretive, phenomenologic. Metropolitan area in the northeastern United States. 25 RNs diagnosed with cancer. Average age was 50 years, and 20 participants were less than five years from initial diagnosis. Interviews. Data were analyzed using the methodology of Newman (1994, 1999) and VanManen (1990). Nurses' professional experiences of cancer survivorship. Professional experiences of cancer survivorship fell into five themes: (a) role ambiguity, (b) a deepening level of compassion for patients and others, (c) self-disclosure as a therapeutic intervention, (d) becoming an advocate for change, and (e) volunteerism. Cancer survivorship was a factor in reshaping participants' clinical practice. Experiencing the role of the patient affirmed the necessity of compassionate care for these participants. Nurses experienced a deepening level of compassion for patients and used self-disclosure as a therapeutic intervention. During and shortly after treatment, role ambiguity (being both patient and nurse) could cause difficulties. Nurses took action to change their clinical environment through their influence on colleagues and the healthcare system and by working through other organizations to improve patient care. Nurse cancer survivors can benefit from the support of colleagues and healthcare providers and an appreciation of the challenge of being both a professional and a patient. The invitation for dialogue as they return to work may help with the challenges of role ambiguity as nurse cancer survivors. Based on this study, nurses value the opportunity to enhance care environments with their two-world knowledge through compassionate care, disclosure, advocacy, and volunteering, and coworkers need to appreciate each nurse's unique response to this potentially life-changing process. Nurses in all settings can learn from their cancer survivor colleagues who have been the recipients of care to

  15. Wired for Controversy

    Science.gov (United States)

    Bohland, Cindy; Collver, Michael; Lally, David; Schmale, David G., III

    2015-01-01

    Autonomous vehicles are poised to become part of our everyday lives. Scientists are now studying ways to integrate similar robotic technology into living organisms. Insect and rodent cyborgs could one day be used for military intelligence, earthquake rescue operations, and as models for neurological studies. As this technology spreads, we need to…

  16. The role of adhesive molecules in endometrial cancer: part II

    Directory of Open Access Journals (Sweden)

    Andrzej Malinowski

    2010-12-01

    Full Text Available The carcinogenesis is a result of both functional and structural disorders in the tissue. It initiates as a mutationin a gene encoding protein that is essential for cellular function. The subsequent cascade of eventsleads to accumulation of mutations and loss of cellular function. The cell loses its tissue-specific morphology,disconnects from other cells and extracellular matrix and migrates – the invasion begins. It is now clear thatadhesive molecules are a key player in this cascade. These proteins of the cell membrane surface are responsiblefor attachment of the cells to each other and to the extracellular matrix. These interactions are crucial forboth structural and functional tissue organization. Lack of this homeostasis destroys the tissue architectureand impairs its function and results in invasion. Abnormal expression of adhesive molecules was reported in allexamined cancers, including endometrial cancer.Endometrial cancer is the most common gynaecological cancer in developed countries. Although in many casesdiagnosed and treated in early stages, and thus with good results, some patients cannot be cured. Completeknowledge of the pathogenesis of the disease will be helpful in identifying the patients with negative prognosticfactors, increased risk of recurrence and, perhaps, to find other therapeutic options. In the paper we are trying tosum up the up-to-date knowledge of the role of adhesive molecules in pathogenesis of endometrial cancer.

  17. The history of hormone therapy use and recent controversy related to heart disease and breast cancer arising from prevention trial outcomes.

    Science.gov (United States)

    Alexander, Ivy M

    2012-01-01

    The reasons for hormone therapy use have changed dramatically over time from being very popular for the purpose of preserving youth in women to menopause-related symptom management, disease prevention, and now back to menopause-related symptom management. Over time, several important risks associated with the use of hormone therapy have become evident, causing dramatic reductions in the use of hormone therapy for periods of time following identification of these risks. Most recently, randomized controlled prevention trials that evaluated hormone therapy for the purpose of reducing or preventing coronary heart disease among women have found that hormone therapy is associated with increased rather than decreased risks for coronary heart disease. The most recent of these trials again identified increased risks for breast cancer associated with estrogen plus progestogen therapy. The evolving evidence base from these randomized controlled prevention trials is complicated and in some cases contradictory. Specifically, the data suggest that the timing of when hormone therapy is initiated once a woman is postmenopausal may influence her risk for developing heart disease and breast cancer. In this article, contradictory evidence is carefully sifted so risks and benefits can be weighed by clinicians when partnering with women to individualize decisions about using hormone therapy. © 2012 by the American College of Nurse-Midwives.

  18. Dose Distribution over Different Parts of Cancer Patients During Radiotherapy Treatment in Bangladesh

    International Nuclear Information System (INIS)

    Miah, F.K.; Ahmed, M.F.; Begum, Z.; Alam, B.; Chowdhury, Q.

    1998-01-01

    Measurements have been carried out to determine the dose distribution over different parts of the body of 12 cancer patients during radiotherapy treatment. Patients with breast cancer, lung cancer, cervix and larynx cancer treated with either X ray therapy or 60 Co therapy were particularly considered. The doses to the organs and tissues outside the primary beam of the patients under treatment were found to vary with a maximum value of 9096 ± 25 mSv at the neck of a lung cancer patient to a minimum value of 2 ± 0.5 mSv at the right leg of a breast cancer patient. The variation of doses was well explained by the exposure and patient data given for each patient. The measured data in each part of the body have been found to be consistent indicating confidence in the measurements. (author)

  19. The health of healthcare, Part II: patient healthcare has cancer.

    Science.gov (United States)

    Waldman, Deane

    2013-01-01

    In this article, we make the etiologic diagnosis for a sick patient named Healthcare: the cancer of greed. When we explore the two forms of this cancer--corporate and bureaucratic--we find the latter is the greater danger to We the Patients. The "treatments" applied to patient Healthcare by the Congressional "doctors" have consistently made the patient worse, not better. At the core of healthcare's woes is the government's diversion of money from healthcare services to healthcare bureaucracy. As this is the root cause, it is what we must address in order to cure, not sedate or palliate, patient Healthcare.

  20. Improving Cancer-Related Outcomes with Connected Health - Part 2: Objective 2

    Science.gov (United States)

    A core principle of connected health is that individuals are empowered to decide when, whether, and how much to participate in their health and healthcare (see Principles of Connected Health in Part 1). Decisions about participation may change over time. Connected health tools are needed to ensure that people at risk for cancer, cancer patients, and cancer survivors have access to the information they need when they need it and in formats that meet their needs.

  1. Storytelling intervention for patients with cancer: part 2--pilot testing.

    Science.gov (United States)

    Crogan, Neva L; Evans, Bronwynne C; Bendel, Robert

    2008-03-01

    To evaluate symptom reports and the impact of a nurse-led storytelling intervention in a supportive group setting on mood, stress level, coping with stress, pain, self-efficacy, and satisfaction with life in patients with cancer. Descriptive pilot project using a pretest/post-test control group. Local regional medical center in the Pacific Northwest region of the United States. Convenience sample of 10 patients with various cancer diagnoses; 7 completed the intervention. Participants were randomly assigned to a storytelling or control group. Using a tool kit generated for this project, a nurse facilitator guided storytelling group participants in 12 1.5-hour sessions. Six instruments, symptom assessments, and a retrospective physician chart review were completed for each group. Data were analyzed using repeated measures analysis of variance. Mood, stress, coping, pain, self-efficacy, and satisfaction with life. Comparison of changes in group mean scores revealed a significant decrease in anxiety in the storytelling group despite disease progression. Documentation of psychosocial symptomatology by physicians is limited; however, nursing assessments were useful in determining psychosocial status before and after the intervention. Results can be viewed only in context of a feasibility study and are not generalizable because of a limited sample size. A trained oncology nurse was able to use the storytelling intervention. Initial results are promising and warrant further study. After additional testing, the intervention could be used to enhance storytelling groups for patients with cancer or for individuals who are uncomfortable in or do not have access to storytelling groups.

  2. History of the Belgian nuclear power controversy

    International Nuclear Information System (INIS)

    Laes, E.

    2009-01-01

    Partly because nuclear energy technology continues to provoke profound controversy, the Flemish institute for technology assessment (viWTA) took the initiative to order a study aimed at mapping out the historical dynamics of the societal debate on nuclear energy. This study was carried out by the Belgian Nuclear Research Centre (SCK-CEN, under the research programme PISA) together with the Free university of Brussels (VUB, research group MEKO) in 2004. In 2007, the report was updated and published by Acco (Leuven) under the title Kernenergie (on)besproken. This study had three main objectives: 1) to discuss the societal debate on nuclear energy in Belgium in relation to major events (Chernobyl, TMI, etc.); 2) to elucidate the role of social actors in the controversy on both a national and international level and 3) to discuss possible alternatives for a better structuring of the debate in the future, building on existing approaches

  3. A radioactive controversy

    International Nuclear Information System (INIS)

    Engler, Veronica

    2002-01-01

    During 2002, the National Congress of Argentina began discussing the 'Agreement between the Republic of Argentina and Australia on cooperation in the peaceful uses of the nuclear energy'. This document has revived the debate regarding development of a national nuclear industry. The debate was spurred by a commercial contract signed in 2000 by INVAP, an Argentinean company who sold a nuclear reactor to the ANSTO, Australian Nuclear and Technology Organization. More than sixty non-governmental organizations are opposed to the ratification of the agreement, because they interpret that the text leaves the door wide open for the transport and deposit of Australian nuclear waste to Argentina, to be processed in national territory. Article 41 of the Argentinean National Constitution, explicitly prohibits the generation of any income from 'radioactive residues'. Those who support the agreement say that it does not promote the deposit of nuclear waste in Argentina, and argue that environmentalists are hampering efforts of this advanced technological industry to flourish in Argentina. The point of conflict in the agreement lies in article 12, which states that Argentina will continue the process of reactor-driven irradiated fuel outside Argentina. Once the treatment is completed, the fuel conditioned and the resulting waste must return to the country of origin for their storage. The possibility of spent fuel being sent to Argentina lies in the hypothetical case that the French company Cogema, which currently holds treatment responsibility, stops treatment sometime within the next fifteen years, when the fuel must be treated. The non-ratification of the agreement on Argentina part will not imply any sort of impediment in the realization of the reactor, it will only put on hold the possibility that the Australians spent fuels will complete treatment in Argentina. The constitutionality of the agreement lies in the question of waste, but this too is not a simple question. The

  4. Sedación paliativa (parte I: Controversias sobre términos, definiciones y aplicaciones clínicas Sedação paliativa (parte I: Controvérsias sobre termos, definições e aplicações clínicas Palliative sedation (part I: Controversies about terms, definitions and clinical applications

    Directory of Open Access Journals (Sweden)

    Paulina Taboada R.

    ão da hidratação e a nutrição medicamente assistida, e os fundamentos éticos e sua diferença com a eutanásia e/ou suicídio medicamente assistido. São revisados alguns aspectos do debate atual sobre o conceito de “sedação paliativa” e suas diferentes definições, assim como também certas controvérsias relacionadas com as suas aplicações clínicas. Ainda que sejam mencionadas brevemente algumas questões éticas relacionadas com esta prática clínica, estas não são abordadas diretamente neste artigo, mas são deixadas deliberadamente para uma análise mais profunda numa segunda parte.This article analyzes the use of palliative sedation, as a potentially useful therapeutic tool in Palliative Medicine. It suggests that, in spite of the improvement of medical knowledge related to palliative sedation during the last decade, available empirical evidence is still limited and controversy persists. The current debate includes aspects such us: 1. The definition and terminology (palliative vs. terminal sedation; 2. The types of sedation that are included under these expressions (intermittent vs. continuous; superficial vs. profound; 3. The clinical indications (physical symptoms vs. existential suffering; 4. The concomitant administration vs. withdrawal of medically assisted nutrition and hydration; 5. The ethical foundations and its difference with euthanasia and/or physician-assisted-suicide. This article analyzes aspects related to the concept of “palliative sedation” and its different definitions, as well as some controversies related to its clinical applications. Although ethical issues related to palliative sedation are briefly mentioned, they are not dealt with in this article, but intentionally left for a deeper analysis in a part II.

  5. Bladder cancer and smoking. Part 3: influence of perceptions and beliefs.

    Science.gov (United States)

    Anderson, Beverley; Naish, Wendy

    This is the third of a four-part series on bladder cancer and smoking. Part one examined the risks factors for bladder cancer, emphasizing that although there are many risk factors, smoking is the main predisposing factor for the disease. Part two presented an overview of bladder cancer, including diagnosis and management of the disease. Part three seeks to determine the extent to which people's concept of what constitutes good health is influenced by their perceptions and beliefs. It then looks at whether educational support, specifically health promotion and health education, are effective in increasing the individual's awareness of the dangers of smoking for their health, and consequently in changing existing behaviours or dissuading them from becoming future smokers.

  6. Penetrating abdominal injuries: management controversies

    Science.gov (United States)

    Butt, Muhammad U; Zacharias, Nikolaos; Velmahos, George C

    2009-01-01

    Penetrating abdominal injuries have been traditionally managed by routine laparotomy. New understanding of trajectories, potential for organ injury, and correlation with advanced radiographic imaging has allowed a shift towards non-operative management of appropriate cases. Although a selective approach has been established for stab wounds, the management of abdominal gunshot wounds remains a matter of controversy. In this chapter we describe the rationale and methodology of selecting patients for non-operative management. We also discuss additional controversial issues, as related to antibiotic prophylaxis, management of asymptomatic thoracoabdominal injuries, and the use of colostomy vs. primary repair for colon injuries. PMID:19374761

  7. Penetrating abdominal injuries: management controversies

    Directory of Open Access Journals (Sweden)

    Velmahos George C

    2009-04-01

    Full Text Available Abstract Penetrating abdominal injuries have been traditionally managed by routine laparotomy. New understanding of trajectories, potential for organ injury, and correlation with advanced radiographic imaging has allowed a shift towards non-operative management of appropriate cases. Although a selective approach has been established for stab wounds, the management of abdominal gunshot wounds remains a matter of controversy. In this chapter we describe the rationale and methodology of selecting patients for non-operative management. We also discuss additional controversial issues, as related to antibiotic prophylaxis, management of asymptomatic thoracoabdominal injuries, and the use of colostomy vs. primary repair for colon injuries.

  8. Cancer incidence in atomic bomb survivors. Part IV: Comparison of cancer incidence and mortality

    International Nuclear Information System (INIS)

    Ron, E.; Preston, D.L.; Mabuchi, Kiyohiko; Thompson, D.E.; Soda, Midori

    1994-01-01

    This report compares cancer incidence and mortality among atomic bomb survivors in the Radiation Effects Research Foundation Life Span Study (LSS) cohort. Because the incidence data are derived from the Hiroshima and Nagasaki tumor registries, case ascertainment is limited to the time (1958-1987) and geographic restrictions (Hiroshima and Nagasaki) of the registries, whereas mortality data are available from 1950-1987 anywhere in Japan. With these conditions, there were 9,014 first primary incident cancer cases identified among LSS cohort members compared with 7,308 deaths for which cancer was listed as the underlying cause of death on death certificates. When deaths were limited to those occurring between 1958-1987 in Hiroshima or Nagasaki, there were 3,155 more incident cancer cases overall, and 1,262 more cancers of the digestive system. For cancers of the oral cavity and pharynx, skin, breast, female and male genital organs, urinary system and thyroid, the incidence series was at least twice as large as the comparable mortality series. Although the incidence and mortality data are dissimilar in many ways, the overall conclusions regarding which solid cancers provide evidence of a significant dose response generally confirm the mortality findings. When either incidence or mortality data are evaluated, significant excess risks are observed for all solid cancers, stomach, colon, liver (when it is defined as primary liver cancer or liver cancer not otherwise specified on the death certificate), lung, breast, ovary and urinary bladder. No significant radiation effect is seen for cancers of the pharynx, rectum, gallbladder, pancreas, nose, larynx, uterus, prostate or kidney in either series. There is evidence of a significant excess of nonmelanoma skin cancer in the incidence data, but not in the mortality series. 19 refs., 2 figs., 10 tabs

  9. Danish Cartoon Crisis/Controversy

    DEFF Research Database (Denmark)

    Hervik, Peter

    2017-01-01

    The Danish Cartoon Crisis Controversy is one of several terms that refer to the turmoil that associates with the Danish newspaper Morgenavisen Jyllands-Posten’s publication of 12 cartoons on 30 September 2005. “The Muhammad Cartoon Crisis” is an alternative heading used for the violent global rea...

  10. Controversial Issues in Learning Disability.

    Science.gov (United States)

    Sapir, Selma C.

    The author discusses controversial issues in the field of learning disabilities (LD). Among topics addressed are conflicting definitions of LD and the impact of the operational definition accepted by the US Government; etiological questions concerning the separation of neurological, environmental, and emotional factors; approaches used in training…

  11. The Satanic Ritual Abuse Controversy.

    Science.gov (United States)

    Putnam, Frank W.

    1991-01-01

    The issues raised by Jonker and Jonker-Bakker and Young et al (EC 601 187-188) illustrate a major controversy dividing the child abuse community, the alleged existence of a conspiracy of satanic, ritual, sexual abuse of children. No evidence is found to support claims that large numbers of babies and children are being sacrificed or abused in…

  12. Risk controversies. Concepts - conflicts - communication

    International Nuclear Information System (INIS)

    Jungermann, H.

    1991-01-01

    Common arguments and differences in risk communication in connection with the controversial discussion surrounding the fields of genetic engineering, chemistry, nuclear engineering, information techniques, and climate research are investigated. Presented are comparative analyses on subjects, those becoming active, and strategies of risk communication. (DG) [de

  13. Introducing Ethics Using Structured Controversies

    Science.gov (United States)

    Wareham, David; Elefsiniotis, Takis P.; Elms, David

    2006-01-01

    This paper describes a method of introducing ethics to a second-year class of civil engineering students. The method, known as a "structured controversy", takes the form of a workshop where the students assume the identity of stakeholders having an interest in a proposed development in an environmentally sensitive region. The instructor…

  14. Desecuritization as Displacement of Controversy

    DEFF Research Database (Denmark)

    Jacobsen, Marc; Strandsbjerg, Jeppe

    2017-01-01

    By signing the Ilulissat Declaration of May 2008, the five littoral states of the Arctic Ocean pre-emptively desecuritized potential geopolitical controversies in the Arctic Ocean by confirming that international law and geo-science are the defining factors underlying the future delimitation...

  15. Current controversies, is there merit?

    DEFF Research Database (Denmark)

    Twetman, S

    2009-01-01

    Xylitol has become a debated measure in caries prevention. This paper aims to examine and comment on some possible controversies, with emphasis on the most recent literature. A search for clinical trials was conducted through 2007 in PubMed, and papers describing a controlled xylitol intervention...

  16. Women's Athletics: Coping with Controversy.

    Science.gov (United States)

    Hoepner, Barbara J., Ed.

    This book is a collection of papers discussing controversial topics in women's athletics. Section one, "Overview--Women's Rights," includes articles on women's rights and equal opportunities in sports, the emergence of women in sports, and significant events in a century of American women's sports. Section two, "Women's Intercollegiate…

  17. Some diagnostic and therapeutic controversies in glaucoma addressed

    NARCIS (Netherlands)

    Müskens, Rogier Peter Hendrik Maria

    2008-01-01

    In the five studies contained in this thesis, several controversies on the diagnosis of and therapy for glaucoma have been addressed. The first part of this thesis consisted of three studies that aimed tot improve existing technologies for diagnosing glaucoma. The latter part consisted of two

  18. Controversial Science and the Media

    Science.gov (United States)

    Riordon, James

    2012-03-01

    The possibility that the OPERA collaboration has detected superluminal neutrinos was among the most controversial topics in physics news in decades, and one of the most widely covered stories in all of science in 2011. Word of the research initially reached journalists and the public prior to publication in peer-reviewed journals. Understandably, many physicists are concerned that the significance of controversial science may be exaggerated or distorted when news organizations report on science at such an early stage. I will offer an overview of the ways the story was promoted by the media relations personnel, and outline the rationales that motivate media relations efforts along with the associated benefits and drawbacks that can result. Finally, I will examine the accuracy and completeness of the superluminal neutrino news stories that ultimately were made available to the general public.

  19. Nuclear controversy with many undercurrents

    International Nuclear Information System (INIS)

    Lingjaerde, R.O.

    1979-01-01

    The president of the Norwegian Atomic Energy Society presents, in the form of an interview his opinions on the nature of the nuclear controversy in Norway. He is very critical of the emotional and uninformed nature of much of the criticism of nuclear power, and emphasises that nuclear power must be regarded as an alternative to other, less favourable forms of thermal power, as a supplement to hydroelectric power, or to electricity rationing. While a society using less energy is quite feasible, it would hardly be acceptable. The waste disposal controversy is quite artifical, as perfectly safe methods of disposal are available. Finally he regrets that it is the conclusions only in the Nuclear Power Commission's report which have attracted attention, and mainly the comments of the dissident minority. (JIW)

  20. Human Papillomavirus Is Associated with Breast Cancer in the North Part of Iran

    Directory of Open Access Journals (Sweden)

    Afsaneh Sigaroodi

    2012-01-01

    Full Text Available We have analyzed the possible relevance of HPV infection for breast cancer risk among Iranian women from north part of Iran. Among women with breast cancer, 25.9% had positive test results for HPV DNA in breast tumor samples in contrast to 2.4% of women with noncancer status (P=0.002. The infection of HPV has increased the risk of breast cancer (OR 14.247; 95% CI 1.558–130.284, P=0.019. The high-risk HPV genotypes (types 16 and 18 in samples of breast cancer patients were the predominant types (53.34%. Other genotypes detected in breast cancer were HPV-6, HPV-11, HPV-15, HPV-23, and HPV-124, and one isolate could not be genotyped compared to HPV reference sequences. While the sole detected HPV in control specimens was HPV-124. Our study reveals that HPV infection and age are the risk factors in breast cancer development in the north part of Iran.

  1. Can we resolve the radiation controversy

    International Nuclear Information System (INIS)

    Webster, E.W.

    1983-01-01

    The past 20 years has seen an intensification of anxieties about potential harm, specifically cancer, from low levels of x or gamma rays. The idea that radiation is more damaging than previously estimated, says the author, is a central theme in current radiation phobia and probably the principal prop of the antinuclear movement. A current law-suit decision in Salt Lake City will settle the issue for the present. Historical data from Japanese A-bomb survivors and other studies are reviewed, the need for further epidemiologic work pointed out, and 20 years more of data collection from the Japanese survivors indicated as the final arbiter of the controversy. 18 references, 8 figures, 11 tables

  2. [On controversies around the Oedipus Complex].

    Science.gov (United States)

    Drwiega, Marek

    2002-01-01

    In the article the author would like to draw the readers' attention to one of the central issues of psychoanalysis, i.e. Oedipus complex. In the development of the psychoanalysis the classical conception of Oedipus complex presented by Freud gave rise to a severe criticism both on the part of some psychoanalysts, especially women such as e.g. Melanie Klein, and on the part of ethnographers such as B. Malinowski. In the paper the author presents the main controversies concerning this interesting discussion. The fact of the matter is that the Oedipus complex is a hotly debated subject, not only from the cultural point of view but also within the psychoanalytical movement.

  3. Hereditary nonpolyposis colorectal cancer and familial colorectal cancer in Central part of Iran, Isfahan

    Directory of Open Access Journals (Sweden)

    Amin Nemati

    2012-01-01

    Full Text Available Background: There is a lack of data on familial aggregation of colorectal cancer (CRC in Iran. We aimed to deter-mine the frequency of hereditary nonpolyposis colorectal cancer (HNPCC and familial colorectal cancer (FCC and to determine the frequency of extracolonic cancers in these families in Isfahan. Methods: We reviewed documents of all patients with a pathologically confirmed diagnosis of CRC admitted to Isfa-han referral hospitals between 1995 and 2006. We also studied our CRC registry at Poursina Hakim Research Institute from 2003 to 2008. We found HNPCC and FCC families based on the Amsterdam II criteria and interviewed them for family history of CRC and extracolonic tumors. The family history was taken at least up to the second-degree relatives. Results: During 1996 to 2008, a total of 2580 CRC cases have been diagnosed. We found 14 HNPCC and 53 FCC families. Mean age of CRC at diagnosis was 48.0 ΁ 14.6 and 49.0 ΁ 13.9 years in the HNPCC and FCC families, re-spectively (p > 0.05. The total numbers of observed extracolonic tumors were 70 (21.6%; mean age = 53.6 ΁ 11.0 years and 157 (13.8%; mean age = 54.8 ΁ 18.0 years in HNPCC and FCC families, respectively (p > 0.05. CRC was respectively found in 52 and 76 members of the HNPCC and FCC families, revealing the frequency of HNPCC and FCC as 2.0% (52/2580 and 2.9% (76/2580, respectively. Conclusions: We found a relative high frequency of HNPCC (2.0% and FCC (2.9% among CRC cases in our socie-ty and high incidence of extracolonic tumors in their families. Further studies focusing on molecular basis in this field and designing a specific screening and national cancer registry program for HNPCC and FCC families should be con-ducted.

  4. The controversy about nuclear power

    International Nuclear Information System (INIS)

    Bethe, H.A.

    1977-01-01

    A short review of the events of the past several years in the conflict in the USA between the groups supporting or opposing nuclear power. Reference is made to publications on both sides of the controversy which the author considers to be well reasoned and useful sources of information. Mention is also made of the legal and legislative actions taken by both sides. The arguments against nuclear power are summarized and solutions to the problems which are the source of these arguments are suggested

  5. Ataxin-10 is part of a cachexokine cocktail triggering cardiac metabolic dysfunction in cancer cachexia

    Directory of Open Access Journals (Sweden)

    Michaela Schäfer

    2016-02-01

    Full Text Available Objectives: Cancer cachexia affects the majority of tumor patients and significantly contributes to high mortality rates in these subjects. Despite its clinical importance, the identity of tumor-borne signals and their impact on specific peripheral organ systems, particularly the heart, remain mostly unknown. Methods and results: By combining differential colon cancer cell secretome profiling with large-scale cardiomyocyte phenotyping, we identified a signature panel of seven “cachexokines”, including Bridging integrator 1, Syntaxin 7, Multiple inositol-polyphosphate phosphatase 1, Glucosidase alpha acid, Chemokine ligand 2, Adamts like 4, and Ataxin-10, which were both sufficient and necessary to trigger cardiac atrophy and aberrant fatty acid metabolism in cardiomyocytes. As a prototypical example, engineered secretion of Ataxin-10 from non-cachexia-inducing cells was sufficient to induce cachexia phenotypes in cardiomyocytes, correlating with elevated Ataxin-10 serum levels in murine and human cancer cachexia models. Conclusions: As Ataxin-10 serum levels were also found to be elevated in human cachectic cancer patients, the identification of Ataxin-10 as part of a cachexokine cocktail now provides a rational approach towards personalized predictive, diagnostic and therapeutic measures in cancer cachexia. Author Video: Author Video Watch what authors say about their articles Keywords: Cancer cachexia, Ataxin-10, Cardiac dysfunction, Fatty acid metabolism

  6. Doctrinal controversies and ecumenical councils | Ogbonnaya ...

    African Journals Online (AJOL)

    This work focused on the doctrinal controversies that have confronted the Church in the course of its development and the accompanying councils that sought to resolve these theological controversies. The paper did this historically, by showing the origin of the problems, the factors and features involved in the controversies ...

  7. Distribution of Thyroid Cancer in the Eastern Part of Turkey 27 Years After the Chernobyl Accident.

    Science.gov (United States)

    Sahin, Serap Baydur; Yucel, Ahmet Fikret; Gucer, Hasan; Pergel, Ahmet; Bedir, Recep; Aydin, Ibrahim; Sehitoglu, Ibrahim; Sahin, Dursun Ali; Sahin, Osman Zikrullah

    2013-12-01

    The Chernobyl accident caused widespread effects across Europe and huge areas where radiocontaminated. The effects of the Chernobyl accident on thyroid cancer have been investigated in most European countries. According to the data of the Turkish Atomic Energy Authority, the eastern part of the Black Sea region was the most radiocontaminated area in Turkey at the time of Chernobyl accident. We therefore aimed to examine the data of thyroid cancers at our center, Rize city which is located in the eastern Black Sea region. This retrospective study included the patients with histologically proven thyroid cancer at our center between January 2008 and May 2012. Pathologic examinations of thyroidectomy materials were reviewed. We evaluated patients' age, gender, size of the primary tumor (all sizes, Chernobyl accident.

  8. Managing Controversies in the Fuzzy Front End

    DEFF Research Database (Denmark)

    Christiansen, John K.; Gasparin, Marta

    2016-01-01

    This research investigates the controversies that emerge in the fuzzy front end (FFE) and how they are closed so the innovation process can move on. The fuzzy front has been characterized in the literature as a very critical phase, but controversies in the FFE have not been studied before....... The analysis investigates the microprocesses around the controversies that emerge during the fuzzy front end of four products. Five different types of controversies are identified: profit, production, design, brand and customers/market. Each controversy represents a threat, but also an opportunity to search...

  9. Predicted supplies of oil: a controversy revisited

    International Nuclear Information System (INIS)

    Mackay, R.M.; Probert, S.D.

    1993-01-01

    This investigation had two objectives. The first was to consider future problems of the oil industry, as envisaged at the time of the impending 1973-74 unit-oil-price crisis. To this end, selected early 1970's pertinent published papers have been analysed and their conclusions now assessed in hindsight. The chosen published articles were considered then to be in part controversial, visionary and simultaneously, often predicting very different outcomes for the future supply, demand and unit cost of crude oil. The second objective was to assess pertinent recent research, and compare what we at present believe to be the status quo for the oil industry, with the perception of how the industry would have developed as portrayed by the early 1970's oil publications. (author)

  10. Breast cancer screening with mammography as part of our comprehensive medical check-up

    International Nuclear Information System (INIS)

    Ishii, Kaname; Kaburaki, Tomonori; Iwata, Keiko; Tsuneda, Atsushi; Mori, Kazuhiro; Takeyama, Shigeru; Tsuji, Hiroshi

    2012-01-01

    In the breast cancer screening program adopted by our hospital's Health Care Center as part of a comprehensive medical check-up, mammography (MMG) is performed in addition to a clinical breast examination to provide better screening quality. The clinical breast examination is performed by our surgeons. Two-view MMG is performed for women in their 40's and one-view MMG for the others. If any abnormality is detected in the clinical breast examination, or if MMG reveals abnormalities of category 3 or over, a more thorough diagnostic work-up is recommended. Each year, 1,400 or more women undergo breast cancer screening at the center, with an average recall rate of 12% and an average breast cancer detection rate of 0.14%. The high recall rate indicates the need for improvement of screening accuracy. Although the breast cancer detection rate and positive predictive value are somewhat low, the majority of the detected cases are early-stage breast cancer, thus demonstrating the efficacy of the screening. Herein, we describe the current state of MMG screening in our comprehensive medical check-up, along with a discussion of the screening procedure. However, further efforts are needed to improve screening accuracy. (author)

  11. Nuclear power. The Windscale controversy

    International Nuclear Information System (INIS)

    Boyle, G.

    1978-01-01

    The aims of this unit are: (1) to provide a basic understanding of nuclear technology and of the associated technical and environmental problems; (2) to provide an understanding of: (a) the historical growth of the nuclear industry; (b) the arguments for the continued development of nuclear power, and the institutions promoting that development; (3) to provide a basic understanding of the mechanisms and institutions which officially regulate the nuclear power programme in the UK; (4) to provide an understanding of the main issues - technical, economic, social and political - involved in the controversy over the proposed expansion of British Nuclear Fuels Ltd's reprocessing facilities at Windscale, and the events leading up to the Public Inquiry on the proposal which began in June 1977; and (5) to examine (a) the reason for the growth in opposition to nuclear power in various countries and the different approaches taken by the opposition groups; (b) the political impact and effectiveness of that opposition. (author)

  12. Subclinical hypothyroidism: Controversies to consensus

    Directory of Open Access Journals (Sweden)

    Syed Abbas Raza

    2013-01-01

    Full Text Available Diagnoses of subclinicaal hypothyroidism (SCH is biochemically made, when serum thyroid stimulating hormone (TSH levels is elevated while free thyroid hormone levels are within normal reference range. SCH is diagnosed after excluding all other causes of elevated TSH levels. Symptoms of SCH may vary from being asymptomatic to having mild nonspecific symptoms. The risk of progression to overt hypothyroidism is related to number of factors including initial serum TSH concentration, presence of auto antibodies, family history and presence goiter. Various screening recommendations for thyroid function assessment are in practice. There are still controversies surrounding SCH and associated risk of various cardiovascular diseases (CVDs, pregnancy outcomes, neuropsychiatric issues, metabolic syndrome, and dyslipidemia. Consensus will require more large randomized clinical studies involving various age groups and medical condition, especially in developing countries. All these efforts will definitely improve our understanding of disease and ultimately patient outcomes.

  13. Partisan Scholarship in Technoscientific Controversies

    DEFF Research Database (Denmark)

    Galis, Vasilis; Hansson, Anders

    2012-01-01

    of who controls, manipulates, and establishes decisions, facts, and knowledge. With this in mind, it is possible to identify different forms of partisan research including capture by participants, de facto and overt partisanship, and mercenary scholarship. These different forms of partisan scholarship...... are characterised by differences in the motives underlying epistemological choices of research topic and method, personal commitments to the fields studied, use of research findings in controversies, and positioning of results in wider debates. Two examples help to illustrate partisan scholarship: first, a study...... of new technologies for managing climate change (carbon dioxide capture and storage); and second, the construction of the new underground metro system in Athens and its accommodation of accessibility standards. Both cases entail partisan positions and raise similar concerns about the orthodox...

  14. The Legitimizing Function of Judicial Rhetoric in the Eugenics Controversy.

    Science.gov (United States)

    Hasian, Marouf, Jr.; Croasmun, Earl

    1992-01-01

    Investigates the possibility that judicial policymaking is responsive to the situational exigencies created in part through public discourse. Investigates the elite and public perspectives regarding the eugenics controversy in the 1920s to explore the emergent relationship between the public and technical spheres of argument. (SR)

  15. Science and controversy a biography of Sir Norman Lockyer

    CERN Document Server

    Meadows, A

    2008-01-01

    Sir Norman Lockyer left Nature, the world''s leading scientific journal, as his lasting memorial. But his life, and controversial theories, are an important part of science history. His ideas were at the forefront of public debate, and ranged from brilliant to perverse. This entertaining book is a fascinating insight into his eventful life

  16. Darwinian Controversies: An Historiographical Recounting

    Science.gov (United States)

    Depew, David J.

    2010-05-01

    This essay reviews key controversies in the history of the Darwinian research tradition: the Wilberforce-Huxley debate in 1860, early twentieth-century debates about the heritability of acquired characteristics and the consistency of Mendelian genetics with natural selection; the 1925 Scopes trial about teaching evolution; tensions about race, culture, and eugenics at the 1959 centenary celebration Darwin’s Origin of Species; adaptationism and its critics in the Sociobiology debate of 1970s and, more recently, Evolutionary Psychology; and current disputes about Intelligent Design. These controversies, I argue, are etched into public memory because they occur at the emotionally charged boundaries between public-political, technical-scientific, and personal-religious spheres of discourse. Over most of them falls the shadow of eugenics. The main lesson is that the history of Darwinism cannot be told except by showing the mutual influence of the different norms of discourse that obtain in the personal, technical, and public spheres. Nor can evolutionary biology successfully be taught to citizens and citizens-to-be until the fractious intersections between spheres of discourse have been made explicit. In the course of showing why, I take rival evolutionary approaches to be dynamical historical research traditions rather than static theories. Accordingly, I distinguish Darwin’s version of Darwinism from its later transformations. I pay special attention to the role Darwin assigned to development in evolution, which was marginalized by twentieth-century population genetical Darwinism, but has recently resurfaced in new forms. I also show how the disputed phrases “survival of the fittest” and “social Darwinism” have shaped personal anxieties about “Darwinism,” have provoked public opposition to teaching evolution in public schools, and have cast a shadow over efforts to effectively communicate to the public largely successful technical efforts to make

  17. Resolving the controversy over beneficial effects of ionizing radiation

    International Nuclear Information System (INIS)

    Cuttler, J.M.

    1999-01-01

    In spite of the extensive research carried out during the past century, intense controversy continues over the health effects of low-level radiation. This controversy is largely due to political, social and economic issues among scientists and analysts in a variety of disciplines. These issues cloud objectivity and strengthen paradigms. Over the past ten years, in 14 universities and two research institutes, Japanese scientists have conducted exceptional research which clearly demonstrates beneficial effects of low-level radiation and cancer cures following therapy with low doses of radiation. Assessment, replication and extension of this work in North America could lead to greater appreciation of its significance. Cancer patients would demand such treatments, leading to universal acceptance of these bio-positive effects and reducing public fear of nuclear technology. (author)

  18. Empowerment in healthcare policy making: three domains of substantive controversy.

    Science.gov (United States)

    Chiapperino, Luca; Tengland, Per-Anders

    2015-12-01

    This paper distinguishes between the uses of empowerment across different contexts in healthcare policy and health promotion, providing a model for the ethical and political scrutiny of those uses. We argue that the controversies currently engendered by empowerment are better understood by means of a historical distinction between two concepts of empowerment, namely, what we call the radical empowerment approach and the new wave of empowerment. Building on this distinction, we present a research agenda for ethicists and policy makers, highlighting three domains of controversy raised by the new wave of empowerment, namely: (1) the relationship between empowerment and paternalistic interferences on the part of professionals; (2) the evaluative commitment of empowerment strategies to the achievement of health-related goals; and (3) the problems arising from the emphasis on responsibility for health in recent uses of empowerment. Finally, we encourage the explicit theorisation of these moral controversies as a necessary step for the development and implementation of ethically legitimate empowerment processes.

  19. HPV vaccines: a controversial issue?

    Science.gov (United States)

    Nicol, A F; Andrade, C V; Russomano, F B; Rodrigues, L L S; Oliveira, N S; Provance, D W

    2016-01-01

    Controversy still exists over whether the benefits of the available HPV vaccines outweigh the risks and this has suppressed uptake of the HPV vaccines in comparison to other vaccines. Concerns about HPV vaccine safety have led some physicians, healthcare officials and parents to withhold the recommended vaccination from the target population. The most common reason for not administering the prophylactic HPV vaccines are concerns over adverse effects. The aim of this review is the assessment of peer-reviewed scientific data related to measurable outcomes from the use of HPV vaccines throughout the world with focused attention on the potential adverse effects. We found that the majority of studies continue to suggest a positive risk-benefit from vaccination against HPV, with minimal documented adverse effects, which is consistent with other vaccines. However, much of the published scientific data regarding the safety of HPV vaccines appears to originate from within the financially competitive HPV vaccine market. We advocate a more independent monitoring system for vaccine immunogenicity and adverse effects to address potential conflicts of interest with regular systematic literature reviews by qualified individuals to vigilantly assess and communicate adverse effects associated with HPV vaccination. Finally, our evaluation suggests that an expanded use of HPV vaccine into more diverse populations, particularly those living in low-resource settings, would provide numerous health and social benefits.

  20. HPV vaccines: a controversial issue?

    Directory of Open Access Journals (Sweden)

    A.F. Nicol

    2016-01-01

    Full Text Available Controversy still exists over whether the benefits of the available HPV vaccines outweigh the risks and this has suppressed uptake of the HPV vaccines in comparison to other vaccines. Concerns about HPV vaccine safety have led some physicians, healthcare officials and parents to withhold the recommended vaccination from the target population. The most common reason for not administering the prophylactic HPV vaccines are concerns over adverse effects. The aim of this review is the assessment of peer-reviewed scientific data related to measurable outcomes from the use of HPV vaccines throughout the world with focused attention on the potential adverse effects. We found that the majority of studies continue to suggest a positive risk-benefit from vaccination against HPV, with minimal documented adverse effects, which is consistent with other vaccines. However, much of the published scientific data regarding the safety of HPV vaccines appears to originate from within the financially competitive HPV vaccine market. We advocate a more independent monitoring system for vaccine immunogenicity and adverse effects to address potential conflicts of interest with regular systematic literature reviews by qualified individuals to vigilantly assess and communicate adverse effects associated with HPV vaccination. Finally, our evaluation suggests that an expanded use of HPV vaccine into more diverse populations, particularly those living in low-resource settings, would provide numerous health and social benefits.

  1. Lyme disease: why the controversy?

    Science.gov (United States)

    Beaman, M H

    2016-12-01

    Some Australians have become convinced of the existence of locally acquired Lyme disease (LD). The history of LD, since its recognition in the early 1970s, is reviewed as a model for investigative approaches to unknown syndromes. Australian Management Guidelines for LD include the requirement for diagnostic testing by National Association of Testing Authorities-accredited laboratories using Therapeutic Goods Administration-licensed tests, which result in the efficient diagnosis of LD in overseas travellers. Despite this, patients who have not left Australia pay many thousands of dollars for non-specialist consultations and testing at overseas laboratories. Unproven long-term therapy with multiple antibiotics has resulted in serious complications, including allergies, line sepsis, pancreatitis and pseudomembranous colitis. Studies have shown that LD vectors are not found in Australia, and Lyme Borrelia has not been found in Australian vectors, animals or patients with autochthonous illnesses. I propose that (i) A non-controversial name for the chronic syndrome should be adopted, 'Australian Multisystem Disorder'. (ii) Research funding should enable the development of a consensus case definition and studies of the epidemiology of this syndrome with laboratory investigations to identify an aetiology and surrogate markers of disease. Prospective, randomised treatment studies could then be undertaken using ethical protocols. © 2016 Royal Australasian College of Physicians.

  2. Controversies in presacral tumors management

    Directory of Open Access Journals (Sweden)

    Nidal Issa

    2017-10-01

    Full Text Available Presacral tumors are rare lesions of the retrorectal space that can present diagnostic and therapeutic difficulty because of their anatomic location and the different tissue types and etiology. Although the diagnosis and management of these tumors has evolved in recent years, several points still to be addressed in order to improve perioperative diagnosis and treatment. In the upcoming we will try to highlight some controversial points; the pre-operative biopsies, neoadjuvant therapy, the necessity of surgery and the role of minimally invasive surgeries of presacral tumors. Resumo: Tumores pré-sacrais são lesões raras do espaço retrorretal que podem trazer dificuldades diagnósticas e terapêuticas por causa de sua localização anatômica e também pelos diferentes tipos de tecidos e etiologia. Embora nos últimos anos o diagnóstico e tratamento desses tumores tenham evoluído, diversos pontos ainda devem ser estudados com vistas à melhora do diagnóstico e tratamento no perioperatório. Mais adiante, tentaremos esclarecer alguns pontos controversos; biópsias pré-operatórias, terapia neoadjuvante, a necessidade de cirurgia e o papel das cirurgias minimamente invasivas para os tumores pré-sacrais. Keywords: Presacral tumor, Preoperative biopsy, Neoadjuvant therapy, Palavras-chave: Tumor pré-sacral, Biópsia pré-operatória, Terapia neoadjuvante

  3. 42 CFR 405.817 - Principles for determining amount in controversy.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Principles for determining amount in controversy... the Medicare Part B Program § 405.817 Principles for determining amount in controversy. (a) Individual... may assert that the aggregation principles contained in this subpart may be applied to determine the...

  4. Understanding Controversies in Urban Climate Change Adaptation

    DEFF Research Database (Denmark)

    Baron, Nina; Petersen, Lars Kjerulf

    2015-01-01

    This article explores the controversies that exist in urban climate change adaptation and how these controversies influence the role of homeowners in urban adaptation planning. A concrete SUDS project in a housing cooperative in Copenhagen has been used as a case study thereby investigating the m...

  5. Rikkunshito Ameliorates Cancer Cachexia Partly through Elevation of Glucarate in Plasma

    Directory of Open Access Journals (Sweden)

    Katsuya Ohbuchi

    2015-01-01

    Full Text Available Cancer cachexia, which is characterized by decreased food intake, weight loss and systemic inflammation, increases patient’s morbidity and mortality. We previously showed that rikkunshito (RKT, a Japanese traditional herbal medicine (Kampo, ameliorated the symptoms of cancer cachexia through ghrelin signaling-dependent and independent pathways. To investigate other mechanisms of RKT action in cancer cachexia, we performed metabolome analysis of plasma in a rat model bearing the Yoshida AH-130 hepatoma. A total of 110 metabolites were detected in plasma and RKT treatment significantly altered levels of 23 of those metabolites in cachexia model rats. Among them, glucarate, which is known to have anticarcinogenic activity through detoxification of carcinogens via inhibition of β-glucuronidase, was increased in plasma following administration of RKT. In our AH-130 ascites-induced cachexia rat model, administration of glucarate delayed onset of weight loss, improved muscle atrophy, and reduced ascites content. Additionally, glucarate reduced levels of plasma interferon-γ (IFN-γ in tumor-bearing rats and was also found to suppress LPS-induced IFN-γ expression in splenocytes in vitro. These results suggest that glucarate has anti-inflammatory activity via a direct effect on immune host cells and suggest that RKT may also ameliorate inflammation partly through the elevation of glucarate in plasma.

  6. Systematic Review of Occupational Therapy and Adult Cancer Rehabilitation: Part 1. Impact of Physical Activity and Symptom Management Interventions.

    Science.gov (United States)

    Hunter, Elizabeth G; Gibson, Robert W; Arbesman, Marian; D'Amico, Mariana

    This article is the first part of a systematic review of evidence for the effectiveness of cancer rehabilitation interventions within the scope of occupational therapy that address the activity and participation needs of adult cancer survivors. This article focuses on the importance of physical activity and symptom management. Strong evidence supports the use of exercise for cancer-related fatigue and indicates that lymphedema is not exacerbated by exercise. Moderate evidence supports the use of yoga to relieve anxiety and depression and indicates that exercise as a whole may contribute to a return to precancer levels of sexual activity. The results of this review support inclusion of occupational therapy in cancer rehabilitation and reveal a significant need for more research to explore ways occupational therapy can positively influence the outcomes of cancer survivors. Part 2 of the review also appears in this issue. Copyright © 2017 by the American Occupational Therapy Association, Inc.

  7. Managing Controversies in the Fuzzy Front End

    DEFF Research Database (Denmark)

    Christiansen, John K.; Gasparin, Marta

    2016-01-01

    . The analysis investigates the microprocesses around the controversies that emerge during the fuzzy front end of four products. Five different types of controversies are identified: profit, production, design, brand and customers/market. Each controversy represents a threat, but also an opportunity to search...... for new solutions in the unpredictable non-linear processes. The study uses an ethnographic approach using qualitative data from interviews, company documents, external communication and marketing material, minutes of meetings, informal conversations and observations. The analysis of four FFE processes...... demonstrates how the fuzzy front requires managers to deal with controversies that emerge from many different places and involve both human and non-human actors. Closing the controversies requires managers to take account of the situation, identify the problem that needs to be addressed, and initiate a search...

  8. Current concepts and controversies on adolescent idiopathic scoliosis: Part I

    Directory of Open Access Journals (Sweden)

    Alok Sud

    2013-01-01

    Full Text Available Adolescent idiopathic scoliosis is the most common spinal deformity encountered by General Orthopaedic Surgeons. Etiology remains unclear and current research focuses on genetic factors that may influence scoliosis development and risk of progression. Delayed diagnosis can result in severe deformities which affect the coronal and sagittal planes, as well as the rib cage, waistline symmetry, and shoulder balance. Patient′s dissatisfaction in terms of physical appearance and mechanical back pain, as well as the risk for curve deterioration are usually the reasons for treatment. Conservative management involves mainly bracing with the aim to stop or slow down scoliosis progression during growth and if possible prevent the need for surgical treatment. This is mainly indicated in young compliant patients with a large amount of remaining growth and progressive curvatures. Scoliosis correction is indicated for severe or progressive curves which produce significant cosmetic deformity, muscular pain, and patient discontent. Posterior spinal arthrodesis with Harrington instrumentation and bone grafting was the first attempt to correct the coronal deformity and replace in situ fusion. This was associated with high pseudarthrosis rates, need for postoperative immobilization, and flattening of sagittal spinal contour. Segmental correction techniques were introduced along with the Luque rods, Harri-Luque, and Wisconsin systems. Correction in both coronal and sagittal planes was not satisfactory and high rates of nonunion persisted until Cotrel and Dubousset introduced the concept of global spinal derotation. Development of pedicle screws provided a powerful tool to correct three-dimensional vertebral deformity and opened a new era in the treatment of scoliosis.

  9. Current concepts and controversies on adolescent idiopathic scoliosis: Part I.

    Science.gov (United States)

    Sud, Alok; Tsirikos, Athanasios I

    2013-03-01

    Adolescent idiopathic scoliosis is the most common spinal deformity encountered by General Orthopaedic Surgeons. Etiology remains unclear and current research focuses on genetic factors that may influence scoliosis development and risk of progression. Delayed diagnosis can result in severe deformities which affect the coronal and sagittal planes, as well as the rib cage, waistline symmetry, and shoulder balance. Patient's dissatisfaction in terms of physical appearance and mechanical back pain, as well as the risk for curve deterioration are usually the reasons for treatment. Conservative management involves mainly bracing with the aim to stop or slow down scoliosis progression during growth and if possible prevent the need for surgical treatment. This is mainly indicated in young compliant patients with a large amount of remaining growth and progressive curvatures. Scoliosis correction is indicated for severe or progressive curves which produce significant cosmetic deformity, muscular pain, and patient discontent. Posterior spinal arthrodesis with Harrington instrumentation and bone grafting was the first attempt to correct the coronal deformity and replace in situ fusion. This was associated with high pseudarthrosis rates, need for postoperative immobilization, and flattening of sagittal spinal contour. Segmental correction techniques were introduced along with the Luque rods, Harri-Luque, and Wisconsin systems. Correction in both coronal and sagittal planes was not satisfactory and high rates of nonunion persisted until Cotrel and Dubousset introduced the concept of global spinal derotation. Development of pedicle screws provided a powerful tool to correct three-dimensional vertebral deformity and opened a new era in the treatment of scoliosis.

  10. Pediatric cancer gone viral. Part I: strategies for utilizing oncolytic herpes simplex virus-1 in children

    Science.gov (United States)

    Cripe, Timothy P; Chen, Chun-Yu; Denton, Nicholas L; Haworth, Kellie B; Hutzen, Brian; Leddon, Jennifer L; Streby, Keri A; Wang, Pin-Yi; Markert, James M; Waters, Alicia M; Gillespie, George Yancey; Beierle, Elizabeth A; Friedman, Gregory K

    2015-01-01

    Progress for improving outcomes in pediatric patients with solid tumors remains slow. In addition, currently available therapies are fraught with numerous side effects, often causing significant life-long morbidity for long-term survivors. The use of viruses to kill tumor cells based on their increased vulnerability to infection is gaining traction, with several viruses moving through early and advanced phase clinical testing. The prospect of increased efficacy and decreased toxicity with these agents is thus attractive for pediatric cancer. In part I of this two-part review, we focus on strategies for utilizing oncolytic engineered herpes simplex virus (HSV) to target pediatric malignancies. We discuss mechanisms of action, routes of delivery, and the role of preexisting immunity on antitumor efficacy. Challenges to maximizing oncolytic HSV in children are examined, and we highlight how these may be overcome through various arming strategies. We review the preclinical and clinical evidence demonstrating safety of a variety of oncolytic HSVs. In Part II, we focus on the antitumor efficacy of oncolytic HSV in pediatric tumor types, pediatric clinical advances made to date, and future prospects for utilizing HSV in pediatric patients with solid tumors. PMID:26436135

  11. Pediatric cancer gone viral. Part I: strategies for utilizing oncolytic herpes simplex virus-1 in children

    Directory of Open Access Journals (Sweden)

    Timothy P Cripe

    Full Text Available Progress for improving outcomes in pediatric patients with solid tumors remains slow. In addition, currently available therapies are fraught with numerous side effects, often causing significant life-long morbidity for long-term survivors. The use of viruses to kill tumor cells based on their increased vulnerability to infection is gaining traction, with several viruses moving through early and advanced phase clinical testing. The prospect of increased efficacy and decreased toxicity with these agents is thus attractive for pediatric cancer. In part I of this two-part review, we focus on strategies for utilizing oncolytic engineered herpes simplex virus (HSV to target pediatric malignancies. We discuss mechanisms of action, routes of delivery, and the role of preexisting immunity on antitumor efficacy. Challenges to maximizing oncolytic HSV in children are examined, and we highlight how these may be overcome through various arming strategies. We review the preclinical and clinical evidence demonstrating safety of a variety of oncolytic HSVs. In Part II, we focus on the antitumor efficacy of oncolytic HSV in pediatric tumor types, pediatric clinical advances made to date, and future prospects for utilizing HSV in pediatric patients with solid tumors.

  12. Controversies in testosterone supplementation therapy

    Directory of Open Access Journals (Sweden)

    Mohit Khera

    2015-04-01

    Full Text Available Testosterone has now become one of the most widely used medications throughout the world. The rapid growth of the testosterone market in the past 10 years is due to many factors. We currently have a worldwide aging population. In the US, the number of men 65 years old or older is increasing 2-3 times faster than the number of men younger than 65 years. In addition, poor general health and certain medical conditions such as diabetes/metabolic syndrome (MetS, cardiovascular disease (CVD, and osteoporosis have been associated with low serum testosterone levels. [1],[2],[3] There are now fewer concerns regarding the development of prostate cancer (PCa after testosterone therapy, making it a more attractive treatment option. Finally, the introduction of different forms of testosterone supplementation therapy (TST with increased promotion, marketing, and direct-to-consumer advertising is also driving market growth. As the demand for TST continues to grow, it is becoming more important for clinicians to understand how to diagnose and treat patients with low testosterone.

  13. Hydroelectric power is green, although controversial

    International Nuclear Information System (INIS)

    Schulp, A.

    2003-01-01

    Hydroelectric power is worldwide the most important source of renewable energy. Still, it has some controversial aspects, which are briefly discussed in this article, focusing on Belgium and the Netherlands [nl

  14. Splenectomy as Part of Cytoreductive Surgery in Recurrent Epithelial Ovarian Cancer.

    Science.gov (United States)

    Bacalbasa, Nicolae; Balescu, Irina; Dima, Simona; Brasoveanu, Vladislav; Popescu, Irinel

    2015-09-01

    To determine the impact of survival of peritoneal versus splenic metastasis in cases submitted to splenectomy as part of cytoreductive surgery in recurrent epithelial ovarian cancer. Between January 2002 and May 2014, 28 patients were submitted to splenectomy as part of secondary, tertiary and beyond tertiary cytoreduction at the Dan Setlacec Center of Gastrointestinal Disease and Liver Transplantation, Fundeni Clinical Institute, Bucharest. Splenectomy was performed as follows: at secondary cytoreduction in 21 cases, at tertiary cytoreduction in six cases, and beyond tertiary cytoreduction in one case. An R0 resection was attempted in all cases; however, in two cases submitted to splenectomy as part of tertiary cytoreduction, R1 and R2 resection, were performed, respectively. Histopathological studies revealed the presence of peritoneal seeding in 11 cases at secondary cytoreduction and in four cases submitted to splenectomy as part of tertiary cytoreduction. Parenchymatous lesions were described in nine cases submitted to splenectomy as part of secondary cytoreduction and in two cases at tertiary cytoreduction. In a single case in which splenectomy was performed in the context of secondary cytoreduction, hilar involvement was found. Peritoneal seeding was described in the patient for whom splenectomy was performed at quaternary cytoreduction. Early postoperative mortality for the entire cohort (within 30 days) was 7.1% (death occurred in two cases submitted to splenectomy during the secondary cytoreduction). The median overall survival in patients with splenic involvement via peritoneal route was 35 months, while in cases with hematogenous splenic lesions, it was 12 months (p=0.2) at secondary cytoreduction. In the sub-group of patients submitted to splenectomy as part of tertiary cytoreduction, the median overall survival in patients with splenic involvement via peritoneal route was 21 months, while in cases with hematogenous splenic lesions it was 4 months (p=0

  15. Controversies in Persistent (Chronic) Lyme Disease

    Science.gov (United States)

    2016-01-01

    The Centers for Disease Control and Prevention estimates that more than 300 000 new cases of Lyme disease occur each year in the United States and that 10% to 20% of these patients will remain symptomatic despite receiving appropriate antibiotic therapy. Many elements of the disease are poorly understood and have generated considerable controversy. This paper discusses the medical controversies related to posttreatment manifestations and their potential impact on infusion nurses. PMID:27755213

  16. NUTRITION AND FITNESS (PART 1: OBESITY, THE METABOLIC SYNDROME, CARDIOVASCULAR DISEASE, AND CANCER

    Directory of Open Access Journals (Sweden)

    Artemis P. Simopoulos

    2005-12-01

    Full Text Available The proceedings of the Fifth International Conference on Nutrition and Fitness held in Athens, Greece, on June 91-2, 2004 are presented in the book as the first volume of the series. The objectives of the book are to review/discuss the latest information on nutrition and fitness by taking into consideration i genetic endowment, ii adaptation to the nutritional factors and the effect of various resources of energy on exercise and performance, iii the epidemiology of obesity, iv the relationship of nutrition and fitness to chronic diseases (cardiovascular diseases, syndrome X, obesity, osteoporosis, diabetes, cancer. The book also discusses the classification system of obesity in several countries and compares the diets used in several regions/countries. FEATURES A common, uniform strategy and evidence-based approach to organizing and interpreting the literature is used in all chapters. This textbook is composed of three parts with sub-sections in three of them. The topics of the parts are: i Obesity and Metabolic Syndrome, ii Coronary Heart Disease and iii Cancer. In each specific chapter, an epidemiological picture has been systematically developed from the data available in prospective, retrospective, case-control, and cross-sectional studies. The tables and figures are numerous, helpful and very useful. AUDIENCE This book is almost a compulsory reading for anyone interested in cardiovascular system, nutrition, metabolism, social and preventive medicine, clinical nutrition, diabetics, genetics, obesity, public health, sports medicine and for those wishing to run comprehensive research in this and relevant areas. The fact that the contributors are leading international researchers in this field makes this book more welcome. ASSESSMENT This book is almost a compulsory reading for anyone interested in pediatric injuries and for those wishing to run comprehensive research in this and relevant areas. The fact that the contributors are leading

  17. Child injury control: trends, themes, and controversies.

    Science.gov (United States)

    Johnston, Brian D; Ebel, Beth E

    2013-01-01

    Injury is a major cause of morbidity and mortality among US children, and an important driver of health status globally. Despite its enormous burden, injury is preventable. Over the last 10 years, significant progress has been made in the reduction of unintentional injury among US children. However, aggregate trends mask important disparities by age group, region, and injury mechanism. Basic and translation research is needed to develop and test prevention strategies to address these new or recalcitrant problems. Motor vehicle occupant injury has fallen to historic lows, but challenges remain in protecting novice drivers and managing the distraction of new technologies. Injury to pedestrians has also declined, but likely as a result of decreased exposure as fewer children walk. This calls for a broader public health perspective to promote activity while enhancing safety. Deaths due to drowning are common and illustrate the difficulty in measuring and promoting appropriate supervision. Environmental modification and use of protective products may be a more appropriate response. Concussion in sport is another challenging issue: public health laws promote identification and appropriate management of concussed athletes, but less progress has been made on primary prevention of these injuries. Unintentional poisoning is on the rise, attributable to misuse of, and overdose with, prescription opioids. Injury deaths to infants are also increasing. This trend is driven in part by better death investigation that classifies more sleep-related deaths as suffocation events. Finally, we examine a sample of cross-cutting themes and controversies in injury control that might be amenable to empiric evaluation. Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  18. The nuclear controversy as reflected in the daily newspapers

    International Nuclear Information System (INIS)

    Buire, S. van.

    1980-01-01

    The development and utilization of nuclear energy has led to conflicts of larger dimensions in our society. What has been the role of the mass communication media in this discussion. Did they fulfill their duty to inform the public, did they actively foster discussions about the facts to be considered, and did they play their part in public opinion making by publishing critical analyses. These are questions answered by this book by presenting analyses of newspaper articles on the nuclear controversy, facts and figures on the opinions and information published in the daily newspapers on the subject of nuclear energy utilization, and analyses of tendencies pro or contra nuclear energy as expressed by the various articles. By an evaluation of the history of discussions, the development and modifications of the arguments put forward and the reactions shown by the various social groups involved in the process are illustrated and commented in the light of the controversy becoming more acute. (orig./HP) [de

  19. Cancer as part of the journey: the role of spirituality in the decision to decline conventional prostate cancer treatment and to use complementary and alternative medicine.

    Science.gov (United States)

    White, Margaret; Verhoef, Marja

    2006-06-01

    The role of spirituality in patients' use of complementary and alternative medicine (CAM) approaches to cancer management has hardly been explored. To explore the role of spirituality in cancer management by men with prostate cancer who have declined conventional treatment and are using CAM. This qualitative analysis is part of a longitudinal study to assess decision making by men with prostate cancer who decline conventional treatment and use CAM. In-depth interviews were conducted at study entry (n = 29). Themes were presented to participants in focus groups to further explore and validate the interview results. For a subset of participants (n = 10), spirituality emerged as an important theme; therefore, we conducted a secondary analysis of the interview data of these men to explore the role of spirituality in cancer management and decision making. Spirituality appeared to influence all aspects of the cancer experience. Most participants intensified their use of spiritual practice after a diagnosis of prostate cancer. These practices included spiritual ceremonies, indigenous healing, prayer, meditation, and use of spiritual imagery. Themes related to the role of spirituality in cancer management include beliefs about Western medicine, the role of spiritual beliefs in treatment decision making, the use of spiritual imager y and metaphor in healing, and the impact of cancer on spirituality. The discussion of these themes draws on quotes and case examples, illustrating how spirituality influenced study participants' response to diagnosis, treatment decision making, and cancer care. Two case examples provide a more in-depth understanding of how some participants incorporated spiritual imagery and metaphor into treatment decision making and cancer care. Ways in which cancer influenced spirituality are also discussed. Having prostate cancer appeared to influence their spirituality by strengthening their links with a spiritual community, increasing feelings of gratitude

  20. Socioeconomic, Rural-Urban, and Racial Inequalities in US Cancer Mortality: Part I-All Cancers and Lung Cancer and Part II-Colorectal, Prostate, Breast, and Cervical Cancers

    International Nuclear Information System (INIS)

    Singh, K. G.; Williams, S. D.

    2011-01-01

    We analyzed socioeconomic, rural-urban, and racial inequalities in US mortality from all cancers, lung, colorectal, prostate, breast, and cervical cancers. A deprivation index and rural-urban continuum were linked to the 2003-2007 county-level mortality data. Mortality rates and risk ratios were calculated for each socioeconomic, rural-urban, and racial group. Weighted linear regression yielded relative impacts of deprivation and rural-urban residence. Those in more deprived groups and rural areas had higher cancer mortality than more affluent and urban residents, with excess risk being marked for lung, colorectal, prostate, and cervical cancers. Deprivation and rural-urban continuum were independently related to cancer mortality, with deprivation showing stronger impacts. Socioeconomic inequalities existed for both whites and blacks, with blacks experiencing higher mortality from each cancer than whites within each deprivation group. Socioeconomic gradients in mortality were steeper in nonmetropolitanlitan areas. Mortality disparities may reflect inequalities in smoking and other cancer-risk factors, screening, and treatment

  1. On the history of the nuclear controversy

    International Nuclear Information System (INIS)

    Muench, E.

    1979-01-01

    For the past ten years or so the introduction and expansion of nuclear power in a number of industrialized countries of the Western world has been accompanied by a sometimes vehement controversy. This controversy has taken many forms and, in almost all countries, has had distinct effects on the utilization of nuclear power for energy supply purposes. It has given rise to considerable delays in the completion of nuclear installations and, in one country, has even resulted in a rejection of nuclear power altogether. The different facets of the picture, i.e. public action groups opposing nuclear power, the nuclear controversy and scientists, political activities, appeals to courts of law and actions bordering on illegality, are described chronologically and their impacts are analyzed. (orig.) [de

  2. Is there a scientific nuclear controversy

    International Nuclear Information System (INIS)

    Muench, E.; Borsch, P.

    1977-01-01

    In the present rather violent discussion about the introduction of nuclear power into the energy supply system it is often alleged that even experts disagree about many aspects, which is interpreted to prove the existence of a scientific controversy in these points. This study about the existence or in existence of such controversy critically reviews both the different collections of signatures organized by scientists and the statements published in specific areas of science. Important partial aspects are the energy requirement and the ways and means available to meet it, the safety and the risks of nuclear technology, radiation exposure and biological effects, the misuse of plutonium, and reprocessing and the ultimate storage of radioactive waste. The study concludes that there is no scientific controversy about the peaceful uses of nuclear power in the sense of the term used here. (orig.) [de

  3. Distress among women taking part in surgical continuity of care for breast cancer - a mixed methods study

    DEFF Research Database (Denmark)

    Jørgensen, Lone

    during breast cancer trajectory. Overall, distress has been linked to suffering, and lower quality of life, increased admission rates, and greater health care costs. This thesis uses mixed methods to investigate the prevalence of distress among women taking part in surgical continuity of care at time...

  4. Localization particularities and development features of cancer in the medial and low thoracic parts of the esophagus

    International Nuclear Information System (INIS)

    Ragimov, R.N.

    2001-01-01

    The role of the initial localization of esophagus cancer and its growth character is important for timely diagnostics and the choice of treatment technique. The results of clinical, radiological and endoscopic examination of 195 cases of esophagus cancer are assessed. The diagnosis is verified on the basis of biopsy and histology. All 195 patients underwent the radiotherapy at ROCUS-M and AGAT-R facilities. Out of 195 cases, esophagus cancer is localized in cervical, medial and lower parts in 7, 125 and 63 patients, respectively. Macroscopically, cancer was of the exophyte from in 105 patients and the endophyte-infiltrative form in 63 patients. The analysis of gamma-therapy results is shown that the complete tumor regression is ascertained in 91 of 105 patients with the exophyte tumor following the curative radiotherapy (60-70 Gy) [ru

  5. 'Mysticism' in quantum mechanics: the forgotten controversy

    International Nuclear Information System (INIS)

    Marin, Juan Miguel

    2009-01-01

    This paper argues that a European controversy over a 'mystical' hypothesis, one assigning the mind a role to play at the material level of reality, shaped much of the debate over the interpretation of the quantum equations. It traces back the controversy to the past two decades, beginning in the late 1920s-birth of quantum theory-and concluding with Erwin Schroedinger's lectures published as 'Mind and Matter'. Becoming aware of the issues at stake can help us understand the historical, philosophical and cultural background from which today's physics emerged

  6. Varicocele: Management and the continuing controversies

    Directory of Open Access Journals (Sweden)

    P S Agbo

    2010-01-01

    Full Text Available Varicoceles have long been associated with infertility. Despite this long history, there remains much controversy regarding their aetiology and management. The aim of this review is to present the most current information on the management of varicoceles and to highlight some of the management controversies: Association of varicocele with male infertility; Management of varicocele in adolescent; safety and effectiveness of varicocele embolization and management of subclinical varicoceles. It is hoped that this review study will stimulate further research into this condition in order to find a more common ground regarding its management.

  7. MYC Targeted Long Noncoding RNA DANCR Promotes Cancer in Part by Reducing p21 Levels.

    Science.gov (United States)

    Lu, Yunqi; Hu, Zhongyi; Mangala, Lingegowda S; Stine, Zachary E; Hu, Xiaowen; Jiang, Dahai; Xiang, Yan; Zhang, Youyou; Pradeep, Sunila; Rodriguez-Aguayo, Cristian; Lopez-Berestein, Gabriel; DeMarzo, Angelo M; Sood, Anil K; Zhang, Lin; Dang, Chi V

    2018-01-01

    The MYC oncogene broadly promotes transcription mediated by all nuclear RNA polymerases, thereby acting as a positive modifier of global gene expression. Here, we report that MYC stimulates the transcription of DANCR, a long noncoding RNA (lncRNA) that is widely overexpressed in human cancer. We identified DANCR through its overexpression in a transgenic model of MYC-induced lymphoma, but found that it was broadly upregulated in many human cancer cell lines and cancers, including most notably in prostate and ovarian cancers. Mechanistic investigations indicated that DANCR limited the expression of cell-cycle inhibitor p21 (CDKN1A) and that the inhibitory effects of DANCR loss on cell proliferation could be partially rescued by p21 silencing. In a xenograft model of human ovarian cancer, a nanoparticle-mediated siRNA strategy to target DANCR in vivo was sufficient to strongly inhibit tumor growth. Our observations expand knowledge of how MYC drives cancer cell proliferation by identifying DANCR as a critical lncRNA widely overexpressed in human cancers. Significance: These findings expand knowledge of how MYC drives cancer cell proliferation by identifying an oncogenic long noncoding RNA that is widely overexpressed in human cancers. Cancer Res; 78(1); 64-74. ©2017 AACR . ©2017 American Association for Cancer Research.

  8. Examining the Effects of Childhood Cancer on the Parental Subsystem: Implications for Parents and Health Care Professionals-Part 3.

    Science.gov (United States)

    Moules, Nancy J; Estefan, Andrew; McCaffrey, Graham; Tapp, Dianne M; Strother, Douglas

    2016-11-01

    This article is the third part of a hermeneutic research study examining the impact of childhood cancer experiences on the parental relationship. In Part 1, we offered an exploration of the phenomenon with background literature; a description of the research question, method, and design; and finally a discussion of relationships that survived, thrived, or demised, with an emphasis on the notions of difference and trading. In Part 2, we furthered the interpretations to look at the complexities of issues such as teams, roles, focus, protection, intimacy, grieving, putting relationships on hold, and reclaiming them. In this article, we discuss the advice that the participants offered us and how that advice might have implications for other parents in similar situations and health care professionals working with families experiencing childhood cancer. © The Author(s) 2016.

  9. JUDGMENTS CONCERNING THE ACCOUNTING CONTROVERSIAL OVER THE REVALUATION OF ESTATE INVESTMENTS

    OpenAIRE

    Raluca Andreea Trandafir; Nicoleta Asalos

    2009-01-01

    The present work tackles as main theme the bookkeeping controversy, which is met when the two international audit standards are put face to face, especially IAS 16 that it refers to corporal immobilizations versus IAS 40, that it refers to an real investment. This work has as a goal the presentation and the differentiation of the bookkeeping controversy between the two audit international standards. In the first part of the work there are presented the two standards, IAS 16 corporal Immobiliz...

  10. Apraxia of Speech: Concepts and Controversies

    Science.gov (United States)

    Ziegler, Wolfram; Aichert, Ingrid; Staiger, Anja

    2012-01-01

    Purpose: This article was written as an editorial to a collection of original articles on apraxia of speech (AOS) in which some of the more recent advancements in the understanding of this syndrome are discussed. It covers controversial issues concerning the theoretical foundations of AOS. Our approach was motivated by a change of perspective on…

  11. The first Pico-Ficino Controversy

    DEFF Research Database (Denmark)

    Aasdalen, Unn Irene

    2011-01-01

    -scale conflict regarding how to live and die according to Platonic ideals. The themes of the controversy are firstly the interpretation of Plato’s Symposium, in particular Diotima’s speech, and secondly the practical conclusions one should draw from Plato’s fictional banquet. Ficino’s position is presented...

  12. Controversies in watermanagement : Frames and mental models

    NARCIS (Netherlands)

    Kolkman, Rien; van der Veen, A.; Geurts, Petrus A.T.M.

    2007-01-01

    Controversies in decision and policy-making processes can be analysed using frame reflection and mental model mapping techniques. The purpose of the method presented in this paper is to improve the quality of the information and interpretations available to decision makers, by surfacing and

  13. Atomic weight versus atomic mass controversy

    International Nuclear Information System (INIS)

    Holden, N.E.

    1985-01-01

    A problem for the Atomic Weights Commission for the past decade has been the controversial battle over the names ''atomic weight'' and ''atomic mass''. The Commission has considered the arguments on both sides over the years and it appears that this meeting will see more of the same discussion taking place. In this paper, I review the situation and offer some alternatives

  14. Controversy, Trials, and Crime--Oh My!

    Science.gov (United States)

    Rott, Kim

    2006-01-01

    Teenagers' innate interest with the justice system is one of the reasons that so many high school literary classics teem with criminals, controversial issues, and trials. Novels such as "To Kill a Mockingbird," "A Separate Peace," "The Crucible," and "Twelve Angry Men" feature high-impact trials. In the author's desire to tap into this interest,…

  15. Federal Judge Orders Showing of Controversial Film.

    Science.gov (United States)

    Flygare, Thomas J.

    1987-01-01

    Reviews a recent court decision in Nebraska regarding the cancellation of a controversial film on the University of Nebraska campus. The film was cancelled after a state senator threatened to close the theater if the movie was shown. The lawsuit alleged the university violated the First Amendment in cancelling the film; the judge ruled for the…

  16. The Saga of the HIV Controversy

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 14; Issue 5. The Saga of the HIV Controversy - Nobel Prize in Physiology or Medicine - 2008. Udaykumar Ranga. General Article Volume 14 Issue 5 May 2009 pp 472-498. Fulltext. Click here to view fulltext PDF. Permanent link:

  17. Controversial Novels and Censorship in the Schools.

    Science.gov (United States)

    Katz, John Stuart

    The legal history of censorship in general in the United States as well as the legal context in particular of the censorship of novels from schools is discussed. This thesis deals with four novels which have aroused substantial controversy when taught in the schools. The novels are: "The Catcher in the Rye," by J. D. Salinger, "The Adventures of…

  18. Debating Diversity: Ethics and Controversial Public Issues

    Science.gov (United States)

    Darr, Christopher R.

    2016-01-01

    Courses: Ethics, Organizational Communication, Political Communication. Objectives: After completing this unit activity, students should be able to (1) apply multiple ethical perspectives to real-world diversity issues in a debate format, and (2) explain the role of informational and social category diversity in current controversies.

  19. Pre-prosthetic surgical alterations in maxillectomy to enhance the prosthetic prognoses as part of rehabilitation of oral cancer patient.

    Science.gov (United States)

    El Fattah, H; Zaghloul, A; Pedemonte, E; Escuin, T

    2012-03-01

    After maxillectomy, prosthetic restoration of the resulting defect is an essential step because it signals the beginning of patient's rehabilitation. The obturator used to restore the defect should be comfortable, restore adequate speech, deglutition, mastication, and be cosmetically acceptable, success will depend on the size and location of the defect and the quantity and integrity of the remaining structures, in addition to pre-prosthetic surgical preparation of defect site. Preoperative cooperation between the oncologist surgeon and the maxillofacial surgeon may allow obturation of a resultant defect by preservation of the premaxilla or the tuberosity on the defect side and maintaining the alveolar bone or teeth adjacent to the defect. This study evaluates the importance of pre-prosthetic surgical alterations at the time maxillectomy on the enhancement of the prosthetic prognoses as part of the rehabilitation of oral cancer patient. The study was carried out between 2003- 2008, on 66 cancer patients(41 male-25 female) age ranged from 33 to 72 years, at National Cancer Institute, Cairo University, whom underwent maxillectomy surgery to remove malignant tumor as a part of cancer treatment. Patients were divided in two groups. Group A: Resection of maxilla followed by preprosthetic surgical preparation. Twenty-four cancer patients (13 male - 11 female). Group B: Resection of maxilla without any preprosthetic surgical preparation. Forty-two cancer patients (28 male-14 female). Outcome variables measured included facial contour and aesthetic results, speech understandability, ability to eat solid foods, oronasal separation, socializing outside the home, and return-to-work status. Flap success and donor site morbidity were also studied. To improve the prosthetic restoration of maxillary defect resulting maxillary resection as part treatment of maxillofacial tumor depends on the close cooperation between prosthodontist and surgeon, by combination of pre

  20. Third-Generation Fatty Emulsions as Part of Parenteral Feeding in Operated Cancer Patients

    Directory of Open Access Journals (Sweden)

    S. V. Lomidze

    2010-01-01

    Full Text Available Objective: to study the efficacy of third- versus secondary-generation fatty emulsions as part of parenteral nutrition in patients operated on for gastric cancer. Subjects and methods. Envelope randomization was used to make up two groups, each comprising 10 patients, operated on for gastric cancer in the scope of gastrectomy. A control group received parenteral nutrition having the following components: Lipofundin MST/LST 20%, (500 ml daily + Nutriflex 48/150 (B. Braun (1000 ml daily, 1744 kcal/day. The study group patients were given Lipoplus 20% (500 ml daily + Nutriflex 48/150 (1000 ml daily, 1745 kcal/day. Parenteral nutrition was used on postoperative days 1 to 5. Results. Nutritional status evaluation revealed a significant increase in the concentration of total protein and albumin in the control and study group patients on postoperative day 6. The use of both second- and third-generation fatty emulsions caused a significant increase in the concentration of triglycerides on day 6 after surgery; no differences were found between the groups. On day 6 following surgery, there was a significant decrease in IL-4 in both groups (p<0.05. At the same time the Lipofundin MST/LST group showed a significantly lower concentration of IL-4 than did the study group (p<0.05. After termination of a parenteral nutrition course, the study and control groups showed a significant decrease in one of the major pro-inflammatory cytokines — IL-6. Conclusion. In the study group, the serum anti-inflammatory activity of IL-4 was more evident than that in the control group and the proinflammatory activity (IL-6 concentration decreased, which can support that as compared with the second-generation fatty emulsions, third-generation ones with a balanced omega 3 to omega-6 fatty acid ratio (1:2.7 had a normalizing effect on systemic inflammatory processes and cytokine balance with increased anti-inflammatory and reduced proinflammatory activities. Key words: third

  1. Solitary pulmonary nodule and {sup 18}F-FDG PET/CT. Part 1: epidemiology, morphological evaluation and cancer probability

    Energy Technology Data Exchange (ETDEWEB)

    Mosmann, Marcos Pretto; Borba, Marcelle Alves; Macedo, Francisco Pires Negromonte; Liguori, Adriano de Araujo Lima; Villarim Neto, Arthur, E-mail: mosmann@gmail.com [Liga Norte Riograndense Contra o Cancer, Natal, RN (Brazil); Lima, Kenio Costa de [Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN (Brazil). Programa de Pos-Graduacao em Saude Coletiva

    2016-01-15

    Solitary pulmonary nodule corresponds to a common radiographic finding, which is frequently detected incidentally. The investigation of this entity remains complex, since characteristics of benign and malignant processes overlap in the differential diagnosis. Currently, many strategies are available to evaluate solitary pulmonary nodules with the main objective of characterizing benign lesions as best as possible, while avoiding to expose patients to the risks inherent to invasive methods, besides correctly detecting cases of lung cancer so as the potential curative treatment is not delayed. This first part of the study focuses on the epidemiology, the morphological evaluation and the methods to determine the likelihood of cancer in cases of indeterminate solitary pulmonary nodule. (author)

  2. Incidental findings of thyroid tissue in cervical lymph nodes: old controversy not yet resolved?

    NARCIS (Netherlands)

    Triantafyllou, A.; Williams, M.D.; Angelos, P.; Shah, J.P.; Westra, W.H.; Hunt, J.L.; Devaney, K.O.; Rinaldo, A.; Slootweg, P.J.; Gnepp, D.R.; Silver, C.; Ferlito, A.

    2016-01-01

    The clinical significance of papillary or follicular thyroid tissue incidentally discovered in cervical lymph nodes during pathological assessment of neck dissections for non-thyroid cancers of the upper aero-digestive tract is critically reviewed. Special emphasis is given to controversies over

  3. Global Banning of a Diffused Controversial Practice

    DEFF Research Database (Denmark)

    Gurses, Kerem; Giones, Ferran; Mehta, Kandarpkumar

    2017-01-01

    We study the deinstitutionalization of a controversial practice that had previously reached a level of international diffusion. We draw on international diffusion and deinstitutionalization theory to study the emergence and diffusion of the third-party ownership practice in the soccer industry. We...... use an inductive case study combining archival and interview data to study the determinants of the international diffusion of a controversial practice at a global scale, the contestation, and finally the deinstitutionalization process that resulted from the ban of the practice. We find...... that the opacity of the practice can be a diffusion driver, locally and at the international level, nevertheless the opacity also may lead to different meaning creation attempts and potential discursive battles between actors, and eventually to deinstitutionalization of the practice. This article advances our...

  4. Epistemic Authority and Genuine Ethical Controversies.

    Science.gov (United States)

    Roberts, Adam James

    2017-05-01

    In 'Professional Hubris and its Consequences', Eric Vogelstein claims that 'that there are no good arguments in favor of professional organizations taking genuinely controversial positions on issues of professional ethics'. In this response, I defend two arguments in favour of organisations taking such positions: that their stance-taking may lead to better public policy, and that it may lead to better practice by medical professionals. If either of those defences succeeds, then Vogelstein's easy path to his conclusion - that professional organisations should not take such stances - is blocked. He or others must instead look to establish that the reasons against stance-taking on genuine ethical controversies are more compelling than those for it: plausibly a more challenging task. © 2017 John Wiley & Sons Ltd.

  5. Gossip in organisations: Contexts, consequences and controversies

    OpenAIRE

    Michelson, G.; van Iverson, A.; Waddington, K.

    2010-01-01

    This article examines the key themes surrounding gossip including its contexts, the various outcomes (positive and negative) of gossip as well as a selection of challenges and controversies. The challenges which are highlighted revolve around definitional issues, methodological approaches, and ethical considerations. Our analysis suggests that the characteristics and features of gossip lend itself to a process-oriented approach whereby the beginning and, particularly, end points of gossip are...

  6. Climatic change science, experience and controversies

    International Nuclear Information System (INIS)

    Le Treut, H.; Van Ypersele, J.P.; Hallegatte, St.; Hourcade, J.Ch.

    2004-01-01

    The international scientific community, gathered in the framework of the inter-governmental group for climate evolution (Giec), has confirmed the influence of human activities on climate and on the global warming. However, this diagnosis is sometimes questioned in the press. This book, published by the institute of sustainable development, gathers a series of articles written by scientists who make comments on the last Giec reports and who outline the knowledge gained, the remaining uncertainties and the controversies. (J.S.)

  7. Congenital bronchopulmonary foregut malformations: concepts and controversies

    International Nuclear Information System (INIS)

    Newman, Beverley

    2006-01-01

    This article addresses the scope, etiology, important associations and imaging features of congenital bronchopulmonary foregut malformations. Etiologic concepts, including airway obstruction and vascular anomalies, are highlighted. Technical imaging advances, especially CT and MR, have greatly enhanced our diagnostic abilities in evaluating these lesions; however, thorough and careful assessment of all aspects of the malformation is still necessary. Several specific lesions are discussed in more detail, particularly regarding controversial issues in classification, understanding, imaging and management. (orig.)

  8. Congenital bronchopulmonary foregut malformations: concepts and controversies

    Energy Technology Data Exchange (ETDEWEB)

    Newman, Beverley [University of Pittsburgh School of Medicine and Children' s Hospital of Pittsburgh, Pittsburgh, PA (United States)

    2006-08-15

    This article addresses the scope, etiology, important associations and imaging features of congenital bronchopulmonary foregut malformations. Etiologic concepts, including airway obstruction and vascular anomalies, are highlighted. Technical imaging advances, especially CT and MR, have greatly enhanced our diagnostic abilities in evaluating these lesions; however, thorough and careful assessment of all aspects of the malformation is still necessary. Several specific lesions are discussed in more detail, particularly regarding controversial issues in classification, understanding, imaging and management. (orig.)

  9. E-cigarettes: scientific and political controversies

    OpenAIRE

    Yussuf Saloojee

    2018-01-01

    Background and challenges to implementation The e-cigarette is touted as a disruptive technology that could make combustible cigarettes obsolete. The product, its science and politics though are controversial. Intervention or response Published journal articles, reports and conference presentations on e-cigarettes were located using PubMed, plus conference, industry and other websites. These were critically reviewed. Results and lessons learnt A number of contenti...

  10. Controversies in faith and health care.

    Science.gov (United States)

    Tomkins, Andrew; Duff, Jean; Fitzgibbon, Atallah; Karam, Azza; Mills, Edward J; Munnings, Keith; Smith, Sally; Seshadri, Shreelata Rao; Steinberg, Avraham; Vitillo, Robert; Yugi, Philemon

    2015-10-31

    Differences in religious faith-based viewpoints (controversies) on the sanctity of human life, acceptable behaviour, health-care technologies and health-care services contribute to the widespread variations in health care worldwide. Faith-linked controversies include family planning, child protection (especially child marriage, female genital mutilation, and immunisation), stigma and harm reduction, violence against women, sexual and reproductive health and HIV, gender, end-of-life issues, and faith activities including prayer. Buddhism, Christianity, Hinduism, Islam, Judaism, and traditional beliefs have similarities and differences in their viewpoints. Improved understanding by health-care providers of the heterogeneity of viewpoints, both within and between faiths, and their effect on health care is important for clinical medicine, public-health programmes, and health-care policy. Increased appreciation in faith leaders of the effect of their teachings on health care is also crucial. This Series paper outlines some faith-related controversies, describes how they influence health-care provision and uptake, and identifies opportunities for research and increased interaction between faith leaders and health-care providers to improve health care. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. The Ground Zero Mosque Controversy: Implications for American Islam

    Directory of Open Access Journals (Sweden)

    Liyakat Takim

    2011-06-01

    Full Text Available The controversy surrounding the “ground zero mosque” is part of a larger debate about the place of Islam in U.S. public space. The controversy also reveals the ways in which the boundaries of American identity continue to be debated, often through struggles over who counts as a “real” American. It further demonstrates the extent to which Islam is figured as un-American and militant, and also the extent to which all Muslims are required to account for the actions of those who commit violence under the rubric of Islam. This paper will discuss how, due to the events of September 11, 2001, Muslims have engaged in a process of indigenizing American Islam. It will argue that the Park51 Islamic Community Center (or Ground Zero mosque is a reflection of this indigenization process. It will go on to argue that projects such as the Ground Zero mosque which try to establish Islam as an important part of the American religious landscape and insist on the freedom of worship as stated in the U.S. constitution, illustrate the ideological battlefield over the place of Islam in the U.S. The paper will also examine the possible ramifications of building the Park51 Islamic Community Center including how this will shape the role that Islam plays in the socio-political lives America Muslims.

  12. The approach of cancer related fatigue in rehabilitation medicine: Part II – Therapeutic interventions

    OpenAIRE

    Salca Amalia; Checiches Alexandra; Irsay Laszlo

    2015-01-01

    Starting with patient’ diagnose and continuing throughout the treatment and thereafter, cancer-related fatigue (CRF) is a distressing and disabling symptom, highly prevalent across the cancer continuum2. This is a review article mainly focusing on the rehabilitation objectives and interventions in CRF, and implementation issues, according to the report of an NCCN member institution4. Implementation is the most problematic, considering the large number of patients to whom it is addressed to...

  13. Human health effects of low doses of ionizing radiation: the BEIR III controversy

    International Nuclear Information System (INIS)

    Radford, E.P.

    1980-01-01

    Controversy in the BEIR III Subcommittee on Somatic Effects concerning human health effects of low doses of low-LET radiation has centered on (a) the appropriate dose-response relationship by which extrapolation to low doses of data obtained at relatively high doses should be governed, and (b) the appropriate human evidence which should be the basis of estimation of lifetime cancer risk from radiation exposure. It is shown that the use of the linear no-threshold dose-response relationship for extrapolation purposes is an excellent approximation that is in agreement with widely accepted fundamental radiobiological principles. The appropriate human data for derivation of cancer risks are the composite age-specific risks derived from all epidemiologic studies of human cancer resulting from partial-body and whole-body radiation exposure; this composite is in good agreement with the currently available cancer incidence dose-response data obtained from the Nagasaki Tumor Registry. The current version of BEIR III significantly underestimates the radiation-induced cancer risk because it ignores the effect of high-dose-rate, low-LET radiation on cell survival in relation to cancer induction probability, and because it emphasizes cancer mortality rather than cancer incidence. The controversy and the way in which it was resolved raises important questions about how the public and its representatives can in the future obtain objective scientific evaluations of issues that may have significant economic, social, and political implications

  14. Mobile Breast Cancer e-Support Program for Chinese Women With Breast Cancer Undergoing Chemotherapy (Part 1): Qualitative Study of Women's Perceptions.

    Science.gov (United States)

    Zhu, Jiemin; Ebert, Lyn; Guo, Dongmei; Yang, Sumei; Han, Qiuying; Chan, Sally Wai-Chi

    2018-04-11

    Women with breast cancer undergoing chemotherapy experience difficulty in accessing adequate cancer care in China. Mobile apps have the potential to provide easily accessible support for these women. However, there remains a paucity of randomized controlled trials to evaluate the effectiveness of app-based programs targeting specifically women with breast cancer undergoing chemotherapy. Moreover, women's perceptions and experiences related to using and interacting within the app-based program have rarely been reported. Therefore, an app-based Breast Cancer e-Support program was developed and evaluated using a randomized controlled trial. Based on the incorporation of Bandura's self-efficacy and social exchange theory, Breast Cancer e-Support program lasted for 12 weeks covering 4 cycles of chemotherapy and had 4 components: (1) a Learning forum, (2) a Discussion forum, (3) an Ask-the-Expert forum, and (4) a Personal Stories forum. As a part of the randomized controlled trial, the aim of this study was to explore the participants' perception of Breast Cancer e-Support program, its strengths and weaknesses, and suggestions to improve the program. A descriptive qualitative study was employed. Thirteen women with breast cancer from 2 university-affiliated hospitals in China, who were randomly allocated to the Breast Cancer e-Support program in the randomized controlled trial, were interviewed from November 2016 to February 2017. Purposive sampling was used based on women's scores of self-efficacy after the completion of the intervention. Inductive content analysis was used to analyze the transcripts, allowing the categories and subcategories to flow from the data. The qualitative interviews revealed that participants perceived the Breast Cancer e-Support program to be helpful in enhancing knowledge, improving confidence level, and promoting emotional well-being. Women also identified access to tailored advice from experts and convenience as the benefits of this program

  15. Project for the National Program of Early Diagnosis of Endometrial Cancer Part I.

    Science.gov (United States)

    Bohîlțea, R E; Ancăr, V; Cirstoiu, M M; Rădoi, V; Bohîlțea, L C; Furtunescu, F

    2015-01-01

    Endometrial cancer recorded a peak incidence in ages 60-64 years in Romania, reaching in 2013 the average value of 8.06/ 100,000 women, and 15.97/ 100,000 women within the highest risk age range, having in recent years an increasing trend, being higher in urban than in rural population. Annually, approximately 800 new cases are registered in our country. The estimated lifetime risk of a woman to develop endometrial cancer is of about 1,03%. Based on an abnormal uterine bleeding, 35% of the endometrial cancers are diagnosed in an advanced stage of the disease, with significantly diminished lifetime expectancy. Drafting a national program for the early diagnosis of endometrial cancer. We proposed a standardization of the diagnostic steps and focused on 4 key elements for the early diagnosis of endometrial cancer: investigation of abnormal uterine bleeding occurring in pre/ post-menopausal women, investigating features/ anomalies of cervical cytology examination, diagnosis, treatment and proper monitoring of precursor endometrial lesions or cancer associated endometrial lesions and screening high risk populations (Lynch syndrome, Cowden syndrome). Improving medical practice based on diagnostic algorithms addresses the four risk groups, by improving information system reporting and record keeping. Improving addressability cases by increasing the health education of the population will increase the rate of diagnosis of endometrial cancer in the early stages of the disease. ACOG = American Society of Obstetricians and Gynecologists, ASCCP = American Society for Colposcopy and Cervical Pathology, PATT = Partial Activated Thromboplastin Time, BRCA = Breast Cancer Gene, CT = Computerized Tomography, IFGO = International Federation of Gynecology and Obstetrics, HLG = Hemoleucogram, HNPCC = Hereditary Nonpolyposis Colorectal Cancer (Lynch syndrome), IHC = Immunohistochemistry, BMI = Body Mass Index, INR = International Normalized Ratio, MSI = Microsatellites instability, MSI

  16. New Reproductive Conception Technologies: Bioethics and Controversies

    Directory of Open Access Journals (Sweden)

    Marlene Tamanini

    2004-01-01

    Full Text Available This article concerns some of the multiple ethical-bioethical and gender issues in the field of new reproductive and contraceptive technologies. The literature presented points to the plurality of possible situations and approaches in a multidimensional and controversial field. It presents some ethical-bioethical principals of biomedical action found in the study of heterosexual couples who use assisted reproduction. and of medical specialists in human reproduction in southern Brazil. It presents the ethical-bioethical presumptions that sanction medical behavior and the continuity of the so-called impregnation treatments, and analyzes the mechanisms used to raise the expectations of couples who lack confidence or success.

  17. Dissociative identity disorder: a controversial diagnosis.

    Science.gov (United States)

    Gillig, Paulette Marie

    2009-03-01

    A brief description of the controversies surrounding the diagnosis of dissociative identity disorder is presented, followed by a discussion of the proposed similarities and differences between dissociative identity disorder and borderline personality disorder. The phenomenon of autohypnosis in the context of early childhood sexual trauma and disordered attachment is discussed, as is the meaning of alters or alternate personalities. The author describes recent neurosciences research that may relate the symptoms of dissociative identity disorder to demonstrable disordered attention and memory processes. A clinical description of a typical patient presentation is included, plus some recommendations for approaches to treatment.

  18. Fetal abuse and neglect: an emerging controversy.

    Science.gov (United States)

    Landwirth, J

    1987-04-01

    Advances in fetal medicine have expanded opportunities for protection of fetal health and intrauterine management of an increasing number of fetal disorders. The legal rights and duties of parents to provide necessary medical treatment for the child may extend to the prenatal period. Resolution of the conflict between the rights of the fetus to be born healthy and the pregnant woman's right of privacy is difficult and controversial. It is suggested that intrusion into a woman's individual fundamental rights for the potential benefit of her fetus should be permissible only in narrowly defined circumstances.

  19. Lessons learnt from the organ retention controversy

    International Nuclear Information System (INIS)

    Madden, D.

    2009-01-01

    This paper examines the lessons to be learnt from the organ retention controversy in the Republic of Ireland. The paper emphasises the importance of good communication between clinicians and families of deceased persons and a move away from a medical culture based on paternalism to a partnership approach between clinicians and patients based on mutual trust and understanding. A model of authorisation rather than consent is proposed as the way forward for dealing with the difficult and traumatic experience of asking families for permission to carry out a post mortem examination on their deceased child. (authors)

  20. Validation of the Intestinal Part of the Prostate Cancer Questionnaire 'QUFW94': Psychometric Properties, Responsiveness, and Content Validity

    International Nuclear Information System (INIS)

    Reidunsdatter, Randi J.; Lund, Jo-Asmund; Fransson, Per; Widmark, Anders

    2010-01-01

    Purpose: Several treatment options are available for patients with prostate cancer. Applicable and valid self-assessment instruments for assessing health-related quality of life (HRQOL) are of paramount importance. The aim of this study was to explore the validity and responsiveness of the intestinal part of the prostate cancer-specific questionnaire QUFW94. Methods and Materials: The content of the intestinal part of QUFW94 was examined by evaluation of experienced clinicians and reviewing the literature. The psychometric properties and responsiveness were assessed by analyzing HRQOL data from the randomized study Scandinavian Prostate Cancer Group 7 (SPCG)/Swedish Association for Urological Oncology 3 (SFUO). Subscales were constructed by means of exploratory factor analyses. Internal consistency was assessed by Cronbach's alpha. Responsiveness was investigated by comparing baseline scores with the 4-year posttreatment follow-up. Results: The content validity was found acceptable, but some amendments were proposed. The factor analyses revealed two symptom scales. The first scale comprised five items regarding general stool problems, frequency, incontinence, need to plan toilet visits, and daily activity. Cronbach's alpha at 0.83 indicated acceptable homogeneity. The second scale was less consistent with a Cronbach's alpha at 0.55. The overall responsiveness was found to be very satisfactory. Conclusion: Two scales were identified in the bowel dimension of the QUFW94; the first one had good internal consistency. The responsiveness was excellent, and some modifications are suggested to strengthen the content validity.

  1. Comprehensive clinical study of concurrent chemotherapy breathing IMRT middle part of locally advanced esophageal cancer

    International Nuclear Information System (INIS)

    Jung, Jae Hong; Moon, Seong Kwon; Kim, Seung Chul

    2015-01-01

    The standard treatment of locally advanced type of mid-esophageal cancer is concurrent chemoradiation therapy (CRT). We evaluated the feasibility of chemotherapy with adding docetaxel to the classical basic regimens of cisplatin plus 5-fluorouracil (5-FU) and radiotherapy up to 70.2 Gy using dose escalations for esophageal cancer. It was possible to escalate radiation treatment dose up to 70.2 Gy by the respiratory-gated intensity- modulated radiotherapy (gated-IMRT) based on the 4DCT-simulation, with improving target coverage and normal tissue (ex., lung, heart, and spinal cord) sparing. This study suggested that the definitive chemo-radiotherapy with docetaxel, cisplatin, and 5-fluorouracil (i.e., DCF-R) and gating IMRT is tolerable and active in patients with locally advanced mid-esophageal cancer (AEC)

  2. [Controversies regarding distribution, instrumentation, and competence of hemodynamics laboratories].

    Science.gov (United States)

    Olivari, Z; Piccolo, E

    2001-01-01

    user population, with interventional laboratories distributed in the reference hospitals and diagnostic laboratories in hospitals equipped with a cardiologic intensive care unit (where there is a sufficiently large user population to guarantee at least the minimum number of procedures envisaged by the standards); both parts should work in close cooperation. On this last point there was a contrasting opinion and it was not possible to reach a consensus. The Scientific Societies should formally express their views on this controversial topic, so that guidelines, standards and VRQ can be updated rapidly. The latter should constitute the reference for the procedures of accreditation to which all laboratories and cardiology departments are subjected to, and it is likely that this will be the best way to overcome the present controversy.

  3. The nuclear controversy as reflected in the daily press

    International Nuclear Information System (INIS)

    Buiren, S. van.

    1980-01-01

    Based on a content analysis of 2047 journal articles of the years 1974 to 1977 on conflicts over nuclear power plants (Wyhl, Brokdorf), the book intends to analyze the role of the media in present social conflicts. The book presents facts and figures concerning the information and opinions on nuclear power in five newspapers and the bias of these newspapers in favour of nuclear power or against it. According to the author, newspaper journalists have failed at least in one thing: to explain the dimensions of the conflict with regard to social policy and to give background information on their own opinions. On the other hand, the press has proved its independence: It is not an extended arm of industrial PR departments - at least not in the nuclear controversy. The greater part of the articles is in opposition to nuclear power. The development and modifications of the arguments stated by the various groups active in the nuclear controversy are analyzed in dependence of the increasingly aggressive nature of the conflict. (HP) [de

  4. Solitary pulmonary nodule and 18F-FDG PET/CT. Part 1: epidemiology, morphological evaluation and cancer probability

    Directory of Open Access Journals (Sweden)

    Marcos Pretto Mosmann

    2016-02-01

    Full Text Available Abstract Solitary pulmonary nodule corresponds to a common radiographic finding, which is frequently detected incidentally. The investigation of this entity remains complex, since characteristics of benign and malignant processes overlap in the differential diagnosis. Currently, many strategies are available to evaluate solitary pulmonary nodules with the main objective of characterizing benign lesions as best as possible, while avoiding to expose patients to the risks inherent to invasive methods, besides correctly detecting cases of lung cancer so as the potential curative treatment is not delayed. This first part of the study focuses on the epidemiology, the morfological evaluation and the methods to determine the likelihood of cancer in cases of indeterminate solitary pulmonary nodule.

  5. Datasprints as a method for Controversy Mapping

    DEFF Research Database (Denmark)

    Jensen, Torben Elgaard; Munk, Anders Kristian; Bach, Daniel

    2017-01-01

    A datasprint is an intensive 3-5 day workshop that brings together humanistic researchers, data experts, and stakeholders from a selected field. Together, the participants visualize and analyse a collection of data sets, which have been prepared before the datasprint. In the beginning of a datasp......A datasprint is an intensive 3-5 day workshop that brings together humanistic researchers, data experts, and stakeholders from a selected field. Together, the participants visualize and analyse a collection of data sets, which have been prepared before the datasprint. In the beginning...... of a datasprint, stakeholders present their understandings and views of the field in question. Following this, the workshop participants explore how the prepared data may shed new light on the field. The final products of a datasprint are prototypes of analyses or digital products that forms the basis for future...... collaboration between the partners. Since 2015, DIGHUMLAB has sponsored a special interest group in controversy mapping. Datasprints have proved to be a very productive format for controversy making and for creating dialogue and joint projects between humanistic researchers....

  6. Glaciers in Patagonia: Controversy and prospects

    Science.gov (United States)

    Kargel, J. S.; Alho, P.; Buytaert, W.; Célleri, R.; Cogley, J. G.; Dussaillant, A.; Guido, Z.; Haeberli, W.; Harrison, S.; Leonard, G.; Maxwell, A.; Meier, C.; Poveda, G.; Reid, B.; Reynolds, J.; Rodríguez, C. A. Portocarrero; Romero, H.; Schneider, J.

    2012-05-01

    Lately, glaciers have been subjects of unceasing controversy. Current debate about planned hydroelectric facilities—a US7- to 10-billion megaproject—in a pristine glacierized area of Patagonia, Chile [Romero Toledo et al., 2009; Vince, 2010], has raised anew the matter of how glaciologists and global change experts can contribute their knowledge to civic debates on important issues. There has been greater respect for science in this controversy than in some previous debates over projects that pertain to glaciers, although valid economic motivations again could trump science and drive a solution to the energy supply problem before the associated safety and environmental problems are understood. The connection between glaciers and climate change—both anthropogenic and natural—is fundamental to glaciology and to glaciers' practical importance for water and hydropower resources, agriculture, tourism, mining, natural hazards, ecosystem conservation, and sea level [Buytaert et al., 2010; Glasser et al., 2011]. The conflict between conservation and development can be sharper in glacierized regions than almost anywhere else. Glaciers occur in spectacular natural landscapes, but they also supply prodigious exploitable meltwater.

  7. The Reviewing of Controversial Juvenile Books: A Study.

    Science.gov (United States)

    Crow, Sherry R.

    1986-01-01

    Describes a study which examined reviewers' treatment of controversial juvenile books in Booklist, Bulletin of Center for Children's Books, Horn Book, and School Library Journal. The total number of controversial books reviewed by each journal, promptness of reviews, and extent of discussion of controversial features are discussed. (MBR)

  8. PARK2, a Large Common Fragile Site Gene, is Part of a Stress Response Network in Normal Cells that is Disrupted During the Development of Ovarian Cancer

    National Research Council Canada - National Science Library

    Smith, David I

    2005-01-01

    .... The central two questions that we want to address with this work are what role does the inactivation of Parkin play in the development of ovarian cancer and whether this gene functions as part...

  9. Cervical cancer screening in partly HPV vaccinated cohorts - A cost-effectiveness analysis

    NARCIS (Netherlands)

    S.K. Naber (Steffie); S.M. Matthijsse (Suzette); K. Rozemeijer (Kirsten); C. Penning (Corine); I.M.C.M. de Kok (Inge); M. van Ballegooijen (Marjolein)

    2016-01-01

    textabstractBackground: Vaccination against the oncogenic human papillomavirus (HPV) types 16 and 18 will reduce the prevalence of these types, thereby also reducing cervical cancer risk in unvaccinated women. This (measurable) herd effect will be limited at first, but is expected to increase over

  10. The approach of cancer related fatigue in rehabilitation medicine: Part II – Therapeutic interventions

    Directory of Open Access Journals (Sweden)

    Salca Amalia

    2015-09-01

    Full Text Available Starting with patient’ diagnose and continuing throughout the treatment and thereafter, cancer-related fatigue (CRF is a distressing and disabling symptom, highly prevalent across the cancer continuum2. This is a review article mainly focusing on the rehabilitation objectives and interventions in CRF, and implementation issues, according to the report of an NCCN member institution4. Implementation is the most problematic, considering the large number of patients to whom it is addressed to and the variety of pathologies within this group of patients. The onset of CRF is difficult to establish, because of the limitations of reporting this symptom4, but it is a valuable predictor in prognosis. The main interventions in rehabilitation applicable to these patients are discussed in correlation to the objectives of each phase of therapeutic management in cancer: pre-operatory, before, during or after radio and/or chemotherapy Conclusion: Rehabilitation interventions should be applied to all patients diagnosed with cancer, according to their phase of oncologic treatment and the objectives. This should be practiced as preventive measure, but as a therapeutic one to, considering the high incidence of CFR before diagnose.

  11. Neuropathic pain in people with cancer (part 2): pharmacological and non-pharmacological management.

    Science.gov (United States)

    Taverner, Tarnia

    2015-08-01

    The aim of this paper is to provide an overview of the management of neuropathic pain associated with cancer and to provide helpful clinical advice for nurses working with patients who may have neuropathic pain. While cancer pain is a mixed-mechanism pain, this article will focus only on neuropathic pain management. The impact of neuropathic pain on patients' quality of life is great and while many patients recover from their cancer, a significant number continue to suffer from a neuropathic pain syndrome. Management of neuropathic pain is significantly different from management of nociceptive pain with respect to pharmacological and non-pharmacological strategies. Neuropathic pain is complex, and as such requires complex management using pharmacological as well as non-pharmacological approaches. Specific drugs for neuropathic pain may be effective for some patients, but not all; therefore, ongoing and comprehensive assessment and management are required. Furthermore, these patients may require trials of several drugs before they find one that works for them. It is important for nurses to understand neuropathic pain, its manifestation, impact on quality of life and management when nursing patients with neuropathic pain associated with cancer.

  12. Eugenol and its synthetic analogues inhibit cell growth of human cancer cells (Part I)

    International Nuclear Information System (INIS)

    Carrasco A, H.; Cardona, W.; Espinoza C, L.; Gallardo, C.; Catalan M, K.; Cardile, V.; Lombardo, L.; Cuellar F, M.; Russo, A.

    2008-01-01

    Eugenol (4-allyl-2-methoxyphenol) (1) has been reported to possess antioxidant and anticancer properties. In an attempt to enhance intrinsic activity of this natural compound, some derivatives were synthesized. Eugenol was extracted from cloves oil and further, the eugenol analogues (2-6) were obtained through acetylation and nitration reactions. Eugenol (1) and its analogues (2-6) were examined by in vitro model of cancer using two human cancer cell lines: DU-145 (androgeninsensitive prostate cancer cells) and KB (oral squamous carcinoma cells). Cell viability, by tetrazolium salts assay, was measured. Lactic dehydrogenase (LDH) release was also investigated to evaluate the presence of cell toxicity as a result of cell disruption, subsequent to membrane rupture. In the examined cancer cells, all compounds showed cell-growth inhibition activity. The obtained results demonstrate that the compounds 5-allyl-3-nitrobenzene-1,2-diol (3) and 4-allyl- 2-methoxy-5-nitrophenyl acetate (5) were significantly (p 50 values in DU-145 cells of 19.02 x 10 -6 and 21.5 x 10 -6 mol L -1 , respectively, and in KB cells of 18.11 x 10 -6 and 21.26 x 10 -6 mol L -1 , respectively, suggesting that the presence of nitro and hydroxyl groups could be important in the activity of these compounds. In addition, our results seem to indicate that apoptotic cell demise appears to be induced in KB and DU-145 cells. In fact, in our experimental conditions, no statistically significant increase in LDH release was observed in cancer cells treated with eugenol and its analogues. (author)

  13. Eugenol and its synthetic analogues inhibit cell growth of human cancer cells (Part I)

    Energy Technology Data Exchange (ETDEWEB)

    Carrasco A, H.; Cardona, W. [Universidad Andres Bello, Vina del Mar (Chile). Dept. de Ciencias Quimicas]. E-mail: hcarrasco@unab.cl; Espinoza C, L.; Gallardo, C.; Catalan M, K. [Universidad Tecnica Federico Santa Maria, Valparaiso (Chile). Dept. de Quimica; Cardile, V.; Lombardo, L. [University of Catania (Italy). Dept. of Physiological Sciences; Cuellar F, M. [Universidad de Valparaiso (Chile). Facultad de Farmacia; Russo, A. [University of Catania (Italy). Dept. of Biological Chemistry, Medical Chemistry and Molecular Biology

    2008-07-01

    Eugenol (4-allyl-2-methoxyphenol) (1) has been reported to possess antioxidant and anticancer properties. In an attempt to enhance intrinsic activity of this natural compound, some derivatives were synthesized. Eugenol was extracted from cloves oil and further, the eugenol analogues (2-6) were obtained through acetylation and nitration reactions. Eugenol (1) and its analogues (2-6) were examined by in vitro model of cancer using two human cancer cell lines: DU-145 (androgeninsensitive prostate cancer cells) and KB (oral squamous carcinoma cells). Cell viability, by tetrazolium salts assay, was measured. Lactic dehydrogenase (LDH) release was also investigated to evaluate the presence of cell toxicity as a result of cell disruption, subsequent to membrane rupture. In the examined cancer cells, all compounds showed cell-growth inhibition activity. The obtained results demonstrate that the compounds 5-allyl-3-nitrobenzene-1,2-diol (3) and 4-allyl- 2-methoxy-5-nitrophenyl acetate (5) were significantly (p < 0,001) more active than eugenol, with IC{sub 50} values in DU-145 cells of 19.02 x 10{sup -6} and 21.5 x 10{sup -6} mol L{sup -1}, respectively, and in KB cells of 18.11 x 10{sup -6} and 21.26 x 10{sup -6} mol L{sup -1}, respectively, suggesting that the presence of nitro and hydroxyl groups could be important in the activity of these compounds. In addition, our results seem to indicate that apoptotic cell demise appears to be induced in KB and DU-145 cells. In fact, in our experimental conditions, no statistically significant increase in LDH release was observed in cancer cells treated with eugenol and its analogues. (author)

  14. Noninvasive diagnostic methods in primary lung cancer Part one: sputum cytology and chest radiography; Metodos diagnosticos no invasivos en cancer pulmonar primario

    Energy Technology Data Exchange (ETDEWEB)

    Bastidas, Alirio; Garcia Herreros, Plutarco; Saavedra, Alfredo; Sanchez, Edgar

    2008-07-01

    Primary lung cancer is a world wide public health problem which generates immense costs to the health system and where its cure is only achieve by an early diagnosis associated to an opportune surgical treatment. For this purpose several non invasive diagnostic methods are currently available, among them the sputum cytology, chest radiography, computed tomography scanner and the positron emission tomography. In the present article, constituted by two parts, the usefulness of these diagnostic methods as screening, diagnosis, staging and follow up tools will be discuss on the basis of the current available literature for this type of neoplasm.

  15. Metastatic canine mammary carcinomas can be identified by a gene expression profile that partly overlaps with human breast cancer profiles

    International Nuclear Information System (INIS)

    Klopfleisch, Robert; Lenze, Dido; Hummel, Michael; Gruber, Achim D

    2010-01-01

    Similar to human breast cancer mammary tumors of the female dog are commonly associated with a fatal outcome due to the development of distant metastases. However, the molecular defects leading to metastasis are largely unknown and the value of canine mammary carcinoma as a model for human breast cancer is unclear. In this study, we analyzed the gene expression signatures associated with mammary tumor metastasis and asked for parallels with the human equivalent. Messenger RNA expression profiles of twenty-seven lymph node metastasis positive or negative canine mammary carcinomas were established by microarray analysis. Differentially expressed genes were functionally characterized and associated with molecular pathways. The findings were also correlated with published data on human breast cancer. Metastatic canine mammary carcinomas had 1,011 significantly differentially expressed genes when compared to non-metastatic carcinomas. Metastatic carcinomas had a significant up-regulation of genes associated with cell cycle regulation, matrix modulation, protein folding and proteasomal degradation whereas cell differentiation genes, growth factor pathway genes and regulators of actin organization were significantly down-regulated. Interestingly, 265 of the 1,011 differentially expressed canine genes are also related to human breast cancer and, vice versa, parts of a human prognostic gene signature were identified in the expression profiles of the metastatic canine tumors. Metastatic canine mammary carcinomas can be discriminated from non-metastatic carcinomas by their gene expression profiles. More than one third of the differentially expressed genes are also described of relevance for human breast cancer. Many of the differentially expressed genes are linked to functions and pathways which appear to be relevant for the induction and maintenance of metastatic progression and may represent new therapeutic targets. Furthermore, dogs are in some aspects suitable as a

  16. Cryotherapy in Treating Patients With Lung Cancer That Has Spread to the Other Lung or Parts of the Body

    Science.gov (United States)

    2017-05-25

    Advanced Malignant Mesothelioma; Extensive Stage Small Cell Lung Cancer; Lung Metastases; Recurrent Malignant Mesothelioma; Recurrent Non-small Cell Lung Cancer; Recurrent Small Cell Lung Cancer; Stage IV Non-small Cell Lung Cancer

  17. Controversies regarding decentralism, regionalism, and local governance in Serbia

    Directory of Open Access Journals (Sweden)

    Mitrović Milovan M.

    2002-01-01

    Full Text Available The article is composed from three parts. In the first part, I emphasize the importance of theoretical and sociological discussion for the design of the model of social system reforms and stress the problems that occur in Serbia with regard to this. In the second part, I discuss public controversies regarding decentralism, regionalism, and local governance in Serbia. I advocate for regionalism that is closer to local then to para-state governance and argue for the advantages of alternative model of 'functional autonomy of different tempo', that could harmonize inherited historical geopolitical, economic, and cultural differences and reconcile current political antagonisms in Serbia. In the third part I give a proposition that envisages central (Republic administration and local (municipal and city self-governance as main levels of territorial organization of governance (with original authorities, while federal and regional levels would be complementary with it, not parallel. In that sense, I propose 15 autonomous regions for Serbia, with possibility of making 4 to 6 larger regions out of them, at different pace.

  18. Articles and contributions to the nuclear controversy - 1

    International Nuclear Information System (INIS)

    Wethe, P.I.

    1976-08-01

    In the beginning of the 1970s the public interest in nuclear power in Norway was negligible, and an active information campaign might have been interpreted as an attack on the dominant hydroelectric development policy. In 1973 the electricity authorities themselves began to propose concrete nuclear power projects. Over a very short interval of time organised protest groups emerged whose main objective was to hinder the establishment of nuclear power in their own districts. T hese have since developed into agressive national groups and in the period up to the spring of 1975 an intense press debate took place. The staff of Institutt for Atomenergi took an active part in this debate and this collection of articles and contributions gives an impression of the nuclear controversy in Norway from 1973 to 1976. (JIW)

  19. Sniffer dogs as part of a bimodal bionic research approach to develop a lung cancer screening.

    Science.gov (United States)

    Boedeker, Enole; Friedel, Godehard; Walles, Thorsten

    2012-05-01

    Lung cancer (LC) continues to represent a heavy burden for health care systems worldwide. Epidemiological studies predict that its role will increase in the near future. While patient prognosis is strongly associated with tumour stage and early detection of disease, no screening test exists so far. It has been suggested that electronic sensor devices, commonly referred to as 'electronic noses', may be applicable to identify cancer-specific volatile organic compounds in the breath of patients and therefore may represent promising screening technologies. However, three decades of research did not bring forward a clinically applicable device. Here, we propose a new research approach by involving specially trained sniffer dogs into research strategies by making use of their ability to identify LC in the breath sample of patients.

  20. Sniffer dogs as part of a bimodal bionic research approach to develop a lung cancer screening†

    Science.gov (United States)

    Boedeker, Enole; Friedel, Godehard; Walles, Thorsten

    2012-01-01

    Lung cancer (LC) continues to represent a heavy burden for health care systems worldwide. Epidemiological studies predict that its role will increase in the near future. While patient prognosis is strongly associated with tumour stage and early detection of disease, no screening test exists so far. It has been suggested that electronic sensor devices, commonly referred to as ‘electronic noses’, may be applicable to identify cancer-specific volatile organic compounds in the breath of patients and therefore may represent promising screening technologies. However, three decades of research did not bring forward a clinically applicable device. Here, we propose a new research approach by involving specially trained sniffer dogs into research strategies by making use of their ability to identify LC in the breath sample of patients. PMID:22345057

  1. Therapeutic peptides for cancer therapy. Part I - peptide inhibitors of signal transduction cascades.

    Science.gov (United States)

    Bidwell, Gene L; Raucher, Drazen

    2009-10-01

    Therapeutic peptides have great potential as anticancer agents owing to their ease of rational design and target specificity. However, their utility in vivo is limited by low stability and poor tumor penetration. The authors review the development of peptide inhibitors with potential for cancer therapy. Peptides that inhibit signal transduction cascades are discussed. The authors searched Medline for articles concerning the development of therapeutic peptides and their delivery. Given our current knowledge of protein sequences, structures and interaction interfaces, therapeutic peptides that inhibit interactions of interest are easily designed. These peptides are advantageous because they are highly specific for the interaction of interest, and they are much more easily developed than small molecule inhibitors of the same interactions. The main hurdle to application of peptides for cancer therapy is their poor pharmacokinetic and biodistribution parameters. Therefore, successful development of peptide delivery vectors could potentially make possible the use of this new and very promising class of anticancer agents.

  2. Modern molecular biomarkers of head and neck cancer. Part I. Epigenetic diagnostics and prognostics: Systematic review.

    Science.gov (United States)

    Juodzbalys, Gintaras; Kasradze, David; Cicciù, Marco; Sudeikis, Aurimas; Banys, Laurynas; Galindo-Moreno, Pablo; Guobis, Zygimantas

    2016-01-01

    Nearly half of the head and neck cancer cases are diagnosed in late stages. Traditional screening modalities have many disadvantages. The aim of the present article was to review the scientific literature about novel head and neck cancer diagnostics - epigenetic biomarkers. A comprehensive review of the current literature was conducted according to the PRISMA guidelines by accessing the NCBI PubMed database. Authors conducted the search of articles in English language published from 2004 to 2015. A total of thirty three relevant studies were included in the review. Fifteen of them concerned DNA methylation alterations, nine evaluation of abundancies in histone expressions and nine miRNA expression changes in HNC. Considerable number of epigenetic biomarkers have been identified in both tumor tissue and salivary samples. Genes with best diagnostic effectiveness rates and further studying prospects were: TIMP3, DCC, DAPK, CDH1, CCNA1, AIM1, MGMT, HIC1, PAX1, PAX5, ZIC4, p16, EDNRB, KIF1A, MINT31, CD44, RARβ , ECAD. Individual histone and miRNA alterations tend to be hnc specific. Prognostic values of separate biomarkers are ambiguous. No established standards for molecular assay of head and neck cancer was found in order to elude the paradoxical results and discrepancies in separate trials.

  3. The Controversies over Bioenergy in Denmark

    DEFF Research Database (Denmark)

    Jørgensen, Michael Søgaard; Andersen, Bente Hessellund

    2012-01-01

    convert coal fired power plants to biomass in order to sustain the role of these power plants. Their increasing use of imported wood pellets is criticized for increasing greenhouse gas emissions because of fast logging of years of forest growth. A Danish biotech company is developing enzymes...... a prominent role in several Danish climate and energy plans, alongside with wind and solar energy, and energy savings. There are major controversies about targets for bioenergy with respect to acceptable types, sources and amounts of biomass. Strong path dependency is identified. Energy companies in Denmark...... for processing of biomass for biofuels. The alignment with the private car regime is strong, because biofuel enables continuation of fuel-driven vehicles as dominating transportation mode. Danish farmers see manure as important source for biogas while arguing for reduction of climate impact and nuisances from...

  4. Element 74, the Wolfram Versus Tungsten Controversy

    Energy Technology Data Exchange (ETDEWEB)

    Holden,N.E.

    2008-08-11

    Two and a quarter centuries ago, a heavy mineral ore was found which was thought to contain a new chemical element called heavy stone (or tungsten in Swedish). A few years later, the metal was separated from its oxide and the new element (Z=74) was called wolfram. Over the years since that time, both the names wolfram and tungsten were attached to this element in various countries. Sixty years ago, IUPAC chose wolfram as the official name for the element. A few years later, under pressure from the press in the USA, the alternative name tungsten was also allowed by IUPAC. Now the original, official name 'wolfram' has been deleted by IUPAC as one of the two alternate names for the element. The history of this controversy is described here.

  5. Status Report: Black Hole Complementarity Controversy

    International Nuclear Information System (INIS)

    Lee, Bum-Hoon; Yeom, Dong-han

    2014-01-01

    Black hole complementarity was a consensus among string theorists for the interpretation of the information loss problem. However, recently some authors find inconsistency of black hole complementarity: large N rescaling and Almheiri, Marolf, Polchinski and Sully (AMPS) argument. According to AMPS, the horizon should be a firewall so that one cannot penetrate there for consistency. There are some controversial discussions on the firewall. Apart from these papers, the authors suggest an assertion using a semi-regular black hole model and we conclude that the firewall, if it exists, should affect to asymptotic observer. In addition, if any opinion does not consider the duplication experiment and the large N rescaling, then the argument is difficult to accept

  6. Epistemological depth in a GM crops controversy.

    Science.gov (United States)

    Hicks, Daniel J

    2015-04-01

    This paper examines the scientific controversy over the yields of genetically modified [GM] crops as a case study in epistemologically deep disagreements. Appeals to "the evidence" are inadequate to resolve such disagreements; not because the interlocutors have radically different metaphysical views (as in cases of incommensurability), but instead because they assume rival epistemological frameworks and so have incompatible views about what kinds of research methods and claims count as evidence. Specifically, I show that, in the yield debate, proponents and opponents of GM crops cite two different sets of claims as evidence, which correspond to two rival epistemological frameworks, classical experimental epistemology and Nancy Cartwright's evidence for use. I go on to argue that, even if both sides of the debate accepted Cartwright's view, they might still disagree over what counts as evidence, because evidence for use ties standards of evidence to what is sometimes called the "context of application." Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Drug safety: Pregnancy rating classifications and controversies.

    Science.gov (United States)

    Wilmer, Erin; Chai, Sandy; Kroumpouzos, George

    2016-01-01

    This contribution consolidates data on international pregnancy rating classifications, including the former US Food and Drug Administration (FDA), Swedish, and Australian classification systems, as well as the evidence-based medicine system, and discusses discrepancies among them. It reviews the new Pregnancy and Lactation Labeling Rule (PLLR) that replaced the former FDA labeling system with narrative-based labeling requirements. PLLR emphasizes on human data and highlights pregnancy exposure registry information. In this context, the review discusses important data on the safety of most medications used in the management of skin disease in pregnancy. There are also discussions of controversies relevant to the safety of certain dermatologic medications during gestation. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. The Social Life of Data (Prototyping Controversies)

    DEFF Research Database (Denmark)

    Jørgensen, Tobias Bornakke; Birkbak, Andreas; Petersen, Morten Krogh

    are out, which leaves it to the public to stumble upon the webpages and explore the results. This unspecified public, however, often seems to have more similarities to a void of non-engagement than a receptive social room. In this paper we take two related steps to counter the lack of public engagement...... that makes available a large relational data set on the Danish power elite (Ellersgaard et al. 2015) through an interactive data navigation tool. The tool allows visitors to explore a data set that is potentially controversial but difficult to navigate. Further, Google Analytics and a simple survey allows us...... to examine how visitors to the website were led to the site in the first place, how they made use of the data navigation tool and how customized maps from the webpage travelled into new and unpredictable arenas. The experiment thus explores the tension between publishing and making things public...

  9. An overview of the Hanford controversy

    International Nuclear Information System (INIS)

    Stewart, A.M.; Kneale, G.W.

    1991-01-01

    In 1964, the Atomic Energy Commission agreed to sponsor 'a study of the lifetime health and mortality experiences of all employees of AEC contractors.' The commission put in charge of this study a physician (Thomas Mancuso) who had recently shown how the U.S. Social Security system could be used to identify the dates and causes of death of all insured workers. As director of the AEC project, Mancuso was at liberty to include any or all the postwar offshoots of the Manhattan Project. His master plan included workers from Oak Ridge, Los Alamos, and Hanford, but it soon became apparent that his attempts to link radiation exposures to subsequent events were proving more successful at Hanford than elsewhere. The authors of this paper, who participated in the study, review the controversy surrounding its eventual publication.22 references

  10. Ibuprofen in paediatrics: pharmacology, prescribing and controversies.

    Science.gov (United States)

    Moriarty, Camilla; Carroll, Will

    2016-12-01

    Ibuprofen, a propionic acid derivative, is a non-steroidal anti-inflammatory drug. The oral formulation is widely used in paediatric practice and after paracetamol it is one of the most common drugs prescribed for children in hospital. The treatment of fever with antipyretics such as ibuprofen is controversial as fever is the normal response of the body to infection and unless the child becomes distressed or symptomatic, fever alone should not be routinely treated. Combined treatment with paracetamol and ibuprofen is commonly undertaken but almost certainly is not helpful. This article aims to describe the indications and mode of action of the drug, outline its pharmacokinetics and highlight the important key messages regarding its use in clinical practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  11. 42 CFR 405.740 - Principles for determining the amount in controversy.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Principles for determining the amount in... Reconsiderations and Appeals Under Medicare Part A § 405.740 Principles for determining the amount in controversy... more appellants, the Secretary may assert that the aggregation principles contained in this subpart may...

  12. The controversy on chronic cerebrospinal venous insufficiency

    Directory of Open Access Journals (Sweden)

    Paolo Zamboni

    2013-08-01

    Full Text Available The objective of this review is to analyze the actual scientific controversy on chronic cerebrospinal venous insufficiency (CCSVI and its association with both neurodegenerative disorders and multiple sclerosis (MS. We revised all published studies on prevalence of CCSVI in MS patients, including ultrasound and catheter venography series. Furthermore, we take into consideration other publications dealing with the pathophysiologic consequences of CCSVI in the brain, as well as ecent data characterizing the pathology of the venous wall in course of CCSVI. Finally, safety and pilot data on effectiveness of endovascular CCSVI treatment were further updated. Studies of prevalence show a big variability in prevalence of CCSVI in MS patients assessed by established ultrasonographic criteria. This could be related to high operator dependency of ultrasound. However, 12 studies, by the means of more objective catheter venography, show a prevalence >90% of CCSVI in MS. Global hypo-hypoperfusion of the brain, and reduced cerebral spinal fluid dynamics in MS was shown to be related to CCSVI. Postmortem studies and histology corroborate the 2009 International Union of Phlebology (UIP Consensus decision to insert CCSVI among venous malformations. Finally, safety of balloon angioplasty of the extracranial veins was certainly demonstrated, while prospective data on the potential effectiveness of endovascular treatment of CCSVI support to increase the level of evidence by proceeding with a randomized control trial (RCT. Taking into account the current epidemiological data, including studies on catheter venography, the autoptic findings, and the relationship between CCSVI and both hypo-perfusion and cerebro-spinal fluid flow, we conclude that CCSVI can be definitively inserted among the medical entities. Research is still inconclusive in elucidating the CCSVI role in the pathogenesis of neurological disorders. The controversy between the vascular and the

  13. Six controversial issues on subclinical Cushing's syndrome.

    Science.gov (United States)

    Chiodini, Iacopo; Albani, Adriana; Ambrogio, Alberto Giacinto; Campo, Michela; De Martino, Maria Cristina; Marcelli, Giorgia; Morelli, Valentina; Zampetti, Benedetta; Colao, Annamaria; Pivonello, Rosario

    2017-05-01

    Subclinical Cushing's syndrome is a condition of hypercortisolism in the absence of signs specific of overt cortisol excess, and it is associated with an increased risk of diabetes, hypertension, fragility fractures, cardiovascular events and mortality. The subclinical Cushing's syndrome is not rare, being estimated to be between 0.2-2 % in the adult population. Despite the huge number of studies that have been published in the recent years, several issues remain controversial for the subclinical Cushing's syndrome screening, diagnosis and treatment. The Altogether to Beat Cushing's syndrome Group was founded in 2012 for bringing together the leading Italian experts in the hypercortisolism-related diseases. This document represents the Altogether to Beat Cushing's syndrome viewpoint regarding the following controversial issues on Subclinical Cushing's syndrome (SCS): (1) Who has to be screened for subclinical Cushing's syndrome? (2) How to screen the populations at risk? (3) How to diagnose subclinical Cushing's syndrome in patients with an adrenal incidentaloma? (4) Which consequence of subclinical Cushing's syndrome has to be searched for? (5) How to address the therapy of choice in AI patients with subclinical Cushing's syndrome? (6) How to follow-up adrenal incidentaloma patients with subclinical Cushing's syndrome surgically or conservatively treated? Notwithstanding the fact that most studies that faced these points may have several biases (e.g., retrospective design, small sample size, different criteria for the subclinical Cushing's syndrome diagnosis), we believe that the literature evidence is sufficient to affirm that the subclinical Cushing's syndrome condition is not harmless and that the currently available diagnostic tools are reliable for identifying the majority of individuals with subclinical Cushing's syndrome.

  14. WE-B-207-00: CT Lung Cancer Screening Part 1

    International Nuclear Information System (INIS)

    2015-01-01

    The US National Lung Screening Trial (NLST) was a multi-center randomized, controlled trial comparing a low-dose CT (LDCT) to posterior-anterior (PA) chest x-ray (CXR) in screening older, current and former heavy smokers for early detection of lung cancer. Recruitment was launched in September 2002 and ended in April 2004 when 53,454 participants had been randomized at 33 screening sites in equal proportions. Funded by the National Cancer Institute this trial demonstrated that LDCT screening reduced lung cancer mortality. The US Preventive Services Task Force (USPSTF) cited NLST findings and conclusions in its deliberations and analysis of lung cancer screening. Under the 2010 Patient Protection and Affordable Care Act, the USPSTF favorable recommendation regarding lung cancer CT screening assisted in obtaining third-party payers coverage for screening. The objective of this session is to provide an introduction to the NLST and the trial findings, in addition to a comprehensive review of the dosimetry investigations and assessments completed using individual NLST participant CT and CXR examinations. Session presentations will review and discuss the findings of two independent assessments, a CXR assessment and the findings of a CT investigation calculating individual organ dosimetry values. The CXR assessment reviewed a total of 73,733 chest x-ray exams that were performed on 92 chest imaging systems of which 66,157 participant examinations were used. The CT organ dosimetry investigation collected scan parameters from 23,773 CT examinations; a subset of the 75,133 CT examinations performed using 97 multi-detector CT scanners. Organ dose conversion coefficients were calculated using a Monte Carlo code. An experimentally-validated CT scanner simulation was coupled with 193 adult hybrid computational phantoms representing the height and weight of the current U.S. population. The dose to selected organs was calculated using the organ dose library and the abstracted scan

  15. WE-B-207-00: CT Lung Cancer Screening Part 1

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-06-15

    The US National Lung Screening Trial (NLST) was a multi-center randomized, controlled trial comparing a low-dose CT (LDCT) to posterior-anterior (PA) chest x-ray (CXR) in screening older, current and former heavy smokers for early detection of lung cancer. Recruitment was launched in September 2002 and ended in April 2004 when 53,454 participants had been randomized at 33 screening sites in equal proportions. Funded by the National Cancer Institute this trial demonstrated that LDCT screening reduced lung cancer mortality. The US Preventive Services Task Force (USPSTF) cited NLST findings and conclusions in its deliberations and analysis of lung cancer screening. Under the 2010 Patient Protection and Affordable Care Act, the USPSTF favorable recommendation regarding lung cancer CT screening assisted in obtaining third-party payers coverage for screening. The objective of this session is to provide an introduction to the NLST and the trial findings, in addition to a comprehensive review of the dosimetry investigations and assessments completed using individual NLST participant CT and CXR examinations. Session presentations will review and discuss the findings of two independent assessments, a CXR assessment and the findings of a CT investigation calculating individual organ dosimetry values. The CXR assessment reviewed a total of 73,733 chest x-ray exams that were performed on 92 chest imaging systems of which 66,157 participant examinations were used. The CT organ dosimetry investigation collected scan parameters from 23,773 CT examinations; a subset of the 75,133 CT examinations performed using 97 multi-detector CT scanners. Organ dose conversion coefficients were calculated using a Monte Carlo code. An experimentally-validated CT scanner simulation was coupled with 193 adult hybrid computational phantoms representing the height and weight of the current U.S. population. The dose to selected organs was calculated using the organ dose library and the abstracted scan

  16. Cytotoxic and pro-oxidative effects of Imperata cylindrica aerial part ethyl acetate extract in colorectal cancer in vitro.

    Science.gov (United States)

    Kwok, Amy Ho Yan; Wang, Yan; Ho, Wing Shing

    2016-05-15

    Colorectal cancer (CRC) is the third most common cancer. Its global incidence and mortality have been on the rise. Recent strategy of therapies has involved the use of non-steroid anti-inflammatory drugs and cyclooxygenase-selective inhibitors. Aerial parts of Imperata cylindrical L. Raeusch (IMP) have been used as an anti-inflammatory agent in traditional Chinese medicine. Asarachidonate acid cascadeis often involved in inflammation-related malignancy and IMP is an anti-inflammatory agent, hence it is hypothesized that IMP aerial part ethyl acetate extract exerts cytotoxic effects on colorectal cancer cells in vitro. The HT-29 adenocarcinoma cell line was used to elucidate its pro-apoptotic activities. Flow cytometry and fluorescent microscopy were performed to assess cell cycle arrest and the accumulation of reactive oxygen species (ROS). The mRNA and hormone levels of arachidonate acid pathways were studied via quantitative reverse transcription PCR (qRT-PCR) and ELISA. The 50% growth inhibitory effect (GI50) of the IMP extract on HT-29 was measured with a value of 14.5 µg/ml. Immuno-blot and caspase-3/7 activity assay showed the pro-apoptotic effect of IMP on the activation of caspase cascade. G2/M arrest was observed via flow cytometry. The ROS activity was modulated by the IMP extraction a concentration-dependent manner in HT-29 cells. The IMP extract increased PGE2 and PGF2α levels qRT-PCR revealed that transcripts of rate-limiting PGE2- and PGF2α-biosynthetic enzymes - COX-1, mPGES1 and AKR1C3 were notably up-regulated. Among the prostanoid receptors, EP1 and FP transcripts were up-regulated while EP4 transcripts decreased. The findings suggest that the proliferative effect of PGE2, which is generally believed to associate with heightened DNA synthesis and cross-talk with MAPK pathways, is likely triggered by the pro-apoptotic or -oxidative effects exerted by IMP extract in HT-29 cells. Concurring with this notion, indomethacin (COX-1/2-inhibitor) was

  17. Clinical picture and treatment of complications of lower part of large intestine resulting from radiotherapy for intra-pelvic cancer

    International Nuclear Information System (INIS)

    Ikeda, Yoshihito; Sunagawa, Keishin; Matsumura, Shigejiro; Watanabe, Kenji; Masaoka, Yoshio

    1976-01-01

    The authors described clinical pictures and those treatments of 40 patients with complications of the lower part of the large intestine resulting from radiotherapy for cancer of the uterus, ovarium or the penis. As the radiotherapy, 60 Co-telecobalt (6,000-16,000R) and 60 Co-needle (1,000-8,568 mch) intracavitary irradiation were used alone or in combination. Findings in the complications of the lower part of the large intestine were classified into Grade I (13 cases), II (14), III (14), and IV (4) according to Sherman. The prodromal symptoms of the complications appeared in 2-6 months following the irradiation in more than a half of the patients, and it appeared within a year in most of the patients. Most of the patients complained about melena, anemia, proctagra, tenesmus and diarrhea. In the cases of Grade III, the symptoms of ileus such as constipation, abdominal distention, and abdominal pain appeared. Internal treatment was given principally, and preternal anus was made when frequent blood transfusion was required. Fourteen cases of those in Grade I and II recovered within 1-3 years. The cases which received proctostomy, including those who had bleeding, stricture and fistulation, had favorable prognosis. This result suggested that the radiotherapy for intra-pelvic cancer should be controlled to prevent further development of the complications in the rectum beyond Grade I. (Serizawa, K.)

  18. Exosomes from adriamycin-resistant breast cancer cells transmit drug resistance partly by delivering miR-222.

    Science.gov (United States)

    Yu, Dan-Dan; Wu, Ying; Zhang, Xiao-Hui; Lv, Meng-Meng; Chen, Wei-Xian; Chen, Xiu; Yang, Su-Jin; Shen, Hongyu; Zhong, Shan-Liang; Tang, Jin-Hai; Zhao, Jian-Hua

    2016-03-01

    Breast cancer (BCa) is one of the major deadly cancers in women. However, treatment of BCa is still hindered by the acquired-drug resistance. It is increasingly reported that exosomes take part in the development, metastasis, and drug resistance of BCa. However, the specific role of exosomes in drug resistance of BCa is poorly understood. In this study, we investigate whether exosomes transmit drug resistance through delivering miR-222. We established an adriamycin-resistant variant of Michigan Cancer Foundation-7 (MCF-7) breast cancer cell line (MCF-7/Adr) from a drug-sensitive variant (MCF-7/S). Exosomes were isolated from cell supernatant by ultracentrifugation. Cell viability was assessed by MTT assay and apoptosis assay. Individual miR-222 molecules in BCa cells were detected by fluorescence in situ hybridization (FISH). Then, FISH was combined with locked nucleic acid probes and enzyme-labeled fluorescence (LNA-ELF-FISH). Individual miR-222 could be detected as bright photostable fluorescent spots and then the quantity of miR-222 per cell could be counted. Stained exosomes were taken in by the receipt cells. MCF-7/S acquired drug resistance after co-culture with exosomes from MCF-7/Adr (A/exo) but did not after co-culture with exosomes from MCF-7/S (S/exo). The quantity of miR-222 in A/exo-treated MCF-7/S was significantly greater than in S/exo-treated MCF-7/S. MCF-7/S transfected with miR-222 mimics acquired adriamycin resistance while MCF-7/S transfected with miR-222 inhibitors lost resistance. In conclusion, exosomes are effective in transmitting drug resistance and the delivery of miR-222 via exosomes may be a mechanism.

  19. Our Way to Understand the World: Darwin's Controversial Inheritance

    Science.gov (United States)

    Schmidt-Salomon, Michael

    Shortly after he had completed the first draft of his theory of evolution in 1844, Charles Darwin wrote to his friend Joseph Hooker, the botanist, that publishing the theory seemed to him "like confessing a murder" (Glaubrecht 2009, p. 161). Right from the beginning, Darwin was aware of the far-reaching impact his theory would have. And this was probably one of the main reasons for his postponing the publication of his ideas for such a long time. After the completion of the 230 page text in 1844, it was another 15 years (!) before his famous book On the Origin of Species was published. Since that time 150 years have passed, but the theory of evolution is as controversial as ever. Darwin's dangerous idea is still putting many traditional world views through some very hard tests. This is the central theme to which I have devoted the following thoughts. I have divided my study into three parts: I shall start by shedding some light on the conflict between Darwin's challenging idea and traditional (Christian) beliefs, a conflict that has lasted till this very day. In the second part, I want to focus on the ideological abuse of the theory of evolution. The third and final part introduces Julian Huxley's concept of 'evolutionary humanism', which links Darwin's scientific inheritance with a distinctly humanist ethic.

  20. Group interventions for patients with cancer and HIV disease: part IV. Clinical and policy recommendations.

    Science.gov (United States)

    Leszcz, Molyn; Sherman, Allen; Mosier, Julie; Burlingame, Gary M; Cleary, Trish; Ulman, Kathleen Hubbs; Simonton, Stephanie; Latif, Umaira; Strauss, Bernhard; Hazelton, Lara

    2004-10-01

    Group interventions have assumed a growing role in primary prevention and supportive care for cancer and HIV disease. Earlier sections of this Special Report examined empirical findings for these interventions and provided recommendations for future research. The current section offers brief recommendations for service providers, policymakers, and stakeholders. Group services now occupy an increasingly prominent place in primary prevention programs and medical settings. In previous sections of this Special Report (Sherman, Leszcz et al., 2004; Sherman, Mosier et al., 2004a, 2004b) we examined the efficacy of different group interventions at different phases of cancer or HIV disease, considered characteristics of the intervention and the participants that might influence outcomes, and discussed mechanisms of action. Methodological challenges and priorities for future research were highlighted. In this, the final section, we offer brief recommendations for service providers, policymakers, and other stakeholders. We consider some of the barriers that constrain use of empirically-based group interventions and note how these programs might be implemented more widely and effectively.

  1. Proton beam radiotherapy as part of comprehensive regional nodal irradiation for locally advanced breast cancer.

    Science.gov (United States)

    Verma, Vivek; Iftekaruddin, Zaid; Badar, Nida; Hartsell, William; Han-Chih Chang, John; Gondi, Vinai; Pankuch, Mark; Gao, Ming; Schmidt, Stacey; Kaplan, Darren; McGee, Lisa

    2017-05-01

    This study evaluates acute toxicity outcomes in breast cancer patients treated with adjuvant proton beam therapy (PBT). From 2011 to 2016, 91 patients (93 cancers) were treated with adjuvant PBT targeting the intact breast/chest wall and comprehensive regional nodes including the axilla, supraclavicular fossa, and internal mammary lymph nodes. Toxicity was recorded weekly during treatment, one month following treatment, and then every 6months according to the Common Terminology Criteria for Adverse Events (CTCAE) v4.0. Charts were retrospectively reviewed to verify toxicities, patient parameters, disease and treatment characteristics, and disease-related outcomes. Median follow-up was 15.5months. Median PBT dose was 50.4 Gray relative biological effectiveness (GyRBE), with subsequent boost as clinically indicated (N=61, median 10 GyRBE). Chemotherapy, when administered, was given adjuvantly (N=42) or neoadjuvantly (N=46). Grades 1, 2, and 3 dermatitis occurred in 23%, 72%, and 5%, respectively. Eight percent required treatment breaks owing to dermatitis. Median time to resolution of dermatitis was 32days. Grades 1, 2, and 3 esophagitis developed in 31%, 33%, and 0%, respectively. PBT displays acceptable toxicity in the setting of comprehensive regional nodal irradiation. Copyright © 2017. Published by Elsevier B.V.

  2. Therapeutic peptides for cancer therapy. Part II - cell cycle inhibitory peptides and apoptosis-inducing peptides.

    Science.gov (United States)

    Raucher, Drazen; Moktan, Shama; Massodi, Iqbal; Bidwell, Gene L

    2009-10-01

    Therapeutic peptides have great potential as anticancer agents owing to their ease of rational design and target specificity. However, their utility in vivo is limited by low stability and poor tumor penetration. The authors review the development of peptide inhibitors with potential for cancer therapy. Peptides that arrest the cell cycle by mimicking CDK inhibitors or induce apoptosis directly are discussed. The authors searched Medline for articles concerning the development of therapeutic peptides and their delivery. Inhibition of cancer cell proliferation directly using peptides that arrest the cell cycle or induce apoptosis is a promising strategy. Peptides can be designed that interact very specifically with cyclins and/or cyclin-dependent kinases and with members of apoptotic cascades. Use of these peptides is not limited by their design, as a rational approach to peptide design is much less challenging than the design of small molecule inhibitors of specific protein-protein interactions. However, the limitations of peptide therapy lie in the poor pharmacokinetic properties of these large, often charged molecules. Therefore, overcoming the drug delivery hurdles could open the door for effective peptide therapy, thus making an entirely new class of molecules useful as anticancer drugs.

  3. Patient-specific radiation dose and cancer risk estimation in CT: Part II. Application to patients

    Energy Technology Data Exchange (ETDEWEB)

    Li Xiang; Samei, Ehsan; Segars, W. Paul; Sturgeon, Gregory M.; Colsher, James G.; Toncheva, Greta; Yoshizumi, Terry T.; Frush, Donald P. [Medical Physics Graduate Program, Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Medical Physics Graduate Program, Department of Physics, and Department of Biomedical Engineering, Duke University Medical Center, Durham, North Carolina 27705 (United States); Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Medical Physics Graduate Program, Duke University Medical Center, Durham, North Carolina 27705 (United States); Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 and Department of Biomedical Engineering, University of North Carolina, Chapel Hill, North Carolina 27599 (United States); Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Duke Radiation Dosimetry Laboratory, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Duke Radiation Dosimetry Laboratory, Department of Radiology, Medical Physics Graduate Program, Duke University Medical Center, Durham, North Carolina 27705 (United States); Division of Pediatric Radiology, Department of Radiology, Medical Physics Graduate Program, Duke University Medical Center, Durham, North Carolina 27710 (United States)

    2011-01-15

    Purpose: Current methods for estimating and reporting radiation dose from CT examinations are largely patient-generic; the body size and hence dose variation from patient to patient is not reflected. Furthermore, the current protocol designs rely on dose as a surrogate for the risk of cancer incidence, neglecting the strong dependence of risk on age and gender. The purpose of this study was to develop a method for estimating patient-specific radiation dose and cancer risk from CT examinations. Methods: The study included two patients (a 5-week-old female patient and a 12-year-old male patient), who underwent 64-slice CT examinations (LightSpeed VCT, GE Healthcare) of the chest, abdomen, and pelvis at our institution in 2006. For each patient, a nonuniform rational B-spine (NURBS) based full-body computer model was created based on the patient's clinical CT data. Large organs and structures inside the image volume were individually segmented and modeled. Other organs were created by transforming an existing adult male or female full-body computer model (developed from visible human data) to match the framework defined by the segmented organs, referencing the organ volume and anthropometry data in ICRP Publication 89. A Monte Carlo program previously developed and validated for dose simulation on the LightSpeed VCT scanner was used to estimate patient-specific organ dose, from which effective dose and risks of cancer incidence were derived. Patient-specific organ dose and effective dose were compared with patient-generic CT dose quantities in current clinical use: the volume-weighted CT dose index (CTDI{sub vol}) and the effective dose derived from the dose-length product (DLP). Results: The effective dose for the CT examination of the newborn patient (5.7 mSv) was higher but comparable to that for the CT examination of the teenager patient (4.9 mSv) due to the size-based clinical CT protocols at our institution, which employ lower scan techniques for smaller

  4. Topical therapy of atopic dermatitis: controversies from Hippocrates to topical immunomodulators.

    Science.gov (United States)

    Tilles, Gérard; Wallach, Daniel; Taïeb, Alain

    2007-02-01

    Although atopic dermatitis can be treated efficiently, there is still much controversy about the risk/benefit ratio of both topical corticosteroids and topical immunomodulators. Conflicting data may be found about the usefulness of bathing, diet regulation, and other therapeutic interventions. These controversies result in part from the persistence of Hippocratic doctrines in modern medical thinking. Humoralist and diathetic doctrines, as they pertain to eczema, are reviewed. The paradoxical worsening of oozing and the deadly hazards of hospitalization before the era of antibiotics are brought to mind. We hope that this historical review will improve the understanding of current controversies and help dermatologists to manage patients with atopic dermatitis and other chronic skin diseases.

  5. Family resources study: part 1: family resources, family function and caregiver strain in childhood cancer.

    Science.gov (United States)

    Panganiban-Corales, Avegeille T; Medina, Manuel F

    2011-10-31

    Severe illness can disrupt family life, cause family dysfunction, strain resources, and cause caregiver burden. The family's ability to cope with crises depends on their resources. This study sought to assess families of children with cancer in terms of family function-dysfunction, family caregiver strain and the adequacy of family resources using a new family resources assessment instrument. This is a cross-sectional study involving 90 Filipino family caregivers of children undergoing cancer treatment. This used a self-administered questionnaire composed of a new 12-item family resources questionnaire (SCREEM-RES) based on the SCREEM method of analysis, Family APGAR to assess family function-dysfunction; and Modified Caregiver Strain Index to assess strain in caring for the patient. More than half of families were either moderately or severely dysfunctional. Close to half of caregivers were either predisposed to strain or experienced severe strain, majority disclosed that their families have inadequate economic resources; many also report inaccessibility to medical help in the community and insufficient educational resources to understand and care for their patients. Resources most often reported as adequate were: family's faith and religion; help from within the family and from health providers. SCREEM-RES showed to be reliable with Cronbach's alpha of 0.80. There is good inter-item correlation between items in each domain: 0.24-0.70. Internal consistency reliability for each domain was also good: 0.40-0.92. Using 2-point scoring system, Cronbach's alpha were slightly lower: full scale (0.70) and for each domain 0.26-.82. Results showed evidence of association between family resources and family function based on the family APGAR but none between family resources and caregiver strain and between family function and caregiver strain. Many Filipino families of children with cancer have inadequate resources, especially economic; and are moderately or severely

  6. Family resources study: part 1: family resources, family function and caregiver strain in childhood cancer

    Directory of Open Access Journals (Sweden)

    Panganiban-Corales Avegeille T

    2011-10-01

    Full Text Available Abstract Background Severe illness can disrupt family life, cause family dysfunction, strain resources, and cause caregiver burden. The family's ability to cope with crises depends on their resources. This study sought to assess families of children with cancer in terms of family function-dysfunction, family caregiver strain and the adequacy of family resources using a new family resources assessment instrument. Methods This is a cross-sectional study involving 90 Filipino family caregivers of children undergoing cancer treatment. This used a self-administered questionnaire composed of a new 12-item family resources questionnaire (SCREEM-RES based on the SCREEM method of analysis, Family APGAR to assess family function-dysfunction; and Modified Caregiver Strain Index to assess strain in caring for the patient. Results More than half of families were either moderately or severely dysfunctional. Close to half of caregivers were either predisposed to strain or experienced severe strain, majority disclosed that their families have inadequate economic resources; many also report inaccessibility to medical help in the community and insufficient educational resources to understand and care for their patients. Resources most often reported as adequate were: family's faith and religion; help from within the family and from health providers. SCREEM-RES showed to be reliable with Cronbach's alpha of 0.80. There is good inter-item correlation between items in each domain: 0.24-0.70. Internal consistency reliability for each domain was also good: 0.40-0.92. Using 2-point scoring system, Cronbach's alpha were slightly lower: full scale (0.70 and for each domain 0.26-.82. Results showed evidence of association between family resources and family function based on the family APGAR but none between family resources and caregiver strain and between family function and caregiver strain. Conclusion Many Filipino families of children with cancer have inadequate

  7. Early Controversies over Athetosis: I. Clinical Features, Differentiation from other Movement Disorders, Associated Conditions, and Pathology

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    Douglas J. Lanska

    2013-03-01

    Full Text Available Background: Since the description of athetosis in 1871 by American neurologist William Alexander Hammond (1828-1900 the disorder has been a source of controversy, as were many aspects of Hammond’s career.  Methods: Review of controversies in the semi-centennial since the description of athetosis.  Results: Hammond struggled to establish athetosis as a distinct clinic-pathological entity, and had successfully predicted the striatal pathology in his initial case (albeit somewhat serendipitously.  Athetosis was, nevertheless, considered by many neurologists to be a form of post-hemiplegic chorea or part of a continuum between chorea and dystonia. European neurologists, and particularly the French, initially ignored or discounted the concept. Additional controversies arose over whether the movements persisted during sleep, whether athetosis was, or could be, associated with imbecility or insanity, and how it should be treated. Discussion: Some controversies concerning athetosis served to identify areas where knowledge was insufficient to make accurate statements, despite prior self-assured or even dogmatic statements to the contrary.  Other controversies illustrated established prejudices, even if these biases were often only apparent with the greater detachment of hindsight. 

  8. Sugars and Health Controversies: What Does the Science Say?123

    Science.gov (United States)

    Rippe, James M; Angelopoulos, Theodore J

    2015-01-01

    The consumption of sugar and its relation to various potential adverse health consequences are the subjects of considerable debate and controversy. This supplement to Advances in Nutrition provides an expanded summary of a symposium held on 26 April 2014 entitled “Sugars and Health Controversies: What Does the Science Say?” as part of the ASN Scientific Sessions and Annual Meeting at Experimental Biology 2014. The articles in the supplement discuss results of current systematic reviews and meta-analyses as well as randomized controlled trials and draw implications for public policy considerations. In addition, future research gaps are identified. Current research trials conducted with commonly consumed sugars [e.g., sucrose and high-fructose corn syrup (HFCS)] do not support a unique relation to obesity, metabolic syndrome, diabetes, risk factors for heart disease, or nonalcoholic fatty liver disease. Neurologic differences in response to studies that used pure fructose compared with pure glucose have not been confirmed using typical sugars that are consumed (i.e., sucrose and HFCS), which contain ∼50% glucose and fructose. We conclude that added sugars consumed in the normal forms in which humans consume them, at amounts typical of the human diet and for the time period studied in randomized controlled trials, do not result in adverse health consequences. Although more research trials are needed in many areas of sugar consumption and health, there is little scientific justification for recommending restricting sugar consumption below the reasonable upper limit recommended by the Dietary Guidelines for Americans, 2010 of no more than 25% of calories.

  9. Cognitive styles: Controversial issues and research problems

    Directory of Open Access Journals (Sweden)

    Natalia N. Volkova

    2016-06-01

    Full Text Available The paper presents an analytical review of cognitive styles research, considering the problems of its theory, methodology, measurement and practical applications. Issues concerning the prospects, as well as theoretical and practical relevance of cognitive styles research, are discussed. We examine the main causes leading to researchers’ declining interest to study of cognitive styles, related to theory, methodology, measurement and practical applications. The main problems discussed relate to lack of clear definition and common theoretical framework. Moreover, the number of empirical studies prevails over the one aimed at theoretical generalization of empirical results and findings, and therefore the primacy of empirics appears. We analyze the possible ways of advancing the field, suggested research programs and potential perspectives for future research. We pose questions of the relationship between cognitive styles and other psychological constructs, such as abilities and cognitive strategies. We emphasize the need to develop integrative models of cognitive styles in order to systematize and organize a large number of existing cognitive styles dimensions. The main controversial issues concerning cognitive styles’ stability and value are considered. We suggest that cognitive style is a psychological mean of cognitive tasks solving, based on both situation circumstances and subject’s current cognitive resources. Issues concerning cognitive styles may answer the question on the nature of individual differences and clarify psychological mechanisms of personality-situation interaction. Furthermore, it may serve as a basis for integrated studies at the areas of personality and cognitive psychology.

  10. Maxillary reconstruction: Current concepts and controversies

    Directory of Open Access Journals (Sweden)

    Subramania Iyer

    2014-01-01

    Full Text Available Maxillary reconstruction is still an evolving art when compared to the reconstruction of the mandible. The defects of maxilla apart from affecting the functions of the speech, swallowing and mastication also cause cosmetic disfigurement. Rehabilitation of the form and function in patients with maxillary defects is either by using an obturator prosthesis or by a surgical reconstruction. Literature is abundant with a variety of reconstructive methods. The classification systems are also varied, with no universal acceptance of any one of them. The oncologic safety of these procedures is still debated, and conclusive evidence in this regard has not emerged yet. Management of the orbit is also not yet addressed properly. Tissue engineering, that has been hyped to be one of the possible solutions for this vexing reconstructive problem, has not come out with reliable and reproducible results so far. This review article discusses the rationale and oncological safety of the reconstructing the maxillary defects, critically analyzes the classification systems, offers the different reconstructive methods and touches upon the controversies in this subject. The management of the retained and exenterated orbit associated with maxillectomy is reviewed. The surgical morbidity, complications and the recent advances in this field are also looked into. An algorithm, based on our experience, is presented.

  11. Maxillary reconstruction: Current concepts and controversies

    Science.gov (United States)

    Iyer, Subramania; Thankappan, Krishnakumar

    2014-01-01

    Maxillary reconstruction is still an evolving art when compared to the reconstruction of the mandible. The defects of maxilla apart from affecting the functions of the speech, swallowing and mastication also cause cosmetic disfigurement. Rehabilitation of the form and function in patients with maxillary defects is either by using an obturator prosthesis or by a surgical reconstruction. Literature is abundant with a variety of reconstructive methods. The classification systems are also varied, with no universal acceptance of any one of them. The oncologic safety of these procedures is still debated, and conclusive evidence in this regard has not emerged yet. Management of the orbit is also not yet addressed properly. Tissue engineering, that has been hyped to be one of the possible solutions for this vexing reconstructive problem, has not come out with reliable and reproducible results so far. This review article discusses the rationale and oncological safety of the reconstructing the maxillary defects, critically analyzes the classification systems, offers the different reconstructive methods and touches upon the controversies in this subject. The management of the retained and exenterated orbit associated with maxillectomy is reviewed. The surgical morbidity, complications and the recent advances in this field are also looked into. An algorithm, based on our experience, is presented. PMID:24987199

  12. Controversial Embodiment: Sport, Masculinity, Dis/Ability

    Directory of Open Access Journals (Sweden)

    Marilena Parlati

    2015-11-01

    Full Text Available This essay is an attempt at investigating visible forms of complex, indeed controversial embodiment, with the specific intention of concentrating on the ways they interrogate delicate issues such as disability, masculinity and prosthetic sport performance. I intend to sound the shifting boundaries between dis-ability and super-ability as manifested in iconic figures such as Stelarc and, in other fields, Oscar Pistorius, whose unsteady position as privileged/disabled bladerunner seems to require – and indeed to gather – particularly intense scrutiny. I shall introduce a few contemporary discourses on corporeality and embodiment, which focus on the ‘troubling’ nature of auxiliary organs Freud refers to in the much contended paragraph I adopt as epigraph and guiding procedural light; I shall move from Butler and Giddens to Jean-Luc Nancy’s work on transplants and/as prostheses to include theoretical debates on disintegrating embodiment and disability studies, in order to proceed towards an analysis of the short-circuiting of allegedly secure practices of (masculine embodiment in sport culture and theory.

  13. Phytosynthesis of nanoparticles: concept, controversy and application

    Science.gov (United States)

    2014-01-01

    Nanotechnology is an exciting and powerful discipline of science; the altered properties of which have offered many new and profitable products and applications. Agriculture, food and medicine sector industries have been investing more in nanotechnology research. Plants or their extracts provide a biological synthesis route of several metallic nanoparticles which is more eco-friendly and allows a controlled synthesis with well-defined size and shape. The rapid drug delivery in the presence of a carrier is a recent development to treat patients with nanoparticles of certain metals. The engineered nanoparticles are more useful in increasing the crop production, although this issue is still in infancy. This is simply due to the unprecedented and unforeseen health hazard and environmental concern. The well-known metal ions such as zinc, iron and copper are essential constituents of several enzymes found in the human system even though the indiscriminate use of similar other metal nanoparticle in food and medicine without clinical trial is not advisable. This review is intended to describe the novel phytosynthesis of metal and metal oxide nanoparticles with regard to their shape, size, structure and diverse application in almost all fields of medicine, agriculture and technology. We have also emphasized the concept and controversial mechanism of green synthesis of nanoparticles. PMID:24910577

  14. Treatment and Controversies in Paraesophageal Hernia Repair

    Directory of Open Access Journals (Sweden)

    P. Marco eFisichella

    2015-04-01

    Full Text Available Background: Historically all paraesophageal hernias were repaired surgically, today intervention is reserved for symptomatic paraesophageal hernias. In this review, we describe the indications for repair and explore the controversies in paraesophageal hernia repair, which include a comparison of open to laparoscopic paraesophageal hernia repair, the necessity of complete sac excision, the routine performance of fundoplication, and the use of mesh for hernia repair.Methods: We searched Pubmed for papers published between 1980 and 2015 using the following keywords: hiatal hernias, paraesophageal hernias, regurgitation, dysphagia, gastroesophageal reflux disease, aspiration, GERD, endoscopy, manometry, pH monitoring, proton pump inhibitors, anemia, iron deficiency anemia, Nissen fundoplication, sac excision, mesh, mesh repair. Results: Indications for paraesophageal hernia repair have changed, and currently symptomatic paraesophageal hernias are recommended for repair. In addition, it is important not to overlook iron-deficiency anemia and pulmonary complaints, which tend to improve with repair. Current practice favors a laparoscopic approach, complete sac excision, primary crural repair with or without use of mesh, and a routine fundoplication.

  15. Phytosynthesis of nanoparticles: concept, controversy and application

    Science.gov (United States)

    Husen, Azamal; Siddiqi, Khwaja Salahuddin

    2014-05-01

    Nanotechnology is an exciting and powerful discipline of science; the altered properties of which have offered many new and profitable products and applications. Agriculture, food and medicine sector industries have been investing more in nanotechnology research. Plants or their extracts provide a biological synthesis route of several metallic nanoparticles which is more eco-friendly and allows a controlled synthesis with well-defined size and shape. The rapid drug delivery in the presence of a carrier is a recent development to treat patients with nanoparticles of certain metals. The engineered nanoparticles are more useful in increasing the crop production, although this issue is still in infancy. This is simply due to the unprecedented and unforeseen health hazard and environmental concern. The well-known metal ions such as zinc, iron and copper are essential constituents of several enzymes found in the human system even though the indiscriminate use of similar other metal nanoparticle in food and medicine without clinical trial is not advisable. This review is intended to describe the novel phytosynthesis of metal and metal oxide nanoparticles with regard to their shape, size, structure and diverse application in almost all fields of medicine, agriculture and technology. We have also emphasized the concept and controversial mechanism of green synthesis of nanoparticles.

  16. VIRTUAL CURRENCY "BITCOIN" – CHALLENGES AND CONTROVERSIES

    Directory of Open Access Journals (Sweden)

    ȘOAVĂ GEORGETA

    2016-06-01

    Full Text Available In the knowledge society, when there is a rapidly evolving information technology, the virtual markets, namely the online transactions, have created the premises emergence and development of new technologies of using of finances, namely virtual coin (Bitcoin. Use of this coin appears as an alternative to traditional currencies, but they are not under the control of no body, are devoid of inflation and maintain the anonymity of users. Following the evolution of this new type of coin, we proposed in this paper to present some general aspects of this coin focusing on global controversies on using Bitcoin. We have reviewed several myths that have arisen with the development and penetration of its on market and because it is a volatile coin can generate huge gains but and huge losses, we have studied fluctuation and implications for users and investors and the attraction of the drug dealers and criminals for using virtual currency, Bitcoin. At the end of the paper, based on the analysis we have tried to outline the future of this modern payment system. Thus, we found that lately, in that its value has fluctuated strongly, and increased buyer confidence, but appeared and increased cyber attacks, and the fear that if the state has no a role in protecting citizens from fraud, we can assist at the development of financial schemes extremely dangerous. The financial experts believe that if the world banks would jointly solve all the problems, the virtual money will have a real chance of life.

  17. Lyme disease: diagnostic issues and controversies.

    Science.gov (United States)

    Aguero-Rosenfeld, Maria E; Wormser, Gary P

    2015-01-01

    The diagnosis of Lyme disease is a controversial topic. Most practitioners and scientists recognize that Lyme disease is associated with certain objective clinical manifestations supported by laboratory evidence of infection with Borrelia burgdorferi sensu lato (the etiologic agent). There are others, however, who believe that patients with Lyme disease may have a wide variety of entirely nonspecific symptoms without any objective clinical manifestation and that laboratory evidence of infection by B. burgdorferi is not required to support the diagnosis. In reality, this perspective is not evidence based and would inevitably lead to innumerable misdiagnoses, given the high frequency of medically unexplained symptoms, such as fatigue and musculoskeletal pains, in the general population. Although those espousing this viewpoint do not believe that a positive laboratory test is required, nevertheless, they often seek out and promote alternative, unapproved testing methods that frequently provide false-positive results to justify their diagnosis. Herein, we provide a brief overview of Lyme disease testing, emphasizing current usage and limitations. We also discuss the use of nonvalidated procedures and the prospects for a reduction in such testing practices in the future.

  18. Energy controversy: the role of nuclear power

    International Nuclear Information System (INIS)

    Schmidt, F.H.; Bodansky, D.

    1975-02-01

    The objective of the paper presented is to show that nuclear fission power is the best, and maybe the only, alternative source of energy. It is written for a wide range of readers, including non-scientists and scientists who are not particularly informed on the issues involved. The first question considered concerns man's need for energy; it is concluded that conservation measures alone cannot suffice. Next, the earth's energy sources are examined, and the extent of each is estimated in the simple context of the length of time it could last at present use rates. Only nuclear fission, nuclear fusion, and solar energy can provide for future time scales commensurate with man's historic past, while avoiding the possibility of catastrophic social upheaval. Fusion and solar energy are rejected on technological grounds because the world energy problem is so pressing that one cannot gamble on hopes for future technological breakthroughs. Thus, only nuclear fission meets the twin criteria of technological feasibility and adequate resource base. Each of the controversial issues surrounding nuclear fission energy is examined in some detail. The conclusion is reached that none is serious, and that nuclear fission offers by far the best energy source from environmental, economic, longevity, and overall safety standpoints

  19. The nuclear energy controversy in Austria

    International Nuclear Information System (INIS)

    Oszuszky, F.; Szeless, A.

    1981-01-01

    The sociological aspects of the energy issue have become of overwhelming importance in the last few years. As a result, traditional considerations such as the importance of adequate and cheap energy supplies as the basis for growth, and the necessity, in a time of politically uncertain oil supplies, of energy supply security and diversity, have been equalled in importance, and sometimes replaced, by arguments about the social goals to be achieved. Nuclear energy has been selected as the vehicle for a socio-political debate on the controversial issue of the application of large-scale technology. Beyond that it has acquired a symbolic role in what is really an emotional attack on the political systems, economy and culture of present day civilization. It stands for the concentration of power, the centralization of technology and society, and man's dependence on the products of that centralization. Nuclear power is seen as one of the motors of further economic growth and thus an apparent pioneer of the further destruction of our natural and social environment. (author)

  20. Some controversy about law on private security

    Directory of Open Access Journals (Sweden)

    Stajić Ljubomir

    2014-01-01

    Full Text Available The Republic of Serbia is one of the last countries that legally regulate the private security sector, which is a new conceptual system of the national security system. Since the law is expected to solve many issues and dilemmas, and bring order to the area, which by some accounts is a very profitable branch of economy. Expectations were that by the end to regulate issues such as: 1 the need for institutionalization of partnership between the public and private sectors for mutual benefit, 2 the need of expressing mutual interest to establish the desired condition of security in the entire society and 3 the need to define the mechanisms and authority to achieve mentioned above. Based on this, legal framework of private security should explicitly provide: 1 a new role of the private sector, 2 communication and data exchange between the public and private sector, 3 mandatory notification about prepared or committed criminal acts on which there is information, 4 cooperation in the tasks of necessarily protected facilities, 4 cooperation in crisis situations including natural disasters, traffic accidents, strikes, sabotage, terrorist attacks, etc., 5 cooperate in the selection and training of staff and 6 cooperation in planning activities and project design of security. This paper presents a critical review of some theoretical and professional controversies in the solutions provided by law, for the purpose of answering whether it is achieving the purpose of passing of such a legal act.

  1. Metastatic Cancer

    Science.gov (United States)

    Metastatic cancer is cancer that spreads from its site of origin to another part of the body. Learn how cancer spreads, possible symptoms, common sites where cancer spreads, and how to find out about treatment options.

  2. Science motivation by discussion and controversy (SMDC) model

    Science.gov (United States)

    Izadi, Dina; Mora Ley, César Eduardo; Ramírez Díaz, Mario Humberto

    2017-05-01

    Succeeding theories and empirical investigations have often been built over conceptual understanding to develop talent education. Opportunities provided by society are crucial at every point in the talent-development process. Abilities differ and can vary among boys and girls. Although they have some responsibility for their own growth and development, the educational system and psychosocial variables influence on the successful development of high levels of education. This research explores students’ attitudes to science education to establish why many disengage with the subject in class and what can be done to reverse this trend to produce unimaginable scientific and practical benefits to society. The control group is students from several schools with traditional education in Iran and the experimental group is teams who have taken part in several activities such as national and international tournaments (2005-2013). This research has two parts: 1—how innovation in teaching and 2—discussion and controversy in class can improve science education and cause motivation. The average scores are divided into 5 ranges in both experimental and traditional groups. As shown by Spearman’s correlation rank (ρ) the difference between boys’ and girls’ average scores is about (2.71) in the control group but it has decreased to (0.29) in the experimental group. The main point of discussion is on problems in class which advance a set of interrelated scientific arguments for outstanding achievement.

  3. [Resection of the Distal Part of the Gastric Tube for the Gastric Tube Cancer after Esophagectomy - A Case Report].

    Science.gov (United States)

    Makutani, Yusuke; Shiraishi, Osamu; Iwama, Mitsuru; Hiraki, Yoko; Kato, Hiroaki; Yasuda, Atsushi; Shinkai, Masayuki; Imano, Motohiro; Kimura, Yutaka; Imamoto, Haruhiko; Yasuda, Takushi

    2017-11-01

    A 76-year-old man was admitted to our hospital for treatment of gastric tube cancer(cT2N0M0, cStage II A)detected by a screening upper gastrointestinal endoscopy. Seven years previously, he had undergone subtotal esophagectomy for esophageal cancer with gastric pull-up via the retrosternal route. At that time, he experienced cardiopulmonary arrest due to ventric- ular tachycardia. He was in a state of poor nutrition(BMI 15 kg/m2). Therefore, reducing operative stress as much as possible, minimizing complications after surgery, and aiming for a satisfactory postoperative course are all important goals. Based on his past history, we performed distal gastrectomy(resection of the distal part of the gastric tube)without excision of the right gastroepiploic artery. The postoperative course was uneventful. He was discharged 40 days after surgery. By considering the risks of surgery due to cardiac dysfunction and malnutrition, we were able to provide effective and safe therapy for the patient.

  4. Chest wall – underappreciated structure in sonography. Part II: Non-cancerous lesions

    Directory of Open Access Journals (Sweden)

    Andrzej Smereczyński

    2017-12-01

    Full Text Available The chest wall is a vast and complex structure, hence the wide range of pathological conditions that may affect it. The aim of this publication is to discuss the usefulness of ultrasound for the diagnosis of benign lesions involving the thoracic wall. The most commonly encountered conditions include sternal and costal injuries and thoracic lymphadenopathy. Ultrasound is very efficient in identifying the etiology of pain experienced in the anterior chest wall following CPR interventions. Both available literature and the authors’ own experience prompt us to propose ultrasound evaluation as the first step in the diagnostic workup of chest trauma, as it permits far superior visualization of the examined structures compared with conventional radiography. Sonographic evaluation allows correct diagnosis in the case of various costal and chondral defects suspicious for cancer. It also facilitates diagnosis of such conditions as degenerative lesions, subluxation of sternoclavicular joints (SCJs and inflammatory lesions of various etiology and location. US may be used as the diagnostic modality of choice in conditions following thoracoscopy or thoracotomy. It may also visualize the fairly common sternal wound infection, including bone inflammation. Slipping rib syndrome, relatively little known among clinicians, has also been discussed in the study. A whole gamut of benign lesions of thoracic soft tissues, such as enlarged lymph nodes, torn muscles, hematomas, abscesses, fissures, scars or foreign bodies, are all easily identified on ultrasound, just like in other superficially located organs.

  5. Human Lung Cancer Risks from Radon – Part I - Influence from Bystander Effects - A Microdose Analysis

    Science.gov (United States)

    Leonard, Bobby E.; Thompson, Richard E.; Beecher, Georgia C.

    2010-01-01

    Since the publication of the BEIR VI report in 1999 on health risks from radon, a significant amount of new data has been published showing various mechanisms that may affect the ultimate assessment of radon as a carcinogen, at low domestic and workplace radon levels, in particular the Bystander Effect (BE) and the Adaptive Response radio-protection (AR). We analyzed the microbeam and broadbeam alpha particle data of Miller et al. (1995, 1999), Zhou et al. (2001, 2003, 2004), Nagasawa and Little (1999, 2002), Hei et al. (1999), Sawant et al. (2001a) and found that the shape of the cellular response to alphas is relatively independent of cell species and LET of the alphas. The same alpha particle traversal dose response behavior should be true for human lung tissue exposure to radon progeny alpha particles. In the Bystander Damage Region of the alpha particle response, there is a variation of RBE from about 10 to 35. There is a transition region between the Bystander Damage Region and Direct Damage Region of between one and two microdose alpha particle traversals indicating that perhaps two alpha particle “hits” are necessary to produce the direct damage. Extrapolation of underground miners lung cancer risks to human risks at domestic and workplace levels may not be valid. PMID:21731539

  6. From the Bench to the Clinic Part 1: Martin McIntosh, Ph.D., Introduces His Lab's Immunotherapy Research | Office of Cancer Genomics

    Science.gov (United States)

    The field of immunotherapy is rapidly advancing and genomics techniques are being incorporated to add a “precision” approach. OCG spoke with two CTD2 investigators from the Fred Hutchinson Cancer Research Center (FHCRC) about new advances in immunotherapy. For the first article of this two-part series, we interviewed Martin McIntosh, Ph.D., member of the Fred Hutchinson Translational Research program and previously Program Head in Computational Biology at FHCRC/University of Washington Comprehensive Cancer Center.

  7. Addressing the nuclear controversy on university campuses

    International Nuclear Information System (INIS)

    Keyes, G.B.; Poncelet, C.G.

    1977-01-01

    A strong anti-nuclear sentiment exists on many university campuses. Young minds are eager to adopt causes which purport to reflect new intellectual approaches to social, political, and economic issues. Hence, the opposition to nuclear power can be made to seem to be based on: 1) technical study of nuclear plants; 2) concern for the environment; 3) concern for public health and safety; 4) requirements for an improved economic order; and 5) demand for public decision on technical issues. All of these elements have the potential of attracting student and faculty interest and support. To contend with this problem, our company decided to attempt to achieve a dialogue with the student and faculty audiences. A small group of young nuclear engineers was chosen to undergo comprehensive training on the controversy and contemporary campus issues in the states to be visited. The selection and training emphasized the ability of the engineers to relate to the students as their peers. They were encouraged to speak candidly and for themselves. Thus, they were not burdened with the image of being viewed merely as typical corporate spokesmen. The rapport made possible by this approach is a very important element in the success of such an effort. Invitations to debate before student audiences were issued to leading opposition groups; also, to the news media to report the events. Response by the media has been outstandingly favorable: not only has the coverage been extensive, but it has carried the pro-nuclear arguments to large audiences on a scale and with a credibility not otherwise achievable. The results to date have been extremely encouraging. Other countries are invited to learn more about the ''Campus America'' program in order to evaluate whether or not such an approach, with appropriate modification, could prove effective in their own situations

  8. Cold dark matter: Controversies on small scales.

    Science.gov (United States)

    Weinberg, David H; Bullock, James S; Governato, Fabio; Kuzio de Naray, Rachel; Peter, Annika H G

    2015-10-06

    The cold dark matter (CDM) cosmological model has been remarkably successful in explaining cosmic structure over an enormous span of redshift, but it has faced persistent challenges from observations that probe the innermost regions of dark matter halos and the properties of the Milky Way's dwarf galaxy satellites. We review the current observational and theoretical status of these "small-scale controversies." Cosmological simulations that incorporate only gravity and collisionless CDM predict halos with abundant substructure and central densities that are too high to match constraints from galaxy dynamics. The solution could lie in baryonic physics: Recent numerical simulations and analytical models suggest that gravitational potential fluctuations tied to efficient supernova feedback can flatten the central cusps of halos in massive galaxies, and a combination of feedback and low star formation efficiency could explain why most of the dark matter subhalos orbiting the Milky Way do not host visible galaxies. However, it is not clear that this solution can work in the lowest mass galaxies, where discrepancies are observed. Alternatively, the small-scale conflicts could be evidence of more complex physics in the dark sector itself. For example, elastic scattering from strong dark matter self-interactions can alter predicted halo mass profiles, leading to good agreement with observations across a wide range of galaxy mass. Gravitational lensing and dynamical perturbations of tidal streams in the stellar halo provide evidence for an abundant population of low-mass subhalos in accord with CDM predictions. These observational approaches will get more powerful over the next few years.

  9. Addressing the nuclear controversy on university campuses

    International Nuclear Information System (INIS)

    Keyes, G.B.; Poncelet, C.G.

    1977-01-01

    A strong anti-nuclear sentiment exists on many university campuses. Young minds are eager to adopt causes which purport to reflect new intellectual approaches to social, political and economic issues. Hence, the opposition to nuclear power can be made to seem to be based on: (1) technical study of nuclear plants; (2) concern for the environment; (3) concern for public health and safety; (4) requirements for an improved economic order; and (5) demand for public decision on technical issues. All these elements could attract student and faculty interest and support. To contend with this problem in the USA, Westinghouse Electric Corporation attempted to achieve a dialogue with the student and faculty audiences. The development and results of the programme up to mid-1977 are reported in this paper. A small group of young nuclear engineers was chosen to undergo comprehensive training on the controversy and contemporary campus issues in the States to be visited. Selection and training emphasized the ability of the engineers to relate to the students as their peers. They were encouraged to speak candidly and for themselves. Thus, they did not give the impression of being merely typical corporate spokesmen. The rapport made possible by this approach is very important to the success of such an effort. Invitations to debate before student audiences were issued to leading opposition groups and to the news media. Response by the media has been outstandingly favourable: not only has the coverage been extensive, but it has carried the pro-nuclear arguments to large audiences on a scale and with a credibility not otherwise achievable. The results up to May 1977, in eight States, have been extremely encouraging. Other countries are invited to learn more about the ''Campus America'' programme in order to evaluate whether or not such an approach, with appropriate modification, could prove effective in their own situations. (author)

  10. Automated discovery systems and the inductivist controversy

    Science.gov (United States)

    Giza, Piotr

    2017-09-01

    The paper explores possible influences that some developments in the field of branches of AI, called automated discovery and machine learning systems, might have upon some aspects of the old debate between Francis Bacon's inductivism and Karl Popper's falsificationism. Donald Gillies facetiously calls this controversy 'the duel of two English knights', and claims, after some analysis of historical cases of discovery, that Baconian induction had been used in science very rarely, or not at all, although he argues that the situation has changed with the advent of machine learning systems. (Some clarification of terms machine learning and automated discovery is required here. The key idea of machine learning is that, given data with associated outcomes, software can be trained to make those associations in future cases which typically amounts to inducing some rules from individual cases classified by the experts. Automated discovery (also called machine discovery) deals with uncovering new knowledge that is valuable for human beings, and its key idea is that discovery is like other intellectual tasks and that the general idea of heuristic search in problem spaces applies also to discovery tasks. However, since machine learning systems discover (very low-level) regularities in data, throughout this paper I use the generic term automated discovery for both kinds of systems. I will elaborate on this later on). Gillies's line of argument can be generalised: thanks to automated discovery systems, philosophers of science have at their disposal a new tool for empirically testing their philosophical hypotheses. Accordingly, in the paper, I will address the question, which of the two philosophical conceptions of scientific method is better vindicated in view of the successes and failures of systems developed within three major research programmes in the field: machine learning systems in the Turing tradition, normative theory of scientific discovery formulated by Herbert Simon

  11. Lichen Planus Pigmentosus: The Controversial Consensus

    Science.gov (United States)

    Ghosh, Aparajita; Coondoo, Arijit

    2016-01-01

    A pigmented variant of lichen planus (LP) was first reported from India in 1974 by Bhutani et al. who coined the term LP pigmentosus (LPP) to give a descriptive nomenclature to it. LP has a number of variants, one of which is LPP. This disease has also later been reported from the Middle East, Latin America, Korea, and Japan, especially in people with darker skin. It has an insidious onset. Initially, small, black or brown macules appear on sun-exposed areas. They later merge to form large hyperpigmented patches. The disease principally affects the sun-exposed areas of the body such as the face, trunk, and upper extremities. The oral mucosa may rarely be involved. However, the palms, soles, and nails are not affected. Histologically, the epidermis is atrophic along with vacuolar degeneration of basal cell layer. The dermis exhibits incontinence of pigment with scattered melanophages and a sparse follicular or perivascular infiltrate. There is a considerable similarity in histopathological findings between LPP and erythema dyschromicum perstans. However, there are immunologic and clinical differences between the two. These observations have led to a controversy regarding the identity of the two entities. While some dermatologists consider them to be the same, others have opined that the two should be considered as distinctly different diseases. A number of associations such as hepatitis C virus infection, frontal fibrosing alopecia, acrokeratosis of Bazex and nephrotic syndrome have been reported with LPP. A rare variant, LPP inversus, with similar clinical and histopathological findings was reported in 2001. As opposed to LPP, this variant occurs in covered intertriginous locations such as groins and axillae and mostly affects white-skinned persons. PMID:27688435

  12. Cervical Cancer Screening in Partly HPV Vaccinated Cohorts - A Cost-Effectiveness Analysis.

    Directory of Open Access Journals (Sweden)

    Steffie K Naber

    Full Text Available Vaccination against the oncogenic human papillomavirus (HPV types 16 and 18 will reduce the prevalence of these types, thereby also reducing cervical cancer risk in unvaccinated women. This (measurable herd effect will be limited at first, but is expected to increase over time. At a certain herd immunity level, tailoring screening to vaccination status may no longer be worth the additional effort. Moreover, uniform screening may be the only viable option. We therefore investigated at what level of herd immunity it is cost-effective to also reduce screening intensity in unvaccinated women.We used the MISCAN-Cervix model to determine the optimal screening strategy for a pre-vaccination population and for vaccinated women (~80% decreased risk, assuming a willingness-to-pay of €50,000 per quality-adjusted life year gained. We considered HPV testing, cytology testing and co-testing and varied the start age of screening, the screening interval and the number of lifetime screens. We then calculated the incremental cost-effectiveness ratio (ICER of screening unvaccinated women with the strategy optimized to the pre-vaccination population as compared to with the strategy optimized to vaccinated women, assuming different herd immunity levels.Primary HPV screening with cytology triage was the optimal strategy, with 8 lifetime screens for the pre-vaccination population and 3 for vaccinated women. The ICER of screening unvaccinated women 8 times instead of 3 was €28,085 in the absence of herd immunity. At around 50% herd immunity, the ICER reached €50,000.From a herd immunity level of 50% onwards, screening intensity based on the pre-vaccination risk level becomes cost-ineffective for unvaccinated women. Reducing the screening intensity of uniform screening may then be considered.

  13. 16 CFR 2.3 - Policy as to private controversies.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Policy as to private controversies. 2.3 Section 2.3 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE... other action when the alleged violation of law is merely a matter of private controversy and does not...

  14. From Classroom to Controversy: Conflict in the Teaching of Religion

    Science.gov (United States)

    Neal, Lynn S.

    2013-01-01

    What happens when a class assignment becomes a source of controversy? How do we respond? What do we learn? By describing the controversy surrounding an assignment on religion and representation, this article examines conflict's productive role in teaching about New Religious Movements (NRMs) and religion. It suggests that we consider how our…

  15. Current controversies and future perspectives in chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Agustí, Alvar; Vestbo, Jørgen

    2011-01-01

    Over the past decade there has been much research and interest in COPD. As a result, the understanding and management of the disease has improved significantly. Yet, there are many uncertainties and controversies that require further work. This review discusses these controversies and anticipates...... some of the changes that may occur in the near future in the field of COPD....

  16. Covering Conflict and Controversy: Measuring Balance, Fairness, Defamation.

    Science.gov (United States)

    Simon, Todd F.; And Others

    1989-01-01

    Measures balance, fairness, and defamation in local stories containing controversy and covering law enforcement, education, local government, and business. Finds that most stories lack balance and that the opposing side of the controversy was not contacted in 28 percent of the instances. (RS)

  17. Current controversies and future perspectives in chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Agustí, Alvar; Vestbo, Jørgen

    2011-01-01

    Over the past decade there has been much research and interest in COPD. As a result, the understanding and management of the disease has improved significantly. Yet, there are many uncertainties and controversies that require further work. This review discusses these controversies and anticipates...

  18. Ego Involvement and Topic Controversiality as Related to Attitude Change.

    Science.gov (United States)

    Sledden, Elizabeth A.; Fernandez, Katherine A.

    Attitude change was measured on four different topics before and immediately after a persuasion was presented in order to compare the degree of change with the level of ego involvement as it relates to topic controversiality. Ego involvement was based on self-ratings of concern for each topic. Objective topic controversiality was based on the…

  19. Predicting Public Acceptability in Controversial Technologies

    International Nuclear Information System (INIS)

    Bruce, Donald M.

    2003-01-01

    Technology and society have a synergic relationship. New technologies are a product of the values and aspirations of the culture in which they emerge. In turn, each new technology shapes and alters these values and aspirations, to a greater or lesser degree. The acceptance by society of any particular technology depends, however, on how far the values embodied in the technology reflect those of the wider society, or only those of some privileged sector - perhaps a ruling elite, a group of academic researchers, a commercial company, or even a special interest group. As public disquiet about controversial technologies has grown, their acceptance can no longer be taken for granted. It is now becoming more important to evaluate in advance the degree of likely mismatch between the aspirations of the technologists and the values of society. This paper explores one approach to making this evaluation, based on the notion of a conditional social contract between technology and society. A given society may be prepared to embrace a new technology to deliver certain benefits, and may accept a certain degree of risk and adaptation of life styles, provided certain basic conditions are fulfilled. These conditions include the upholding of basic values, familiarity, how it compares with similar technologies, the degree of control and choice, trust in those in control, the nature of any risks, the tangible benefits, and the media profile given to the new area. If several of these factors are not fulfilled, the technology is unlikely to be accepted. This was dramatically illustrated in the UK public reaction to food products derived from imported US GM soya and maize. These failed nearly all the conditions, so that public rejection should have been seen as a foregone conclusion. In the light of this, the likely public reaction to a number of future biotechnological innovations is assessed, based on the same conditions. Some examples taken from the energy sector are also compared. The

  20. Why Map Issues? On Controversy Analysis as a Digital Method.

    Science.gov (United States)

    Marres, Noortje

    2015-09-01

    This article takes stock of recent efforts to implement controversy analysis as a digital method in the study of science, technology, and society (STS) and beyond and outlines a distinctive approach to address the problem of digital bias. Digital media technologies exert significant influence on the enactment of controversy in online settings, and this risks undermining the substantive focus of controversy analysis conducted by digital means. To address this problem, I propose a shift in thematic focus from controversy analysis to issue mapping. The article begins by distinguishing between three broad frameworks that currently guide the development of controversy analysis as a digital method, namely, demarcationist, discursive, and empiricist. Each has been adopted in STS, but only the last one offers a digital "move beyond impartiality." I demonstrate this approach by analyzing issues of Internet governance with the aid of the social media platform Twitter.

  1. KNOW NUKES: a model for teaching controversial issues

    International Nuclear Information System (INIS)

    Thomashow, M.S.

    1986-01-01

    This dissertation articulates elements of an educational strategy derived from the experience of the KNOW NUKES program, a teacher training project designed to introduce the nuclear power controversy in the high school classroom. This strategy can be used as means of furthering the effectiveness of controversial issues education, not only in the area of nuclear power, but in teaching about any environmental issue. This is specifically achieved by (2) placing the KNOW NUKES institute in the broader context of controversial issues education; (2) describing in detail KNOW NUKES project planning; (3) reviewing the structure and content of the various teaching techniques and materials that have been developed for the KNOW NUKES institute; (4) utilizing a particular technique developed by the institute that reveals varying perspectives on controversial issues, in this case, an instrumental for decoding the controversial issues that are explicit and implicit in corporate image advertisements; and (5) qualitatively evaluating the practical implementation of the KNOW NUKES model

  2. The IARC monographs: critics and controversy.

    Science.gov (United States)

    Samet, Jonathan M

    2015-07-01

    The monograph program of the International Agency for Research on Cancer (IARC), which relies on the efforts of volunteer Working Groups, uses a transparent approach to evaluate the carcinogenicity of agents for which scoping has determined that there is sufficient evidence to warrant a review. Because of the potentially powerful implications of the conclusions of the monographs and the sometimes challenging nature of the evidence reviewed, the monographs and the IARC process have been criticized from time to time. This commentary describes the IARC monograph process and addresses recent criticisms of the program, drawing on a recent defense of the program authored by 124 researchers. These authors concluded that the IARC processes are robust and transparent and not flawed and biased as suggested by some critics. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  3. LNT-an apparent rather than a real controversy?

    Energy Technology Data Exchange (ETDEWEB)

    Charles, M W [School of Physics and Astronomy, University of Birmingham, Edgbaston, Birmingham B15 2TT (United Kingdom)

    2006-09-15

    Can the carcinogenic risks of radiation that are observed at high doses be extrapolated to low doses? This question has been debated through the whole professional life of the author-now nearing four decades. In its extreme form the question relates to a particular hypothesis (LNT) used widely by the international community for radiological protection applications. The linear no-threshold (LNT) hypothesis propounds that the extrapolation is linear and that it extends down to zero dose. The debate on the validity of LNT has increased dramatically in recent years. This is in no small part due to concern that exaggerated risks at low doses leads to undue amounts of societal resources being used to reduce man-made human exposure and because of the related growing public aversion to diagnostic and therapeutic medical exposures. The debate appears to be entering a new phase. There is a growing realisation of the limitations of fundamental data and the scientific approach to address this question at low doses. There also appears to be an increasing awareness that the assumptions necessary for a workable and acceptable system of radiological protection at low doses must necessarily be based on considerable pragmatism. Recent developments are reviewed and a historical perspective is given on the general nature of controversies in radiation protection over the years. All the protagonists in the debate will at the end of the day probably be able to claim that they were right{exclamation_point} (opinion)

  4. Developing a Philippine Cancer Grid. Part 1: Building a Prototype for a Data Retrieval System for Breast Cancer Research Using Medical Ontologies

    Science.gov (United States)

    Coronel, Andrei D.; Saldana, Rafael P.

    Cancer is a leading cause of morbidity and mortality in the Philippines. Developed within the context of a Philippine Cancer Grid, the present study used web development technologies such as PHP, MySQL, and Apache server to build a prototype data retrieval system for breast cancer research that incorporates medical ontologies from the Unified Medical Language System (UMLS).

  5. Systematic Review of Occupational Therapy and Adult Cancer Rehabilitation: Part 2. Impact of Multidisciplinary Rehabilitation and Psychosocial, Sexuality, and Return-to-Work Interventions.

    Science.gov (United States)

    Hunter, Elizabeth G; Gibson, Robert W; Arbesman, Marian; D'Amico, Mariana

    This article is the second part of a systematic review of evidence for the effectiveness of cancer rehabilitation interventions within the scope of occupational therapy that address the activity and participation needs of adult cancer survivors. This article focuses on the use of multidisciplinary rehabilitation and interventions that address psychosocial outcomes, sexuality, and return to work. Strong evidence indicates that multidisciplinary rehabilitation benefits cancer survivors and that psychosocial strategies can reduce anxiety and depression. Moderate evidence indicates that interventions can support survivors in returning to the level of sexuality desired and help with return to work. Part 1 of the review also appears in this issue. Copyright © 2017 by the American Occupational Therapy Association, Inc.

  6. The design of an enzyme: a chronology on the controversy.

    Science.gov (United States)

    Buc, Henri

    2013-05-13

    After the publication of the Monod-Wyman-Changeux model, a controversy arose between Jacques Monod, Francis Crick and Jeffries Wyman about the comparison of the regulatory performances of an oligomer undergoing a concerted transition between two states and a monomer having the same composition and subjected to a similar conformational equilibrium. The controversy took place between September 1965 and March 1966. It gave rise to several unpublished notes. Numerous misunderstandings between the participants were not fully dissipated as the controversy abruptly ended. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Controversies Surrounding Exercise in Genetic Cardiomyopathies.

    Science.gov (United States)

    Atteya, Gourg; Lampert, Rachel

    2018-04-01

    Exercise and sports are an integral part of daily life for millions of Americans, with 16% of the US population older than age 15 years engaged in sports or exercise activities (Bureau of Labor statistics). The physical and psychological benefits of exercise are well-recognized. However, high-profile cases of athletes dying suddenly on the field, often due to undiagnosed genetic cardiomyopathies, raise questions about the risks and benefits of exercise for those with cardiomyopathy. Copyright © 2018 Elsevier Inc. All rights reserved.

  8. Pediatric cancer gone viral. Part II: potential clinical application of oncolytic herpes simplex virus-1 in children

    Directory of Open Access Journals (Sweden)

    Gregory K Friedman

    Full Text Available Oncolytic engineered herpes simplex viruses (HSVs possess many biologic and functional attributes that support their use in clinical trials in children with solid tumors. Tumor cells, in an effort to escape regulatory mechanisms that would impair their growth and progression, have removed many mechanisms that would have protected them from virus infection and eventual virus-mediated destruction. Viruses engineered to exploit this weakness, like mutant HSV, can be safely employed as tumor cell killers, since normal cells retain these antiviral strategies. Many preclinical studies and early phase trials in adults demonstrated that oncolytic HSV can be safely used and are highly effective in killing tumor cells that comprise pediatric malignancies, without generating the toxic side effects of nondiscriminatory chemotherapy or radiation therapy. A variety of engineered viruses have been developed and tested in numerous preclinical models of pediatric cancers and initial trials in patients are underway. In Part II of this review series, we examine the preclinical evidence to support the further advancement of oncolytic HSV in the pediatric population. We discuss clinical advances made to date in this emerging era of oncolytic virotherapy.

  9. Behavioral consequences of conflict-oriented health news coverage: the 2009 mammography guideline controversy and online information seeking.

    Science.gov (United States)

    Weeks, Brian E; Friedenberg, Laura M; Southwell, Brian G; Slater, Jonathan S

    2012-01-01

    Building on channel complementarity theory and media-system dependency theory, this study explores the impact of conflict-oriented news coverage of health issues on information seeking online. Using Google search data as a measure of behavior, we demonstrate that controversial news coverage of the U.S. Preventive Services Task Force's November 2009 recommendations for changes in breast cancer screening guidelines strongly predicted the volume of same-day online searches for information about mammograms. We also found that this relationship did not exist 1 year prior to the coverage, during which mammography news coverage did not focus on the guideline controversy, suggesting that the controversy frame may have driven search behavior. We discuss the implications of these results for health communication scholars and practitioners.

  10. Pension Reform Act 2004 and its Controversies: Repeating or ...

    African Journals Online (AJOL)

    Pension Reform Act 2004 and its Controversies: Repeating or Learning from Past Mistakes? ... Journal of Research in National Development ... and discusses how the present pension reform will affect active employees when they retire.

  11. Electrical stimulation in dysphagia treatment: a justified controversy?

    NARCIS (Netherlands)

    Bogaardt, H. C. A.

    2008-01-01

    Electrical stimulation in dysphagia treatment: a justified controversy? Neuromuscular electrostimulation (LAMES) is a method for stimulating muscles with short electrical pulses. Neuromuscular electrostimulation is frequently used in physiotherapy to strengthen healthy muscles (as in sports

  12. Understanding and Developing Controversial Issues in College Courses.

    Science.gov (United States)

    Payne, Brian K.; Gainey, Randy R.

    2003-01-01

    Discusses common controversial issues in different college disciplines, such as the death penalty and drug legalization. Also suggests useful methods for encouraging enlightening discussions, such as verbal and physical cues, student-centered activities, and text selection. (SLD)

  13. Social reporting, engagements, controversies and conflict in an arena context

    NARCIS (Netherlands)

    Georgakopoulos, G.; Thomson, I.

    2008-01-01

    Purpose - To empirically investigate relationships between engagement activities and social reporting practices in a controversial and environmentally sensitive industry. The interactions investigated were not restricted to stakeholder relationships but included other communications between

  14. Radiotherapy of lymphogranulomatosis. Present position and controversies

    Energy Technology Data Exchange (ETDEWEB)

    Roettinger, E M; Sack, H [Koeln Univ. (Germany, F.R.). Inst. und Poliklinik fuer Strahlentherapie

    1976-03-01

    Increased knowledge about the course of lymphogranulomatosis and technological progress in radiotherapy during the past 20 years have brought permanent recovery for a major part of patients from this disease which had been infaust before. The supplementation of the local radiotherapy by the systematic effects of chemotherapy enables us at the same time to control the infiltrations and disseminations which cannot be manifested clinically especially in malignant forms and later stages. The good healing results obtained presuppose careful clinical examination of the patient and attentive care during the therapy with regard to the potential complications of radio- and chemotherapy. As potential complications which may occur according to the method used we may name damage to the kidneys, radiopneumonia or pulmonal fibrosis, myocarditis or pericarditis, oeosophagitis, enteritis, and hepatitis. Relatively seldom we see the permanent depression of the bone marrow, induction of leucaemia, and myxoedema. All these complications can occure more frequently in the case of additional chemotherapy.

  15. Mapping Controversies with Social Media: The Case for Symmetry

    Directory of Open Access Journals (Sweden)

    Noortje Marres

    2015-09-01

    Full Text Available This article assesses the usefulness for social media research of controversy analysis, an approach developed in Science and Technology Studies (STS and related fields. We propose that this approach can help to address an important methodological problem in social media research, namely, the tension between social media as resource for social research and as an empirical object in its own right. Initially developed for analyzing interactions between science, technology, and society, controversy analysis has in recent decades been implemented digitally to study public debates and issues dynamics online. A key feature of controversy analysis as a digital method, we argue, is that it enables a symmetrical approach to the study of media-technological dynamics and issue dynamics. It allows us to pay equal attention to the ways in which a digital platform like Twitter mediates public issues, and to how controversies mediate “social media” as an object of public attention. To sketch the contours of such a symmetrical approach, the article discusses examples from a recent social media research project in which we mapped issues of “privacy” and “surveillance” in the wake of the National Security Agency (NSA data leak by Edward Snowden in June 2013. Through a discussion of social media research practice, we then outline a symmetrical approach to analyzing controversy with social media. We conclude that the digital implementation of such an approach requires further exchanges between social media researchers and controversy analysts.

  16. The chilling effect: how do researchers react to controversy?

    Directory of Open Access Journals (Sweden)

    Joanna Kempner

    2008-11-01

    Full Text Available BACKGROUND: Can political controversy have a "chilling effect" on the production of new science? This is a timely concern, given how often American politicians are accused of undermining science for political purposes. Yet little is known about how scientists react to these kinds of controversies. METHODS AND FINDINGS: Drawing on interview (n = 30 and survey data (n = 82, this study examines the reactions of scientists whose National Institutes of Health (NIH-funded grants were implicated in a highly publicized political controversy. Critics charged that these grants were "a waste of taxpayer money." The NIH defended each grant and no funding was rescinded. Nevertheless, this study finds that many of the scientists whose grants were criticized now engage in self-censorship. About half of the sample said that they now remove potentially controversial words from their grant and a quarter reported eliminating entire topics from their research agendas. Four researchers reportedly chose to move into more secure positions entirely, either outside academia or in jobs that guaranteed salaries. About 10% of the group reported that this controversy strengthened their commitment to complete their research and disseminate it widely. CONCLUSIONS: These findings provide evidence that political controversies can shape what scientists choose to study. Debates about the politics of science usually focus on the direct suppression, distortion, and manipulation of scientific results. This study suggests that scholars must also examine how scientists may self-censor in response to political events.

  17. The Chilling Effect: How Do Researchers React to Controversy?

    Science.gov (United States)

    Kempner, Joanna

    2008-01-01

    Background Can political controversy have a “chilling effect” on the production of new science? This is a timely concern, given how often American politicians are accused of undermining science for political purposes. Yet little is known about how scientists react to these kinds of controversies. Methods and Findings Drawing on interview (n = 30) and survey data (n = 82), this study examines the reactions of scientists whose National Institutes of Health (NIH)-funded grants were implicated in a highly publicized political controversy. Critics charged that these grants were “a waste of taxpayer money.” The NIH defended each grant and no funding was rescinded. Nevertheless, this study finds that many of the scientists whose grants were criticized now engage in self-censorship. About half of the sample said that they now remove potentially controversial words from their grant and a quarter reported eliminating entire topics from their research agendas. Four researchers reportedly chose to move into more secure positions entirely, either outside academia or in jobs that guaranteed salaries. About 10% of the group reported that this controversy strengthened their commitment to complete their research and disseminate it widely. Conclusions These findings provide evidence that political controversies can shape what scientists choose to study. Debates about the politics of science usually focus on the direct suppression, distortion, and manipulation of scientific results. This study suggests that scholars must also examine how scientists may self-censor in response to political events. PMID:19018657

  18. Current Opinion and Controversies of Dialyser Reuse

    Directory of Open Access Journals (Sweden)

    Brown Colin

    2001-01-01

    Full Text Available Reuse of dialysers has been an integral part of hemodialysis since its inception. Over the past decade, reuse has increased significantly in many countries, most notably in the United States, while vanishing entirely in some other countries, such as Portugal and France. In the United States, which is most widely used as an example because of the large amount of data available, the mortality of dialysis patients has steadily decreased even as reuse has increased. This improvement is probably the result of a complex of factors including understanding the role of comorbidity, treatment unit characteristics, barriers to adequate dialysis, nutrition, anemia, high flux dialysis and dialyser membrane improvements and the desired dialysis dose. Reuse provides a significant economic benefit that allows the use of more efficient and expensive larger biocompatible synthetic membranes to provide high-quality dialysis in the face of cost inflation, limited medical resources and fixed reimbursement. Rather than being legitimized by clinical practice alone, reprocessing, supported by clinical studies, allows the provision of superior treatment to more patients safely and economically. Recent reports concerning dialyser reprocessing have centered not only on morbidity and mortality, but also on questions of the specific effects of different germicides on various types of dialyser membranes (e.g., cellulosic, synthetic, high-flux, etc. and on the possible role of dialyser reprocessing in the transmission of hepatitis C.

  19. An investigation of routes to cancer diagnosis in 10 international jurisdictions, as part of the International Cancer Benchmarking Partnership: survey development and implementation

    Science.gov (United States)

    Weller, David; Vedsted, Peter; Anandan, Chantelle; Zalounina, Alina; Fourkala, Evangelia Ourania; Desai, Rakshit; Liston, William; Jensen, Henry; Barisic, Andriana; Gavin, Anna; Grunfeld, Eva; Lambe, Mats; Law, Rebecca-Jane; Malmberg, Martin; Neal, Richard D; Kalsi, Jatinderpal; Turner, Donna; White, Victoria; Bomb, Martine

    2016-01-01

    Objectives This paper describes the methods used in the International Cancer Benchmarking Partnership Module 4 Survey (ICBPM4) which examines time intervals and routes to cancer diagnosis in 10 jurisdictions. We present the study design with defining and measuring time intervals, identifying patients with cancer, questionnaire development, data management and analyses. Design and setting Recruitment of participants to the ICBPM4 survey is based on cancer registries in each jurisdiction. Questionnaires draw on previous instruments and have been through a process of cognitive testing and piloting in three jurisdictions followed by standardised translation and adaptation. Data analysis focuses on comparing differences in time intervals and routes to diagnosis in the jurisdictions. Participants Our target is 200 patients with symptomatic breast, lung, colorectal and ovarian cancer in each jurisdiction. Patients are approached directly or via their primary care physician (PCP). Patients’ PCPs and cancer treatment specialists (CTSs) are surveyed, and ‘data rules’ are applied to combine and reconcile conflicting information. Where CTS information is unavailable, audit information is sought from treatment records and databases. Main outcomes Reliability testing of the patient questionnaire showed that agreement was complete (κ=1) in four items and substantial (κ=0.8, 95% CI 0.333 to 1) in one item. The identification of eligible patients is sufficient to meet the targets for breast, lung and colorectal cancer. Initial patient and PCP survey response rates from the UK and Sweden are comparable with similar published surveys. Data collection was completed in early 2016 for all cancer types. Conclusion An international questionnaire-based survey of patients with cancer, PCPs and CTSs has been developed and launched in 10 jurisdictions. ICBPM4 will help to further understand international differences in cancer survival by comparing time intervals and routes to cancer

  20. Eye Cancer

    Science.gov (United States)

    Cancer of the eye is uncommon. It can affect the outer parts of the eye, such as the eyelid, which are made up ... and nerves. If the cancer starts inside the eyeball it's called intraocular cancer. The most common intraocular ...

  1. Oral Cancer

    Science.gov (United States)

    Oral cancer can form in any part of the mouth. Most oral cancers begin in the flat cells that cover the ... your mouth, tongue, and lips. Anyone can get oral cancer, but the risk is higher if you are ...

  2. Comparative Phytochemical Analysis of Essential Oils from Different Biological Parts of Artemisia herba alba and Their Cytotoxic Effect on Cancer Cells

    Science.gov (United States)

    Tilaoui, Mounir; Ait Mouse, Hassan; Jaafari, Abdeslam; Zyad, Abdelmajid

    2015-01-01

    Purpose Carrying out the chemical composition and antiproliferative effects against cancer cells from different biological parts of Artemisia herba alba. Methods Essential oils were studied by gas chromatography coupled to mass spectrometry (GC–MS) and their antitumoral activity was tested against P815 mastocytoma and BSR kidney carcinoma cell lines; also, in order to evaluate the effect on normal human cells, oils were tested against peripheral blood mononuclear cells PBMCs. Results Essential oils from leaves and aerial parts (mixture of capitulum and leaves) were mainly composed by oxygenated sesquiterpenes 39.89% and 46.15% respectively; capitulum oil contained essentially monoterpenes (22.86%) and monocyclic monoterpenes (21.48%); esters constituted the major fraction (62.8%) of stem oil. Essential oils of different biological parts studied demonstrated a differential antiproliferative activity against P815 and BSR cancer cells; P815 cells are the most sensitive to the cytotoxic effect. Leaves and capitulum essential oils are more active than aerial parts. Interestingly, no cytotoxic effect of these essential oils was observed on peripheral blood mononuclear cells. Conclusion Our results showed that the chemical composition variability of essential oils depends on the nature of botanical parts of Artemisia herba alba. Furthermore, we have demonstrated that the differential cytotoxic effect depends not only on the essential oils concentration, but also on the target cells and the botanical parts of essential oils used. PMID:26196123

  3. Nuclear controversy as reflected in the daily newspapers. Die Kernenergie-Kontroverse im Spiegel der Tageszeitungen

    Energy Technology Data Exchange (ETDEWEB)

    van Buire, S

    1980-01-01

    The development and utilization of nuclear energy has led to conflicts of larger dimensions in our society. What has been the role of the mass communication media in this discussion. Did they fulfill their duty to inform the public, did they actively foster discussions about the facts to be considered, and did they play their part in public opinion making by publishing critical analyses. These are questions answered by this book by presenting analyses of newspaper articles on the nuclear controversy, facts and figures on the opinions and information published in the daily newspapers on the subject of nuclear energy utilization, and analyses of tendencies pro or contra nuclear energy as expressed by the various articles. By an evaluation of the history of discussions, the development and modifications of the arguments put forward and the reactions shown by the various social groups involved in the process are illustrated and commented in the light of the controversy becoming more acute.

  4. Referral rates and trends in radiotherapy as part of primary treatment of cancer in South Netherlands, 1988-2002

    International Nuclear Information System (INIS)

    Vulto, Ans; Louwman, Marieke; Rodrigus, Patrick; Coebergh, Jan Willem W.

    2006-01-01

    Background and purpose: To study referral rates and time trends in the use of primary radiotherapy (RT). Patients and Methods: The proportion and number of irradiated patients were calculated in a population-based setting among 58,436 cancer patients diagnosed between 1988 and 2002. Results: The number of patients receiving RT within 6 months of diagnosis (RT6mo) increased by about 3.3% annually, the proportion of all incident cases that received RT6mo remained stable (±30%). Only 20% of elderly patients (75+) received RT6mo. The proportion of cancer patients that received RT6mo increased markedly between 1988-1992 and 1998-2002 for patients with prostate cancer (15 and 28%, respectively), rectal cancer (33 and 43%) and brain tumours (48 and 67%). The absolute number of irradiated breast cancer patients increased 30% between 1988 and 2002. Among patients with rectal cancer, a shift occurred from postoperative to preoperative RT since 1995. The percentage of irradiated patients with stage I endometrial cancer decreased from 47% in 1988-1992 to 15% in 1998-2002. Conclusions: The percentage of cancer patients who received primary RT remained stable throughout 1988-2002, being consistently lower for older patients. The increased number of irradiated patients was due mainly to earlier detection and the ageing of the population. To clarify the overall percentage of patients irradiated, population-based studies on RT given after 6 months since diagnosis are warranted

  5. New late Paleozoic paleopoles from the Donbas Foldbelt (Ukraine): Implications for the Pangea A vs. B controversy

    NARCIS (Netherlands)

    Meijers, M.J.M.; Hamers, M.; van Hinsbergen, D.J.J.; Meer van der, D.; Kitchka, A.; Langereis, C.G.; Stephenson, R.A.

    2010-01-01

    The Carboniferous to early Permian apparent polar wander (APW) path for Eurasia is not well constrained, because of the paucity of reliable paleomagnetic poles. This is at least partly responsible for the Pangea A vs. B controversy in the early Permian: is the overlap between the northern and

  6. Variation in mutation spectrum partly explains regional differences in the breast cancer risk of female BRCA mutation carriers in the Netherlands.

    Science.gov (United States)

    Vos, Janet R; Teixeira, Natalia; van der Kolk, Dorina M; Mourits, Marian J E; Rookus, Matti A; van Leeuwen, Flora E; Collée, Margriet; van Asperen, Christi J; Mensenkamp, Arjen R; Ausems, Margreet G E M; van Os, Theo A M; Meijers-Heijboer, Hanne E J; Gómez-Garcia, Encarna B; Vasen, Hans F; Brohet, Richard M; van der Hout, Annemarie H; Jansen, Liesbeth; Oosterwijk, Jan C; de Bock, Geertruida H

    2014-11-01

    We aimed to quantify previously observed relatively high cancer risks in BRCA2 mutation carriers (BRCA2 carriers) older than 60 in the Northern Netherlands, and to analyze whether these could be explained by mutation spectrum or population background risk. This consecutive cohort study included all known pathogenic BRCA1/2 carriers in the Northern Netherlands (N = 1,050). Carrier and general reference populations were: BRCA1/2 carriers in the rest of the Netherlands (N = 2,013) and the general population in both regions. Regional differences were assessed with HRs and ORs. HRs were adjusted for birth year and mutation spectrum. All BRCA1 carriers and BRCA2 carriers younger than 60 had a significantly lower breast cancer risk in the Northern Netherlands; HRs were 0.66 and 0.64, respectively. Above age 60, the breast cancer risk in BRCA2 carriers in the Northern Netherlands was higher than in the rest of the Netherlands [HR, 3.99; 95% confidence interval (CI), 1.11-14.35]. Adjustment for mutational spectrum changed the HRs for BRCA1, BRCA2 <60, and BRCA2 ≥60 years by -3%, +32%, and +11% to 0.75, 0.50, and 2.61, respectively. There was no difference in background breast cancer incidence between the two regions (OR, 1.03; 95% CI, 0.97-1.09). Differences in mutation spectrum only partly explain the regional differences in breast cancer risk in BRCA2 carriers, and for an even smaller part in BRCA1 carriers. The increased risk in BRCA2 carriers older than 60 may warrant extension of intensive breast screening beyond age 60. ©2014 American Association for Cancer Research.

  7. Neuroimaging of nonaccidental head trauma: pitfalls and controversies

    Energy Technology Data Exchange (ETDEWEB)

    Fernando, Sujan [University of Missouri-Kansas School of Medicine, Department of Medicine, Kansas City, MO (United States); Obaldo, Ruby E. [The University of Kansas Medical Center, Department of Radiology, Kansas City, MO (United States); Walsh, Irene R. [The University of Missouri-Kansas City, Children' s Mercy Hospitals and Clinics, Department of Emergency Medicine, Kansas City, MO (United States); Lowe, Lisa H. [The University of Missouri-Kansas City, Children' s Mercy Hospitals and Clinics, Department of Radiology, Kansas City, MO (United States)

    2008-08-15

    Although certain neuroimaging appearances are highly suggestive of abuse, radiological findings are often nonspecific. The objective of this review is to discuss pitfalls, controversies, and mimics occurring in neuroimaging of nonaccidental head trauma in order to allow the reader to establish an increased level of comfort in distinguishing between nonaccidental and accidental head trauma. Specific topics discussed include risk factors, general biomechanics and imaging strategies in nonaccidental head trauma, followed by the characteristics of skull fractures, normal prominent tentorium and falx versus subdural hematoma, birth trauma versus nonaccidental head trauma, hyperacute versus acute on chronic subdural hematomas, expanded subarachnoid space versus subdural hemorrhage, controversy regarding subdural hematomas associated with benign enlarged subarachnoid spaces, controversy regarding hypoxia as a cause of subdural hematoma and/or retinal hemorrhages without trauma, controversy regarding the significance of retinal hemorrhages related to nonaccidental head trauma, controversy regarding the significance of subdural hematomas in general, and pitfalls of glutaric aciduria type 1 and hemophagocytic lymphohistiocytosis mimicking nonaccidental head trauma. (orig.)

  8. Studying a Controversy amongst Pashtuns of Torghar, Balochistan, Pakistan

    Directory of Open Access Journals (Sweden)

    Luc Bellon

    2007-10-01

    Full Text Available Much has been written about the political structures of tribal groups. The present article looks at political dynamics amongst Pashtuns of Balochistan, through the prism of a controversy. The sociological interest of studying the arguments used during a controversy has been underlined by Boltanski and Thevenot. A controversy finishes by the establishment, through consensus, of a common agreement upon accepted norms, determined limits, redefinition of social values, etc. The advantage of focusing on the argumentation itself is to avoid taking the agreement as a pre-established social truth, a reference that concerned people would reluctantly challenge. To study a controversy is to study the social realities in the making, to study the archaeology of collective consensus, to reinstate history, contingencies and individual plurality within the social dynamics and to take seriously their performative actions alongside other social determinisms. This article shows that to study controversy is a way not only to set light on political dynamics and structures, but also to discuss the impact and definition of concepts such as segmentarity, equality, rights, interests, and their relevance within the Pashtun society which was observed.

  9. COOPERATIVE CONTROVERSY TECHNIQUE TO IMPROVE STUDENTS’ MOTIVATION IN ENGLISH DEBATE

    Directory of Open Access Journals (Sweden)

    Suciati Suciati

    2016-03-01

    Full Text Available Many students do not like English debate. They argue that in the debate, they should apply four skills in English and should have appropriate matter, manner, and method. One of the reasons which make them do not like the debate is their lack of motivation. To solve this problem, teacher or lecturer should apply the appropriate technique in the teaching-learning process. Cooperative controversy technique is different with the traditional debate. In this technique, debaters change positions and try to reach a consensus at the end of the debate. By doing it before practicing the real English debate format, the students will get the basic knowledge about the debate so they do not directly practice the complicated one. Cooperative controversy increases the number of ideas, quality of ideas, feelings of stimulation, and enjoyment and originality of expression in creative problem solving. If it is compared to the group which does not use controversy, in controversy, the members get motivation and satisfaction in solving the problems.Keywords: English debate, students’ motivation, cooperative controversy

  10. Neuroimaging of nonaccidental head trauma: pitfalls and controversies

    International Nuclear Information System (INIS)

    Fernando, Sujan; Obaldo, Ruby E.; Walsh, Irene R.; Lowe, Lisa H.

    2008-01-01

    Although certain neuroimaging appearances are highly suggestive of abuse, radiological findings are often nonspecific. The objective of this review is to discuss pitfalls, controversies, and mimics occurring in neuroimaging of nonaccidental head trauma in order to allow the reader to establish an increased level of comfort in distinguishing between nonaccidental and accidental head trauma. Specific topics discussed include risk factors, general biomechanics and imaging strategies in nonaccidental head trauma, followed by the characteristics of skull fractures, normal prominent tentorium and falx versus subdural hematoma, birth trauma versus nonaccidental head trauma, hyperacute versus acute on chronic subdural hematomas, expanded subarachnoid space versus subdural hemorrhage, controversy regarding subdural hematomas associated with benign enlarged subarachnoid spaces, controversy regarding hypoxia as a cause of subdural hematoma and/or retinal hemorrhages without trauma, controversy regarding the significance of retinal hemorrhages related to nonaccidental head trauma, controversy regarding the significance of subdural hematomas in general, and pitfalls of glutaric aciduria type 1 and hemophagocytic lymphohistiocytosis mimicking nonaccidental head trauma. (orig.)

  11. Oral toxicity management in head and neck cancer patients treated with chemotherapy and radiation: Dental pathologies and osteoradionecrosis (Part 1) literature review and consensus statement.

    Science.gov (United States)

    Buglione, Michela; Cavagnini, Roberta; Di Rosario, Federico; Sottocornola, Lara; Maddalo, Marta; Vassalli, Lucia; Grisanti, Salvatore; Salgarello, Stefano; Orlandi, Ester; Paganelli, Corrado; Majorana, Alessandra; Gastaldi, Giorgio; Bossi, Paolo; Berruti, Alfredo; Pavanato, Giovanni; Nicolai, Piero; Maroldi, Roberto; Barasch, Andrei; Russi, Elvio G; Raber-Durlacher, Judith; Murphy, Barbara; Magrini, Stefano M

    2016-01-01

    Radiotherapy alone or in combination with chemotherapy and/or surgery is the typical treatment for head and neck cancer patients. Acute side effects (such as oral mucositis, dermatitis, salivary changes, taste alterations, etc.), and late toxicities in particular (such as osteo-radionecrosis, hypo-salivation and xerostomia, trismus, radiation caries etc.), are often debilitating. These effects tend to be underestimated and insufficiently addressed in the medical community. A multidisciplinary group of head and neck cancer specialists met in Milan with the aim of reaching a consensus on clinical definitions and management of these toxicities. The Delphi Appropriateness method was used for developing the consensus, and external experts evaluated the conclusions. This paper contains 10 clusters of statements about the clinical definitions and management of head and neck cancer treatment sequels (dental pathologies and osteo-radionecroses) that reached consensus, and offers a review of the literature about these topics. The review was split into two parts: the first part dealt with dental pathologies and osteo-radionecroses (10 clusters of statements), whereas this second part deals with trismus and xerostomia. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Review of the recent carbon dioxide-climate controversy

    International Nuclear Information System (INIS)

    Luther, F.M.; Cess, R.D.

    1992-01-01

    Model calculations of the climatic impact of the increasing atmospheric carbon dioxide (CO 2 ) concentration consistently suggest that a doubling of the CO 2 concentration would lead to a warming of global average surface air temperatures by as much as several degrees Celsius. In this appendix, this controversy about the effect of CO 2 on climate is reviewed. Because the surface energy balance approach to estimating climate sensitivity has been the source of much of the controversy, a review of this approach is presented. It is shown that prior applications of this approach violate the law of conservation of energy (the first law of thermodynamics); therefore, these results are incorrect. Empirical data indicating the relationship between atmospheric emittance and surface vapor pressure and surface air temperature are shown to be consistent with climate model calculations. Consequently, it is not the experimental data that are the basis of the controversy, but rather the analysis and interpretation of these data

  13. Teaching controversial issues in the secondary school science classroom

    Science.gov (United States)

    van Rooy, Wilhelmina

    1993-12-01

    A sample of fourteen secondary school biology teachers chosen from twelve schools were interviewed. The purpose was to determine their views on how controversial issues in science might be handled in the secondary school science classroom and whether the issues of surrogacy and human embryo experimentation were suitable controversial issues for discussion in schools. In general, teachers indicated that controversial issues deserve a more prominent place in the science curriculum because they have the potential to foster thinking, learning, and interest in science. The issues of surrogacy and human embryo experimentation were seen as appropriate contexts for learning, provided that teachers were well informed and sensitive to both the students and to the school environment.

  14. Controversy and consensus nuclear beta decay 1911-1934

    CERN Document Server

    Jensen, Carsten

    2000-01-01

    In 1920s, a long-lasting controversy on the interpretation of nuclear beta spectrum arose between Lise Meitner and Charles Drummond Ellis. This controversy, and the reactions from the contending parties when it was settled, reflect clearly the difference between the scientific communities in Berlin and Cambridge at that time. The Meitner-Ellis controversy ended in 1929, and it left an anomaly that attracted leading theoretical physicists. A new dispute, this time between Niels Bohr and Wolfgang Pauli, broke out. It concerned the explanation of the continuity of the primary beta particles and dominated the discussions for the next five years. Pauli argued for a new particle, and Bohr for a new theory; both suggestions were radical steps, but they reflected two different ways of doing physics.

  15. The cartoon controversy as a case of multiculturalrecognition

    DEFF Research Database (Denmark)

    Lægaard, Sune

    2007-01-01

    The paper considers what ‘recognition' might mean in theory and which policies would in practice qualify as policies of recognition in relation to multicultural conflicts such as the ‘cartoon controversy' sparked by the publication of drawings of the Prophet Mohammad in the Danish Newspaper...... Jyllands-Posten. The paper provides a general theoretical account of recognition as a strictly political concept, including distinctions between different conceptions hereof, and asks whether the cartoon controversy can be described in these terms and what the relevant meaning of recognition might then be...

  16. Intraprostatic testosterone and dihydrotestosterone. Part I: concentrations and methods of determination in men with benign prostatic hyperplasia and prostate cancer

    NARCIS (Netherlands)

    van der Sluis, T.M.; Vis, A.N.; van Moorselaar, R.J.A.; Bui, H.N.; Blankenstein, M.A.; Meuleman, E.J.H.; Heijboer, A.C.

    2012-01-01

    Owing to inconsistencies and methodological differences, the present peer-reviewed literature lacks conclusive data on the intraprostatic levels of androgens, in particular dihydrotestosterone (DHT), in untreated benign prostatic hyperplasia (BPH) and prostate cancer. To date, no difference has been

  17. Safe but controversial: A study of recent high-visibility spent fuel shipping campaigns

    International Nuclear Information System (INIS)

    Grimm, P.D.; Harmon, L.H.

    1987-01-01

    Since the need to move radioactive materials is at the core of every part of the fuel cycle, it is not surprising that the waste management program also has a critical transportation link. Yet, in spite of a nearly flawless safety record, transportation of spent fuel is an extremely controversial and emotional issue. There are reactions at every political level and pressures from special interest groups across the Nation. In many cases the courts make the final decisions. An example is the DOE program to move spent fuel from Brookhaven National Laboratory which took ten years to accomplish and wound up being decided by the U.S. Supreme Court. Two other DOE shipping campaigns now underway contain all of the same elements of controversy. About 35 - 40 rail shipments are intended to move the damaged Three-Mile Island core to DOE's Idaho facility. In addition, approximately 50 shipments of spent fuel will be made from the VEPCO plant at Surry, Virginia, to Idaho for use in testing above-ground storage methods. This paper traces the background of the campaigns and the controversies generated. Comparisons and contrasts of ''routine'' shipments of recent years with problems of today, including lawsuits to prevent shipment, are given along with implications for the future

  18. Information, education, and health behaviors: Evidence from the MMR vaccine autism controversy.

    Science.gov (United States)

    Chang, Lenisa V

    2018-05-02

    In the wake of strong, although later refuted, claims of a link between autism and the measles-mumps-rubella (MMR) vaccine, I examine whether fewer parents immunized or delayed vaccinations for their children and if there was a differential response by mother's education level. Using various controls and a differencing strategy that compares in MMR take-up with other vaccines, I find that the MMR-autism controversy led to a decline in the immediate years and that there were negative spillovers onto other vaccines. I also find evidence that more highly educated mothers responded more strongly to the controversy either by not immunizing their children altogether or, to a lesser degree, delaying vaccination. Moreover, the educational gap was greater in states where there was greater media attention devoted to the controversy. This is consistent with the health allocative efficiency hypothesis whereby part of the education gradient in health outcomes is due to more-educated individuals absorbing and responding to health information more quickly. However, unlike in the United Kingdom, where previous studies find that the gap was eliminated after the link was refuted, the evidence for the United States suggests that the educational gap persisted. Copyright © 2018 John Wiley & Sons, Ltd.

  19. Nuclear critics and nuclear controversy: Lessons for the next 50 years

    International Nuclear Information System (INIS)

    Perkins, B.

    1992-01-01

    For more than a decade, nuclear electric power was at the center of one of the most widespread and passionate controversies in the United States. A combination of local community groups and a sophisticated national opposition seriously delayed nuclear plants being built in state after state, contributing to major cost increases and, in some instances, project cancellations. According to plans of the US government and electric power industry, new nuclear power plants will be ordered by the mid-1990s and will be in operation around the turn of the century. The success of these plans will depend in part on how well the government and industry learned the lessons of the years of controversy - how well they can rally public support despite the inevitable opposition of nuclear critics. This paper is based on a review of the national nuclear controversy of the 1970s and early 1980s. It analyzes the key lessons to be learned from those experiences and projects them onto the new societal and political setting of the 1990s, reflecting more recent research into effective siting procedures, public participation, risk communications, and other disciplines related to the development of public acceptance for nuclear power plants

  20. Science and Social Studies Teachers’ Beliefs and Practices about Teaching Controversial Issues: Certain Comparisons

    Directory of Open Access Journals (Sweden)

    Zafer Kuş

    2015-09-01

    Full Text Available The current study aims to investigate social studies and science teachers’ attitudes and classroom practices associated with controversial issues. The study is a qualitative research based on data collected through interviews and observation. Social studies and Science teachers participated in the current study which was conducted in Kirsehir, a city in the center of Turkey, during the 2012-2013 academic years. Data were collected through classroom observation and interviews with teachers. In this study, teachers' positioning during controversial issues are determined by Kelly's (1986 positioning classification: Exclusive Neutrality, Exclusive Partiality, Neutral Impartiality, and Committed Impartiality. According to results of the research, violence against women, education system, terrorism and nationalism are the leading issues among the controversial issues that both social studies and science teachers listed in Turkey. In relation to their area, social studies teachers stated that the issues such as Kemalism, democracy, military coups, and deep state, which are associated with recent history of Turkey, were among the important controversial issues. Science teachers on the other hand stated issues such as cancer and anti-toxic foods and global warming among the controversial issues in Turkey. Both social studies and science teachers stated that the most frequently encountered problem in discussions was lack of knowledge by students. Whereas social studies teachers stated that their priority goals were particularly to raise active citizens and to set up a democratic classroom environment, science teachers pointed to raising scientifically thinking students and increasing students’ knowledge as their priority goals. During in-class discussions teachers take some positions. The positions stated by the teachers and in-class observations of them conflict. Whereas the teachers stated that they prefer the 4th and 3rd positions, the in

  1. Cancer

    Science.gov (United States)

    Cancer begins in your cells, which are the building blocks of your body. Normally, your body forms ... be benign or malignant. Benign tumors aren't cancer while malignant ones are. Cells from malignant tumors ...

  2. Removing Mill Weirs in France: The Structure and Dynamics of an Environmental Controversy

    Directory of Open Access Journals (Sweden)

    Regis Barraud

    2017-10-01

    Full Text Available In France, as in many other parts of Europe and North America, the vast increase in the number of dam removals in order to restore ecological continuity has led to a large number of local conflicts, resulting in a significant ecological controversy. Most of these hydraulic works were connected to former water mills. This article will suggest new analytical methods to help understand and interpret this controversy through the use of two complementary approaches. The first is based on a geohistorical approach. It allows us to identify the development of the meanings and values associated with mill weirs and also to trace the development, since the 19th century, of state involvement in dealing with their ecological impact. Our second method, based on political ecology, attempts to decipher the current state of the controversy. Taking this as our objective we have undertaken a qualitative analysis of the discourse produced on a national level and also of the network of actors who make up the oppositional base to dam removal. The affective and emotional dimensions of the controversy, and also the attachment to local places, both of which are often crucial in the expression of opposition on the local scale, can be identified in the discourse. Yet, the discourse we have analysed reveals argumentative poles which translate both the opposition based on rational arguments and also an alternative vision of the development of rivers (heritage status, green and local power production. The oppositional argument which has been developed notably includes a discussion of the knowledge and scientific expertise upon which the process of dam removal is based. It also includes a critique of local consultation and decision-making methods.

  3. Changing Trends in Gastric Cancer Surgery

    Directory of Open Access Journals (Sweden)

    İlter Özer

    2017-02-01

    Full Text Available Gastric cancer is one of the most common causes of cancer-related death. It requires multimodal treatment and surgery is the most effective treatment modality. Radical surgery includes total or subtotal gastrectomy with lymph node dissection. The extent of lymphadenectomy still remains controversial. Eastern surgeons have performed D2 or more extended lymphadenectomy while their Western colleagues have performed more limited lymph node dissection. However, the trend has been changing in favour of D2 lymph node dissection in both hemispheres. Currently, D2 is the recommended type of lymphadenectomy in experienced centres in the west. In Japan, D2 lymph node dissection is the standard surgical approach. More extensive lymphadenectomy than D2 has not been found to be associated with improved survival and generally is not performed. Bursectomy and splenectomy are additional controversial issues in surgical performance, and trends regarding them will be discussed. The performance of bursectomy is controversial and there is no clear evidence of its clinical benefit. However, a trend toward better survival in patients with serosal invasion has been reported. Routine splenectomy as a part of lymph node dissection has largely been abandoned, although splenectomy is recommended in selected cases. Minimally invasive surgery has gained wide popularity and indications for minimally invasive procedures have been expanding due to increasing experience and improving technology. Neoadjuvant therapy has been shown to have beneficial effects and seems necessary to provide a survival benefit. Diagnostic laparoscopy should be kept in mind prior to treatment

  4. Participation in water-exercising long-term after breast cancer surgery: Experiences of significant factors for continuing exercising as a part of cancer rehabilitation.

    Science.gov (United States)

    Enblom, A; Lindquist, H; Bergmark, K

    2018-01-01

    Although physical exercising has great benefits, little is known regarding factors of significance for cancer survivors to continue exercising within their rehabilitation. The objective was to describe factors experienced to be of significance for cancer survivors to continue with water-exercising long-term after breast cancer surgery. Women (n = 29) who had undergone breast cancer surgery (mastectomy 79%, axillary surgery 86%, and radiotherapy 86%) for median (md) 13 (25th-75th percentile 3-21.5) was followed up regarding their rehabilitation, arm function Disabilities of Arm Shoulder and Hand (md 14, IQR 7-32), EQ-5D score (md 0.8, IQR 0.73-1.0) and quality of life EQ health barometer (md 80, IQR 64-95). We performed qualitative focus-group interviews regarding the women's views (n = 24). The women had participated in water-exercising 1-46 semesters, md 8 (25th-75th percentile 3-21.5) semesters. Nearly all, 97%, participated in the water-exercising group every week, and 21 (72%) had participated in the water-exercising group at least half of the time since their breast cancer surgery, without complications. The women experienced that factors of significance to continue with water-exercising were the convenience of easily modified weightless exercising in the water, social interaction, and access to a private dressing room. These factors would be important to consider to encourage continuing in exercising. © 2017 John Wiley & Sons Ltd.

  5. Phase I, Dose-Escalation, Two-Part Trial of the PARP Inhibitor Talazoparib in Patients with Advanced Germline BRCA1/2 Mutations and Selected Sporadic Cancers.

    Science.gov (United States)

    de Bono, Johann; Ramanathan, Ramesh K; Mina, Lida; Chugh, Rashmi; Glaspy, John; Rafii, Saeed; Kaye, Stan; Sachdev, Jasgit; Heymach, John; Smith, David C; Henshaw, Joshua W; Herriott, Ashleigh; Patterson, Miranda; Curtin, Nicola J; Byers, Lauren Averett; Wainberg, Zev A

    2017-06-01

    Talazoparib inhibits PARP catalytic activity, trapping PARP1 on damaged DNA and causing cell death in BRCA1/2 -mutated cells. We evaluated talazoparib therapy in this two-part, phase I, first-in-human trial. Antitumor activity, MTD, pharmacokinetics, and pharmacodynamics of once-daily talazoparib were determined in an open-label, multicenter, dose-escalation study (NCT01286987). The MTD was 1.0 mg/day, with an elimination half-life of 50 hours. Treatment-related adverse events included fatigue (26/71 patients; 37%) and anemia (25/71 patients; 35%). Grade 3 to 4 adverse events included anemia (17/71 patients; 24%) and thrombocytopenia (13/71 patients; 18%). Sustained PARP inhibition was observed at doses ≥0.60 mg/day. At 1.0 mg/day, confirmed responses were observed in 7 of 14 (50%) and 5 of 12 (42%) patients with BRCA mutation-associated breast and ovarian cancers, respectively, and in patients with pancreatic and small cell lung cancer. Talazoparib demonstrated single-agent antitumor activity and was well tolerated in patients at the recommended dose of 1.0 mg/day. Significance: In this clinical trial, we show that talazoparib has single-agent antitumor activity and a tolerable safety profile. At its recommended phase II dose of 1.0 mg/day, confirmed responses were observed in patients with BRCA mutation-associated breast and ovarian cancers and in patients with pancreatic and small cell lung cancer. Cancer Discov; 7(6); 620-9. ©2017 AACR. This article is highlighted in the In This Issue feature, p. 539 . ©2017 American Association for Cancer Research.

  6. Evidence-Based Management and Controversies in Blunt Splenic Trauma

    NARCIS (Netherlands)

    Olthof, D. C.; van der Vlies, C. H.; Goslings, J. C.

    2017-01-01

    The study aims to describe the evidence-based management and controversies in blunt splenic trauma. A shift from operative management to non-operative management (NOM) has occurred over the past decades where NOM has now become the standard of care in haemodynamically stable patients with blunt

  7. Reading "Daddy's Roommate": Preservice Teachers Respond to a Controversial Text.

    Science.gov (United States)

    Williams, Shawyn

    2002-01-01

    Explores the responses of the author's 31 pre-service teachers to a controversial picture book. Begins by searching for a short text geared to elementary age children and suited for read-alouds. Notes that she believes that the majority of pre-service teachers at this stage in the program are still very impressionable and must be given multiple…

  8. [The controversy of routine articulator mounting in orthodontics].

    Science.gov (United States)

    Wang, Li; Han, Xianglong; Bai, Ding

    2013-06-01

    Articulators have been widely used by clinicians of dentistry. But routine articulator mounting is still controversial in orthodontics. Orthodontists oriented by gnathology approve routine articulator mounting while nongnathologic orthodontists disapprove it. This article reviews the thoughts of orthodontist that they agree or disagree with routine articulator mounting based on the considerations of biting, temporomandibular disorder (TMD), periodontitis, and so on.

  9. Ethical Perspectives on the Current Controversy Regarding Openness in Adoption.

    Science.gov (United States)

    Tavis, Timothy M.

    This paper outlines current changes in American adoption practice and the controversies surrounding these changes. It includes a discussion of the role that neo-Kantian and utilitarian perspectives have played in American adoption policy and practice, and offers an alternative, the communitarian perspective, described by Sandel (1984). Adoption…

  10. 37 CFR 351.3 - Controversy and further proceedings.

    Science.gov (United States)

    2010-07-01

    ..., the contested amount of a claim is $10,000 or less, the Copyright Royalty Judges shall decide the... CONGRESS COPYRIGHT ROYALTY JUDGES RULES AND PROCEDURES PROCEEDINGS § 351.3 Controversy and further... negotiation period, the Copyright Royalty Judges will issue an order declaring that further proceedings are...

  11. Adolescent Controversial Status Brokers: A Double-Edged Sword

    Science.gov (United States)

    Borowski, Sarah; Zeman, Janice; Carboni, Inga; Gilman, Rich; Thrash, Todd

    2017-01-01

    Using a 3-wave longitudinal, multidimensional approach, this study investigated the influence of social network position and social status on the psychosocial outcomes of 440 youth (45.1% girls; M[subscript age] = 16.1 years; 90.9% Caucasian) over 26 months, focusing on the controversial status classification (i.e., youth who are highly liked and…

  12. Allocative inefficiency and the capital-energy controversy

    International Nuclear Information System (INIS)

    Christopoulos, Dimitris K.; Tsionas, Efthymios G.

    2002-01-01

    The purpose of the paper is to estimate a system of input demands for Greek manufacturing deviating from the standard practice of assuming strict cost minimization. The study allows for the presence of price distortions and allocative inefficiency in the decision process. This assumption affects parameter estimates and estimated elasticities materially, and throws new light on the capital-energy controversy in Greek manufacturing

  13. The Future Path of Organic Farming - Values, Standards and Controversy!

    DEFF Research Database (Denmark)

    Kjærgård, Bente; Pedersen, Kirsten Bransholm; Land, Birgit

    The study focuses on the recent debate about what is, or what constitutes, organic farming and what is the right path for organic farming in the future. The study is based on a critical discourse analysis of the controversy about suspending the private standard for organic farming adopted by the ...

  14. Should We Teach Homosexuality as a Controversial Issue?

    Science.gov (United States)

    Hand, Michael

    2007-01-01

    Philosophers of education disagree on how the question of the moral status of homosexual acts should be tackled in the classroom. Some argue that the question should be taught as a controversial issue, that we should present rival moral positions as even-handedly as possible; others maintain that we should actively promote the view that homosexual…

  15. D. W. Griffith's Controversial Film, "The Birth of a Nation."

    Science.gov (United States)

    Pitcher, Conrad

    1999-01-01

    Presents a lesson plan that enables students to investigate race relations during the Progressive Era by analyzing D. W. Griffith's "The Birth of a Nation" and the controversy surrounding the release of the film. Explores the pros and cons of using motion pictures as teaching tool. Includes two student handouts. (CMK)

  16. Diversity in Information Technology Education: Issues and Controversies

    Science.gov (United States)

    Trajkovski, Goran, Ed.

    2006-01-01

    "Diversity in Information Technology Education: Issues and Controversies" sheds light on the status of diversity in the field of IT education. It identifies a wide range of problems that educators face on a daily basis, and gives practical, applicable solutions, mainly by showcasing successful and replicable examples. The chapters in "Diversity in…

  17. The Animal Experimentation Controversy: Ethical Views of Prospective Teachers

    Science.gov (United States)

    de Villiers, Rian

    2012-01-01

    Vivisection (live animal experimentation) is a controversial issue for many people. The purpose of this case study is to examine the attitudes of prospective teachers toward vivisection in education and research, to determine if gender has an influence on these attitudes, and to discuss the implications of these attitudes with regard to teaching…

  18. Controversial Therapies for Young Children with Developmental Disabilities.

    Science.gov (United States)

    Nickel, Robert E.

    1996-01-01

    This article examines reasons parents may choose a controversial alternative treatment for a child with developmental disabilities and reviews a few specific treatments--vitamin B-6 and magnesium, auditory integration training, megavitamins and minerals, Piracetam, intravenous immunoglobulin, and melatonin. Recommendations on talking with families…

  19. Integration of basic controversies in cross-cultural psychology

    NARCIS (Netherlands)

    Poortinga, Y.H.

    2016-01-01

    This article discusses controversies in the field of cross-cultural psychology, including cultural psychology, with a view to possible integration.1 It briefly describes the indigenisation movement as a reaction against Western scientific ethnocentrism and mentions two methodological topics, that

  20. Teaching Controversy by Seminar: An Example in Quaternary Geomorphology.

    Science.gov (United States)

    Harwood, Doug

    1987-01-01

    Describes how seminar work can be structured to help students develop skills of critical thinking and expression when discussing controversial issues in their chosen subject. Particular emphasis is given to methods of organizing instructional materials and appropriate roles for seminar leaders. The debate surrounding the existence of a prehistoric…

  1. Before We Were Us, We Were Them: Curating Controversy

    Science.gov (United States)

    Watson, Keri

    2014-01-01

    Prompted by the passage of Alabama House Bill 56, I organized the museum studies course I taught for Auburn University at Montgomery in the 2013 spring semester around an exhibition on immigration. The course offered the opportunity to engage students, faculty, and the community in discussion of an important, timely, and controversial topic.…

  2. Nuclear Deterrence in Cyber-ia: Challenges and Controversies

    Science.gov (United States)

    2016-09-01

    54 | Air & Space Power Journal Nuclear Deterrence in Cyber-ia Challenges and Controversies © Dr. Stephen J. Cimbala* Disclaimer: The views and...into here. 11. Mazanec, “International Order in Cyberspace,” 83. 12. Joel Brenner, Glass Houses: Privacy , Secrecy, and Cyber Insecurity in a Transparent

  3. Taking One's Principles Seriously: A Teacher Confronts Controversy

    Science.gov (United States)

    Hare, William

    2010-01-01

    A teacher faces hostility from certain colleagues who view his decision to attend a controversial lecture as tantamount to the repudiation of the principle of inclusive education and the rights of students with disabilities. The teacher sees the proposed boycott of the lecture as a form of censorship threatening freedom of inquiry and critical…

  4. Race and Genetics: Controversies in Biomedical, Behavioral, and Forensic Sciences

    Science.gov (United States)

    Ossorio, Pilar; Duster, Troy

    2005-01-01

    Among biomedical scientists, there is a great deal of controversy over the nature of race, the relevance of racial categories for research, and the proper methods of using racial variables. This article argues that researchers and scholars should avoid a binary-type argument, in which the question is whether to use race always or never.…

  5. Multidisciplinary management of head and neck cancer: First expert consensus using Delphi methodology from the Spanish Society for Head and Neck Cancer (part 1).

    Science.gov (United States)

    Mañós, M; Giralt, J; Rueda, A; Cabrera, J; Martinez-Trufero, J; Marruecos, J; Lopez-Pousa, A; Rodrigo, J P; Castelo, B; Martínez-Galán, J; Arias, F; Chaves, M; Herranz, J J; Arrazubi, V; Baste, N; Castro, A; Mesía, R

    2017-07-01

    Head and neck cancer is one of the most frequent malignances worldwide. Despite the site-specific multimodality therapy, up to half of the patients will develop recurrence. Treatment selection based on a multidisciplinary tumor board represents the cornerstone of head and neck cancer, as it is essential for achieving the best results, not only in terms of outcome, but also in terms of organ-function preservation and quality of life. Evidence-based international and national clinical practice guidelines for head and neck cancer not always provide answers in terms of decision-making that specialists must deal with in their daily practice. This is the first Expert Consensus on the Multidisciplinary Approach for Head and Neck Squamous Cell Carcinoma (HNSCC) elaborated by the Spanish Society for Head and Neck Cancer and based on a Delphi methodology. It offers several specific recommendations based on the available evidence and the expertise of our specialists to facilitate decision-making of all health-care specialists involved. Copyright © 2017. Published by Elsevier Ltd.

  6. European consensus conference on diagnosis and treatment of germ cell cancer: a report of the second meeting of the European Germ Cell Cancer Consensus Group (EGCCCG): part II

    DEFF Research Database (Denmark)

    Krege, Susanne; Beyer, Jörg; Souchon, Rainer

    2007-01-01

    OBJECTIVES: The first consensus report that had been presented by the European Germ Cell Cancer Consensus Group (EGCCCG) in 2004 has found widespread approval by many colleagues throughout the world. In November 2006, the group met a second time under the auspices of the Department of Urology of ...

  7. European consensus conference on diagnosis and treatment of germ cell cancer: a report of the second meeting of the European Germ Cell Cancer Consensus group (EGCCCG): part I

    DEFF Research Database (Denmark)

    Krege, Susanne; Beyer, Jörg; Souchon, Rainer

    2007-01-01

    OBJECTIVES: The first consensus report presented by the European Germ Cell Cancer Consensus Group (EGCCCG) in the year 2004 has found widespread approval by many colleagues throughout the world. In November 2006, the group met a second time under the auspices of the Department of Urology of the A...

  8. Evaluation of a Bladder Cancer Cluster in a Population of Criminal Investigators with the Bureau of Alcohol, Tobacco, Firearms and Explosives—Part 1: The Cancer Incidence

    Directory of Open Access Journals (Sweden)

    Susan R. Davis

    2012-01-01

    Full Text Available This study investigated a bladder cancer cluster in a cohort of employees, predominately criminal investigators, participating in a medical surveillance program with the United States Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF between 1995 and 2007. Standardized incidence ratios (SIRs were used to compare cancer incidences in the ATF population and the US reference population. Seven cases of bladder cancer (five cases verified by pathology report at time of analysis were identified among a total employee population of 3,768 individuals. All cases were white males and criminal investigators. Six of seven cases were in the 30 to 49 age range at the time of diagnosis. The SIRs for white male criminal investigators undergoing examinations were 7.63 (95% confidence interval = 3.70–15.75 for reported cases and 5.45 (2.33–12.76 for verified cases. White male criminal investigators in the ATF population are at statistically significant increased risk for bladder cancer.

  9. Parenteral estrogen versus combined androgen deprivation in the treatment of metastatic prostatic cancer: part 2. Final evaluation of the Scandinavian Prostatic Cancer Group (SPCG) Study No. 5

    DEFF Research Database (Denmark)

    Hedlund, P.O.; Damber, J.E.; Hagerman, I.

    2008-01-01

    To compare parenteral estrogen therapy in the form of high-dose polyestradiol phosphate (PEP; Estradurin) with combined androgen deprivation (CAD) in the treatment of prostate cancer patients with skeletal metastases. The aim of the study was to compare anticancer efficacy and adverse events...

  10. [3rd and 4th generation estroprogestatives French controversy: What effect on women's behavior?].

    Science.gov (United States)

    Torres, Luis; Frapard, Christian; Daumas, Aurélie; Guibert, Nicolas; Lagouanelle-Simeoni, Marie-Claude; Rakoto, Jean-Claude; Villani, Patrick; Sambuc, Roland

    2016-04-01

    patients who simply changed their method. In all, 52.1% of women who completely stopped their contraception indicated that this choice was at least partly due to a change in their sexuality or reproductive life. This reason was evoked only in 19.0% of women who have simply made a change of contraceptive method. Among the views of women, the EP controversy was one of the reasons for a change of contraception method in 41.8% of cases, while advices from a doctor did play a role in 19.9% of cases. One has seen a decline of 11.0% of oral contraception between 2012 and 2013, almost superimposed on that of oral 3rd and 4th generation EP (10.6%). However, the use of 1st and 2nd generation EP stagnated: their increase was 0.4%. Beyond any change of contraceptive method, 66.9% of women expressed the absence of any impact of the controversy on their behavior. Of the women, 6.1% showed a loss of confidence in health professionals. We have shown how patients who stopped or modified their contraception method during 2013 placed the controversy influence in the forefront of the reasons for their decision. Although a medical reason has been widely quoted, only one in five felt that the advice of her doctor had clearly contributed to her choice. The influence of the media seemed to encroach on the doctor-patient relationship, which is fundamental to the quality of healthcare in the long term. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  11. Mobile Breast Cancer e-Support Program for Chinese Women With Breast Cancer Undergoing Chemotherapy (Part 2): Multicenter Randomized Controlled Trial.

    Science.gov (United States)

    Zhu, Jiemin; Ebert, Lyn; Liu, Xiangyu; Wei, Di; Chan, Sally Wai-Chi

    2018-04-30

    Women undergoing chemotherapy for the treatment of breast cancer have frequently reported unmet supportive care needs. Moreover, easily accessible and innovative support is lacking. The purpose of this trial was to determine the effectiveness of an app-based breast cancer e-support program to address women's self-efficacy (primary outcome), social support, symptom distress, quality of life, anxiety, and depression. Secondary objectives included exploring the association between women's health outcomes and the breast cancer e-support usage data. A multicenter, single-blinded, randomized controlled trial was conducted. A total of 114 women with breast cancer, who were commencing chemotherapy and were able to access internet through a mobile phone, were recruited in the clinics from 2 university-affiliated hospitals in China. Women were randomized either to the intervention group (n=57) receiving breast cancer e-support plus care as usual or the control group (n=57) receiving care as usual alone. The health care team and research assistants collecting data were blinded to the women's group allocation. Bandura's self-efficacy theory and the social exchange theory guided the development of the breast cancer e-support program, which has 4 components: (1) a Learning forum, (2) a Discussion forum, (3) an Ask-the-Expert forum, and (4) a Personal Stories forum. Moderated by an experienced health care professional, the breast cancer e-support program supported women for 12 weeks covering 4 cycles of chemotherapy. Health outcomes were self-assessed through paper questionnaires in clinics at baseline before randomization (T0), after 3 (T1), and 6 months (T2) of follow-ups. Fifty-five participants in the intervention group and 49 in the control group completed the follow-up assessments (response rate: 91.2%). During the 12-week intervention, the log-in frequency ranged from 0 to 774 times (mean 54.7; SD 131.4; median 11; interquartile range, IQR 5-27), and the total usage

  12. Gc, gc-ms analysis of lipophilic fractions of aerial parts of fagonia indica burm.f. showing growth inhibitory effect on ht 29 colorectal cancer cells

    International Nuclear Information System (INIS)

    Farheen, R.; Mahmood, I.

    2016-01-01

    Fagonia indica Burm.f. is a small genus of herbs and under shrubs. The plant contains potentially active substances and has been used traditionally for the treatment of many illnesses including cancer. Many polar compounds have been reported from this plant but its non-polar constituents have only been rarely studied. In the present studies these constituents of aerial parts of Fagonia indica Burm.f. and its sub fractions showing growth inhibitory effect on HT 29 colorectal cancer cells were analyzed using flame ionization detector (GC-FID) and GC-EIMS analysis. The present studies exhibited the presence of free fatty acids and their esters along with structurally diverse constituents including triterpene, heterocyclic organic compound, aromatics, hydrocarbons, alcohols, lactone and sterols which may be responsible for this activity. The results suggest that the non-polar constituents of F. indica bear a potential of further studies. (author)

  13. Absolute and Functional Iron Deficiency Anemia among Different Tumors in Cancer Patients in South Part of Iran, 2014

    Science.gov (United States)

    Hashemi, Seyed Mehdi; Mashhadi, Mohammad Ali; Mohammadi, Mehdi; Ebrahimi, Maryam; Allahyari, Abolghasem

    2017-01-01

    Background: Anemia is a common problem in cancer patients. This study aimed to investigate the frequency rate of absolute and functional iron deficiency anemia among different tumors and its distribution in different stages of cancer in solid tumors. Materials and Methods: This study was performed on 597 patients with cancer referred to Ali-Ebne-Abitaleb Hospital in Zahedan. Laboratory tests included serum iron, transferrin saturation, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and complete blood count (CBC). The malignancy type and stages were recorded. Data were analysed using SPSS statistics software (Ver.19). Results: Four hundred and fifty-seven patients (76.5 %) diagnosed with solid tumors and 140 (23.5%) suffered from hematologic malignancies. Among patients with solid tumors, functional iron deficiency had the highest rate (300 patients had anemia and 243 (53.2%) of whom were functionally iron deficient), but in hematologic malignancies most of patients had not iron deficiency (66 patients had not iron deficiency against 12 patients had absolute iron deficiency and 62 patients had functional iron deficiency anemia) (P-value=0.021). No significant differences were observed among the various stages of cancers in terms of degrees of iron deficiency (P>0.05). Conclusion: The results of the study showed that solid tumors had a higher rate of absolute and functional iron deficiency anemia, compared to hematologic malignancies. But there was no difference between the different stages of the disease. PMID:28989585

  14. ACR Appropriateness Criteria for external beam radiation therapy treatment planning for clinically localized prostate cancer, part II of II

    Directory of Open Access Journals (Sweden)

    Nicholas G. Zaorsky, MD

    2017-07-01

    Conclusions: External beam radiation is a key component of the curative management of T1 and T2 prostate cancer. By combining the most recent medical literature, these Appropriateness Criteria can aid clinicians in determining the appropriate treatment delivery and personalized approaches for individual patients.

  15. En-bloc pelvic resection with concomitant rectosigmoid colectomy and immediate anastomosis as part of primary cytoreductive surgery for patients with advanced ovarian cancer.

    Science.gov (United States)

    Yildirim, Y; Ertas, I E; Nayki, U; Ulug, P; Nayki, C; Yilmaz, I; Gultekin, E; Dogan, A; Aykas, A; Ulug, S; Ozdemir, A; Solmaz, U

    2014-01-01

    To assess the authors' experiences in en bloc pelvic resection with concomitant rectosigmoid colectomy and primary anastomosis as a part of primary cytoreductive surgery for patients with advanced ovarian cancer. Atotal of 22 patients with FIGO Stage IIB-IV epithelial ovarian cancer who underwent en bloc pelvic resection with anastomosis were retrospectively reviewed. Data analyses were carried out using SPSS 10.0 and descriptive statistics, Kaplan-Meier survival curves, and Log Rank (Mantel-Cox) test were used for statistical estimations. Median age was 58.8 years. FIGO stage distribution of the patients was; one (4.5%) IIB, three (13.7%) IIC, three (13.7%) IIIA, six (27.3%) IIIB, and nine (40.9%) IIIC. Median peritoneal cancer index (PCI) was 8 (range 5-22) and optimal cytoreduction was achieved in 18 patients (81.8%) of whom 13 (59.1%) had no macroscopic residual disease (complete cytoreduction). There was no perioperative mortality. A total of nine complications occurred in seven (31.8%) patients. Anastomotic leakage was observed in one (4.5%) patient. There was no re-laparotomy. Mean follow-up time was 60 months. There were 15 (68.2%) recurrences of which 12 (80%) presented in extra-pelvic localizations. Mean disease-free survival (DFS) and overall survival (OVS) were estimated as 43.6 and 50.5 months, respectively. Patients with complete cytoreduction had a better DFS (p = 0.006) and OVS (p = 0.003) than those with incomplete cytoreduction. En bloc pelvic resection, as a part of surgical cytoreduction, seems to be a safe and effective procedure in many patients with advanced ovarian cancer if required. Despite relatively high general complication rate, anastomosis-related morbidity of this procedure is low as 0.8%. Nevertheless, surgical plan and perioperative care should be personalized according to medical and surgical conditions of the patient.

  16. Oral toxicity management in head and neck cancer patients treated with chemotherapy and radiation: Xerostomia and trismus (Part 2). Literature review and consensus statement.

    Science.gov (United States)

    Buglione, Michela; Cavagnini, Roberta; Di Rosario, Federico; Maddalo, Marta; Vassalli, Lucia; Grisanti, Salvatore; Salgarello, Stefano; Orlandi, Ester; Bossi, Paolo; Majorana, Alessandra; Gastaldi, Giorgio; Berruti, Alfredo; Trippa, Fabio; Nicolai, Pietro; Barasch, Andrei; Russi, Elvio G; Raber-Durlacher, Judith; Murphy, Barbara; Magrini, Stefano M

    2016-06-01

    Radiotherapy alone or in combination with chemotherapy and/or surgery is a well-known radical treatment for head and neck cancer patients. Nevertheless acute side effects (such as moist desquamation, skin erythema, loss of taste, mucositis etc.) and in particular late toxicities (osteoradionecrosis, xerostomia, trismus, radiation caries etc.) are often debilitating and underestimated. A multidisciplinary group of head and neck cancer specialists from Italy met in Milan with the aim of reaching a consensus on a clinical definition and management of these toxicities. The Delphi Appropriateness method was used for this consensus and external experts evaluated the conclusions. The paper contains 20 clusters of statements about the clinical definition and management of stomatological issues that reached consensus, and offers a review of the literature about these topics. The review was split into two parts: the first part dealt with dental pathologies and osteo-radionecrosis (10 clusters of statements), whereas this second part deals with trismus and xerostomia (10 clusters of statements). Copyright © 2016. Published by Elsevier Ireland Ltd.

  17. MicroRNA-10a is reduced in breast cancer and regulated in part through retinoic acid

    International Nuclear Information System (INIS)

    Khan, Sonja; Wall, Deirdre; Curran, Catherine; Newell, John; Kerin, Michael J; Dwyer, Roisin M

    2015-01-01

    MicroRNAs (miRNAs) are short non-coding RNA molecules that play a critical role in mRNA cleavage and translational repression, and are known to be altered in many diseases including breast cancer. MicroRNA-10a (miR-10a) has been shown to be deregulated in various cancer types. The aim of this study was to investigate miR-10a expression in breast cancer and to further delineate the role of retinoids and thyroxine in regulation of miR-10a. Following informed patient consent and ethical approval, tissue samples were obtained during surgery. miR-10a was quantified in malignant (n = 103), normal (n = 30) and fibroadenoma (n = 35) tissues by RQ-PCR. Gene expression of Retinoic Acid Receptor beta (RARβ) and Thyroid Hormone receptor alpha (THRα) was also quantified in the same patient samples (n = 168). The in vitro effects of all-trans Retinoic acid (ATRA) and L-Thyroxine (T 4 ) both individually and in combination, on miR-10a expression was investigated in breast cancer cell lines, T47D and SK-BR-3. The level of miR-10a expression was significantly decreased in tissues harvested from breast cancer patients (Mean (SEM) 2.1(0.07)) Log 10 Relative Quantity (RQ)) compared to both normal (3.0(0.16) Log 10 RQ, p < 0.001) and benign tissues (2.6(0.17) Log 10 RQ, p < 0.05). The levels of both RARβ and THRα gene expression were also found to be decreased in breast cancer patients compared to controls (p < 0.001). A significant positive correlation was determined between miR-10a and RARβ (r = 0.31, p < 0.001) and also with THRα (r = 0.32, p < 0.001). In vitro stimulation assays revealed miR-10a expression was increased in both T47D and SK-BR-3 cells following addition of ATRA (2 fold (0.7)). While T 4 alone did not stimulate miR-10a expression, the combination of T 4 and ATRA was found to have a positive synergistic effect. The data presented supports a potential tumour suppressor role for miR-10a in breast cancer, and highlights retinoic acid as a positive regulator of the

  18. Curcumin sensitizes prostate cancer cells to radiation partly via epigenetic activation of miR-143 and miR-143 mediated autophagy inhibition.

    Science.gov (United States)

    Liu, Jianbo; Li, Min; Wang, Yuewei; Luo, Jianchao

    2017-08-01

    Curcumin has been reported as a radiosensitizer in prostate cancer. But the underlying mechanism is not well understood. In this study, we firstly assessed how curcumin affects the expression of miR-143/miR-145 cluster. Then, we investigated whether miR-143 is involved in regulation of radiosensitivity and its association with autophagy in prostate cancer cells. Our data showed that PC3, DU145 and LNCaP cells treated with curcumin had significantly restored miR-143 and miR-145 expression. Curcumin showed similar effect as 5-AZA-dC on reducing methylation of CpG dinucleotides in miR-143 promoter. In addition, curcumin treatment reduced the expression of DNMT1 and DNMT3B, which contribute to promoter hypermethylation of the miR-143/miR-145 cluster. Therefore, we infer that curcumin can restore miR-143 and miR-145 expression via hypomethylation. MiR-143 overexpression and curcumin pretreatment enhanced radiation induced cancer cell growth inhibition and apoptosis. MiR-143 and curcumin remarkably reduced radiation-induced autophagy in PC3 and DU145 cells. MiR-143 overexpression alone also reduced the basal level of autophagy in DU145 cells. Mechanistically, miR-143 can suppress autophagy in prostate cancer cells at least via downregulating ATG2B. Based on these findings, we infer that curcumin sensitizes prostate cancer cells to radiation partly via epigenetic activation of miR-143 and miR-143 mediated autophagy inhibition.

  19. Using deliberation to address controversial issues: Developing Holocaust education curriculum.

    Directory of Open Access Journals (Sweden)

    THOMAS MISCO

    2007-10-01

    Full Text Available This paper explores how a cross-cultural project responded to the need for new Holocaust educational materials for the Republic of Latvia through the method of curriculum deliberation. Analysis of interview, observational, and document data drawn from seven curriculum writers and numerous project members suggest that curriculum deliberation helped awaken a controversial and silenced history while attending to a wide range of needs and concerns for a variety of stakeholders. The findings highlight structural features that empowered the curriculum writers as they engaged in protracted rumination, reflected upon competing norms, and considered the nuances of the curriculum problem in relation to implementation. Understanding the process, challenges, and promises of cross-cultural curriculum deliberation holds significance for educators, curricularists, and educational researchers wishing to advance teaching and learning within silenced histories and controversial issues.

  20. Unconsciously against it. Psychological aspects of the nuclear controversy

    International Nuclear Information System (INIS)

    Wuenschmann, A.

    1980-06-01

    The book deals with the psychological aspects of the nuclear controversy. An attempt is made to describe, in psychological terms, arrange, explain and, in this sense, 'comprehend' the phenomenon of the nuclear controversy in the light of the following facts: - individual and archetypal spectra of associations arising in the minds of many people in combination with the term 'nuclear power plant', the existence of different psychological types; the suggestion and psychological regression in the group. Especially the nuclear opponents, more or less successfully, have used the individual and archetypal association spectrum as an instrument to further their own ends and have thus contributed to the erection of psychological barriers against nuclear power in the minds of many people. (orig./RW) [de

  1. Understanding the agreements and controversies surrounding childhood psychopharmacology

    Directory of Open Access Journals (Sweden)

    Johnston Josephine

    2008-02-01

    Full Text Available Abstract The number of children in the US taking prescription drugs for emotional and behavioral disturbances is growing dramatically. This growth in the use of psychotropic drugs in pediatric populations has given rise to multiple controversies, ranging from concerns over off-label use and long-term safety to debates about the societal value and cultural meaning of pharmacological treatment of childhood behavioral and emotional disorders. This commentary summarizes the authors' eight main findings from the first of five workshops that seek to understand and produce descriptions of these controversies. The workshop series is convened by The Hastings Center, a bioethics research institute located in Garrison, New York, U.S.A.

  2. Behavioural controversy concerning homo economicus: a Humean perspective

    Directory of Open Access Journals (Sweden)

    Khandakar Elahi

    2014-05-01

    Full Text Available In his monumental masterpiece, A Treatise on Human Nature, which explains the methodology of human reasoning concerning matters of fact and describes the roles that passions and morals play in it, Hume arrives at an enormously interesting maxim: An academic controversy cannot continue for long unless the disputants assign different meanings to the major terms employed in the debate. This theory has been applied in this paper to examine the behavioural criticisms about Homo Economicus (HE, the pivotal perception in the neoclassical microeconomic model.To achieve this objective, the paper discusses the origin and evolution of the concept, reviews behavioural criticisms, summarises the main tenets of Hume’s philosophy of human knowledge and finally examines the behavioural opinions from Hume’s perspective. The paper concludes that Hume’s theory convincingly explains the reason why the HE controversy is continuing for over half century- a fact that both the mainstream and behavioural economists are ignoring.

  3. The rocky flats controversy on radionuclide soil action levels

    International Nuclear Information System (INIS)

    Earle, T.C.

    2004-01-01

    This report describes the Rocky Flats radionuclide soil action level controversy as a case study for the purpose of understanding the nature and value of stakeholder involvement in the management of radiological hazards. The report consists of three main sections. The first section outlines the Rocky Flats story, including the Cold War era, the post-Cold War era, and the transition between the two. This provides the context necessary to understand the radionuclide soil action level controversy, the main events of which are described in the second section. In the final section, the Rocky Flats case is briefly discussed within the framework of a general model of stakeholder involvement and the lessons learned from the case are identified. (author)

  4. Nuclear energy: public controversies and the analysis of risks

    International Nuclear Information System (INIS)

    Sills, D.L.

    1984-01-01

    Energy is a social concept, the product of social, economic, and political processes that define certain raw materials as resources and thus convert them into usable energy. Like all social concepts, energy is controversial. Out of a wide range of controversies, three are selected for analysis here: (1) the relationship of nuclear power systems to nuclear weapons proliferation; (2) the risks of terrorism and sabotage associated with the operation of nuclear power facilities, including threats to civil liberties; and (3) the problems associated with the long-term management of radioactive wastes. The final section of the paper describes various modes of analyzing risks and the perception of risks. It is concluded that it may take many decades to learn whether nuclear energy is as natural a source of electrical power as wells are of drinking water, or whether nuclear energy is a horror that mankind in the 1980s or 1990s took a hard look at and then backed away. (author)

  5. Mercury, vaccines, and autism: one controversy, three histories.

    Science.gov (United States)

    Baker, Jeffrey P

    2008-02-01

    The controversy regarding the once widely used mercury-containing preservative thimerosal in childhood vaccines has raised many historical questions that have not been adequately explored. Why was this preservative incorporated in the first place? Was there any real evidence that it caused harm? And how did thimerosal become linked in the public mind to the "autism epidemic"? I examine the origins of the thimerosal controversy and their legacy for the debate that has followed. More specifically, I explore the parallel histories of three factors that converged to create the crisis: vaccine preservatives, mercury poisoning, and autism. An understanding of this history provides important lessons for physicians and policymakers seeking to preserve the public's trust in the nation's vaccine system.

  6. Autonomy, Respect, and Arrogance in the Danish Cartoon Controversy

    OpenAIRE

    Rostbøll, Christian F.

    2009-01-01

    Udgivelsesdato: 2009 Autonomy is increasingly rejected as a fundamental principle by liberal political theorists, because it is regarded as incompatible with respect for diversity. This article seeks, via an analysis of the Danish cartoon controversy, to show that the relationship between autonomy and diversity is more complex than often posited. Particularly, it asks whether the autonomy defense of freedom of expression encourages disrespect for religious feelings. Autonomy leads to disre...

  7. Socio-scientific controversies and beginning teachers’ pedagogical practice

    Directory of Open Access Journals (Sweden)

    Pedro Reis

    2005-08-01

    Full Text Available The current investigation aimed to study the impact of recent socio-scientific controversies, made public through the media, on the concepts and practices of a group of Natural Science teachers at the start of their careers. This study is particularly relevant at a time that is heavily marked by much debate regarding the social and environmental impact of several scientific and technological innovations and by the implementation of new science curricula, that stress the importance of discussing socio-scientific controversies in the context of students’ scientific alphabetisation (namely in their understanding of the nature of science and its relation to society and culture (McComas, 2000. This investigation followed an interpretative approach of a qualitative nature. Through the construction of case studies, it sought to analyse the possible impact of socio-scientific controversies on the teachers’ concepts (about the nature, teaching and learning of science and pedagogic practice. For data collection semi-structured interviews were conducted and classes observed.The controversial issues raised by certain recent technological innovations – namely the environmental, social and cultural impact they may have – did have an impact on the teachers’ concepts about the nature, teaching and learning of science. Besides reinforcing the duality of feelings as regards science and technology, as a source of both progress and concern, they triggered in these teachers the idea of the need for a widespread scientific alphabetisation that empowers the population for understanding and deciding and acting upon these issues. However, the concept of scientific alphabetisation and the best way to achieve it vary among the teachers participating in this study.

  8. Cooperative Learning, Responsibility, Ambiguity, Controversy and Support in Motivating Students

    Directory of Open Access Journals (Sweden)

    Ronald Brecke, PhD

    2007-08-01

    Full Text Available This paper argues that student motivation is nurtured more by intrinsic rather than extrinsic rewards. Rather than relying on grades alone to stimulate students, this paper explores how engendering a natural critical learning environment can give students a sense of ownership in their own learning and lead to their commitment to that learning. We examine uses of cooperative learning, shared responsibility, ambiguity, controversy and support in student motivation.

  9. Cooperative Learning, Responsibility, Ambiguity, Controversy and Support in Motivating Students

    Directory of Open Access Journals (Sweden)

    Ronald Brecke

    2007-01-01

    Full Text Available This paper argues that student motivation is nurtured more by intrinsic rather than extrinsic rewards. Rather than relying on grades alone to stimulate students, this paper explores how engendering a natural critical learning environment can give students a sense of ownership in their own learning and lead to their commitment to that learning. We examine uses of cooperative learning, shared responsibility, ambiguity, controversy and support in student motivation.

  10. Current Therapeutic Cannabis Controversies and Clinical Trial Design Issues

    OpenAIRE

    Russo, Ethan B.

    2016-01-01

    This overview covers a wide range of cannabis topics, initially examining issues in dispensaries and self-administration, plus regulatory requirements for production of cannabis-based medicines, particularly the Food and Drug Administration “Botanical Guidance.” The remainder pertains to various cannabis controversies that certainly require closer examination if the scientific, consumer, and governmental stakeholders are ever to reach consensus on safety issues, specifically: whether botanica...

  11. Systematic Review of Breast Cancer Biology in Developing Countries (Part 2: Asian Subcontinent and South East Asia

    Directory of Open Access Journals (Sweden)

    Andrew G Hill

    2011-05-01

    Full Text Available There has been no systematic appraisal of ethnicity-based variations in breast cancer (BC biology amongst women from developing countries. A qualitative systematic review was conducted of breast cancer size, stage, grade, histological type, extra-mammary involvement, hormone receptor status as well as patient demographics. This review includes patients from Africa, the Middle East, Eastern Europe, Mexico, the Caribbean and South America. BC in these regions present at an earlier age with large aggressive tumours. Distant metastases are frequently present at the time of diagnosis. African women have a higher frequency of triple negative tumours. Over half of Middle Eastern women have lymph node involvement at the time of diagnosis. Despite experiencing a lower incidence compared to the Ashkenazi Jewish population, Palestinian women have poorer five-year survival outcomes. The majority of women from Mexico and South America have stage two or three disease whilst over sixty percent of women from Eastern Europe have either stage one or stage two disease. The biological characteristics of BC in the Caribbean cannot be fully assessed due to a paucity of data from the region. BC amongst the developing world is characterised by an early peak age of onset with aggressive biological characteristics. Strategies that improve breast cancer awareness, address amenable risk factors and improve early detection are essential.

  12. Systematic Review of Breast Cancer Biology in Developing Countries (Part 2): Asian Subcontinent and South East Asia

    International Nuclear Information System (INIS)

    Bhikoo, Riyaz; Srinivasa, Sanket; Yu, Tzu-Chieh; Moss, David; Hill, Andrew G

    2011-01-01

    There has been no systematic appraisal of ethnicity-based variations in breast cancer (BC) biology amongst women from developing countries. A qualitative systematic review was conducted of breast cancer size, stage, grade, histological type, extra-mammary involvement, hormone receptor status as well as patient demographics. This review includes patients from Africa, the Middle East, Eastern Europe, Mexico, the Caribbean and South America. BC in these regions present at an earlier age with large aggressive tumours. Distant metastases are frequently present at the time of diagnosis. African women have a higher frequency of triple negative tumours. Over half of Middle Eastern women have lymph node involvement at the time of diagnosis. Despite experiencing a lower incidence compared to the Ashkenazi Jewish population, Palestinian women have poorer five-year survival outcomes. The majority of women from Mexico and South America have stage two or three disease whilst over sixty percent of women from Eastern Europe have either stage one or stage two disease. The biological characteristics of BC in the Caribbean cannot be fully assessed due to a paucity of data from the region. BC amongst the developing world is characterised by an early peak age of onset with aggressive biological characteristics. Strategies that improve breast cancer awareness, address amenable risk factors and improve early detection are essential

  13. Systematic Review of Breast Cancer Biology in Developing Countries (Part 2): Asian Subcontinent and South East Asia

    Energy Technology Data Exchange (ETDEWEB)

    Bhikoo, Riyaz, E-mail: riyazbhikoo@gmail.com; Srinivasa, Sanket; Yu, Tzu-Chieh [Department of Surgery, South Auckland Clinical School, University of Auckland, Auckland 1640 (New Zealand); Moss, David [Department of Surgery, Middlemore Hospital, Auckland 1640 (New Zealand); Hill, Andrew G [Department of Surgery, South Auckland Clinical School, University of Auckland, Auckland 1640 (New Zealand)

    2011-05-13

    There has been no systematic appraisal of ethnicity-based variations in breast cancer (BC) biology amongst women from developing countries. A qualitative systematic review was conducted of breast cancer size, stage, grade, histological type, extra-mammary involvement, hormone receptor status as well as patient demographics. This review includes patients from Africa, the Middle East, Eastern Europe, Mexico, the Caribbean and South America. BC in these regions present at an earlier age with large aggressive tumours. Distant metastases are frequently present at the time of diagnosis. African women have a higher frequency of triple negative tumours. Over half of Middle Eastern women have lymph node involvement at the time of diagnosis. Despite experiencing a lower incidence compared to the Ashkenazi Jewish population, Palestinian women have poorer five-year survival outcomes. The majority of women from Mexico and South America have stage two or three disease whilst over sixty percent of women from Eastern Europe have either stage one or stage two disease. The biological characteristics of BC in the Caribbean cannot be fully assessed due to a paucity of data from the region. BC amongst the developing world is characterised by an early peak age of onset with aggressive biological characteristics. Strategies that improve breast cancer awareness, address amenable risk factors and improve early detection are essential.

  14. The Patient Concerns Inventory integrated as part of routine head and neck cancer follow-up consultations: frequency, case-mix, and items initiated by the patient.

    Science.gov (United States)

    Rogers, S N; Thomson, F; Lowe, D

    2018-03-01

    Introduction The National Institute for Health and Care Excellence guidance Improving Supportive and Palliative Care for Adults with Cancer (2004) and the Cancer Reform Strategy (2007) support the premise that assessment and discussion of patients' needs for physical, social, psychological, and spiritual wellbeing should be undertaken during oncology follow-up. We report the use of the Patient Concerns Inventory in a routine head and neck cancer clinic setting over a seven-year period, summarising the number of available clinics, the number of patients completing the inventory within a clinic, the range of clinical characteristics and the concerns they wanted to discuss. Methods The data were analysed from oncology follow-up clinics between 1 August 2007 and 10 December 2014. Audit approval was given by the Clinical Audit Department, University Hospital Aintree. Results There were 386 patients with 1198 inventories completed at 220 clinics, median 6 (range 4-7) per clinic. The most common concerns raised by patients across all the clinic consultations were dry mouth (34%), fear of recurrence (33%), sore mouth (26%), dental health (25%), chewing (22%) and fatigue/tiredness (21%). Conclusions The incorporation of the Patient Concerns Inventory as part of routine oncology clinics allows for a more patient initiated and focused consultation available to the majority of patients throughout their follow-up. The inventory allows for greater opportunity to provide holistic targeted multiprofessional intervention and support.

  15. Controversy matters: Impacts of topic and solution controversy on the perceived credibility of a scientist who advocates.

    Directory of Open Access Journals (Sweden)

    Lindsey Beall

    Full Text Available In this article, we focus on the potential influence of a scientist's advocacy position on the public's perceived credibility of scientists as a whole. Further, we examine how the scientist's solution position (information only, non-controversial, and controversial affects the public's perception of the scientist's motivation for sharing information about specific issues (flu, marijuana, climate change, severe weather. Finally, we assess how perceived motivations mediate the relationship between solution position and credibility. Using data from a quota sample of American adults obtained by Qualtrics (n = 2,453, we found that in some conditions advocating for a solution positively predicted credibility, while in one condition, it negatively predicted scientist credibility. We also found that the influence of solution position on perceived credibility was mediated by several motivation perceptions; most notably through perception that the scientist was motivated to: (a serve the public and (b persuade the public. Further results and implications are discussed.

  16. Yes to early detection of cancer - no to routine mammography examinations. Parting from wishful thinking, turning to new strategies

    CERN Document Server

    Dersee, T; Koehnlein, W; Kuni, H; Lengfelder, E; Pflugbeil, S; Schmitz-Feuerhake, I

    2002-01-01

    Many experts find it difficult to accept what experience has shown, namely that routine mammography examinations have lowered neither the breast cancer fatality rate nor the crude death rate. One aspect that has been neglected in propagating screenings is the high radiation sensitivity of genetically predisposed females (0.5% - 1.0%). These females should not be exposed to repeated X-rays for screening purposes. True preventive measures, which promise significant effects, include the avoidance of radiation exposure, especially during the early stages of life, and a restrictive use of oestrogen substitution therapies.

  17. Yes to early detection of cancer - no to routine mammography examinations. Parting from wishful thinking, turning to new strategies

    International Nuclear Information System (INIS)

    Dersee, T.; Dieckmann, H.; Koehnlein, W.; Kuni, H.; Lengfelder, E.; Pflugbeil, S.; Schmitz-Feuerhake, I.

    2002-01-01

    Many experts find it difficult to accept what experience has shown, namely that routine mammography examinations have lowered neither the breast cancer fatality rate nor the crude death rate. One aspect that has been neglected in propagating screenings is the high radiation sensitivity of genetically predisposed females (0.5% - 1.0%). These females should not be exposed to repeated X-rays for screening purposes. True preventive measures, which promise significant effects, include the avoidance of radiation exposure, especially during the early stages of life, and a restrictive use of oestrogen substitution therapies

  18. Research awareness, attitudes and barriers among clinical staff in a regional cancer centre. Part 1: a quantitative analysis.

    Science.gov (United States)

    Caldwell, B; Coltart, K; Hutchison, C; McJury, M; Morrison, A; Paterson, C; Thomson, M

    2017-09-01

    Research is of key importance in delivering high-quality patient care through evidence-based practice. Attitude towards research and barriers to research can have an impact on research activity. A survey was conducted to establish the levels of research awareness and attitudes among clinical staff groups in this regional cancer centre and identify any barriers to participation in research. The survey consisted of 26 questions and was distributed electronically and completed online. The response rate was 22.3% (n = 123). All participants felt that clinical research will help the regional cancer centre develop and progress treatments in the future. A positive attitude towards research was evident and consistent across professional groups. The main identified barriers to research included lacking the required knowledge, skills and training, lacking support from managers, and lack of opportunity or time to be involved in research, in particular for allied health professionals. However, there appears to be the foundation of a healthy research culture for nurses supported by management. The results of the survey support the implementation of an action plan based on the recommendations of this journal article. © 2016 John Wiley & Sons Ltd.

  19. THE APPROACH OF CANCER RELATED FATIGUE IN RHEABILITATION MEDICINE: PART I – MECHANISMS, SYMPTOMS, CLINICAL EVALUATION AND SCREENING

    Directory of Open Access Journals (Sweden)

    SALCA Amalia

    2015-05-01

    Full Text Available Cancer related fatigue (CRF is the most disabling and distressing symptom in cancer, throughout the whole history of the illness, including successfully treated cases. Rehabilitation medicine could have a positive impact on these patients’ outcomes, if well targeted. With these purpose, the rehabilitation clinician needs to correctly assess fatigue using standard, reliable scales. This review of articles and trials synthesizes the epidemiology, mechanics (including causes and effects, clinical presentation and means of assessment in CRF. CRF causes and mechanisms are not well known. Understanding them would provide specific targets to fatigue management. Clinical presentation is very variable, a wide range of features being found in literature. Poorly medical reports in assessing fatigue offer variable percentages of prevalence, inconsistent with patients’ daily burden due to CRF. There are many tools used to assess fatigue in clinical research and on them depends the percentages reported as fatigue prevalence. The hereby gathered information are useful in the approach of a patient that addresses to a rehabilitation clinician for CRF management.

  20. Colorectal Cancer

    Science.gov (United States)

    ... rectum are part of the large intestine. Colorectal cancer occurs when tumors form in the lining of ... men and women. The risk of developing colorectal cancer rises after age 50. You're also more ...

  1. Cancer - penis

    Science.gov (United States)

    ... an organ that makes up part of the male reproductive system. Causes Cancer of the penis is rare. Its ... penis; Glansectomy; Partial penectomy Images Male reproductive anatomy Male reproductive system References Heinlen JE, Culkin DJ. Cancer of the ...

  2. Combined androgen blockade in the treatment of advanced prostate cancer--an overview. The Scandinavian Prostatic Cancer Group

    DEFF Research Database (Denmark)

    Iversen, P

    1997-01-01

    The value of combined androgen blockade in the treatment of patients with advanced prostate cancer is still controversial. In this review by the Scandinavian Prostatic Cancer Group, the literature addressing the concept and its clinical use is critically reviewed....

  3. [Sampling in qualitative research: basic principles and some controversies].

    Science.gov (United States)

    Martínez-Salgado, Carolina

    2012-03-01

    This paper presents the rationale for the choice of participants in qualitative research in contrast with that of probability sampling principles in epidemiological research. For a better understanding of the differences, concepts of nomothetic and ideographic generalizability, as well as those of transferability and reflexivity, are proposed, Fundamentals of the main types of sampling commonly used in qualitative research, and the meaning of the concept of saturation are mentioned. Finally, some reflections on the controversies that have arisen in recent years on various paradigmatic perspectives from which to conduct qualitative research, their possibilities of combination with epidemiological research, and some implications for the study of health issues are presented.

  4. Controversies in water management: Frames and mental models

    International Nuclear Information System (INIS)

    Kolkman, M.J.; Veen, A. van der; Geurts, P.A.T.M.

    2007-01-01

    Controversies in decision and policy-making processes can be analysed using frame reflection and mental model mapping techniques. The purpose of the method presented in this paper is to improve the quality of the information and interpretations available to decision makers, by surfacing and juxtaposing the different frames of decision makers, experts, and special interests groups. The research provides a new method to analyse frames. It defines a frame to consist of perspectives and a mental model, which are in close interaction (through second order learning processes). The mental model acts like a 'filter' through which the problem situation is observed. Five major perspective types guide the construction of meaning out of the information delivered by the mental model, and determine what actors see as their interests. The perspective types are related to an actor's institutional and personal position in the decision making process. The method was applied to a case, in order to test its viability. The case concerns the decision making process and environmental impact assessment procedure for the improvement of dike ring 53 in the Netherlands, which was initiated by the Dutch 'Flood Defences Act 1996'. In this specific case the perspectives and mental models of stakeholders were elicited to explain controversies. The case was analysed with regard to the conflicts emerging between stakeholders, on an individual level. The influence of institutional embedding of individuals on the use of information and the construction of meaning, and the limits of a participatory approach were analysed within the details of controversies that emerged during the case analysis. Complicating factor appeared to be the interaction between national dike safety norms (short term) and local water management problems (long term). Revealed controversies mainly concerned disputes between an organisational and a technical perspective. But also disputes on distribution of responsibilities

  5. Controversy about Management of Hydrocephalus - Shunt vs. Endoscopic Third Ventriculostomy.

    Science.gov (United States)

    Kumar, Vikas; Bodeliwala, Shaam; Singh, Daljit

    2017-08-01

    The best management of hydrocephalus is still controversial in the twenty-first century. Shunt treatment for hydrocephalus is the most common procedure performed in neurosurgical practice and is associated with the highest complications rate. But during the last 2 decades, the treatment of hydrocephalus has improved with better shunt devices available today, increased facilities for investigations and newer approaches like endoscopic third ventriculostomy. The recent advances in development of better endoscopes have provided the patient and treating doctor with an option for an alternative surgery for treatment of hydrocephalus.

  6. Current controversies in infective endocarditis [version 1; referees: 3 approved

    Directory of Open Access Journals (Sweden)

    Thomas J. Cahill

    2015-11-01

    Full Text Available Infective endocarditis is a life-threatening disease caused by a focus of infection within the heart. For clinicians and scientists, it has been a moving target that has an evolving microbiology and a changing patient demographic. In the absence of an extensive evidence base to guide clinical practice, controversies abound. Here, we review three main areas of uncertainty: first, in prevention of infective endocarditis, including the role of antibiotic prophylaxis and strategies to reduce health care-associated bacteraemia; second, in diagnosis, specifically the use of multimodality imaging; third, we discuss the optimal timing of surgical intervention and the challenges posed by increasing rates of cardiac device infection.

  7. Nuclear controversy and the political organisations and pressure groups

    International Nuclear Information System (INIS)

    Robin, M.

    1983-01-01

    This paper describes the rise of nuclear controversy in France and the organisation of pressure groups in a political context. The author points out that public opinion became alerted to the dangers of nuclear energy much later in France than for example in the United States and highlights the action of ecologist groups. He concludes that contrary to the case in Australia, the FRG and Sweden anti-nuclear pressure groups have not been successful in truly influencing French governmental policy in that area. (NEA) [fr

  8. The nuclear controversy: unequal competition in public policy-making

    International Nuclear Information System (INIS)

    Sanderson, I.

    1980-05-01

    The subject is discussed under the headings: introduction; some epistemological problems; energy policy-making and the energy crisis; the nuclear controversy - substantive issues (the need for nuclear power; the desirability of nuclear power (safety of nuclear power; cost of nuclear power; nuclear power and weapons proliferation; nuclear power and civil liberties; some other aspects of nuclear power development); conclusion); the dominance of pro-nuclear thinking; conclusion and prospects. Appendix A describes the structure of the UK nuclear industry and its European connections. (U.K.)

  9. Journalism, controversy and convincing practices: the words and the training

    Directory of Open Access Journals (Sweden)

    Francisco José Castilhos Karam

    2012-09-01

    Full Text Available Journalism is raised by Greco-RomanRhetoric and Dialectics and comes through thepresent days without ever giving up on its centralpillar: words. Words are to be found everywhere:in writt en texts, static or dynamic images; in infographicsand great, typical journalistic tales. Theyare to be found in chronics, comics, informal talkand social networks. To become a journalist meansto not give up on words that are central when oneacknowledges the importance of the surroundings,of detection methods and narrative models. Wordsare at the core of controversy and convincing practices.They are at the core of becoming a journalist.

  10. Management of radiation therapy-induced mucositis in head and neck cancer patients. Part II: supportive treatments

    Directory of Open Access Journals (Sweden)

    Wei Cheong Ngeow

    2011-12-01

    Full Text Available Oropharyngeal mucositis is the acute inflammatory and ulcerative reaction of the oral mucosa following radiation therapy to the head and neck region. It is such a common problem that nearly all head and neck cancer patients develop some degree of mucositis. This complication is usually transient in nature but it also represents an important clinical problem as it is a painful, debilitating, dose-dependent side effect for which there is no widely acceptable prophylaxis or effective treatment. As several authoritative groups have recently either undertaken systematic reviews or issued guidelines on the management of mucositis, it is the aim of this review instead, to provide an overview of all the remedies and pharmaceutical agents available, as well as highlighting to researchers the gaps that need to be filled.

  11. Hilbert-Schmidt and Sobol sensitivity indices for static and time series Wnt signaling measurements in colorectal cancer - part A.

    Science.gov (United States)

    Sinha, Shriprakash

    2017-12-04

    Ever since the accidental discovery of Wingless [Sharma R.P., Drosophila information service, 1973, 50, p 134], research in the field of Wnt signaling pathway has taken significant strides in wet lab experiments and various cancer clinical trials, augmented by recent developments in advanced computational modeling of the pathway. Information rich gene expression profiles reveal various aspects of the signaling pathway and help in studying different issues simultaneously. Hitherto, not many computational studies exist which incorporate the simultaneous study of these issues. This manuscript ∙ explores the strength of contributing factors in the signaling pathway, ∙ analyzes the existing causal relations among the inter/extracellular factors effecting the pathway based on prior biological knowledge and ∙ investigates the deviations in fold changes in the recently found prevalence of psychophysical laws working in the pathway. To achieve this goal, local and global sensitivity analysis is conducted on the (non)linear responses between the factors obtained from static and time series expression profiles using the density (Hilbert-Schmidt Information Criterion) and variance (Sobol) based sensitivity indices. The results show the advantage of using density based indices over variance based indices mainly due to the former's employment of distance measures & the kernel trick via Reproducing kernel Hilbert space (RKHS) that capture nonlinear relations among various intra/extracellular factors of the pathway in a higher dimensional space. In time series data, using these indices it is now possible to observe where in time, which factors get influenced & contribute to the pathway, as changes in concentration of the other factors are made. This synergy of prior biological knowledge, sensitivity analysis & representations in higher dimensional spaces can facilitate in time based administration of target therapeutic drugs & reveal hidden biological information within

  12. Nuclear controversy as reflected in the daily press. Die Kernenergie-Kontroverse im Spiegel der Tageszeitungen

    Energy Technology Data Exchange (ETDEWEB)

    van Buiren, S

    1980-01-01

    Based on a content analysis of 2047 journal articles of the years 1974 to 1977 on conflicts over nuclear power plants (Wyhl, Brokdorf), the book intends to analyze the role of the media in present social conflicts. The book presents facts and figures concerning the information and opinions on nuclear power in five newspapers and the bias of these newspapers in favour of nuclear power or against it. According to the author, newspaper journalists have failed at least in one thing: to explain the dimensions of the conflict with regard to social policy and to give background information on their own opinions. On the other hand, the press has proved its independence: It is not an extended arm of industrial PR departments - at least not in the nuclear controversy. The greater part of the articles is in opposition to nuclear power. The development and modifications of the arguments stated by the various groups active in the nuclear controversy are analyzed in dependence of the increasingly aggressive nature of the conflict.

  13. Patients' perspective on controversial issues in total knee arthroplasty.

    Science.gov (United States)

    Kim, Tae Kyun; Choi, Jinbae; Shin, Kwang Sook; Chang, Chong Bum; Seong, Sang Cheol

    2008-03-01

    We investigated the level of patient knowledge and preferences over the currently controversial issues in TKA. One hundred patients who had decided to undergo TKA for advanced osteoarthritis were asked to complete a questionnaire inquiring their knowledge and preferences over three controversial issues: (1) computer assisted surgery (CAS), (2) minimal invasive surgery (MIS), and (3) ceramic femoral component. The patient preferences over the three issues were questioned again after they had been informed of advantages and disadvantages of each option using an explanatory document. Most (more than 75%) of the patients did not have sufficient knowledge and their knowledge was based on non-professional sources (more than 85%). Before the information was given, most (more than 80%) of the patients preferred a new option. After the information was provided, more patients preferred a standard option in the issues of CAS (60%) and MIS (88%). This study prompts health care providers to become more active in providing accurate information and to consider patients perspective in making decisions which will influence the benefits and risk of the patients.

  14. Endothelial progenitor cell subsets and preeclampsia: Findings and controversies

    Directory of Open Access Journals (Sweden)

    Armin Attar

    2017-10-01

    Full Text Available Vascular remodeling is an essential component of gestation. Endothelial progenitor cells (EPCs play an important role in the regulation of vascular homeostasis. The results of studies measuring the number of EPCs in normal pregnancies and in preeclampsia have been highly controversial or even contradictory because of some variations in technical issues and different methodologies enumerating three distinct subsets of EPCs: circulating angiogenic cells (CAC, colony forming unit endothelial cells (CFU-ECs, and endothelial colony-forming cells (ECFCs. In general, most studies have shown an increase in the number of CACs in the maternal circulation with a progression in the gestational age in normal pregnancies, while functional capacities measured by CFU-ECs and ECFCs remain intact. In the case of preeclampsia, mobilization of CACs and ECFCs occurs in the peripheral blood of pregnant women, but the functional capacities shown by culture of the derived colony-forming assays (CFU-EC and ECFC assays are altered. Furthermore, the number of all EPC subsets will be reduced in umbilical cord blood in the case of preeclampsia. As EPCs play an important role in the homeostasis of vascular networks, the difference in their frequency and functionality in normal pregnancies and those with preeclampsia can be expected. In this review, there was an attempt to provide a justification for these controversies.

  15. The rocky flats controversy on radionuclide soil action levels

    International Nuclear Information System (INIS)

    Earle, T.C.

    2004-01-01

    An account of the Rocky Flats radionuclide soil action level controversy is presented as: a case study for the purpose of understanding the nature and value of stakeholder involvement in the management of radiological hazards. The report consists of three main sections. The first section outlines the Rocky Flats story, including the Cold War era, which was characterised by secrecy and distrust, the post-Cold War era, in which trust and co-operation between risk managers and the public began to develop. This contrast between these two historical periods provides the context necessary to understand the radionuclide soil action level controversy, the main events of which are described in the second section. In the final section, the Rocky Flats case is briefly discussed within the framework of a general model of stakeholder involvement and the lessons learned from the case are identified: (1) without a basis in shared values, collaborative public involvement in the management of radiological hazards is not possible; (2) given a basis in shared values, collaborative public involvement can lead to improved solutions to the management of radiological hazards; and (3) risk managers should therefore seek to understand the values of public stakeholders and to identify ways, through stakeholder involvement, that those values can be incorporated in management practice. (author)

  16. Controversies Concerning the Canadian Not Criminally Responsible Reform Act.

    Science.gov (United States)

    Lacroix, Robert; O'Shaughnessy, Roy; McNiel, Dale E; Binder, Renée L

    2017-03-01

    In Canada, individuals found not criminally responsible on account of mental disorder are subject to the disposition recommendations of the Provincial or Territorial Review Board of the jurisdiction where the offense was committed. Bill C-14, known as "The Not Criminally Responsible Reform Act" made changes to the postverdict disposition process of these individuals. This legislation was consistent with a broader "tough-on-crime" agenda of the previous federal government. The legislative changes codify that Review Boards take public safety as the "paramount consideration" in making their recommendations. The legislation also creates a new "high-risk" category for certain offenders and imposes limitations on their liberty. Further, Bill C-14 seeks to enhance victim involvement in the disposition process. The passage of this legislation has generated significant controversy in the medical and legal fields. Critics have stated that there is an absence of empirical evidence on which to base the amendments, that the legislation was an overreaction to high-profile cases, and that Bill C-14 is in questionable compliance with the Canadian Charter of Rights and Freedoms. In this review, we explore the potential catalysts involved in the creation of Bill C-14, the controversy surrounding the legislation, and the potential future impact on practicing forensic psychiatrists and on the forensic mental health system in Canada. © 2017 American Academy of Psychiatry and the Law.

  17. The portrayal of J. Marion Sims' controversial surgical legacy.

    Science.gov (United States)

    Spettel, Sara; White, Mark Donald

    2011-06-01

    In the mid 1800s Dr. J. Marion Sims reported the successful repair of vesicovaginal fistulas with a technique he developed by performing multiple operations on female slaves. A venerated physician in his time, the legacy of Dr. Sims is controversial and represents a significant chapter in the mistreatment of African-Americans by the medical establishment. This review compares the modern debate surrounding his legacy with the presentation of his operation in widely consulted urological texts and journals. A literature review was performed of medical, sociological and periodical sources (1851 to the present) regarding J. Marion Sims and vesicovaginal fistula repair. During the last several decades, while the controversy around Dr. Sims' surgical development has produced a steady stream of articles in the historical and popular literature, relatively little mention is found in standard urology textbooks or journals. With increased public attention, some have debated the removal or modification of public tributes to Dr. Sims. This move has been countered by arguments against the validity of judging a 19th century physician by modern standards. While historians, ethicists and the popular press have debated Dr. Sims' legacy, medical sources have continued to portray him unquestionably as a great figure in medical history. This division keeps the medical profession uninformed and detached from the public debate on his legacy and, thus, the larger issues of ethical treatment of surgical patients. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  18. Controversies relating to the management of acromioclavicular joint dislocations.

    Science.gov (United States)

    Modi, C S; Beazley, J; Zywiel, M G; Lawrence, T M; Veillette, C J H

    2013-12-01

    The aim of this review is to address controversies in the management of dislocations of the acromioclavicular joint. Current evidence suggests that operative rather than non-operative treatment of Rockwood grade III dislocations results in better cosmetic and radiological results, similar functional outcomes and longer time off work. Early surgery results in better functional and radiological outcomes with a reduced risk of infection and loss of reduction compared with delayed surgery. Surgical options include acromioclavicular fixation, coracoclavicular fixation and coracoclavicular ligament reconstruction. Although non-controlled studies report promising results for arthroscopic coracoclavicular fixation, there are no comparative studies with open techniques to draw conclusions about the best surgical approach. Non-rigid coracoclavicular fixation with tendon graft or synthetic materials, or rigid acromioclavicular fixation with a hook plate, is preferable to fixation with coracoclavicular screws owing to significant risks of loosening and breakage. The evidence, although limited, also suggests that anatomical ligament reconstruction with autograft or certain synthetic grafts may have better outcomes than non-anatomical transfer of the coracoacromial ligament. It has been suggested that this is due to better restoration horizontal and vertical stability of the joint. Despite the large number of recently published studies, there remains a lack of high-quality evidence, making it difficult to draw firm conclusions regarding these controversial issues.

  19. The mesh controversy [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Joshua A. Cohn

    2016-09-01

    Full Text Available Pelvic organ prolapse and stress urinary incontinence are common conditions for which approximately 11% of women will undergo surgical intervention in their lifetime. The use of vaginal mesh for pelvic organ prolapse and stress urinary incontinence rose rapidly in the early 2000s as over 100 mesh products were introduced into the clinical armamentarium with little regulatory oversight for their use. US Food and Drug Administration Public Health Notifications in 2008 and 2011, as well as reclassification of transvaginal mesh for prolapse to class III in early 2016, were a response to debilitating complications associated with transvaginal mesh placement in many women. The midurethral sling has not been subject to the same reclassification and continues to be endorsed as the “gold standard” for surgical management of stress urinary incontinence by subspecialty societies. However, litigators have not differentiated between mesh for prolapse and mesh for incontinence. As such, all mesh, including that placed for stress urinary incontinence, faces continued controversy amidst an uncertain future. In this article, we review the background of the mesh controversy, recent developments, and the anticipated role of mesh in surgery for prolapse and stress urinary incontinence going forward.

  20. Staggering successes amid controversy in California water management

    Science.gov (United States)

    Lund, J. R.

    2012-12-01

    Water in California has always been important and controversial, and it probably always will be. California has a large, growing economy and population in a semi-arid climate. But California's aridity, hydrologic variability, and water controversies have not precluded considerable economic successes. The successes of California's water system have stemmed from the decentralization of water management with historically punctuated periods of more centralized strategic decision-making. Decentralized management has allowed California's water users to efficiently explore incremental solutions to water problems, ranging from early local development of water systems (such as Hetch Hetchy, Owens Valley, and numerous local irrigation projects) to more contemporary efforts at water conservation, water markets, wastewater reuse, and conjunctive use of surface and groundwater. In the cacophony of local and stakeholder interests, strategic decisions have been more difficult, and consequently occur less frequently. California state water projects and Sacramento Valley flood control are examples where decades of effort, crises, floods and droughts were needed to mobilize local interests to agree to major strategic decisions. Currently, the state is faced with making strategic environmental and water management decisions regarding its deteriorating Sacramento-San Joaquin Delta. Not surprisingly, human uncertainties and physical and fiscal non-stationarities dominate this process.

  1. Spine Trauma-What Are the Current Controversies?

    Science.gov (United States)

    Oner, Cumhur; Rajasekaran, Shanmuganathan; Chapman, Jens R; Fehlings, Michael G; Vaccaro, Alexander R; Schroeder, Gregory D; Sadiqi, Said; Harrop, James

    2017-09-01

    Although less common than other musculoskeletal injuries, spinal trauma may lead to significantly more disability and costs. During the last 2 decades there was substantial improvement in our understanding of the basic patterns of spinal fractures leading to more reliable classification and injury severity assessment systems but also rapid developments in surgical techniques. Despite these advancements, there remain unresolved issues concerning the management of these injuries. At this moment there is persistent controversy within the spinal trauma community, which can be grouped under 6 headings. First of all there is still no unanimity on the role and timing of medical and surgical interventions for patients with associated neurologic injury. The same is also true for type and timing of surgical intervention in multiply injured patients. In some common injury types like odontoid fractures and burst type (A3-A4) fractures in thoracolumbar spine, there is wide variation in practice between operative versus nonoperative management without clear reasons. Also, the role of different surgical approaches and techniques in certain injury types are not clarified yet. Methods of nonoperative management and care of elderly patients with concurrent complex disorders are also areas where there is no consensus. In this overview article the main reasons for these controversies are reviewed and the possible ways for resolutions are discussed.

  2. Playful biometrics: controversial technology through the lens of play.

    Science.gov (United States)

    Ellerbrok, Ariane

    2011-01-01

    This article considers the role of play in the context of technological emergence and expansion, particularly as it relates to recently emerging surveillance technologies. As a case study, I consider the trajectory of automated face recognition—a biometric technology of numerous applications, from its more controversial manifestations under the rubric of national security to a clearly emerging orientation toward play. This shift toward “playful” biometrics—or from a technology traditionally coded as “hard” to one now increasingly coded as “soft”—is critical insofar as it renders problematic the traditional modes of critique that have, up until this point, challenged the expansion of biometric systems into increasingly ubiquitous realms of everyday life. In response to this dynamic, I propose theorizing the expansion of face recognition specifically in relation to “play,” a step that allows us to broaden the critical space around newly emerging playful biometrics, as well as playful surveillance more generally. In addition, play may also have relevance for theorizing other forms of controversial technology, particularly given its potential role in processes of obfuscation, normalization, and marginalization.

  3. Comprehension of Relations among Controversial Texts: Effects of External Strategy Use

    Science.gov (United States)

    Kobayashi, Keiichi

    2009-01-01

    This study examined the effects of external strategy use on the comprehension of relations among controversial texts. About 80 undergraduates read six controversial texts for the purpose of either finding intertextual relations or forming their opinion about the controversial issue. Half of them were permitted to use external strategies, the other…

  4. Health effects of low level exposure to ionizing radiation: origin and development of a controversy

    International Nuclear Information System (INIS)

    Masse, Roland

    2014-06-01

    Health hazard assessment related to doses of ionizing radiation lower than 100-200 mSv is a matter of controversy, and more acutely when choosing transition towards a new energetic paradigm. Neither epidemiological nor experimental data can be used to determine the shape of the dose-effect relationship from 0 to 100 mSv. Recently, however, long term follow-up of children and young adults exposed to CT scans evidenced that doses of 50 to 60 mGy delivered at high dose-rate were associated to a significant increase of leukemias and cancers, including brain cancer. On the basis of the available data, this article leaves some questions about the plausibility of the linear no threshold hypothesis (LNT) used by radiological protection bodies to control overexposure of the members of public and workers. It concludes that although the plausibility of LNT is fairly weak, using LNT helps to situate the order of magnitude of health risks associated with the development of nuclear power plants and to compare them with those resulting from burning fossil fuels and biomass; the results show that sparing human lives can only be achieved with nuclear for the same quantity of energy produced. (author)

  5. Malignant pleural mesothelioma: history, controversy and future of a manmade epidemic

    Directory of Open Access Journals (Sweden)

    Oluf Dimitri Røe

    2015-03-01

    Full Text Available Asbestos is the term for a family of naturally occurring minerals that have been used on a small scale since ancient times. Industrialisation demanded increased mining and refining in the 20th century, and in 1960, Wagner, Sleggs and Marchand from South Africa linked asbestos to mesothelioma, paving the way to the current knowledge of the aetiology, epidemiology and biology of malignant pleural mesothelioma. Pleural mesothelioma is one of the most lethal cancers, with increasing incidence worldwide. This review will give some snapshots of the history of pleural mesothelioma discovery, and the body of epidemiological and biological research, including some of the controversies and unresolved questions. Translational research is currently unravelling novel circulating biomarkers for earlier diagnosis and novel treatment targets. Current breakthrough discoveries of clinically promising noninvasive biomarkers, such as the 13-protein signature, microRNAs and the BAP1 mesothelioma/cancer syndrome, are highlighted. The asbestos history is a lesson to not be repeated, but here we also review recent in vivo and in vitro studies showing that manmade carbon nanofibres could pose a similar danger to human health. This should be taken seriously by regulatory bodies to ensure thorough testing of novel materials before release in the society.

  6. Ectopic expression of miR-34a enhances radiosensitivity of non-small cell lung cancer cells, partly by suppressing the LyGDI signaling pathway

    International Nuclear Information System (INIS)

    Duan Weiming; Xu Yaxiang; Dong Yujin; Cao Lili; Tong Jian; Zhou Xinwen

    2013-01-01

    miR-34a is transcriptionally induced by the tumor suppressor gene p53, which is often downregulated in non-small cell lung cancer (NSCLC). To address whether the downstream signal of miR-34a is sufficient to induce apoptosis and to alter cellular radiosensitivity, a chemical synthetic miR-34a mimic was delivered into A549 and H1299 cells, with or without co-treatment of γ-irradiation. Results showed that ectopic expression of miR-34a induced dose-dependent cell growth inhibition and apoptosis in a p53-independent manner in both NSCLC cell lines. Interestingly, LyGDI was discovered as a new target gene of miR-34a, and downregulation of LyGDI promoted Rac1 activation and membrane translocation, resulting in cell apoptosis. Furthermore, restoration of miR-34a indirectly reduced cyclooxygenase-2 (COX-2) expression. Taken together, these results demonstrate that restoration of miR-34a expression enhances radiation-induced apoptosis, partly by suppressing the LyGDI signaling pathway, and miR-34a could possibly be used as a radiosensitizer for non-small cell lung cancer therapy. (author)

  7. Human Lung Cancer Risks from Radon – Part II – Influence from Combined Adaptive Response and Bystander Effects – A Microdose Analysis

    Science.gov (United States)

    Leonard, Bobby E.; Thompson, Richard E.; Beecher, Georgia C.

    2010-01-01

    In the prior Part I, the potential influence of the low level alpha radiation induced bystander effect (BE) on human lung cancer risks was examined. Recent analysis of adaptive response (AR) research results with a Microdose Model has shown that single low LET radiation induced charged particles traversals through the cell nucleus activates AR. We have here conducted an analysis based on what is presently known about adaptive response and the bystander effect (BE) and what new research is needed that can assist in the further evaluation human cancer risks from radon. We find that, at the UNSCEAR (2000) worldwide average human exposures from natural background and man-made radiations, the human lung receives about a 25% adaptive response protection against the radon alpha bystander damage. At the UNSCEAR (2000) minimum range of background exposure levels, the lung receives minimal AR protection but at higher background levels, in the high UNSCEAR (2000) range, the lung receives essentially 100% protection from both the radon alpha damage and also the endogenic, spontaneously occurring, potentially carcinogenic, lung cellular damage. PMID:22461760

  8. Evidence to the Windscale Inquiry on the social and political implications of the nuclear controversy

    International Nuclear Information System (INIS)

    Taylor, P.J.

    1977-01-01

    Mr.Taylor's paper has the following section headings: preface; my relevant experience; the problem of controversy; the nature of the nuclear power controversy; the role of argument; paranoia and repression; structural inertia and conflict; the internationalisation of the opposition; the place of THORP in the context of an environmental revolution; the effect on THORP; the disposal controversy; the safety controversy; the psychological aspects of the nuclear controversy; nuclear power and symbolic representation; my own view as a social anthropologist (fledgling). (U.K.)

  9. Role of Internal Mammary Node Radiation as a Part of Modern Breast Cancer Radiation Therapy: A Systematic Review

    International Nuclear Information System (INIS)

    Verma, Vivek; Vicini, Frank; Tendulkar, Rahul D.; Khan, Atif J.; Wobb, Jessica; Edwards-Bennett, Sophia; Desai, Anand; Shah, Chirag

    2016-01-01

    Purpose: Despite data from multiple randomized trials, the role of internal mammary lymph node irradiation as a part of regional nodal irradiation (IMLN RT–RNI) remains unanswered. Recent noteworthy data and modern RT techniques might identify a subset of patients who will benefit from IMLN RT–RNI, lending insight into the balance between improved outcomes and acceptable toxicity. We evaluated the current role of IMLN RT–RNI by analyzing randomized, prospective, and retrospective data. Methods and Materials: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a review of the published data was performed using PubMed to evaluate published studies from 1994 to 2015. The information evaluated included the number of patients, follow-up period, technical aspects of RT, and outcomes (clinical outcomes, complications/toxicity). Results: We included 16 studies (4 randomized, 4 nonrandomized, 7 retrospective, and 1 meta-analysis). Although older randomized trials failed to show differences in clinical outcomes or toxicity with IMLN RT–RNI, recent randomized data suggest the potential for improved outcomes, including overall survival, with IMLN RT–RNI. Furthermore, nonrandomized data have suggested a potential benefit for central tumors with IMLN RT–RNI. Although recent data have suggested a potential increase in pulmonary complications with IMLN RT–RNI with the use of advanced radiation techniques, toxicity rates remain low with limited cardiac toxicity data available. Conclusions: Increasing data from recent randomized trials support the use of IMLN RT–RNI. IMLN RT can be considered based on the inclusion of IMLN RT as a part of RNI in recent trials and the inclusion criteria from IMLN RT–RNI trials and for patients with central or medial tumors and axillary disease.

  10. Role of Internal Mammary Node Radiation as a Part of Modern Breast Cancer Radiation Therapy: A Systematic Review

    Energy Technology Data Exchange (ETDEWEB)

    Verma, Vivek [Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska (United States); Vicini, Frank [Michigan Healthcare Professionals/21st Century Oncology, Farmington Hills, Michigan (United States); Tendulkar, Rahul D. [Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States); Khan, Atif J. [Department of Radiation Oncology, Rutgers Robert Wood Johnson Medical School and the Cancer Institute of New Jersey, New Brunswick, New Jersey (United States); Wobb, Jessica [Department of Radiation Oncology, Ohio State University, Columbus, Ohio (United States); Edwards-Bennett, Sophia [21st Century Oncology, Myrtle Beach, South Carolina (United States); Desai, Anand [Department of Radiation Oncology, Summa Health System, Akron, Ohio (United States); Shah, Chirag, E-mail: csshah27@hotmail.com [Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States)

    2016-06-01

    Purpose: Despite data from multiple randomized trials, the role of internal mammary lymph node irradiation as a part of regional nodal irradiation (IMLN RT–RNI) remains unanswered. Recent noteworthy data and modern RT techniques might identify a subset of patients who will benefit from IMLN RT–RNI, lending insight into the balance between improved outcomes and acceptable toxicity. We evaluated the current role of IMLN RT–RNI by analyzing randomized, prospective, and retrospective data. Methods and Materials: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a review of the published data was performed using PubMed to evaluate published studies from 1994 to 2015. The information evaluated included the number of patients, follow-up period, technical aspects of RT, and outcomes (clinical outcomes, complications/toxicity). Results: We included 16 studies (4 randomized, 4 nonrandomized, 7 retrospective, and 1 meta-analysis). Although older randomized trials failed to show differences in clinical outcomes or toxicity with IMLN RT–RNI, recent randomized data suggest the potential for improved outcomes, including overall survival, with IMLN RT–RNI. Furthermore, nonrandomized data have suggested a potential benefit for central tumors with IMLN RT–RNI. Although recent data have suggested a potential increase in pulmonary complications with IMLN RT–RNI with the use of advanced radiation techniques, toxicity rates remain low with limited cardiac toxicity data available. Conclusions: Increasing data from recent randomized trials support the use of IMLN RT–RNI. IMLN RT can be considered based on the inclusion of IMLN RT as a part of RNI in recent trials and the inclusion criteria from IMLN RT–RNI trials and for patients with central or medial tumors and axillary disease.

  11. In Referees We Trust? Controversies over Grant Peer Review in the Late Twentieth Century

    Science.gov (United States)

    Baldwin, Melinda

    While many accounts of external refereeing assume that it has been a consistent part of science since the seventeenth century, the practice developed far more slowly and haphazardly than many observers realize, and it was not until after the Second World War that ''peer review'' became considered an essential part of scientific publishing or grant-making. This talk will explore refereeing procedures at American grant-giving organizations in the twentieth century, focusing especially on the National Science Foundation and the National Institutes of Health. The creators of the NSF and the NIH put refereeing systems in place at their foundation. However, the form and function of these systems differed from modern ''peer review'' in several important ways. At the NSF the initial purpose of the referee process was to advise the NSF program directors, not to dictate funding decisions. At the NIH, small ''study sections'' devoted to particular subjects made recommendations to the NIH leadership, which rendered final judgments. However, beginning in the 1960s a series of controversies about NIH and NSF grants placed refereeing procedures at these organizations under more intense scrutiny. These debates culminated in six days of Special Oversight Hearings into the NSF's peer review process in the summer of 1975. Following the hearings, both the NSF and NIH reformed their review processes to place more emphasis on referees' opinions about grant proposals, making peer review increasingly responsible for decision-making. These controversies illustrate that refereeing continued to undergo significant changes in form and purpose throughout the twentieth century, and further suggest that both the scientific community and the public placed increased emphasis on the role of the referee during the late twentieth century.

  12. Legitimacy of hospital reconfiguration: the controversial downsizing of Kidderminster hospital.

    Science.gov (United States)

    Oborn, Eivor

    2008-04-01

    This paper examines the contested organizational legitimacy of hospital reconfiguration, which continues to be a central issue in health care management. A qualitative study which focuses on the controversial downsizing of Kidderminster Hospital, a highly publicized landmark case of district general hospital closure. Rhetorical strategies are analysed to examine how legitimacy was constructed by stakeholder groups and how these strategies were used to support or resist change. Stakeholders promoting change legitimized re-organization pragmatically and morally arguing the need for centralization as a rational necessity. Stakeholders resisting change argued for cognitive and moral legitimacy in current service arrangements, contrasting local versus regionalized aspects of safety and provision. Groups managed to talk past each other, failing to establish a dialogue, which led to significant conflict and political upheaval. Stakeholders value hospitals in different ways and argue for diverse accounts of legitimacy. Broader discourses of medical science and democratic participation were drawn into rhetorical texts concerning regionalization to render them more powerful.

  13. The angus mammoth: A decades-old scientific controversy resolved

    Science.gov (United States)

    Holen, S.R.; May, D.W.; Mahan, S.A.

    2011-01-01

    The Angus Mammoth site in south-central Nebraska has been controversial since its discovery in 1931 when a fluted artifact was reported to be associated with the mammoth. For nearly 80 years it has not been known if Angus was a paleontol??gica! site predating the human occupation of North America as has been asserted by some geologists and paleontologists, or an archaeological site dating to the late Pleistocene as has been advocated by some archaeologists. Geomorphic study and luminescence dating have finally solved the problem after nearly eight decades. Although microwear and technological analyses have determined that the Angus biface is an authentic artifact, TL and IRSL dates have shown that the matrix above the mammoth is much too old for a mammoth/fluted point association to be valid. Copyright ??2011 by the Society for American Archaeology.

  14. Guidelines for Qualitative Research in Organization Studies: Controversy and Possibilities

    Directory of Open Access Journals (Sweden)

    Maria Fernanda Rios Cavalcanti

    2017-09-01

    Full Text Available The aim of the present article is to tackle the controversy of establishing guidelines for qualitative research in Organization and Management Theory (OMT and to present a summary of suggestions on how to conduct good qualitative research given by methodologists on top-tier international publications. In order to do so, the article discusses: general guidelines for qualitative research; how to achieve coherence and transparency in a qualitative empirical study; the meaning and importance of the concept of reflexivity; and, finally how to establish a theoretical contribution and transferability of findings in such context. The work presents a valuable contribution because such guidelines, concepts, and approaches can be adopted by students and researchers when conducting a qualitative research proposal, and by periodic reviewers to evaluate the quality of existing empirical studies.

  15. The significance test controversy revisited the fiducial Bayesian alternative

    CERN Document Server

    Lecoutre, Bruno

    2014-01-01

    The purpose of this book is not only to revisit the “significance test controversy,”but also to provide a conceptually sounder alternative. As such, it presents a Bayesian framework for a new approach to analyzing and interpreting experimental data. It also prepares students and researchers for reporting on experimental results. Normative aspects: The main views of statistical tests are revisited and the philosophies of Fisher, Neyman-Pearson and Jeffrey are discussed in detail. Descriptive aspects: The misuses of Null Hypothesis Significance Tests are reconsidered in light of Jeffreys’ Bayesian conceptions concerning the role of statistical inference in experimental investigations. Prescriptive aspects: The current effect size and confidence interval reporting practices are presented and seriously questioned. Methodological aspects are carefully discussed and fiducial Bayesian methods are proposed as a more suitable alternative for reporting on experimental results. In closing, basic routine procedures...

  16. AMS and controversies in history The Spanish conquest of Peru

    CERN Document Server

    Zoppi, U; Jacobsen, G; Laurencich-Minelli, L; Lawson, E M; Sarkisian, G; Tuniz, C

    2000-01-01

    The quest for understanding the past often contains a subjective component. Legends, myths, traditions and personal beliefs can unconsciously influence the interpretation of the scientific outcomes or, in the worst instances, even lead to forgery. Fortunately, an increasing number of scientific tools are available nowadays and can be combined to discredit such detriments and offer more reliable foundations for an objective analysis. Radiocarbon dating by AMS is a relatively non-invasive method and is particularly useful when valuable historical artefacts are involved. In this paper, we will present controversial cases where AMS is playing an important role in understanding the past. In particular, we will discuss the use of AMS to authenticate historical documents revealing a new version of the conquest of Peru by Pizarro in the early 1530s.

  17. Autonomy, Respect, and Arrogance in the Danish Cartoon Controversy

    DEFF Research Database (Denmark)

    Rostbøll, Christian F.

    2009-01-01

    is understood as something we should presume everyone possesses, it provides a strong basis for equal respect among people from diverse cultures. A Kantian conception of autonomy can justify the right to freedom of expression while it at the same time requires that we in the exercise of freedom of expression......Autonomy is increasingly rejected as a fundamental principle by liberal political theorists, because it is regarded as incompatible with respect for diversity. This article seeks, via an analysis of the Danish cartoon controversy, to show that the relationship between autonomy and diversity is more...... complex than often posited. Particularly, it asks whether the autonomy defense of freedom of expression encourages disrespect for religious feelings. Autonomy leads to disrespect for diversity only when it is understood as a character ideal that must be promoted as an end in itself. If it by contrast...

  18. Unitization in Brazil: controversial issues; Unitizacao no Brasil: questoes controversas

    Energy Technology Data Exchange (ETDEWEB)

    Bucheb, Jose Alberto [PETROBRAS, Rio de Janeiro, RJ (Brazil)

    2008-07-01

    One of the main consequences of the growing number of the tendered blocks is the increasing probability of the discovery of oil and gas accumulations that extends through more than one concession. In these cases, the Brazilian Petroleum Law determines that the concessionaires of the adjoining blocks shall agree on the unitization of the production. In this context, the negotiations of the first agreements have brought some controversies not yet resolved. The first one is related to the instrument that will define the basis of the unitization process in case of non-agreement within the maximum period established by the ANP. Another issue still in discussion relates to the scope of the unitization process: field, block, vertical prism of indeterminate depth, vertical prism of determinate depth or reservoir (accumulation). Additionally, the unitization involving concessions with different local content commitments is analyzed. (author)

  19. Open access and the humanities contexts, controversies and the future

    CERN Document Server

    Eve, Martin Paul

    2014-01-01

    If you work in a university, you are almost certain to have heard the term 'open access' in the past couple of years. You may also have heard either that it is the utopian answer to all the problems of research dissemination or perhaps that it marks the beginning of an apocalyptic new era of 'pay-to-say' publishing. In this book, Martin Paul Eve sets out the histories, contexts and controversies for open access, specifically in the humanities. Broaching practical elements alongside economic histories, open licensing, monographs and funder policies, this book is a must-read for both those new to ideas about open-access scholarly communications and those with an already keen interest in the latest developments for the humanities.

  20. Thermal conductance of nanofluids: is the controversy over?

    International Nuclear Information System (INIS)

    Keblinski, Pawel; Prasher, Ravi; Eapen, Jacob

    2008-01-01

    Over the last decade nanofluids (colloidal suspensions of solid nanoparticles) sparked excitement as well as controversy. In particular, a number of researches reported dramatic increases of thermal conductivity with small nanoparticle loading, while others showed moderate increases consistent with the effective medium theories on well-dispersed conductive spheres. Accordingly, the mechanism of thermal conductivity enhancement is a hotly debated topic. We present a critical analysis of the experimental data in terms of the potential mechanisms and show that, by accounting for linear particle aggregation, the well established effective medium theories for composite materials are capable of explaining the vast majority of the reported data without resorting to novel mechanisms such as Brownian motion induced nanoconvection, liquid layering at the interface, or near-field radiation. However, particle aggregation required to significantly enhance thermal conductivity, also increases fluid viscosity rendering the benefit of nanofluids to flow based cooling applications questionable.

  1. Restaurant Menu Labeling Policy: Review of Evidence and Controversies

    Science.gov (United States)

    VanEpps, Eric M.; Roberto, Christina A.; Park, Sara; Economos, Christina D.; Bleich, Sara N.

    2016-01-01

    In response to high rates of obesity in the USA, several American cities, counties, and states have passed laws requiring restaurant chains to post labels identifying the energy content of items on menus, and nationwide implementation of menu labeling is expected in late 2016. In this review, we identify and summarize the results of 16 studies that have assessed the impact of real-world numeric calorie posting. We also discuss several controversies surrounding the US Food and Drug Administration's implementation of federally mandated menu labeling. Overall, the evidence regarding menu labeling is mixed, showing that labels may reduce the energy content of food purchased in some contexts, but have little effect in other contexts. However, more data on a range of ong-term consumption habits and restaurant responses is needed to fully understand the impact menu labeling laws will have on the US population's diet. PMID:26877095

  2. Discussing agrochemical themes: an approach through socio-scientific controversies

    Directory of Open Access Journals (Sweden)

    Eril Medeiros da Fonseca

    2017-12-01

    Full Text Available The theme of "agro-toxicology" in the Rural Education pervades key issues to be problematized, such as the care of rural workers, from the concept of health as something broad, involving access to cultural goods, leisure and communication and still, the collective physical, mental and social well-being. The use of pesticides, in addition to compromising the health of those who work in the field and those who feed on what is produced in the field, brings with it a conception of health that, in addition to suffering and individualizing, affects our biological diversity. The objective of this study is to discuss pesticides and their implications for health, through the approach of Socio-Scientific Controversies (CSC in Science Teaching and Rural Education.

  3. Ecotheology and the theology of eating: controversies and convergencies

    Directory of Open Access Journals (Sweden)

    Panu Pihkala

    2015-01-01

    Full Text Available Environmental theology (or, ecotheology developed slowly during the first half of the twentieth century and has become a major field of study since the late 1960s. While many of the issues discussed in ecotheological works have included consequences for food production and eating habits, these themes were often not explicitly discussed. The reasons for this are interesting and complex. Issues related to food have been culturally very sensitive and have manifold connections to religiosity. In regard to the discussion about the rights and value of animals, controversies have been seen to arise between ecotheology and ‘animal theology’. Recently, a new interest has arisen in the themes of food, eating, and Christian theology, which has resulted in a new field of literature which could be called the ‘theology of eating’. This article gives an overview of the relations between these fields, with an emphasis on both early ecotheology and new literature about the theology of eating.

  4. [Neurosis as a mental disease--controversies surrounding insurance certification].

    Science.gov (United States)

    Jabłoński, Christian; Kobek, Mariusz; Kowalczyk-Jabłońska, Dorota

    2011-01-01

    In the years 2008-2009, experts from the Department of Forensic Medicine in Katowice issued a dozen of expert opinions on the nature of the neurosis, addressing the question whether neurosis is a mental disease as understood under the general insurance conditions or whether neurosis is a mental disease as such. All the submitted cases involved policemen who had been diagnosed as neurotic and were refused insurance payments since the insurance company claimed payments could not have been effected due to the diagnosis of mental disease, meaning neurosis in the discussed cases. The plaintiffs invoked the fact that medical terminology describes such states as "mental disorders". In the article, the authors present the adopted model of opinionating, make an attempt at explaining the controversy and discuss the subtleties of medical terminology and the core differences between the terms "mental disorder" and "mental disease" as employed in medico-legal opinionating in such cases.

  5. Unicameral bone cysts: general characteristics and management controversies.

    Science.gov (United States)

    Pretell-Mazzini, Juan; Murphy, Robert Francis; Kushare, Indranil; Dormans, John P

    2014-05-01

    Unicameral bone cysts are benign bone lesions that are often asymptomatic and commonly develop in the proximal humerus and femur of skeletally immature patients. The etiology of these lesions remains unknown. Most patients present with a pathologic fracture, but these cysts can be discovered incidentally, as well. Radiographically, a unicameral bone cyst appears as a radiolucent lesion with cortical thinning and is centrally located within the metaphysis. Although diagnosis is frequently straightforward, management remains controversial. Because the results of various management methods are heterogeneous, no single method has emerged as the standard of care. New minimally invasive techniques involve cyst decompression with bone grafting and instrumentation. These techniques have yielded promising results, with low rates of complications and recurrence reported; however, prospective clinical trials are needed to compare these techniques with current evidence-based treatments.

  6. AMS and controversies in history: The Spanish conquest of Peru

    International Nuclear Information System (INIS)

    Zoppi, U.; Hua, Q.; Jacobsen, G.; Sarkissian, G.; Lawson, E.M.; Tuniz, C.; Laurencich Minelli, L.

    2000-01-01

    The quest for understanding the past often contains a subjective component. Legends, myths, traditions and personal beliefs can unconsciously influence the interpretation of the scientific outcomes or, in the worst instances, even lead to forgery. Fortunately, an increasing number of scientific tools are available nowadays and can be combined to discredit such detriments and offer more reliable foundations for an objective analysis. Radiocarbon dating by AMS is a relatively non-invasive method and is particularly useful when valuable historical artefacts are involved. In this paper, we will present controversial cases where AMS is playing an important role in understanding the past. In particular, we will discuss the use of AMS to authenticate historical documents revealing a new version of the conquest of Peru by Pizarro in the early 1530s

  7. Data Sprints: A Collaborative Format in Digital Controversy Mapping

    DEFF Research Database (Denmark)

    Munk, Anders Kristian; Tommaso, Venturini; Meunier, Axel

    2017-01-01

    driven by a desire to provide navigational aids to actors faced with the challenge of making sense of complicated techno-scientific problems. Natively digital media technologies have thus been re-appropriated by STS researchers specifically for the purpose of mapping controversies in a way that would...... experiences with various forms of public engagement and participation. Through a concrete reappropriation of a collaborative format that is indeed native to the digital domain - namely the hackathon - we will show how digital methods can make a difference in participatory STS research. The data sprint, as we...... in amsterdam. Through a mix of digital methods ranging from web cartography and text mining to scientometrics and social media analysis we took on questions related to climate adaptation funding, vulnerability assessment, project management, and dynamics of the international negotiations. The sprints hardwired...

  8. Present state of the controversy about the grain boundary relaxation

    International Nuclear Information System (INIS)

    Povolo, F.; Molinas, B.J.

    1990-04-01

    An analysis of the internal friction produced by grain boundary relaxation in metals, alloys and ceramics is presented. The different interpretations given in the literature to relaxation phenomena occurring at temperatures above about half the melting point which include the influence of grain boundaries and their interaction with solutes and precipitates are discussed in detail. A complete set of the experimental data disposable in this field since 1972 until today is reviewed. Finally, some recent experiments are discussed and new ones are suggested. They might solve the actual controversy about the real origin of the relaxation phenomena observed. If this is the case, a considerable amount of information already published can be taken into account with a good degree of confidence. This information contributes to the description of the structure and behaviour of grain boundaries, both being important topics for materials science. (author). 119 refs, 21 figs, 1 tab

  9. A VLBI resolution of the Pleiades distance controversy.

    Science.gov (United States)

    Melis, Carl; Reid, Mark J; Mioduszewski, Amy J; Stauffer, John R; Bower, Geoffrey C

    2014-08-29

    Because of its proximity and its youth, the Pleiades open cluster of stars has been extensively studied and serves as a cornerstone for our understanding of the physical properties of young stars. This role is called into question by the "Pleiades distance controversy," wherein the cluster distance of 120.2 ± 1.5 parsecs (pc) as measured by the optical space astrometry mission Hipparcos is significantly different from the distance of 133.5 ± 1.2 pc derived with other techniques. We present an absolute trigonometric parallax distance measurement to the Pleiades cluster that uses very long baseline radio interferometry (VLBI). This distance of 136.2 ± 1.2 pc is the most accurate and precise yet presented for the cluster and is incompatible with the Hipparcos distance determination. Our results cement existing astrophysical models for Pleiades-age stars. Copyright © 2014, American Association for the Advancement of Science.

  10. Present status of controversies regarding the thermal Casimir force

    International Nuclear Information System (INIS)

    Mostepanenko, V M; Bezerra, V B; Decca, R S; Geyer, B; Fischbach, E; Klimchitskaya, G L; Krause, D E; Lopez, D; Romero, C

    2006-01-01

    It is well known that, beginning in 2000, the behaviour of the thermal correction to the Casimir force between real metals has been hotly debated. As was shown by several research groups, the Lifshitz theory, which provides the theoretical foundation for the calculation of both the van der Waals and Casimir forces, leads to different results depending on the model of metal conductivity used. To resolve these controversies, theoretical considerations based on the principles of thermodynamics and new experimental tests were invoked. We analyse the present status of the problem (in particular, the advantages and disadvantages of the approaches based on the surface impedance and on the Drude model dielectric function) using rigorous analytical calculations of the entropy of a fluctuating field. We also discuss the results of a new precise experiment on the determination of the Casimir pressure between two parallel plates by means of a micromechanical torsional oscillator

  11. Neural tube defects – recent advances, unsolved questions and controversies

    Science.gov (United States)

    Copp, Andrew J.; Stanier, Philip; Greene, Nicholas D. E.

    2014-01-01

    Neural tube defects (NTDs) are severe congenital malformations affecting around 1 in every 1000 pregnancies. Here we review recent advances and currently unsolved issues in the NTD field. An innovation in clinical management has come from the demonstration that closure of open spina bifida lesions in utero can diminish neurological dysfunction in children. Primary prevention by folic acid has been enhanced through introduction of mandatory food fortification in some countries, although not yet in UK. Genetic predisposition comprises the majority of NTD risk, and genes that regulate folate one-carbon metabolism and planar cell polarity have been strongly implicated. The sequence of human neural tube closure events remains controversial, but study of mouse NTD models shows that anencephaly, open spina bifida and craniorachischisis result from failure of primary neurulation, while skin-covered spinal dysraphism results from defective secondary neurulation. Other ‘NTD’ malformations, such as encephalocele, are likely to be post-neurulation disorders. PMID:23790957

  12. Mapping intravascular ultrasound controversies in interventional cardiology practice.

    Directory of Open Access Journals (Sweden)

    David Maresca

    Full Text Available Intravascular ultrasound is a catheter-based imaging modality that was developed to investigate the condition of coronary arteries and assess the vulnerability of coronary atherosclerotic plaques in particular. Since its introduction in the clinic 20 years ago, use of intravascular ultrasound innovation has been relatively limited. Intravascular ultrasound remains a niche technology; its clinical practice did not vastly expand, except in Japan, where intravascular ultrasound is an appraised tool for guiding percutaneous coronary interventions. In this qualitative research study, we follow scholarship on the sociology of innovation in exploring both the current adoption practices and perspectives on the future of intravascular ultrasound. We conducted a survey of biomedical experts with experience in the technology, the practice, and the commercialization of intravascular ultrasound. The collected information enabled us to map intravascular ultrasound controversies as well as to outline the dynamics of the international network of experts that generates intravascular ultrasound innovations and uses intravascular ultrasound technologies. While the technology is praised for its capacity to measure coronary atherosclerotic plaque morphology and is steadily used in clinical research, the lack of demonstrated benefits of intravascular ultrasound guided coronary interventions emerges as the strongest factor that prevents its expansion. Furthermore, most of the controversies identified were external to intravascular ultrasound technology itself, meaning that decision making at the industrial, financial and regulatory levels are likely to determine the future of intravascular ultrasound. In light of opinions from the responding experts', a wider adoption of intravascular ultrasound as a stand-alone imaging modality seems rather uncertain, but the appeal for this technology may be renewed by improving image quality and through combination with

  13. Dialogs on the Yucca Mountain controversy. Special report No. 10

    International Nuclear Information System (INIS)

    Schluter, C.M.; Szymanski, J.S.

    1993-08-01

    In an attempt to resolve the controversial issue of tectonic and hydrologic stability of the Yucca Mountain region, the National Academy of Sciences established a Panel on Coupled Hydrologic/Tectonic/HydrothermaI Systems. The Panel has recently released it's findings in a report entitled Ground Water at Yucca Mountain: How High Can It Rise? The representation of data and the scientific validity of this report was the subject of comprehensive evaluations and reviews which has led to correspondence between Dr. Charles Archarnbeau and Dr. Frank Press, the President of the National Academy of Sciences. All such correspondence prior to April 9, 1993 is covered by TRAC Special Report No. 5, open-quotes Dialogs on the Yucca Mountain Controversy.close quotes The present report represents a continuation of the dialog between Dr. Archambeau and Dr. Press; specifically the letter from Dr. Press to Dr. Archambeau dated April 9, 1993 and Archambeau's response to Press, dated August 19, 1993. In addition to the correspondence between Press and Archambeau, a series of recent reports by other investigators, referred to in the correspondence from Archambeau, are included in this report and document new data and inferences of importance for resolution of the question of suitability of the Yucca Mountain site as a high level nuclear waste repository. These reports also demonstrate that other scientists, not previously associated with the government's program at Yucca Mountain or the National Academy review of an aspect of that program, have arrived at conclusions that are different than those stated by the Academy review and DOE program scientists

  14. Review- Cancer: Some genetic considerations | Salem | Egyptian ...

    African Journals Online (AJOL)

    Malignant transformation of normal cells to cancer cells represents an enigmatic phenomenon because of the many ambiguous controversies embodied within most of its aspects. Within a clinical context, cancer, with very few exceptions, is a dreadful disease that ends lethally. Within a biological context, however, cancer is ...

  15. The sacrifice of animals in Afro-Brasilian religions: analysis of a recent controversy in the Brazilian state of Rio Grande do Sul

    Directory of Open Access Journals (Sweden)

    Ari Pedro Oro

    2006-01-01

    Full Text Available The paper analyses a controversy in Rio Grande do Sul, involving the local Afro-religious community, after the State Assembly approved a State Code for the Protection of Animals, which could jeopardize the ritual practice of sacrificing animals in "terreiros". We examine the different standpoints on animal sacrifice in Afro-religious rituals on the part of the main actors and institutions involved, as well as the repercussions of such debates in Brazil and abroad. The controversy is an opportunity for discussing the limits of religious freedom in Brazil.

  16. Hormone replacement therapy in cancer survivors: Utopia?

    Science.gov (United States)

    Angioli, Roberto; Luvero, Daniela; Armento, Grazia; Capriglione, Stella; Plotti, Francesco; Scaletta, Giuseppe; Lopez, Salvatore; Montera, Roberto; Gatti, Alessandra; Serra, Giovan Battista; Benedetti Panici, Pierluigi; Terranova, Corrado

    2018-04-01

    As growing of old women population, menopausal women will also increase: an accurate estimation of postmenopausal population is an essential information for health care providers considering that with aging, the incidence of all cancers is expected to increase. Hormone replacement therapy (HRT) has proven to be highly effective in alleviating menopausal symptoms such as hot flashes, night sweats, dyspareunia, sexual disorders, and insomnia and in preventing osteoporosis. According to preclinical data, estrogen and progesterone are supposed to be involved in the induction and progression of breast and endometrial cancers. Similarly, in epithelial ovarian cancer (EOC), the pathogenesis seems to be at least partly hormonally influenced. Is HRT in gynecological cancer survivors possible? The literature data are controversial. Many clinicians remain reluctant to prescribe HRT for these patients due to the fear of relapse and the risk to develop coronary heart disease or breast cancer. Before the decision to use HRT an accurate counselling should be mandatory in order to individualizing on the basis of potential risks and benefits, including a close follow-up. Nevertheless, we do believe that with strong informed consent doctors may individually consider to prescribe some course of HRT in order to minimize menopausal symptoms and disease related to hormonal reduction. Copyright © 2018 Elsevier B.V. All rights reserved.

  17. Is the N170 face specific? Controversy, context, and theory

    Directory of Open Access Journals (Sweden)

    Brian D. Earp

    2013-04-01

    Full Text Available In cognitive science, there is an ongoing debate about the architecture of the mind: does it consist of a number of mental “organs” each managing a different function in isolation, or is it more of general processor, adaptable to a wide range of tasks? One corner of this debate has centered on face processing. This is because face-perception is crucial to normal human functioning and some evidence shows that faces may be processed by the brain in a privileged way compared to other types of stimuli. For example, in EEG brain recordings, the N170 is a characteristic signal that occurs after a participant is exposed to an image of a face, but it is much less pronounced when other stimuli are shown. More than 15 years of research on the “N170 face effect” have yielded the standard view that the N170 is at the very least face-sensitive, and possibly even face-specific, that is, indexing modular processes tied exclusively to facial geometries. The specificity claim is clearly stronger, and hence subject to significant controversy; while the more conservative “sensitivity” claim had been regarded (until recently as effectively settled. Nevertheless, Thierry and colleagues, in a contentious 2007 article, sought to undermine even this “conservative” consensus: they argued that the apparent face-responsiveness of the N170 in prior research was due to systematic flaws in experimental design. Fiery debate has followed. In this review, we put the debate in its historical and philosophical context, and try to spell out some of the theoretical and logical assumptions that underlie the claims of the competing camps. We then show that the best available evidence counts, at least partially, against the Thierry et al. construal of the N170. Accordingly, it would be premature to abandon the “conservative” account of the N170, according to which it is – minimally – responsive to faces. We conclude by returning to the more controversial claim

  18. Stress and Cancer

    DEFF Research Database (Denmark)

    Christoffer, Johansen,; Sørensen, Ivalu; Lim Høeg, Beverly

    2017-01-01

    The role of stress in relation to cancer remains controversial. Stress is assumed to be an emerging public health problem in modern society. Still, we argue that it is relevant to view the role of stress in cancer from a scientific point of view. A critical overview of existing evidence...... is presented through previous review studies, and the importance of methodological challenges is highlighted. We summarize the evidence on the role of stress as a cause of cancer, on the impact of stress on cancer prognosis, and on how coping mechanisms may influence stress levels in cancer patients. Finally......, we describe the evidence on interventions to relieve stress in cancer patients for the purpose of improving both well-being and cancer prognosis. Against public opinion, we critically dismiss the evidence on psychotherapy as a tool to prolong life after cancer as inconsistent and unresolved....

  19. Low-level laser therapy/photobiomodulation in the management of side effects of chemoradiation therapy in head and neck cancer: part 2: proposed applications and treatment protocols

    Science.gov (United States)

    Zecha, Judith A. E. M.; Raber-Durlacher, Judith E.; Nair, Raj G.; Epstein, Joel B.; Elad, Sharon; Hamblin, Michael R.; Barasch, Andrei; Migliorati, Cesar A.; Milstein, Dan M. J.; Genot, Marie-Thérèse; Lansaat, Liset; van der Brink, Ron; Arnabat-Dominguez, Josep; van der Molen, Lisette; Jacobi, Irene; van Diessen, Judi; de Lange, Jan; Smeele, Ludi E.; Schubert, Mark M.

    2016-01-01

    Purpose There is a large body of evidence supporting the efficacy of low-level laser therapy (LLLT), more recently termed photobiomodulation (PBM) for the management of oral mucositis (OM) in patients undergoing radiotherapy for head and neck cancer (HNC). Recent advances in PBM technology, together with a better understanding of mechanisms involved and dosimetric parameters may lead to the management of a broader range of complications associated with HNC treatment. This could enhance patient adherence to cancer therapy, and improve quality of life and treatment outcomes. The mechanisms of action, dosimetric, and safety considerations for PBM have been reviewed in part 1. Part 2 discusses the head and neck treatment side effects for which PBM may prove to be effective. In addition, PBM parameters for each of these complications are suggested and future research directions are discussed. Methods Narrative review and presentation of PBM parameters are based on current evidence and expert opinion. Results PBM may have potential applications in the management of a broad range of side effects of (chemo)radiation therapy (CRT) in patients being treated for HNC. For OM management, optimal PBM parameters identified were as follows: wavelength, typically between 633 and 685 nm or 780–830 nm; energy density, laser or light-emitting diode (LED) output between 10 and 150 mW; dose, 2–3 J (J/cm2), and no more than 6 J/cm2 on the tissue surface treated; treatment schedule, two to three times a week up to daily; emission type, pulsed (<100 Hz); and route of delivery, intraorally and/or transcutaneously. To facilitate further studies, we propose potentially effective PBM parameters for prophylactic and therapeutic use in supportive care for dermatitis, dysphagia, dry mouth, dysgeusia, trismus, necrosis, lymphedema, and voice/speech alterations. Conclusion PBM may have a role in supportive care for a broad range of complications associated with the treatment of HNC with CRT

  20. Cervical Cancer Screening

    Science.gov (United States)

    ... Cancer found early may be easier to treat. Cervical cancer screening is usually part of a woman's health ... may do more tests, such as a biopsy. Cervical cancer screening has risks. The results can sometimes be ...

  1. Breast cancer

    OpenAIRE

    Gablerová, Pavlína

    2010-01-01

    In this work the topic of breast cancer treated more generally and mainly focused on risk factors for the development. The theoretical part describes the general knowledge about breast cancer as a stage or treatment. The practical part is to have clarified the risk factors that have some bearing on the diagnosis of breast cancer. What level are involved in the probability of occurrence? Can we eliminate them? As a comparison of risk factors examined in the Czech Republic, England, Australia a...

  2. Screening and prevention of breast cancer in primary care.

    Science.gov (United States)

    Tice, Jeffrey A; Kerlikowske, Karla

    2009-09-01

    Mammography remains the mainstay of breast cancer screening. There is little controversy that mammography reduces the risk of dying from breast cancer by about 23% among women between the ages of 50 and 69 years, although the harms associated with false-positive results and overdiagnosis limit the net benefit of mammography. Women in their 70s may have a small benefit from screening mammography, but overdiagnosis increases in this age group as do competing causes of death. While new data support a 16% reduction in breast cancer mortality for 40- to 49-year-old women after 10 years of screening, the net benefit is less compelling in part because of the lower incidence of breast cancer in this age group and because mammography is less sensitive and specific in women younger than 50 years. Digital mammography is more sensitive than film mammography in young women with similar specificity, but no improvements in breast cancer outcomes have been demonstrated. Magnetic resonance imaging may benefit the highest risk women. Randomized trials suggest that self-breast examination does more harm than good. Primary prevention with currently approved medications will have a negligible effect on breast cancer incidence. Public health efforts aimed at increasing mammography screening rates, promoting regular exercise in all women, maintaining a healthy weight, limiting alcohol intake, and limiting postmenopausal hormone therapy may help to continue the recent trend of lower breast cancer incidence and mortality among American women.

  3. Adiponectin as a Biomarker of Osteoporosis in Postmenopausal Women: Controversies

    Directory of Open Access Journals (Sweden)

    Anna Lubkowska

    2014-01-01

    Full Text Available The literature reports indicating a link between plasma levels of adiponectin and body fat, bone mineral density, sex hormones, and peri- and postmenopausal changes, draw attention to the possible use of adiponectin as an indicator of osteoporotic changes, suggesting that adiponectin may also modulate bone metabolism. In this study, we attempted to analyze the available in vitro and in vivo results which could verify this hypothesis. Although several studies have shown that adiponectin has an adverse effect on bone mass, mainly by intensifying resorption, this peptide has also been demonstrated to increase the proliferation and differentiation of osteoblasts, inhibit the activity of osteoclasts, and reduce bone resorption. There are still many ambiguities; for example, it can be assumed that concentrations of adiponectin in plasma do not satisfactorily reflect its production by adipose tissue, as well as conflicting in vitro and in vivo results. It seems that the potential benefit in the treatment of patients with osteoporosis associated with the pharmacological regulation of adiponectin is controversial.

  4. Advance euthanasia directives: a controversial case and its ethical implications.

    Science.gov (United States)

    Miller, David Gibbes; Dresser, Rebecca; Kim, Scott Y H

    2018-03-03

    Authorising euthanasia and assisted suicide with advance euthanasia directives (AEDs) is permitted, yet debated, in the Netherlands. We focus on a recent controversial case in which a Dutch woman with Alzheimer's disease was euthanised based on her AED. A Dutch euthanasia review committee found that the physician performing the euthanasia failed to follow due care requirements for euthanasia and assisted suicide. This case is notable because it is the first case to trigger a criminal investigation since the 2002 Dutch euthanasia law was enacted. Thus far, only brief descriptions of the case have been reported in English language journals and media. We provide a detailed description of the case, review the main challenges of preparing and applying AEDs for persons with dementia and briefly assess the adequacy of the current oversight system governing AEDs. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. ACCOUNTING CONTROVERSY ON THE RECOGNITION AND EVALUATION OF DEVELOPMENT EXPENDITURE

    Directory of Open Access Journals (Sweden)

    TULVINSCHI MIHAELA

    2017-12-01

    Full Text Available The development of technology in recent decades has forced the transition from the industrialized society, where the main role was occupied by tangible assets, to an information society, where the essential place is played by intangible assets. These are assets that can not be touched or felt, but are very important to produce wealth and to maintain competitiveness. Within these, development expenditure occupies an important place because it influences the analysis of an entity and its future. The accounting practices applicable to development expenditure are based on theoretical fundamentals and ambiguous typologies. The purpose of the article is to present the controversies about recognizing and evaluating development expenditure. Although development expenditure involves large initial investments, it generates, on medium and long term, significant savings. Depending on the purpose for which it is carried out, research and development expenditure can in time generate identifiable intangible assets but also intangible unidentifiable assets. An optimistic attitude regarding the chances of success of a development project will lead to the capitalization of development expenditure. Capitalizing development expenditures, the usefulness of financial statements is increased, which is generally measured in the ability to explain stock prices through earnings and accounting values.

  6. Three controversies over item disclosure in medical licensure examinations

    Directory of Open Access Journals (Sweden)

    Yoon Soo Park

    2015-09-01

    Full Text Available In response to views on public's right to know, there is growing attention to item disclosure – release of items, answer keys, and performance data to the public – in medical licensure examinations and their potential impact on the test's ability to measure competence and select qualified candidates. Recent debates on this issue have sparked legislative action internationally, including South Korea, with prior discussions among North American countries dating over three decades. The purpose of this study is to identify and analyze three issues associated with item disclosure in medical licensure examinations – 1 fairness and validity, 2 impact on passing levels, and 3 utility of item disclosure – by synthesizing existing literature in relation to standards in testing. Historically, the controversy over item disclosure has centered on fairness and validity. Proponents of item disclosure stress test takers’ right to know, while opponents argue from a validity perspective. Item disclosure may bias item characteristics, such as difficulty and discrimination, and has consequences on setting passing levels. To date, there has been limited research on the utility of item disclosure for large scale testing. These issues requires ongoing and careful consideration.

  7. Risk perception, psychological heuristics and the water fluoridation controversy.

    Science.gov (United States)

    Perrella, Andrea M L; Kiss, Simon J

    2015-04-29

    Increasingly, support for water fluoridation has come under attack. We seek an explanation, focusing on the case of Waterloo, Ontario, where a 2010 referendum overturned its water fluoridation program. In particular, we test whether individuals perceive the risks of water fluoridation based not on 'hard' scientific evidence but on heuristics and cultural norms. A sample of 376 residents in Waterloo were surveyed in June 2012 using random digit dialing. We use factor analysis, OLS regression, as well as t-tests to evaluate a survey experiment to test the credibility hypothesis. Perceptions of fluoride as a risk are lower among those who perceive fluoride's benefits (B = .473, p < 0.001) and those whose cultural view is 'egalitarian' (B = .156, p < 0.05). The experiment shows a lower level of perception of fluoride's benefits among respondents who are told that water fluoridation is opposed by a national advocacy group (Group A) compared to those who are told that the government and the World Health Organization support fluoridation (Group B) (t = 1.6547, p < 0.05), as well as compared to the control group (t = 1.8913, p < 0.05). There is no difference between Group B and the control, possibly because people's already general support for fluoridation is less prone to change when told that other public organizations also support fluoridation. Public health officials should take into account cultural norms and perceptions when individuals in a community appear to rise up against water fluoridation, with implications for other public health controversies.

  8. Current Therapeutic Cannabis Controversies and Clinical Trial Design Issues.

    Directory of Open Access Journals (Sweden)

    Ethan Budd Russo

    2016-09-01

    Full Text Available This overview covers a wide range of cannabis topics, initially examining issue in dispensaries and self-administration, plus regulatory requirement for production of cannabis-based medicines, particularly the Food and Drug Administration Botanical Guidance. The remainder pertains to various cannabis controversies that certainly require closer examination if the scientific, consumer and governmental stakeholders are ever to reach consensus on safety issues, specifically: whether botanical cannabis displays herbal synergy of its components, pharmacokinetics of cannabis and dose titration, whether cannabis medicines produce cyclo-oxygenase inhibition, cannabis-drug interactions and cytochrome P450 issues, whether cannabis randomized clinical trials are properly blinded, combatting the placebo effect in those trials via new approaches, the drug abuse liability of cannabis-based medicines and their regulatory scheduling, their effects on cognitive function and psychiatric sequelae, immunological effects, cannabis and driving safety, youth usage, issues related to cannabis smoking and vaporization, cannabis concentrates and vape-pens, and laboratory analysis for contamination with bacteria and heavy metals. Finally, the issue of pesticide usage on cannabis crops is addressed. New and disturbing data on pesticide residues in legal cannabis products in Washington State are presented with the observation of an 84.6% contamination rate including potentially neurotoxic and carcinogenic agents. With ongoing developments in legalization of cannabis in medical and recreational settings, numerous scientific, safety and public health issues remain.

  9. Controversies, development and trends of biofuel industry in the world

    Directory of Open Access Journals (Sweden)

    WenJun Zhang

    2012-09-01

    Full Text Available Controversies, development and trends of biofuel industry in the world were discussed in present article. First-generation biofuels, i.e., grain and land based biofuels, occupied large areas of arable lands and severely constrained food supplies, are widely disputed. They have been replaced by second-generation biofuels. The raw materials of the second-generation biofuels include plants, straw, grass and other crops and forest residues. However, the cost for production of the second-generation biofuels is higher. Therefore the development of the third-generation biofuels is undergoing. The third-generation technologies use, mainly algae, as raw material to produce bioethanol, biobutanol, biodiesel and hydrogen, and use discarded fruits to produce dimethylfuran, etc. Different countries and regions are experiencing different stages of biofuel industry. In the future the raw materials for biofuel production will be focused on various by-products, wastes, and organisms that have not direct economic benefit for human. Production technologies should be improved or invented to reduce carbon emission and environmental pollution during biofuel production and to reduce production cost.

  10. Cannabis Controversies: How genetics can inform the study of comorbidity

    Science.gov (United States)

    Agrawal, Arpana; Lynskey, Michael T.

    2014-01-01

    Aims To review three key and controversial comorbidities of cannabis use – other illicit drug use, psychosis and depression as well as suicide, from a genetically informed perspective. Design Selective review. Results Genetic factors play a critical role in the association between cannabis use, particularly early-onset use and use of other illicit drugs, psychosis and depression as well as suicide, albeit via differing mechanisms. For other illicit drugs, while there is strong evidence for shared genetic influences, residual association that is attributable to causal or person-specific environmental factors cannot be ruled out. For depression, common genetic influences are solely responsible for the association with cannabis use but for suicidal attempt, evidence for person-specific factors persists. Finally, even though rates of cannabis use are inordinately high in those with psychotic disorders, there is no evidence of shared genetic etiologies underlying this comorbidity. Instead, there is limited evidence that adolescent cannabis use might moderate the extent to which diathesis influences psychosis. Conclusions Overlapping genetic influences underlie the association between early-onset cannabis use and other illicit drug use as well as depression and suicide. For psychosis, mechanisms other than shared genetic influences might be at play. PMID:24438181

  11. Controversies in office based anesthesia: obstructive sleep apnea considerations.

    Science.gov (United States)

    Gupta, Ruchir; Pyati, Srinivas

    2018-05-14

    As the number of procedures being performed in the office based anesthesia (OBA) setting are increasing, so are the number of patients presenting for surgery with obstructive sleep apnea (OSA). There continues to be controversy regarding whether these patients can be safely cared for in the OBA setting. To date, no national guideline has clearly addressed this issue and while some have extrapolated lessons from what has been published for OSA in the ambulatory surgery center (ASC) setting, some argue that there is a significant difference in the availability of resources in the ASC versus the OBA setting. Those opposing OSA patients for OBA setting point to the prevalence of "practice drift," and no federal oversight as overarching reasons why the OBA is not an appropriate setting. Proponents of the OBA setting argue that a well equipped OBA can have similar resources, and therefore similar outcomes, as an OR in the ASC setting. In this paper we explore the divergent views on this topic and present some recommendations based on best evidence.

  12. Understanding the nuclear controversy: An application of cultural theory

    International Nuclear Information System (INIS)

    Graaff, Shashi van de

    2016-01-01

    The need for a secure and sustainable energy future has become firmly entrenched on the global political agenda. Governments worldwide are seeking solutions that will ensure security of their energy supplies, while reducing carbon emissions in the fight against climate change. Advocates of nuclear power have reframed the technology as the most reliable, cost-effective and immediate solution to both of these policy problems, and predicted the emergence of a 'nuclear renaissance’. However, there is little evidence to date that suggests a nuclear renaissance has actually taken place. Public opinion polling demonstrates that many remain unconvinced of the need for nuclear power. This paper uses Cultural Theory as a heuristic to understand why the arguments for a nuclear renaissance have been largely unsuccessful. It argues that the failure of nuclear advocates to engage with a wider cross-section of world-views has prevented the controversy surrounding nuclear power from being resolved, and the nuclear renaissance from becoming a reality. In doing so, this paper builds upon a growing recognition of the contribution that social science research can make to understanding public acceptance of energy policy choices. - Highlights: • There is little evidence of a nuclear renaissance taking place in Western Europe or North America. • Public opinion on nuclear power continues to be deeply divided. • Pro-nuclear arguments are dominated by a particular cultural rationality. • A broader range of cultural perspectives needs to be recognised for the nuclear debate to progress.

  13. The race prussienne controversy: scientific internationalism and the nation.

    Science.gov (United States)

    Manias, Chris

    2009-12-01

    This essay examines a dispute between the French and German anthropological communities in the aftermath of the Franco-Prussian War. While the debate ostensibly revolved around the ethnological classification of the Prussian population presented in Jean Louis Armand de Quatrefages's La race prussienne, this overlays much deeper points of contention, presenting a case study of how commitments to nationalism and internationalism in late nineteenth-century science were not mutually exclusive but could operate in a highly synergistic manner, even during periods of intense international crisis. In the controversy, a group of scholars attempted to reconcile national rivalries with a commitment to scientific universalism and define how anthropological ideas of race and progress related to political developments. The French and German communities retained similar views that anthropology was an international science and that politically defined nationality was separate from scientifically discerned race. Yet they nevertheless regarded their work as strongly affected by processes of national consolidation and employed the language of scientific universalism to accuse their rivals of misusing science for political purposes.

  14. Current Therapeutic Cannabis Controversies and Clinical Trial Design Issues

    Science.gov (United States)

    Russo, Ethan B.

    2016-01-01

    This overview covers a wide range of cannabis topics, initially examining issues in dispensaries and self-administration, plus regulatory requirements for production of cannabis-based medicines, particularly the Food and Drug Administration “Botanical Guidance.” The remainder pertains to various cannabis controversies that certainly require closer examination if the scientific, consumer, and governmental stakeholders are ever to reach consensus on safety issues, specifically: whether botanical cannabis displays herbal synergy of its components, pharmacokinetics of cannabis and dose titration, whether cannabis medicines produce cyclo-oxygenase inhibition, cannabis-drug interactions, and cytochrome P450 issues, whether cannabis randomized clinical trials are properly blinded, combatting the placebo effect in those trials via new approaches, the drug abuse liability (DAL) of cannabis-based medicines and their regulatory scheduling, their effects on cognitive function and psychiatric sequelae, immunological effects, cannabis and driving safety, youth usage, issues related to cannabis smoking and vaporization, cannabis concentrates and vape-pens, and laboratory analysis for contamination with bacteria and heavy metals. Finally, the issue of pesticide usage on cannabis crops is addressed. New and disturbing data on pesticide residues in legal cannabis products in Washington State are presented with the observation of an 84.6% contamination rate including potentially neurotoxic and carcinogenic agents. With ongoing developments in legalization of cannabis in medical and recreational settings, numerous scientific, safety, and public health issues remain. PMID:27683558

  15. Controversial Issues in Kyphoplasty and Vertebroplasty in Osteoporotic Vertebral Fractures

    Directory of Open Access Journals (Sweden)

    Ioannis D. Papanastassiou

    2014-01-01

    Full Text Available Kyphoplasty (KP and vertebroplasty (VP have been successfully employed for many years for the treatment of osteoporotic vertebral fractures. The purpose of this review is to resolve the controversial issues raised by the two randomized trials that claimed no difference between VP and SHAM procedure. In particular we compare nonsurgical management (NSM and KP and VP, in terms of clinical parameters (pain, disability, quality of life, and new fractures, cost-effectiveness, radiological variables (kyphosis correction and vertebral height restoration, and VP versus KP for cement extravasation and complications profile. Cement types and optimal filling are analyzed and technological innovations are presented. Finally unipedicular/bipedicular techniques are compared. Conclusion. VP and KP are superior to NSM in clinical and radiological parameters and probably more cost-effective. KP is superior to VP in sagittal balance improvement and cement leaking. Complications are rare but serious adverse events have been described, so caution should be exerted. Unilateral procedures should be pursued whenever feasible. Upcoming randomized trials (CEEP, OSTEO-6, STIC-2, and VERTOS IV will provide the missing link.

  16. Oncologic PET/CT: current status and controversies

    International Nuclear Information System (INIS)

    Siegel, B.A.; Dehdashti, F.

    2005-01-01

    The introduction of integrated PET/CT has dramatically increased the worldwide rate of growth for PET, predominantly for oncologic imaging with the glucose analog 18 F-fluorodeoxyglucose (FDG). A rapidly expanding body of literature demonstrates that the use FDG-PET/CT and the resultant ability to interpret coregistered and fused PET and CT images lead to improved observer confidence and improved diagnostic performance by comparison with PET alone, CT alone, and visually correlated PET and CT. The value of PET/CT is likely to be even greater with new PET radiopharmaceuticals under development, many of which produce PET images with even fewer anatomical landmarks than FDG images. PET/CT is also likely to lead to the resurrection of 18 F-fluoride as a principal agent for radionuclide bone imaging. There are a number of controversies related to PET/CT, including minimum training and experience requirements for interpreting physicians and defining new models for technical and professional reimbursement. (orig.)

  17. Controversies in the Diagnosis and Management of NAFLD and NASH.

    Science.gov (United States)

    Rinella, Mary E; Loomba, Rohit; Caldwell, Stephen H; Kowdley, Kris; Charlton, Michael; Tetri, Brent; Harrison, Stephen A

    2014-04-01

    Nonalcoholic fatty liver disease (NAFLD) is recognized as the most common cause of chronic liver disease in the United States. Nonalcoholic steatohepatitis (NASH) occurs in a subset of patients with NAFLD and is characterized by the presence of hepa-tocellular injury, which is progressive in a substantial proportion of cases and can lead to cirrhosis and all of its complications. Although the diagnosis of NAFLD can be made through imaging studies or liver biopsy, the diagnosis of NASH still requires histologic confirmation. Liver biopsy should be performed in the presence of risk factors for advanced disease. Measures aimed at promoting weight loss, a healthier lifestyle, and optimization of metabolic risk factors remain the cornerstone of management of NAFLD. Therapeutic agents that are presently considered the most promising in NAFLD are effective in less than 50% of patients. Among patients with biopsy-proven NASH, treatment with pharmacologic agents should be considered; however, the role of specific agents in NASH still needs further study. Despite a wealth of research over the past 15 years, many controversies remain with respect to the diagnosis and management of NAFLD and NASH as well as the influence of alcohol on liver disease progression in these patients.

  18. Streamlining antibiotic therapy with procalcitonin protocols: consensus and controversies.

    Science.gov (United States)

    Haubitz, Sebastian; Mueller, Beat; Schuetz, Philipp

    2013-04-01

    Accumulating evidence supports procalcitonin (PCT) as an accurate surrogate biomarker for likelihood and severity of bacterial infections. In community-acquired pneumonia and other respiratory infections, PCT-guided antibiotic therapy algorithms resulted in reduced antibiotic exposure while maintaining a similar or even better level of safety compared with standard care. Reductions in antibiotic use translate into lower treatment costs, decreased risk of side effects and decreased bacterial multiresistance. This is especially important, as acute respiratory infections represent the most frequent reason for antibiotic prescriptions worldwide. Still, there is some controversy about the benefits of PCT measurement in sepsis patients in the intensive care unit and for nonrespiratory infections. Highly sensitive PCT assays are readily available in many hospitals today, and point-of-care assays with high enough sensitivity for antibiotic guidance are expected to be available soon. Herein, the authors provide an overview of recent studies evaluating PCT in different clinical situations and an outlook of currently enrolling or upcoming interventional trials.

  19. Consensus and controversy regarding osteoporosis in the pediatric population.

    Science.gov (United States)

    Bachrach, Laura Keyes

    2007-09-01

    To review current consensus and controversy surrounding the diagnosis and treatment of osteoporosis in childhood and adolescence. The medical literature was reviewed with emphasis on the importance of early skeletal health, risk factors for bone fragility, and the diagnosis and management of children at risk for osteoporosis. Childhood and adolescence are critical periods for optimizing bone growth and mineral accrual. Bone strength is determined by bone size, geometry, quality, and mass-variables that are influenced by genetic factors, activity, nutrition, and hormones. For children with genetic skeletal disorders or chronic disease, bone growth and mineral accrual may be compromised, increasing the lifetime risk of osteoporosis. The goal for the clinician is to identify children at greatest risk for future fragility fracture. Bone densitometry and turnover markers are challenging to interpret in children. Prevention and treatment of bone fragility in children are less well established than in adults. Optimizing nutrition and activity may not restore bone health, but the drug armamentarium is limited. Sex steroid replacement has not proven effective in restoring bone mass in patients with anorexia nervosa or exercise-associated amenorrhea. Bisphosphonates can increase bone mass and may reduce bone pain and fractures, most convincingly in patients with osteogenesis imperfecta. Further studies are needed to establish the safety, efficacy, and optimal drug, duration, and dosage in pediatric patients. Bone health during the first 2 decades contributes to the lifetime risk of osteoporosis. Further research is needed to develop evidence-based recommendations for the diagnosis and treatment of osteoporosis in childhood.

  20. Sustainable Development? Controversies over Prawn Farming on Mafia Island, Tanzania

    Directory of Open Access Journals (Sweden)

    Pat Caplan

    2016-01-01

    Full Text Available The world market for crustaceans has increased exponentially in recent years and so too have the number of production sites. However, the growth of this industry has not been without controversy, particularly regarding its environmental effects. In 2002, a large company based in Kenya applied to locate a prawn farm on Mafia Island, Tanzania, close to the Rufiji Delta. This scheme raised very differing views among various 'stakeholders': villagers living around the proposed site, the Mafia District Councillors (madiwan, government officials at varying levels, local and national activists (some in NGOs, the prawn farming company, and the experts whom they hired to produce environmental impact reports. There were opposing discourses around the rights of locals as citizens to retain control of 'their' resources, on the one hand, versus the needs of 'development' and the creation of jobs, on the other. There were also fierce debates about the importance and meaning of environment and sustainability, and the perceived role of corruption. This paper, based on fieldwork in 2002 and 2004, explores these complex debates and the ways in which the decision was finally made to allow the prawn farm to go ahead. It reveals the means by which the legal rights of citizens at the local level may be trumped by pressures emanating from those coming from above and outside who wield greater power.

  1. Gender dysphoria and the controversy over the Safe Schools program.

    Science.gov (United States)

    Parkinson, Patrick

    2017-10-01

    The Safe Schools program has attracted great controversy. On one end of the spectrum, it is defended as an anti-bullying program for young people who identify themselves as gay or lesbian, or have issues concerning their gender identity. On the other end of the spectrum, it is regarded as social engineering. This article seeks to promote a discussion of the way in which gender identity issues are addressed in the Safe Schools program. It is argued that the information in this program to Principals, teachers and young people is inaccurate and misleading. The program, as presently designed, may actually cause harm to children and young people who experience gender identity issues because it promotes gender transitioning without expert medical advice. The Safe Schools materials do not acknowledge that the great majority of children resolve gender dysphoria issues around the time of puberty. It may be much more difficult for a child to accept his or her gender at puberty if he or she has already changed name and gender identity in primary school. These deficits need to be addressed if the program is to continue.

  2. The controversy of sports technology: a systematic review.

    Science.gov (United States)

    Dyer, Bryce

    2015-01-01

    Changes or introductions of technology or equipment can affect how a sport is played or influence its performances. This article conducted a systematic review of peer-reviewed literature to identify any case studies of controversial events surrounding the implementation or use of sports technology. 56 articles were identified that highlighted 31 different case studies found over a three decade time period. Thematic analysis revealed six distinctive themes when reviewing the articles. Whilst the sport of golf had the highest number of case studies, it was found that a significant level of attention had been recorded in the cases of Oscar Pistorius use of prosthetic legs in athletics and the use of full length swimsuits in swimming. The trend surrounding the number of articles was shown to be initially intermittent but saw a peak period from 2008 to 2010. However, the frequency of such articles since this peak has been more consistent. It is proposed that long periods of time without intervention or resolution by a governing body often increases the peer-reviewed attention paid to such cases in examples such as those identified in this systematic review.

  3. Sensory processing disorders – diagnostic and therapeutic controversies

    Directory of Open Access Journals (Sweden)

    Aneta R. Borkowska

    2017-09-01

    Full Text Available This article presents the current state of knowledge regarding the controversial issue of sensory integration dysfunction/sensory processing disorder. Symptoms are defined as impairments in the accurate reception and registering of stimuli, differentiation of stimulus intensity, and adequate reactivity to stimulation. They can be of specific character and occur in isolation and can also be a nonspecific element of a clinical picture of another disease entity. Psychophysiological and neuroimaging studies confirm the existence of both a distinct group of children with symptoms of sensory processing disorder diagnosed based on descriptions of behaviours listed in questionnaires and of a specific neurobiological basis of this disorder. In clinical practice, it is of key importance to determine whether behavioural problems observed in children are caused by disorders other than sensory processing disorders. Results of meta-analyses regarding sensory integration therapy are inconclusive and do not allow this form of treatment to be considered fact-based. Future studies with high methodological standards are necessary in order to verify the effectiveness of different forms of sensory integration therapy. Parents should be informed about the existing limitations.

  4. Cord blood banking and transplantation: advances and controversies.

    Science.gov (United States)

    Yoder, Mervin C

    2014-04-01

    A review of articles published since January 2012 on the topic of cord blood banking and cord blood stem cell transplantation was conducted for this the 25th anniversary year of the first cord blood transplant performed in a human. Cord blood banking is performed throughout the world. Umbilical cord blood (UCB) transplantation is recognized as an acceptable alternative stem cell source for paediatric and adults requiring a haematopoietic transplant, particularly for patients of racial and ethnic minorities. To further advance the use of UCB, methods to enhance UCB stem cell expansion, engraftment and maintenance may be required. Controversy on the most effective and economically sustainable model for banking and storing an optimal UCB product continues to persist. Cord blood banking and transplantation of cord blood stem cells has advanced rapidly over the initial 25 years, as more than 30 ,000 patients have benefited from the therapy. New concepts on the use of methods to expand UCB stem cells for transplantation and use for nonhaematopoietic indications may increase demand for UCB over the next few decades.

  5. [Parental alienation and the controversy surrounding psychiatric diagnostics].

    Science.gov (United States)

    Migchels, C; De Wachter, D

    The phenomenon of parental alienation can arise when a child allies with one parent and refuses to have contact with the other parent. The concept has attracted a great deal of attention over the last few years. There has been controversy about whether parental alienation should be recognised as a psychiatric syndrome of the alienated child caught up in a conflict between supporters and opponents. AIM: To try to determine whether parental alienation belongs to psychiatric diagnostics. METHOD: We made a careful study of various databases in order to find literature relating to parental alienation. RESULTS: Parental alienation is situated on the border between psychiatry, sociology and justice. One of the main tasks of psychiatry in this border area is to safeguard the domain of diagnostics. CONCLUSION: Because so much attention is being given to the question of whether parental alienation syndrome should be recognised as a diagnosis, there is often a tendency to ignore the possible impact of parental alienation and to pay very little attention to ways of coping with the problem.

  6. Unwaged Posts in UK Universities: Controversies and Campaigns

    Directory of Open Access Journals (Sweden)

    Kirsten Forkert

    2015-09-01

    Full Text Available This article examines unwaged posts at UK universities, using recent examples of advertised job posts. While unpaid work is common in the UK higher education system, unwaged posts are not. The posts under scrutiny in this article differ from traditional honorary titles as they target early career academics, who are unlikely to have a paid position elsewhere, rather than established scholars. The article contextualizes the appearance of these posts in a climate of increasing marketization of higher education, entrenching managerialism in higher education institutions, and the casualization of academic work. We also discuss resistance to the posts, arguing that the controversy surrounding unpaid internships in the creative industries created a receptive environment for resisting unwaged posts in academia. We analyze the campaigns that were fought against the advertisement of the posts, mostly through social media and the University and College Union. We explore the tactics used and discuss the advantages and limitations of the use of social media, as well as the role of trade unions in the campaigns against these posts, and we reflect on what future campaigns can learn from these experiences.

  7. [Methodological controversies in chronic obstructive pulmonary disease therapeutic trials].

    Science.gov (United States)

    Suissa, Samy

    2009-03-01

    Pharmacological treatment of chronic obstructive pulmonary disease (COPD) relies principally on long-acting bronchodilators. Inhaled corticosteroids (ICS) were introduced for COPD two decades ago, despite the fact that no randomized trial had yet assessed their efficacy for this indication. Since then, the numerous randomized trials and meta-analyses performed to justify their use in COPD have been contradictory and controversial. Moreover, observational studies have reported efficacy rates so exceptional that they are almost too good to be true. These studies contain important methodological flaws that produce the appearance of efficacy. The randomized trials infringe the fundamental principle of intention-to-treat analysis, an analysis necessary to prevent important biases. Two other complications are the interruption of treatment at the moment of randomization and the use of a run-in period; in both cases, the withdrawal of treatment can introduce bias. The observational studies reporting phenomenal reductions in mortality with ICS were distorted by "immortal time" bias. Finally, recent data suggest that the effect of ICS/bronchodilator combinations is due mainly to the effect of the long-acting bronchodilator. Given the absence of proof of the efficacy of inhaled corticosteroids in COPD and their associated risks, especially of ocular damage and pneumonia, and particularly among the elderly, as well as the high doses currently prescribed in COPD, it is difficult to recommend their use in this indication. They should be prescribed in COPD for at most a limited population of patients.

  8. Perspectives on classical controversies about the motor cortex.

    Science.gov (United States)

    Omrani, Mohsen; Kaufman, Matthew T; Hatsopoulos, Nicholas G; Cheney, Paul D

    2017-09-01

    Primary motor cortex has been studied for more than a century, yet a consensus on its functional contribution to movement control is still out of reach. In particular, there remains controversy as to the level of control produced by motor cortex ("low-level" movement dynamics vs. "high-level" movement kinematics) and the role of sensory feedback. In this review, we present different perspectives on the two following questions: What does activity in motor cortex reflect? and How do planned motor commands interact with incoming sensory feedback during movement? The four authors each present their independent views on how they think the primary motor cortex (M1) controls movement. At the end, we present a dialogue in which the authors synthesize their views and suggest possibilities for moving the field forward. While there is not yet a consensus on the role of M1 or sensory feedback in the control of upper limb movements, such dialogues are essential to take us closer to one. Copyright © 2017 the American Physiological Society.

  9. Zollinger-Ellison syndrome: classical considerations and current controversies.

    Science.gov (United States)

    Epelboym, Irene; Mazeh, Haggi

    2014-01-01

    Zollinger-Ellison syndrome (ZES) is an endocrinopathy characterized by gastrin-secreting tumors, responsible for causing the formation of multiple, refractory, and recurrent peptic ulcers in the distal duodenum and proximal jejunum. Two main variants have been described, sporadic and those found in association with parathyroid and pituitary tumors, a genetic disorder known as multiple endocrine neoplasia-1 (MEN-1). Biochemical serum evaluation for elevated gastrin, followed by radiological or nuclear localization of the primary lesion, is mandated for establishing diagnosis. The mainstays of treatment include management of hypersecretory state with medical suppression of gastric acid production and surgical resection of primary tumor for the prevention of malignant transformation and metastatic complications. Medical therapy with proton pump inhibitors has virtually eliminated the need for acid-reducing surgical procedures. Surgical approach to sporadic and MEN-1-associated ZES varies based on our understanding of the natural history of the condition and the probability of cure; however, resection to a negative microscopic margin is indicated in both cases. Postoperative surveillance involves measurement of gastrin level, followed by imaging if elevation is detected. Re-excision of recurrent or resection of metastatic disease is a subject of controversy; however, at the present time aggressive cytoreductive approach is favored.

  10. Emerging from the rib: resolving the turtle controversies.

    Science.gov (United States)

    Rice, Ritva; Riccio, Paul; Gilbert, Scott F; Cebra-Thomas, Judith

    2015-05-01

    Two of the major controversies in the present study of turtle shell development involve the mechanism by which the carapacial ridge initiates shell formation and the mechanism by which each rib forms the costal bones adjacent to it. This paper claims that both sides of each debate might be correct-but within the species examined. Mechanism is more properly "mechanisms," and there is more than one single way to initiate carapace formation and to form the costal bones. In the initiation of the shell, the rib precursors may be kept dorsal by either "axial displacement" (in the hard-shell turtles) or "axial arrest" (in the soft-shell turtle Pelodiscus), or by a combination of these. The former process would deflect the rib into the dorsal dermis and allow it to continue its growth there, while the latter process would truncate rib growth. In both instances, though, the result is to keep the ribs from extending into the ventral body wall. Our recent work has shown that the properties of the carapacial ridge, a key evolutionary innovation of turtles, differ greatly between these two groups. Similarly, the mechanism of costal bone formation may differ between soft-shell and hard-shell turtles, in that the hard-shell species may have both periosteal flattening as well as dermal bone induction, while the soft-shelled turtles may have only the first of these processes. © 2015 Wiley Periodicals, Inc.

  11. [Vitamins and minerals with antioxidant properties and cardiometabolic risk: controversies and perspectives].

    Science.gov (United States)

    Catania, Antonela Siqueira; Barros, Camila Risso de; Ferreira, Sandra Roberta G

    2009-07-01

    Oxygen reactive species (ROS) are generated during cellular processes. In excess, they may cause damages to the cell. Oxidative stress is an imbalance in the redox state that favors oxidation. Endogenous enzymes and some vitamins and minerals participate in the plasma antioxidant defense. Vitamin E is found in the plasma and in the LDL particle, avoiding lipid peroxidation. Observational studies reported an inverse association between vitamin E consumption and cardiometabolic (CM) risk. However, clinical trials were not able to prove the efficacy of its supplementation on CM endpoints. Vitamin C participates in the vitamin E regeneration system, keeping the plasma's antioxidant potential. Data about beneficial effects of its supplementation in CM risk reduction are inconclusive. The antioxidant activity of carotenoids is partially responsible for its protective role against cardiovascular diseases and cancer. Supplementation of this nutrient did not provide consistent findings in terms of CM risk reduction. Recently, zinc and selenium's participation in the antioxidant defense has been studied, yet its supplementation in individuals with normal levels and adequate ingestion of these nutrients does not seem necessary. In summary, the role of these micronutrients for CM risk is still very controversial. Epidemiological studies suggest that diets rich in antioxidants, or simply in fruit and vegetables intake, can reduce CM risk. Further studies are needed before recommending antioxidant supplements for this purpose.

  12. Risk of childhood leukaemia in the vicinity of nuclear installations: Findings and recent controversies

    International Nuclear Information System (INIS)

    Dominique Laurier; Bernd Grosche; Hall, Per

    2002-01-01

    The identification of a local excess of cancer cases, possibly associated with ionizing radiation, always receives substantial media coverage and communication about clusters is difficult. We reviewed studies that examined the risk of leukaemia among young people near nuclear installations. An excess of leukaemia exists near some nuclear installations, at least for the reprocessing plants at Sellafield and Dounreay and the nuclear power plant Kruemmel. Nonetheless, the results of multi-site studies invalidate the hypothesis of an increased risk of leukaemia related to nuclear discharge. Up until now, analytic studies have not found an explanation for the leukaemia clusters observed near certain nuclear installations. The hypothesis of an infectious aetiology associated with population mixing has been proposed, but needs to be investigated further. The review illustrates two recent examples in France (La Hague reprocessing plant) and in Germany (Kruemmel power plant), where controversies developed after reports of increased leukaemia risks. These examples show the importance of recalling the current epidemiological knowledge and of using systematic recording of cases to replace the alleged excesses in a more general framework. Some elements should also be suggested from the recent French and German experiences to reinforce credibility in the results

  13. [Occupational skin cancer : Prevention and recommendations for UV protection as part of the treatment approved by the public statutory employers' liability insurance].

    Science.gov (United States)

    Rocholl, M; Ludewig, M; Skudlik, C; Wilke, A

    2018-04-27

    In Germany, approximately 2 to 3 million employees work in outdoor professions. They are exceptionally exposed to solar ultraviolet (UV) radiation for a large part of their daily working time. Cumulative UV exposure is associated with a significantly increased risk of skin cancer for outdoor workers from various occupational groups (e. g. landscape and horticulture, agriculture and forestry, fisheries and seafaring, construction and trade, as well as sports teachers, lifeguards and mountain guides). Since 1 January 2015, squamous cell carcinoma and multiple actinic keratosis due to natural UV radiation can be recognised as occupational disease No. 5103 by the German statutory social accident insurance. Reducing cumulative UV exposure is the main prevention aspect of this type of skin damage. Therefore, technical, organisational and personal UV protection measures should be implemented in the professional and private environment. Moreover, they have to be regularly used in an appropriate way. In addition to guideline-oriented therapy, training and counselling of patients with already existing actinic skin damage or a recognised occupational disease No. 5103 is therefore of particular importance. The focus should be on improving the individual UV protection behaviour. This article gives an overview of current recommendations for UV protection in the professional environment. It outlines possible solutions for patient counselling in terms of UV protection in everyday practice.

  14. The epigenetic promise for prostate cancer diagnosis.

    Science.gov (United States)

    Van Neste, Leander; Herman, James G; Otto, Gaëtan; Bigley, Joseph W; Epstein, Jonathan I; Van Criekinge, Wim

    2012-08-01

    Prostate cancer is the most common cancer diagnosis in men and a leading cause of death. Improvements in disease management would have a significant impact and could be facilitated by the development of biomarkers, whether for diagnostic, prognostic, or predictive purposes. The blood-based prostate biomarker PSA has been part of clinical practice for over two decades, although it is surrounded by controversy. While debates of usefulness are ongoing, alternatives should be explored. Particularly with recent recommendations against routine PSA-testing, the time is ripe to explore promising biomarkers to yield a more efficient and accurate screening for detection and management of prostate cancer. Epigenetic changes, more specifically DNA methylation, are amongst the most common alterations in human cancer. These changes are associated with transcriptional silencing of genes, leading to an altered cellular biology. One gene in particular, GSTP1, has been widely studied in prostate cancer. Therefore a meta-analysis has been conducted to examine the role of this and other genes and the potential contribution to prostate cancer management and screening refinement. More than 30 independent, peer reviewed studies have reported a consistently high sensitivity and specificity of GSTP1 hypermethylation in prostatectomy or biopsy tissue. The meta-analysis combined and compared these results. GSTP1 methylation detection can serve an important role in prostate cancer managment. The meta-analysis clearly confirmed a link between tissue DNA hypermethylation of this and other genes and prostate cancer. Detection of DNA methylation in genes, including GSTP1, could serve an important role in clinical practice. Copyright © 2011 Wiley Periodicals, Inc.

  15. Prevalence of human papillomavirus in epithelial ovarian cancer tissue. A meta-analysis of observational studies

    DEFF Research Database (Denmark)

    Svahn, Malene F; Faber, Mette Tuxen; Christensen, Jane

    2014-01-01

    The role of human papillomavirus (HPV) in the pathogenesis of ovarian cancer is controversial, and conflicting results have been published. We conducted a systematic review and meta-analysis to estimate the prevalence of HPV in epithelial ovarian cancer tissue....

  16. Sirenomelia: A Multi-systemic Polytopic Field Defect with Ongoing Controversies.

    Science.gov (United States)

    Boer, Lucas L; Morava, Eva; Klein, Willemijn M; Schepens-Franke, Annelieke N; Oostra, Roelof Jan

    2017-06-01

    The most impressive phenotypic appearance of sirenomelia is the presence of a 180°-rotated, axially positioned, single lower limb. Associated gastrointestinal and genitourinary anomalies are almost always present. This rare anomaly is still the subject of ongoing controversies concerning its nosology, pathogenesis, and possible genetic etiology. Sirenomelia can be part of a syndromic continuum, overlapping with other complex conditions including caudal dysgenesis and VATER/VACTERL/VACTERL-H associations, which could all be part of a heterogeneous spectrum, and originate from an early defect in blastogenesis. It is imaginable that different "primary field defects," whether or not genetically based, induce a spectrum of caudal malformations. In the current study, we review the contemporary hypotheses and conceptual approaches regarding the etiology and pathogenesis of sirenomelia, especially in the context of concomitant conditions. To expand on the latter, we included the external and internal dysmorphology of one third trimester sirenomelic fetus from our anatomical museum collection, in which multiple concomitant but discordant anomalies were observed compared with classic sirenomelia, and was diagnosed as VACTERL-H association with sirenomelia. Birth Defects Research 109:791-804, 2017. © 2017 The Authors. Birth Defects Research Published by Wiley Periodicals, Inc. © 2017 The Authors. Birth Defects Research Published by Wiley Periodicals, Inc.

  17. Inferior vena cava filters in pulmonary embolism: A historic controversy.

    Science.gov (United States)

    Jerjes-Sanchez, Carlos; Rodriguez, David; Navarrete, Aline; Parra-Cantu, Carolina; Joya-Harrison, Jorge; Vazquez, Eduardo; Ramirez-Rivera, Alicia

    Rationale for non-routine use of inferior venous cava filters (IVCF) in pulmonary embolism (PE) patients. Thrombosis mechanisms involved with IVCF placement and removal, the blood-contacting medical device inducing clotting, and the inorganic polyphosphate in the contact activation pathway were analyzed. In addition, we analyzed clinical evidence from randomized trials, including patients with and without cancer. Furthermore, we estimated the absolute risk reduction (ARR), the relative risk reduction (RRR), and the number needed to treat (NNT) based on the results of each study using a frequency table. Finally, we analyzed the outcome of our PE patients that were submitted to thrombolysis with short and long term follow-up. IVCF induces thrombosis by several mechanisms including placement and removal, rapid protein adsorption, and simultaneous surface-induced activation via the contact activation pathway. Also, inorganic polyphosphate has an important role as a procoagulant, reversing the effect of anticoagulants. Randomized control trials included 904 cancer and non-cancer PE patients. In terms of ARR, RRR, and NNT, there is no evidence for routine use of IVCF. In 290 patients with proved PE, extensive thrombotic burden and right ventricular dysfunction under thrombolysis and oral anticoagulation, we observed a favorable outcome in a short- and long-term follow-up; additionally, IVCF was only used in 5% of these patients. Considering the complex mechanisms of thrombosis related with IVCF, the evidence from randomized control trials and ARR, RRR, and NNT obtained from venous thromboembolism patients with and without cancer, non-routine use of IVCF is recommended. Copyright © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

  18. Key non-controversial concepts of population education.

    Science.gov (United States)

    Sikes, O J; Palacio, J; Kerr, B

    1993-03-01

    The important components of population education should focus on sexuality rather than sex education; content for inclusion depends upon whether the goal is population awareness or critical awareness. Population awareness is the better understanding of the nature, causes, and consequences of population changes experienced by a community, country, region. Critical awareness is the intent and ability to change the sociocultural or educational characteristics that influence fertility, mortality, and migration. 6 basic concepts with universal applicability are discussed, because if not handled properly, the topic become controversial. The concepts are linked to developing thinking or reasoning ability. The concepts are as follows: 1) respect for others, particularly those of the opposite sex; 2) development of self-esteem for both boys and girls; 3) the knowledge that planning is possible and desirable; 4) postponement of first pregnancy; 5) acceptance of responsibility for the consequences of behavior; and 6) the ability to recognize and withstand social pressure. When children learn respect for others, there is little likelihood that others will be harmed. Respect for girls and women is particularly important, and harmful stereotyping and their effects should be pointed out. The key is to develop healthy attitudes and values toward people, not just an intellectualization of gender issues. Self-esteem is used here to mean self-worth in the present and the future. Children can be helped to develop confidence, perseverance, and optimism. Children need to understand that carefully thought out decisions should precede a birth; fatalism and destiny is a choice. Postponing the first pregnancy can lead to economic, emotional, and physical benefits. Risk to the health of the mother and baby occurs during the teen years. The best time for pregnancy is between the ages of 20 and 30 years. A pregnancy in the teen years may have longterm consequences such as more pregnancy and

  19. Controversy in the management of optic nerve glioma

    International Nuclear Information System (INIS)

    Weiss, L.; Sagerman, R.H.; King, G.A.; Chung, C.T.; Dubowy, R.L.

    1987-01-01

    The records of 16 patients with optic nerve glioma treated between 1961 and 1984 were reviewed. All patients except two had extension of tumor beyond the chiasm to the hypothalamus, adjacent brain and/or along the posterior optic tract. Eleven of 16 cases were biopsy-proven, two patients had craniotomy and visual inspection but no biopsy was performed, and in two cases the biopsy was not diagnostic. Fourteen patients received radiation therapy, usually consisting of 50 Gy in 5 weeks (range 40-56 Gy), one patient was treated surgically and one with chemotherapy. With a follow-up of 1 to 20 years, 7 of the 14 patients irradiated are alive, three patients are dead of disease at 3, 6 and 9 years post-treatment, three were lost to follow-up at 1, 8, and 8 years, and one is dead of intercurrent disease at 5.5 years. Overall vision was improved in five patients and stable in seven following treatment. In two patients, vision could not be evaluated because of young age at presentation. Four patients had recurrences. One was retreated with 30 Gy in 3 weeks and shows no evidence of disease at 20 years. The three other patients died of their disease. There is controversy over the best treatment for these patients. Based on these results and a review of the literature, the authors recommendation is to irradiate tumors with extension beyond the chiasm at the time of presentation rather than waiting for increasing symptoms because function that is lost may not always be recovered. Chemotherapy needs to be further investigated but holds promise, especially for the younger children

  20. 25 Years of Self-organized Criticality: Concepts and Controversies

    Science.gov (United States)

    Watkins, Nicholas W.; Pruessner, Gunnar; Chapman, Sandra C.; Crosby, Norma B.; Jensen, Henrik J.

    2016-01-01

    Introduced by the late Per Bak and his colleagues, self-organized criticality (SOC) has been one of the most stimulating concepts to come out of statistical mechanics and condensed matter theory in the last few decades, and has played a significant role in the development of complexity science. SOC, and more generally fractals and power laws, have attracted much comment, ranging from the very positive to the polemical. The other papers (Aschwanden et al. in Space Sci. Rev., 2014, this issue; McAteer et al. in Space Sci. Rev., 2015, this issue; Sharma et al. in Space Sci. Rev. 2015, in preparation) in this special issue showcase the considerable body of observations in solar, magnetospheric and fusion plasma inspired by the SOC idea, and expose the fertile role the new paradigm has played in approaches to modeling and understanding multiscale plasma instabilities. This very broad impact, and the necessary process of adapting a scientific hypothesis to the conditions of a given physical system, has meant that SOC as studied in these fields has sometimes differed significantly from the definition originally given by its creators. In Bak's own field of theoretical physics there are significant observational and theoretical open questions, even 25 years on (Pruessner 2012). One aim of the present review is to address the dichotomy between the great reception SOC has received in some areas, and its shortcomings, as they became manifest in the controversies it triggered. Our article tries to clear up what we think are misunderstandings of SOC in fields more remote from its origins in statistical mechanics, condensed matter and dynamical systems by revisiting Bak, Tang and Wiesenfeld's original papers.

  1. Why are U.S. nuclear weapon modernization efforts controversial?

    Science.gov (United States)

    Acton, James

    2016-03-01

    U.S. nuclear weapon modernization programs are focused on extending the lives of existing warheads and developing new delivery vehicles to replace ageing bombers, intercontinental ballistic missiles, and ballistic missile submarines. These efforts are contested and controversial. Some critics argue that they are largely unnecessary, financially wasteful and potentially destabilizing. Other critics posit that they do not go far enough and that nuclear weapons with new military capabilities are required. At its core, this debate centers on three strategic questions. First, what roles should nuclear weapons be assigned? Second, what military capabilities do nuclear weapons need to fulfill these roles? Third, how severe are the unintended escalation risks associated with particular systems? Proponents of scaled-down modernization efforts generally argue for reducing the role of nuclear weapons but also that, even under existing policy, new military capabilities are not required. They also tend to stress the escalation risks of new--and even some existing--capabilities. Proponents of enhanced modernization efforts tend to advocate for a more expansive role for nuclear weapons in national security strategy. They also often argue that nuclear deterrence would be enhanced by lower yield weapons and/or so called bunker busters able to destroy more deeply buried targets. The debate is further fueled by technical disagreements over many aspects of ongoing and proposed modernization efforts. Some of these disagreements--such as the need for warhead life extension programs and their necessary scope--are essentially impossible to resolve at the unclassified level. By contrast, unclassified analysis can help elucidate--though not answer--other questions, such as the potential value of bunker busters.

  2. Management of ß-thalassemia – Consensus and controversies!

    Directory of Open Access Journals (Sweden)

    Mamta V. Manglani

    2017-12-01

    Full Text Available The mainstay of treatment of ß-Thalassemia major includes life-long regular packed red cell transfusions and iron chelation. With advances in understanding the molecular biology and its implications in the patients, newer modalities are now being explored to offer a better quality of life to transfusion dependent thalassemic patients. Improved safety of transfusions, newer chelator drugs and combination of chelators have improved outcomes in these patients. Amlodipine along with chelators may be a future option for preventing cardiac iron overload related complications. Drugs which improve HbF levels and thus ameliorate anemia such as hydroxyurea, butyrates azacytidine etc. have also been explored with little relief to transfusion dependent patients. HSCT, which is the only curative treatment available at present, has its own limitations as sibling donors may not be available to many. However, there has been extensive work done on improving outcomes with MUD and Haplo-identical HSCT in the recent times. Gene therapy using lentiviral vectors is also offering great hope to these children. Induced Pluripotent Stem Cells (iPSC is a promising advance in the treatment of thalassemia. Several newer molecules targeting different pathophysiologic aspects are being explored and have met with good success. These include luspatercept, sotatercept, macrophage inhibition, JAK2 inhibition using ruxolitinib etc. Controversies regarding use of wheat grass and ESAs are relatively less worrisome. But use of thalidomide should be done with great caution. Despite its success reported in anecdotal reports, in the absence of adequate data with larger trials, its role in routine management of thalassemia syndromes remains to be ascertained.

  3. [Psyche and cancer].

    Science.gov (United States)

    Lopez, M; Cauchi, C; Sergi, D; Amodio, A; Paoletti, G; Vici, P; Di Lauro, L

    2010-01-01

    Although the relationship between psyche and cancer dates back many centuries, and several studies were conducted on this topic during the last decades, the role of psychological factors in the development of cancer is still controversial. Although a lot of factors have been considered, attention has been focused mainly on stress, which has been evaluated also in experimental models. Generally, the results of case-control studies have been contradictory, and at times more stressfull events have been recorded in patients with benign tumors than in those with cancer. On the contrary, a higher incidence of stress-related cancers has not been documented in cohort studies. Since cancer is a genetic disease, it is difficult to hypothesize that psychological factors may permanently alter nucleotide sequence giving rise to multiple mutations needed for cancer development. At present, there is no sufficient evidence to affirm that psychological factors may contribute without doubt to cancer development.

  4. What Can We Learn from Taiwanese Teachers about Teaching Controversial Public Issues?

    Science.gov (United States)

    Hung, Yu-Han

    2016-01-01

    This study explores how history teachers in Taiwan make curricular decisions while engaging controversial public issues. The main political controversies discussed in Taiwanese society center on the relationship between Taiwan and the People's Republic of China. This study documents how four social studies teachers formulate their curricular…

  5. Teacher College Students' Views of Controversial Environmental Issues: Ambivalence and Readiness to Adopt a Stance

    Science.gov (United States)

    Weinberger, Yehudith; Dreyfus, Amos

    2013-01-01

    One of the most important goals of discussing controversial issues in the classroom is to educate students to possess an inclination towards reason, open mindedness and fairness. However, research tends to show that teachers are not adequately trained to lead fruitful discussions about controversial issues and do not possess the necessary skills…

  6. Controversy and consensus on a clinical pharmacist in primary care in the Netherlands

    NARCIS (Netherlands)

    Hazen, Ankie C M; Wal, Aletta W Van Der; Sloeserwij, Vivianne M.; Zwart, Dorien L M; Gier, Johan J De; de Wit, Niek J; Leendertse, Anne J.; Bouvy, Marcel L.; Bont, Antoinette A De

    2016-01-01

    Background Controversy about the introduction of a non-dispensing pharmacist in primary care practice hampers implementation. Objective The aim of this study is to systematically map the debate on this new role for pharmacists amongst all stakeholders to uncover and understand the controversy and

  7. The Role of Historical-Philosophical Controversies in Teaching Sciences: The Debate between Biot and Ampere

    Science.gov (United States)

    Braga, Marco; Guerra, Andreia; Reis, Jose Claudio

    2012-01-01

    This paper evaluates the viability of using controversies in teaching. An educational project has been elaborated in which some historical-philosophical clashes were introduced into the classical syllabus of physics. The historical-philosophical controversy dealt with here, took place between the French physicists Biot and Ampere in the 19th…

  8. Emergence of controversy in technology transitions: Green revolution and Bt cotton in India

    NARCIS (Netherlands)

    Ramani, S.V.; Thutupalli, A.

    2015-01-01

    Technology transitions following radical technological breakthroughs are often marked by controversies and the transitions to Green Revolution (GR) and Genetically Modified (GM) seeds in India were no exceptions to this rule. Controversies can trigger social dilemmas, but in economics we do not yet

  9. [Skin, sun exposure and vitamin D: facts and controversies].

    Science.gov (United States)

    Leccia, M-T

    2013-03-01

    Vitamin D plays a clearly defined role in phosphorus, calcium and bone metabolism. In addition to its effects on cellular proliferation and differentiation, and on immunity, it appears to exert other action, poorly understood to date, on human physiology and disease. A number of epidemiological studies have demonstrated a protective role of sun exposure with regard to the incidence of certain immune diseases and cancer, and upon the related mortality rates. Furthermore, over the last 10 years, studies have purported to find levels judged "inadequate" in numerous populations, and, in the absence of any strict scientific arguments, a correlation was established by certain authors between supposedly "inadequate" levels, sun exposure and risk of cancer. However, analysis of the literature shows that there is in fact no precise and consensual definition of normal ranges and that the notion of inadequacy was created artificially using assay techniques lacking in sensitivity and reproducibility. Photosynthesis of vitamin D can in fact be considered perfectly adequate in the majority of populations. However, greater care is needed with elderly subjects and with subjects exposed very little to sunlight. Current studies show that the means of photoprotection used in everyday life do not adversely affect such photosynthesis. In the event of documented vitamin D deficiency, oral supplements should be given, and exposure to natural or artificial UV radiation should not be prescribed. Ultraviolet radiation has been shown to be carcinogenic and responsible for the onset of most skin cancers, and the population must be warned against misleading advertising from the tanning industry. Care should also be taken with regard to the potential harmful effects of inappropriate vitamin D supplementation. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  10. Contrast-Enhanced Ultrasound in the Diagnosis of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma: Controversy over the ASSLD Guideline

    Directory of Open Access Journals (Sweden)

    Le-Hang Guo

    2015-01-01

    Full Text Available Hepatocellular carcinoma (HCC and intrahepatic cholangiocarcinoma (ICC are both regarded as primary liver cancers, having different biological behaviors and prognoses. Correct differentiation between them is essential for surgical planning and prognosis assessment. In 2005, the American Association for the Study of Liver Diseases (AASLD recommended that noninvasive diagnosis of HCC is achievable by a single dynamic technique (including contrast-enhanced ultrasound (CEUS showing intense arterial uptake followed by washout of contrast in the venous-delayed phases. However, CEUS has been dropped from the diagnostic techniques in the latest AASLD guideline according to the opinion of some authors from Europe that CEUS may offer false positive HCC diagnosis in patients with ICC. Since the update of AASLD guideline has been released, increased attention has been paid to this interesting topic. Remarkable controversy over this issue is present and this removal was not well received in Europe and Asia. This commentary summarized the opinions for the role of CUES in differentiation between HCC and ICC in recent years. It is concluded that prospective studies with strict design and large case series are mandatory to solve the controversies and stratification of ICC in terms of tumor size and liver background is also essential.

  11. Surgical treatment of dislocated acromioclavicular syndesmolysis remains controversial

    Directory of Open Access Journals (Sweden)

    Slaviša Mihaljevič

    2007-12-01

    Full Text Available Background: Operative treatment of acromioclavicular (AC joint dislocations Allman-Tossy III type is controversial. There are more than 30 types of operative treatments described. At the Department of Traumatology of Celje General and Teaching Hospital (CGTH we operate the AC joint dislocation by the AC joint opened reduction and fixation using two Kirschner wires and additional figure of eight wire loop over the AC joint. The purpose of the analysis is to evaluate the results of acromioclavicular joint complete dislocation Allman-Tossy III type operative treatment.Patients and methods: In the 2-year period from July 1st 1997, to June 31st, 1999, at the Department of Traumatology of CGTH we operatively treated 59 injured persons with the AC joint dislocation. There were 55 men (93 % and 4 women (7 %. The average age was 40 years (from 20 to 72 years. 56 (95 % injured persons had the AC joint injury of Allman-Tossy III type. In first three weeks (early reconstruction we operated 45 injured persons (76.3 %. The applied material was removed after 8 weeks. 47 (79.7 % injured persons were re-examined at least one year after the injury (27 months in average; 14–39 months. The results were evaluated according to University of California at Los Angeles (UCLA scale for the shoulder function evaluation. The impact of factors on a good treatment result was presented by the odds ratio and uni-variant analysis calculation.Results: Out of 47 injured persons re-examined according to the UCLA scale at least one year after the injury there were 17 injured persons (36.2 % rated with an excellent result (UCLA 34– 35, 22 good (46.8 % (UCLA 28–33, 5 satisfactory (10.6 % (UCLA 21–27 and 3 bad (6.4 % (UCLA 0–20. In total we achieved 83 % of excellent and good results. The injured persons age did not significantly affect the treatment result. Complications occurred in 14 (29.8 % injured patients. If no complications were occurred the odds ratio for good

  12. The heritage and museums field: A controversial cultural space

    Directory of Open Access Journals (Sweden)

    Arrieta Urtizberea, Iñaki

    2010-12-01

    Full Text Available The processes of acceptance as heritage and musealisation do not respond to history or aesthetics-related criteria, but rather to identity-related criteria. They do not concern scientists, specialists and policy-makers alone, but also social groups. The choice of cultural assets is not an objective consequence of their formal characteristics. It is the result of the selection made by social agents so as to represent a group identity. But no social group is homogeneous; on the contrary they are diverse and complex so the identity references, and therefore the cultural assets, do not have to be univocal. Beyond the aseptic discourses, many of these processes are controversial. Differences regarding the identity references and the uses to be made of cultural assets lead to the field of heritage and museums being spaces where interests and values clash. This article presents and analyses the conflicts that arose in the Basque municipality of Legazpi when the process of musealisation and acceptance of iron production as heritage first started.

    Los procesos de patrimonialización y musealización de la cultura no responden a criterios históricos o estéticos, sino identitarios. No atañen a científicos, especialistas y políticos solamente, sino a colectivos sociales. La elección de unos bienes culturales no es una consecuencia objetiva de sus características formales, es el resultado de la selección llevada a cabo por agentes sociales con el fin de representar una identidad grupal. Pero ningún colectivo social es uniforme, sino, al contrario, es diverso y complejo, de tal modo que los referentes identitarios y, consecuentemente, los bienes culturales no tienen por qué ser unívocos. Más allá de los discursos asépticos, muchos de esos procesos se presentan conflictivos. Diferencias acerca de los referentes identitarios y de los usos que se les quieren dar a los bienes culturales acarrean que el campo patrimonial y museístico sea un

  13. The Neglected Patent Controversies in the Twenty First Century

    Directory of Open Access Journals (Sweden)

    Birgitte Andersen

    2003-01-01

    Full Text Available Na virada do século, assistimos a um reforço do sistema de patentes. No entanto, os gestores de políticas deixam sistematicamente de lado as controvérsias sobre patentes. Este artigo examina criticamente as complexas relações entre, por um lado, as razões para os direitos de patente e, por outro lado, seus efeitos sociais e econômicos. Só quando entendermos essa relação, seremos capazes de projetar regimes adequados de Direitos de Propriedade Intelectual (DPI para o novo paradigma tecnoeconômico de microeletrônica baseada em conhecimento e invenções de amplo alcance implementadas por computador. O foco se concentra nas razões morais, nas razões de incentivo econômico, e nas razões de aumento da concorrência e "proteção do talento empresarial no mercado", e nas razões econômicas para organizar ciência, tecnologia e criatividade. Afirma-se aqui que os sistemas de patentes não são neutros, eles estabelecem as regras do jogo em que indivíduos e organizações são os jogadores.At the turn of the century we have seen a tightening of the patent system. However, policy makers systematically neglect the patent controversies. This article critically reviews the complex relationships between the rationales for patent rights on the one hand, and the social and economic effects of such on the other hand. Only when we understand this relationship, will we be able to design appropriate Intellectual Property Right (IPR regimes for the new technoeconomic paradigm of knowledge-based micro-electronics and computer implemented pervasive inventions. Focus is on moral rationales, economic incentive rationales, increased competition and "market protection of entrepreneurial talent" rationales, and the economic rationales for organizing science, technology and creativity. It is argued that patent systems are not neutral, but set the rules of the game in which individuals and organizations are the players.

  14. The experiences of cancer patients.

    Science.gov (United States)

    Alifrangis, C; Koizia, L; Rozario, A; Rodney, S; Harrington, M; Somerville, C; Peplow, T; Waxman, J

    2011-12-01

    To assess the needs of cancer patients for information about their condition and to understand the psychological impact of their illness. The discussion of prognosis and treatment options in the palliative setting is an important and difficult part of oncology practice. To evaluate this, we examined the experiences of cancer patients of the physical and psychological impact of their disease on their life, and their opinions on the communication of end-of-life decisions and treatment options. A patient questionnaire was designed that encompassed communication regarding treatment and prognosis, quality-of-life attitudes subsequent to cancer diagnosis, end-of-life care and cancer drug funding. One hundred and twenty-five patients with a diagnosis of cancer were asked to participate and 96 questionnaires were completed and available for analysis. The questionnaire consisted of 63 questions and was completed in both an inpatient and outpatient setting. This survey brought to light a number of controversial issues in cancer service provision, highlighting the emotional and psychological changes brought about by a cancer diagnosis. Major concerns of our patients include fear of death and pain, changes in interpersonal relationships and financial constraints. Only 66% of the patients wanted to be given a prognosis by their clinicians and just 70% of the patients recalled being given a detailed prognosis. 11% of the patients were not prepared to undergo palliative treatment. In all, 7% were not prepared to accept treatment for 1 year and 2% for 5 years of life in exchange for the potential side effects of cytotoxic chemotherapy. 12% of the patients would not want to be in possession of the information that they were in the terminal phase of the illness with a short time to live and 16% would not want this discussed with their next of kin. This study informs medical professionals about the importance of tailoring information to the needs of the individual patient, and we

  15. Diffusion-weighted imaging as part of hybrid PET/MRI protocols for whole-body cancer staging: Does it benefit lesion detection?

    Energy Technology Data Exchange (ETDEWEB)

    Buchbender, Christian, E-mail: christian.buchbender@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Hartung-Knemeyer, Verena, E-mail: verena.hartung@uk-essen.de [Univ Duisburg-Essen, Medical Faculty, Department of Nuclear Medicine, Hufelandstr. 55, D-45147 Essen (Germany); Beiderwellen, Karsten, E-mail: karsten.beiderwellen@uk-essen.de [Univ Duisburg-Essen, Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, Hufelandstr. 55, D-45147 Essen (Germany); Heusch, Philipp, E-mail: philipp.heusch@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Kühl, Hilmar, E-mail: hilmar.kuehl@uni-due.de [Univ Duisburg-Essen, Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, Hufelandstr. 55, D-45147 Essen (Germany); Lauenstein, Thomas C., E-mail: thomas.lauenstein@uk-essen.de [Univ Duisburg-Essen, Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, Hufelandstr. 55, D-45147 Essen (Germany); Forsting, Michael, E-mail: michael.forsting@uk-essen.de [Univ Duisburg-Essen, Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, Hufelandstr. 55, D-45147 Essen (Germany); Antoch, Gerald, E-mail: antoch@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Heusner, Till A., E-mail: heusner@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany)

    2013-05-15

    Purpose: Positron emission tomography/magnetic resonance imaging (PET/MRI) requires efficient scan protocols for whole-body cancer staging. The aim of this study was to evaluate if the application of diffusion-weighted MR imaging (DWI) results in a diagnostic benefit for lesion detection in oncologic patients if added to a whole-body [18F]-fluorodesoxyglucose ([18F]-FDG) PET/MRI protocol. Methods: 25 consecutive oncologic patients (16 men, 9 women; age 57 ± 12 years) prospectively underwent whole-body [18F]-FDG-PET/MRI including DWI on a hybrid PET/MRI scanner. A team of two readers assessed [18F]-FDG PET/MRI without DWI for primary tumors and metastases. In a second session, now considering DWI, readers reassessed [18F]-FDG PET/MRI accordingly. Additionally, the lesion-to-background contrast on [18F]-FDG PET and DWI was rated qualitatively (0, invisible; 1, low; 2, intermediate; 3, high). Wilcoxon's signed-rank test was performed to test for differences in the lesion-to-background contrast. Results: 49 lesions were detected in 16 patients (5 primaries, 44 metastases). All 49 lesions were concordantly detected by [18F]-FDG PET/MRI alone and [18F]-FDG PET/MRI with DWI. The lesion-to-background contrast on DWI compared to [18F]-FDG PET was rated lower in 22 (44.9%) of 49 detected lesions resulting in a significantly higher lesion-to-background contrast on [18F]-FDG PET compared to DWI (P = 0.001). Conclusions: DWI as part of whole-body [18F]-FDG PET/MRI does not benefit lesion detection. Given the necessity to optimize imaging protocols with regard to patient comfort and efficacy, DWI has to be questioned as a standard tool for whole-body staging in oncologic PET/MRI.

  16. Commentary on "identification of 23 new prostate cancer susceptibility loci using the iCOGS custom genotyping array." COGS-Cancer Research UK GWAS-ELLIPSE (part of GAME-ON) Initiative; Australian Prostate Cancer Bioresource; UK Genetic Prostate Cancer Study Collaborators/British Association

    DEFF Research Database (Denmark)

    Olumi, Aria F; Nordestgaard, Børge G.

    2014-01-01

    Prostate cancer is the most frequently diagnosed cancer in males in developed countries. To identify common prostate cancer susceptibility alleles, we genotyped 211,155 SNPs on a custom Illumina array (iCOGS) in blood DNA from 25,074 prostate cancer cases and 24,272 controls from the internationa...

  17. Open reduction and internal fixation of three and four-part fractures of the proximal part of the humerus

    NARCIS (Netherlands)

    Wijgman, A. J.; Roolker, W.; Patt, T. W.; Raaymakers, E. L. F. B.; Marti, R. K.

    2002-01-01

    BACKGROUND: Controversy persists concerning the preferred treatment of displaced fractures of the proximal part of the humerus. The present study was undertaken to evaluate the results of open reduction and internal fixation of three and four-part fractures of the proximal part of the humerus and

  18. Notes on some Acanthaceous genera and species of controversial position

    NARCIS (Netherlands)

    Bremekamp, C.E.B.

    1956-01-01

    The genus Stenandriopsis was created by S. Moore in Journ. of Bot. 44: 153. 1906 for a plant collected first by Vaughan Thompson and afterwards by Baron in an unspecified part of Madagascar. As the plate by which the description is accompanied depicts the specimen collected by Baron (n. 6708), the

  19. Concepts and controversies in disorders of upper gastrointestinal tract

    African Journals Online (AJOL)

    The upper gastrointestinal tract is one part of the digestive system where tremendous innovations and advancements in knowledge have been recorded in the last several decades. The discovery of Helicobacter pylori by Warren and Marshal in 1983 and the introduction of Rome process for the classification, diagnosis and ...

  20. Hanford study: a review of its limitations and controversial conclusions

    International Nuclear Information System (INIS)

    Gilbert, E.S.

    1984-10-01

    The Hanford data set has attracted attention primarily because of analyses conducted by Mancuso, Stewart, and Kneale (MSK). These investigators claim that the Hanford data provide evidence that our current estimates of cancer mortality resulting from radiation exposure are too low, and advocate replacing estimates based on populations exposed at relatively high doses (such as the Japanese atom bomb survivors) with estimates based on the Hanford data. In this paper, it is shown that the only evidence of association of radiation exposure and mortality provided by the Hanford data is a small excess of multiple myeloma, and that this data set is not adequate for reliable risk estimation. It is demonstrated that confidence limits for risk estimates are very wide, and that the data are not adequate to differentiate among models. The more recent MSK analyses, which claim to provide adequate models and risk estimates, are critiqued. 18 references, 1 table

  1. Unnessecary nuclear controversy in Iran. Greater chances by an alternative energy strategy

    International Nuclear Information System (INIS)

    Supersberger, Nikolaus

    2008-01-01

    Nuclear power is not an indispensable part of Iran's future energy supply. It can be phased out without endangering the reliability of supply. A nuclear controversy is unnecessary from an energy view. The supply sectors for which nuclear power is envisaged can be abandoned without any problem. Also, there is no inherent need for a high consumption growth rate. Enormous amounts of petroleum and natural gas could be saved if Iran were to use the available energy efficiency potential (and also renewable energy sources). Scenario analyses show a very diverse picture of the Iranian power supply system. They show no indication of the extremely urgent need for new power stations that is forecasted by the Iranian government. The number of new power plants that are required is much lower, even if a very conservative business-as-usual energy consumption scenario is assumed. On the other hand, if the current consumption trend continues, Iran's energy future will not be very promising: Already by 2040, Iran will become a net importer of petroleum. The dramatic increase in energy consumption will be made even more problematic by the decreasing petroleum production. Natural gas production can still be enhanced significantly, but consumption in Iran will be growing so rapidly that, after a period of high gas exports, Iran will soon have to import natural gas. (orig./RHM)

  2. 1988-year of high integrity container evaluation, controversy and regulatory action

    International Nuclear Information System (INIS)

    Jones, D.

    1989-01-01

    During 1988, the Nuclear Regulatory Commission(NRC) completed review of and prepared technical evaluation reports on several topical reports describing containers designed to meet the 10CFR61 requirements for high integrity containers (HICs). An all metal Ferralium container and a stainless steel/polyethylene lined container were approved by the NRC. However, the NRC did not approve any containers designed from polyethylene material. The NRC staff concluded that polyethylene containers do not meet the structural stability requirements of Part 61, and unless they are combined with some engineered structure or overpack, they are not adequate for disposal of low-level radioactive wastes that require disposal in a structurally stable form. In conflict with these NRC findings, the State of South Carolina Department of Health and Environmental Control (SCDHEC) has given interim approval for continued use of polyethylene containers at the Barnwell disposal site with some restrictions on how the containers are buried depending on the classification of the waste. This paper reviews the applicable federal regulations, presents a chronology of events describing how the controversy over high integrity containers evolved from 1980 to 1989, summarizes the technical issues involved and suggests an approach that waste generators should follow during this situation of regulatory uncertainty

  3. RAPE CASES: GENRE AND RHETORICAL ANALYSIS OF CONTROVERSIAL MALAYSIAN LEGAL JUDGEMENTS

    Directory of Open Access Journals (Sweden)

    Maya Khemlani David

    2016-12-01

    Full Text Available Kachru and Smith (2008 emphasize that effectual communication in the context in which different varieties of world English are used, entails awareness of the varieties in use and their cultural, social, and ideational functions. Court reports by Malaysian Judges are part of legal documents, which may be considered as a genre. Investigating the linguistic details of these reports may be helpful in understanding the argumentative and persuasive strategies used in these judgments. The issue of rape and justice is an important concern in society. The aim of this study is to investigate Malaysian judgment reports in the English language on rape cases from a linguistic perspective. Specifically, the aim of the study is to identify court of appeal judgment reports of rape cases as a Genre and to identify the moves used in this genre. The moves within the genre were identified by studying two controversial reports which showed that the judgments might suffer from relying on pathos argumentation in one critical move.

  4. The Controversy of Corporate Social Responsibility: What Is Best For Business

    Directory of Open Access Journals (Sweden)

    Danciu Victor

    2015-12-01

    Full Text Available The Corporate Social Responsibility (CSR is the subject of permanent theoretical debates and the constant object of a company's business practices but also of some controversy. This makes it necessary to bring some valid arguments to support the growing role of CSR in the company' s efforts to achieve its objectives. This article aims to contribute to a better understanding of CSR issues and how it may help by better meeting the demands of society. It begins with a brief overview of the phenomenon of social irresponsibility which is justifying a better understanding of CSR issues. Therefore, the second part deals with the concept and the improved content of CSR which includes an author’s proposal of a new updated structure of the CSR content and ends with the presentation of its potential contribution to the company's performance and to better satisfy the demands of society. The conclusions highlight the main ideas and arguments of the article. At first, they present the arguments in favor of CSR that are justified by the changes in contemporary society and then the ones which stems from the fact that the companies are members of the society. The article has as support the idea of Riley (2012 who argues that "ignoring CSR potentially damage stakeholders, embracing CSR creates value".

  5. Trade liberalization in the south east Europe: Effects and controversial issues

    Directory of Open Access Journals (Sweden)

    Pjerotić Ljiljana

    2008-01-01

    Full Text Available Included in the regional cooperation of SEE countries, trade liberalization is considered the most important factor of a sustainable economic growth which should contribute to the mutual trade among SEE countries, growth of the foreign direct investments, further production specialization and export structure change. Countries of the region have accepted liberalization as one of the conditions of the Stabilization and Association Process (SAP, hoping, each of them individually, that in that way they would improve proper position. Creating a free trade area will contribute to a further increase of intra-regional trade flows, but it shouldn't be expected that the relative importance of mutual exchange will prevail the importance which EU has for the SEE countries, except Moldova. Paper is divided into five sections. After the introduction, the trade liberalization process in the SEE region is explained in the second part (section 2. The third section analyses actual intra-regional trade flows and SEE countries trade relations with the EU (section 3. Some controversial issues raised in recent debates on trade liberalization in SEE are also discussed (section 4. The main conclusions are given at the end (section 5. .

  6. Controversies in the Management of Borderline Resectable Proximal Pancreatic Adenocarcinoma with Vascular Involvement

    Directory of Open Access Journals (Sweden)

    Olga N. Tucker

    2008-01-01

    Full Text Available Synchronous major vessel resection during pancreaticoduodenectomy (PD for borderline resectable pancreatic adenocarcinoma remains controversial. In the 1970s, regional pancreatectomy advocated by Fortner was associated with unacceptably high morbidity and mortality rates, with no impact on long-term survival. With the establishment of a multidisciplinary approach, improvements in preoperative staging techniques, surgical expertise, and perioperative care reduced mortality rates and improved 5-year-survival rates are now achieved following resection in high-volume centres. Perioperative morbidity and mortality following PD with portal vein resection are comparable to standard PD, with reported 5-year-survival rates of up to 17%. Segmental resection and reconstruction of the common hepatic artery/proper hepatic artery (CHA/PHA can be performed to achieve an R0 resection in selected patients with limited involvement of the CHA/PHA at the origin of the gastroduodenal artery (GDA. PD with concomitant major vessel resection for borderline resectable tumours should be performed when a margin-negative resection is anticipated at high-volume centres with expertise in complex pancreatic surgery. Where an incomplete (R1 or R2 resection is likely neoadjuvant treatment with systemic chemotherapy followed by chemoradiation as part of a clinical trial should be offered to all patients.

  7. [Opinion and Participation in the Regional Early Breast Cancer Detection Program in 2007 on the part of family physicians from a health district in the Autonomous Community of Madrid, Spain].

    Science.gov (United States)

    Garrido Elustondo, Sofía; Sánchez Padilla, Elisabeth; Ramírez Alesón, Victoria; González Hernández, Ma José; González Navarro, Andrés; López Gómez, Carlos

    2008-01-01

    Mammogram screening is the most effective method for the early detection of breast cancer. The objective of this study is to evaluate the degree of knowledge, the opinion and the participation in the early breast cancer detection program on the part of the family physicians of the Autonomous Community of Madrid. The population studied was comprised of family physicians from Madrid Health District Seven. An anonymous, self-administered questionnaire comprised of 30 questions grouped into physicians characteristics and opinion concerning the early breast cancer detection programs. A total of 46% of the physicians replied. A total of 94% of the physicians believed that it is their duty to inform their patients concerning preventive activities, including breast cancer screening, and 95% believed their advice to be useful for convincing women to have a mammogram. A total of 72% believed information to be lacking on this program. During the time when mammograms are being taken at their centres, 24% of the physicians surveyed always or almost always ask the women if they have any doubts or would like further information, 43% having set up appointments for them and 95% advising them to have a mammogram taken. The family physicians have a good opinion of the early breast cancer detection program and feel their advice to be effective for improving the participation in the program. They report lack of information and inform women about the program to only a small degree.

  8. Communicating uncertainty media coverage of new and controversial science

    CERN Document Server

    Dunwoody, Sharon; Rogers, Carol L

    1997-01-01

    This work, by the editors of "Scientists and Journalists: Reporting Science as News", explores scientific uncertainty and media coverage of it in such major public issues as AISA, biotechnology, dioxin, global warming, and nature vs. nurture. It examines the interrelations of the major actors in constructing and explaining uncertainty: scientists, journalists, scholars, and the larger public. Part 1 examines participants in the scientific uncertainty arena and how the major actors react to, cope with and manage uncertain issues. It also describes how scientists and journalists vie for control over uncertain science. The panel discussion at the end of this section is a spirited discourse on how they handle scientific uncertainty. Part 2 explores instances of scientific uncertainty in the public arena, highlighting studies involving uncertainty and biotechnology, dioxin, human resources for science, and human behaviour. The panel discussion concluding this section reacts to several of these specific issues and ...

  9. Cannabis: a controversial 21st-century drug of antiquity.

    Science.gov (United States)

    Greydanus, D; Holt, M

    2014-05-01

    Cannabis consumption has been popular for thousands of years and its historical use is noted in many parts of the world including ancient China, India, the Middle East. It is currently the most popular illicit drug in the world, is being utilized as a medicinal plant, and many parts of the world are legalizing this drug. This discussion considers various aspects of cannabis use including its prevalence, history, co-morbid drug abuse, designer cannabinoids, psychiatric adverse effects, medical adverse effects, and management options. The youth of the world should be comprehensively taught that cannabis is neither a safe nor a benign drug. Prevention with comprehensive drug education is the best plan for our youth since management of a chronic or heavy cannabis consummer remains difficult and fraught with failure if cessation is the goal. Caveat emptor!

  10. Human Lung Cancer Risks from Radon – Part III - Evidence of Influence of Combined Bystander and Adaptive Response Effects on Radon Case-Control Studies - A Microdose Analysis

    Science.gov (United States)

    Leonard, Bobby E.; Thompson, Richard E.; Beecher, Georgia C.

    2012-01-01

    Since the publication of the BEIR VI (1999) report on health risks from radon, a significant amount of new data has been published showing various mechanisms that may affect the ultimate assessment of radon as a carcinogen, in particular the potentially deleterious Bystander Effect (BE) and the potentially beneficial Adaptive Response radio-protection (AR). The case-control radon lung cancer risk data of the pooled 13 European countries radon study (Darby et al 2005, 2006) and the 8 North American pooled study (Krewski et al 2005, 2006) have been evaluated. The large variation in the odds ratios of lung cancer from radon risk is reconciled, based on the large variation in geological and ecological conditions and variation in the degree of adaptive response radio-protection against the bystander effect induced lung damage. The analysis clearly shows Bystander Effect radon lung cancer induction and Adaptive Response reduction in lung cancer in some geographical regions. It is estimated that for radon levels up to about 400 Bq m−3 there is about a 30% probability that no human lung cancer risk from radon will be experienced and a 20% probability that the risk is below the zero-radon, endogenic spontaneous or perhaps even genetically inheritable lung cancer risk rate. The BEIR VI (1999) and EPA (2003) estimates of human lung cancer deaths from radon are most likely significantly excessive. The assumption of linearity of risk, by the Linear No-Threshold Model, with increasing radon exposure is invalid. PMID:22942874

  11. Prevention of pancreatic cancer

    Directory of Open Access Journals (Sweden)

    Stefan Kuroczycki-Saniutycz

    2017-02-01

    Full Text Available Pancreatic ductal adenocarcinoma (PDA accounts for 95% of all pancreatic cancers. About 230,000 PDA cases are diagnosed worldwide each year. PDA has the lowest five-year survival rate as compared to others cancers. PDA in Poland is the fifth leading cause of death after lung, stomach, colon and breast cancer. In our paper we have analysed the newest epidemiological research, some of it controversial, to establish the best practical solution for pancreatic cancer prevention in the healthy population as well as treatment for patients already diagnosed with pancreatic cancer. We found that PDA occurs quite frequently but is usually diagnosed too late, at its advanced stage. Screening for PDA is not very well defined except in subgroups of high-risk individuals with genetic disorders or with chronic pancreatitis. We present convincing, probable, and suggestive risk factors associated with pancreatic cancer, many of which are modifiable and should be introduced and implemented in our society.

  12. The Tibagi river and representations: a water controversy and development of Tibagi Project(1970 - 2000

    Directory of Open Access Journals (Sweden)

    Eliane Aparecida Biasetto

    2014-12-01

    Full Text Available The river Tibagi from the city of Londrina, in the years 1970 and 1980 was a subject of much discussion and controversy due to the project of raising its waters to supply the population of the cities of Londrina and region. In articles published in newspapers, especially in the Folha de Londrina, in the 1970s and 1980s, it was identified that, this time, the perception emerged that the river was polluted. Thus, our primary goal in the first part of this research is to investigate how it came to creating this image. Therefore, we used a collection of newspaper clippings about the controversy raised from the waters Tibagi and interviews with Nelson Amanthea civil engineer and agronomist Marcos Antonio Castanheira, both participated in discussions on the project. It was in this period that the ideas of ecology was entered and began to circulate in the city in the late 1970s. In this context, the emergence of the "age of ecology”, allegations and actions to combat pollution started to become more effective and broad, as well as, arose environmental associations, specialized government agencies and specific legislation. Thus, the objective of this research is also investigating the involvement of scientists and institutions in environmental issues through research of river Tibagi that became evident in the late 1980 and early next decade when the University State of Londrina initiated research in Tibagi river basin. Is emphasized the participation of members of the Department of Animal Biology and Plant - UEL, the company Klabin Pulp and Paper, Telêmaco Borba - PR and COPATI - Intermunicipal Consortium of Tibagi Basin, projects and actions in order to promote their recovery. A major action was investigated Project “Appearance of  Fauna and Flora River Tibagi” which became known as “Project Tibagi “. In this sense sought to investigate the origins of the project, the main participants involved, their development, search results, the

  13. The use of content analysis in the assessment of medical controversies.

    Science.gov (United States)

    de Villiers, F P

    1991-12-01

    Medicine is fraught with controversies, and several strategies have been developed in order to reach rational conclusions. Examples are using more subjects or an improved research design, developing consensus statements or using meta-analysis. An additional strategy is described in this paper. The language content of scientific papers is examined to establish whether the authors use factual (informational) language or emotional appeals (directive language) to convince the reader. This type of content analysis is then applied to a sample controversy. The paper shows that directive language content analysis can be applied effectively to scientific publications to clarify the basis of and reasoning behind some controversies.

  14. Treatment of the prostate cancer with high dose rate brachytherapy

    International Nuclear Information System (INIS)

    Martinez, Alvaro; Torres Silva, Felipe

    2002-01-01

    The prostate cancer treatment in early stages is controversial. The high dose rate brachytherapy has been used like monotherapy or boost with external beam radiotherapy in advanced disease. This paper describes the technique and the advantages over other modalities

  15. [Organized breast cancer screening].

    Science.gov (United States)

    Rouëssé, Jacques; Sancho-Garnier, Hélèn

    2014-02-01

    Breast screening programs are increasingly controversial, especially regarding two points: the number of breast cancer deaths they avoid, and the problem of over-diagnosis and over-treatment. The French national breast cancer screening program was extended to cover the whole country in 2004. Ten years later it is time to examine the risk/benefit ratio of this program and to discuss the need for change. Like all forms of cancer management, screening must be regularly updated, taking into account the state of the art, new evidence, and uncertainties. All screening providers should keep themselves informed of the latest findings. In the French program, women aged 50-74 with no major individual or familial risk factors for breast cancer are offered screening mammography and clinical breast examination every two years. Images considered non suspicious of malignancy by a first reader are re-examined by a second reader. The devices and procedures are subjected to quality controls. Participating radiologists (both public and private) are required to read at least 500 mammographies per year. The program's national participation rate was 52.7 % in 2012. When individual screening outside of the national program is taken into account (nearly 15 % of women), coverage appears close to the European recommendation of 65 %. Breast cancer mortality has been falling in France by 0.6 % per year for over 30 years, starting before mass screening was implemented, and by 1.5 % since 2005. This decline can be attributed in part to earlier diagnosis and better treatment, so that the specific impact of screening cannot easily be measured. Over-treatment, defined as the detection and treatment of low-malignancy tumors that would otherwise not have been detected in a person's lifetime, is a major negative effect of screening, but its frequency is not precisely known (reported to range from 1 % to 30 %). In view of these uncertainties, it would be advisable to modify the program in order to

  16. Roman primacy and the development of the synodal institution in the period of the Arian controversy

    Directory of Open Access Journals (Sweden)

    Zakharov Georgii

    2015-01-01

    Full Text Available The object of this study is process of evolution of church organization in the 4th century, especially the relationships between Roman primacy and synodal institution in the epoch of the Arian controversy. The author examines evolution of the institution of the Roman synod and practice of participation of the Roman See in church councils outside Rome, focusing on the unsuccessful attempt to convene the general council in Rome in 382. Analysis of historical data shows that the ability of the Roman see to organize in a short time a representative council (mainly of the Italian bishops allowed Rome to claim for a special status within the church communion. In the same time the Roman See did not become in the 4th century the center of conciliar activity at the universal level. Participation of Rome in Ecumenical and Western councils was quite passive. In the second part of the paper the author attempts to reconstruct various models of church organization, which were typical for the western and the eastern episcopate in the 4th century. The author concludes that the real initiator of the development of universal primacy of Rome was not originally the pope, but the western episcopate (council of Serdica, 343. In the second part of the 4th century pope Damasus developed this conception, putting the principle of primacy of the Roman See as the chair of Peter above principle of synodal consensus. At the same time eastern bishops considered the Roman chair as the center of the West, rather than the head of the whole Church. Sometimes they invited bishop of Rome and other western bishops to act as arbiters in the eastern conflicts, but more often they defended the idea of full autonomy of the East.

  17. Complicaciones neurológicas de la endocarditis infecciosa: controversias Neurological complications of infective endocarditis: controversies

    Directory of Open Access Journals (Sweden)

    Federico A Silva

    2011-07-01

    Full Text Available En la endocarditis infecciosa aguda se describen complicaciones neurológicas entre 20% y 40% de los casos, lo cual representa un importante factor que predice morbimortalidad, secuelas y discapacidad. Esta entidad se caracteriza por un amplio espectro clínico debido a su compleja fisiopatología, que involucra entre otros, fenómenos inflamatorios, inmunes, infecciosos y embólicos. A pesar de la notable frecuencia de las complicaciones neurológicas en la endocarditis infecciosa, dadas especialmente por enfermedad cerebrovascular y neuroinfecciones, aun existen controversias acerca de algunos aspectos diagnósticos y terapéuticos, en parte por la poca evidencia disponible, las cuales se discuten a continuación, a partir de una serie de casos atendidos en la Fundación Cardiovascular de Colombia.Neurological complications of acute infective endocarditis are described in 20%-40% of cases, representing an important predictive factor of morbidity, mortality, sequels and disability. Acute endocarditis is characterized by a wide clinical spectrum due to its complex physiopathology that involves inflammatory, immune, infectious and embolic phenomena. Despite the remarkable frequency of neurological complications in the infective endocarditis especially by cerebrovascular disease and neuroinfections, there are still some controversies about some diagnostic and therapeutic aspects, partly because of the little evidence available. This paper describes a number of cases seen in the Fundación Cardiovascular de Colombia and discusses some aspects related with the diagnosis and treatment of the neurological complications of acute endocarditis.

  18. REVIEW ARTICLE: PROSTATE CANCER SCREENING USING ...

    African Journals Online (AJOL)

    FOBUR

    ABSTRACT. Background: Prostate cancer is the commonest cancer among men in Nigeria and early detection is key to cure and survival but its screening through prostate specific antigen (PSA) has remain controversial in literature. Screening with prostate specific antigen (PSA) has led to more men diagnosed with ...

  19. Rickets: Part I.

    Science.gov (United States)

    Shore, Richard M; Chesney, Russell W

    2013-01-01

    Rickets is characterized by impaired mineralization and ossification of the growth plates of growing children caused by a variety of disorders, the most frequent of which is nutritional deficiency of vitamin D. Despite ample knowledge of its etiology and the availability of cost-effective methods of preventing it, vitamin D deficiency rickets remains a significant problem in developing and developed countries. This two-part review covers the history, etiology, pathophysiology and clinical and radiographical findings of vitamin D deficiency rickets. Other less frequent causes of rickets and some of the disorders entering into the differential diagnoses of rickets are also considered. Controversial issues surrounding vitamin D deficiency include determination of what constitutes vitamin D sufficiency and the potential relationship between low levels of vitamin D metabolites in many individuals and unexplained fractures in infants.

  20. PARK2, a Large Common Fragile Site Gene, is Part of a Stress Response Network in Normal Cells That is Disrupted During the Development of Ovarian Cancer

    National Research Council Canada - National Science Library

    Smith, David I; Zhu, Yu

    2007-01-01

    .... The central two questions that we want to address with this work are what role does inactivation of Parkin and other large CFS genes play in the development of ovarian cancer and whether these genes...