WorldWideScience

Sample records for cancer controversies part

  1. Controversial Messages on Cancer.

    Science.gov (United States)

    Mustieles, Vicente; Olea, Nicolas; Sanchez, Maria Jose; Fernandez, Mariana F

    2015-01-01

    A direct connection between certain lifestyle factors and an increased risk of cancer has already been established. Despite well-documented associations, controversial messages on causes of cancer often appear without taking into consideration their impact on the general population. While mainstream coverage of cancer research is clearly welcome, consideration must be given to the risk of transmitting provocative messages with serious negative consequences for cancer research and public health. We must avoid becoming a breeding ground for the misinterpretation of scientific information. Polemical results can stimulate scientific research and progress, but controversial messages encourage confusion and impotence in an increasingly disoriented population. The correct communication of health messages is at least as important as research on risk factors.

  2. 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.

  3. Photoprotection: part II. Sunscreen: development, efficacy, and controversies.

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    Jansen, Rebecca; Osterwalder, Uli; Wang, Steven Q; Burnett, Mark; Lim, Henry W

    2013-12-01

    In addition to the naturally occurring, physical, and systemic photoprotective agents reviewed in part I, topical ultraviolet radiation filters are an important cornerstone of photoprotection. Sunscreen development, efficacy, testing, and controversies are reviewed in part II of this continuing medical education article. Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  4. Cancer stem cell targeted therapy: progress amid controversies

    Science.gov (United States)

    Wang, Tao; Shigdar, Sarah; Gantier, Michael P.; Hou, Yingchun; Wang, Li; Li, Yong; Shamaileh, Hadi Al; Yin, Wang; Zhou, Shu-Feng; Zhao, Xinhan; Duan, Wei

    2015-01-01

    Although cancer stem cells have been well characterized in numerous malignancies, the fundamental characteristics of this group of cells, however, have been challenged by some recent observations: cancer stem cells may not necessary to be rare within tumors; cancer stem cells and non-cancer stem cells may undergo reversible phenotypic changes; and the cancer stem cells phenotype can vary substantially between patients. Here the current status and progresses of cancer stem cells theory is illustrated and via providing a panoramic view of cancer therapy, we addressed the recent controversies regarding the feasibility of cancer stem cells targeted anti-cancer therapy. PMID:26496035

  5. Cancer symptom clusters: current concepts and controversies.

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    Aktas, Aynur

    2013-03-01

    Cluster research examines complex interrelationships between multiple concurrent symptoms and their mechanisms. An individual's varying understanding of the cluster concept and variations in assessment tools results in discrepancies. This article will focus on the conceptual and methodological issues associated with definitions, symptom interrelationships, and outcomes of cancer symptom clusters. An important issue in symptom cluster research is to clarify the definition of a cluster. Some evidence suggests that 'symptom pairs' should be treated as clusters. There is substantial evidence (both qualitative and quantitative) to support a psychoneurological symptom cluster in cancer patients. It has been proposed that consistent clusters are those that have similar 'core' symptoms over time. Research has also shown that a 'sentinel' symptom can predict the presence of other relevant symptoms within a cluster. Identification of patient subgroups with higher symptom severity may be useful in targeting the most needy individuals for intervention. Symptom clusters are predictors of patient outcomes, including decreased functional performance and shorter cancer survival. Additional efforts should refine the cluster definition and elucidate the cluster stability and sentinel symptom. Both conceptual and empirical contributions should advance symptom cluster research. The qualitative approaches can explore the experience of symptom clusters and provide a conceptual basis for future research.

  6. Staging Lung Cancer: Current Controversies and Strategies

    Directory of Open Access Journals (Sweden)

    Riyad Karmy-Jones

    1997-01-01

    Full Text Available A consistent approach to staging is required for the rational management of lung cancer. This paper was prepared at the request of the Standards Committee of the Canadian Thoracic Society, and reviews and discusses the relative merits of the available methods of staging. Whichever methods are chosen by a particular institution, the following points must be stressed. No patient can be considered automatically "unresectable" when chest radiography and/ or computed tomography demonstrate adenopathy or only suggest local invasion. Clinical and/or radiographical evidence suggesting extensive local or metastatic disease should be evaluated as completely as possible before subjecting the patient to a possible "nontherapeutic" thoracotomy. Finally, in some cases thoracotomy is required to decide whether the lesion is "completely" resectable.

  7. 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.

  8. Screening for prostate cancer: the current evidence and guidelines controversy.

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    Gomella, Leonard G; Liu, Xiaolong S; Trabulsi, Edouard J; Kelly, Wm Kevin; Myers, Ronald; Showalter, Timothy; Dicker, Adam; Wender, Richard

    2011-10-01

    Prostate cancer presents a global public health dilemma. While screening with prostate specific antigen (PSA) has led to more men diagnosed with prostate cancer than in previous years, the potential for negative effects from over-diagnosis and treatment cannot be ignored. We reviewed Medline for recent articles that discuss clinical trials, evidence based recommendations and guidelines from major medical organizations in the United States and worldwide concerning prostate cancer screening. Results from the European Randomized Screening for Prostate Cancer (ERSPC), the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, and Göteborg Swedish trials regarding prostate screening are controversial with the ERSPC and Göteborg showing a reduction in prostate cancer mortality and the PLCO trial showing no benefit. Recommendations from the American Urological Association (AUA), Japanese Urological Association (JUA), and National Comprehensive Cancer Network (NCCN) have recommended that all men obtain a baseline PSA beginning at age 40. The American Cancer Society (ACS) stratifies screening recommendations based on age and risk, but states that screening should take place only after an informed discussion between provider and patient. The United States Preventative Health Service Task Force (USPSTF) states that evidence is insufficient to assess the risks and benefits of prostate cancer screening in men younger than 75 years. Other major international health organizations offer a similar reserved approach or recommend against screening for prostate cancer. Most groups indicate that screening to determine who should undergo prostate biopsy typically includes both a serum PSA and digital rectal examination, with the latest ACS publications noting that the rectal exam is optional. A common theme from all groups is that an informed discussion with the patients is strongly recommended and that screening does increase the number of men diagnosed with non

  9. Controversies in communication of genetic risk for hereditary breast cancer.

    Science.gov (United States)

    Mackenzie, Amy; Patrick-Miller, Linda; Bradbury, Angela R

    2009-01-01

    Increased availability and heightened consumer awareness of "cancer genes" has increased consumer interest in, and demand for breast cancer risk assessment, and thus a pressing need for providers to identify effective, efficient methods of communicating complicated genetic information to consumers and their potentially at-risk relatives. With increasing direct-to-consumer and -physician marketing of predictive genetic tests, there has been considerable growth in web- and telephone-based genetic services. There is urgent need to further evaluate the psychosocial and behavioral outcomes (i.e., risks and benefits) of telephone and web-based methods of delivery before they become fully incorporated into clinical care models. Given the implications of genetic test results for family members, and the inherent conflicts in health care providers' dual responsibilities to protect patient privacy and to "warn" those at-risk, new models for communicating risk to at-risk relatives are emerging. Additional controversies arise when the at-risk relative is a minor. Research evaluating the impact of communicating genetic risk to offspring is necessary to inform optimal communication of genetic risk for breast cancer across the lifespan. Better understanding the risks and benefits associated with each of these controversial areas in cancer risk communication are crucial to optimizing adherence to recommended breast cancer risk management strategies and ensuring psycho-social well-being in the clinical delivery of genetic services for breast cancer susceptibility.

  10. 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.

  11. Physician–Patient Discussions of Controversial Cancer Screening Tests

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    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

  12. Treatment of cellulite: Part II. Advances and controversies.

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    Khan, Misbah H; Victor, Frank; Rao, Babar; Sadick, Neil S

    2010-03-01

    Treatments for localized adiposities range from topical creams to liposuction. Most treatments lack a substantial proof of efficacy. The unpredictable treatment outcome can be related to the fact that cellulite adipose tissue is physiologically and biochemically different from subcutaneous tissue found elsewhere in the body. Part II of this two-part series on cellulite reviews the various treatment options that are currently available for human adipose tissue including, but not limited to, cellulite. It also focuses on newer techniques that can be potentially useful in the future for the treatment of cellulite. Copyright 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  13. 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

  14. PSA screening for prostate cancer: why so much controversy?

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    Labrie, Fernand

    2013-09-01

    Since prostate cancer reaches the advanced and non curable stage in the absence of any specific symptom or sign, it seems reasonable to diagnose this cancer at an early and curable stage. Screening by prostate-specific antigen (PSA) has been the common technology used. The last follow-up of the first two prospective and randomized screening studies for prostate cancer, namely the Quebec and ERSPC (European Randomized Study of Screening for Prostate Cancer) clinical trials started in 1988 and 1991, respectively, have shown reductions of prostate cancer death of 62% (PProstate Lung Colorectal and Ovarian Cancer) screening trial reported no benefit. It has been estimated, however, that 85% of men in the planned 'non-screened' group of the US study have been screened. With such a serious flaw, the PLCO study does not have the statistical power to reach any valid conclusion. In the Quebec study, only 7.3% of men were screened in the control arm. The important benefit observed in the ERSPC study was achieved using a less than optimal 4-year PSA screening interval which misses a significant number of cancers while the Quebec study used the optimal 1-year interval. With proper information obtained from their physicians or otherwise using data collected only from the clinical trials having the required statistical power, men should be in a good position to decide about being or not being screened for prostate cancer.

  15. 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.

  16. 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

  17. Current controversies in the management of patients with early-stage vulvar cancer

    NARCIS (Netherlands)

    Oonk, Maaike H. M.; de Hullu, Joanne A.; van der Zee, Ate G. J.

    Purpose of review The purpose of this review is to outline current controversies in management of early-stage vulvar cancer. The main focus will be on the procedures for assessing the sentinel node and the treatment of those with evidence of metastatic involvement. Recent findings Assessment of the

  18. The Controversy over Controversial Issues

    Science.gov (United States)

    Zimmerman, Jonathan; Robertson, Emily

    2018-01-01

    Avoiding the discussion of controversial topics in U.S. classrooms deprives students of an important part of their learning. Jonathan Zimmerman and Emily Robertson, authors of "The Case for Contention: Teaching Controversial Issues in American Schools" (University of Chicago Press, 2017) say Americans are terrible at having informed,…

  19. 3rd St. Gallen EORTC Gastrointestinal Cancer Conference: Consensus recommendations on controversial issues in the primary treatment of pancreatic cancer

    NARCIS (Netherlands)

    Lutz, M.P. (Manfred P.); J. Zalcberg (John); M. Ducreux (Michel); G. Aust (Gabriela); M.J. Bruno (Marco); M.W. Buchler (M.); Delpero, J.-R. (Jean-Robert); Gloor, B. (Beat); R. Glynne-Jones; Hartwig, W. (Werner); Huguet, F. (Florence); P. Laurent-Puig (Pierre); F. Lordick (Florian); P. Maisonneuve (Patrick); J. Mayerle (Julia); Martignoni, M. (Marc); J.P. Neoptolemos (John); Rhim, A.D. (Andrew D.); Schmied, B.M. (Bruno M.); T. Seufferlein (Thomas); Werner, J. (Jens); van Laethem, J.-L. (Jean-Luc); F. Otto (Florian)

    2017-01-01

    textabstractThe primary treatment of pancreatic cancer was the topic of the 3rd St. Gallen Conference 2016. A multidisciplinary panel reviewed the current evidence and discussed controversial issues in a moderated consensus session. Here we report on the key expert recommendations. It was generally

  20. Controversies about fertility and pregnancy issues in young breast cancer patients: current state of the art.

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    Lambertini, Matteo; Goldrat, Oranite; Clatot, Florian; Demeestere, Isabelle; Awada, Ahmad

    2017-07-01

    For trying to help physicians in counseling their young patients with breast cancer interested in fertility preservation and future reproductive plans, this manuscript aims to perform an overview of the main available data on 10 controversies in this field. Thanks to the improvement in patients' prognosis, a growing attention towards fertility and pregnancy issues has been given over the past years and is currently provided to young breast cancer patients. However, several grey zones persist in many domains of this field and some physicians are still uncomfortable to deal with these issues. Despite the great number of breast cancer patients experiencing fertility and pregnancy concerns at the time of diagnosis, the pursuit of fertility preserving strategies is realized only for a small proportion of them. The lack of adequate oncofertility counseling at the time of anticancer treatment decisions and the high costs of fertility preserving procedures can be considered the main explanations for these findings. The several ongoing registries and prospective studies investigating fertility and pregnancy issues in young breast cancer patients are crucial to acquire more robust data and try to address and solve the still unmet controversies in this field.

  1. 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.

  2. Best Clinical Practice: Current Controversies in Evaluation of Low-Risk Chest Pain-Part 1.

    Science.gov (United States)

    Long, Brit; Koyfman, Alex

    2016-12-01

    Chest pain is a common presentation to the emergency department (ED), though the majority of patients are not diagnosed with acute coronary syndrome (ACS). Many patients are admitted to the hospital due to fear of ACS. Our aim was to investigate controversies in low-risk chest pain evaluation, including risk of missed ACS, stress test, and coronary computed tomography angiography (CCTA). Chest pain accounts for 10 million ED visits in the United States annually. Many patients are at low risk for a major cardiac adverse event (MACE). With negative troponin and nonischemic electrocardiogram (ECG), the risk of MACE and myocardial infarction (MI) is evaluation in low- to intermediate-risk patients within 72 h. These modalities add little to further risk stratification. These evaluations do not appropriately risk stratify patients who are already at low risk, nor do they diagnose acute MI. CCTA is an anatomic evaluation of the coronary vasculature with literature support to decrease ED length of stay, though it is associated with downstream testing. Literature is controversial concerning further risk stratification in already low-risk patients. With nonischemic ECG and negative cardiac biomarker, the risk of ACS approaches chest pain patients is controversial. These tests may allow prognostication but do not predict ACS risk beyond ECG and troponin. CCTA may be useful for intermediate-risk patients, though further studies are required. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Controversial roles of methylenetetrahydrofolate reductase polymorphisms and folate in breast cancer disease.

    Science.gov (United States)

    Bravatà, Valentina

    2015-02-01

    Breast cancer (BC) represents a highly heterogeneous tumour at both the clinical and molecular levels. Single-nucleotide polymorphisms (SNPs) of the folate-metabolising enzyme methylenetetrahydrofolate-reductase (MTHFR) may modify the association between folate intake and BC and influence plasma folate concentration. The role of folate in BC is equivocal, association studies between the common MTHFR SNPs C677T and A1298C and BC risk are controversial. In this study, I have reviewed observed associations between folate intake, as well as its blood levels, and BC. The purpose of this review is to analyse the role of folate and the two SNPs associated with reduced enzyme activity in BC. I explored the most relevant and updated work that emphasises positive and negative associations among these variables. My findings indicate that no definitive conclusions can be drawn from the studies on this topic. However, this manuscript highlights variables that could be useful to explore in further association analyses.

  4. Targeting Bone Metabolism in Patients with Advanced Prostate Cancer: Current Options and Controversies

    Directory of Open Access Journals (Sweden)

    Tilman Todenhöfer

    2015-01-01

    Full Text Available Maintaining bone health remains a clinical challenge in patients with prostate cancer (PC who are at risk of developing metastatic bone disease and increased bone loss due to hormone ablation therapy. In patients with cancer-treatment induced bone loss (CTIBL, antiresorptive agents have been shown to improve bone mineral density (BMD and to reduce the risk of fractures. For patients with bone metastases, both zoledronic acid and denosumab delay skeletal related events (SREs in the castration resistant stage of disease. Novel agents targeting the Wnt inhibitors dickkopf-1 and sclerostin are currently under investigation for the treatment of osteoporosis and malignant bone disease. New antineoplastic drugs such as abiraterone, enzalutamide, and Radium-223 are capable of further delaying SREs in patients with advanced PC. The benefit of antiresorptive treatment for patients with castration sensitive PC appears to be limited. Recent trials on the use of zoledronic acid for the prevention of bone metastases failed to be successful, whereas denosumab delayed the occurrence of bone metastases by a median of 4.1 months. Currently, the use of antiresorptive drugs to prevent bone metastases still remains a field of controversies and further trials are needed to identify patient subgroups that may profit from early therapy.

  5. 3rd St. Gallen EORTC Gastrointestinal Cancer Conference: Consensus recommendations on controversial issues in the primary treatment of pancreatic cancer.

    Science.gov (United States)

    Lutz, Manfred P; Zalcberg, John R; Ducreux, Michel; Aust, Daniela; Bruno, Marco J; Büchler, Markus W; Delpero, Jean-Robert; Gloor, Beat; Glynne-Jones, Rob; Hartwig, Werner; Huguet, Florence; Laurent-Puig, Pierre; Lordick, Florian; Maisonneuve, Patrick; Mayerle, Julia; Martignoni, Marc; Neoptolemos, John; Rhim, Andrew D; Schmied, Bruno M; Seufferlein, Thomas; Werner, Jens; van Laethem, Jean-Luc; Otto, Florian

    2017-07-01

    The primary treatment of pancreatic cancer was the topic of the 3rd St. Gallen Conference 2016. A multidisciplinary panel reviewed the current evidence and discussed controversial issues in a moderated consensus session. Here we report on the key expert recommendations. It was generally accepted that radical surgical resection followed by adjuvant chemotherapy offers the only evidence-based treatment with a chance for cure. Initial staging should classify localised tumours as resectable or unresectable (i.e. locally advanced pancreatic cancer) although there remains a large grey-zone of potentially resectable disease between these two categories which has recently been named as borderline resectable, a concept which was generally accepted by the panel members. However, the definition of these borderline-resectable (BR) tumours varies between classifications due to their focus on either (i) technical hurdles (e.g. the feasibility of vascular resection) or (ii) oncological outcome (e.g. predicting the risk of a R1 resection and/or occult metastases). The resulting expert discussion focussed on imaging standards as well as the value of pretherapeutic laparoscopy. Indications for biliary drainage were seen especially before neoadjuvant therapy. Following standard resection, the panel unanimously voted for the use of adjuvant chemotherapy after R0 resection and considered it as a reasonable standard of care after R1 resection, even though the optimal pathologic evaluation and the definition of R0/R1 was the issue of an ongoing debate. The general concept of BR tumours was considered as a good basis to select patients for preoperative therapy, albeit its current impact on the therapeutic strategy was far less clear. Main focus of the conference was to discuss the limits of surgical resection and to identify ways to standardise procedures and to improve curative outcome, including adjuvant and perioperative treatment. Copyright © 2017 The Authors. Published by Elsevier

  6. 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)

  7. Annexin A1 influences in breast cancer: Controversies on contributions to tumour, host and immunoediting processes.

    Science.gov (United States)

    Tu, Yan; Johnstone, Cameron N; Stewart, Alastair G

    2017-05-01

    Annexin A1 is a multifunctional protein characterised by its actions in modulating the innate and adaptive immune response. Accumulating evidence of altered annexin A1 expression in many human tumours raises interest in its functional role in cancer biology. In breast cancer, altered annexin A1 expression levels suggest a potential influence on tumorigenic and metastatic processes. However, reports of conflicting results reveal a relationship that is much more complex than first conceptualised. In this review, we explore the diverse actions of annexin A1 on breast tumour cells and various host cell types, including stromal immune and structural cells, particularly in the context of cancer immunoediting. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. [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.

  9. EGFR as a potential target for the treatment of pancreatic cancer: dilemma and controversies.

    Science.gov (United States)

    Nedaeinia, Reza; Avan, Amir; Manian, Mostafa; Salehi, Rasoul; Ghayour-Mobarhan, Majid

    2014-01-01

    Pancreatic Ductal Adenocarcinoma (PDAC) is among the most lethal solid tumors with grim prognosis. This dismal outcome can partially be explained by the resistance to currently available chemotherapy regimens or the failure of most anticancer agents, which prompted the development of new and effective therapeutic-approaches, such as inhibitors of the epidermal growth factor receptor (EGFR). Some of these EGFR inhibitors (e.g., erlotinib) are approved for lungcancer, however available data are inconclusive for treatment of pancreatic cancer patients with EGFR-targeted-therapies. Here we describe the critical role of EGFR pathway in pancreatic-cancer, strategies to enhance the effectiveness of EGFRinhibitors as well as the preclinical/clinical studies with particular emphasis on recent findings with monoclonal antibodies and tyrosine-inhibitors. Several combinations of EGFR inhibitors with other agents illustrate inhibition of tumor-induced angiogenesis and cell growth. Moreover, combination of erlotinib with gemcitabine showed statistically significance in overall-survival, compared to gemcitabine-alone. However high cost, little survival gain and increased risk of toxicities have limited its efficacy. Considering the multiple genetic mutations and the crosstalk of signaling pathways, (1) development of multiple targeted-therapies; (2) identification of predictive-biomarkers; and (3) those patients who are most likely benefit from therapy, could provide valuable direction for the clinical development of EGFR inhibitors. Moreover further preclinical/clinical studies are warranted to identify determinants of the activity of EGFR-inhibitors and mechanisms leading to resistance to EGFR inhibitors, through the analysis of genetic and environmental alterations affecting EGFR and parallel pro-cancer pathways. These studies will be critical to improve the efficacy and selectivity of current anticancer strategies targeting EGFR in pancreatic cancer.

  10. Adjuvant therapy with aromatase inhibitors for postmenopausal women with early breast cancer: evidence and ongoing controversy.

    Science.gov (United States)

    Wheler, Jennifer; Johnson, Melissa; Seidman, Andrew

    2006-12-01

    Results of five major randomized trials have increased our understanding of the role of aromatase inhibitors in the adjuvant setting. Two of these trials, the Anastrozole or Tamoxifen Alone or in Combination (ATAC) trial and the International Breast Cancer Study Group's BIG 1-98 trial compared an aromatase inhibitor versus tamoxifen as initial hormonal therapy. Three other trial were designed as cross-over studies; the Intergroup Exemestane Study (IES) and the Austrian Breast and Colorectal Cancer Study Group (ABCSG) Trial 8/German ARNO 95 trial compared a crossover from tamoxifen to an aromatase inhibitor versus continued tamoxifen in women who had completed 2 to 3 years of tamoxifen. The MA-17 trial compared the use of letrozole with placebo for 5 years, following 5 years of tamoxifen. Based on the results of these studies, the use of an aromatase inhibitor for the adjuvant treatment of postmenopausal women with hormone receptor-positive early breast cancer has largely replaced the previous standard of 5 years of tamoxifen. Still unanswered, however, are questions regarding optimal sequencing, selection of aromatase inhibitor, and duration of treatment. This review will provide an overview of the major studies with an emphasis on these important questions.

  11. Persuasive Interventions for Controversial Cancer Screening Recommendations: Testing a Novel Approach to Help Patients Make Evidence-Based Decisions.

    Science.gov (United States)

    Saver, Barry G; Mazor, Kathleen M; Luckmann, Roger; Cutrona, Sarah L; Hayes, Marcela; Gorodetsky, Tatyana; Esparza, Nancy; Bacigalupe, Gonzalo

    2017-01-01

    We wanted to evaluate novel decision aids designed to help patients trust and accept the controversial, evidence-based, US Preventive Services Task Force recommendations about prostate cancer screening (from 2012) and mammography screening for women aged 40 to 49 years (from 2009). We created recorded vignettes of physician-patient discussions about prostate cancer screening and mammography, accompanied by illustrative slides, based on principles derived from preceding qualitative work and behavioral science literature. We conducted a randomized crossover study with repeated measures with 27 men aged 50 to 74 years and 35 women aged 40 to 49 years. All participants saw a video intervention and a more traditional, paper-based decision aid intervention in random order. At entry and after seeing each intervention, they were surveyed about screening intentions, perceptions of benefits and harm, and decisional conflict. Changes in screening intentions were analyzed without regard to order of intervention after an initial analyses showed no evidence of an order effect. At baseline, 69% of men and 86% of women reported wanting screening, with 31% and 6%, respectively, unsure. Mean change on a 3-point, yes, unsure, no scale was -0.93 (P = persuasive video interventions significantly changed the screening intentions of substantial proportions of viewers. Our approach needs further testing but may provide a model for helping patients to consider and accept evidence-based, counterintuitive recommendations. © 2017 Annals of Family Medicine, Inc.

  12. The controversial role of electrochemotherapy in head and neck cancer: a systematic review of the literature.

    Science.gov (United States)

    Lenzi, Riccardo; Muscatello, Luca; Saibene, Alberto Maria; Felisati, Giovanni; Pipolo, Carlotta

    2017-06-01

    Electroporation, also known as electrochemotherapy, combines an antineoplastic agent with electroporation, causing localized progressive necrosis in the treated area. Today it is primarily used in the palliative treatment of cutaneous and subcutaneous metastases and has been found to be safe and efficacious in head and neck cancer recurrences. Despite the steady increase in the number of published studies this treatment is not universally available and used systematically in head and neck carcinomas. To shed light on its limitations and analyze treatment outcome we have, therefore, reviewed all available literature regarding this topic. This systematic review includes 16 studies on head and neck squamous cell carcinoma and reports the data of 200 treated patients. The combined results show a very heterogeneous overall response rate, ranging from 0 to 100%, while the complete response rate ranges between 0 and 83.3%. No major side effects have been described in those who used electrochemotherapy as a mono modality palliative treatment. This systematic review shows how standardization of treatment is still pivotal to achieve a more homogeneous response rate in the approach to head and neck tumors. In conclusion, due to the scarcity of alternatives of treatment in advanced stage cancer in this anatomical region and the good tolerability and mostly high success rates of electrochemotherapy, this palliative approach should be taken into consideration in these patients.

  13. Evidence and controversies on the role of XMRV in prostate cancer and chronic fatigue syndrome.

    Science.gov (United States)

    Menéndez-Arias, Luis

    2011-01-01

    The recent discovery of xenotropic murine leukaemia virus-related virus (XMRV) in prostate cancer tissues and in the blood of individuals suffering from chronic fatigue syndrome has attracted considerable interest. However, the relevance and significance of XMRV to human disease remain unclear, since the association has not been confirmed in other studies. XMRV is the first gammaretrovirus to be found in humans. XMRV and murine leukaemia viruses share similar structures and genomic organisation. Human restriction factors such as APOBEC3 or tetherin inhibit XMRV replication. Although XMRV induces low rates of transformation in cell culture, it might be able to induce cancer by low-frequency insertional activation of oncogenes or through the generation of highly active transforming viruses. A preference for regulatory regions of transcriptional active genes has been observed after a genomic-wide analysis of XMRV integration sites. Genes related to carcinogenesis and androgen signalling have been identified in the vicinity of integration sites. The XMRV genome contains a glucocorticoid responsive element, and androgens could modulate viral replication in the prostate. Evidence supporting the involvement of XMRV in chronic fatigue syndrome is still very weak, and needs further confirmation and validation. Currently approved anti-retroviral drugs such as zidovudine, tenofovir and raltegravir are efficient inhibitors of XMRV replication in vitro. These drugs might be useful to treat XMRV infection in humans. The identification of XMRV has potentially serious health implications for the implementation of novel techniques including gene therapy or xenotransplantation, while raising concerns on the need for screening donated blood to prevent transmission through transfusion. Copyright © 2010 John Wiley & Sons, Ltd.

  14. Jonckheere Double Star Photometry - Part V: Cancer

    Science.gov (United States)

    Knapp, Wilfried

    2017-07-01

    If any double star discoverer is in urgent need of photometry then it is Jonckheere. There are over 3000 Jonckheere objects listed in the WDS catalog and a good part of them have magnitudes which are obviously far too bright. This report covers the Jonckheere objects in the constellation Cancer. Only one image per object was taken as despite the risk of random effects even a single measurement is better than the currently usually given estimation, although the J-objects in this constellation seem with some exceptions better covered with observations as usual for Jonckheere doubles.

  15. 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...

  16. The breast cancer hormone receptor retesting controversy in Newfoundland and Labrador, Canada: lessons for the health system.

    Science.gov (United States)

    Gregory, Deborah M; Parfrey, Patrick S

    2010-01-01

    The treatment of newly diagnosed breast cancer patients with hormonal treatment is determined by the presence of estrogen receptor and progesterone receptor status in breast cancer. In Newfoundland and Labrador (NL), 425 of 1088 (39.1%) patients who had original "negative" receptor tests conducted between 1997 and 2005, had positive results upon retesting in a specialized laboratory. This commentary addresses (1) the diagnostic utility of estrogen and progesterone testing for breast cancer in general, (2) specific testing problems that occurred in NL, (3) scientific problems associated with retesting, and (4) the impact on public trust and the resulting legal and political responses that occurred as a result of the adverse events associated with false-negative hormone receptor tests. Finally, the lessons learned will be discussed including known high false-negative rates associated with the tests and the bias associated with retesting, the need for quality assurance and national standards, public education, and appropriate communication with patients and the public.

  17. 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

  18. Perceptions of Prostate Cancer Screening Controversy and Informed Decision Making: Implications for Development of a Targeted Decision Aid for Unaffected Male First-Degree Relatives.

    Science.gov (United States)

    Gwede, Clement K; Davis, Stacy N; Wilson, Shaenelle; Patel, Mitul; Vadaparampil, Susan T; Meade, Cathy D; Rivers, Brian M; Yu, Daohai; Torres-Roca, Javier; Heysek, Randy; Spiess, Philippe E; Pow-Sang, Julio; Jacobsen, Paul

    2015-01-01

    First-degree relatives (FDRs) of prostate cancer (PC) patients should consider multiple concurrent personal risk factors when engaging in informed decision making (IDM) about PC screening. This study assessed perceptions of IDM recommendations and risk-appropriate strategies for IDM among FDRs of varied race/ethnicity. A cross-sectional, qualitative study design was used. Study setting was a cancer center in southwest Florida. The study comprised 44 participants (24 PC patients and 20 unaffected FDRs). Focus groups and individual interviews were conducted and analyzed using content analysis and constant comparison methods. Patients and FDRs found the PC screening debate and IDM recommendations to be complex and counterintuitive. They overwhelmingly believed screening saves lives and does not have associated harms. There was a strongly expressed need to improve communication between patients and FDRs. A single decision aid that addresses the needs of all FDRs, rather than one separating by race/ethnicity, was recommended as sufficient by study participants. These perspectives guided the development of an innovative decision aid that deconstructs the screening controversy and IDM processes into simpler concepts and provides step-by-step strategies for FDRs to engage in IDM. Implementing IDM among FDRs is challenging because the IDM paradigm departs from historical messages promoting routine screening. These contradictions should be recognized and addressed for men to participate effectively in IDM. A randomized pilot study evaluating outcomes of the resulting decision aid is underway.

  19. A Web of Controversies

    DEFF Research Database (Denmark)

    Baron, Christian

    2011-01-01

    Using the Burgess Shale controversies as a case-study, this paper argues that controversies within different domains may interact as to create a situation of “com- plicated intricacies,” where the practicing scientist has to navigate through a context of multiple thought collectives. To some extent...... Shale debate shows that this encapsulated kind of analysis is not enough....

  20. The Business Controversy Exercise.

    Science.gov (United States)

    Muir, Clive

    2001-01-01

    Describes an exercise used in business communication courses that uses controversial business news to provoke discussion and build critical thinking as well as help students to develop writing and speaking skills as they prepare to face the communications implications of workplace controversies and crises. (SR)

  1. Best Clinical Practice: Current Controversies in the Evaluation of Low-Risk Chest Pain with Risk Stratification Aids. Part 2.

    Science.gov (United States)

    Long, Brit; Koyfman, Alex

    2017-01-01

    Chest pain accounts for 10% of emergency department (ED) visits annually, and many of these patients are admitted because of potentially life-threatening conditions. A substantial percentage of patients with chest pain are at low risk for a major cardiac adverse event (MACE). We investigated controversies in the evaluation of patients with low-risk chest pain, including clinical scores, decision pathways, and shared decision-making. ED patients with chest pain who have negative biomarker results and nonischemic electrocardiograms are at low risk for MACE. With the large number of chest pain patients evaluated in the ED, several risk scores and pathways are in use based on history, electrocardiographic results, and biomarker results. The Thrombolysis in Myocardial Infarction and Global Registry of Acute Coronary Events scores are older rules with validation; however, they do not have adequate sensitivity or are not easy to use in the ED. The Vancouver chest pain and North American chest pain rules may be used for patients with undifferentiated chest pain in the ED. The Manchester Acute Coronary Syndromes rule uses eight factors, several of which are not available in the United States. The history, electrocardiography, age, risk factors, and troponin (HEART) score and pathway are easy to use, have high sensitivity and negative predictive values, and have better discriminatory capability for categorization. The use of pathways with shared decision-making involves the patient in management, shortens the duration of stay, and decreases risk to both the patient and the provider. Risk stratification of ED patients with chest pain has evolved, and there are many tools available. The HEART pathway, designed for ED use, has several attributes that provide safe and efficient care for patients with chest pain. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. 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.

  3. Intraoperative photodynamic therapy in laryngeal part of pharynx cancers

    Science.gov (United States)

    Loukatch, Erwin V.; Trojan, Vasily; Loukatch, Vjacheslav

    1996-12-01

    In clinic intraoperative photodynamic therapy (IPT) was done in patients with primal squamous cells cancer of the laryngeal part of the pharynx. The He-Ne laser and methylene blue as a photosensibilizator were used. Cobalt therapy in the postoperative period was done in dose 45 Gr. Patients of control groups (1-th group) with only laser and (2-th group) only methylene blue were controlled during three years with the main group. The statistics show certain differences of recidives in the main group compared to the control groups. These facts are allowing us to recommend the use of IPT as an additional method in ENT-oncology diseases treatment.

  4. Cartography of architectural controversies

    DEFF Research Database (Denmark)

    Lotz, Katrine

    2009-01-01

    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....

  5. Cancer

    Science.gov (United States)

    ... Prostate cancer Lung cancer Colorectal cancer In US women, other than skin cancer the three most common cancers are: Breast cancer Lung cancer Colorectal cancer Some cancers are more common in certain parts of the world. For example, in Japan, there are many cases of stomach cancer . But ...

  6. Controversies in Odontogenic Tumours

    Science.gov (United States)

    Siwach, Pooja; Joy, Tabita; Tupkari, Jagdish; Thakur, Arush

    2017-01-01

    Odontogenic tumours are lesions that occur solely within the oral cavity and are so named because of their origin from the odontogenic (i.e. tooth-forming) apparatus. Odontogenic tumours comprise a variety of lesions ranging from non-neoplastic tissue proliferations to benign or malignant neoplasms. However, controversies exist regarding the pathogenesis, categorisation and clinical and histological variations of these tumours. The recent 2017 World Health Organization classification of odontogenic tumours included new entities such as primordial odontogenic tumours, sclerosing odontogenic carcinomas and odontogenic carcinosarcomas, while eliminating several previously included entities like keratocystic odontogenic tumours and calcifying cystic odonogenic tumours. The aim of the present review article was to discuss controversies and recent concepts regarding odontogenic tumours so as to increase understanding of these lesions. PMID:29062548

  7. Controversies in dengue pathogenesis

    Science.gov (United States)

    Halstead, Scott B

    2012-01-01

    Research into the pathogenesis of dengue fever has exploded over the last half-century, with issues that were considered simple becoming more complex as additional data are found. This has led to the development of a number of controversies that are being studied across the globe and debated in the literature. In this paper, the following six controversies are analysed and, where possible, resolved: the 1997 World Health Organization (WHO) case definition of dengue haemorrhagic fever (DHF) is not useful; DHF is not significantly associated with secondary dengue infection; DHF results from infection with a ‘virulent’ dengue virus; DHF is owing to abnormal T-cell responses; DHF results from auto-immune responses; and DHF results from direct infection of endothelial cells. PMID:22668442

  8. Exploring Controversy in Twitter

    OpenAIRE

    Garimella, Kiran; Mathioudakis, Michael; De Francisci Morales, Gianmarco; Gionis, Aristides

    2016-01-01

    Among the topics discussed on social media, some spark more heated debate than others. For example, experience suggests that major political events, such as a vote for healthcare law in the US, would spark more debate between opposing sides than other events, such as a concert of a popular music band. Exploring the topics of discussion on Twitter and understanding which ones are controversial is extremely useful for a variety of purposes, such as for journalists to understand what issues divi...

  9. 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.

  10. Screening Mammography and Digital Breast Tomosynthesis: Controversies.

    Science.gov (United States)

    Funaro, Kimberly; Drukteinis, Jennifer; Falcon, Shannon

    2017-10-01

    Breast cancer screening with mammography reduces breast cancer mortality; however, diverging recommendations regarding screening have caused controversy. The emerging technology of digital breast tomosynthesis (DBT) may soon become the mainstay of breast cancer screening. We present recommendations for breast cancer screening based on guidelines. A PubMed literature review was performed and the results from five large clinical studies comparing the efficacy of digital mammography alone versus digital mammography with DBT are examined. We emphasize the importance of annual screening to reduce breast cancer mortality. Our review of the literature demonstrates that DBT increases cancer detection rates and reduces callbacks. Additional research is needed to determine whether the increased cancer detection rates are associated with a decrease in mortality.

  11. Trending Cardiovascular Nutrition Controversies.

    Science.gov (United States)

    Freeman, Andrew M; Morris, Pamela B; Barnard, Neal; Esselstyn, Caldwell B; Ros, Emilio; Agatston, Arthur; Devries, Stephen; O'Keefe, James; Miller, Michael; Ornish, Dean; Williams, Kim; Kris-Etherton, Penny

    2017-03-07

    The potential cardiovascular benefits of several trending foods and dietary patterns are still incompletely understood, and nutritional science continues to evolve. However, in the meantime, a number of controversial dietary patterns, foods, and nutrients have received significant media exposure and are mired by hype. This review addresses some of the more popular foods and dietary patterns that are promoted for cardiovascular health to provide clinicians with accurate information for patient discussions in the clinical setting. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  12. The conodont controversies.

    Science.gov (United States)

    Aldridge, R J; Purnell, M A

    1996-11-01

    The discovery of fossilized conodont soft tissues has led to suggestions that these enigmatic animals were among the earliest vertebrates and that they were macrophagous, using their oropharyngeal skeletal apparatus to capture and process prey. These conclusions have proved controversial. There is now a consensus that conodonts belong within the chordates, but their position within the clade is hotly debated. Resolution of these questions has major implications for our understanding of the origin of the vertebrates and the selective pressures that led to the development of the vertebrate skeleton.

  13. 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.

  14. The Case of the Danish Cartoons Controversy: The Paradox of Civility

    DEFF Research Database (Denmark)

    Lægaard, Sune

    2014-01-01

    , and what is taken to be at stake in the controversy. The paper focuses on the non-legal terms of the cartoons controversy and considers how one might understand what was at stake in the controversy thus understood. An important part of the non-legal controversy can be captured and understood...

  15. The HPV vaccine mandate controversy.

    Science.gov (United States)

    Haber, Gillian; Malow, Robert M; Zimet, Gregory D

    2007-12-01

    In this editorial we address the controversies surrounding human papillomavirus (HPV) vaccine school-entry mandate legislation, but differentiate between the mandate debate and issues specific to the vaccine itself. Our goal is not to take a stand in favor of or opposed to mandates, but rather to critically examine the issues. We discuss the following arguments against HPV vaccine school-entry requirements: 1. The public health benefit of mandated HPV vaccination is not sufficient to warrant the intrusion on parental autonomy; 2. A vaccine that prevents a non-casually transmitted infection should not be mandated; 3. Opt-out provisions are inherently unfair to parents who oppose HPV vaccination; 4. Limited health care dollars should not be directed toward cervical cancer prevention; and 5. The vaccine is expensive and potential problems with supply suggest that mandates should not be implemented until insurance coverage and supply issues are resolved. Next, we critically evaluate the following critiques of HPV vaccination itself: 1. Giving girls HPV vaccine implies tacit consent to engage in sexual activity; 2. Giving girls this vaccine will confer a false sense of protection from sexually transmitted infections and will lead to sexual disinhibition; 3. Children already have too many vaccinations on the immunization schedule; 4. Long-term side effects of HPV vaccine are unknown; 5. The vaccine's enduring effectiveness is unknown and booster shots may be required; and 6. It is wrong to only target girls with HPV vaccine; boys should be vaccinated as well.

  16. Bisphenol A: Understanding the Controversy.

    Science.gov (United States)

    Metz, Cynthia Marie

    2016-01-01

    Healthy People 2020 lists Bisphenol A (BPA) as a potential endocrine disruptor for which exposure should be reduced. The Healthy People 2020 Environmental Health Objectives focus on addressing environmental factors that negatively affect individuals' health even though the health effects of some toxic substances are not yet fully understood. An American Association of Occupational Health Nurses (AAOHN) position statement outlined the role occupational health nurses play in creating healthy and productive workplaces by promoting worker health. BPA is implicated in a variety of health outcomes such as breast and prostate cancer, menstrual irregularities, genital abnormalities in male babies, infertility in men and women, early puberty in girls, and metabolic disorders such as diabetes and obesity. The overall health issues attributed to BPA exposure are complex and controversial. Concerns regarding environmental health are growing as individuals become more dependent on plastics. Numerous health concerns have been directly connected to daily exposures to products manufactured with BPA. Government agencies support the use of BPA as a safe consumer product with the exception of BPA use in baby bottles and sippy cups, which has been banned in the United States and several other countries. Many agencies (e.g., Federal Drug Administration [FDA], World Health Organization [WHO], U.S. Department of Health & Human Services [U.S. DHHS], and the Centers for Disease Control and Prevention [CDC]) have expressed "some concern" about BPA based on research, and stated further research is warranted. © 2016 The Author(s).

  17. Mouth Cancer for Clinicians Part 3: Risk Factors (Traditional: Tobacco).

    Science.gov (United States)

    Kalavrezos, Nicholas; Scully, Crispian

    2015-06-01

    A MEDLINE search early in 2015 revealed more than 250,000 papers on head and neck cancer; over 100,000 on oral cancer; and over 60,000 on mouth cancer. Not all publications contain robust evidence. We endeavour to encapsulate the most important of the latest information and advances now employed in practice, in a form comprehensible to healthcare workers, patients and their carers. This series offers the primary care dental team, in particular, an overview of the aetiopathogenesis, prevention, diagnosis and multidisciplinary care of mouth cancer, the functional and psychosocial implications, and minimization of the impact on the quality of life of patient and family. CPD/CLINICAL RELEVANCE: This article offers the dental team an overview of the main cancer risk factors, tobacco and alcohol, betel and other chewing habits, and environmental factors.

  18. Skin cancer screening: recommendations for data-driven screening guidelines and a review of the US Preventive Services Task Force controversy

    Science.gov (United States)

    Johnson, Mariah M; Leachman, Sancy A; Aspinwall, Lisa G; Cranmer, Lee D; Curiel-Lewandrowski, Clara; Sondak, Vernon K; Stemwedel, Clara E; Swetter, Susan M; Vetto, John; Bowles, Tawnya; Dellavalle, Robert P; Geskin, Larisa J; Grossman, Douglas; Grossmann, Kenneth F; Hawkes, Jason E; Jeter, Joanne M; Kim, Caroline C; Kirkwood, John M; Mangold, Aaron R; Meyskens, Frank; Ming, Michael E; Nelson, Kelly C; Piepkorn, Michael; Pollack, Brian P; Robinson, June K; Sober, Arthur J; Trotter, Shannon; Venna, Suraj S; Agarwala, Sanjiv; Alani, Rhoda; Averbook, Bruce; Bar, Anna; Becevic, Mirna; Box, Neil; E Carson, William; Cassidy, Pamela B; Chen, Suephy C; Chu, Emily Y; Ellis, Darrel L; Ferris, Laura K; Fisher, David E; Kendra, Kari; Lawson, David H; Leming, Philip D; Margolin, Kim A; Markovic, Svetomir; Martini, Mary C; Miller, Debbie; Sahni, Debjani; Sharfman, William H; Stein, Jennifer; Stratigos, Alexander J; Tarhini, Ahmad; Taylor, Matthew H; Wisco, Oliver J; Wong, Michael K

    2017-01-01

    Melanoma is usually apparent on the skin and readily detected by trained medical providers using a routine total body skin examination, yet this malignancy is responsible for the majority of skin cancer-related deaths. Currently, there is no national consensus on skin cancer screening in the USA, but dermatologists and primary care providers are routinely confronted with making the decision about when to recommend total body skin examinations and at what interval. The objectives of this paper are: to propose rational, risk-based, data-driven guidelines commensurate with the US Preventive Services Task Force screening guidelines for other disorders; to compare our proposed guidelines to recommendations made by other national and international organizations; and to review the US Preventive Services Task Force's 2016 Draft Recommendation Statement on skin cancer screening. PMID:28758010

  19. 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…

  20. On Controversies in Relativity Theory

    OpenAIRE

    Vankov, Anatoli Andrei

    2006-01-01

    Controversies arise when specialists disagree on some particular issue. This normally occurs in any scientific brunch. We analyze some controversies, which have a good cause in Special Relativity. The paper does not question Special Relativity Theory but it challenges changing deeply held academic beliefs about imaginary experiments in Special Relativity Theory. PACS 03.30.+p

  1. 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.

  2. The role of adhesive molecules in endometrial cancer: part I

    Directory of Open Access Journals (Sweden)

    Michał Wojciechowski

    2010-10-01

    Full Text Available The carcinogenesis is a result of both functional and structural disorders in the tissue. It initiates as a mutation in a gene encoding protein that is essential for cellular function. The subsequent cascade of events leads 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 that adhesive molecules are a key player in this cascade. These proteins of the cell membrane surface are responsible for attachment of the cells to each other and to the extracellular matrix. These interactions are crucial for both structural and functional tissue organization. Lack of this homeostasis destroys the tissue architecture, impairs its function and results in invasion. Abnormal expression of adhesive molecules was reported in all examined cancers, including endometrial cancer.Endometrial cancer is the most common gynaecological cancer in developed countries. Although in many cases it is diagnosed and treated in early stages, and thus with good results, some patients cannot be cured. A complete knowledge of the pathogenesis of the disease will be helpful in identifying patients with negative prognostic factors, increased risk of recurrence and, perhaps, finding other therapeutic options. In the paper we are trying to sum up the up-to-date knowledge of the role of adhesive molecules in pathogenesis of endometrial cancer.

  3. Silicosis: controversy in detection

    Directory of Open Access Journals (Sweden)

    Diemen Darwin Delgado García

    2014-03-01

    Full Text Available In many countries, the work of mining, quarrying, construction of tunnels and galleries, abrasive jet cleaning and smelting continue to present significant risks of silica exposure and silicosis epidemics still occur, even in developed countries. Patients with silicosis are particularly susceptible to opportunistic lung infections such as aspergillosis and tuberculosis. Occasionally silicosis is associated with scleroderma, systemic lupus erythematosus, nephritis and cancer. Early detection of silicosis is made by chest X-ray method, being the presence of rounded opacities the main sign of illness. However, no systematic information is available that allows use as a standard method of evaluation because their interpretation remains operator dependent both conventional radiological technique, digital and interpretation of computed tomography with high resolution.

  4. Partisan Scholarship in Technoscientific Controversies

    DEFF Research Database (Denmark)

    Galis, Vasilis; Hansson, Anders

    2012-01-01

    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......Several academic traditions have addressed epistemological objectivity and/or partisanship in the study of technoscientific controversies. On the one hand, positivist and relativist scholars agree that the political commitments of the social researcher should not impinge on scientific enquiry...... epistemological assumptions underpinning sociotechnical systems, especially when it comes to technoscientific controversies. Supporting STS partisan scholarship, therefore, enables greater social and democratic engagement with technoscientific development....

  5. AGROECOLOGY: POLYSEMY, PLURALISM AND CONTROVERSIES

    National Research Council Canada - National Science Library

    LUIZ ANTONIO NORDER; CLAIRE LAMINE; STEPHANE BELLON; ALFIO BRANDENBURG

    2016-01-01

      In recent years, a growing number of actors and institutions, in different countries, have begun using the notion of Agroecology, which has led to an expansion of its polysemy and its controversies...

  6. Quantifying Controversy in Social Media

    OpenAIRE

    Garimella, Kiran; Morales, Gianmarco De Francisci; Gionis, Aristides; Mathioudakis, Michael

    2015-01-01

    Which topics spark the most heated debates on social media? Identifying those topics is not only interesting from a societal point of view, but also allows the filtering and aggregation of social media content for disseminating news stories. In this paper, we perform a systematic methodological study of controversy detection by using the content and the network structure of social media. Unlike previous work, rather than study controversy in a single hand-picked topic and use domain specific ...

  7. 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.

  8. 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.

  9. Disturbing pasts: Memories, controversies and creativity

    Directory of Open Access Journals (Sweden)

    Leon Wainwright

    2014-10-01

    Full Text Available This themed issue of the Open Arts Journal, ‘Disturbing pasts: Memories, controversies and creativity’, brings together a range of artists, curators, policy-makers and academics from around the world, who explore creative engagements with controversial and traumatic pasts in art practice, curating and museums. The material is presented in three parts: ‘Difficult Pasts and Public Space’ (writings on historical issues and museums, ‘Visual Investigations’ (artists’ statements and criticism, and ‘Collaborations’ (visual analysis and artist-scholar pairings of writings and original artworks. This collection was developed through a two-year international research project led by Leon Wainwright, which involved three consortia of researchers from universities throughout Europe, and focused on a major public event at the Museum of Ethnology Vienna/ Weltmuseum, Wien (November 2011. The project is funded by HERA (Humanities in the European Research Area, the European Science Foundation.

  10. Insulin: discovery and controversy.

    Science.gov (United States)

    Rosenfeld, Louis

    2002-12-01

    During the first two decades of the 20th century, several investigators prepared extracts of pancreas that were often successful in lowering blood sugar and reducing glycosuria in test animals. However, they were unable to remove impurities, and toxic reactions prevented its use in humans with diabetes. In the spring of 1921, Frederick G. Banting, a young Ontario orthopedic surgeon, was given laboratory space by J.J.R. Macleod, the head of physiology at the University of Toronto, to investigate the function of the pancreatic islets. A student assistant, Charles Best, and an allotment of dogs were provided to test Banting's hypothesis that ligation of the pancreatic ducts before extraction of the pancreas, destroys the enzyme-secreting parts, whereas the islets of Langerhans, which were believed to produce an internal secretion regulating sugar metabolism, remained intact. He believed that earlier failures were attributable to the destructive action of trypsin. The name "insuline" had been introduced in 1909 for this hypothetic substance. Their experiments produced an extract of pancreas that reduced the hyperglycemia and glycosuria in dogs made diabetic by the removal of their pancreases. They next developed a procedure for extraction from the entire pancreas without the need for duct ligation. This extract, now made from whole beef pancreas, was successful for treating humans with diabetes. Facilitating their success was a development in clinical chemistry that allowed blood sugar to be frequently and accurately determined in small volumes of blood. Success with purification was largely the work of J.B. Collip. Yield and standardization were improved by cooperation with Eli Lilly and Company. When the Nobel Prize was awarded to Banting and Macleod for the discovery of insulin, it aggravated the contentious relationship that had developed between them during the course of the investigation. Banting was outraged that Macleod and not Best had been selected, and he

  11. Grandparents' experiences of childhood cancer, part 1: doubled and silenced.

    Science.gov (United States)

    Moules, Nancy J; Laing, Catherine M; McCaffrey, Graham; Tapp, Dianne M; Strother, Douglas

    2012-01-01

    In this study, the authors examined the experiences of grandparents who have had, or have, a grandchild with childhood cancer. Sixteen grandparents were interviewed using unstructured interviews, and the data were analyzed according to hermeneutic-phenomenological tradition, as guided by the philosophical hermeneutics of Hans-Georg Gadamer. Interpretive findings indicate that grandparents suffer and worry in many complex ways that include a doubled worry for their own children as well as their grandchildren. According to the grandparents in this study, this worry was, at times, silenced in efforts to protect the parents of the grandchild from the burden of concern for the grandparent. Other interpretations include the nature of having one's universe shaken, of having lives put on hold, and a sense of helplessness. The grandparents in this study offer advice to other grandparents as well as to the health care system regarding what kinds of things might have been more helpful to them as one level of the family system, who, like other subsystems of the family, are also profoundly affected by the event of childhood cancer.

  12. Exploring Cancer Therapeutics with Natural Products from African Medicinal Plants, Part II: Alkaloids, Terpenoids and Flavonoids.

    Science.gov (United States)

    Nwodo, Justina N; Ibezim, Akachukwu; Simoben, Conrad V; Ntie-Kang, Fidele

    2016-01-01

    Cancer stands as second most common cause of disease-related deaths in humans. Resistance of cancer to chemotherapy remains challenging to both scientists and physicians. Medicinal plants are known to contribute significantly to a large population of Africa, which is to a very large extent linked to folkloric claims which is part of their livelihood. In this review paper, the potential of naturally occurring anti-cancer agents from African flora has been explored, with suggested modes of action, where such data is available. Literature search revealed plant-derived compounds from African flora showing anti-cancer and/or cytotoxic activities, which have been tested in vitro and in vivo. This corresponds to 400 compounds (from mildly active to very active) covering various compound classes. However, in this part II, we only discussed the three major compound classes which are: flavonoids, alkaloids and terpenoids.

  13. BREAST AND/OR OVARIAN CANCER AS PART OF FAMILY CANCER SYNDROME

    Directory of Open Access Journals (Sweden)

    L. N. Lyubchenko

    2009-01-01

    Full Text Available The problems in the early diagnosis, primary and secondary prevention of family cancer of the breast and/or ovaries are successfully solved within medical genetic counseling at a cancer clinic. Its genetic diagnosis is confirmed, individual risks for breast and/or ovarian cancer are calculated, risk-modifying factors are studied, and treatment, family planning, and childbirth are discussed during clinicogenetic studies.

  14. Part I: cancer in Sudan—burden, distribution, and trends breast, gynecological, and prostate cancers.

    Science.gov (United States)

    Elamin, Amany; Ibrahim, Muntaser E; Abuidris, Dafalla; Mohamed, Kamal Eldin H; Mohammed, Sulma Ibrahim

    2015-03-01

    Despite the growing burden of cancer worldwide, it continues to receive low priority in Africa, across the continent and specifically in Sudan. This is due to political unrest, limited health resources, and other pressing public health issues such as infectious diseases. Lack of awareness about the magnitude of the current and future cancer burden among policy makers play a major role as well. Although, the real scope of cancer in Sudan is not known, the reported cases have increased from 303 in 1967-6303 in 2010. According to Globocan estimates, the top most common cancers in both sexes are breast, non-Hodgkin lymphoma, leukemia, esophagus, and colorectum. This review is the first of four papers that focuses on cancer, its distribution and trend as well as the risk factors most common in Sudan. It is expected that cancer will increase in Sudan as a result of migration of people from rural areas to urban cities in the pursuit of a better standard of living, which has resulted in lifestyle and behavioral changes that include tobacco chewing and smoking, unhealthy dieting, and a lack of physical activity. These changes are further exacerbated by the aging population and have made the country vulnerable to many diseases including cancer. These reviews are meant to provide a better understanding and knowledge required to plan appropriate cancer-control and prevention strategies in the country. © 2015 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  15. Teaching Controversial Issues of Bioethics.

    Science.gov (United States)

    Stronck, David R.

    Many teachers avoid controversial topics because they do not want to upset students or parents, do not know appropriate instructional strategies, and fail to recognize the importance of motivating students through placing science in its relevant context. An example is provided for use in a methods course for helping future high school teachers to…

  16. Darwinian Controversies: An Historiographical Recounting

    Science.gov (United States)

    Depew, David J.

    2010-01-01

    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,…

  17. The Controversy around Black History.

    Science.gov (United States)

    Pitre, Abul; Ray, Ruth

    2002-01-01

    Controversy over black history began in 1926, when Carter G. Woodson introduced Negro history week, and has continued into the 21st century. Proponents of black history believe it promotes diversity, develops self-esteem, and corrects myths and stereotypes. Opponents argue it is dishonest, divisive, and lacks academic credibility and rigor.…

  18. Societal Controversies in Wikipedia Articles

    NARCIS (Netherlands)

    Borra, E.; Weltevrede, E.; Ciuccarelli, P.; Kaltenbrunner, A.; Laniado, D.; Magni, G.; Mauri, M.; Rogers, R.; Venturini, T.

    2015-01-01

    Collaborative content creation inevitably reaches situations where different points of view lead to conflict. We focus on Wikipedia, the free encyclopedia anyone may edit, where disputes about content in controversial articles often reflect larger societal debates. While Wikipedia has a public edit

  19. Organic Reaction Mechanism Controversy: Pedagogical ...

    African Journals Online (AJOL)

    The paper investigated the pedagogical implications of the controversy generated by the nature of reaction mechanism in organic chemistry as to whether it can be proven or not. A conference of a chemist, chemical educator, a graduate chemistry teacher and a graduate assistant was organized. The conference lasted for ...

  20. Cartography of Controversies about MOOCs

    DEFF Research Database (Denmark)

    Khalid, Md. Saifuddin; Sorensen, Elsebeth Korsgaard

    2015-01-01

    in current literature result in the production of systematic literature reviews, case studies, and theoretical or conceptual frameworks. This work-in-progress paper explores the controversies about MOOCs by adopting the recently developed method “cartography of controversies” from the science and technology...

  1. 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...

  2. Cancer modelling in the NGS era - Part I: Emerging technology and initial modelling.

    Science.gov (United States)

    Rovigatti, Ugo

    2015-11-01

    It is today indisputable that great progresses have been made in our molecular understanding of cancer cells, but an effective implementation of such knowledge into dramatic cancer-cures is still belated and yet desperately needed. This review gives a snapshot at where we stand today in this search for cancer understanding and definitive treatments, how far we have progressed and what are the major obstacles we will have to overcome both technologically and for disease modelling. In the first part, promising 3rd/4th Generation Sequencing Technologies will be summarized (particularly IonTorrent and OxfordNanopore technologies). Cancer modelling will be then reviewed from its origin in XIX Century Germany to today's NGS applications for cancer understanding and therapeutic interventions. Developments after Molecular Biology revolution (1953) are discussed as successions of three phases. The first, PH1, labelled "Clonal Outgrowth" (from 1960s to mid 1980s) was characterized by discoveries in cytogenetics (Nowell, Rowley) and viral oncology (Dulbecco, Bishop, Varmus), which demonstrated clonality. Treatments were consequently dominated by a "cytotoxic eradication" strategy with chemotherapeutic agents. In PH2, (from the mid 1980s to our days) the description of cancer as "Gene Networks" led to targeted-gene-therapies (TGTs). TGTs are the focus of Section 3: in view of their apparent failing (Ephemeral Therapies), alternative strategies will be discussed in review part II (particularly cancer immunotherapy, CIT). Additional Pitfalls impinge on the concepts of tumour heterogeneity (inter/intra; ITH). The described pitfalls set the basis for a new phase, PH3, which is called "NGS Era" and will be also discussed with ten emerging cancer models in the Review 2nd part. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Long-Term Surgical Complications in the Oral Cancer Patient: a Comprehensive Review. Part I

    Directory of Open Access Journals (Sweden)

    Antonia Kolokythas

    2010-07-01

    Full Text Available Objectives: Oral and oropharyngeal cancer remains among the top ten most common malignancies in the United States and worldwide. Over the last several decades the approach to treatment of oral cancer has changed very little with regards to primary tumour extirpation while the approach to the “at risk” lymph nodes has evolved significantly. Perhaps the most significant change in the surgical treatment of cancer is the introduction of free flap for reconstruction post resection. Despite these surgical advances, oral cancer ablation, still results in the sacrifice of several functional and aesthetic organs. The aim of this article was to provide a comprehensive review of the potential long-term complications associated with surgical treatment of oral cancer and their management.Material and Methods: The available English language literature relevant to long-term surgical complications associated with surgical treatment of oral cancer was reviewed. The potential common as well as rarer complications that may be encountered and their treatment are summarized.Results: In total 50 literature sources were obtained and reviewed. The topics covered in the first part of this review series include ablative surgery complications, issues with speech, swallowing and chewing and neurologic dysfunction.Conclusions: The early complications associated with oncologic surgery for oral cancer are similar to other surgical procedures. The potential long-term complications however are quite challenging for the oncologic team and the patient who survives oral cancer, primarily due to the highly specialized regional tissues involved in the surgical field.

  4. Telehomecare technology across sectors: claims of jurisdiction and emerging controversies

    Directory of Open Access Journals (Sweden)

    Birthe Dinesen

    2007-11-01

    Full Text Available Purpose: The purpose of this study was to explore and identify inter-organisational and inter-professional controversies that emerge when telehomecare technology is implemented across healthcare sectors. Theory: A combined inter-organisational and inter-professional perspective constitutes the conceptual framework for this study. Methods: The case study approach was applied as the overall methodology of the study. A triangulation of data collection techniques was used in order to provide multiple sources of evidence for exploring and identifying controversies (documents, participant observation, qualitative interviews, focus group interviews. Findings: During the design and implementation phases of a telehomecare system, several types of controversies emerged as part of the inter-organisational and inter-professional agenda. These controversies involved competing claims of jurisdiction, controversies over knowledge technologies, or differences in network visions and network architecture. Discussion and conclusions: The identification of such controversies and differences in the design and implementation process of the concept of home hospitalisation for heart patients by means of telehomecare technology can contribute to the uncovering of new knowledge. These issues should be taken into account when initiating a telehomecare project and implementing telehomecare technology. Technology in a network and across inter-professional relations poses a challenge to this new field. There is a particular need to precisely define the claims of jurisdiction, and the accompanying controversies that can arise related to knowledge technologies, network visions and network architecture.

  5. Telehomecare technology across sectors: claims of jurisdiction and emerging controversies.

    Science.gov (United States)

    Dinesen, Birthe; Gustafsson, Jeppe; Nøhr, Christian; Kjærandersen, Stig; Sejersen, Holger; Toft, Egon

    2007-11-21

    The purpose of this study was to explore and identify inter-organisational and inter-professional controversies that emerge when telehomecare technology is implemented across healthcare sectors. A combined inter-organisational and inter-professional perspective constitutes the conceptual framework for this study. The case study approach was applied as the overall methodology of the study. A triangulation of data collection techniques was used in order to provide multiple sources of evidence for exploring and identifying controversies (documents, participant observation, qualitative interviews, focus group interviews). During the design and implementation phases of a telehomecare system, several types of controversies emerged as part of the inter-organisational and inter-professional agenda. These controversies involved competing claims of jurisdiction, controversies over knowledge technologies, or differences in network visions and network architecture. The identification of such controversies and differences in the design and implementation process of the concept of home hospitalisation for heart patients by means of telehomecare technology can contribute to the uncovering of new knowledge. These issues should be taken into account when initiating a telehomecare project and implementing telehomecare technology. Technology in a network and across inter-professional relations poses a challenge to this new field. There is a particular need to precisely define the claims of jurisdiction, and the accompanying controversies that can arise related to knowledge technologies, network visions and network architecture.

  6. 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

  7. 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.

  8. Role of omentectomy as part of radical surgery for gastric cancer

    NARCIS (Netherlands)

    Jongerius, E. J.; Boerma, D.; Seldenrijk, K. A.; Meijer, S. L.; Scheepers, J. J. G.; Smedts, F.; Lagarde, S. M.; Balague Ponz, O.; van Berge Henegouwen, M. I.; van Sandick, J. W.; Gisbertz, S. S.

    2016-01-01

    A complete omentectomy is recommended as part of radical (sub)total gastrectomy for gastric cancer, but there is little evidence to suggest any survival benefit. The aim of this study was to evaluate the incidence of, and risk factors for, metastases in the greater omentum in patients undergoing

  9. Controversies in Odontogenic Tumours: Review.

    Science.gov (United States)

    Siwach, Pooja; Joy, Tabita; Tupkari, Jagdish; Thakur, Arush

    2017-08-01

    Odontogenic tumours are lesions that occur solely within the oral cavity and are so named because of their origin from the odontogenic (i.e. tooth-forming) apparatus. Odontogenic tumours comprise a variety of lesions ranging from non-neoplastic tissue proliferations to benign or malignant neoplasms. However, controversies exist regarding the pathogenesis, categorisation and clinical and histological variations of these tumours. The recent 2017 World Health Organization classification of odontogenic tumours included new entities such as primordial odontogenic tumours, sclerosing odontogenic carcinomas and odontogenic carcinosarcomas, while eliminating several previously included entities like keratocystic odontogenic tumours and calcifying cystic odonogenic tumours. The aim of the present review article was to discuss controversies and recent concepts regarding odontogenic tumours so as to increase understanding of these lesions.

  10. HPV vaccines: a controversial issue?

    OpenAIRE

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

    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 o...

  11. Controversies in neurosciences critical care.

    Science.gov (United States)

    Chang, Tiffany R; Naval, Neeraj S; Carhuapoma, J Ricardo

    2012-06-01

    Neurocritical care is an evolving subspecialty with many controversial topics. The focus of this review is (1) transfusion thresholds in patients with acute intracranial bleeding, including packed red blood cell transfusion, platelet transfusion, and reversal of coagulopathy; (2) indications for seizure prophylaxis and choice of antiepileptic agent; and (3) the role of specialized neurocritical care units and specialists in the care of critically ill neurology and neurosurgery patients. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. Cancer concepts and principles: primer for the interventional oncologist-part II.

    Science.gov (United States)

    Hickey, Ryan; Vouche, Michael; Sze, Daniel Y; Hohlastos, Elias; Collins, Jeremy; Schirmang, Todd; Memon, Khairuddin; Ryu, Robert K; Sato, Kent; Chen, Richard; Gupta, Ramona; Resnick, Scott; Carr, James; Chrisman, Howard B; Nemcek, Albert A; Vogelzang, Robert L; Lewandowski, Robert J; Salem, Riad

    2013-08-01

    This is the second of a two-part overview of the fundamentals of oncology for interventional radiologists. The first part focused on clinical trials, basic statistics, assessment of response, and overall concepts in oncology. This second part aims to review the methods of tumor characterization; principles of the oncology specialties, including medical, surgical, radiation, and interventional oncology; and current treatment paradigms for the most common cancers encountered in interventional oncology, along with the levels of evidence that guide these treatments. Copyright © 2013 SIR. Published by Elsevier Inc. All rights reserved.

  13. 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.

  14. Personalization of loco-regional care for primary breast cancer patients (part 2).

    Science.gov (United States)

    Toi, Masakazu; Winer, Eric P; Benson, John R; Inamoto, Takashi; Forbes, John F; von Minckwitz, Gunter; Robertson, John F R; Grobmyer, Stephen R; Jatoi, Ismail; Sasano, Hironobu; Kunkler, Ian; Ho, Alice Y; Yamauchi, Chikako; Chow, Louis W C; Huang, Chiun-Sheng; Han, Wonshik; Noguchi, Shinzaburo; Pegram, Mark D; Yamauchi, Hideko; Lee, Eun-Sook; Larionov, Alexey A; Bevilacqua, Jose L B; Yoshimura, Michio; Sugie, Tomoharu; Yamauchi, Akira; Krop, Ian E; Noh, Dong Young; Klimberg, V Suzanne

    2015-01-01

    Kyoto Breast Cancer Consensus Conference, Kyoto, Japan, 18-20 February 2014 The loco-regional management of breast cancer is increasingly complex with application of primary systemic therapies, oncoplastic techniques and genetic testing for breast cancer susceptibility. Personalization of loco-regional treatment is integral to optimization of breast cancer care. Clinical and pathological tumor stage, biological features and host factors influence loco-regional treatment strategies and extent of surgical procedures. Key issues including axillary staging, axillary treatment, radiation therapy, primary systemic therapy (PST), preoperative hormonal therapy and genetic predisposition were identified and discussed at the Kyoto Breast Cancer Consensus Conference (KBCCC2014). In the second of a two part conference scene, consensus recommendations for radiation treatment, primary systemic therapies and management of genetic predisposition are reported and focus on the following topics: influence of both clinical response to PST and stage at presentation on recommendations for postmastectomy radiotherapy; use of regional nodal irradiation in selected node-positive patients and those with adverse pathological factors; extent of surgical resection following downstaging of tumors with PST; use of preoperative hormonal therapy in premenopausal women with larger, node-negative luminal A-like tumors and managing increasing demands for contralateral prophylactic mastectomy in patients with a unilateral sporadic breast cancer.

  15. Controversial reversal of nuclear option

    Directory of Open Access Journals (Sweden)

    Mesarović Miodrag

    2002-01-01

    Full Text Available Nuclear option is in a unique position to restore its original role of the main source of energy with an increased attention paid to the security of electricity supply as well as regulatory changes affecting fossil fuels, particularly with due introduction of climate change prevention measures. Recent developments indicate the advantages of nuclear option over other possible options in terms of sustainable development. However, a large number of controversial issues on nuclear energy make its reversal less clear. These are discussed with particular attention paid to recent developments worldwide, including the World Summit on Sustainable Development held in September 2002 in Johannesburg, South Africa.

  16. 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...... reactions that broke out in early 2006 as localized reactions to stories about the publication of the cartoons, the Danish government’s denial of dialogue, and two delegations of Muslims travelling from Denmark to the Middle East to rally for political, moral, and religious support....

  17. Nutrition and Cancer: An Historical Perspective.-The Past, Present, and Future of Nutrition and Cancer. Part 2. Misunderstanding and Ignoring Nutrition.

    Science.gov (United States)

    Campbell, T Colin

    2017-01-01

    The role that nutrition plays in cancer development and treatment has received considerable attention in recent decades, but it still engenders considerable controversy. Within the cancer research and especially the clinical community, for example, nutritional factors are considered to play, at best, a secondary role. The role of nutrition in cancer development was noted by authorities as far back as the early 1800s, generally under the theory that cancer is "constitutional" in its origin, implying a complex, multifactorial, multistage etiology. Opponents of this idea insisted, rather vigorously, that cancer is a local unifactorial disease, best treated through surgery, with little attention paid to the etiology and possible prevention of cancer. This "local" theory, developed during the late 1700s and early 1800s, gradually included, in the late 1800s and early 1900s, chemotherapy and radiotherapy as treatment modalities, which now remain, along with surgery, as the basis of present-day cancer treatment. This highly reductionist paradigm left in its wake unfortunate consequences for the present day, which is the subject of this perspective.

  18. Current controversies in childhood vaccination.

    Science.gov (United States)

    Carrillo-Marquez, Maria; White, Lisa

    2013-01-01

    As pediatric practitioners, one of the contemporary challenges in providing medical care for children is the increasing proportion of vaccination refusal. This occurs in spite of the demonstrated individual and collective benefit and cost effectiveness of vaccination. Controversies regarding vaccine components and side effects have misled parents to believe that vaccines might be harmful based on inaccurate data from the Internet, celebrities, as well as misinterpreted and frankly bad science. This belief of vaccines being harmful has led to fear and decreased immunization rates in spite of sound scientific evidence supporting the safety of vaccines and their lack of association with autism, developmental disabilities or other medical disorders. Some parents also believe in alternative ways to avoid disease, often adhering to practices that have little foundation in the best of empiric science. It is not a coincidence that recent outbreaks of vaccine-preventable diseases, including measles and pertussis (whooping cough), have occurred in areas where vaccination has declined largely due to exemptors. This article intends to review some of the common vaccine myths and controversies and to serve as a resource to provide accurate information and references for busy practitioners and the families that we serve.

  19. Long-Term Surgical Complications in the Oral Cancer Patient: a Comprehensive Review. Part II

    Directory of Open Access Journals (Sweden)

    Antonia Kolokythas

    2010-07-01

    Full Text Available Objectives: Surgery remains the preferred treatment for the majority of oral cancers. The aim of the present article was to provide a comprehensive review of complications associated with surgical treatment of oral cancer including hardware failure; complications associated with choice of reconstruction, donor site morbidity as well as functional and aesthetic issues that impact on the quality of life.Material and Methods: The available English language literature relevant to complications associated with surgical treatment of oral cancer was reviewed. Complications associated with potential for disfigurement, choice of reconstruction, donor site morbidity as well as functional and aesthetic issues that impact on the quality of life are summarized.Results: In total 35 literature sources were obtained and reviewed. The topics covered in the second part of this review series include hardware failure, scars and fistula formation; complications associated with choice of reconstruction, donor site morbidity as well as functional and aesthetic issues.Conclusions: Cancer resection should be planned around two very important concepts. First and foremost is the eradication of disease. This should be the ultimate goal of the ablative team and all potential complications that may be the result of appropriately executed oncologic resection should be discussed in details with the patient. Adequate reconstruction of the defects with restoration of form and function is the second, but not of less importance, goal for the successful care of the head and neck cancer patient.

  20. Personalization of loco-regional care for primary breast cancer patients (part 1).

    Science.gov (United States)

    Toi, Masakazu; Winer, Eric P; Benson, John R; Inamoto, Takashi; Forbes, John F; von Minckwitz, Gunter; Robertson, John F R; Grobmyer, Stephen R; Jatoi, Ismail; Sasano, Hironobu; Kunkler, Ian; Ho, Alice Y; Yamauchi, Chikako; Chow, Louis W C; Huang, Chiun-Sheng; Han, Wonshik; Noguchi, Shinzaburo; Pegram, Mark D; Yamauchi, Hideko; Lee, Eun-Sook; Larionov, Alexey A; Bevilacqua, Jose L B; Yoshimura, Michio; Sugie, Tomoharu; Yamauchi, Akira; Krop, Ian E; Noh, Dong Young; Klimberg, V Suzanne

    2015-01-01

    ABSTRACT  Kyoto Breast Cancer Consensus Conference, Kyoto, Japan, 18-20 February 2014 The loco-regional management of breast cancer is increasingly complex with application of primary systemic therapies, oncoplastic techniques and genetic testing for breast cancer susceptibility. Personalization of loco-regional treatment is integral to optimization of breast cancer care. Clinical and pathological tumor stage, biological features and host factors influence loco-regional treatment strategies and extent of surgical procedures. Key issues including axillary staging, axillary treatment, radiation therapy, primary systemic therapy (PST), preoperative hormonal therapy and genetic predisposition were identified and discussed at the Kyoto Breast Cancer Consensus Conference (KBCCC2014). In the first of a two part conference scene, consensus recommendations for axillary management are presented and focus on the following topics: indications for completion axillary lymph node dissection in primary surgical patients with ≤2 macrometastases or any sentinel nodal deposits after PST; the timing of sentinel lymph node biopsy in the context of PST; use of axillary irradiation as a component of primary treatment plans and the role of intraoperative node assessment in the post-Z0011 era.

  1. 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

  2. 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...... 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...

  3. Isotretinoin: controversies, facts, and recommendations.

    Science.gov (United States)

    Bauer, Lindsey B; Ornelas, Jennifer N; Elston, Dirk M; Alikhan, Ali

    2016-11-01

    Since it was introduced to the market by Hoffman-La Roche (Roche) in 1982, isotretinoin has remained the most effective treatment for severe and recalcitrant acne. However, it has also been surrounded by controversy due to its teratogenicity and inconsistent associations with depression, suicidality, inflammatory bowel disease, increases in lipid levels, and elevated transaminases. Areas covered: In this article, we reviewed data regarding safety of isotretinoin and its association with these conditions. A thorough and comprehensive search on the topics was performed using pubmed and google scholar. Expert commentary: Despite common misperceptions, there is weak evidence for increased incidence of depression, suicidality, or inflammatory bowel disease with isotretinoin use. Furthermore, data indicates that transient increases in transaminases and lipid levels do not typically necessitate discontinuation of therapy. We hope to provide clinicians with information necessary to have meaningful discussions with patients regarding the safety and efficacy of isotretinoin.

  4. 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.

  5. Barrier creams: facts and controversies.

    Science.gov (United States)

    Corazza, Monica; Minghetti, Sara; Bianchi, Anna; Virgili, Annarosa; Borghi, Alessandro

    2014-01-01

    Barrier creams (BCs) represent devices aiming to protect the skin from contact with exogenous hazardous substances, especially under working conditions. By preventing penetration and absorption of contaminants, BCs are designed to reduce the risk of developing both irritant and allergic contact dermatitis. In fact, BCs should improve stratum corneum hydration as well as provide emolliency to maintain skin integrity and to restore and repair the epidermis barrier function. The formulation and ingredients of the available BCs vary widely, and thus the choice of a BC should depend on the kind of contaminants, occupational conditions, and skin dysfunction. Although BCs are commonly recommended to prevent occupational contact dermatitis, their real benefit remains controversial. The aims of this review are to help the choice of appropriate BCs and to analyze the actual effectiveness in maintaining an intact skin barrier, preventing contact dermatitis, and speeding up the healing of barrier-impaired skin.

  6. 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

  7. CONTROVERSIES ON VERTEBROPLASTY AND KYPHOPLASTY FOR VERTEBRAL COMPRESSION FRACTURES

    Directory of Open Access Journals (Sweden)

    Alisson Roberto Teles

    2015-12-01

    Full Text Available Vertebroplasty and kyphoplasty are widely used for osteoporotic and cancer-related vertebral compression fractures refractory to medical treatment. Many aspects of these procedures have been extensively discussed in the literature during the last few years. In this article, we perform a critical appraisal of current evidence on effectiveness and ongoing controversies regarding surgical technique, indications and contraindications, clinical outcomes and potential complications of these procedures.

  8. Controversies in the Management of Endometrial Carcinoma: An Update

    Directory of Open Access Journals (Sweden)

    Mohamed K. Mehasseb

    2012-01-01

    Full Text Available Endometrial carcinoma is the commonest type of female genital tract malignancy in the developed countries. Endometrial carcinoma is usually confined to the uterus at the time of diagnosis and as such usually carries an excellent prognosis with high curability. Our understanding and management of endometrial cancer have continuously developed. Current controversies focus on screening and early detection, the extent of nodal surgery, and the changing roles of radiation therapy and chemotherapy and will be discussed in this paper.

  9. CONTROVERSIES ON VERTEBROPLASTY AND KYPHOPLASTY FOR VERTEBRAL COMPRESSION FRACTURES

    OpenAIRE

    Alisson Roberto Teles; Tobias Alécio Mattei; Orlando Righesso; Asdrubal Falavigna

    2015-01-01

    Vertebroplasty and kyphoplasty are widely used for osteoporotic and cancer-related vertebral compression fractures refractory to medical treatment. Many aspects of these procedures have been extensively discussed in the literature during the last few years. In this article, we perform a critical appraisal of current evidence on effectiveness and ongoing controversies regarding surgical technique, indications and contraindications, clinical outcomes and potential complications of these procedu...

  10. Familial breast cancer. Part II: Relationships with histology, staging, steroid receptors and serum tumor markers.

    Science.gov (United States)

    Gavrilov, I; Nacheva, M; Tzingilev, D

    2002-01-01

    To identify differences in clinical characteristics, histological features, hormone receptor status, and tumor marker expression between patients with sporadic and familial breast cancer. As in the previous Part I of this study, two groups of women with breast cancer were compared. The first group (group I) included 504 patients with a family history of breast cancer. The second (control) group (group II) consisted of 300 patients not reporting such a history in their relatives. The examined parameters in this report were stage and axillary lymph node involvement at the time of the initial diagnosis, treatment methods, hormone receptor status, and serum levels of the tumor markers CEA and CA 15.3. The data were processed and analysed using the SPSS statistical package. The statistical significance of differences between groups and subgroups was evaluated by x(2) Pearson's test and Student's paired t-test. Compared to sporadic cases, patients with familial breast cancer were more often diagnosed at an advanced III or IV stage; metastatic involvement of the regional lymph nodes was more frequent in group I patients. In the same group more radical surgical procedures combined with chemotherapy and local irradiation were performed. In group I the percentage of negative hormone receptors was higher (35.3% versus 22.6%; p result of their particular characteristics, these patients require more radical surgical techniques combined with pre- or postoperative local radiotherapy and systemic chemotherapy.

  11. 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.

  12. The Social Life of Data (Prototyping Controversies)

    DEFF Research Database (Denmark)

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

    with controversy maps. First, we try to distribute the production of issues and maps beyond the academy. Drawing on design thinking (e.g. Brown 2009 and Björgvisson, Ehn & Hillgren 2012), we ask what it might mean to co-produce data visualizations together with visitors of the website. Second, we abandon the claim...... that we have produced a map of the controversy. Rather we attempt to make available a potentially controversial data set, followed by an invitation for actors to raise new issues with it. In sum, we try to move from mapping controversies to prototyping controversies. In order to do so, we build a website...... 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...

  13. 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.

  14. 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.

  15. 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.

  16. The health controversies of parabens.

    Science.gov (United States)

    Kirchhof, Mark G; de Gannes, Gillian C

    2013-02-01

    Parabens are preservatives used in a variety of personal care, cosmetic, pharmaceutical and food products. Studies have confirmed the ubiquitous presence of parabens, with levels detected in wastewater, rivers, soil and house dust. Parabens have also been detected in human tissues and bodily fluids, but it is the discovery of these chemical compounds in the breast tissue of patients with breast cancer that has raised public concern over their use. It is hypothesized that the estrogenic properties of parabens may play a role in breast cancer development. However, studies investigating the health effects of parabens are conflicting. At this point, there is an insufficient amount of data suggesting serious consequences from paraben use and exposure to warrant drastic avoidance measures or government regulations.

  17. Grandparents' experiences of childhood cancer, part 2: the need for support.

    Science.gov (United States)

    Moules, Nancy J; McCaffrey, Graham; Laing, Catherine M; Tapp, Dianne M; Strother, Douglas

    2012-01-01

    In this study, the authors examined the experiences of grandparents who have had, or have, a grandchild with childhood cancer. Sixteen grandparents were interviewed using unstructured interviews, and the data were analyzed according to a hermeneutic-phenomenological tradition, as guided by the philosophical hermeneutics of Hans-Georg Gadamer. In Part 1 of this report, interpretive findings around worry, burden, silence, the nature of having one's universe shaken, of having lives put on hold, and a sense of helplessness were addressed. In Part 2, the authors discuss interpretations related to the notions of support, burden, protection, energy, standing by, buffering, financial shouldering, and relationship. The study concludes with implications that the grandparents in the study bring to pediatric nurses in their practices with families in pediatric oncology.

  18. 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.

  19. Diet in dermatology: Part I. Atopic dermatitis, acne, and nonmelanoma skin cancer.

    Science.gov (United States)

    Bronsnick, Tara; Murzaku, Era Caterina; Rao, Babar K

    2014-12-01

    Patients commonly inquire about dietary modifications as a means to prevent or manage skin disease. Answering these questions is often challenging, given the vast and conflicting evidence that exists on this topic. This 2-part continuing medical education article summarizes the evidence to date to enable physicians to answer patients' questions in an evidence-based manner. Part I includes atopic dermatitis, acne, and nonmelanoma skin cancer. The role of dietary supplementation, dietary exclusion, food allergy, maternal diet, and breastfeeding in the development and/or prevention of atopic dermatitis is summarized. The dermatoendocrinologic mechanism for the effects of glycemic index/glycemic load and milk on acne is described, as well as related clinical evidence for dietary modifications. Finally, evidence and recommendations for restriction or supplementation of dietary factors in the prevention of nonmelanoma skin cancer, including fat, vitamins A, C, D, and E, and selenium, are reported. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  20. If It's Controversial, Why Teach It?

    Science.gov (United States)

    Soley, Mary

    1995-01-01

    Reveals that teaching about controversial issues increases students' self-confidence and interest in civic participation. Asserts that the current proliferation of social problems combined with exploitative media coverage necessitates civil and objective study of controversial issues. Includes several examples of, and approaches to, teaching about…

  1. Nuclear Weapons: Concepts, Issues, and Controversies.

    Science.gov (United States)

    Reardon, Betty; And Others

    1983-01-01

    The schools must confront and deal with the issues of the nuclear weapons controversy on pain of ceasing to be relevant to the critical needs of the rising generation. Every aspect of the nuclear arms controversy needs to be discussed in secondary and university classrooms. (RM)

  2. Predicting Controversial News Using Facebook Reactions

    NARCIS (Netherlands)

    Basile, Angelo; Caselli, Tommaso; Nissim, Malvina

    2017-01-01

    Different events and their re- ception in different reader communities may give rise to controversy. We pro- pose a distant supervised entropy-based model that uses Facebook reactions as proxies for predicting news controversy. We prove the validity of this approach by running within- and

  3. Teaching about NAFTA Using Academic Controversy.

    Science.gov (United States)

    Starr, Eileen M.

    1997-01-01

    Examines a teaching strategy called "constructive controversy" where students are required to argue both the pro and con positions concerning a controversial current topic. Describes students' response to a class using this method to examine the North American Free Trade Agreement (NAFTA). Student response was generally favorable. (MJP)

  4. Evolutionary Psychology: Controversies, Questions, Prospects, and Limitations

    Science.gov (United States)

    Confer, Jaime C.; Easton, Judith A.; Fleischman, Diana S.; Goetz, Cari D.; Lewis, David M. G.; Perilloux, Carin; Buss, David M.

    2010-01-01

    Evolutionary psychology has emerged over the past 15 years as a major theoretical perspective, generating an increasing volume of empirical studies and assuming a larger presence within psychological science. At the same time, it has generated critiques and remains controversial among some psychologists. Some of the controversy stems from…

  5. Varicocele: Management and the continuing controversies | Agbo ...

    African Journals Online (AJOL)

    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 ...

  6. Psychoeducational Interventions with Pediatric Cancer Patients: Part II. Effects of Information and Skills Training on Health-Related Outcomes

    Science.gov (United States)

    Beale, Ivan L.; Bradlyn, Andrew S.; Kato, Pamela M.

    2003-01-01

    In Part I of this paper, we described a model that was used as a framework for reviewing studies of psychoeducational interventions intended to influence illness- and treatment-related behaviors and attitudes in pediatric cancer patients. In Part II, we distinguish between interventions that attempt to influence patients' behaviors just by…

  7. Benefits of Cervical Cancer Screening by Liquid-Based Cytology as Part of Routine Antenatal Assessment.

    Science.gov (United States)

    Parkpinyo, Nichamon; Inthasorn, Perapong; Laiwejpithaya, Somsak; Punnarat, Tippawan

    2016-01-01

    To determine the prevalence of abnormal cervical cytology, as diagnosed using a liquid-based cytology technique, in pregnant women attending the Antenatal Care (ANC) clinic at Siriraj Hospital. This cross-sectional study included 655 first-visit pregnant women who attended ANC clinic at Siriraj Hospital during June to November 2015 study period. After receiving routine antenatal care, cervical cytology screening was performed with the Siriraj liquid-based cytology technique. All specimens were reviewed by a certi ed cytopathologist using Bethesda System 2001 criteria. Patients with abnormal PAP results characterized as epithelial cell abnormalities were referred to a gynecologic oncologist for further management according to ASCCP Guidelines 2012. Mean age of participants was 28.9±6.2 years. Prevalence of abnormal cervical cytology was 3.4% (95% CI: 2.0-4.7). Among this group, there were ASC-US, ASC-H, LSIL, HSIL for 12(1.8%), 2(0.3%), 7(1.1%) and 1(0.2%), respectively. In 633 specimens of the normal group, infection was identified in 158 specimens (24.1%) which were caused by Candida spp. and Trichomonas vaginalis. Regarding patient perception about the importance of cervical cancer screening, although most women perceived screening to be important, 54% of participants had never been screened for cervical cancer. Rate of loss to follow-up in the postpartum period was as high as 41.8%. Prevalence of abnormal cervical cytology in pregnant women attending the ANC clinic at Siriraj Hospital was 3.4%. Inclusion of cervical cancer screening as part of antenatal assessment can help to identify precancerous lesions or cervical cancers in patients who might otherwise not be screened, thereby facilitating early treatment and improved patient outcomes.

  8. Awareness of and reactions to mammography controversy among immigrant women.

    Science.gov (United States)

    Nagler, Rebekah H; Lueck, Jennifer A; Gray, Lauren S

    2017-08-01

    There is substantial expert disagreement about the use of mammography to screen for breast cancer, and this disagreement routinely plays out in the media. Evidence suggests that some women are aware of the controversy over mammography, but less is known about whether immigrant and other underserved women have heard about it and, if so, how they react to it. To explore immigrant women's awareness of and reactions to mammography controversy. Community-engaged qualitative study: we conducted six focus groups with 53 women aged 35-55 from three immigrant communities (Somali, Latina and Hmong) in a major US metropolitan area. A grounded theory approach was used to identify themes; NVivo 10 was used to enhance analyses. Several themes emerged: (i) low awareness of mammography controversy across groups, despite self-reported attention to health information; (ii) high intentions to be screened, even after being told about the controversy; (iii) few reported discussions of mammography's risks and benefits with clinicians; (iv) substantial interest in learning more about mammography and breast cancer, but some low self-efficacy to obtain such information; and (v) questions about whether health recommendations matter and what qualifies as evidence. Given on-going expert disagreement about mammography screening, it is important for clinicians to help women understand mammography's risks and benefits so they can make an informed choice. This is particularly critical for immigrant and other underserved women, who may be less able to access, attend to, process, retain and act on health information (a phenomenon known as communication inequality). © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  9. Cellulite: advances in treatment: facts and controversies.

    Science.gov (United States)

    Emanuele, Enzo

    2013-01-01

    Cellulite is traditionally considered a highly prevalent aesthetic condition in women. From a clinical standpoint, it is characterized by a cottage-cheese-like appearance of the skin, which can be most commonly found in certain areas of the body (eg, thighs, buttocks, and legs). Although cellulite is generally asymptomatic, the more severe stages can be accompanied by the appearance of painful nodules and increased local temperature, which are suggestive of an inflammatory reaction occurring in the dermis and in the underlying subcutaneous adipose tissue. Whether cellulite is a real disease or only a disturbing aesthetic issue is still a matter of controversy. This debate notwithstanding, it seems clear from market trends that there is considerable commercial interest in developing effective strategies aimed at reducing the cottage-cheese-like appearance of cellulite areas. Quite disturbingly, the majority of treatment attempts to date have been conducted in an empirical manner and without the application of rigorous scientific methodology. This is likely due--at least in part--to the lack of major, evidence-based pathophysiological insights into the nature of this condition. More stringent regulatory control is needed over commercial products aiming at improving the appearance of cellulite. © 2013 Elsevier Inc. All rights reserved.

  10. Obestatin: an interesting but controversial gut hormone.

    Science.gov (United States)

    Lacquaniti, Antonio; Donato, Valentina; Chirico, Valeria; Buemi, Antoine; Buemi, Michele

    2011-01-01

    Obestatin is a 23-amino acid peptide hormone released from the stomach and is present not only in the gastrointestinal tract, but also in the spleen, mammary gland, breast milk and plasma. Obestatin appears to function as part of a complex gut-brain network whereby hormones and substances from the stomach and intestines signal the brain about satiety or hunger. In contrast to ghrelin, which causes hyperphagia and obesity, obestatin appears to act as an anorectic hormone, decreasing food intake and reducing body weight gain. Further studies have shown that obestatin is also involved in improving memory, regulating sleep, affecting cell proliferation, increasing the secretion of pancreatic juice enzymes and inhibiting glucose-induced insulin secretion. This hormone has not only been studied in the field of physiology but also in the fields of obesity and diabetes mellitus, and in patients with psychogenic eating disorders. Obestatin has a role in regulating the cell cycle by exerting proliferative effects that may be seen in cell physiology and oncology. Given the current controversy regarding the effects of obestatin and its cognate ligand, this article provides the latest review of the physiological and pathological characteristics of this hormone. Copyright © 2011 S. Karger AG, Basel.

  11. Physics controversies in proton therapy.

    Science.gov (United States)

    Engelsman, Martijn; Schwarz, Marco; Dong, Lei

    2013-04-01

    The physical characteristics of proton beams are appealing for cancer therapy. The rapid increase in operational and planned proton therapy facilities may suggest that this technology is a "plug-and-play" valuable addition to the arsenal of the radiation oncologist and medical physicist. In reality, the technology is still evolving, so planning and delivery of proton therapy in patients face many practical challenges. This review article discusses the current status of proton therapy treatment planning and delivery techniques, indicates current limitations in dealing with range uncertainties, and proposes possible developments for proton therapy and supplementary technology to try to realize the actual potential of proton therapy. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Declining incidence of esophageal cancer in the Turkmen Plain, eastern part of the Caspian Littoral of Iran: a retrospective cancer surveillance.

    Science.gov (United States)

    Semnani, Shahriar; Sadjadi, Alireza; Fahimi, Saman; Nouraie, Mehdi; Naeimi, Mohamad; Kabir, Javad; Fakheri, Hafez; Saadatnia, Hasan; Ghavamnasiri, Mohamad Reza; Malekzadeh, Reza

    2006-01-01

    Previous studies have shown that upper gastrointestinal cancers are the most common cancers in Caspian Littoral, and rate of esophageal cancer (EC) in Iranian Turkmens residing in the Eastern part of littoral are among the highest in the world. Our aim was to reassess the rate 30 years later and following socioeconomic changes in the region. A comprehensive retrospective search was undertaken to find all new cancer cases during the 1996-2000 period. Diagnosis of cancer was based on histopathological reports in 68.2%, clinical and/or radiological evidence in 29.7% and death certificate only (DCO) in 2.1% of the cases. A total of 5143 new cancer cases were registered of whom 3063 (59.6%) were males. The median (IQR) age was 60 (44-69) years. Age-standardized rates (ASR) for all cancers in males and females were 134.7 and 104.5 per 100,000, respectively. Based on ASR, the top five common cancers in males (excluding skin cancer) were cancers of esophagus (43.4), stomach (27.8), colorectal (10.7), bladder (7.8) and oral cavity (6.3), while in females cancer of esophagus (36.3) was followed by cancers of breast (15.7), stomach (8.3) colorectal (6.6) and cervix (3.6). We conclude that EC incidence rate has decreased to less than half the rate reported 30 years ago, while the incidence rates of colorectal and breast cancers have increased significantly.

  13. Impact of Medicare Part D on out-of-pocket drug costs and medical use for patients with cancer.

    Science.gov (United States)

    Kircher, Sheetal M; Johansen, Michael E; Nimeiri, Halla S; Richardson, Caroline R; Davis, Matthew M

    2014-11-01

    Medicare Part D was designed to reduce out-of-pocket (OOP) costs for Medicare beneficiaries, but to the authors' knowledge the extent to which this occurred for patients with cancer has not been measured to date. The objective of the current study was to examine the impact of Medicare Part D eligibility on OOP cost for prescription drugs and use of medical services among patients with cancer. Using the Medical Expenditure Panel Survey (MEPS) for the years 2002 through 2010, a differences-in-differences analysis estimated the effects of Medicare Part D eligibility on OOP pharmaceutical costs and medical use. The authors compared per capita OOP cost and use between Medicare beneficiaries (aged ≥65 years) with cancer to near-elderly patients aged 55 years to 64 years with cancer. Statistical weights were used to generate nationally representative estimates. A total of 1878 near-elderly and 4729 individuals with Medicare were included (total of 6607 individuals). The mean OOP pharmaceutical cost for Medicare beneficiaries before the enactment of Part D was $1158 (standard error, ±$52) and decreased to $501 (standard error, ±$30), a decline of 43%. Compared with changes in OOP pharmaceutical costs for nonelderly patients with cancer over the same period, the implementation of Medicare Part D was associated with a further reduction of $356 per person. Medicare Part D appeared to have no significant impact on the use of medications, hospitalizations, or emergency department visits, but was associated with a reduction of 1.55 in outpatient visits. Medicare D has reduced OOP prescription drug costs and outpatient visits for seniors with cancer beyond trends observed for younger patients, with no major impact on the use of other medical services noted. © 2014 American Cancer Society.

  14. 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

  15. 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.

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

    Science.gov (United States)

    Sud, Alok; Tsirikos, Athanasios I

    2013-01-01

    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. PMID:23682172

  17. 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.

  18. Radiofrequency (mobile telephones) Exposures and Health Risks: Findings and Controversies - Linet

    Science.gov (United States)

    Radiofrequency (mobile telephones) Exposures and Health Risks: Findings and Controversies by Dr. Martha Linet - part of the Radiation Epidemiology and Dosimetry Course on the health effects of radiation exposure

  19. 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

  20. 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.

  1. 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

  2. Selectivity of Sources: Reporting the Marijuana Controversy.

    Science.gov (United States)

    Shepherd, R. Gordon

    1981-01-01

    Discusses the common practice within the media of relying on a few "science celebrities," rather than specialists conducting relevant research, for their scientific information. Cites the marijuana controversy as an example of this situation. (JMF)

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

    DEFF Research Database (Denmark)

    Jørgensen, Lone

    of cancer and if metastases are detected, an axillary clearance is performed. Consequences of breast cancer are manifold and vary within individuals, but the most cited are anxiety, depression, pain, sleep disturbance, fatigue, and/or altered body image. These consequences may cause distress at some point...... 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. 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

  5. [Clinical observation of partial pancreatectomy as part of primary cytoreductive surgery in advanced epithelial ovarian cancer].

    Science.gov (United States)

    Xiang, L B; Tu, Y X; He, T C; Pei, X; Shen, X X; Yang, W T; Wu, X H; Yang, H J

    2016-05-25

    The aim of this study is to evaluate the safety and efficacy of partial pancreatectomy as part of primary cytoreductive surgery in advanced epithelial ovarian cancer (EOC). A total of 8 patients were recruited in this study who underwent partial pancreatectomy during the primary cytoreductive surgeries for advanced EOC in Fudan University Shanghai Cancer Center from April 2009 to July 2015. Their clinicopathological characteristics, diameter of metastatic tumors, the scope of cytoreductive surgeries, residual diseases after cytoreductive surgeries, postoperative complications and survival situation were retrospective analyzed. (1) Clinicopathological characteristics: the median age of these patients was 58 years old (range: 39-63 years old) . The median value of preoperative serum CA125 was 1 688 kU/L (range: 119-5 000 kU/L) . The median diameter of metastatic tumors involved in pancreatic body or tail was 4.5 cm (range: 3-10 cm). All the tumors from the 8 patients were confirmed to be high-grade serous carcinoma. Four patients were staged as International Federation of Gynecology and Obstetrics (FIGO) Ⅳ, and the other 4 patients were staged as FIGO Ⅲc. (2) Tumor metastases and the scope of cytoreductive surgeries: all of these 8 patients had widely disseminated ovarian cancer, with involvement of upper abdominal, middle abdominal and pelvic cavity. Each patient underwent extensive intra-abdominal cytoreductive surgeries, including hysterectomy, bilateral salpingo-oophorectomy, omentectomy, pelvic peritonectomy, splenectomy, partial pancreatectomy. Each patient had cytoreductive surgeries of 9.6 different sites on average. Of all 8 patients who underwent partial pancreatectomy, 7 patients had pancreatic tails removed; the other 1 patient had pancreatic body and tail removed. The median volume of blood loss during surgery was 1 350 ml (range: 300-3 500 ml) , blood transfusion was performed in 7 patients with the median volume of 1 150 ml (range: 500-1 800 ml

  6. MODERN AND HUMAN DEVELOPMENT: DISCURSIVE ELEMENTS AND CONTROVERSIAL

    Directory of Open Access Journals (Sweden)

    Williams Aranguren Álvarez

    2015-11-01

    Full Text Available The purpose of this research is to analyze the discussion about modernity, postmodernism and liquid modernity and its relationship to human development, as an emerging element of the development model represented by modernity. This is done for a theoretical and documentary research, analyzing the discursive and controversial parts of the contributions of important authors in the field, arising mainly from sociology. It ends with contributions of useful ideas to continue the analysis and discussion on the subject, as part of a pending agenda that requires research and care in the field of social sciences.

  7. Ethical controversies in prenatal microarray.

    Science.gov (United States)

    Stark, Zornitza; Gillam, Lynn; Walker, Susan P; McGillivray, George

    2013-04-01

    Chromosome microarray (CMA) analysis enables genome interrogation at a much higher resolution than is possible with conventional karyotyping. CMA is considered 'standard of care' for postnatal genetic testing, yet its introduction into the prenatal setting has been delayed, in part because of ethical concerns about possible psychosocial harm and deficits in informed consent. The findings of several large trials have now been reported, allowing preliminary quantification of the relative benefits and harms of CMA in prenatal diagnosis. Qualitative studies have also provided insights into the patient experience particularly in cases in which results of uncertain significance are provided. In an attempt to minimize potential harms, some professional guidelines have suggested limiting access to CMA to patients with fetal abnormality on ultrasound, limiting the diagnostic power of CMA by using targeted platforms or limiting reporting. We provide an overview of the relative benefits and harms of prenatal CMA, and critically examine the strategies proposed to minimize harms in the context of other important ethical issues such as patient autonomy, justice and equity of access. We advocate for improved patient consent, counselling and support so that patients can fully benefit from the improved diagnostic yield of CMA despite the challenges that are intrinsic to the prenatal setting.

  8. [Arterosclerosis and its prevention. The problem and its natural controversy].

    Science.gov (United States)

    Chávez Dominguez, R

    1979-01-01

    It scarcely has a glimpse about the knowledge of aterosclerosis nature. About preventive recommendations, it has not yet surpassed hypothetic level, but problem is in force and requires to prove hypothetic and theoretical models that have been proposed. Everything that has been said as preventive recommendations has arisen all kind of opinions that constitute the existent controversy. Discussion is composed by the diametrically adverse points of view, in spite of that they are refered to the same data. Positive aspect that can remain is to centralize the knowledge and to comprehend best the problem nature. Controversy is a part of the collective thinking process about the theme. Obviously no one researcher has the complete solution, neither it is a lonely person work. There are exposed at the work some details of the subjacent process implicit into the term of risk factors. In order to comprehend the controversy, it is necessary to take on account the process that has been followed for the concepts formation, by no one manner it can be taken with frivolity and less to under-value it. Most part of researches on the subject agree that infancy and youthfulness are the best ages to make intervene primary prevention. There are revised these concept's bases and it is concluded that it is necessary at our ambient to acquire own experience about the theme, but we have to be very cautious at the best resources' utilization that are to our disposition.

  9. Controversies in the Treatment of Early Stage Endometrial Carcinoma

    Directory of Open Access Journals (Sweden)

    Joshua Z. Press

    2012-01-01

    Full Text Available Despite the publication of numerous studies, including some multicentered randomized controlled trials, there continues to be vigorous debate regarding the optimal management of early stage endometrial cancer, including the extent of surgery and the role of adjuvant chemotherapy and radiation. Resolving these questions has become increasingly important in view of the increase of endometrial cancer, related to the aging population and the alarming incidence of obesity. Furthermore, there are more surgical challenges encountered when operating on elderly patients or on patients with increased BMI and the associated comorbidities, such as diabetes, hypertension, heart disease, and pulmonary dysfunction. This paper will focus on the advantages of minimally invasive surgery, the value of lymphadenectomy including sentinel lymph node mapping, and some of the current controversies surrounding adjuvant chemotherapy and radiation.

  10. 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

    Directory of Open Access Journals (Sweden)

    Gopal K. Singh

    2011-01-01

    Full Text Available 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 nonmetropolitan than in metropolitan areas. Mortality disparities may reflect inequalities in smoking and other cancer-risk factors, screening, and treatment.

  11. AMPK/mTOR-mediated inhibition of survivin partly contributes to metformin-induced apoptosis in human gastric cancer cell

    Science.gov (United States)

    Han, Gang; Gong, Hangjun; Wang, Yidong; Guo, Shaowen; Liu, Kun

    2015-01-01

    Recent studies demonstrated that metformin exerts anti-neoplastic effect in a spectrum of malignancies. However, the mechanism whereby metformin affects various cancers, including gastric cancer, is poorly elucidated. Considering apoptosis plays critical role in tumorigenesis, we, in the present study, investigated the in vitro apoptotic effect of metformin on human gastric cancer cell and the underlying mechanism. Three differently-differentiated gastric cancer cell lines, MKN-28, SGC-7901 and BGC-823, along with one noncancerous gastric cell line GES-1 were used. We found that metformin treatment selectively induces apoptosis in the 3 cancer cell lines, but not the noncancerous one, as confirmed by flow cytometry, Caspase-Glo assay and western blotting against PARP and cleaved caspase 3. Moreover, the apoptotic effect of metformin seems to correlate negatively with the differentiation degree of gastric cancer. Metformin-induced apoptosis may be partially mediated through inhibition of anti-apoptotic survivin. Additionally, AMPK and mTOR, 2 important regulatory molecules responsible for metformin action, were investigated for their possible involvements in metformin-induced apoptosis of gastric cancer cell. AMPK knockdown by siRNA restores metformin-inhibited survivin expression and partially abolishes metformin-induced apoptosis. Similarly, forced overexpression of mTOR downstream effector p70S6K1 relieves metformin-induced inhibition of survivin and partly attenuates metformin-induced apoptosis. More importantly, survivin overexpression alleviates metformin-induced apoptosis. Xenograft nude mouse experiment also confirmed that AMPK/mTOR-mediated decrease of suvivin is in vivo implicated in metformin-induced apoptosis. Taken together, these evidences suggest that AMPK/mTOR-mediated inhibition of survivin may partly contribute to metformin-induced apoptosis of gastric cancer cell. PMID:25456211

  12. AMPK/mTOR-mediated inhibition of survivin partly contributes to metformin-induced apoptosis in human gastric cancer cell.

    Science.gov (United States)

    Han, Gang; Gong, Hangjun; Wang, Yidong; Guo, Shaowen; Liu, Kun

    2015-01-01

    Recent studies demonstrated that metformin exerts anti-neoplastic effect in a spectrum of malignancies. However, the mechanism whereby metformin affects various cancers, including gastric cancer, is poorly elucidated. Considering apoptosis plays critical role in tumorigenesis, we, in the present study, investigated the in vitro apoptotic effect of metformin on human gastric cancer cell and the underlying mechanism. Three differently-differentiated gastric cancer cell lines, MKN-28, SGC-7901 and BGC-823, along with one noncancerous gastric cell line GES-1 were used. We found that metformin treatment selectively induces apoptosis in the 3 cancer cell lines, but not the noncancerous one, as confirmed by flow cytometry, Caspase-Glo assay and western blotting against PARP and cleaved caspase 3. Moreover, the apoptotic effect of metformin seems to correlate negatively with the differentiation degree of gastric cancer. Metformin-induced apoptosis may be partially mediated through inhibition of anti-apoptotic survivin. Additionally, AMPK and mTOR, 2 important regulatory molecules responsible for metformin action, were investigated for their possible involvements in metformin-induced apoptosis of gastric cancer cell. AMPK knockdown by siRNA restores metformin-inhibited survivin expression and partially abolishes metformin-induced apoptosis. Similarly, forced overexpression of mTOR downstream effector p70S6K1 relieves metformin-induced inhibition of survivin and partly attenuates metformin-induced apoptosis. More importantly, survivin overexpression alleviates metformin-induced apoptosis. Xenograft nude mouse experiment also confirmed that AMPK/mTOR-mediated decrease of suvivin is in vivo implicated in metformin-induced apoptosis. Taken together, these evidences suggest that AMPK/mTOR-mediated inhibition of survivin may partly contribute to metformin-induced apoptosis of gastric cancer cell.

  13. Clinically Localized Prostate Cancer: AUA/ASTRO/SUO Guideline. Part I: Risk Stratification, Shared Decision Making, and Care Options.

    Science.gov (United States)

    Sanda, Martin G; Cadeddu, Jeffrey A; Kirkby, Erin; Chen, Ronald C; Crispino, Tony; Fontanarosa, Joann; Freedland, Stephen J; Greene, Kirsten; Klotz, Laurence H; Makarov, Danil V; Nelson, Joel B; Rodrigues, George; Sandler, Howard M; Taplin, Mary Ellen; Treadwell, Jonathan R

    2017-12-14

    This guideline is structured to provide a clinical framework stratified by cancer severity to facilitate care decisions and guide the specifics of implementing the selected management options. The summary presented represents Part I of the two-part series dedicated to Clinically Localized Prostate Cancer: AUA/ASTRO/SUO Guideline discussing risk stratification and care options by cancer severity. The systematic review utilized in the creation of this guideline was completed by the Agency for Healthcare Research and Quality and through additional supplementation by ECRI Institute. This review included articles published between January 2007 and March 2014 with an update search conducted through August 2016. When sufficient evidence existed, the body of evidence for a particular treatment was assigned a strength rating of A (high), B (moderate), or C (low) for support of Strong, Moderate, or Conditional Recommendations. Additional information is provided as Clinical Principles and Expert Opinions (table 2 in supplementary unabridged guideline, http://jurology.com/). The AUA (American Urological Association), ASTRO, and SUO (Society of Urologic Oncology) formulated an evidence-based guideline based on a risk-stratified clinical framework for the management of localized prostate cancer. This guideline attempts to improve a clinician's ability to treat patients diagnosed with localized prostate cancer, but higher quality evidence in future trials will be essential to improve the level of care for these patients. In all cases, patient preferences should be considered when choosing a management strategy. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  14. 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

  15. Using the Pluto Controversy to Teach the Scientific Process

    Science.gov (United States)

    Shipman, Harry L.

    2009-01-01

    Pluto's perilous peregrination from planet to dwarf planet to plutoid has generated an amount of public interest unparalleled since the first space mission to Jupiter. This paper reports on the results of an activity where students at a variety of grade levels were asked to assess the Pluto controversy and recommend the appropriate place of Pluto in a scale model solar system. This activity addresses aspects of the scientific process that are often difficult to treat using other learning sequences, namely: • The tentative nature of scientific knowledge • Constructing a scientific argument that supports a particular point of view, and including evidence in that argument • The way that scientific communities attempt to develop consensus about controversial issues. Data from these activities reveals that 8th grade students, college students, and adults are all still interested in Pluto and will engage with the challenge of producing a credible argument. Preliminary analyses of the papers submitted by college students doing this exercise reveals that 54% of their arguments were classified as "high quality” arguments, using scales drawn from the argumentation literature. High quality arguments use several different logical sequences, not only one, and have some degree of logical complexity. 46 % of these arguments used several pieces of evidence to back up their viewpoint. A separate paper (Shipman and Bergeron 2007) reveals that, apart from the tremendous publicity, the Pluto controversy was rather similar to other controversies in astronomy and chemistry. Thus the conclusions which students draw from Pluto have a decent chance of being applicable to science in general. This research has been supported in part by the National Science Foundation's Distinguished Teaching Scholars program.

  16. 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

  17. 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)

  18. [Medroxyprogesterone Acetate as Part of Palliative Care for Terminal-Stage Breast Cancer Patients--A Report of Two Cases].

    Science.gov (United States)

    Okamoto, Akiko; Ueno, Hiroshi; Yamashiro, Akiko; Okada, Megumi; Nakasone, Arisa; Hatano, Takahiko; Harada, Akiho; Taniguchi, Ayano; Onishi, Keiko; Kwon, Chul; Fukazawa, Keita; Taguchi, Tetsuya; Amaya, Fumimasa; Hosokawa, Toyoshi

    2016-03-01

    Various effective strategies have recently been described in the treatment of breast cancer, including endocrine therapy, chemotherapy, and molecular-targeted therapy, providing long-term survival benefits even after cancer recurrence. However, terminal-stage patients experience side effects and worse quality of life (QOL), in addition to deterioration of their general condition caused by the progression of the disease itself. When providing the best supportive care, use of anti-cancer drugs is not taboo and can represent a good option as long as physical, social, psychological, and spiritual supports are provided to both the patients and their families. Medroxyprogesterone acetate (MPA) is an endocrine therapeutic drug. In Japan, MPA is used only as a late-line endocrine therapy for breast cancer recurrence because many other endocrine therapy drugs are much more effective and MPA increases the risk of thrombosis and obesity. Here, we report 2 patients with breast cancer who reached terminal stage more than 10 years after the first diagnosis. MPA was administered as the final-line treatment. During that time, their appetite and QOL improved and the patients became more active than when they had been undergoing aggressive anticancer treatment. Both patients spent quality time with their families until their death. MPA may be a good option as part of palliative care of breast cancer patients in terminal stage.

  19. The Honeybee Dance-Language Controversy

    Indian Academy of Sciences (India)

    GENERAL I ARTICLE. The Honeybee Dance-Language Controversy. Robot Bee Comes to the Rescue. Ragha'fJendra Gadagkar. Language is usually credited with being the major factor in making humans so different from other higher animals. The fact that honey bees have a dance language that is unparalleled in the ...

  20. Blood cell morphology : controversies and alternatives

    NARCIS (Netherlands)

    Meer, Wim van der

    2006-01-01

    In this thesis we describe controversial morphologic features in both microscopic and automated differentiation of blood cells. In addition, we have investigated alternative methods to overcome these shortcomings. Furthermore we describe the variance of microscopic counting of band cells and variant

  1. Anticipation and Controversy Surround "Superman" Release

    Science.gov (United States)

    Aarons, Dakarai I.

    2010-01-01

    Well in advance of its official release, the education film "Waiting For Superman" has attracted a level of attention that could make it one of the year's most-watched documentaries--and one of the most controversial among educators, some of whom question its depictions of the American school system and how to improve it. Made by…

  2. LCA – Unique and Controversial Case Studies

    Science.gov (United States)

    This session will focus on case studies and applications that have a unique or controversial aspect. Some of the most recent topics that seem to have significant interest include: LCA-based product declarations, LCA-based standards, LCA-based labels, alternative energy, agricul...

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

    African Journals Online (AJOL)

    The paper limited its concern to the doctrine of Trinity and Christology. It also evaluated these doctrines in the light of Asouzu‟s principle of integration or science of missing link. Through it, their strengths and weaknesses are shown. Key Words: Doctrine, Ecumanical, Trinity, Christology, Controversy, Creeds, Church.

  4. Controversies in Pediatric Sports Medicine (Commentary).

    Science.gov (United States)

    Dyment, Paul G.

    1989-01-01

    Discusses controversial issues that have arisen in children's sports, including infant exercise programs, trampolines, amenorrhea in the adolescent athlete, coed contact sports, and sport participation by children with Down Syndrome. Policy statements are included from the American Academy of Pediatrics. (JD)

  5. 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.

  6. Parental Voices and Controversies in Autism

    Science.gov (United States)

    Langan, Mary

    2011-01-01

    Parents of children with autism have played a prominent role in controversies surrounding this condition. Parental voices were critical in challenging the "refrigerator mother" theory and more recently have attracted public attention for claims that autism may be caused by childhood vaccinations and that "unorthodox biomedical" treatments may…

  7. Fair and Unfair Strategies in Public Controversies

    NARCIS (Netherlands)

    van Laar, Jan Albert; Krabbe, Erik C. W.

    2016-01-01

    Contemporary theory of argumentation offers many insights about the ways in which, in the context of a public controversy, arguers should ideally present their arguments and criticize those of their opponents. We also know that in practice not all works out according to the ideal patterns: numerous

  8. 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…

  9. Teaching Controversial Issues in Social Studies.

    Science.gov (United States)

    Guyton, Edith M.; Hoffman, Alan J.

    The design of a methods course offered at Georgia State University to prepare social studies teachers for dealing with controversial issues in the middle school or secondary social studies classroom is presented. The course focuses on identification, selection, an analysis of an issue as well as the requirement that the student develop some method…

  10. 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…

  11. 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:

  12. The controversy about a possible relationship between mobile phone use and cancer A controvérsia sobre a possível relação entre o uso do telefone celular e câncer

    Directory of Open Access Journals (Sweden)

    Michael Kundi

    2010-08-01

    Full Text Available Over the last decade, mobile phone use increased to almost 100% prevalence in many countries. Evidence for potential health hazards accumulated in parallel by epidemiologic investigations has raised controversies about the appropriate interpretation and the degree of bias and confounding responsible for reduced or increased risk estimates. Overall, 33 epidemiologic studies were identified in the peer-reviewed literature, mostly (25 about brain tumors. Methodologic considerations revealed that three important conditions for epidemiologic studies to detect an increased risk are not met:no evidence-based exposure metric is available; the observed duration of mobile phone use is generally still too low; no evidence-based selection of end points among the grossly different types of neoplasias is possible because of lack of etiologic hypotheses. The overall evidence speaks in favor of an increased risk, but its magnitude cannot be assessed at present because of insufficient information on long-term use.Na última década, a prevalência do uso do telefone celular aumentou cerca de 100% em muitos países. Evidências de potenciais riscos acumulados para saúde em paralelo por pesquisas epidemiológicas levantam controvérsias sobre a interpretação apropriada e o grau de influência e desordem responsável pela redução ou aumento das estimativas de risco. Ao todo, 33 estudos epidemiológicos foram revistos por pares, sendo a maioria (25 sobre tumores cerebrais. Considerações metodológicas revelaram que não foram atendidas três importantes condições de estudos epidemiológicos para detectar um aumento de risco: não há nenhuma métrica de exposição baseada em evidências; a duração do uso de telefone celular observada é geralmente ainda muito baixa; não é possível a seleção de parâmetros com base em evidências entre os tipos de neoplasias totalmente diferentes, devido à falta de hipóteses etiológicas. As evidências no geral

  13. Long-Term Surgical Complications in the Oral Cancer Patient: a Comprehensive Review. Part I

    OpenAIRE

    Antonia Kolokythas

    2010-01-01

    Objectives: Oral and oropharyngeal cancer remains among the top ten most common malignancies in the United States and worldwide. Over the last several decades the approach to treatment of oral cancer has changed very little with regards to primary tumour extirpation while the approach to the “at risk” lymph nodes has evolved significantly. Perhaps the most significant change in the surgical treatment of cancer is the introduction of free flap for reconstruction post resection. Despite these s...

  14. Music therapy as part of the alternative-complementary therapy in cancer patients in hospital

    OpenAIRE

    Efstratios Athanassakis; Savvato Karavassiliadou

    2012-01-01

    Cancer is one of the modern health problems of people living in developed countries. Furthermore, therapeutic approaches to cancer patients is constantly updated with new data. Aim: The aim of the present study was to review the international literature referred to the application of music therapy in the treatment for pediatric and adult patients with cancer. Method and materials: The method of this study included bibliography research from both the review and the research literature on MEDLI...

  15. A review of dental treatment of head and neck cancer patients, before, during and after radiotherapy: part 2.

    Science.gov (United States)

    Jawad, H; Hodson, N A; Nixon, P J

    2015-01-01

    The incidence of head and neck cancer is on the rise. Radiation therapy is one of the major treatment modalities for the management of oral malignancies. As with any treatment modality, radiation therapy is associated with various complications. The second part of this series is a review of the oral changes that occur during and after radiotherapy and the oral management of head and neck oncology patients before, during and after radiotherapy. Dental practitioners will encounter patients who have been affected by cancer or who are current cancer patents. General dental practitioners (GDPs) have a vital and proactive role in supporting such patients. The aim of this article is to review the oral management of these patients during and after radiotherapy, and gives practical advice for GDPs and their teams in the long-term care of these patients.

  16. Long-term consequences of CNS treatment for childhood cancer, Part I: Pathologic consequences and potential for oncogenesis

    Energy Technology Data Exchange (ETDEWEB)

    Cohen, M.E.; Duffner, P.K. (Department of Neurology, State University of New York, Buffalo (United States))

    1991-05-01

    The pathologic changes associated with the treatment of cancer of the nervous system are reviewed. Computed tomographic, magnetic resonance imaging, and positron emission tomographic findings of these abnormalities are described, followed by discussion of the known histopathologic features. For the most part, pathologic effects are primary vascular and/or demyelinating. They authors review each of these effects at all levels of the neural axis. This review concludes with a discussion of the risk of developing second malignancies. Although this complication is infrequent, the likelihood that survivors of childhood cancer will develop a second malignancy is 10 times that of age-matched controls. This phenomenon in part relates to genetic predisposition, environmental factors, and host susceptibility. These qualifications not withstanding, most studies implicate central nervous system radiation with and without chemotherapy as the primary etiology for second malignancies. 48 references.

  17. 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...

  18. Axial coding and the grounded theory controversy.

    Science.gov (United States)

    Kendall, J

    1999-12-01

    The purpose of this article is to describe the similarities and differences between two approaches to grounded theory research: grounded theory as espoused by Glaser and grounded theory as espoused by Strauss and Corbin. The focus of the article is the controversy surrounding the use of axial coding. The author proposes a resolution to the controversy by suggesting that one does not need to view either approach as right or wrong; rather, the qualitative and grounded theory researcher can choose an approach, and that choice is based on the goal of the researcher's study. Examples of both approaches, from the author's research study on the experiences of living in a family with a child with attention deficit hyperactivity disorder (ADHD), are provided.

  19. 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 multiple understandings “Sustainable Urban Drainages System’s” (SUDS). Several different perspectives are identified with regard to what are and what will become the main climate problems in the urban environment as well as what are considered to be the best responses to these problems. Building...... on the actor-network inspired theory of “urban green assemblages” we argue that at least three different assemblages can be identified in urban climate change adaptation. Each assemblage frames problems and responses differently, and thereby assigns different types of roles to homeowners. As climate change...

  20. Datasprints as a method for Controversy Mapping

    DEFF Research Database (Denmark)

    Jensen, Torben Elgaard; Bach, Daniel; Israelsson, Pelle

    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...... 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....

  1. 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.

  2. Gossip in organisations: Contexts, consequences and controversies

    OpenAIRE

    Michelson, G.; 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...

  3. Pertussis and Rotavirus Vaccines - Controversies and Solutions.

    Science.gov (United States)

    Dash, Nabaneeta; Verma, Sanjay

    2017-06-16

    Pertussis and rotavirus vaccines have been the subject of several controversies over the years. In this paper the authors discuss facts and myths behind these controversies and also suggest solutions to overcome some limitations of these vaccines. The whole-cell pertussis vaccine (wPV) came into disrepute due to the associated adverse reactions, resulting in its replacement by acellular pertussis vaccine (aPV) in industrialized nations in 1990s. Although wPV is known to have more side effects; but they are usually minor. Whole-cell pertussis containing vaccine is being used safely in the National Immunization programme in India from many years. Another controversy erupted during 2009-2010, when there were reports of resurgence of pertussis cases among adolescents and adults, from developed nations. Present literature review raises doubts about long term protection offered by aPV, when compared with wPV. In spite of prevailing controversy, acellular pertussis containing vaccines should be acceptable, if timely delivery of primary and booster doses is ensured; including vaccination of adolescents and pregnant women. Initial rotavirus vaccine was withdrawn from the market because of increased risk of intussusception. Although three new generation rotavirus vaccines are currently available for use in India, but doubts about their efficacy, long term protection and safety still exists. Present literature review found them to be safe and moderately efficacious because of reasonable good cross protection. Even a moderately efficacious vaccine like rotavirus vaccine could significantly improve the outcome if disease burden is high. Therefore, it is being included in National Immunization Programme of India.

  4. A controversy with respect to occlusion

    OpenAIRE

    Fukushima, Shunji

    2016-01-01

    Summary There are very little controversies on occlusion in healthy individuals, where centric relation is regarded as the criterion for assessing the present occlusion and also for establishing a new occlusal relationship between the upper and the lower jaws. On the other hand, the occlusal position in patients with deformed condyles still remains to be clarified. In this review, the effectiveness and limits of centric relation in these patients are discussed. In addition, the muscle induced...

  5. 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.

  6. Timely and/or Controversial Information for Family Physicians.

    Science.gov (United States)

    Bowman, Marjorie A; Neale, Anne Victoria; Seehusen, Dean A

    2015-01-01

    Plan to spend some time reading this information-dense issue with a large amount of new material and ideas. From the humanoid behavioral health coach to tackling the controversial topic of environmental causes of autism spectrum disorders, this issue encompasses a broad range of topics. New anticoagulants for an extremely common entity, atrial fibrillation, are discussed. Learn about the shocking increase in oropharyngeal cancers with a changing epidemiology: younger patients with a different clinical presentations. Researchers evaluate changes after new or revised guidelines. "Near miss" reporting can facilitate quality improvement. Pets can make humans ill, yet they are beloved and can improve the health of their human owners. © Copyright 2015 by the American Board of Family Medicine.

  7. An in-depth exploration of information-seeking behavior among individuals with cancer: part 2: understanding patterns of information disinterest and avoidance.

    Science.gov (United States)

    Lambert, Sylvie D; Loiselle, Carmen G; Macdonald, Mary Ellen

    2009-01-01

    This is the second of a 2-part article describing differential health information-seeking behavior (HISB) patterns within the context of a cancer diagnosis that emerged in our grounded theory study. Data from 30 semistructured interviews and 8 focus groups with individuals diagnosed with breast, prostate, or colorectal cancer were analyzed using constant comparison analysis, diagramming, and open, axial, and selective coding. In part 1, 3 HISB patterns illustrating variation in active information-seeking behavior were described: (1) intense information seeking a keen interest in detailed cancer information, (2) complementary information seeking the process of getting "good enough" cancer information, and (3) fortuitous information seeking the search for cancer information mainly from others diagnosed with cancer. Part 2 describes 2 additional patterns coined in this study as minimal information-seeking behavior limited interest for cancer information and guarded information-seeking behavior avoidance of certain types of cancer information. Part 2 challenges traditional views that consider disinterest and avoidance as similar concepts subsumed under "blunting." Findings may be used to refine informational interventions and measurement strategies to best differentiate between cancer information avoidance and disinterest.

  8. Breast cancer surgery: an historical narrative. Part I. From prehistoric times to Renaissance.

    Science.gov (United States)

    Sakorafas, George H; Safioleas, Michael

    2009-11-01

    Cancer was known as a disease since prehistoric times. Management of breast cancer evolved slowly through centuries in the ancient world up to the Renaissance. This period is marked by the absence of any scientifically verifiable understanding of the true nature of cancer and its natural history and consequently by a lack of effective treatment. Breast has been considered as a symbol of femininity, fertility and beauty. Hippocrates proposed that breast cancer, among other neoplasms, was a 'systemic disease' caused by an excess of black bile. The humoral theory was further supported by Galen and dominated for centuries in medicine. Fulguration and breast amputation by using various instruments to achieve a rapid operation were widely used up to the 18th century. The Renaissance was a revolutionary period, since it stimulated medical practice; at that time physicians started to scientifically study medicine. Vesalius greatly contributed in the advancement of surgery, and he vigorously opposed Galen's doctrines. Many great surgeons of that time (including Paré, Cabrol, Servetto, Scultetus, Tulp, Fabry von Hilded, etc.) advanced the science of surgery. Interestingly, Bartoleny Gabrol (1590) in Montpellier advocated radical mastectomy, which was popularised by Halsted, 300 years later. However, the lack of anaesthesia and the problem of wound infections (due to the lack of the aseptic techniques) generated significance and often problems for the surgeons of that time. Surgery was often 'heroic' but primitive and even inhumane by current standards. Therapeutic nihilism was the prevailing altitude regarding breast cancer, at least among the vast majority of surgeons.

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

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Jae Hong; Moon, Seong Kwon [Dept. of Radiation Oncology, College of Medicine, Soonchunhyang University , Asan (Korea, Republic of); Kim, Seung Chul [Dept. of Radiology, Songho College, Hoengseong (Korea, Republic of)

    2015-12-15

    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)

  10. 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.

  11. Intellectual property and information controversy (II)

    Science.gov (United States)

    Aoyama, Hirokazu

    As advanced information has been proceeded rapidly, intellectual property has become more important than ever as business resources of enterprises. Based on the former report by the author "present status of and trend in intellectual property" this paper describes "information" related intellectual property controversy which have been occurred, that is, 1) affairs related to computer hardwares and softwares (the case of compatible machines and OS, the case of application softwares, computer crimes) and 2) affairs on trade secret (the case of revealing enterprises'secret, the case of industrial espionage). It also discusses how intellectual property should be protected and utilized from now on.

  12. 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...... digested manure. Such biogas is questioned by some NGOs who fear manure-based biogas is used as argument for increased animal husbandry. The bioenergy controversies concern also methodologies for environmental assessments, including for indirect land use changes (ILUC), and reliability of certification...

  13. 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...... mainly through the seventh book of his Symposium commentary, and Pico’s counter-position from his detailed commentary on a canzone by Girolamo Benivieni’s, the Amor dalle cui, in his Commento....

  14. Bioavailability of the Polyphenols: Status and Controversies

    Science.gov (United States)

    D’Archivio, Massimo; Filesi, Carmelina; Varì, Rosaria; Scazzocchio, Beatrice; Masella, Roberta

    2010-01-01

    The current interest in polyphenols has been driven primarily by epidemiological studies. However, to establish conclusive evidence for the effectiveness of dietary polyphenols in disease prevention, it is useful to better define the bioavailability of the polyphenols, so that their biological activity can be evaluated. The bioavailability appears to differ greatly among the various phenolic compounds, and the most abundant ones in our diet are not necessarily those that have the best bioavailability profile. In the present review, we focus on the factors influencing the bioavailability of the polyphenols. Moreover, a critical overview on the difficulties and the controversies of the studies on the bioavailability is discussed. PMID:20480022

  15. 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.

  16. A review of dental treatment of head and neck cancer patients, before, during and after radiotherapy: part 1.

    Science.gov (United States)

    Jawad, H; Hodson, N A; Nixon, P J

    2015-01-01

    The incidence of head and neck cancer is on the rise. Most head and neck cancers are treated with surgery, radiotherapy, chemotherapy or a combination of these modalities. Patients undergoing radiotherapy can experience several unwanted oral side effects, which have both short and long term implications. Dental general practitioners should be aware of these implications and should liaise closely with the restorative consultants and the oncology team to establish the best oral care pathway. This two-part series is a review of the oral changes that occur during and after radiotherapy and the oral management of head and neck oncology before, during and after radiotherapy. This article deals with both immediate sequelae such as cellulitis, mucositis, dysphagia, dysguesia and weight loss as well as long term sequelae such as rampant caries, trismus, xerostomia and osteoradionecrosis. It also encompasses the importance and need for pre-radiotherapy assessment.

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

    Science.gov (United States)

    Lanska, Douglas J

    2013-01-01

    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. Primary sources have been used to review controversies in the 50-year period since the initial description of athetosis, in particular those concerning clinical features, differentiation from other movement disorders, associated conditions, and pathology. Controversies concerning treatment will be addressed in a subsequent article. Hammond struggled to establish athetosis as a distinct clinical-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. 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.

  18. 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)

  19. Does a controversial topic affect the quality of urologic information on the Internet?

    Science.gov (United States)

    Routh, Jonathan C; Gong, Edward M; Cannon, Glenn M; Nelson, Caleb P

    2011-11-01

    Increasingly, patients seek medical information via the Internet, despite highly variable information quality. We sought to determine whether controversial urological topics are associated with decreased content quality or search characteristics. We systematically searched the Internet for 5 noncontroversial (cryptorchidism, testicular torsion, urethral stricture, testicular cancers, renal cancers) and 5 controversial (disorders of sexual differentiation, circumcision, penile elongation, interstitial cystitis, testosterone therapy) conditions. Number of total hits, sponsored links, page owner and author, accreditation, updates, advertising, readability, and content quality were assessed for each topic. Content quality was determined on a 5-point scale for accuracy and completeness of 3 domains: diagnosis, natural history, and treatment. In total, 100 websites were evaluated. Noncontroversial topics had more hits (1,610,000 vs 475,000) and more sponsored links (30% vs 10%) than controversial topics. Noncontroversial web pages were more likely to have government or medical owners (58% vs 30%, P = .009) than controversial web pages. Website quality was significantly different between noncontroversial and controversial topics. In regard to accuracy, noncontroversial topics had higher scores for diagnosis (4.6 vs 3.8, P topics had higher completeness scores for diagnosis (3.8 vs 3.0, P = .001), natural history (3.7 vs 3.0, P = .003), and treatment (3.6 vs 3.0, P = .006). Web pages dedicated to controversial urological topics have lower quality content in regard to diagnosis, natural history, and treatment. Such quality issues may contribute to ongoing public confusion and misinformation regarding these challenging topics. Copyright © 2011 Elsevier Inc. All rights reserved.

  20. Avulsions and intrusions: the controversial displacement injuries.

    Science.gov (United States)

    Kenny, David J; Barrett, Edward J; Casas, Michael J

    2003-05-01

    Avulsions and intrusions are the most complicated and controversial displacement injuries of permanent teeth. Clinical guidelines published by authorities such as the American Association of Endodontists, the Royal College of Surgeons of England and the International Association of Dental Traumatology are inconsistent. While a certain amount of inconsistency might be expected, some of these guidelines recommend treatments that are experimental or have not incorporated research information from the past 5 years, and in one case the guidelines incorrectly describe the nature of Hank's balanced salt solution. Recent laboratory studies support previous clinical outcome studies in emphasizing that only for teeth replanted within 5 minutes of avulsion is there a chance of regeneration of the periodontal ligament and normal function. Teeth replanted beyond 5 minutes will take another path, that of repair followed by root resorption, ankylosis and eventual extraction. Dentists should explain these outcomes at the time of the replantation decision. Severe intrusions also have predictable outcomes. Teeth intruded beyond 6 mm cannot regenerate a functional periodontal ligament and so are prone to root resorption and eventual extraction as well. In this situation the decision is one of immediate extraction or repositioning, with the understanding that it is inevitable that the tooth will eventually be extracted. Authoritative clinical guidelines available on the Internet provide the clinician with useful outlines for treatment. However, individual inconsistencies stimulate academic controversies and, in some cases, clinical misdirection.

  1. 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.

  2. Vascular Access Guidelines: Summary, Rationale, and Controversies.

    Science.gov (United States)

    Sequeira, Adrian; Naljayan, Mihran; Vachharajani, Tushar J

    2017-03-01

    Dialysis vascular access management in the United States changed significantly after National Kidney Foundation-Kidney Disease Outcome Quality Initiative (NKF-KDOQI) clinical practice guidelines were first published in 1997. The Centers for Medicare and Medicaid Service adopted these guidelines and in collaboration with the End-Stage Renal Disease Networks established the Fistula First Breakthrough Initiative (FFBI) in 2003 to improve the rate of arteriovenous fistula use over arteriovenous graft and central venous catheter in the dialysis population. The implementation of guidelines and FFBI has led to a significant increase in the arteriovenous fistula use in the prevalent dialysis population. The guidelines are criticized for being opinion based and often impractical. Over the past 2 decades, the patient population undergoing dialysis has become older with complex comorbidities and challenges for creating an ideal vascular access. Advancing knowledge about access pathophysiology, improved treatment options, and improved process of care with team approach model point toward diminishing relevance of few of the existing guidelines. Moreover, several guidelines remain controversial and may be leading to clinical decisions that may be unfavorable to the patients. The review discusses the historical aspect of vascular access care in the United States and evolution of current practice standards and controversies surrounding few of these guidelines in the current time. Published by Elsevier Inc.

  3. Evolutionary psychology. Controversies, questions, prospects, and limitations.

    Science.gov (United States)

    Confer, Jaime C; Easton, Judith A; Fleischman, Diana S; Goetz, Cari D; Lewis, David M G; Perilloux, Carin; Buss, David M

    2010-01-01

    Evolutionary psychology has emerged over the past 15 years as a major theoretical perspective, generating an increasing volume of empirical studies and assuming a larger presence within psychological science. At the same time, it has generated critiques and remains controversial among some psychologists. Some of the controversy stems from hypotheses that go against traditional psychological theories; some from empirical findings that may have disturbing implications; some from misunderstandings about the logic of evolutionary psychology; and some from reasonable scientific concerns about its underlying framework. This article identifies some of the most common concerns and attempts to elucidate evolutionary psychology's stance pertaining to them. These include issues of testability and falsifiability; the domain specificity versus domain generality of psychological mechanisms; the role of novel environments as they interact with evolved psychological circuits; the role of genes in the conceptual structure of evolutionary psychology; the roles of learning, socialization, and culture in evolutionary psychology; and the practical value of applied evolutionary psychology. The article concludes with a discussion of the limitations of current evolutionary psychology. 2009 APA, all rights reserved.

  4. 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

  5. Storytelling intervention for patients with cancer: part 1--development and implementation.

    Science.gov (United States)

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

    2008-03-01

    To develop a nurse-led storytelling intervention for patients with cancer and implement the intervention using trained oncology nurses. Descriptive pilot project using qualitative methods to assess implementation of an intervention tool kit, with investigators blinded to control and intervention group membership. Local regional medical center in the Pacific Northwest region of the United States. A convenience sample of 11 patients with various cancer diagnoses was used for tool kit generation. Intervention and control groups were then formed and used to study tool kit implementation. Participant exit interviews and facilitator debriefing questionnaires assessed the ability of a nurse facilitator to use a group storytelling intervention tool kit. Data from control and intervention groups were analyzed and compared with qualitative procedures. A nurse-led storytelling intervention. Analysis of interviews and questionnaires revealed implementation of storytelling tool kit principles and differences between storytelling and control groups in three patterns: finding a soft place to fall, understanding the cancer experience, and figuring out how (if) to get through it. Techniques contained in the tool kit were implemented and deemed clinically useful by oncology nurses. Given the small testing groups, pilot project results must be interpreted with caution, but with additional research and instructional development, the tool kit could be useful to nurses in a variety of settings and locales.

  6. 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.

  7. 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.

  8. 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/.

  9. Controversies Surrounding Classification of Personality Disorder

    Science.gov (United States)

    Tyrer, Peter

    2010-01-01

    Nowadays, it is apparent that personality disorder is a common condition. Some of the concepts of personality disorder that are currently in use are flawed and need to be revised. The aim of this article is to discuss the controversy created by the uncertainties in the current classification system and to suggest ways forward. In particular, the clinician needs to be aware of the importance of assessing personality abnormality in terms of a severity dimension, and of the ways in which such an abnormality can impact on treatments for other conditions. These changes in the notion of personality disorder are needed as, for the first time, a good evidence base is being established for potential treatments and these will be maximized if we have a classification fit for therapeutic purpose. PMID:20396426

  10. Diabetes mellitus and tuberculosis facts and controversies

    Science.gov (United States)

    2013-01-01

    Tuberculosis (TB) and diabetes mellitus (DM) are both important health issues. A bidirectional association between them has been demonstrated by many researchers. The link of DM and TB is more prominent in developing countries where TB is endemic and the burden of diabetes mellitus is increasing. The association between diabetes and tuberculosis may be the next challenge for global tuberculosis control worldwide. Proper planning and collaboration are necessary to reduce the dual burden of diabetes and TB. One model similar to the TB-HIV program for prevention, screening and treatment of both diseases can be the best approach. In this paper, we review existing data and discuss the matters of controversy that would be helpful for determining research priorities in different countries. PMID:24360398

  11. The Breivik controversy: politics, terrorism and psychiatry.

    Science.gov (United States)

    Tietze, Tad

    2014-08-01

    To examine and analyse the controversy over psychiatric aspects of the case of Norwegian far right mass murderer Anders Behring Breivik. Because of a basic acceptance of methodological individualism and scientific positivism, mainstream psychiatry is currently ill suited to being broadly applied to the spheres of politics and political violence. Rather than jettison psychiatric insights in such cases, the choices facing the profession are either to accept the narrowness of its utility or to work towards a theoretical framework that sees the individual psyche as socially embedded rather than as socially constitutive, and psychiatric science itself as socially constructed and hence inescapably value-laden. © The Royal Australian and New Zealand College of Psychiatrists 2014.

  12. 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.

  13. Evolution of the Two Cultures controversy

    Science.gov (United States)

    Bieniek, Ronald J.

    1981-05-01

    The Two Cultures schism is a persistent problem in our society. For over a century, scientific spokesmen and literary critics, from T. H. Huxley and M. Arnold to C. P. Snow and F. R. Leavis, have been involved in the Two Cultures issue. This article examines the evolution of the controversy between the ''scientific'' and ''humanistic'' elements of Western culture and its relation to educational policies. The division and antagonism between these two cultures appears to have arisen from differences in the human attitudes that they are preceived to engender. ''Scientific'' professionalism has been associated with a progressive optimism and self-assurance that nurture a broad humanitarianism, while the ''literary'' tradition is characterized by restraint, acceptance, and a more selective humanism.

  14. A controversy with respect to occlusion

    Directory of Open Access Journals (Sweden)

    Shunji Fukushima, DDS, PhD

    2016-08-01

    Full Text Available There are very little controversies on occlusion in healthy individuals, where centric relation is regarded as the criterion for assessing the present occlusion and also for establishing a new occlusal relationship between the upper and the lower jaws. On the other hand, the occlusal position in patients with deformed condyles still remains to be clarified. In this review, the effectiveness and limits of centric relation in these patients are discussed. In addition, the muscle induced occlusal positions, such as the muscular position and the terminal positions of habitual closing movements, are suggested as a substitution for centric relation. Finally, the importance of a stable intercuspal position, where the habitual closing movements terminate without any premature tooth contact, is emphasized.

  15. The calcium and vitamin D controversy

    DEFF Research Database (Denmark)

    Abrahamsen, Bo

    2017-01-01

    or subanalyses while maintaining balancing. Though large clinical RCTs currently evaluate the effects of higher vitamin D doses (equivalent to 50–83 μg/d) there is no current research effort regarding the calcium controversy. In the absence of such studies it is not possible to provide clinicians with evidence......Areas of the world where vitamin D levels are low for months of the year and intakes of calcium are high have a high prevalence of osteoporosis and cardiovascular disease. This suggests a public health message of avoiding calcium supplements and increasing vitamin D intake. No message could be more...... welcome as vitamin D can be given as a bolus while calcium must be taken daily and may be poorly tolerated. This approach is based on no evidence from intervention studies. Randomized controlled trials (RCTs) suggest that vitamin D given with calcium elicits a small reduction in fracture risk and deaths...

  16. A controversy with respect to occlusion.

    Science.gov (United States)

    Fukushima, Shunji

    2016-08-01

    There are very little controversies on occlusion in healthy individuals, where centric relation is regarded as the criterion for assessing the present occlusion and also for establishing a new occlusal relationship between the upper and the lower jaws. On the other hand, the occlusal position in patients with deformed condyles still remains to be clarified. In this review, the effectiveness and limits of centric relation in these patients are discussed. In addition, the muscle induced occlusal positions, such as the muscular position and the terminal positions of habitual closing movements, are suggested as a substitution for centric relation. Finally, the importance of a stable intercuspal position, where the habitual closing movements terminate without any premature tooth contact, is emphasized.

  17. 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

  18. 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

  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. 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

  1. An interactive way of learning about cancer and healthy living in a multicultural setting (part one)?

    Science.gov (United States)

    Betancourt, Juan; Fuentes, Lucía; Cáceres, Ana; Rivas, Silvia

    2012-01-01

    Health education is essential not only for preventing illnesses but also for knowing how to act when disease comes. In countries where the education system is inefficient for most of the population and where health issues are often ignored or mistreated because of ignorance or well-intended but ineffective belief in nature's energy and magic, it is important that people have access to truthful information about health issues. Such access allows them to act adequate knowledge and also to learn ways to avoid illness by changing their daily habits into a "healthy way of living." Approaching the young population is a way to achieve this objective. The program described here considers the education of both majority (indigenous) and minority (non indigenous) populations. It approaches the communication of information in such a way that it involves the participants in the "making" of the education. The participants actively interact with didactic material that allows them to experience "hands on" the issues about cancer and healthy living. It is intended to have a profound impact on the participant, so that he/she will remember the "education" not only as information but also as an experience. The program includes specific material for the indigenous population, which is based on their idiosyncrasy (corn plants) so that they can more easily understand the concepts. In Guatemala, UNOP (Unidad Nacional de Oncologia Pediatrica) is the only institution that provides a quality integral service for the majority of the entire children-with-cancer population. UNOP and the Psychology Department are interested in the development and implementation of education programs such as this where the participant not only learns but also experiences information about this disease and its prevention.

  2. 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

    National Research Council Canada - National Science Library

    White, Margaret; Verhoef, Marja

    2006-01-01

    ...) approaches to cancer management has hardly been explored. Objective: To explore the role of spirituality in cancer management by men with prostate cancer who have declined conventional treatment and are using CAM. Methods...

  3. 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.

  4. The Controversy over the Buddhas of Bamiyan

    Directory of Open Access Journals (Sweden)

    Pierre Centlivres

    2008-12-01

    Full Text Available The author analyses a rare case of mirror-outrage that followed the destruction of the Buddhas of Bamiyan. This event brought the Taliban and the international community into opposition in 2001. The article first stresses the intriguing paradigmatic similarities between the destruction of the Buddhas and the destruction of Artemis Temple in 356 BC, when the eradication of a monument, sacred as well as emblematic of a cultural heritage, was perceived as an outrage against piety and beauty. This analogy helps the author emphasize the uncertainty regarding the identification of the victims: were they ‘the people’ in general, abstract deities, or specific communities? The article then elaborates on the argumentation and self-justification presented by the Taliban, and underlies their sense of indignation at a protest coming from ‘Christian’ countries, which they saw as exclusively concerned with saving ‘idols’ but ignorant of the ordeal endured by the Afghans. It finally argues that conflicting visions over the very meaning of ‘cultural heritage’ were at the core of the controversy.

  5. 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.

  6. 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.

  7. 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.

  8. Discoveries and controversies in cutaneous mosaicism.

    Science.gov (United States)

    Castori, Marco; Tadini, Gianluca

    2016-06-01

    Genetic mosaicism is thought to be a common phenomenon in inherited skin disorders. It is the leading molecular mechanism explaining cutaneous hamartomas and nevoid disorders, skin manifestations of most X-linked genodermatoses and specific forms of clinical variability and topographic distribution in autosomal skin disorders. The developmental (in utero) origin and timing dependence are two major attributes for the current definition of cutaneous mosaicism. Chromosomal mosaicism, lyonization in X-linked genodermatoses, and various types of mosaicism (i.e. type 1, type 2 and revertant mosaicism) in autosomal skin disorders are mechanisms well defined at the molecular level. All these concepts have been fully included in the current medical terminology in dermatology and genetics. Mitotic crossing-over, paradominant inheritance, monoallelic expression of autosomal traits and mosaicism in acquired skin disorders remain without a formal molecular proof and still represent sources of debate in the scientific community. This review summarizes current concepts, discoveries and controversies in the field of cutaneous mosaicism for practitioners and clinical researchers to enhance their understanding of such a underestimated clinical phenomenon and its biological basis.

  9. Mendelian controversies: a botanical and historical review.

    Science.gov (United States)

    Fairbanks, D J; Rytting, B

    2001-05-01

    Gregor Mendel was a 19(th) century priest and botanist who developed the fundamental laws of inheritance. The year 2000 marked a century since the rediscovery of those laws and the beginning of genetics. Although Mendel is now recognized as the founder of genetics, significant controversy ensued about his work throughout the 20(th) century. In this paper, we review five of the most contentious issues by looking at the historical record through the lens of current botanical science: (1) Are Mendel's data too good to be true? (2) Is Mendel's description of his experiments fictitious? (3) Did Mendel articulate the laws of inheritance attributed to him? (4) Did Mendel detect but not mention linkage? (5) Did Mendel support or oppose Darwin?A synthesis of botanical and historical evidence supports our conclusions: Mendel did not fabricate his data, his description of his experiments is literal, he articulated the laws of inheritance attributed to him insofar as was possible given the information he had, he did not detect linkage, and he neither strongly supported nor opposed Darwin.

  10. 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.

  11. Gliomatosis Cerebri: Current Understanding and Controversies

    Directory of Open Access Journals (Sweden)

    Surabhi Ranjan

    2017-08-01

    Full Text Available Gliomatosis cerebri (GC is a rare, extensively infiltrating glioma involving multiple contiguous lobes of the brain. This lethal disease affects all age groups, and the majority of patients have a poor outcome despite aggressive treatment. Despite its initial recognition in 1938, GC remains a controversial entity with little consensus in its definition, histology, or treatment. The majority of GC tumors are astrocytic, although mixed phenotypes have been identified. Treatment of GC is challenging as surgery is generally not an option due to the extensive areas of brain involved, the benefit of radiation therapy is unclear, and no chemotherapy has proven efficacy. Due to the rarity of the disease and its heterogeneity, both at histopathological and molecular levels, it is difficult to conduct clinical trials tailored for this diagnosis. This review summarizes our current knowledge, examines clinical studies focusing on the treatment of GC, highlights ongoing challenges, and discusses the recent molecular insights into adult and pediatric GC. We conclude that, although no longer recognized as a distinct pathological entity, GC represents a unique disease phenotype. Given the histologic and molecular overlap with other diffuse gliomas, the research emphasis should be on investigating its unique invasive biology.

  12. Management of radiation therapy-induced mucositis in head and neck cancer patients. Part I: Clinical significance, pathophysiology and prevention

    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 to provide instead an overview of all the possible remedies available, as well as highlighting to researchers the gaps that need to be filled. The first part of this review outlines the clinical significance and pathophysiology of radiation-induced mucositis, and looks into some of the preventive approaches available.

  13. Compact Stokes shift and fluorescence spectroscopic diagnostics LED ratiometer unit with no moving parts for cancer detection

    Science.gov (United States)

    Sordillo, Laura A.; Pu, Yang; Budansky, Yury; Alfano, R. R.

    2012-01-01

    A compact Stokes shift and fluorescence spectroscopy (S3) LED device with no moving parts is presented. This device can be used diagnostically for the identification of the native biomolecules within cancerous tissue samples. This S3-LED ratiometer unit measures both the emission and absorption spectra of key native organic biomolecules within a tissue sample by using multiple wavelength LEDs (light emitting diodes) coupled to an optical fiber. Thus, an optical fingerprint of the sample can be obtained. This technique could be used to distinguish benign and malignant tissues, and to check for residual or recurrent carcinoma after treatment, thus reducing the necessity of second biopsies. The S3-LED ratiometer unit was tested in vitro on human breast malignant and normal paired tissue samples.

  14. Cancer systems biology in the genome sequencing era: part 2, evolutionary dynamics of tumor clonal networks and drug resistance.

    Science.gov (United States)

    Wang, Edwin; Zou, Jinfeng; Zaman, Naif; Beitel, Lenore K; Trifiro, Mark; Paliouras, Miltiadis

    2013-08-01

    A tumor often consists of multiple cell subpopulations (clones). Current chemo-treatments often target one clone of a tumor. Although the drug kills that clone, other clones overtake it and the tumor recurs. Genome sequencing and computational analysis allows to computational dissection of clones from tumors, while singe-cell genome sequencing including RNA-Seq allows profiling of these clones. This opens a new window for treating a tumor as a system in which clones are evolving. Future cancer systems biology studies should consider a tumor as an evolving system with multiple clones. Therefore, topics discussed in Part 2 of this review include evolutionary dynamics of clonal networks, early-warning signals (e.g., genome duplication events) for formation of fast-growing clones, dissecting tumor heterogeneity, and modeling of clone-clone-stroma interactions for drug resistance. The ultimate goal of the future systems biology analysis is to obtain a 'whole-system' understanding of a tumor and therefore provides a more efficient and personalized management strategies for cancer patients. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  15. 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

  16. 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.

  17. 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

  18. Psychological controversies in gastroparesis: A systematic review.

    Science.gov (United States)

    Woodhouse, Sally; Hebbard, Geoff; Knowles, Simon R

    2017-02-21

    To systematically review literature addressing three key psychologically-oriented controversies associated with gastroparesis. A comprehensive search of PubMed, CINAHL, and PsycINFO databases was performed to identify literature addressing the relationship between gastroparesis and psychological factors. Two researchers independently screened all references. Inclusion criteria were: an adult sample of gastroparesis patients, a quantitative methodology, and at least one of the following: (1) evaluation of the prevalence of psychopathology; (2) an outcome measure of anxiety, depression, or quality of life; and (3) evidence of a psychological intervention. Case studies, review articles, and publications in languages other than English were excluded from the current review. Prevalence of psychopathology was evaluated by three studies (n = 378), which found that combined anxiety/depression was present in 24% of the gastroparesis cohort, severe anxiety in 12.4%, depression in 21.8%-23%, and somatization in 50%. Level of anxiety and depression was included as an outcome measure in six studies (n = 1408), and while limited research made it difficult to determine the level of anxiety and depression in the cohort, a clear positive relationship with gastroparesis symptom severity was evident. Quality of life was included as an outcome measure in 11 studies (n = 2076), with gastroparesis patients reporting lower quality of life than population norms, and a negative relationship between quality of life and symptom severity. One study assessed the use of a psychological intervention for gastroparesis patients (n = 120) and found that depression and gastric function were improved in patients who received psychological intervention, however the study had considerable methodological limitations. Gastroparesis is associated with significant psychological distress and poor quality of life. Recommendations for future studies and the development of psychological interventions are

  19. Risky, early, controversial. Puberty in medical discourses.

    Science.gov (United States)

    Cozzi, Donatella; Vinel, Virginie

    2015-10-01

    This article comes within the compass of a research program (entitled CorAge. Bodily Experiences and AgePassages among 9-13 year-olds (ANR-09-ENFT-017) conducted between 2009 and 2013 about the emergence of a "new" age in life--"preadolescence"--as instanced in France (Alsace, Lorraine) and Italy (Venetia). The impressive amount of references to "early puberty" and "precocious puberty", in a context of feeling of a premature end of childhood, led us to make an in-depth study of this issue: first, through an analysis of international and French and Italian medical journals; second, through interviews with health professionals. Following the thesis of Foucault, we assume that the discourses on puberty timing participate of classifications of the child body drenched with moral representations of childhood, especially on gender and age issue. Our results: the question of whether a secular trend in puberty timing even exists continues to be debated between American and European scientists. Second, the terms "puberty", "precocious puberty", "early puberty" have been used to indicate a variety of puberty markers, increasing confusion. A controversy has focused on early breast development in girls, because this attribute is questioning the order of ages and gender. Moreover, psychosocial factors presented as accelerating early puberty, do not demonstrate the relation between earliness and risk behavior. The literature, as it is moved by the female precocity, creates a medical category to objectify the complex and flexible process of puberty and invent female child precocity. These differences between American and European scholars and the interviews with French and Italian health professional show a gap between the international literature and practitioners, clinicians and nurses who regularly work with children: they neither find pubertal advancement, nor increase of "true precocious puberty", although they share concerns about premature feminization of girls (France) or

  20. The (178m2)Hf Controversy

    Energy Technology Data Exchange (ETDEWEB)

    Becker, J A; Gemmell, D S; Schiffer, J P; Wilhelmy, J B

    2003-07-24

    Since its discovery in the 1960's the {sup 178m2}Hf isomer has garnered high attention from both the basic and applied communities in nuclear science. It's combination of high spin (16+), long half life (31 yrs), and high excitation energy (2.446 MeV) offer unique possibilities as an energy storage medium. Interest in the isomer was rekindled beginning in 1999 when a series of publications began to appear from a group (referred to here as the ''Texas collaboration'') primarily based at the University of Texas, Dallas [1]. They reported observations that some of the stored energy could be released (''triggered'') when the isomer was exposed to a fluence of photons in the energy range {approx}10 to {approx}60 keV. The implications of this observation are profound. Even though the claimed cross section for the process was {approx}7 orders of magnitude greater than would be predicted from the known systematics of photon absorption by nuclei in this mass range [2], such a highly efficient method for triggering the isomeric deexcitation immediately suggested applications utilizing the explosive or the controlled gradual energy release from a very compact source. The prospect of such applications has focused considerable interest on realizing the promise that is implicit in the reported observations. However, two experiments performed by a group from ANL/LANL/LLNL at the Advanced Photon Source at Argonne (the ''APS collaboration'') reported negative results for the observation of any photon-triggered deexcitation of the {sup 178m2}Hf isomer [3]. This has led to a continued controversy, where both sides have adamantly defended their observations. At this point an outsider has difficulty determining whether there is indeed a triggering effect that should be pursued energetically with substantial resources, or whether the phenomenon consists of overly optimistic interpretation of data.

  1. Lichen planus pigmentosus: The controversial consensus

    Directory of Open Access Journals (Sweden)

    Aparajita Ghosh

    2016-01-01

    Full Text Available 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.

  2. 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.

  3. The LNT-controversy and the concept of "controllable dose".

    Science.gov (United States)

    Kellerer, A M; Nekolla, E A

    2000-10-01

    There is no firm scientific information on the potential health effects, such as increased cancer rates, due to low doses of ionizing radiation. In view of this uncertainty ICRP has adopted as a prudent default option the linear no-threshold (LNT) assumption and has used it to derive nominal risk coefficients. Subsequent steps, such as the comparison of putative fatality rates in radiation workers with observed accident rates in other professions, have given the risk estimates a false appearance of scientific fact. This has encouraged meaningless computations of radiation-induced fatalities in large populations and has caused a trend to measure dose limits for the public not against the magnitude of the natural radiation exposure and its geographic variations, but against the numerical risk estimates. In reaction to this development, opposing claims are being made of a threshold in dose for deleterious health effects in humans. In view of the growing polarization, ICRP is now exploring a new concept "controllable dose" that aims to abandon the quantity collective dose, emphasizing, instead, individual dose and, in particular, the control of the maximum individual dose from single sources. Essential features of the new proposal are here examined, and it is concluded that the control of individual dose will still have to be accompanied by the avoidance of unnecessary exposures of large populations, even if their magnitude lies below that acceptable to the individual. If a reasonable cut-off at trivial doses is made, the collective dose can remain useful. Misapplications of collective dose are not the deeper cause of the current controversy; the actual root is the misrepresentation of the LNT-assumption as a scientific fact and the amplification of this confusion by loose terminology. If over-interpretation and distortion are avoided, the current system of radiation protection is workable and essentially sound, and there is no need for a fruitless LNT-controversy. The

  4. Nanoparticle-based Paclitaxel vs Solvent-based Paclitaxel as Part of Neoadjuvant Chemotherapy for Early Breast Cancer (GeparSepto)

    Science.gov (United States)

    2016-10-11

    Tubular Breast Cancer Stage II; Mucinous Breast Cancer Stage II; Breast Cancer Female NOS; Invasive Ductal Breast Cancer; Tubular Breast Cancer Stage III; HER-2 Positive Breast Cancer; Inflammatory Breast Cancer Stage IV; Inflammatory Breast Cancer

  5. The double-edged sword of ovarian cancer information for women at increased risk who have previously taken part in screening.

    Science.gov (United States)

    Smits, Stephanie; Boivin, Jacky; Menon, Usha; Brain, Kate

    2016-01-01

    Women at increased risk who decide not to have, or to delay, risk-reducing salpingo-oophorectomy have to rely on early diagnosis through symptom awareness and presenting to primary care as soon as possible in the absence of screening. However, little is known about the acceptability to women of this strategy. We aimed to gain an in-depth understanding of women's perceptions and previous experiences of ovarian cancer symptom management, and the influences on ovarian cancer awareness and anticipated symptom presentation. Qualitative interviews were conducted with eight women at increased risk of ovarian cancer who had previously taken part in ovarian cancer screening and analysed using interpretative phenomenological analysis (IPA). Familial experience of ovarian cancer and perceived personal risk shaped women's perceptions and behavioural responses to disease threat. Ovarian cancer information was perceived to be a double-edged sword, regarded as either useful for increasing knowledge and confidence in discussing symptom concerns with health professionals or to be avoided due to fears about cancer. Women may be cautious about searching for information independently and in the absence of routine ovarian screening. Thought needs to be given to how best to create and disseminate credible ovarian cancer symptom information materials.

  6. Mammography: review of the controversy, health disparities, and impact on young african american women.

    Science.gov (United States)

    Kidd, April D; Colbert, Alison M; Jatoi, Ismail

    2015-06-01

    Ongoing debate about mammography screening for women in their 40s has brought awareness to the opportunities and challenges for achieving optimal breast health in young African American women and in battling health inequities that place them at greater risk for mortality from breast cancer. Despite the screening controversy, a need exists to understand the complex issues related to mammography knowledge, attitudes, and behaviors of young minority women, while empowering them to take an active role in their breast health care. The purpose of this article is to describe the complicated issues related to screening in young African American women within the context of the uncertainty about the evidence surrounding screening practices. Literature was reviewed to garner a comprehensive update of the mammography screening controversy and its impact on mammography practices. Nurses should be aware of the mammography screening controversy and breast cancer risk assessment and how they affect young women's participation in mammography screening. Mammography screening should be a shared decision between the patient and healthcare provider. A better understanding of breast health and its effect on young minority women is needed. Nurses have a prominent role to advocate for, empower, and educate patients as they face the task of deciding whether to begin or continue mammography in their 40s.

  7. Current challenges for HER2 testing in diagnostic pathology: state of the art and controversial issues

    Directory of Open Access Journals (Sweden)

    Anna eSapino

    2013-05-01

    Full Text Available HER2 overexpression and anti-HER2 agents represent probably the best story of success of individualized therapy in breast cancer. Due to the important therapeutic implications, the issue under the spotlight has been, since ever, the correct identification of true HER2 positivity on tissue specimens. Eligibility to anti-HER2 agents is strictly dependent on the demonstration of HER2 overexpression (by immunohistochemistry or of HER2 gene amplification by in situ techniques (Fluorescence In Situ Hybridization, FISH, however there are controversial issues involving cases with equivocal HER2 status based on conventional techniques (about 20% of specimens. In terms of HER2 expression a major debate is the presence of full-length and truncated forms of the protein and controversial clinical data have been reported on the therapeutic implications of these HER2 fragments. In terms of HER2 gene assessment, the occurrence of amplification of the chromosome 17 centromeric region (CEP17 has been proven responsible for misleading HER2 FISH results, precluding anti-HER2 based therapy to some patients. Finally HER2 activating mutations have been recently described as a biological mechanisms alternative to HER2 gene amplification. In this review we will focus on the controversies that pathologists and oncologists routinely face in the attempt to design the most tailored treatment for breast cancer patients. We will focus on the HER2 gene and on the protein, both at technical and interpretational levels.

  8. Current Challenges for HER2 Testing in Diagnostic Pathology: State of the Art and Controversial Issues.

    Science.gov (United States)

    Sapino, Anna; Goia, Margherita; Recupero, Daniele; Marchiò, Caterina

    2013-01-01

    HER2 overexpression and anti-HER2 agents represent probably the best story of success of individualized therapy in breast cancer. Due to the important therapeutic implications, the issue under the spotlight has been, since ever, the correct identification of true HER2 positivity on tissue specimens. Eligibility to anti-HER2 agents is strictly dependent on the demonstration of HER2 overexpression (by immunohistochemistry) or of HER2 gene amplification by in situ techniques (fluorescence in situ hybridization, FISH), however there are controversial issues involving cases with "equivocal" HER2 status based on conventional techniques (about 20% of specimens). In terms of HER2 expression a major debate is the presence of full-length and truncated forms of the protein and controversial clinical data have been reported on the therapeutic implications of these HER2 fragments. In terms of HER2 gene assessment, the occurrence of amplification of the chromosome 17 centromeric region (CEP17) has been proven responsible for misleading HER2 FISH results, precluding anti-HER2 based therapy to some patients. Finally HER2 activating mutations have been recently described as a biological mechanisms alternative to HER2 gene amplification. In this review we will focus on the controversies that pathologists and oncologists routinely face in the attempt to design the most tailored treatment for breast cancer patients. We will focus on the HER2 gene and on the protein, both at technical and interpretational levels.

  9. 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)

  10. Implants and Ethnocide: Learning from the Cochlear Implant Controversy

    Science.gov (United States)

    Sparrow, Robert

    2010-01-01

    This paper uses the fictional case of the "Babel fish" to explore and illustrate the issues involved in the controversy about the use of cochlear implants in prelinguistically deaf children. Analysis of this controversy suggests that the development of genetic tests for deafness poses a serious threat to the continued flourishing of Deaf…

  11. 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...

  12. 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....

  13. The Procedurally Directive Approach to Teaching Controversial Issues

    Science.gov (United States)

    Gregory, Maughn Rollins

    2014-01-01

    Recent articles on teaching controversial topics in schools have employed Michael Hand's distinction between "directive teaching," in which teachers attempt to persuade students of correct positions on topics that are not rationally controversial, and "nondirective teaching," in which teachers avoid persuading students on…

  14. Structured Academic Controversies in the Professional Physical Education Classroom.

    Science.gov (United States)

    Overby, Lynnette Young; And Others

    1996-01-01

    Structured academic controversy is a cooperative learning strategy that can promote learning in theoretical physical education classes at the college level. This article explains how to conduct structured academic controversy, providing examples of topics (e.g., adapted physical education, biomechanics, motor development, and sport psychology).…

  15. Preparing Students for Science in the Face of Social Controversy

    Science.gov (United States)

    Bramschreiber, Terry; Westmoreland, David

    2015-01-01

    Science educators often teach topics that are largely resolved in the scientific community yet remain controversial in broader society. In such cases, students may perceive the teacher as biased. We present two exercises that foster more objective learning about the scientific underpinnings of socially controversial topics. The first exercise…

  16. Tennessee to Texas: Tracing the Evolution Controversy in Public Education

    Science.gov (United States)

    Armenta, Tony; Lane, Kenneth E.

    2010-01-01

    Darwin's Theory of Evolution has stirred controversy since its inception. Public schools in the United States, pressed by special interest groups on both sides of the controversy, have struggled with how best to teach the theory, if at all. Court cases have dealt with whether states can ban the teaching of evolutionary theory, whether Creationism…

  17. Stereotactic ablative radiotherapy for stage I NSCLC: Recent advances and controversies

    Science.gov (United States)

    Senan, Suresh; Palma, David A.; Lagerwaard, Frank J.

    2011-01-01

    Stereotactic ablative radiotherapy (SABR) is a technique that has rapidly entered routine care for early-stage peripheral non-small cell lung cancer in many countries in the last decade. The adoption of SABR was partly stimulated by advances in the so-called ‘image guided’ radiotherapy delivery. In the last 2 years, a growing body of publications has reported on clinical outcomes, acute and late radiological changes after SABR, and sub-acute and late toxicity. The local control rates in many publications have exceeded 90% when tumors of up to 5 cm have been treated, with corresponding regional nodal failure rates of approximately 10%. However, these results are not universal: lower control rates reported by some authors serve to emphasize the importance of quality assurance in all steps of SABR treatment planning and delivery. High-grade toxicity is uncommon when so-called ‘risk-adapted’ fractionation schemes are applied; an approach which involves the use of lower daily doses and more fractions when critical normal organs are in the proximity of the tumor volume. This review will address the new data available on a number of controversial topics such as the treatment of patients without a tissue diagnosis of malignancy, data on SABR outcomes in patients with severe chronic obstructive airways disease, use of a classification system for late radiological changes post-SABR, late treatment-related toxicity, and the evidence to support a need for expert multi-disciplinary teams in the follow-up of such patients. PMID:22263087

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

    Science.gov (United States)

    2015-01-01

    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. PMID:26336325

  19. Controversy and the state: lord ARPA and intelligent computing.

    Science.gov (United States)

    Guice, J

    1998-02-01

    This is a study of a well-known controversy in computer science, between artificial intelligence and neural networks researchers. It examines claims made by participants in the field that the controversy was triggered, shaped and finally resolved in connection to activities of state research agencies, particularly the US Department of Defense Advanced Research Projects Agency (ARPA). In contrast to these claims, this account concludes that, although ARPA's relations to the controversy among researchers were important, they were indirect. This study thus beings the analytical resources of studies of scientific controversy to bear on a domain which has so far gone largely unexamined in studies of 20th-century controversies - namely, state research policy and management. The account is based on contemporary documents, historical literatuare, and interviews with researchers and ARPA officials.

  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. On the controversies of spine surgery research

    NARCIS (Netherlands)

    Jacobs, W.C.H.

    1974-01-01

    This thesis is about effectiveness of surgical interventions in the spine and the value of different methodologies for providing a valid answer. In the first part five systematic reviews were performed. One reviewed cervical degenerative disc disease comparing the different anterior fusion

  2. Mass News: Practices, Controversies, and Alternatives.

    Science.gov (United States)

    Leroy, David J., Ed.; Sterling, Christopher H., Ed.

    This selection of readings, primarily intended for a college journalism course, discusses the strengths and weaknesses of the major sources of the public news--the wire services, newspapers, and television. The first part of the book deals with the context of mass news and serves as an introduction to some of the crucial ideas shaping thinking…

  3. 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.

  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. 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.

  6. AMPK/mTOR-mediated inhibition of survivin partly contributes to metformin-induced apoptosis in human gastric cancer cell

    OpenAIRE

    Han, Gang; Gong, Hangjun; Wang, Yidong; Guo, Shaowen; Liu, Kun

    2014-01-01

    Recent studies demonstrated that metformin exerts anti-neoplastic effect in a spectrum of malignancies. However, the mechanism whereby metformin affects various cancers, including gastric cancer, is poorly elucidated. Considering apoptosis plays critical role in tumorigenesis, we, in the present study, investigated the in vitro apoptotic effect of metformin on human gastric cancer cell and the underlying mechanism. Three differently-differentiated gastric cancer cell lines, MKN-28, SGC-7901 a...

  7. Managing controversy through consultation: a qualitative study of communication and trust around MMR vaccination decisions.

    Science.gov (United States)

    McMurray, Robert; Cheater, Francine M; Weighall, Anna; Nelson, Carolyn; Schweiger, Martin; Mukherjee, Suzanne

    2004-07-01

    Controversy over the measles, mumps, and rubella (MMR) vaccine has reduced uptake, raising concerns of a future disease epidemic. To explore parents' accounts of decision making relating to the MMR vaccine controversy, identifying uptake determinants and education needs. Qualitative interviews analysed using the 'framework' approach. Five general practices in the Leeds area, 2002-2003. Sixty-nine interviews conducted with parents of children aged between 4 and 5 years, and 12 interviews with primary care practitioners, managers and immunisation coordinators serving participating sites. Participants were interviewed one-to-one in a place of their choice. The vaccination decision is primarily a function of parental assessments of the relative acceptability and likelihood of possible outcomes. For most parents the evidence of science and medicine plays little role in the decision. Although local general practitioners and health visitors are trusted information sources, the influence of primary care providers on the vaccination decision is limited by concerns over consultation legitimacy, discussion opportunity, and perceptions of financial and political partiality. Parents and practitioners identify a need for new approaches to support decisions and learning when faced with this and similar healthcare controversies. These include new collaborative approaches to information exchange designed to transform rather than supplant existing parent knowledge as part of an ongoing learning process. The study identified new ways in which parents and practitioners need to be supported in order to increase understanding of medical science and secure more informed decisions in the face of health controversy.

  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. 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.

  10. The neurobiology of decision: consensus and controversy.

    Science.gov (United States)

    Kable, Joseph W; Glimcher, Paul W

    2009-09-24

    We review and synthesize recent neurophysiological studies of decision making in humans and nonhuman primates. From these studies, the basic outline of the neurobiological mechanism for primate choice is beginning to emerge. The identified mechanism is now known to include a multicomponent valuation stage, implemented in ventromedial prefrontal cortex and associated parts of striatum, and a choice stage, implemented in lateral prefrontal and parietal areas. Neurobiological studies of decision making are beginning to enhance our understanding of economic and social behavior as well as our understanding of significant health disorders where people's behavior plays a key role.

  11. Lactobacillus species: taxonomic complexity and controversial susceptibilities.

    Science.gov (United States)

    Goldstein, Ellie J C; Tyrrell, Kerin L; Citron, Diane M

    2015-05-15

    The genus Lactobacillus is a taxonomically complex and is composed of over 170 species that cannot be easily differentiated phenotypically and often require molecular identification. Although they are part of the normal human gastrointestinal and vaginal flora, they can also be occasional human pathogens. They are extensively used in a variety of commercial products including probiotics. Their antimicrobial susceptibilities are poorly defined in part because of their taxonomic complexity and are compounded by the different methods recommended by Clinical Laboratory Standards Institute and International Dairy Foundation. Their use as probiotics for prevention of Clostridium difficile infection is prevalent among consumers worldwide but raises the question of will the use of any concurrent antibiotic effect their ability to survive. Lactobacillus species are generally acid resistant and are able to survive ingestion. They are generally resistant to metronidazole, aminoglycosides and ciprofloxacin with L. acidophilus being susceptible to penicillin and vancomycin, whereas L. rhamnosus and L. casei are resistant to metronidazole and vancomycin. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  12. 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

  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. The protective role of estrogen and estrogen receptors in cardiovascular disease and the controversial use of estrogen therapy.

    Science.gov (United States)

    Iorga, Andrea; Cunningham, Christine M; Moazeni, Shayan; Ruffenach, Gregoire; Umar, Soban; Eghbali, Mansoureh

    2017-10-24

    Epidemiologic studies have previously suggested that premenopausal females have reduced incidence of cardiovascular disease (CVD) when compared to age-matched males, and the incidence and severity of CVD increases postmenopause. The lower incidence of cardiovascular disease in women during reproductive age is attributed at least in part to estrogen (E2). E2 binds to the traditional E2 receptors (ERs), estrogen receptor alpha (ERα), and estrogen receptor beta (ERβ), as well as the more recently identified G-protein-coupled ER (GPR30), and can exert both genomic and non-genomic actions. This review summarizes the protective role of E2 and its receptors in the cardiovascular system and discusses its underlying mechanisms with an emphasis on oxidative stress, fibrosis, angiogenesis, and vascular function. This review also presents the sexual dimorphic role of ERs in modulating E2 action in cardiovascular disease. The controversies surrounding the clinical use of exogenous E2 as a therapeutic agent for cardiovascular disease in women due to the possible risks of thrombotic events, cancers, and arrhythmia are also discussed. Endogenous local E2 biosynthesis from the conversion of testosterone to E2 via aromatase enzyme offers a novel therapeutic paradigm. Targeting specific ERs in the cardiovascular system may result in novel and possibly safer therapeutic options for cardiovascular protection.

  15. Morin, a flavonoid from Moraceae, suppresses growth and invasion of the highly metastatic breast cancer cell line MDA-MB‑231 partly through suppression of the Akt pathway.

    Science.gov (United States)

    Jin, Hana; Lee, Won Sup; Eun, So Young; Jung, Ji Hyun; Park, Hyeon-Soo; Kim, Gonsup; Choi, Yung Hyun; Ryu, Chung Ho; Jung, Jin Myung; Hong, Soon Chan; Shin, Sung Chul; Kim, Hye Jung

    2014-10-01

    Morin, a flavonoid found in figs and other Moraceae, displays a variety of biological actions, such as anti-oxidant, anti-inflammatory and anti-carcinogenic. However, the anticancer effects of morin and in particular its anti-metastatic effects are not well known. Therefore, in the present study, we investigated the anticancer effects of morin on highly metastatic human breast cancer cells. Our results showed that morin significantly inhibited the colony forming ability of highly metastatic MDA-MB‑231 breast cancer cells from low doses (50 µM) without cytotoxicity. In addition, morin changed MDA-MB‑231 cell morphology from mesenchymal shape to epithelial shape and inhibited the invasion of MDA-MB‑231 cells in a dose-dependent manner. Morin decreased matrix metalloproteinase-9 (MMP-9) secretion and expression of the mesenchymal marker N-cadherin of MDA-MB‑231 cells, suggesting that morin might suppress the EMT process. Furthermore, morin significantly decreased the phosphorylation of Akt, and inhibition of the Akt pathway significantly reduced MDA-MB‑231 invasion. In an in vivo xenograft mouse model, morin suppressed MDA-MB‑231 cancer cell progression. Taken together, our findings suggest that morin exhibits an inhibitory effect on the cancer progression and EMT process of highly metastatic breast cancer cells at least in part through inhibiting Akt activation. This study provides evidence that morin may have anticancer effects against metastatic breast cancer.

  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

    2008-11-18

    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. 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. 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.

  18. 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.

  19. 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

  20. Targeted dose enhancement in radiotherapy for breast cancer using gold nanoparticles, part 1: A radiobiological model study.

    Science.gov (United States)

    Ferrero, Veronica; Visonà, Giovanni; Dalmasso, Federico; Gobbato, Andrea; Cerello, Piergiorgio; Strigari, Lidia; Visentin, Sonja; Attili, Andrea

    2017-05-01

    Gold nanoparticles (GNPs) are being proposed in combination with radiotherapy to improve tumor control. However, the exact mechanisms underlying GNP radiosensitization are yet to be understood, thus, we present a new approach to estimate the nanoparticle-driven increase in radiosensitivity. A stochastic radiobiological model, derived from the Local Effect Model (LEM), was coupled with Monte Carlo simulations to estimate the increase in radiosensitivity produced by the interactions between photons and GNPs at nanometric scale. The model was validated using in vitro survival data of MDA-MB-231 breast cancer cells containing different concentrations of 2 nm diameter GNPs receiving different doses using 160 kVp, 6 MV, and 15 MV photons. A closed analytical formulation of the model was also derived and a study of RBE and TCP behavior was conducted. Results support the increased radiosensitivity due to GNP-driven dose inhomogeneities on a nanometric scale. The model is in good agreement with experimental clonogenic survival assays for 160 kVp, 6 MV, and 15 MV photons. The model suggests a RBE and TCP enhancement when lower energies and lower doses per fraction are used in the presence of GNPs. The evolution of the local effect model was implemented to assess cellular radiosensitization in the presence of GNPs and then validated with in vitro data. The model provides a useful framework to estimate the nanoparticle-driven radiosensitivity in treatment irradiations and could be applied to real clinical treatment predictions (described in a second part of this paper). © 2017 American Association of Physicists in Medicine.

  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. Unravelling the pharmacologic opportunities and future directions for targeted therapies in gastro-intestinal cancers part 2: Neuroendocrine tumours, hepatocellular carcinoma, and gastro-intestinal stromal tumours.

    Science.gov (United States)

    Neuzillet, Cindy; de Mestier, Louis; Rousseau, Benoît; Mir, Olivier; Hebbar, Mohamed; Kocher, Hemant M; Ruszniewski, Philippe; Tournigand, Christophe

    2017-07-16

    Until the 1990s, cytotoxic chemotherapy has been the cornerstone of medical therapy for gastrointestinal (GI) cancers. Better understanding of the cancer cell molecular biology has led to the therapeutic revolution of targeted therapies, i.e. monoclonal antibodies or small molecule inhibitors directed against proteins that are specifically overexpressed or mutated in cancer cells. These agents, being more specific to cancer cells, were expected to be less toxic than conventional cytotoxic agents. However, their effects have sometimes been disappointing, due to intrinsic or acquired resistance mechanisms, or to an activity restricted to some tumour settings, illustrating the importance of patient selection and early identification of predictive biomarkers of response to these therapies. Targeted agents have provided clinical benefit in many GI cancer types. Particularly, some GI tumours are considered chemoresistant and targeted therapies have offered a new therapeutic base for their management. Hence, somatostatin receptor-directed strategies, sorafenib, and imatinib have revolutioned the management of neuroendocrine tumours (NET), hepatocellular carcinoma (HCC), and gastrointestinal stromal tumours (GIST), respectively, and are now used as first-line treatment in many patients affected by these tumours. However, these agents face problems of resistances and identification of predictive biomarkers from imaging and/or biology. We propose a comprehensive two-part review providing a panoramic approach of the successes and failures of targeted agents in GI cancers to unravel the pharmacologic opportunities and future directions for these agents in GI oncology. In this second part, we will focus on NET, HCC, and GIST, whose treatment relies primarily on targeted therapies. Copyright © 2017. Published by Elsevier Inc.

  3. 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.

  4. 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

  5. A comparison of the result of a three-part study with the rights of cancer patients presented in public reports, laws and regulations.

    Science.gov (United States)

    Saegrov, S

    2007-11-01

    People diagnosed with cancer often state that they are left to their own resources after receiving their diagnosis and possibly receiving treatment at a hospital. In all likelihood, most of those afflicted with cancer will require follow-up care. The Norwegian Cancer Plan of 1997 proposed that more should be done for people afflicted with cancer. With these factors as the starting point, a three-part study with use of interviews and questionnaires was conducted to identify and evaluate the scope of follow-up care in one Norwegian county with 26 municipalities in a sparsely populated region. This article examines consequences of the sickness for those afflicted. Next, the article discusses who is responsible for organizing follow-up care, and the related official reports, laws and regulations. The article also discusses the results of a three-part study that sought to identify those components of follow-up care that worked effectively and those that did not, with the aim of drafting a follow-up care programme.

  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...... trials. Despite technical improvements, expert clinical skills will continue to be one of the major determinants for the prognosis of patients with germ cell cancer. In addition, the particular needs of testicular cancer survivors have been acknowledged Udgivelsesdato: 2008/3...

  7. 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.

  8. 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......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...... in 2004 remain valid 3 yr later, refinements in the treatment of early- and advanced-stage testicular cancer have emerged from clinical trials. Despite technical improvements, expert clinical skills will continue to be one of the major determinants for the prognosis of patients with germ cell cancer...

  9. Mortality and incidence of cancer among oil exposed workers in a Norwegian cable manufacturing company. Part 2. Mortality and cancer incidence 1953-84.

    Science.gov (United States)

    Rønneberg, A; Andersen, A; Skyberg, K

    1988-09-01

    Mortality and incidence of cancer 1953-84 was studied in a cohort of 529 men exposed to mineral oils in a Norwegian cable manufacturing company. Expected numbers of deaths were calculated from national death rates and cases of cancer from regional incidence rates. Among the 195 men who had worked for less than one year, there were statistically significant excesses of deaths from all causes (O/E = 75/39.3) and from malignant neoplasms, ischaemic heart disease, non-malignant respiratory disease, and violence. In a subcohort of all 248 men with known work category and at least one year's employment in oil exposed work statistically significant excesses of deaths from ischaemic heart disease (O/E = 26/16.1) and cases of lung cancer (O/E = 10/3.9) were observed. Nine of the cases of lung cancer had occurred 20 years or more after first employment (2.7 expected; p less than 0.01). In smokers of this subcohort there were 7.06 cases of lung cancer per 1000 person-years compared with 1.30 in smokers of a general population sample. It is concluded that exposure to mineral oils has probably been an important contributing factor in the development of lung cancer among these workers.

  10. Carbohydrate intake, obesity, metabolic syndrome and cancer risk? A two-part systematic review and meta-analysis protocol to estimate attributability.

    Science.gov (United States)

    Sartorius, B; Sartorius, K; Aldous, C; Madiba, T E; Stefan, C; Noakes, T

    2016-01-04

    Linkages between carbohydrates, obesity and cancer continue to demonstrate conflicting results. Evidence suggests inconclusive direct linkages between carbohydrates and specific cancers. Conversely, obesity has been strongly linked to a wide range of cancers. The purpose of the study is to explore linkages between carbohydrate intake and cancer types using a two-step approach. First the study will evaluate the linkages between carbohydrate intake and obesity, potentially stratified by metabolic syndrome status. Second, the estimated attributable fraction of obesity ascribed to carbohydrate intake will be multiplied against obesity attributable fractions for cancer types to give estimated overall attributable fraction for carbohydrate versus cancer type. We will perform a comprehensive search to identify all possible published and unpublished studies that have assessed risk factors for obesity including dietary carbohydrate intake. Scientific databases, namely PubMed MEDLINE, EMBASE, EBSCOhost and ISI Web of Science will be searched. Following study selection, paper/data acquisition, and data extraction and synthesis, we will appraise the quality of studies and risk of bias, as well as assess heterogeneity. Meta-weighted attributable fractions of obesity due to carbohydrate intake will be estimated after adjusting for other potential confounding factors (eg, physical inactivity, other dietary intake). Furthermore, previously published systematic reviews assessing the cancer-specific risk associated with obesity will also be drawn. These estimates will be linked with the attributability of carbohydrate intake in part 1 to estimate the cancer-specific burden that can be attributed to dietary carbohydrates. This systematic review protocol has been developed according to the 'Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) 2015'. The current study will be based on published literature and data, and, as such, ethics approval is not

  11. Carcinoid-syndrome: recent advances, current status and controversies.

    Science.gov (United States)

    Ito, Tetsuhide; Lee, Lingaku; Jensen, Robert T

    2018-02-01

    To review recent advances and controversies in all aspects of carcinoid-syndrome. Over the last few years there have been a number of advances in all aspects of carcinoid syndrome as well as new therapies. These include new studies on its epidemiology which demonstrate it is increasing in frequency; increasing insights into the pathogenesis of its various clinical manifestations and into its natural history: definition of prognostic factors; new methods to verify its presence; the development of new drugs to treat its various manifestations, both initially and in somatostatin-refractory cases; and an increased understanding of the pathogenesis, natural history and management of carcinoid heart disease. These advances have generated several controversies and these are also reviewed. There have been numerous advances in all aspects of the carcinoid-syndrome, which is the most common functional syndrome neuroendocrine tumors produce. These advances are leading to new approaches to the management of these patients and in some cases to new controversies.

  12. 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.

  13. Humanitarian law: the controversial historical construction of a universal moral

    Directory of Open Access Journals (Sweden)

    Soraya Nour Sckell

    2012-01-01

    Full Text Available Humanitarian law was conceived by legal and moral normativism founded on universal principles. Despite its undeniable universal moral content, its formulations and application methods are however the result of historical conflicts. This article aims to analyze how the universality of humanitarian law is produced by highly controversial conflicts. It is necessary to overcome the antagonism between an analysis that focuses on the moral undeniable value of humanitarian law by ignoring its controversies and an analysis that focuses on social antagonism questioning the achievability of the moral and universal value of humanitarian law. For this, we must consider that humanitarian law is a construction. It appears as autonomous and independent of power relationships, as based on the rationality of morality and thus worthy of universal recognition. Yet its development is only possible when one considers the historical roots of reason. It is only through political struggle that humanitarian law is realized in history. The aim of this paper is to analyze how the universal nature of humanitarian law is produced by highly controversial conflicts. Firstly, an analysis is offered on the universal but at the same controversial character in the codification of humanitarian law, recalling controversies around the creation of the Additional Protocols of 1977 (Section 1. Next, an analysis is given on the conflictual character of organizations supporting humanitarian law, taking in account conflicts between the Red Cross and Doctors Without Borders and controversies around the ambitions to pass from an humanitarian law to a right of humanitarian intervention (Section 2. Finally, a reflection is offered on how the theories of international relations that most appropriately grasp the universal nature of humanitarian law must be complemented by a "historical sociology of the universal" that embraces the conflicting historical dimension in the construction of the

  14. The current revolution in newborn screening: new technology, old controversies.

    Science.gov (United States)

    Tarini, Beth A

    2007-08-01

    Newborn screening has provided a model of a successful public health screening program for the past 40 years. However, the history of newborn screening is not without controversy. Many of these controversies have been rekindled with the introduction of tandem mass spectrometry, a technology that has greatly increased our ability to detect potential disease in asymptomatic newborns. This review highlights the challenges raised by this and future technological advances as we strive to maintain the success of newborn screening in the 21st century.

  15. Food-based natural products for cancer management: Is the whole greater than the sum of the parts?

    Science.gov (United States)

    Hussain, Suleman S; Kumar, Addanki P; Ghosh, Rita

    2016-10-01

    The rise in cancer incidence and mortality in developing countries together with the human and financial cost of current cancer therapy mandates a closer look at alternative ways to overcome this burgeoning global healthcare problem. Epidemiological evidence for the association between cancer and diet and the long latency of most cancer progression have led to active exploration of whole and isolated natural chemicals from different naturally occurring substances in various preclinical and clinical settings. In general the lack of systemic toxicities of most 'whole' and 'isolated' natural compounds, their potential to reduce toxic doses and potential to delay the development of drug-resistance makes them promising candidates for cancer management. This review article examines the suggested molecular mechanisms affected by these substances focusing to a large extent on prostate cancer and deliberates on the disparate results obtained from cell culture, preclinical and clinical studies in an effort to highlight the use of whole extracts and isolated constituents for intervention. As such these studies underscore the importance of factors such as treatment duration, bioavailability, route of administration, selection criteria, standardized formulation and clinical end points in clinical trial design with both entities. Overall lack of parallel comparison studies between the whole natural products and their isolated compounds limits decisive conclusions regarding the superior utility of one over the other. We suggest the critical need for rigorous comparative research to identify which one of the two or both entities from nature would be best qualified to take on the mantle of cancer management. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. 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

    2017-08-15

    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.

  17. 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 ...

  18. 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…

  19. 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…

  20. Blackwater fever: An insight into a controversy | Chiabi | Clinics in ...

    African Journals Online (AJOL)

    Blackwater fever: An insight into a controversy. A Chiabi, C Mbarga, G Mbonda, E Deungwe, MT Obama, J Minkande Ze, Xiao Yan Yang, PF Tchokoteu. Abstract. The authors present a comprehensive review of the possible pathogenetic mechanisms, pathophysiology and therapeutic options of blackwater fever. The review ...

  1. Design Piracy: Student Perceptions of a Constructive Controversy Activity

    Science.gov (United States)

    Marcketti, Sara B.

    2007-01-01

    Optimal learning occurs when students are interested in the subject matter, are motivated with challenging and quality learning opportunities, and when immersed in atmospheres that make learning enjoyable. One technique to promote optimal learning is through the use of constructive controversies. The purpose of this study was to provide an example…

  2. 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

  3. Childhood Psychological Disorders: Current Controversies. Making Sense of Psychology

    Science.gov (United States)

    Bursztyn, Alberto M., Ed.

    2011-01-01

    This accessible, informative book will help teachers, parents, and practitioners make sense of current issues and controversies surrounding childhood disabilities. Almost 12 percent of children in American schools have been identified as disabled in ways that interfere with their capacity to learn. Yet parents of children with disabilities often…

  4. 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…

  5. The controversy of parasitic infection in pediatric appendicitis: a ...

    African Journals Online (AJOL)

    Background Controversy still exists regarding the relationship between parasitic infections and acute appendicitis. Aim To investigate the role of parasitic infections in the etiology of acute pediatric appendicitis. Patients and methods A two-center retrospective study included 1500 pediatric and adolescent patients who had ...

  6. Women, Webquests, and Controversial Issues in the Social Studies

    Science.gov (United States)

    Crocco, Margaret Smith; Cramer, Judith

    2005-01-01

    America has been called "the argument culture," but you would not know it from many social studies classrooms. Despite a longstanding tradition in social studies of teaching controversial issues, all too few of today's classrooms accommodate this kind of intellectual activity. Perhaps it is the pressure of high stakes testing, or the emphasis on…

  7. The Seal Killing Controversy: What Are the Facts?

    Science.gov (United States)

    Scheffer, Victor B.

    1973-01-01

    Discusses the seal controversy using the harp and Alaska fur seals to illustrate the two distinct issues, i.e., conservation (the effect of killing upon the animal population); and two, morality (the effect of killing upon the human spirit). Factual information combines with personal philosophy. (LK)

  8. 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.…

  9. Using Debate in Helping Students Discuss Controversial Topics

    Science.gov (United States)

    Fallahi, Carolyn R.; Haney, Joseph D.

    2007-01-01

    We used 2 debates over the course of a semester to encourage upper level psychology students to engage in discussion about controversial issues. The debates considered issues in Affirmative Action and sexual diversity. Students completed a survey assessing their experiences both individually and as a team member. Students found it easier to…

  10. The Ebb and Flow of Controversial Debates on Social Media

    OpenAIRE

    Garimella, Kiran; Morales, Gianmarco De Francisci; Gionis, Aristides; Mathioudakis, Michael

    2017-01-01

    We explore how the polarization around controversial topics evolves on Twitter - over a long period of time (2011 to 2016), and also as a response to major external events that lead to increased related activity. We find that increased activity is typically associated with increased polarization; however, we find no consistent long-term trend in polarization over time among the topics we study.

  11. [Organic foods and human health: a study of controversies].

    Science.gov (United States)

    Sousa, Anete Araújo de; Azevedo, Elaine de; Lima, Elinete Eliete de; Silva, Ana Paula Ferreira da

    2012-06-01

    The study of controversies is a methodological tool that generates knowledge about the social and political dimensions of science. This approach can be used to understand and explore the topic of organic foods. The present study aimed to analyze the controversies regarding the status of organic foods. We carried out a review of studies published since 1990 in three websites: International Foundation for Organic Agriculture, Soil Association, and Food and Agriculture Organization. The following controversies were identified: 1) effects on human health of the presence of chemical contaminants in organic foods; 2) the quality of organic foods as compared to conventionally grown foods; and 3) price of organic foods. Based on this review, it is possible to conclude that, even though organic foods stand out for their low toxicity, higher durability, and nutritional content of some items, more comparative studies are required to confirm the nutritional superiority of organic foods and to solve the controversies. The discussion must be contextualized within a broad spectrum of health promotion, in which organic farming appears associated with the support for small farming, biodiversity, and local sustainable development, so as to increase offer and demand for organic products at fair prices for individual and institutional consumers.

  12. Stem Cell Research-Concept And Controversies | Kalu | Benin ...

    African Journals Online (AJOL)

    Benin Journal of Postgraduate Medicine. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 8, No 1 (2006) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Stem Cell Research-Concept And Controversies. OO Kalu. Abstract.

  13. 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…

  14. Know Nukes: A Model for Teaching Controversial Issues.

    Science.gov (United States)

    Thomashow, Mitchell

    1984-01-01

    Summarizes a nuclear power workshop that presented techniques useful in controversial issues education. An introductory exercise and an overview of propagandistic techniques (listed in "The Propaganda Game") related to self-deception, language, irrelevance, exploitation, form, and maneuver are included. Outline of workshop presentation…

  15. 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.…

  16. Teaching Darwin: Contemporary Social Studies through Controversial Issues

    Science.gov (United States)

    Swanson, Helge

    2010-01-01

    I explore Darwin and his Theory of Natural Selection from a Social Science perspective and a social studies approach of inquiry into contemporary issues. This approach augments the more common natural science focus on the mechanics of natural selection and evolution in favor of a focus on social issues, controversy, and dialog necessary to support…

  17. MMR and autism: moving from controversy toward consensus.

    Science.gov (United States)

    Coffin, Susan E

    2002-08-01

    As controversy swirls around the putative association between the measles-mumps-rubella vaccine and autism, the methods of scientific investigation, established more than 150 years ago, bear remembering. In this article, we will discuss the origins of this hypothesis, evidence in support of and at variance with this theory and future investigations that may help to resolve this debate.

  18. The Traditional Courts Bill: Controversy around process, substance ...

    African Journals Online (AJOL)

    This article introduces the Traditional Courts Bill (B15-2008). The Bill has caused controversy, and drawn criticism from rural communities and civil society. Key to the concerns raised was the flawed consultative process that the Department of Justice and Constitutional Development followed in bringing the Bill before ...

  19. ORIGINAL ARTICLES Ethical and legal controversies in cloning for ...

    African Journals Online (AJOL)

    Society remains divided on the highly controversial issue of the moral status of, and what is owed to, developing human life. This divergence of opinion also poses an impediment towards arriving at a solution on what is owed to the cloned embryo. The moral status of the embryo was deliberated extensively but not resolved ...

  20. Is Race Really Controversial in the University Classroom?

    Science.gov (United States)

    Philion, Stephen

    2009-01-01

    Today, even though "social justice" programs exist as a virtual growth industry on US campuses and many universities have incorporated classes on race and racism into their curricula, everyone continues to be faced with the perception that race is a "controversial" topic that has to be broached with care due to its "sensitive nature". This is even…

  1. 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...

  2. Stem Cell Research-Concept And Controversies | Kalu | Benin ...

    African Journals Online (AJOL)

    Benin Journal of Postgraduate Medicine. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 8, No 1 (2006) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Stem Cell Research-Concept And Controversies.

  3. Relational Frame Theory: An Overview of the Controversy

    Science.gov (United States)

    Gross, Amy C.; Fox, Eric J.

    2009-01-01

    Although Skinner's "Verbal Behavior" (1957) was published over 50 years ago, behavior-analytic research on human language and cognition has been slow to develop. In recent years, a new behavioral approach to language known as relational frame theory (RFT) has generated considerable attention, research, and debate. The controversy surrounding RFT…

  4. "We Make It Controversial": Elementary Preservice Teachers' Beliefs about Race

    Science.gov (United States)

    Buchanan, Lisa Brown

    2015-01-01

    The impetus for this study began during an elementary teacher education course meeting, where preservice teachers discussed whether or not it was appropriate to discuss controversial topics--including race--with young children. Preservice teachers disclosed their "uncomfortableness" with race at large, and emphasized that discussions…

  5. [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.

  6. Hate Speech: The History of an American Controversy.

    Science.gov (United States)

    Walker, Samuel

    Noting that no other country in the world offers protection to offensive speech, this book provides a comprehensive account of the history of the hate speech controversy in the United States. The book examines the issue, from the conflicts over the Ku Klux Klan in the 1920s and American Nazi groups in the 1930s, to the famous Skokie, Illinois…

  7. Creationism in the Classroom: A Controversy with Serious Consequences

    Science.gov (United States)

    Baker, Sylvia

    2010-01-01

    The resignation of the Revd Professor Michael Reiss from his position as Director of Education at the Royal Society over the issue of the teaching of creationism in school science classes provides the background to this article. The immediate controversy is described and considered in relation to its wider context and to the serious questions that…

  8. 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...

  9. 'Like doing a jigsaw with half the parts missing': community pharmacists and the management of cancer pain in the community.

    Science.gov (United States)

    Savage, Imogen; Blenkinsopp, Alison; Closs, S Jose; Bennett, Michael I

    2013-06-01

    The aim was to explore and describe community pharmacists' current and potential place in the cancer pain pathway. Objectives were to describe pharmacists' role in advising patients and their carers on optimum use of opioid drugs for pain relief, identify elements of medicines management that could be modified and identify opportunities for improved communication with patients and other professionals. Semi-structured interviews were conducted with 25 community pharmacists in three areas of England. Data were analysed using the Framework method. Pharmacists had no reliable method to identify patients with cancer and no access to disease stage and treatment plan information. There was little evidence of any routine communication with other professionals about patient care. Contact with patients was limited. Access to palliative care medicines could be problematic for patients and medicines use reviews (MURs) were rarely done. Interview data suggested variable levels of knowledge about optimal opioid use in cancer pain or awareness of patients' priorities. For some pharmacists, proactive involvement appeared to be inhibited by fear of discussing emotional and wider social aspects and accounts showed that a wide range of issues and concerns were raised by family members, indicating considerable unmet need. Pharmacists tended to assume information had already been provided by others and felt isolated from other care team members. Many felt that their potential contribution to cancer pain management was constrained but aspired to do more. There is significant scope for improving access to and interaction with, community pharmacists by people with cancer pain and their families. Finding ways to embed pharmacists within palliative care teams could provide a starting point for a greater contribution to cancer pain management. © 2012 The Authors. IJPP © 2012 Royal Pharmaceutical Society.

  10. 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.

    NARCIS (Netherlands)

    Krege, S.; Beyer, J.; Souchon, R.; Albers, P.; Albrecht, W.; Algaba, F.; Bamberg, M.; Bodrogi, I.; Bokemeyer, C.; Cavallin-Stahl, E.; Classen, J.; Clemm, C.; Cohn-Cedermark, G.; Culine, S.; Daugaard, G.; Mulder, P.H.M. de; Santis, M. de; Wit, M. de; Wit, R. de; Derigs, H.G.; Dieckmann, K.P.; Dieing, A.; Droz, J.P.; Fenner, M.; Fizazi, K.; Flechon, A.; Fossa, S.D.; Muro, X.G. del; Gauler, T.; Geczi, L.; Gerl, A.; Germa-Lluch, J.R.; Gillessen, S.; Hartmann, J.T.; Hartmann, M.; Heidenreich, A.; Hoeltl, W.; Horwich, A.; Huddart, R.; Jewett, M.; Joffe, J.; Jones, W.G.; Kisbenedek, L.; Klepp, O.; Kliesch, S.; Koehrmann, K.U.; Kollmannsberger, C.; Kuczyk, M.; Laguna, P.; Galvis, O.L.; Loy, V.; Mason, M.D.; Mead, G.M.; Mueller, R.; Nichols, C.; Nicolai, N.; Oliver, T.; Ondrus, D.; Oosterhof, G.O.; Ares, L.P.; Pizzocaro, G.; Pont, J.; Pottek, T.; Powles, T.; Rick, O.; Rosti, G.; Salvioni, R.; Scheiderbauer, J.; Schmelz, H.U.; Schmidberger, H.; Schmoll, H.J.; Schrader, M.; Sedlmayer, F.; Skakkebaek, N.E.; Sohaib, A.; Tjulandin, S.; Warde, P.; Weinknecht, S.; Weissbach, L.; Wittekind, C.; Winter, E.; Wood, L.; Maase, H. von der

    2008-01-01

    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

  11. 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.

    NARCIS (Netherlands)

    Krege, S.; Beyer, J.; Souchon, R.; Albers, P.; Albrecht, W.; Algaba, F.; Bamberg, M.; Bodrogi, I.; Bokemeyer, C.; Cavallin-Stahl, E.; Classen, J.; Clemm, C.; Cohn-Cedermark, G.; Culine, S.; Daugaard, G.; Mulder, P.H.M. de; Santis, M. De; Wit, M. de; Wit, R. de; Derigs, H.G.; Dieckmann, K.P.; Dieing, A.; Droz, J.P.; Fenner, M.; Fizazi, K.; Flechon, A.; Fossa, S.D.; Muro, X.G. del; Gauler, T.; Geczi, L.; Gerl, A.; Germa-Lluch, J.R.; Gillessen, S.; Hartmann, J.T.; Hartmann, M.; Heidenreich, A.; Hoeltl, W.; Horwich, A.; Huddart, R.; Jewett, M.; Joffe, J.; Jones, W.G.; Kisbenedek, L.; Klepp, O.; Kliesch, S.; Koehrmann, K.U.; Kollmannsberger, C.; Kuczyk, M.; Laguna, P.; Galvis, O.L.; Loy, V.; Mason, M.D.; Mead, G.M.; Mueller, R.; Nichols, C.; Nicolai, N.; Oliver, T.; Ondrus, D.; Oosterhof, G.O.; Paz-Ares, L.; Pizzocaro, G.; Pont, J.; Pottek, T.; Powles, T.; Rick, O.; Rosti, G.; Salvioni, R.; Scheiderbauer, J.; Schmelz, H.U.; Schmidberger, H.; Schmoll, H.J.; Schrader, M.; Sedlmayer, F.; Skakkebaek, N.E.; Sohaib, A.; Tjulandin, S.; Warde, P.; Weinknecht, S.; Weissbach, L.; Wittekind, C.; Winter, E.; Wood, L.; Maase, H. von der

    2008-01-01

    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 the

  12. 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.

  13. Neurotoxicity in breast cancer survivors a parts per thousand yen10 years post-treatment is dependent on treatment type

    NARCIS (Netherlands)

    Stouten-Kemperman, Myrle M.; de Ruiter, Michiel B.; Koppelmans, Vincent; Boogerd, Willem; Reneman, Liesbeth; Schagen, Sanne B.

    2015-01-01

    Adjuvant chemotherapy (CT) for breast cancer (BC) is associated with very late side-effects on brain function and structure. However, little is known about neurotoxicity of specific treatment regimens. To compare neurotoxicity profiles after different treatment strategies, we used neurocognitive

  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. Resistance of Nonmelanoma Skin Cancer to Nonsurgical Treatments. Part II: Photodynamic Therapy, Vismodegib, Cetuximab, Intralesional Methotrexate, and Radiotherapy.

    Science.gov (United States)

    Gracia-Cazaña, T; Salazar, N; Zamarrón, A; Mascaraque, M; Lucena, S R; Juarranz, Á

    2016-11-01

    A wide range of treatments is now available for nonmelanoma skin cancer, including 5-fluorouracil, ingenol mebutate, imiquimod, diclofenac, photodynamic therapy, methotrexate, cetuximab, vismodegib, and radiotherapy. All are associated with high clinical and histologic response rates. However, some tumors do not respond due to resistance, which may be primary or acquired. Study of the resistance processes is a broad area of research that aims to increase our understanding of the nature of each tumor and the biologic features that make it resistant, as well as to facilitate the design of new therapies directed against these tumors. In this second article, having covered the topical treatments of nonmelanoma skin cancer, we review resistance to other nonsurgical treatments, such as monoclonal antibodies against basal and squamous cell carcinomas, intralesional chemotherapy, photodynamic therapy, and radiotherapy. Copyright © 2016 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Natural health products that inhibit angiogenesis: a potential source for investigational new agents to treat cancer-Part 1.

    Science.gov (United States)

    Sagar, S M; Yance, D; Wong, R K

    2006-02-01

    An integrative approach for managing a patient with cancer should target the multiple biochemical and physiologic pathways that support tumour development and minimize normal-tissue toxicity. Angiogenesis is a key process in the promotion of cancer. Many natural health products that inhibit angiogenesis also manifest other anticancer activities. The present article focuses on products that have a high degree of anti-angiogenic activity, but it also describes some of the many other actions of these agents that can inhibit tumour progression and reduce the risk of metastasis. Natural health products target molecular pathways other than angiogenesis, including epidermal growth factor receptor, the HER2/neu gene, the cyclooxygenase-2 enzyme, the nuclear factor kappa-B transcription factor, the protein kinases, the Bcl-2 protein, and coagulation pathways. The herbs that are traditionally used for anticancer treatment and that are anti-angiogenic through multiple interdependent processes (including effects on gene expression, signal processing, and enzyme activities) include Artemisia annua (Chinese wormwood), Viscum album (European mistletoe), Curcuma longa (curcumin), Scutellaria baicalensis (Chinese skullcap), resveratrol and proanthocyanidin (grape seed extract), Magnolia officinalis (Chinese magnolia tree), Camellia sinensis (green tea), Ginkgo biloba, quercetin, Poria cocos, Zingiber officinalis (ginger), Panax ginseng, Rabdosia rubescens hora (Rabdosia), and Chinese destagnation herbs. Quality assurance of appropriate extracts is essential prior to embarking upon clinical trials. More data are required on dose-response, appropriate combinations, and potential toxicities. Given the multiple effects of these agents, their future use for cancer therapy probably lies in synergistic combinations. During active cancer therapy, they should generally be evaluated in combination with chemotherapy and radiation. In this role, they act as modifiers of biologic response or as

  17. Canine prostate models in preclinical studies of minimally invasive interventions: part I, canine prostate anatomy and prostate cancer models

    OpenAIRE

    Sun, Fei; B?ez-D?az, Claudia; S?nchez-Margallo, Francisco Miguel

    2017-01-01

    The high prevalence of prostate cancer (PCa) in elderly men and technical advances in early detection of localized PCa have led to continued efforts to develop new therapeutic options of minimally invasive nature in current urologic oncology community. Increasing newly emerging therapies are undergoing preclinical tests on the technical feasibility, efficacy and safety in animal experiments. The dog is an ideal large animal because of its similar anatomy to human and the capability allowing t...

  18. 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.

  19. European guidelines for topical photodynamic therapy part 2: emerging indications--field cancerization, photorejuvenation and inflammatory/infective dermatoses.

    Science.gov (United States)

    Morton, C A; Szeimies, R-M; Sidoroff, A; Braathen, L R

    2013-06-01

    In addition to established indications in non-melanoma skin cancer in immunocompetent patients, photodynamic therapy (PDT) has been studied for the treatment, and possible prevention, of superficial skin cancers in immunosuppressed patients. As a topical photosensitizer can be applied over large areas, PDT is also increasingly used for field cancerization in photodamaged skin, with evidence of potential to delay the development of actinic keratoses and basal cell carcinoma, although direct evidence of prevention of invasive squamous cell carcinoma remains limited. PDT has been studied in patch/plaque-stage cutaneous T-cell lymphoma, with efficacy more likely in unilesional disease. Accumulating evidence supports the use of PDT in acne and several other inflammatory/infective dermatoses including cutaneous leishmaniasis, although protocols are still to be refined. Despite proven efficacy, PDT is not widely used in viral/genital warts, where pain during treatment can be intense. PDT is a therapeutic option for photorejuvenation, with improvement in fine wrinkles, mottled hyperpigmentation, roughness and sallowness reported. © 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology.

  20. Breast radiotherapy as part of loco-regional treatments in stage IV breast cancer patients with oligometastatic disease.

    Science.gov (United States)

    Bourgier, Céline; Khodari, Wassim; Vataire, Anne-Lise; Pessoa, Eduardo Lima; Dunant, Ariane; Delaloge, Suzette; Uzan, Catherine; Balleyguier, Corinne; Mathieu, Marie-Christine; Marsiglia, Hugo; Arriagada, Rodrigo

    2010-08-01

    Local treatments seem to improve metastasis progression-free survival (MPFS) and overall survival (OS) when added to systemic therapies in stage IV breast cancer. From 1990 to 2003, we reviewed 9138 cases treated and registered in the Institut Gustave-Roussy breast cancer database. Among them, 308 had presented with stage IV disease. Eighty percent of patients (n=239) had received a loco-regional treatment and they were categorized into two groups: loco-regional radiotherapy (LRRT) alone (Group 1; n=147) or breast and axillary surgery+/-LRRT (Group 2; n=92). The median follow-up was 6.5 years. LRRT obtained a long-standing loco-regional clinical response in 85% of patients. The 3-year MPFS rates were 20% in Group 1 and 39% in Group 2; the 3-year OS rates were 39% and 57%, respectively. However, no significant differences in MPFS or OS were observed between the two groups when adjusted on prognostic factors. Radiation therapy alone provides long-standing local control and yields MPFS and OS rates equivalent to those obtained when radiation therapy is combined with surgery, whatever the prognostic factors. Loco-regional therapies, especially radiation therapy alone, may have an important role to play in the treatment of selected patients with stage IV breast cancer. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  1. Social controversy belongs in the climate science classroom

    Science.gov (United States)

    Walsh, Elizabeth M.; Tsurusaki, Blakely K.

    2014-04-01

    Scientists, educators and stakeholders are grappling with how to best approach climate change education for diverse audiences, a task made difficult due to persistent social controversy. This Perspective examines how sociocultural learning theories can inform the design and implementation of climate change education experiences for learners with varied understandings of and attitudes towards climate change. The literature demonstrates that explicitly addressing learners' social and community experiences, values and knowledge supports understandings of and increased concern about climate change. Science learning environments that situate climate change in its social context can support conceptual understandings, shift attitudes and increase the participation of diverse communities in responding to climate change. Examples are provided of successful programmes that attend to social dimensions and learners' previous experiences, including experiences of social controversy.

  2. Controversies in the management of primary sclerosing cholangitis

    Science.gov (United States)

    Nayagam, Jeremy S; Pereira, Stephen P; Devlin, John; Harrison, Phillip M; Joshi, Deepak

    2016-01-01

    Primary sclerosing cholangitis (PSC) remains a rare but significant disease, which affects mainly young males in association with inflammatory bowel disease. There have been few advances in the understanding of the pathogenesis of the condition and no therapeutics with proven mortality benefit aside from liver transplantation. There remain areas of controversy in the management of PSC which include the differentiation from other cholangiopathies, in particular immunoglobulin G4 related sclerosing cholangitis, the management of dominant biliary strictures, and the role of ursodeoxycholic acid. In addition, the timing of liver transplantation in PSC remains difficult to predict with standard liver severity scores. In this review, we address these controversies and highlight the latest evidence base in the management of PSC. PMID:26925200

  3. The pertussis vaccine controversy in Great Britain, 1974-1986.

    Science.gov (United States)

    Baker, Jeffrey P

    2003-09-08

    This historical essay analyzes the role played by Great Britain in the pertussis vaccine controversy of the 1970s and 1980s. Public backlash against this vaccine not only took place earlier in Britain than the United States, but also was so widespread that a series of whooping cough epidemics soon followed. As with the more recent dispute involving measles-mumps-rubella (MMR) vaccine and autism, the United Kingdom played a primary role in defining, promoting, and ultimately exporting this controversy. This essay seeks to explain this phenomenon by situating it in Britain's long history of suspicion regarding vaccines evident among both the public and the medical profession, a theme dating back to the compulsory vaccination laws of the 19th century. It argues that anti-vaccinationism, far from being simply a new development related to the public's lack of awareness of childhood vaccine-preventable illness, actually represents a revival of a much older movement.

  4. 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.

  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. 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.

  7. Acute disseminated encephalomyelitis: current controversies in diagnosis and outcome.

    Science.gov (United States)

    Koelman, Diederik L H; Mateen, Farrah J

    2015-09-01

    Acute disseminated encephalomyelitis (ADEM) is a rare inflammatory, demyelinating disorder of the CNS. Only in the past 15 years have larger groups of patients from several geographical areas been reported for comparisons across studies. In spite of the increased recognition of ADEM, the diagnosis of ADEM remains clinical, aided by neuroimaging confirmation, because of the lack of a biological marker. The diagnosis may be difficult, given that several diseases may present similar to ADEM. The controversial existence of multiphasic forms necessitates a continuous evaluation of the diagnosis by tracking subsequent events. Despite proposed consensus criteria, the diagnostic criteria employed to characterize ADEM range widely among the largest reported cohorts to date. This review comprehensively evaluates the current knowledge and controversies that surround ADEM, with special consideration of the distinction between ADEM and other demyelinating diseases such as multiple sclerosis. In addition, we present implications of the current knowledge of ADEM for both research and clinical practice.

  8. Early management of severe sepsis: concepts and controversies.

    Science.gov (United States)

    Marik, Paul E

    2014-06-01

    Sepsis is among the most common reasons for admission to ICUs throughout the world, and it is believed to be the third most common cause of death in the United States. The pathogenetic mechanism and physiologic changes associated with sepsis are exceedingly complex, but our understanding is evolving rapidly. The major pathophysiologic changes in patients with septic shock include vasoplegic shock (distributive shock), myocardial depression, altered microvascular flow, and a diffuse endothelial injury. These pathophysiologic changes play a central role in the management of sepsis. The early management of patients with severe sepsis and septic shock centers on the administration of antibiotics, IV fluids, and vasoactive agents, followed by source control. However, the specific approach to the resuscitation of patients with septic shock remains highly controversial. This review provides a practical and physiologic-based approach to the early management of sepsis and explores the controversies surrounding the management of this complex condition.

  9. 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.

  10. The controversy over the new star of AD.1408

    Science.gov (United States)

    Guangchao, Wang

    2015-08-01

    In recent years, the likelihood of a supernova occurring in AD 1408 has aroused a controversy in Chinese astronomy. The initial suggestion was made by Li Qi-bin, who discussed several Chinese records of temporary stars seen during the year and suggested that these records related to the same object- a supernova appearing in Cygnus. Stephenson considered that these records might be possible as a comet or meteor. Until now, the two sides still differ with each other over the question of these records. This article examines the controversy over the new star of AD 1408. Based on some fresh historical materials, this article partially support F. Richard Stephenson‘s pinpoint and put forward some ideas of identifying historical novae or supernovae.

  11. Controversies in management of slipped capital femoral epiphysis

    Science.gov (United States)

    Johari, Ashok N; Pandey, Ritesh A

    2016-01-01

    The traditional treatment of the hip with a slip of the capital femoral epiphysis has been an in situ fixation using a single screw. This has the sanctity of a long term result. Recent literature stresses the outcomes of failure to restore the upper femoral alignment and on the basis of the poor results makes a plea for capital realignment. This being a recent development, it lacks the support of long term follow up and it remains to be seen if this is a better alternative of managing displaced and unstable slipped capital femoral epiphysis. The authors look at some of the available literature on the subject to highlight these controversies and their implications for orthopedic surgeons. Other controversies pertain to contralateral fixation, duration of immobilization and amount of weight bearing after an in situ fixation. PMID:26925378

  12. Controversies in knee rehabilitation: anterior cruciate ligament injury.

    Science.gov (United States)

    Failla, Mathew J; Arundale, Amelia J H; Logerstedt, David S; Snyder-Mackler, Lynn

    2015-04-01

    Controversy in management of athletes exists after anterior cruciate ligament (ACL) injury and reconstruction. Consensus criteria for evaluating successful outcomes following ACL injury include no reinjury or recurrent giving way, no joint effusion, quadriceps strength symmetry, restored activity level and function, and returning to preinjury sports. Using these criteria, the success rates of current management strategies after ACL injury are reviewed and recommendations are provided for the counseling of athletes after ACL injury. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Industrial Ecology for Sustainable Development: Six Controversies in Theory Building

    OpenAIRE

    Jouni Korhonen

    2005-01-01

    This article is building the theory for the scientific field of industrial ecology. For this, the industrial ecosystem (IE) concept is used. IE uses the model of sustainable ecosystems in unsustainable industrial systems for making progress towards the vision of the industrial ecosystem. Six controversies are revealed and identified as research challenges. I invite all those who are interested in industrial ecology to respond to this contribution.

  14. Is alveolar cleft reconstruction still controversial? (Review of literature)

    OpenAIRE

    Seifeldin, Sameh A

    2015-01-01

    Cleft lip and palate (CL/P) is a frequent congenital malformation that manifests in several varieties including unilateral or bilateral and complete or incomplete. Alveolar cleft reconstruction remains controversial with regard to timing, graft materials, surgical techniques, and methods of evaluation. Many studies have been conducted addressing these points to develop an acceptable universal protocol for managing CL/P. The primary goal of alveolar cleft reconstruction in CL/P patients is to ...

  15. The tidelands oil controversy: The prize and the responsibility

    Energy Technology Data Exchange (ETDEWEB)

    Hagar, A.V.

    1995-12-31

    This article reviews the legal history of the Tidelands oil controversy in the Santa Barbara Channel of Southern California. A blowout of a well in an offshore platform in 1969 marked the beginning of California`s anti-oil movement. Santa Barbara today is a combination of industrialization and recreation, and like the oil and water that are the lifeblood of these two pursuits, they do not mix.

  16. Chlorine: Undergraduate Research on an Element of Controversy

    Science.gov (United States)

    Chang, Hasok

    2009-04-01

    If chemical elements were people, chlorine would be a celebrity. Although intrinsically no more or less important than any other element, chlorine has had a knack of making headlines. The genre of "object biography" has been quite successful in popular science recently. We took this opportunity to write a "biographical" study of chlorine. Chlorine's wide range of interesting controversies is well suited for attracting and maintaining the enthusiasm of the diverse range of students we teach in our department.

  17. 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...

  18. The Controversy of Anti Pornography and Pornoaction Bill In Indonesia

    OpenAIRE

    IDRIS, NUR ISDAH

    2015-01-01

    -- The controversy over the pornography bill has revealed that various groups in society are involved in a struggle for domination over public morality. Sexuality, the human body and moral values are being negotiated, and thus can be better understood, within the context of power relations. The pornoactions ban (which may now be dropped by the Bill???s supporters) would prohibit people from public displays of affection (such as kissing and holding hands), or exposing ???sensitive??? bod...

  19. Controversies in isolation and general infection control practices in pediatrics.

    Science.gov (United States)

    Siegel, Jane D

    2002-01-01

    Current controversies in pediatric isolation and infection control include correct application of standard precautions, importance of providing adequate staffing levels in intensive care units to prevent transmission of infectious agents, use of rapid diagnostic testing and best precautions to prevent transmission of respiratory syncytial virus, best methods to prevent transmission of multidrug-resistant organisms in acute care settings, and preventing transmission of infections to pregnant healthcare workers. Recommendations are evidence-based.

  20. Controversies and challenges of vaccination: an interview with Elizabeth Miller.

    Science.gov (United States)

    Miller, Elizabeth

    2015-10-16

    Although strong evidence exists that the benefits of vaccination by far outweigh potential adverse events, controversy still exists. This has led opponents of vaccination to question its safety, efficacy and necessity. In an interview with Professor Elizabeth Miller, we discuss the continuum of beliefs held by vaccine refusers and hesitators, the resulting health consequences, and ways in which health professionals and industry regulators can help promote transparency to better convey the substantial health benefits of vaccination.

  1. Stakeholders’ Views on Barriers to Research on Controversial Controlled Substances

    OpenAIRE

    Andreae,; Bourgiose,; Indyk,; Rhodes, Dell; Sacks,

    2016-01-01

    Many diseases and disease symptoms still lack effective treatment. At the same time, certain controversial Schedule I drugs, such as heroin and cannabis, have been reputed to have considerable therapeutic potential for addressing significant medical problems. Yet, there is a paucity of U.S. clinical studies on the therapeutic uses of controlled drugs. For example, people living with HIV/AIDS experience a variety of disease- and medication-related symptoms. Their chronic pain is intense, frequ...

  2. Beyond Controversies: Sexuality Education for Adolescents in India

    OpenAIRE

    Jagdish Khubchandani; Jeffrey Clark(Fermilab); Raman Kumar

    2014-01-01

    Sexuality education for adolescents is one of the most controversial topics in the field of child health. In the past decade, policymakers in India have also struggled with the issue and there has been greater public discourse. However, policymaking and public discussions on adolescent sexuality education are frequently fueled by religious, social, and cultural values, while receiving scant scientific attention. To meet the needs of an expanding young population in India, scientific evidence ...

  3. Controversial medical and agri-food biotechnology: a cultivation analysis.

    Science.gov (United States)

    Bauer, Martin W

    2002-04-01

    Whether biotechnology is one or several developments is not clear. Once distinctions are required, the question is: Which one prevails? When the good, the bad, and the ugly settle, where do they fall? Evaluation implies distinction, and representation drives attitude. The controversies over biotechnology are fertile ground on which to study these issues. The imports of genetically modified (GM) soya into Europe in 1996-97 and the cloning of Dolly the sheep from adult cells in 1997 changed the symbolic environment for genetic engineering. The ensuing public controversies came to focus mainly on field trials of GM crops and food labeling. This paper will explore the relationship between quality press coverage and public perception, in particular the cultivation of the contrast between "desirable" biomedical (RED) and "undesirable" agri-food (GREEN) biotechnology in Britain. The argument draws on a systematic analysis of the British press coverage of biotechnology from 1973 to 1999 and analysis of public perceptions in 1996 and 1999. The paper concludes that the debate over GM crops and food ingredients fostered the RED-GREEN contrast among the newspaper-reading public, thereby shielding RED biotechnology from public controversy, and ushered in a realignment of the regulatory framework in 2000.

  4. Degenerative spondylolisthesis: review of current trends and controversies.

    Science.gov (United States)

    Sengupta, Dilip K; Herkowitz, Harry N

    2005-03-15

    A literature-based review. To review management and controversies and to present authors recommendations. There is considerable controversy regarding indication for surgery, role for decompression alone, and decompression with fusion with or without instrumentation. Review of English language medical literature. The condition may stabilize itself with the collapse of the disc spaces and osteophytes but may continue to progress in nearly a third of the cases. It may cause predominantly back pain due to segmental instability, or radicular pain/neurogenic claudication secondary to root entrapment or spinal stenosis. When conservative treatment fails, the mainstay of surgical treatment is decompressive laminectomy and fusion, with or without instrumentation. Decompression primarily relieves radicular symptoms and neurogenic claudication whereas fusion primarily relieves back pain by elimination of instability. The goals for instrumentation are to promote fusion and to correct deformity. Fusion has a better long-term outcome than decompression alone. There is evidence that instrumentation improves fusion rate but does not improve clinical outcome in a relatively short-term follow-up. However, outcome of pseudarthrosis cases deteriorates over time and solid fusion produces better long-term outcome. The benefit of instrumentation comes with a price of higher postoperative morbidity and complication rate. Bone morphogenetic proteins are being tried to increase the rate of fusion, without increasing the complication rate, but the cost is prohibitive. More recently, dynamic stabilization with instrumentation but without fusion has been introduced as an alternative treatment. The current trends of surgical treatment and controversies are discussed.

  5. Natural health products that inhibit angiogenesis: a potential source for investigational new agents to treat cancer-Part 2.

    Science.gov (United States)

    Sagar, S M; Yance, D; Wong, R K

    2006-06-01

    The herbalist has access to hundreds of years of observational data on the anticancer activity of many herbs. Laboratory studies are expanding the clinical knowledge that is already documented in traditional texts. The herbs that are traditionally used for anti-cancer treatment and that are anti-angiogenic through multiple interdependent processes (including effects on gene expression, signal processing, and enzyme activities) include Artemisia annua (Chinese wormwood), Viscum album (European mistletoe), Curcuma longa (curcumin), Scutellaria baicalensis (Chinese skullcap), resveratrol and proanthocyanidin (grape seed extract), Magnolia officinalis (Chinese magnolia tree), Camellia sinensis (green tea), Ginkgo biloba, quercetin, Poria cocos, Zingiber officinalis (ginger), Panax ginseng, Rabdosia rubescens hora (Rabdosia), and Chinese destagnation herbs. Natural health products target molecular pathways other than angiogenesis, including epidermal growth factor receptor, the HER2/neu gene, the cyclo-oxygenase-2 enzyme, the nuclear factor kappa-B transcription factor, the protein kinases, the Bcl-2 protein, and coagulation pathways. Quality assurance of appropriate extracts is essential prior to embarking upon clinical trials. More data are required on dose-response, appropriate combinations, and potential toxicities. Given the multiple effects of these agents, their future use for cancer therapy probably lies in synergistic combinations. During active cancer therapy they should generally be evaluated in combination with chemotherapy and radiation. In this role, they act as modifiers of biologic response or as adaptogens, potentially enhancing the efficacy of the conventional therapies or reducing toxicity. Their effectiveness may be increased when multiple agents are used in optimal combinations. New designs for trials to demonstrate activity in human subjects are required. Although controlled trials may be preferable, smaller studies with appropriate endpoints and

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

    Science.gov (United States)

    Beall, Lindsey; Myers, Teresa A; Kotcher, John E; Vraga, Emily K; Maibach, Edward W

    2017-01-01

    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.

  7. 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.

  8. Studies on quinones. Part 45: novel 7-aminoisoquinoline-5,8-quinone derivatives with antitumor properties on cancer cell lines.

    Science.gov (United States)

    Valderrama, Jaime A; Ibacache, J Andrea; Arancibia, Verónica; Rodriguez, Jaime; Theoduloz, Cristina

    2009-04-01

    A variety of 7-aminoisoquinoline-5,8-quinone derivatives were prepared from 2,5-dihydroxyacetophenone, methyl aminocrotonate, and the corresponding amines, through a highly efficient three-step sequence. The members of this series were tested on normal human fibroblasts and on a panel of three human cancer cell lines and their redox properties were determined by cyclic voltammetry in acetonitrile. Both the cytotoxicity and antitumor activity of 7-phenylaminoisoquinoline-5,8-quinone derivatives showed correlation with their half wave potentials and lipophilicities.

  9. 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.

  10. 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 ... adults are melanoma and lymphoma. The most common eye cancer in children is retinoblastoma, which starts in ...

  11. 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 ...

  12. Uterine Cancer

    Science.gov (United States)

    ... it starts, even if it spreads to other body parts later. When cancer starts in the uterus, it is called uterine cancer. The uterus is the pear-shaped organ in a woman’s pelvis (the area below ...

  13. Resveratrol as MDR reversion molecule in breast cancer: An overview.

    Science.gov (United States)

    Alamolhodaei, Nafiseh Sadat; Tsatsakis, Aristidis M; Ramezani, Mohammad; Hayes, A Wallace; Karimi, Gholamreza

    2017-05-01

    Breast cancer is the most common cause of cancer mortality among women worldwide; therefore, a strategy to defeat breast cancer is an extremely important medical issue. One of the major challenges in this regard is multidrug resistance (MDR). Resveratrol, a well-known phytoestrogen, may be helpful as part of an overall strategy to defeat breast cancer. The mixed agonist and antagonist role of resveratrol for the estrogen receptor makes it a controversial but interesting molecule in cancer therapy, especially in hormone dependent cancers. Several in vitro investigations have suggested that resveratrol can reverse multidrug resistance. However, poor bioavailability of resveratrol is a potential limitation for resveratrol treatment and cancer outcome in vivo. Fortunately, combination therapy with other selected compounds improves resveratrol's bioavailability and/or a delay in its metabolism. This review summaries the available published literature dealing with the effects of resveratrol on multidrug resistance in cancer and more specifically, breast cancer. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. 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.

  15. 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

  16. Teaching Controversial Topics to Skeptical High School Students

    Science.gov (United States)

    Ford, K. S.

    2012-12-01

    Tennessee passes the "Monkey Bill" (HB 0368, SB 0893), North Carolina's state government passes a law to criminalize reference in state documents to scientific models that predict sea level rise to reach at least one meter by the next century, and public concern still lags far behind the scientific community's concern on climate change. The American public and even science teachers across the country seem to have lost faith in the ability of the scientific community to unify a strong message about several important scientific lessons, including global warming in particular. This lack of a unified message has weakened the ability of science teachers to effectively teach the lesson of global warming. For science teachers in strongly conservative areas of the country, it is much easier to omit difficult topics and avoid angering parents and school board members. Teachers who do feel strongly about scientifically proven, yet publically controversial topics CAN teach these topics in conservative areas by confirming students' belief systems by being honest and open about motivations surrounding both sides of controversial topics, and by using vocabulary that avoids triggering negative perceptions about these controversial topics. For true learning and change of preconceived opinion to take place, it is important for students to come to the understanding in their own minds in an open and safe learning environment instead of having the message "preached" to them, which only serves to make them feel unintelligent and defensive if they disagree. This presentation will include lessons learned from a practicing science teacher who works in a community that overwhelmingly disputes the validity of human impacts on climate change.

  17. Beyond Controversies: Sexuality Education for Adolescents in India

    Science.gov (United States)

    Khubchandani, Jagdish; Clark, Jeffrey; Kumar, Raman

    2014-01-01

    Sexuality education for adolescents is one of the most controversial topics in the field of child health. In the past decade, policymakers in India have also struggled with the issue and there has been greater public discourse. However, policymaking and public discussions on adolescent sexuality education are frequently fueled by religious, social, and cultural values, while receiving scant scientific attention. To meet the needs of an expanding young population in India, scientific evidence for best practices must be kept at the core of policymaking in the context of sexuality education for adolescents. PMID:25374847

  18. 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.

  19. Controversies on the Publishing of the Newspaper “Curentul”

    Directory of Open Access Journals (Sweden)

    Fănel Teodoraşcu

    2014-06-01

    Full Text Available The emergence of “Curentul” Journal has been enthusiastically welcomed by the readers, this publication bringing a fresh vim to the Romanian inter-war press. Many contemporary journalists have distrustfully considered Pamfil Șeicaru‟s Journal. This “horrendous” journalist was charged by his peers of having sustained this publication with funding provided by the Government. The controversies derived from this subject can be found in the articles and memories of those who knew the director of “Curentul”, but also in the novels which had him as a source of inspiration.

  20. Beyond controversies: Sexuality education for adolescents in India

    Directory of Open Access Journals (Sweden)

    Jagdish Khubchandani

    2014-01-01

    Full Text Available Sexuality education for adolescents is one of the most controversial topics in the field of child health. In the past decade, policymakers in India have also struggled with the issue and there has been greater public discourse. However, policymaking and public discussions on adolescent sexuality education are frequently fueled by religious, social, and cultural values, while receiving scant scientific attention. To meet the needs of an expanding young population in India, scientific evidence for best practices must be kept at the core of policymaking in the context of sexuality education for adolescents.

  1. 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.

  2. Regaining lost youth: the controversial and colorful beginnings of hormone replacement therapy in aging.

    Science.gov (United States)

    Kahn, Arnold

    2005-02-01

    The quest for regaining lost youth seems to have existed since the beginning of recorded history and has taken many forms. One strategy that began in earnest in the latter part of the 19th century and continues to have enormous momentum today is based on the notion that by replacing internally secreted substances, that is, hormones, that decline with age, the vitality and physical attributes associated with youth can be regained. Although the approach remains highly controversial as, for example, in "anti-aging medicine," it is no more controversial than it was many years ago when the work of three high profile investigators, Charles Eduoard Brown-Séquard, Eugen Steinach, and Serge Voronoff set the basis for using this strategy. In the case of all three individuals, the therapies they developed received widespread attention (including ridicule) in the popular press, were spread rapidly by practitioners of questionable training and ethical motivation, and finally and relatively quickly disappeared from common use. However, and ultimately more importantly, in the process of developing and promoting their therapies, these individuals made important contributions to the origins of endocrinology, the biology of sex, and establishment of hormone replacement therapy. It remains to be seen whether contemporary efforts using hormone replacement therapy to blunt and reverse aging have the same fate as their predecessors and make comparable important contributions to biology and medicine.

  3. 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.......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....

  4. Protocol Outlines for Parts 1 and 2 of the Prospective Endoscopy III Study for the Early Detection of Colorectal Cancer

    DEFF Research Database (Denmark)

    Rasmussen, Louise; Wilhelmsen, Michael; Christensen, Ib Jarle

    2016-01-01

    concepts, particularly when combinations of the various components appear to lead to significant improvements. OBJECTIVES: The protocol described in this paper focuses on the validation of concepts based on biomarkers in blood in a major population screened by FIT. METHODS: In Part 1, participants...... sensitivity for detection of participants with non-symptomatic CRC. Therefore, research approaches have been initiated to develop screening concepts based on biomarkers in blood. Preliminary results show that protein, genetic, epigenetic, and metabolomic components may be valuable in blood-based screening...

  5. 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.

  6. Mutation and recombination in pathogen evolution: Relevance, methods and controversies.

    Science.gov (United States)

    Arenas, Miguel; Araujo, Natalia M; Branco, Catarina; Castelhano, Nadine; Castro-Nallar, Eduardo; Pérez-Losada, Marcos

    2017-09-22

    Mutation and recombination drive the evolution of most pathogens by generating the genetic variants upon which selection operates. Those variants can, for example, confer resistance to host immune systems and drug therapies or lead to epidemic outbreaks. Given their importance, diverse evolutionary studies have investigated the abundance and consequences of mutation and recombination in pathogen populations. However, some controversies persist regarding the contribution of each evolutionary force to the development of particular phenotypic observations (e.g., drug resistance). In this study, we revise the importance of mutation and recombination in the evolution of pathogens at both intra-host and inter-host levels. We also describe state-of-the-art analytical methodologies to detect and quantify these two evolutionary forces, including biases that are often ignored in evolutionary studies. Finally, we present some of our former studies involving pathogenic taxa where mutation and recombination played crucial roles in the recovery of pathogenic fitness, the generation of interspecific genetic diversity, or the design of centralized vaccines. This review also illustrates several common controversies and pitfalls in the analysis and in the evaluation and interpretation of mutation and recombination outcomes. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Intravenous fluid administration and controversies in Acid-base.

    Science.gov (United States)

    Story, D A

    1999-06-01

    To present an overview of acidosis following intravenous fluid infusion and to highlight the current controversy in acid-base physiology. Articles and reviews from peer reviewed journals and books on acid-base physiology and post infusion acidosis. Infusion of intravenous fluids can produce an acidosis particularly in the setting of large volume infusion. The explanation of this phenomenon has centred around dilution of plasma bicarbonate. An alternative explanation can be found in the work of Peter Stewart, which highlights the use of strong ion difference in assessing metabolic acidosis. The Stewart approach differs from the traditional Henderson-Hasselbalch approach to acid-base. Further study is required to determine which approach is correct. Solutions containing base anions such as lactate may attenuate such an infusion acidosis. Animal and clinical studies using Hartmann's solution and Plasmalyte 148 support this idea. There is controversy regarding mechanisms in acid-base physiology. The clinical significance of post infusion acidosis is unclear, however use of Hartmann's solution may minimize the acidosis.

  8. 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.

  9. 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.

  10. Communications Contingency Plan: Planning for Crises and Controversy. Phase 1

    Science.gov (United States)

    Treise, Deborah; Bernstein, Arla G.; Yates, Brad

    1998-01-01

    Interviews were conducted with a variety of Marshall Space Flight Center personnel and local media representatives in Huntsville, Alabama, in order to identify the current perceptions of these individuals regarding communication effectiveness between MSFC and the media. The purposes of the Phase One report are to (1) assess the need for a contingency plan for communicating in situations of crisis and controversy; (2) identify goals and objectives for the planning process; and (3) provide recommendations for future planning activities to achieve the goals and objectives outlined in Phase One. It is strongly recommended that MSFC personnel who are involved in communications with the media participate in a facilitated, strategic communications planning process in order to develop Phase Two of the Communications Contingency Plan (CCP). Phase Two will address (1) the categorizing, ranking and prioritizing of crises and controversies; (2) the development of action steps and implementation strategies for the CCP; and (3) the development of a monitoring and evaluation process for ongoing plan effectiveness.

  11. 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.

  12. The acute respiratory distress syndrome network controversy: lessons and legacy.

    Science.gov (United States)

    Silverman, Henry J

    2004-12-01

    Several of the Acute Respiratory Disease Syndrome Network clinical trials embrace a clinical trial design that evaluates contrasting strategies, one or both of which represents only a segment of standard practices. Such a trial design has engendered ethical controversy regarding the value of such trials and their ability to protect human subjects. During the past year, commentators have continued to reflect on the significance of such trials. Several authors have reflected on the ethical significance of the standard of care in clinical trial design and have offered a framework for determining control group selection in critical care trials. Other authors have written on methodologic issues and approaches to determine whether control groups are reflective of standard practices. Surveys have been performed to determine the impact and hence the relevancy of the Acute Respiratory Disease Syndrome Network tidal volume trial on clinical practice. The controversy related to and the impact of the Acute Respiratory Disease Syndrome Network clinical trial design on clinical practice offer an opportunity to explore the trade-offs between explanatory and pragmatic types of clinical trials. Such discussions will lead to a clearer understanding of the value of both types of clinical trials and the optimal ethical conduct of such trials.

  13. Case-Based Teacher Preparation for Teaching Controversial Topics in Middle School

    Science.gov (United States)

    Muth, K. Denise; Polizzi, Nicholas C.; Glynn, Shawn M.

    2007-01-01

    Many middle school teachers are not prepared to develop units and lesson plans on controversial topics. In addition, many are not prepared to respond effectively when controversial topics arise unexpectedly during routine lessons. This is a significant problem because controversial topics are arising with increasing frequency in middle school…

  14. The Clash of Practice: Political Controversy and the United Nations Peacebuilding Commission

    Science.gov (United States)

    Bueger, Christian

    2011-01-01

    Controversy is at the heart of politics. Theories of practice offer a productive way of understanding controversies and potentially negotiating in them. In this paper, drawing on the work of Theodore Schatzki, Michel Callon and Bruno Latour, I introduce a heuristic for understanding controversies. I argue that what is often at stake in…

  15. Long-term survival with surgery as part of a multimodality approach for N3 lung cancer.

    Science.gov (United States)

    Riquet, Marc; Mordant, Pierre; Fabre-Guillevin, Elizabeth; Arame, Alex; Foucault, Christophe; Dujon, Antoine; Le Pimpec Barthes, Françoise

    2013-12-01

    The extension of non-small-cell lung cancer (NSCLC) to supraclavicular (SC) and contralateral (CL) mediastinal lymph nodes is termed N3 and usually forbids surgical resection. However, scarce surgical series have reported encouraging results, and we sought to analyse our experience with this particular subgroup of patients. We retrospectively reviewed the charts of 5857 patients undergoing surgery for NSCLC during the last 30 years in two French centres. Eleven patients presenting with pathological-N3 were found, and more closely analysed concerning lymphatic spread, surgical indication and prognosis. N3 consisted of tumoural extension to the SC (n = 5), CL mediastinal (n = 5) or both (SC + CL, n = 1) stations. Patients underwent induction treatment with chemotherapy alone (n = 4), chemoradiotherapy (n = 3) or first-line surgery (n = 4). All patients underwent a complete surgical resection of the tumour associated with ipsilateral systematic mediastinal lymph node dissection. Additional resection of N3 lymph nodes was performed in 8 cases. Adjuvant treatment included chemoradiotherapy (n = 6), chemotherapy alone (n = 1) or radiation therapy alone (n = 1). All 5 patients with SC-N3 presented with ipsilateral disease; 3 of them survived 5 years. Four patients with CL-N3 presented with left-sided tumour and nodal extension to the 4R station, and none of them survived. Some N3-patients with specific anatomical location may benefit from multimodality treatment including surgery. These results support further prospective studies for selected N3-patients.

  16. Cardiovascular Health, Part 1

    Science.gov (United States)

    Gupta, Sanjaya; Baman, Timir; Day, Sharlene M.

    2009-01-01

    Context: Identification of potentially fatal cardiac conditions in otherwise healthy athletes presents a major challenge to the sports medicine community. The requirements for preparticipation screening vary among countries and even from state to state within the United States. The mandated use of an electrocardiogram as a screening implement has provoked international controversy. Evidence acquisition: Part 1 of this review highlights the current guidelines and controversies surrounding cardiovascular screening, with a focus on the diagnostic challenges associated with identifying athletes with inheritable cardiomyopathies. Data sources were limited to peer-reviewed publications from 1984 to the present. Results: Preparticipation screening should include at least a history and a physical examination for all athletes, whereas use of an electrocardiogram is still controversial. Diagnosis of inherited cardiomyopathies presents unique challenges, particularly in hypertrophic cardiomyopathy, where many features can mimic those found in the “athlete’s heart.” Conclusions: Recognizing cardiac conditions in athletes that can predispose them to sudden cardiac death or other adverse outcomes is of vital importance, as is the appropriate exclusion of these athletes from competition. Further studies are needed to determine the most efficient and cost-effective means of screening and to increase the sensitivity and specificity of diagnostic testing for inheritable cardiovascular diseases. PMID:23015913

  17. Breast Cancer in Young Women: Clinical Decision-Making in the Face of Uncertainty: 1

    National Research Council Canada - National Science Library

    Kathryn J Ruddy; Ann H Partridge

    2009-01-01

      Dr. Peppercorn reviews significant controversies regarding optimal care for young women with breast cancer, emphasizing the fragile balance between maximizing reduction of recurrence risk and minimizing...

  18. 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.

  19. 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.

  20. Controversy undermines support for state mandates on the human papillomavirus vaccine.

    Science.gov (United States)

    Gollust, Sarah E; Dempsey, Amanda F; Lantz, Paula M; Ubel, Peter A; Fowler, Erika Franklin

    2010-11-01

    State actions requiring adolescent girls to receive the human papillomavirus (HPV) vaccine created controversy following the vaccine's approval in 2006. Some health professionals worried that the controversy might dampen public support for those state policies and for other school immunizations in general. We fielded an experimental Internet survey to determine how controversy affects attitudes about vaccines. We discovered that public support for the HPV vaccine mandates wanes when the public is informed that the policies are controversial. However, the experimental survey also revealed that exposure to this policy controversy did not spill over and reduce public support for immunizations in general.

  1. Type 2 diabetes mellitus is associated with increased risk of pancreatic cancer: A veteran administration registry study.

    Science.gov (United States)

    Makhoul, Issam; Yacoub, Abdulraheem; Siegel, Eric

    2016-01-01

    The etiology of pancreatic cancer remains elusive. Several studies have suggested a role for diabetes mellitus, but the magnitude of its contribution remains controversial. Utilizing a large administrative database, this retrospective cohort study was designed to investigate the relationship between type 2 diabetes mellitus and pancreatic cancer. Using the Veterans Integrated Services Network 16 database, 322,614 subjects were enrolled in the study, including 110,919 with type 2 diabetes mellitus and 211,695 diabetes-free controls matched by gender, year of birth and healthcare facility. A significantly higher incidence of pancreatic cancer was observed in patients with type 2 diabetes mellitus, with an adjusted hazard ratio (95% confidence interval) of 2.17 (1.70-2.77) for type 2 diabetes mellitus compared to controls (p type 2 diabetes mellitus and pancreatic cancer was statistically significant and may, in part, explain the rising incidence of pancreatic cancer.

  2. Teaching Controversial Topics in the Humanities and Social Sciences in Ireland: Using Structured Academic Controversy to Develop Multi-Perspectivity in the Learner

    Science.gov (United States)

    Bruen, Jennifer; Crosbie, Veronica; Kelly, Niamh; Loftus, Maria; Maillot, Agnès; McGillicuddy, Áine; Péchenart, Juliette

    2016-01-01

    Purpose: This study had two main objectives: The first was to explore the extent to which a group of University lecturers feel that they are prepared to deal with controversial issues in their classrooms. The second was to elicit their views on a didactic approach known as Structured Academic Controversy (SAC). SAC is a constructivist teaching…

  3. Cancer

    Science.gov (United States)

    ... tobacco uselifestyle choices (such as diet and exercise)family historyfactors in your workplace and environment.How do I know if I am at ... you…Diet Choices to Prevent CancerRead Article >>Healthy Food ChoicesDiet Choices to ... is powered by © 2018 American Academy of Family Physicians

  4. Anticoagulants in cirrhotic patients: controversies and certainties in PVT management.

    Science.gov (United States)

    Ponziani, F R; Zocco, M A; Tortora, A; Gasbarrini, G; Gasbarrini, A

    2011-07-01

    Portal vein thrombosis (PVT) is a relatively common event in patients with advanced-stage liver cirrhosis, even in patients with a compensated disease. Because of the protean clinical manifestation of PVT, ranging from massive variceal bleeding and mesenteric infarction to the complete absence of any symptom, it is mandatory to provide an early diagnosis and a prompt management. However, even if various treatments have been tested in clinical studies, most of them can be suitable only for a limited number of patients and anticoagulants are recognized as the gold standard, even if the debate about their use in PVT management in cirrhotic patients is still opened. In particular, "old" and "new" generations of anticoagulants have always been used carefully and, sometimes, with skepticism or diffidence in cirrhotic patients. In this review, we report the rationale of anticoagulants use in PVT cirrhotic patients management, analyzing the most accepted controversies and certainties, with a particular attention to their possible role as preemptive therapy.

  5. 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

  6. Neural tube defects: recent advances, unsolved questions, and controversies.

    Science.gov (United States)

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

    2013-08-01

    Neural tube defects are severe congenital malformations affecting around one in every 1000 pregnancies. An innovation in clinical management has come from the finding that closure of open spina bifida lesions in utero can diminish neurological dysfunction in children. Primary prevention with folic acid has been enhanced through introduction of mandatory food fortification in some countries, although not yet in the UK. Genetic predisposition accounts for most of the risk of neural tube defects, 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 studies of mouse models of neural tube defects show that anencephaly, open spina bifida, and craniorachischisis result from failure of primary neurulation, whereas skin-covered spinal dysraphism results from defective secondary neurulation. Other malformations, such as encephalocele, are likely to be postneurulation disorders. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Baltimore and the Beginnings of the Fluoride Controversy.

    Science.gov (United States)

    Daws, Steven

    2015-01-01

    The fluoridation of municipal water as a preventive dental health measure has proven to be a contentious issue from its very outset. In 1952, Baltimore became the first major city in the United States to artificially add fluoride to its water supply. This study draws largely on print media sources as a means of discerning public sentiment, in order to evaluate the nature of Baltimore's fluoride controversy in its infancy. Initial response was influenced by prior exposure to the substance within the context of dentistry, as well as a continued trend of conservatism within the community. Logistical issues during implementation due to the necessary upscale of established practices to accommodate Baltimore's population served to further exacerbate concerns. Much of the opposition was predicated on the breadth of the measure, as evidenced by the myriad of personal concerns put forth in objection. Personal concerns developed into demands for personal autonomy, providing a philosophical foundation for the anti-fluoridation movement that persists today.

  8. Controversial Aspects of Innovative Trends of Vocational Pedagogic Education

    Directory of Open Access Journals (Sweden)

    E. F. Zeyer

    2015-03-01

    Full Text Available The paper discusses the controversial theoretical and practical aspects of vocational pedagogical education, its target orientation and distinction from the general pedagogical education. The authors propose the heuristic model of professional educational environment as the methodology basis for fostering the vocational teacher training; the model involves the synergy principle and includes the three coordinate vectors: human subjects of the above environment, continuing vocational education, and professional world. The paper provides the comparative paradigm analysis of traditional and innovative advanced education, and traces the logic of innovative achievements and their implementation in educational practice. The author regards the interdisciplinary education as the main factor improving the effectiveness of innovative education, and suggests the project method as a means for integrating the disciplines and developing the interdisciplinary competence. In conclusion, the author emphasizes the need for updating the vocational pedagogical education by consolidated efforts of scientists and practicing teachers. 

  9. Verrucous lymphovascular malformation versus verrucous hemangioma: controversial nomenclature.

    Science.gov (United States)

    Brown, Allison; Warren, Simon; Losken, H Wolfgang; Morrell, Dean S

    2008-05-01

    The International Society for the Study of Vascular Anomalies (ISSVA) divides congenital vascular anomalies into malformations and tumors and subclassified hemangiomas under tumors. However, evidence shows this accepted classification has not been widely employed. Particularly troublesome is the use of the term hemangioma, commonly used to describe a variety of vascular lesions (both malformations and tumors). The term verrucous hemangioma has been used to describe a congenital vascular anomaly with a progressive verrucous epidermal surface persisting throughout life unless surgically excised. Recent evidence suggests that some of these lesions may share histologic features of both hemangiomas and malformations, thereby causing nosologic confusion. We report a 15-year-old adolescent girl with such a lesion and review the literature and controversy of verrucous hemangiomas. In our case, the most appropriate diagnosis is verrucous lymphovascular malformation. Further testing of similar lesions will be necessary to fully understand the nature and classification of these lesions.

  10. Resolving controversy of unusually high refractive index of a tubulin

    Science.gov (United States)

    Krivosudský, O.; Dráber, P.; Cifra, M.

    2017-02-01

    The refractive index of a tubulin is an important parameter underlying fundamental electromagnetic and biophysical properties of microtubules - protein fibers essential for several cell functions including cell division. Yet, the only experimental data available in the current literature show values of the tubulin refractive index (n=2.36\\text{--}2.90) which are much higher than what the established theories predict based on the weighted contribution of the polarizability of individual amino acids constituting the protein. To resolve this controversy, we report here modeling and rigorous experimental analysis of the refractive index of a purified tubulin dimer. Our experimental data revealed that the refractive index of the tubulin is n=1.64 at wavelength 589 nm and 25 °C, that is much closer to the values predicted by the established theories than what the earlier experimental data provide.

  11. Nervous system lyme disease: is there a controversy?

    Science.gov (United States)

    Halperin, John J

    2011-07-01

    Infection with the tick-borne spirochete, BORRELIA BURGDORFERI, affects the nervous system in well-defined ways. Accurate diagnostic tools and effective therapeutic regimens are now well established. Persistent misconceptions about (1) the role and interpretation of laboratory tests, (2) what is and is not evidence of nervous system infection, and (3) what constitutes an expected response to treatment have fostered widespread perceptions that this disease is highly controversial. Infection causes the classically described triad of meningitis, radiculoneuritis, and cranial neuritis; however, virtually every known neurologic disorder has been blamed on this infection. For most (multiple sclerosis, amyotrophic lateral sclerosis, Alzheimer disease, Parkinson disease), evidence is scant, nonexistent, or coincidental. For some (cerebral vasculitis with stroke, optic neuritis) a few case reports suggest a rare possible causal link. © Thieme Medical Publishers.

  12. 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.

  13. 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

    2016-03-01

    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.

  14. 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...

  15. 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.

  16. [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.

  17. 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)

  18. Controversies surrounding critical illness-related corticosteroid insufficiency in animals.

    Science.gov (United States)

    Creedon, Jamie M Burkitt

    2015-01-01

    To describe the controversies surrounding critical illness-related corticosteroid insufficiency (CIRCI) and the use of hydrocortisone in critically ill patients, and to present published diagnostic and therapeutic strategies in companion veterinary species. Critical illness-related corticosteroid insufficiency may be due to hypothalamic-pituitary-adrenal (HPA) axis dysfunction, alterations in cortisol-plasma protein binding, target cell enzymatic changes, changes in glucocorticoid receptor (GR) function, or a combination of these or other factors present during critical illness. Appropriate tests to diagnose CIRCI are unknown. The diagnosis in people is currently based on response to treatment with hydrocortisone. There is currently no consensus on appropriate diagnostic feature(s) in veterinary species. Low-dose hydrocortisone is the treatment of choice for patients with CIRCI. If the patient survives the critical illness, prognosis for resolution of CIRCI and hydrocortisone dependence is very good. © Veterinary Emergency and Critical Care Society 2014.

  19. 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.

  20. Management Controversies in Head and Neck Melanoma: A Systematic Review.

    Science.gov (United States)

    Zenga, Joseph; Nussenbaum, Brian; Cornelius, Lynn A; Linette, Gerald P; Desai, Shaun C

    2017-01-01

    Head and neck melanoma is one of the leading causes of death in the United States and is currently increasing in prevalence. While there is a tremendous amount of research published on melanoma, the actual evidence for complex clinical decision-making can be difficult to interpret and to stay up-to-date on current clinical standards. To address, in a systematic and evidence-based approach, the most common clinical controversies with regard to the workup and management of head and neck melanoma. A PubMed and Medline search was performed of the entire English literature with respect to head and neck melanoma. Priority of review was given to those studies with higher-quality levels of evidence. Main topics reviewed in this article include workup for new melanoma, surgical treatment of the primary site, surgical treatment of the neck, adjuvant radiation therapy, and systemic therapy. Levels of evidence are used for each controversial clinical question to help the clinician understand the reliability of the current evidence when making complex clinical decisions for melanoma management of the head and neck. However, much of the work done in melanoma, particularly large randomized clinical trials, includes many other regions of the body. Therefore, these data must be interpreted in light of the potential differences in clinical behavior and draining lymphatics between trunk, limbs, and head and neck subsites. The management of head and neck melanoma requires a multidisciplinary approach, particularly for advanced-stage disease. An in-depth knowledge of the current evidence available will help guide the surgeon in the management of this difficult disease.

  1. Protocol Outlines for Parts 1 and 2 of the Prospective Endoscopy III Study for the Early Detection of Colorectal Cancer: Validation of a Concept Based on Blood Biomarkers.

    Science.gov (United States)

    Rasmussen, Louise; Wilhelmsen, Michael; Christensen, Ib Jarle; Andersen, Jens; Jørgensen, Lars Nannestad; Rasmussen, Morten; Hendel, Jakob W; Madsen, Mogens R; Vilandt, Jesper; Hillig, Thore; Klærke, Michael; Münster, Anna-Marie Bloch; Andersen, Lars M; Andersen, Berit; Hornung, Nete; Erlandsen, Erland J; Khalid, Ali; Nielsen, Hans Jørgen

    2016-09-13

    Programs for population screening of colorectal cancer (CRC) have been implemented in several countries with fecal immunochemical testing (FIT) as the preferred platform. However, the major obstacle for a feces-based testing method is the limited compliance that reduces the clinical sensitivity for detection of participants with non-symptomatic CRC. Therefore, research approaches have been initiated to develop screening concepts based on biomarkers in blood. Preliminary results show that protein, genetic, epigenetic, and metabolomic components may be valuable in blood-based screening concepts, particularly when combinations of the various components appear to lead to significant improvements. The protocol described in this paper focuses on the validation of concepts based on biomarkers in blood in a major population screened by FIT. In Part 1, participants will be identified and included through the Danish CRC Screening Program comprising initial FIT and subsequent colonoscopy to those with a positive result. Blood samples will be collected from 8000 FIT-positive participants, who are offered subsequent colonoscopy. Findings and interventions at colonoscopy together with personal data including co-morbidity will be recorded. Blood samples and data will also be collected from 6000 arbitrarily chosen participants with negative FIT. In Part 2, blood samples and data will be collected from 30,000 FIT-negative participants three times within 4 years. The blood samples will be analyzed using various in-house and commercially available manual and automated analysis platforms. We anticipate Part 1 to terminate late August 2016 and Part 2 to terminate late September 2022. The results from Parts 1 and 2 will be presented within 12 to 18 months from termination. The purpose of this study is to improve the efficacy of identifying participants with neoplastic bowel lesions, to identify false negative participants, to identify participants at risk of interval neoplastic lesions

  2. 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 ...

  3. Urothelial Carcinoma Stem Cells: Current Concepts, Controversies, and Methods.

    Science.gov (United States)

    Hatina, Jiri; Parmar, Hamendra Singh; Kripnerova, Michaela; Hepburn, Anastasia; Heer, Rakesh

    2018-01-01

    Cancer stem cells are defined as a self-renewing and self-protecting subpopulation of cancer cells able to differentiate into morphologically and functionally diverse cancer cells with a limited lifespan. To purify cancer stem cells, two basic approaches can be applied, the marker-based approach employing various more of less-specific cell surface marker molecules and a marker-free approach largely based on various self-protection mechanisms. Within the context of urothelial carcinoma, both methods could find use. The cell surface markers have been mainly derived from the urothelial basal cell, a probable cell of origin of muscle-invasive urothelial carcinoma, with CD14, CD44, CD90, and 67LR representing successful examples of this strategy. The marker-free approaches involve side population sorting, for which a detailed protocol is provided, as well as the Aldefluor assay, which rely on a specific overexpression of efflux pumps or the detoxification enzyme aldehyde dehydrogenase, respectively, in stem cells. These assays have been applied to both non-muscle-invasive and muscle-invasive bladder cancer samples and cell lines. Urothelial carcinoma stem cells feature a pronounced heterogeneity as to their molecular stemness mechanisms. Several aspects of urothelial cancer stem cell biology could enter translational development rather soon, e.g., a specific CD44(+)-derived gene expression signature able to identify non-muscle-invasive bladder cancer patients with a high risk of progression, or deciphering a mechanism responsible for repopulating activity of urothelial carcinoma stem cells within the context of therapeutic resistance.

  4. What ethical and legal principles should guide the genotyping of children as part of a personalised screening programme for common cancer?

    Science.gov (United States)

    Hall, Alison Elizabeth; Chowdhury, Susmita; Pashayan, Nora; Hallowell, Nina; Pharoah, Paul; Burton, Hilary

    2014-03-01

    Increased knowledge of the gene-disease associations contributing to common cancer development raises the prospect of population stratification by genotype and other risk factors. Individual risk assessments could be used to target interventions such as screening, treatment and health education. Genotyping neonates, infants or young children as part of a systematic programme would improve coverage and uptake, and facilitate a screening package that maximises potential benefits and minimises harms including overdiagnosis. This paper explores the potential justifications and risks of genotyping children for genetic variants associated with common cancer development within a personalised screening programme. It identifies the ethical and legal principles that might guide population genotyping where the predictive value of the testing is modest and associated risks might arise in the future, and considers the standards required by population screening programme validity measures (such as the Wilson and Jungner criteria including cost-effectiveness and equitable access). These are distinguished from the normative principles underpinning predictive genetic testing of children for adult-onset diseases-namely, to make best-interests judgements and to preserve autonomy. While the case for population-based genotyping of neonates or young children has not yet been made, the justifications for this approach are likely to become increasingly compelling. A modified evaluative and normative framework should be developed, capturing elements from individualistic and population-based approaches. This should emphasise proper communication and genuine parental consent or informed choice, while recognising the challenges associated with making unsolicited approaches to an asymptomatic group. Such a framework would be strengthened by complementary empirical research.

  5. Interference with endogenous EZH2 reverses the chemotherapy drug resistance in cervical cancer cells partly by up-regulating Dicer expression.

    Science.gov (United States)

    Cai, Liqiong; Wang, Zehua; Liu, Denghua

    2016-05-01

    Cervical cancer is one of the most common female malignancies in the world, and chemotherapeutic drug resistance is a major obstacle to cancer therapy. Enhancer of zeste homolog 2 (EZH2) is an enzymatic subunit of polycomb repressive complex 2 (PRC2) and catalyzes the repressive histone H3 lysine 27 trimethylation (H3K27me3). However, the role of EZH2 on the chemotherapy drug resistance in cervical cancers remains unclear. In the present study, the cervical carcinoma specimens and paired normal tissue specimens were obtained and the expression of EZH2 was detected by western blotting. The results showed that high levels of EZH2 were detected in cervical carcinoma tissues, compared with paired control tissues (**p EZH2 were designed and used to interfere with endogenous EZH2 expression. Cell viability was assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assays following treatment with various concentrations of cisplatin in HeLa and HeLa/DDP cells. The MTT assay results showed that knockdown of EZH2 in HeLa/DDP cells caused a 2.29- or 1.83-fold decrease in the cisplatin IC50 values (for shRNA1-EZH2, 34.88 vs. 15.21 μg/mL; p EZH2, 34.88 vs. 19.09 μg/mL; p EZH2 activity was also suppressed by 3-deazaneplanocin A (DZNep), EZH2 inhibitor, and the results demonstrated that, meanwhile, DZNep potently inhibited cell viability of HeLa/DDP cells, partly by suppression the levels of EZH2 and H3K27me3, but not H3K27me2, which was detected by western blotting analysis. Moreover, cell migration assay results showed that knockdown of EZH2 decreased cell metastasis of cervical cancer cells. Furthermore, cell cycle was detected by fluorescence-activated cell sorting (FACS) assay and the results demonstrated that interference with EZH2 expression increased the percentage of cells at G0/G1 phase and the HeLa/DDP cells were blocked at G0/G1 phase. Interestingly, western blotting results revealed that higher expression of EZH2 was related with

  6. Return to the Rural Environment in Contemporary Sociology. Theories and controversies

    Directory of Open Access Journals (Sweden)

    IOANA PETRE

    2008-03-01

    Full Text Available The study is a synthetic presentation of the main theoretical trends in contemporary sociology with respect to the rural environment and rurality, starting with the conceptual mapping of the main representations of rurality, structured on three main types of discourse: sociological, social and political. The first part is dedicated to arguments justifying from a scientific and practical perspective the need of returning to the preoccupation for the evolution of rural communities in contemporary society. As such, against the background of the unprecedented degradation of the quality of life in the urban environment (dominant in a large part of the world, nature and life in the rural environment become increasingly important values. Valuing or revaluing the rural environment (the return to the village and the values thereof occurs both in real life and in reflexive thought, inclusively in sociology. The second part of the work places in contrast two main trends of contemporary rural sociology, starting especially from the European intellectual tradition, the French one in particular. This is the controversy between H. Mendras and M. Jollivet, two great personalities of the French and international rural sociology, which mainly developed around two works of rural sociology published in 1971 and 1976: the theory of peasantry, created by Mendras, formed around the conceptual trilogy: "sauvage", "paysans" and "agriculteurs" is seen by Jollivet as a simplistic evolutionist sketch.

  7. A controversial idea as a cultural resource: The Lysenko controversy and discussions of genetics as a 'democratic' science in postwar Japan.

    Science.gov (United States)

    Iida, Kaori

    2015-08-01

    The Japanese discussion of the theory of Soviet agronomist Trofim D. Lysenko began in the postwar years under the American occupation. Leftists introduced Lysenko's theory immediately after the war as part of a postwar scientists' movement. Unlike many American geneticists, who sharply criticized the theory, Japanese geneticists initially participated in the discussion in an even-handed way; their scientific interests in the roles of cytoplasm and the environment in heredity shaped their initial sympathetic reaction. As the Cold War divide deepened, however, Japanese scientists began expressing sharp anti-Lysenko criticisms that resembled the American criticisms. Interestingly, throughout the period, Japanese geneticists' overall aim in the discussion remained largely unchanged: to effectively reconstruct their discipline and maintain its proper image and authority. However, the shift in their reaction occurred due to an evolving sociopolitical context, especially the shift in the meaning of 'democratic' science from a science that employed democratic processes to a science of a liberal-democratic state. Regarding Lysenko's idea as a cultural resource could help to explain how and why it was treated differently in different places, and why a controversy emerged in certain contexts but not in others.

  8. 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

  9. 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; Bensadoun, René-Jean

    2016-06-01

    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. Narrative review and presentation of PBM parameters are based on current evidence and expert opinion. 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/cm(2)), and no more than 6 J/cm(2) 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. PBM may have a role in supportive care for a broad range of complications associated with the treatment of HNC with CRT. The suggested PBM irradiation

  10. The Changing World of Breast Cancer

    Science.gov (United States)

    Kuhl, Christiane K.

    2015-01-01

    Abstract Compared with other fields of medicine, there is hardly an area that has seen such fast development as the world of breast cancer. Indeed, the way we treat breast cancer has changed fundamentally over the past decades. Breast imaging has always been an integral part of this change, and it undergoes constant adjustment to new ways of thinking. This relates not only to the technical tools we use for diagnosing breast cancer but also to the way diagnostic information is used to guide treatment. There is a constant change of concepts for and attitudes toward breast cancer, and a constant flux of new ideas, new treatment approaches, and new insights into the molecular and biological behavior of this disease. Clinical breast radiologists and even more so, clinician scientists, interested in breast imaging need to keep abreast with this rapidly changing world. Diagnostic or treatment approaches that are considered useful today may be abandoned tomorrow. Approaches that seem irrelevant or far too extravagant today may prove clinically useful and adequate next year. Radiologists must constantly question what they do, and align their clinical aims and research objectives with the changing needs of contemporary breast oncology. Moreover, knowledge about the past helps better understand present debates and controversies. Accordingly, in this article, we provide an overview on the evolution of breast imaging and breast cancer treatment, describe current areas of research, and offer an outlook regarding the years to come. PMID:26083829

  11. Climate change, vector-borne disease and interdisciplinary research: social science perspectives on an environment and health controversy.

    Science.gov (United States)

    Brisbois, Ben W; Ali, S Harris

    2010-12-01

    Over the last two decades, the science of climate change's theoretical impacts on vector-borne disease has generated controversy related to its methodological validity and relevance to disease control policy. Critical social science analysis, drawing on science and technology studies and the sociology of social movements, demonstrates consistency between this controversy and the theory that climate change is serving as a collective action frame for some health researchers. Within this frame, vector-borne disease data are interpreted as a symptom of climate change, with the need for further interdisiplinary research put forth as the logical and necessary next step. Reaction to this tendency on the part of a handful of vector-borne disease specialists exhibits characteristics of academic boundary work aimed at preserving the integrity of existing disciplinary boundaries. Possible reasons for this conflict include the leadership role for health professionals and disciplines in the envisioned interdiscipline, and disagreements over the appropriate scale of interventions to control vector-borne diseases. Analysis of the competing frames in this controversy also allows identification of excluded voices and themes, such as international political economic explanations for the health problems in question. A logical conclusion of this analysis, therefore, is the need for critical reflection on environment and health research and policy to achieve integration with considerations of global health equity.

  12. 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

  13. Medullary Thyroid Carcinoma – Update and Present Management Controversies

    Science.gov (United States)

    Al-Rawi, Mahir; Wheeler, Malcolm H

    2006-01-01

    INTRODUCTION Medullary thyroid carcinoma (MTC) is a rare thyroid malignancy arising from the parafollicular C cells. It accounts for 5–10% of thyroid malignancies and occurs in sporadic and hereditary forms. There are still many controversial aspects relating to the diagnosis and management of this unusual tumour in its various forms. The present article addresses the more important of these issues. METHODS A literature review was performed using Pubmed database combined with additional original papers obtained from citations in those articles identified in the original literature search. Only those articles which related specifically to the controversial issues addressed in this review were included. RESULTS Genetically determined tumours constitute approximately 25% of MTC and have special clinical interest because of their association with other endocrinopathies including phaeochromocytoma and hyperparathyroidism in the multiple endocrine neoplasia syndromes (MEN IIa and MEN IIb). Familial medullary thyroid carcinoma (FMTC) is a rare form not associated with any other endocrinopathies. The genetic basis for these familial tumours derives from a series of missense germline mutations in the RET proto-oncogene. Genetic testing by DNA analysis facilitates identification of family members at risk who can now be offered early ‘prophylactic thyroidectomy’ with an increased prospect of surgical success and long-term survival. MTC is a tumour which does not take up radioactive iodine, is relatively radioresistant and poorly responsive to chemotherapy. Therefore, surgery is the only treatment which can offer the prospect of cure. Total thyroidectomy with central and lateral nodal dissection can achieve biochemical cure (normocalcitonaemia) in more than 80% of cases. Compartmental orientated microdissection of cervical nodes has significantly improved the results of primary surgery but even so a group of 20% of patients will prove to have recurrent or residual

  14. Medullary thyroid carcinoma--update and present management controversies.

    Science.gov (United States)

    Al-Rawi, Mahir; Wheeler, Malcolm H

    2006-09-01

    Medullary thyroid carcinoma (MTC) is a rare thyroid malignancy arising from the parafollicular C cells. It accounts for 5-10% of thyroid malignancies and occurs in sporadic and hereditary forms. There are still many controversial aspects relating to the diagnosis and management of this unusual tumour in its various forms. The present article addresses the more important of these issues. A literature review was performed using Pubmed database combined with additional original papers obtained from citations in those articles identified in the original literature search. Only those articles which related specifically to the controversial issues addressed in this review were included. Genetically determined tumours constitute approximately 25% of MTC and have special clinical interest because of their association with other endocrinopathies including phaeochromocytoma and hyperparathyroidism in the multiple endocrine neoplasia syndromes (MEN IIa and MEN IIb). Familial medullary thyroid carcinoma (FMTC) is a rare form not associated with any other endocrinopathies. The genetic basis for these familial tumours derives from a series of missense germline mutations in the RET protooncogene. Genetic testing by DNA analysis facilitates identification of family members at risk who can now be offered early 'prophylactic thyroidectomy' with an increased prospect of surgical success and long-term survival. MTC is a tumour which does not take up radioactive iodine, is relatively radioresistant and poorly responsive to chemotherapy. Therefore, surgery is the only treatment which can offer the prospect of cure. Total thyroidectomy with central and lateral nodal dissection can achieve biochemical cure (normocalcitonaemia) in more than 80% of cases. Compartmental orientated microdissection of cervical nodes has significantly improved the results of primary surgery but even so a group of 20% of patients will prove to have recurrent or residual disease. These cases require detailed

  15. 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....

  16. The use of uHear™ to screen for hearing loss in older patients with cancer as part of a comprehensive geriatric assessment.

    Science.gov (United States)

    Lycke, Michelle; Debruyne, Philip R; Lefebvre, Tessa; Martens, Evi; Ketelaars, Lore; Pottel, Hans; Van Eygen, Koen; Derijcke, Sofie; Werbrouck, Patrick; Vergauwe, Philippe; Stellamans, Karin; Clarysse, Philippe; Dhooge, Ingeborg; Schofield, Patricia; Boterberg, Tom

    2017-10-24

    We previously validated uHear™ to screen for hearing loss in older patients with cancer without a known hearing loss, as part of a comprehensive geriatric assessment (CGA). In view of low specificity, we tested a new modified uHear™ scoring system as described by Handzel. Patients, aged ≥70 years, were evaluated by uHear™ and conventional audiometry, which is considered the gold standard, as part of a CGA. The pass or fail screening cut-off for uHear™ was defined as having ≥2 consecutive hearing grades starting from the moderate-severe threshold zone ranging from 0.5 to 2.0 kHz (modified Handzel-uHear™ scoring system). To accept the modified Handzel-uHear™ as screening tool, it was predefined that the combined sensitivity (S) and specificity (Sp) of the test (S + Sp/2) was at least 80% and that an actual combined (S + Sp)/2 of 90% would be found. Ninety ears (45 subjects) were tested. Of those ears, 24.4% were identified as impaired by conventional audiometry. Modified Handzel-uHear™ identified 26.7% of tested ears as impaired. The combined (S + Sp)/2 of the modified Handzel-uHear™ was calculated as 77.5%, while in previous cohort, this was retrospectively calculated as 94.6%. A new uHear™ scoring system was proposed and tested in current and previous cohort. A (S + Sp)/2 of 80.2 and 78.8%, respectively, were obtained. uHear™ is a feasible tool for use within the CGA and shows promising results. However, further research is warranted to optimize the cut-off method before it could be routinely implemented within geriatric oncology.

  17. Controversies in modern evolutionary biology: the imperative for error detection and quality control.

    Science.gov (United States)

    Prosdocimi, Francisco; Linard, Benjamin; Pontarotti, Pierre; Poch, Olivier; Thompson, Julie D

    2012-01-04

    The data from high throughput genomics technologies provide unique opportunities for studies of complex biological systems, but also pose many new challenges. The shift to the genome scale in evolutionary biology, for example, has led to many interesting, but often controversial studies. It has been suggested that part of the conflict may be due to errors in the initial sequences. Most gene sequences are predicted by bioinformatics programs and a number of quality issues have been raised, concerning DNA sequencing errors or badly predicted coding regions, particularly in eukaryotes. We investigated the impact of these errors on evolutionary studies and specifically on the identification of important genetic events. We focused on the detection of asymmetric evolution after duplication, which has been the subject of controversy recently. Using the human genome as a reference, we established a reliable set of 688 duplicated genes in 13 complete vertebrate genomes, where significantly different evolutionary rates are observed. We estimated the rates at which protein sequence errors occur and are accumulated in the higher-level analyses. We showed that the majority of the detected events (57%) are in fact artifacts due to the putative erroneous sequences and that these artifacts are sufficient to mask the true functional significance of the events. Initial errors are accumulated throughout the evolutionary analysis, generating artificially high rates of event predictions and leading to substantial uncertainty in the conclusions. This study emphasizes the urgent need for error detection and quality control strategies in order to efficiently extract knowledge from the new genome data. © 2012 Prosdocimi et al; licensee BioMed Central Ltd.

  18. Gastric Cancer Screening

    OpenAIRE

    Ayala Acosta, Juan Carlos; Pontificia Universidad Javeriana; Lotero Gómez, Juan David; Pontificia Universidad Javeriana

    2012-01-01

    Gastric cancer is the fourth most common cancer worldwide and is the second leading cause of cancer mortality in the world, being more common in developing countries. An early detection of the disease and an early treatment are key strategies to reduce mortality. in this review will present recent data regarding epidemiology and the most effective methods for screening of gastric cancer, which remain subject to review and ongoing controversy in the world due to the emergence of new techniques...

  19. RESOLVING VEGA AND THE INCLINATION CONTROVERSY WITH CHARA/MIRC

    Energy Technology Data Exchange (ETDEWEB)

    Monnier, J. D.; Che Xiao; Baron, F.; Kraus, S. [Astronomy Department, University of Michigan (Astronomy), 500 Church St, Ann Arbor, MI 48109 (United States); Zhao Ming [Department of Astronomy and Astrophysics, Pennsylvania State University, University Park, PA 16802 (United States); Ekstroem, S. [Geneva Observatory, University of Geneva, Maillettes 51, 1290, Sauverny (Switzerland); Maestro, V.; Tuthill, P. G. [Sydney Institute for Astronomy (SIfA), School of Physics, University of Sydney, NSW 2006 (Australia); Aufdenberg, Jason [Physical Sciences Department, Embry-Riddle Aeronautical University, Daytona Beach, FL 32114 (United States); Georgy, C. [Centre de Recherche Astrophysique, Ecole Normale Superieure de Lyon, F-69384 Lyon cedex 07 (France); McAlister, H.; Sturmann, J.; Sturmann, L.; Ten Brummelaar, T.; Turner, N. [The CHARA Array of Georgia State University, Mt. Wilson, CA, 91023 (United States); Pedretti, E. [The Scottish Association for Marine Science, Dunstaffnage, Oban, Argyll PA37 1QA (United Kingdom); Ridgway, S. [National Optical Astronomy Observatory, 950 N. Cherry Ave, Tucson AZ 85719 (United States); Thureau, N., E-mail: monnier@umich.edu [Department of Physics and Astronomy, University of St. Andrews (United Kingdom)

    2012-12-10

    Optical and infrared interferometers definitively established that the photometric standard Vega (={alpha} Lyrae) is a rapidly rotating star viewed nearly pole-on. Recent independent spectroscopic analyses could not reconcile the inferred inclination angle with the observed line profiles, preferring a larger inclination. In order to resolve this controversy, we observed Vega using the six-beam Michigan Infrared Combiner on the Center for High Angular Resolution Astronomy Array. With our greater angular resolution and dense (u, v)-coverage, we find that Vega is rotating less rapidly and with a smaller gravity darkening coefficient than previous interferometric results. Our models are compatible with low photospheric macroturbulence and are also consistent with the possible rotational period of {approx}0.71 days recently reported based on magnetic field observations. Our updated evolutionary analysis explicitly incorporates rapid rotation, finding Vega to have a mass of 2.15{sup +0.10}{sub -0.15} M{sub Sun} and an age 700{sup -75}{sub +150} Myr, substantially older than previous estimates with errors dominated by lingering metallicity uncertainties (Z = 0.006{sup +0.003}{sub -0.002}).

  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. 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.

  2. 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.

  3. Is alveolar cleft reconstruction still controversial? (Review of literature).

    Science.gov (United States)

    Seifeldin, Sameh A

    2016-01-01

    Cleft lip and palate (CL/P) is a frequent congenital malformation that manifests in several varieties including unilateral or bilateral and complete or incomplete. Alveolar cleft reconstruction remains controversial with regard to timing, graft materials, surgical techniques, and methods of evaluation. Many studies have been conducted addressing these points to develop an acceptable universal protocol for managing CL/P. The primary goal of alveolar cleft reconstruction in CL/P patients is to provide a bony bridge at the cleft site that allows maxillary arch continuity, oronasal fistula repair, eruption of the permanent dentition into the newly formed bone, enhances nasal symmetry through providing alar base support, orthodontic movement and placement of osseointegrated implants when indicated. Other goals include improving speech, improvement of periodontal conditions, establishing better oral hygiene, and limiting growth disturbances. In order to rehabilitate oral function in CL/P patients alveolar bone grafting is necessary. Secondary bone grafting is the most widely accepted method for treating alveolar clefts. Autogenous bone graft is the primary source for reconstructing alveolar cleft defects and is currently the preferred grafting material.

  4. Is alveolar cleft reconstruction still controversial? (Review of literature

    Directory of Open Access Journals (Sweden)

    Sameh A. Seifeldin

    2016-01-01

    Full Text Available Cleft lip and palate (CL/P is a frequent congenital malformation that manifests in several varieties including unilateral or bilateral and complete or incomplete. Alveolar cleft reconstruction remains controversial with regard to timing, graft materials, surgical techniques, and methods of evaluation. Many studies have been conducted addressing these points to develop an acceptable universal protocol for managing CL/P. The primary goal of alveolar cleft reconstruction in CL/P patients is to provide a bony bridge at the cleft site that allows maxillary arch continuity, oronasal fistula repair, eruption of the permanent dentition into the newly formed bone, enhances nasal symmetry through providing alar base support, orthodontic movement and placement of osseointegrated implants when indicated. Other goals include improving speech, improvement of periodontal conditions, establishing better oral hygiene, and limiting growth disturbances. In order to rehabilitate oral function in CL/P patients alveolar bone grafting is necessary. Secondary bone grafting is the most widely accepted method for treating alveolar clefts. Autogenous bone graft is the primary source for reconstructing alveolar cleft defects and is currently the preferred grafting material.

  5. Controversies and challenges in the management of chronic urticaria.

    Science.gov (United States)

    Staubach, P; Zuberbier, T; Vestergaard, C; Siebenhaar, F; Toubi, E; Sussman, G

    2016-07-01

    This supplement reports proceedings of the second international Global Urticaria Forum, which was held in Berlin, Germany in November 2015. Despite the clear international guideline, there remain a number of controversies and challenges in the management of patients with chronic urticaria (CU). As a result of major advancements in urticaria over the past 4 years, the current EAACI/GA(2) LEN/EDF/WAO urticaria guideline treatment algorithm requires updating. Case studies from patients with chronic spontaneous urticaria (CSU) [also called chronic idiopathic urticaria (CIU)], chronic inducible urticaria (CIndU) or diseases and syndromes related to CU are useful in describing and exploring challenges in disease management. Case studies of specific CSU patient populations such as children with CU or patients with angio-edema but no hives also require consideration as potentially challenging groups with unmet needs. The current EAACI/GA(2) LEN/EDF/WAO urticaria guideline provides a general framework for the management of patients with CU but, as these cases highlight, a personalized approach based on the expert knowledge of the physician may be required. © 2016 European Academy of Dermatology and Venereology.

  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. 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

  8. 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.

  9. 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.

  10. Gender dysphoria and the controversy over the Safe Schools program.

    Science.gov (United States)

    Parkinson, Patrick

    2017-05-30

    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.

  11. Controversial Issues in Kyphoplasty and Vertebroplasty in Osteoporotic Vertebral Fractures

    Science.gov (United States)

    Papanastassiou, Ioannis D.; Filis, Andreas; Gerochristou, Maria A.; Vrionis, Frank D.

    2014-01-01

    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. PMID:24724106

  12. 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.

  13. Stakeholders' Views on Barriers to Research on Controversial Controlled Substances.

    Science.gov (United States)

    Rhodes, Evelyn; Andreae, Michael; Bourgiose, Tyler; Indyk, Debbie; Rhodes, Rosamond; Sacks, Henry

    2016-01-01

    Many diseases and disease symptoms still lack effective treatment. At the same time, certain controversial Schedule I drugs, such as heroin and cannabis, have been reputed to have considerable therapeutic potential for addressing significant medical problems. Yet, there is a paucity of U.S. clinical studies on the therapeutic uses of controlled drugs. For example, people living with HIV/AIDS experience a variety of disease- and medication-related symptoms. Their chronic pain is intense, frequent, and difficult to treat. Nevertheless, clinical trials of compassionate management for their chronic symptoms, which should be a research priority, are stymied. We employed qualitative methods to develop an understanding of the barriers to research on potential therapeutic uses of Schedule I drugs so that they might be addressed. We elicited the perspectives of key stakeholder groups that would be involved in such studies: people living with HIV/AIDS, clinicians, and members of institutional review boards. As we identified obstacles to research, we found that all of the stakeholder groups arrived at the same conclusion, that clinical research on the therapeutic potential of these drugs is ethically required. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.

  14. Controversies in omega-3 efficacy and novel concepts for application

    Directory of Open Access Journals (Sweden)

    J.E. Radcliffe

    2016-09-01

    Full Text Available Interest in the cardioprotective effects of long chain omega-3 polyunsaturated fatty acids (LCn3 was largely influenced by the low rates of cardiovascular disease (CVD amongst the Inuits of Greenland who consumed a high marine fat diet rich in LCn3s. This finding stimulated years of epidemiological and clinical studies investigating the cardioprotective effects of LCn3s, thought to be primarily mediated through anti-inflammatory (and anti-aggregatory prostaglandins that protect the vascular wall from pro-inflammatory effects of metabolic stress precipitated by poor diet and lifestyle. Although the original hypothesis of the link between LCn3s and CVD protection was based on a high LCn3 containing diet (namely a high marine fat diet the majority of clinical trials since have focussed on EPA and DHA supplementation, and results of repeated meta-analyses have not shown conclusive evidence in support of their beneficial health effects. In this review we focus on the controversies that surround the efficacy of LCn3s in cardiovascular and other chronic diseases and present emerging areas of research for novel applications. We will examine factors that can impact on the efficacy of LCn3s such as source (plant vs marine vs supplements (algal vs marine, stability of product, dose, trial duration, ratio of EPA:DHA, and ratio of LCn6:LCn3 fatty acids in the diet.

  15. [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.

  16. Treatment of scabies and pediculosis: facts and controversies.

    Science.gov (United States)

    Wolf, Ronni; Davidovici, Batya

    2010-01-01

    Unlike many other skin diseases, success or failure of therapy of ectoparasitic infestation depends much more on how to use the topical preparation and whom we treat than on which scabicide or pediculicides to use. The diagnosis of scabies should no longer rely on the rather uncommon and unpractical sign of finding a burrow or the number of parasites per infected patient. Most infested individuals have been shown to have several-fold more acari than the oft-quoted average of 12 adult acari per infected patient that appears in most of our textbooks (stemming from Mellanby's work). Contrary to what Mellanby taught us, we know that indirect transmission (ie, without personal contact) does occur. As to which agent to use, the winner remains undeclared at present. Although indirect contact transmission of hair lice has been clarified after thousands of years of infestation, there are still numerous questions, uncertainties, disagreements, and controversies on the subject; for example, we know that lice survive immersion in water but are probably not transmitted in swimming pools. There is no consensus on the best or most correct way to diagnose lice, nor is the problem of resistance resolved. We do not recommend a "no-nit" policy. Copyright 2010 Elsevier Inc. All rights reserved.

  17. Kidney repair and stem cells: a complex and controversial process.

    Science.gov (United States)

    Yeagy, Brian A; Cherqui, Stephanie

    2011-09-01

    Over the last decade, stem cells have been the topic of much debate and investigation for their regenerative potential in the case of renal injury. This review focuses on bone marrow stem cells (BMSC) for renal repair and the potential origins of the controversial results between studies. Some authors have shown that BMSC can differentiate into renal cells and reverse renal dysfunction while others obtained contradictory results. One significant variation between these studies is the choice of BMSC used. According to the literature and our own experience, unfractionated bone marrow cells and hematopoietic stem cells are able to lead to long-term cell tissue engraftment and repair, whereas mesenchymal stem cells have a short-term paracrine effect. Detection of the bone-marrow-derived cells is also an important source of error. However, the major difference between studies is the model of kidney injury used. Two categories of models have to be distinguished: acute and chronic kidney disease. However, variation within these categories also exists. The outcomes of various strategies for BMSC transplantation after injury to the kidney must be compared within a single model and cannot be transposed from one model to another.

  18. Maternal obesity and inflammatory mediators: A controversial association.

    Science.gov (United States)

    Pendeloski, Karen Priscilla Tezotto; Ono, Erika; Torloni, Maria Regina; Mattar, Rosiane; Daher, Silvia

    2017-05-01

    The link between maternal obesity and inflammatory mediators is still unclear. Our aim was to summarize the main findings of recently published studies on this topic. We performed a search in Medline for studies published in the last years on obesity, human pregnancy, and inflammatory mediators. We report the findings of 30 studies. The characteristics and number of participants, study design, gestational age at sample collection, and type of sample varied widely. Approximately two-thirds of them investigated more than one mediator, and 50% included participants in only one trimester of pregnancy. The most frequently investigated mediators were leptin, tumour necrosis factor-alpha (TNF-α), and interleukin (IL)-6. Almost all studies reported an association between maternal obesity, leptin, and C-reactive protein (CRP) serum levels but not with IL-1β and IL-10. The association of IL-6, TNF-α, monocyte chemo-attractant protein-1 (MCP-1), adiponectin, and resistin with maternal obesity is still controversial. To clarify the physiopathological link between maternal obesity and inflammation, more high-quality studies are needed. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Management of type 3 acromioclavicular joint dislocations--current controversies.

    Science.gov (United States)

    Kim, Suezie; Blank, Alan; Strauss, Eric

    2014-01-01

    AC (acromioclavicular) joint dislocations are a common injury seen by physicians. Symptoms range from minor discomfort with activity to complete disability of the extremity. Although most orthopaedic surgeons agree on how to treat either mild (type 1-2) or severe (type 4-6) injuries, there is no consensus for treatment of type 3 injuries. This article reviews the relevant literature pertaining to the anatomy of the injury, evaluation of the patient, pertinent imaging as well as the controversial management of type 3 AC joint dislocations. With improvement in surgical techniques over the past 30 years, there have been many published studies evaluating both operative and non-operative care. Surgery has shown dramatic improvement in patient-rated outcomes; however, it is not always without complications. These risks in some patients may not be worth the potential surgical benefits. In type 3 AC joint injuries each patient and pathology must be carefully analyzed to ensure that the correct treatment option is chosen.

  20. 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

  1. Controversial issues in treating the dental patient with autism.

    Science.gov (United States)

    Rada, Robert E

    2010-08-01

    The author conducted a literature review to investigate concerns that parents of a child with an autism spectrum disorder may have when oral health care is provided to the child. The author conducted a search of PubMed using the terms "mercury," "fluoride," "nitrous oxide," "antibiotics," "gluten," "casein," "acetaminophen" and "dentistry" each with the term "autism." He identified controlled studies and literature reviews in both medical and alternative medical literature that were related to areas of importance to oral health care workers. The use of mercury, fluoride, nitrous oxide, antibiotic agents and acetaminophen all are sources of controversy between dentistry and the parents of children who have autism. The author found that patients who have autism frequently also have allergies, immune system problems, gastrointestinal disturbances and seizures. Dental health care workers must be aware of these comorbid conditions so they can provide optimal care to the children with autism spectrum disorders. The author found two distinct theories as to what causes autism: one that focuses on genetic causes, and one that focuses on the impact of the environment. He found that the interpretation of these theories might affect parents' concerns about various dental treatments. Dentists treating patients who have autism may need to provide more than standard patient care, as the use of time-tested dental treatment and prevention modalities may be questioned or refused by parents.

  2. 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.

  3. Intestinal Neuronal Dysplasia Type B in Adults: A Controversial Entity

    Directory of Open Access Journals (Sweden)

    Vasillis Vougas

    2014-01-01

    Full Text Available Intestinal neuronal dysplasia (IND is a well-defined entity which raises controversy among authors, described as a congenital malformation of gastrointestinal innervation and caused by dysplastic embryonal development of the enteric nervous system. It is potentially associated with mild and chronic gastrointestinal motility disturbances. IND is rarely reported in adults and especially elderly patients. The present study reports on the case of a 71-year-old man suffering from longstanding idiopathic constipation and who was misdiagnosed for more than 60 years, despite several hospital admissions and a sigmoidectomy in the meantime. On the last admission, the patient presented with megacolon, abdominal pain and X-ray finding of bowel obstruction. Due to massive large bowel dilatation, an exploratory laparotomy failed to reveal any obvious mechanical cause, and a subtotal colectomy and Hartmann's procedure was performed. Bowel continuity was performed 3 months later. Analysis of full-thickness biopsies revealed enlarged myenteric and submucosal neurons as well as an increased number of giant cells and increased acetylcholinesterase activity in the mucosa. The diagnosis of IND was established. The main diagnostic criteria, the underlining pathophysiology and the recommended therapeutic approach of this rare entity are extensively reviewed.

  4. 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.

  5. The Europeanisation of Austria: Misfit, Adaptation and Controversies

    Directory of Open Access Journals (Sweden)

    Gerda Falkner

    2001-12-01

    Full Text Available This article analyses the multiple dimensions of Austria’s Europeanisation and the high degree of both misfit and conflict involved therein. Austria’s path to EU membership was characterised by fundamental doubts due to the country’s status of neutrality, and by a basic reinterpretation of this concept. After accession, need for institutional adaptation to the EU’s decision-making patterns was significant since major tenets of the Austrian political system are special. Furthermore, policy misfit between the domestic and the EU level was considerable in several fields, among them highly symbolic ones. Austria’s EU-related diplomacy recently witnessed a major crisis with the other 14 member states ‘sanctioning’ the new centre-right government in a controversial way. Against this background of strong and multi-dimensional misfit, Austrian performance in implementing EU law is still surprisingly good. By contrast, public appreciation of EU membership has declined even further, and a majority of Austrians oppose enlargement while the Freedom Party advocates a referendum on that issue. Therefore, the conclusions argue that improved communication processes and mutual learning across the multiple levels of the EU system are crucial.

  6. The Europeanisation of Austria: Misfit, Adaptation and Controversies

    Directory of Open Access Journals (Sweden)

    Gerda Falkner

    2001-12-01

    Full Text Available This article analyses the multiple dimensions of Austrias Europeanisation and the high degree of both misfit and conflict involved therein. Austrias path to EU membership was characterised by fundamental doubts due to the countrys status of neutrality, and by a basic reinterpretation of this concept. After accession, need for institutional adaptation to the EUs decision-making patterns was significant since major tenets of the Austrian political system are special. Furthermore, policy misfit between the domestic and the EU level was considerable in several fields, among them highly symbolic ones. Austrias EU-related diplomacy recently witnessed a major crisis with the other 14 member states sanctioning the new centre-right government in a controversial way. Against this background of strong and multi-dimensional misfit, Austrian performance in implementing EU law is still surprisingly good. By contrast, public appreciation of EU membership has declined even further, and a majority of Austrians oppose enlargement while the Freedom Party advocates a referendum on that issue. Therefore, the conclusions argue that improved communication processes and mutual learning across the multiple levels of the EU system are crucial.

  7. Detection of Blastocystis hominis: a controversial human pathogen.

    Science.gov (United States)

    Basak, Silpi; Rajurkar, Monali N; Mallick, Sanjay Kumar

    2014-01-01

    Blastocystis hominis has been reclassified as a protozoan parasite. Its role as a human pathogen is somewhat controversial. There has been a dramatic increase in the frequency of B. hominis infection in association with diarrhea especially in immunocompromised hosts like AIDS patients, travelers, homosexuals, day care children, animal handlers especially zoo keepers, etc. Recent reports suggest that B. hominis is an emerging pathogen; hence, we have undertaken this study to detect B. hominis from stool samples of patients attending our hospital. About 200 stool samples were tested by light microscopic examination, for observing wet mounts with saline and Lugol's iodine. Permanent staining of fecal smear by Gram's staining and modified acid fast staining was done. The stool sample which was microscopically positive for B. hominis was cultured on Lowenstein-Jensen's (LJ) medium. In one patient, the vacuolated form of B. hominis was observed in wet mount with saline preparation of stool sample. This was very clearly seen in wet mount with Lugol's iodine. In Gram's stained preparation, also the vacuolated form was observed. Detection of B. hominis was not possible by modified acid fast staining. B. hominis was also grown on LJ medium which is an egg-containing medium. Clinical microbiology laboratories should start screening of stool samples for B. hominis as it is an emerging pathogen.

  8. Ethical controversies in organ donation after circulatory death.

    Science.gov (United States)

    2013-05-01

    The persistent mismatch between the supply of and need for transplantable organs has led to efforts to increase the supply, including controlled donation after circulatory death (DCD). Controlled DCD involves organ recovery after the planned withdrawal of life-sustaining treatment and the declaration of death according to the cardiorespiratory criteria. Two central ethical issues in DCD are when organ recovery can begin and how to manage conflicts of interests. The "dead donor rule" should be maintained, and donors in cases of DCD should only be declared dead after the permanent cessation of circulatory function. Permanence is generally established by a 2- to 5-minute waiting period. Given ongoing controversy over whether the cessation must also be irreversible, physicians should not be required to participate in DCD. Because the preparation for organ recovery in DCD begins before the declaration of death, there are potential conflicts between the donor's and recipient's interests. These conflicts can be managed in a variety of ways, including informed consent and separating the various participants' roles. For example, informed consent should be sought for premortem interventions to improve organ viability, and organ procurement organization personnel and members of the transplant team should not be involved in the discontinuation of life-sustaining treatment or the declaration of death. It is also important to emphasize that potential donors in cases of DCD should receive integrated interdisciplinary palliative care, including sedation and analgesia.

  9. Controversy over genetically modified organisms: the governing laws and regulations.

    Science.gov (United States)

    Keatley, K L

    2000-01-01

    Genetically Modified Organisms (GMOs) are increasingly becoming a topic of controversy in the U.S. and abroad. The public is questioning their safety and wanting the products labeled as genetically modified. There are other concerns from some of the scientific world and some government officials and organizations such as the Food & Agricultural Organization (FAO) that question whether adequate research has been done to qualify GMOs as safe for long-term use. Of particular concern are the allergenic properties, a GMO may impart, possible transfer effects of antibiotic resistance (given that antibiotic resistant marker genes are used for many GMOs), the expression of previously unexpressed traits, and the drift of pollen from genetically modified crops. It has also been noted that the laws and regulations governing the biotechnology world are outdated, are not comprehensive, and span too many agencies. The primary agencies currently regulating biotechnology are the U.S. Department of Agriculture (USDA), the Food and Drug Administration (FDA), and the Environmental Protection Agency (EPA).

  10. 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.

  11. Simultaneous bilateral total knee replacement: a persistent controversy.

    Science.gov (United States)

    Noble, J; Goodall, J R; Noble, D J

    2009-12-01

    The benefits and risks of Simultaneous Bilateral Total Knee Replacement (SBTKR) remain controversial. A review of the English speaking literature was undertaken and found that many papers took staunch positions either for or against the procedure. It was also noted that earlier papers supporting SBTKR suggested cost benefits. There was a huge disparity in the incidence of mortality and morbidity and it was not possible to compare many papers, because in some medically frail patients were excluded from the SBTKR cohorts. In large published series the proportion of patients having a SBTKR varied between 3% and 70%. Many, but not all, series highlighted age and co-morbidity as risk factors. Overall there was no clear case for or against SBTKR. The evidence suggested that careful preoperative assessment and patient selection on a strict protocol were essential. The procedure should be confined to hospitals where high dependency nursing is readily available and the literature indicated that the risk is less in high through-put units. By refining preoperative assessment and preparation it can be a safe and effective procedure in an appropriate clinical setting for postoperative care.

  12. 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.

  13. Dietary fiber intake and risk of colorectal cancer: A pooled analysis of prospective cohort studies

    NARCIS (Netherlands)

    Park, Y.; Hunter, D.J.; Spiegelman, D.; Bergkvist, L.; Berrino, F.; Brandt, P.A. van den; Buring, J.E.; Colditz, G.A.; Freudenheim, J.L.; Fuchs, C.S.; Giovannucci, E.; Goldbohm, R.A.; Graham, S.; Harnack, L.; Hartman, A.M.; Jacobs, D.R.; Kato, I.; Krogh, V.; Leitzmann, M.F.; McCullough, M.L.; Miller, A.B.; Pietinen, P.; Rohan, T.E.; Schatzkin, A.; Willett, W.C.; Wolk, A.; Zeleniuch-Jacquotte, A.; Zhang, S.M.; Smith-Warner, S.A.

    2005-01-01

    Context: Inconsistent findings from observational studies have continued the controversy over the effects of dietary fiber on colorectal cancer. Objective: To evaluate the association between dietary fiber intake and risk of colorectal cancer. Design, Setting, and Participants: From 13 prospective

  14. The evolving role of familial history for prostate cancer.

    Science.gov (United States)

    Colloca, Giuseppe; Venturino, Antonella

    2011-01-01

    family history of prostate cancer is a risk factor for prostate cancer occurrence. Differently from other neoplasms no major predisposing gene has been identified. this review article presents the controversial results of studies about the prognostic and predictive role of family history in prostate cancer, reports the discovered predisposing genes, and biologic and pathologic findings. mortality from PC remains a significant health care problem, but no trial investigated if it changed in presence of positive family history. The largest family study yet published concluded that men with family history are diagnosed and die at earlier ages than men without it. However, it failed to stress the prognostic value of family history. Genome-wide association studies of prostate cancer have identified a number of genetic variants at different loci in different populations. Prostate neoplasms of patients with positive family history exhibit a different pattern of expression of genes related with estrogen and androgen metabolism within the tumor. High-penetrance and low-penetrance genes in diagnosis and prognosis of prostate cancer, difficulties to define a classification and to quantify relative risks of single genes, documented gene-environment interactions are discussed. family history stands for both shared genetic and environmental factors and their interaction. The availability of prostate-specific antigen test could explain partly the high familial risk, among brothers or shortly after the diagnosis of prostate cancer. Polymorphisms in genes associated with prostate cancer probably represent the most part of familial prostate cancer burden. An increasing knowledge of disregulated cellular pathways of lethal prostate cancer could define which of all genetic alterations have a role in defining new preventive and therapeutic strategies.

  15. 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.

  16. 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.

  17. Use of macrolides in lung diseases: recent literature controversies.

    Science.gov (United States)

    Silva Filho, Luiz Vicente Ribeiro Ferreira da; Pinto, Leonardo Araujo; Stein, Renato Tetelbom

    2015-01-01

    To review the mechanisms of action of macrolides in pediatric respiratory diseases and their clinical indications. Review in the PubMed database, comprising the following terms in English: "macrolide and asthma"; "macrolide and cystic fibrosis"; "macrolide bronchiolitis and viral acute"; "macrolide and bronchiolitis obliterans" and "macrolide and non-CF bronchiectasis". The spectrum of action of macrolides includes production of inflammatory mediators, control of mucus hypersecretion, and modulation of host-defense mechanisms. The potential benefit of macrolide antibiotics has been studied in a variety of lung diseases, such as cystic fibrosis (CF), bronchiectasis, asthma, acute bronchiolitis, and non-CF bronchiectasis. Several studies have evaluated the benefits of macrolides in asthma refractory to therapy, but the results are controversial and indications should be limited to specific phenotypes. In viral bronchiolitis, there is no consistent benefit in acute conditions, although recent data have shown an effect in recurrent wheezing prevention. In patients with CF results are also contradictory, but the consensus states there is a small clinical benefit, especially for patients infected with P. aeruginosa. There was also no positive action of macrolides in patients with post-infectious bronchiolitis obliterans. Children with non-CF bronchiectasis seem to have clear benefits regarding the use of macrolides, which showed clinical advantages in parenchyma protection and lung function. The long-term use of macrolides should be limited to highly selected situations, especially in patients with bronchiectasis. Careful evaluation of the benefits and potential damage are tools for their indication in specific groups. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  18. [Neuroethics and bioethics--implications of Balkanization controversy].

    Science.gov (United States)

    Kagawa, Chiaki

    2009-01-01

    There have been considerable disputes the positioning of neuroethics as a new field since its emergence in 2002. It is the novelty of the neuroethical issues and the necessity for updated moral approaches to them that leading exponents of neuroethics have emphasized; advances in neurosciences have created an entirely new field of moral inquiries that the conventional bioethics had never noticed. Futher, as neuroethics embraces the subdivision of ethics in neuroscience, it should take precedence over bioethics, which depends on the fundamental moral concepts without questioning their bases. Many bioethicists have squarely opposed these insistences and thereby detected the claim of neuroethics exceptionalism: the asserted newness of issues comes mainly from the ignorance of exponents of this new field regarding accumulated bioethical inquiries, so that the overlapping concerns between bioethics and neuroethics are passed on to the future by them. Moreover, bioethicists point out that the recent tendency of Balkanization in the field of bioethics could endanger the integrity of moral investigations. Subfields of bioethics, such as geneethics, neuroethics, nanoethics and so on, originate consecutively, entail wastage of valuable time and money, and increase the risk of fragmentizing moral considerations in an inconsistent way. By reviewing this controversy between neuroethics and bioethics, I argue that the relevant scientific investigations and technologies, which have appeared to promote the proliferation of bioethical sub-disciplines to date, are beginning to converge into 1 complex that demands not the division into subspecialities but the novel integration of bioethical inquiries: it is time to attempt the unification of bioethical applied ethics for moral considerations regarding nano-bio-info-cogno convergent technologies.

  19. 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.

  20. Specific Antibody Deficiency: Controversies in Diagnosis and Management

    Science.gov (United States)

    Perez, Elena; Bonilla, Francisco A.; Orange, Jordan S.; Ballow, Mark

    2017-01-01

    Specific antibody deficiency (SAD) is a primary immunodeficiency disease characterized by normal immunoglobulins (Igs), IgA, IgM, total IgG, and IgG subclass levels, but with recurrent infection and diminished antibody responses to polysaccharide antigens following vaccination. There is a lack of consensus regarding the diagnosis and treatment of SAD, and its clinical significance is not well understood. Here, we discuss current evidence and challenges regarding the diagnosis and treatment of SAD. SAD is normally diagnosed by determining protective titers in response to the 23-valent pneumococcal polysaccharide vaccine. However, the definition of an adequate response to immunization remains controversial, including the magnitude of response and number of pneumococcal serotypes needed to determine a normal response. Confounding these issues, anti-polysaccharide antibody responses are age- and probably serotype dependent. Therapeutic strategies and options for patients with SAD are often based on clinical experience due to the lack of focused studies and absence of a robust case definition. The mainstay of therapy for patients with SAD is antibiotic prophylaxis. However, there is no consensus regarding the frequency and severity of infections warranting antibiotic prophylaxis and no standardized regimens and no studies of efficacy. Published expert guidelines and opinions have recommended IgG therapy, which are supported by observations from retrospective studies, although definitive data are lacking. In summary, there is currently a lack of evidence regarding the efficacy of therapeutic strategies for patients with SAD. We believe that it is best to approach each patient as an individual and progress through diagnostic and therapeutic interventions together with existing practice guidelines. PMID:28588580

  1. Specific Antibody Deficiency: Controversies in Diagnosis and Management

    Directory of Open Access Journals (Sweden)

    Elena Perez

    2017-05-01

    Full Text Available Specific antibody deficiency (SAD is a primary immunodeficiency disease characterized by normal immunoglobulins (Igs, IgA, IgM, total IgG, and IgG subclass levels, but with recurrent infection and diminished antibody responses to polysaccharide antigens following vaccination. There is a lack of consensus regarding the diagnosis and treatment of SAD, and its clinical significance is not well understood. Here, we discuss current evidence and challenges regarding the diagnosis and treatment of SAD. SAD is normally diagnosed by determining protective titers in response to the 23-valent pneumococcal polysaccharide vaccine. However, the definition of an adequate response to immunization remains controversial, including the magnitude of response and number of pneumococcal serotypes needed to determine a normal response. Confounding these issues, anti-polysaccharide antibody responses are age- and probably serotype dependent. Therapeutic strategies and options for patients with SAD are often based on clinical experience due to the lack of focused studies and absence of a robust case definition. The mainstay of therapy for patients with SAD is antibiotic prophylaxis. However, there is no consensus regarding the frequency and severity of infections warranting antibiotic prophylaxis and no standardized regimens and no studies of efficacy. Published expert guidelines and opinions have recommended IgG therapy, which are supported by observations from retrospective studies, although definitive data are lacking. In summary, there is currently a lack of evidence regarding the efficacy of therapeutic strategies for patients with SAD. We believe that it is best to approach each patient as an individual and progress through diagnostic and therapeutic interventions together with existing practice guidelines.

  2. 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

  3. 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.......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....

  4. Controversies in the management of cold, hot, and occult thyroid nodules.

    Science.gov (United States)

    Giuffrida, D; Gharib, H

    1995-12-01

    Some aspects of thyroid nodule evaluation and management remain controversial. Radionuclide scanning provides functional information about nodules and differentiates cold from hot nodules. Although thyroid cancers are cold on scan, most cold nodules are benign. Ultrasonography visualizes the thyroid gland and nodules with remarkable clarity and provides structural information about location, number, size, and consistency of nodules. Widespread application of ultrasonography has resulted in the frequent discovery of incidental (occult) nodules in the general population. The clinical significance of these nodules remains unknown, and their management has created a dilemma for physicians. Current cost-effective evaluation of nodules does not include scanning or ultrasonography as routine frontline tests. In most centers, fine-needle aspiration biopsy has supplanted imaging studies as the routine initial procedure for differentiating benign from malignant nodules. Cytologic diagnosis is reliable and inexpensive, and it results in a better selection of patients for surgery. Limitations include false-negative diagnoses, nondiagnostic results, and indeterminate "suspicious" results. Laboratory test results are usually normal, but determination of serum thyrotropin may identify a hot nodule, and plasma calcitonin may help diagnose medullary thyroid carcinoma. Treatment of thyroid nodules is controversial. In some practices, benign colloid nodules are treated with suppressive doses of levothyroxine. Recent reports cast doubt on the efficacy of this approach, and it is no longer acceptable to select patients for surgical treatment on the basis of suppressive therapy. Furthermore, suppressive levothyroxine therapy may be associated with significant bone and cardiac side effects, especially in elderly patients and postmenopausal women. Our approach is observation for most patients, and we suggest a careful risk-benefit analysis when suppression is considered. Hot (autonomous

  5. A Case Report of Male Occult Breast Cancer First Manifesting as Axillary Lymph Node Metastasis With Part of Metastatic Mucinous Carcinoma

    OpenAIRE

    He, Mengna; Liu, He; Jiang, Yuxin

    2015-01-01

    Abstract Occult breast cancer (OBC) is a type of breast cancer without any symptoms in the breast (no primary cancer lesion is found in either breast on a physical examination or imaging examination such as ultrasound and mammography). The incidence of OBC is rare in females, whereas in males, there are few cases of breast cancer, and the rate of OBC is very low. This is the first time report a case of male OBC first manifested as axillary metastasis, of which the pathological results showed ...

  6. 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

  7. 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…

  8. Reasoning versus association in animal cognition : Current controversies and possible ways forward

    NARCIS (Netherlands)

    Beckers, T.; De Houwer, J.; Dwyer, D.M.

    2016-01-01

    The study of animal cognition is rife with controversy, and among the most long-standing and most intensely debated controversies in the field is the question of the extent to which the behavior of nonhuman animals can be fully understood on the basis of purely associative principles, or whether

  9. Scientific Experts and the Controversy about Teaching Creation/Evolution in the UK Press

    Science.gov (United States)

    Allgaier, Joachim

    2010-01-01

    The issue whether creationist accounts of the origins of life should be taught in science education alongside or even instead Darwin's theory of evolution is controversial in many countries. In 2002 there was a controversy around teaching creationism in science classes at a secondary school in England. The research presented in this paper uses…

  10. The Emergence of the Controversy around the Theory of Evolution and Creationism in UK Newspaper Reports

    Science.gov (United States)

    Allgaier, Joachim; Holliman, Richard

    2006-01-01

    The question of whether religious explanations about the origin of life should be taught alongside scientific accounts in compulsory science education has sparked controversy in several countries for decades. An important site for these controversies is media reporting. This article presents the results of a quantitative and qualitative analysis…

  11. Accreditation in Kinesiology: The Process, Criticism and Controversy, and the Future

    Science.gov (United States)

    Templin, Thomas J.; Blankenship, Bonnie Tjeerdsma

    2007-01-01

    The question of accreditation has been quite controversial in higher education. Some consider accreditation as a necessary "evil" while others reject it outright. It is a process designed to promote quality assurance and improvement in institutions and programs, yet one mired in various issues. While accreditation is controversial in a number of…

  12. Annotated Bibliography of Materials Relating to the Evolution-Creationism Controversy.

    Science.gov (United States)

    Haughton, Buzz

    In examining the literature on materials relating to the evolution-creationism controversy, it was found that there have been no comprehensive bibliographies compiled since the early 1980s. This paper presents an annotated bibliography on the creationism-evolution controversy including materials published or made available since 1980. (ASK)

  13. 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, of Urological Surgeons' Section of Oncology; UK ProtecT (Prostate testing for cancer and Treatment) Study

    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 international...... PRACTICAL Consortium. Twenty-three new prostate cancer susceptibility loci were identified at genome-wide significance (Pcancer susceptibility loci, explaining ~30% of the familial risk for this disease, have now been identified. On the basis of combined risks conferred...... by the new and previously known risk loci, the top 1% of the risk distribution has a 4.7-fold higher risk than the average of the population being profiled. These results will facilitate population risk stratification for clinical studies....

  14. 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

  15. 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.

  16. [Controversies in the substitute hormonal treatment of menopause].

    Science.gov (United States)

    Clavero Núñez, José Antonio

    2003-01-01

    Recent publications in magazines of the maximum impact raise serious and big doubts among the gynecologists. Of a side, the substitute hormonal therapy (THS) doesn't seem to have value like preventive of the heart attack neither of the osteoporosis. Of other, it can carry thrombosis in the first months of treatment, besides the already acquaintance increment of the mamma cancer risk starting from the fifth year of THS. In the present communication the systematic one is exposed continued so far, and the possible alternatives that we should adopt to avoid presumed complications, and the subsequent reclamations that the patients could file.

  17. Breast Reconstruction: A Century of Controversies and Progress.

    Science.gov (United States)

    Homsy, Antoine; Rüegg, Eva; Montandon, Denys; Vlastos, Georges; Modarressi, Ali; Pittet, Brigitte

    2018-01-31

    Breast cancer treatment has dramatically changed over the past century. Since Halsted's first description of radical mastectomy in 1882, breast reconstruction has evolved slowly from being considered as a useless or even dangerous procedure by surgeons to the possibility nowadays of reconstructing almost any kind of defect. In this review on the development of breast reconstruction, we outline the historical milestone innovations that led to the current management of the mastectomy defect in an attempt to understand the economic, social and psychological factors, which contributed to slow down its acceptance for several decades.

  18. 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.

  19. Research Gaps and Controversies in Chronic Traumatic Encephalopathy: A Review.

    Science.gov (United States)

    Asken, Breton M; Sullan, Molly J; DeKosky, Steven T; Jaffee, Michael S; Bauer, Russell M

    2017-10-01

    Scientific and lay interest in negative outcomes associated with exposure to repetitive brain trauma (RBT) continues to strengthen. Concerns about the association between RBT and dementia began more than a century ago, but have resurfaced in the last decade with the more recently described chronic traumatic encephalopathy (CTE). Chronic traumatic encephalopathy is a tauopathy associated with RBT that has become inextricably linked to conversations about sport-related concussion and mild traumatic brain injury. Accordingly, specific populations such as collision sport athletes and certain military personnel are of particular interest owing to their unique exposure to RBT. The gaps and controversies in our understanding of the epidemiologic factors, mechanism, and clinicopathological correlates of CTE reflect the current reliance on postmortem case series investigations. This review discusses the state of the science of CTE and raises considerations for researching and interpreting cognitive changes in members of at-risk populations. The recent development of pathological diagnostic criteria for CTE represented an important step for differentiating CTE from other neurodegenerative diseases. By comparison, defining the clinical syndrome(s) associated with CTE and the necessary and sufficient symptoms needed for its diagnosis lags behind. The absence of validated in vivo biomarkers of pathological characteristics of CTE and longitudinal tracking with neuropsychological evaluation remains a significant hurdle. Attribution of candidate symptoms in retired athletes to CTE is complicated by the presence of multiple premorbid and comorbid factors affecting cognitive reserve that influence normal or expected cognitive functioning. This is a critical issue in appropriately defining reference groups for normative comparisons. Available data, while limited and complicated by selection bias, indicate that exposure to RBT represents the greatest risk factor for CTE pathological

  20. Overdiagnosis in cancer screening: the need for a standardized denominator.

    Science.gov (United States)

    Ripping, Theodora M; Verbeek, André Lm; Broeders, Mireille Jm

    2016-06-01

    It is widely accepted that overdiagnosis is a major harm of screening, but its extent is still topic of controversy. This is partly the result of incomparable overdiagnosis estimates in scientific literature, as a variety of denominators are used to calculate the percentage of overdiagnosis in cancer screening. We propose to use the following denominator to calculate the percentage of overdiagnosis: 'all cancers detected during the screening period, both interval and screen-detected, in participants of a screening programme'. This denominator is more appropriate than existing denominators because it presents overdiagnosis as a real percentage, is unaffected by attendance percentages, is applicable to all observational study designs, and can be easily recalculated to absolute numbers. This denominator can be widely applied and increases comparability between overdiagnosis estimates, which is needed to correctly present the balance between the benefits and harms of screening. © The Author(s) 2015.