Pub Date : 2021-07-28DOI: 10.1515/9781503628687-024
J. Tanchuco
In this issue of our journal, Encinas-Latoy, et al., report on the diagnostic yield of bronchoscopic techniques in evaluating primary lung cancer.1 Fiberoptic bronchoscopy is an important diagnostic modality for lung cancer which remains a major global and national health problem. New cases of lung cancer ranked number one, comprising 11.6% of the total 18 million new cases of cancer globally.2,3 Lung cancer also accounted for the greatest number of deaths due to malignancy with 1.8 million persons. In the Philippines, it was estimated that there were 109,280 new cases of cancer with 66,151 cancer deaths in 2015.4 Of these, lung cancer remains the most common cause of new cases (12.5%) and deaths (17.8%). Many patients with lung cancer do not survive within a year following diagnosis with a five-year survival rate in Metro Manila patients being just 12% lower than the global average for that time. Diagnosis of lung cancer, therefore, remains a top priority in our country. But primary lung cancer describes a heterogeneous group of malignancies.5-7 The most common group, traditionally called bronchogenic carcinomas arising from the bronchial airways are classically grouped into the small and non-small cell types as well as many mixed types in between. These are the cancers that are more likely accessible by fiberoptic bronchoscopy since they occur in the airways. However, as the authors also mention, those lesions that are more centrally-located, i.e., those in the bigger airways, are the ones more likely to be detected by bronchoscopy since they are the ones that can be reached by an endoscope of a certain diameter. And that is where the term diagnostic yield can get quite complex. Similar to other diagnostic procedures, how patients are selected to undergo the procedure can determine how many are eventually diagnosed. In bronchogenic carcinomas, the diagnostic objective is not only to verify the malignant nature of the pulmonary mass but to get biopsy confirmation of its histologic type because the choice of treatment is highly dependent on the histologic types and sub-types. The authors cite a figure of 86% diagnostic yield which at first glance makes it an attractive diagnostic step of first choice. But as the authors also mention, not all patients with pulmonary mass and suspicion of lung malignancy were subjected to bronchoscopy. According to the mentioned institutional practice, patients with “a more central location, at least 1 to 2 cm in size, and located near an airway...” are selected for bronchoscopy. Rightfully so, lesions that are nearer the carina have long been previously described to predict a higher diagnostic yield.8-10 That patient profile alone can significantly increase the diagnostic yield. However, the authors did not specifically state that fiberoptic bronchoscopy in the study was limited only to those patients who were found to have centrally-located masses. If so, with a diagnostic yield of 86%, it would suggest that fibe
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Pub Date : 2019-10-07DOI: 10.1515/9781503628687-026
Kristine Veldheer
For librarians working in research, reference, and instruction, information literacy (IL) is foundational to their work. Since the advent of the Association of College and Research Libraries' Framework for Information Literacy for Higher Education, IL has been substantially reimagined both theoretically and in professional practice. While much attention and scholarship has focused on broad-based, undergraduate education, there has been less work on information literacy for specific disciplines, such as theological and religious studies, or in library settings with unique curricular and professional needs.Information Literacy and Theological Librarianship: Theory & Praxis gathers together reflective practices and theoretical explorations from librarians across a range of theological libraries, including research universities with divinity schools, seminaries, religious universities, and small liberal arts colleges. This volume engages key concepts and concerns in information literacy pedagogy for theological libraries, and furnishes applied examples drawn from instructional experience. Placing the Framework in conversation with the study of religion and theological education, Information Literacy and Theological Librarianship provides theological and religious studies librarians working in different academic environments with concrete and practical ways to extend their own work on information literacy that is grounded in pedagogy and applicable to the unique features of theological librarianship.
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Pub Date : 2015-10-13DOI: 10.1002/9781119055259.CH1
Cole Nussbaumer Knaflic
1237 Journal of Thoracic Oncology ® • Volume 10, Number 9, September 2015 Therapeutic strategies directed against defined molecular subsets of non-small cell lung cancer (NSCLC) has underscored the transformative potential of biomarker directed drug development in oncogene-driven solid tumors. Riding on the success of targeting epidermal growth factor receptor (EGFR) mutations and anaplastic lymphoma kinase (ALK) rearrangements, small molecule inhibitors of the phosphatidyl-inositol 3-kinase (PI3K)/AKT/mammalian target of rapamycin (mTOR) pathway have engendered much excitement due to its critical role as a central signaling axis downstream of several receptor tyrosine kinases implicated in NSCLC (e.g., EGFR and MET). Although published data of novel agents targeting the PI3K/AKT/mTOR pathway in NSCLC have only demonstrated modest clinical activity to date (Table 1), the majority of studies have been conducted in unselected patient populations. In this issue of the journal, Vansteenkiste et al report the final efficacy results from a phase II trial of buparlisib, a pan-class I PI3K inhibitor in selected “PI3K-activated” NSCLC patients. In a commendable effort, 1242 patient samples underwent molecular prescreening for PIK3CA mutations, PTEN mutations, or PTEN loss by immunohistochemistry, identifying 63 subjects (13.5%) that were enrolled into two cohorts (squamous and nonsquamous). In terms of efficacy analysis, this trial used a conservative futility criterion—defined as 12-week progression-free survival rate less than 50%—that was unfortunately met in the first stage, terminating the trial early. Despite being a negative study from an efficacy standpoint, this trial has provided unique insights into the current challenges with targeted therapies directed against genetic alterations. Underpinning the success of contemporary trials evaluating targeted therapeutics are patient enrichment strategies using high-precision predictive biomarkers. Are PTEN and PIK3CA alterations sufficiently specific to select for tumors most likely to respond to PI3K inhibitors? Preclinical data certainly support this hypothesis, where PIK3CA-mutant transgenic lung cancer mouse models clearly respond to PI3K/mTOR inhibitors, and conditional ablation of PIK3CA or PIK3CB (through which PTEN signals) in cell-based models result in a significant reduction in cell growth. Yet, despite selecting for the relevant alterations in this trial, tumor responses were disappointingly low at 3% in both nonsquamous and squamous cell carcinoma, and there was no difference in progressionfree survival regardless of whether patients’ tumors were PIK3CA mutant or wild type. Furthermore, a subgroup of 23 patients with sufficient archival tissue subjected to broader sequencing of 600 genes failed to yield any notable coalterations that may have limited the efficacy of PI3K inhibitors. Similarly, responders were not differentiated by a specific mutational profile, with one patient harboring PT
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Pub Date : 2009-09-01DOI: 10.1515/9781503628687-021
G. Loescher, James Milner
The likelihood that those in protracted exile may spend significant amounts of time either in camp-like situations or unprotected in urban settings often has negative implications for their human rights and livelihoods as well as for states security.
{"title":"Understanding the Challenge","authors":"G. Loescher, James Milner","doi":"10.1515/9781503628687-021","DOIUrl":"https://doi.org/10.1515/9781503628687-021","url":null,"abstract":"The likelihood that those in protracted exile may spend significant amounts of time either in camp-like situations or unprotected in urban settings often has negative implications for their human rights and livelihoods as well as for states security.","PeriodicalId":350627,"journal":{"name":"From Mandate to Blueprint","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124967706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The UK now has an Internet censorship system that is used to address various unlawful use of the Internet, but it was initially restricted to blocking images of child sexual abuse. The system is easy to bypass, but it was hoped to reduce the likelihood of people accidentally accessing such images. At any one time there were only a few hundred web addresses blocked, and all entries were manually checked, so it was rare for material to be incorrectly categorised. However, once the blocking system was in place, there was pressure for its remit to be extended. First, the movie and music industries successfully obtained court orders to add entire websites which facilitated access to copyright infringing material. Now the UK government are proposing censoring legal adult websites too (unless the person who pays for the Internet connection requests an opt-out from the blocking system, and proves their identity and age). The system to block adult material is already in place for customers of mobile Internet connections, but due to the huge number of websites now being blocked, the quality of checking of what belongs on the list has gone down. Websites being incorrectly blocked include political parties, news sites, and sexual education information. Measures that started off as blocking of a small number of carefully selected web addresses containing illegal material universally regarded as abhorrent have morphed into the mass censorship of legal material with little or no human intervention. In the US, Internet users can even be disconnected entirely from the Internet if anyone from their household is too frequently accused of infringing copyright; the UK government is one of several others discussing similar measures. Blocking child sexual abuse images does not stop the crime, and for the vast majority of other crimes involving the Internet there are no technical measures which can prevent the crime occurring. Therefore the emphasis in legislation has been on detecting and punishing perpetrators in the hope that it will deter others. One area of rapid growth in this field has been Internet surveillance, with the draft Communications Data Bill being the UK government's latest and most privacy-intrusive proposal yet. This law, if enacted, would allow public bodies to order ISPs to record their customers' activities, even when the customer is not suspected of having committed a crime and where there has been no judicial oversight of the order. The costs of implementing …
英国现在有一个互联网审查系统，用来解决各种非法使用互联网的问题，但它最初仅限于阻止儿童性虐待的图像。该系统很容易绕过，但希望能减少人们意外访问此类图像的可能性。在任何时候，只有几百个网址被屏蔽，而且所有条目都是人工检查的，所以很少有材料被错误分类。然而，一旦封锁制度到位，就有压力要求其职权范围扩大。首先，电影和音乐行业成功地获得了法院的命令，增加了整个网站，方便了人们获取侵犯版权的材料。现在，英国政府也提议审查合法的成人网站(除非付费上网的人要求退出屏蔽系统，并证明自己的身份和年龄)。虽然针对移动互联网用户的成人内容屏蔽系统已经到位，但由于目前被屏蔽的网站数量庞大，因此检查列表内容的质量有所下降。被错误屏蔽的网站包括政党、新闻网站和性教育信息。最初的措施是封锁少数精心挑选的包含普遍被认为令人憎恶的非法内容的网址，现在已经演变成对合法材料的大规模审查，几乎没有或根本没有人为干预。在美国，如果家里有人经常被指控侵犯版权，互联网用户甚至可能被完全切断与互联网的联系;英国政府是讨论类似措施的其他几个国家之一。阻止儿童性虐待图像并不能阻止犯罪，对于绝大多数涉及互联网的其他犯罪，没有技术措施可以防止犯罪的发生。因此，立法的重点一直是发现和惩罚犯罪者，希望它能吓阻其他人。这一领域快速增长的一个领域是互联网监控，《通信数据法案》(Communications Data Bill)草案是英国政府迄今为止最新、也是最侵犯隐私的提案。这项法律如果颁布，将允许公共机构命令互联网服务提供商记录其客户的活动，即使客户没有犯罪嫌疑，也没有对该命令进行司法监督。实施的成本…
{"title":"No Magic Formula","authors":"K. McArdle, Fintan O'toole, Ulf Dantanus","doi":"10.2307/29735402","DOIUrl":"https://doi.org/10.2307/29735402","url":null,"abstract":"The UK now has an Internet censorship system that is used to address various unlawful use of the Internet, but it was initially restricted to blocking images of child sexual abuse. The system is easy to bypass, but it was hoped to reduce the likelihood of people accidentally accessing such images. At any one time there were only a few hundred web addresses blocked, and all entries were manually checked, so it was rare for material to be incorrectly categorised. However, once the blocking system was in place, there was pressure for its remit to be extended. First, the movie and music industries successfully obtained court orders to add entire websites which facilitated access to copyright infringing material. Now the UK government are proposing censoring legal adult websites too (unless the person who pays for the Internet connection requests an opt-out from the blocking system, and proves their identity and age). The system to block adult material is already in place for customers of mobile Internet connections, but due to the huge number of websites now being blocked, the quality of checking of what belongs on the list has gone down. Websites being incorrectly blocked include political parties, news sites, and sexual education information. Measures that started off as blocking of a small number of carefully selected web addresses containing illegal material universally regarded as abhorrent have morphed into the mass censorship of legal material with little or no human intervention. In the US, Internet users can even be disconnected entirely from the Internet if anyone from their household is too frequently accused of infringing copyright; the UK government is one of several others discussing similar measures. Blocking child sexual abuse images does not stop the crime, and for the vast majority of other crimes involving the Internet there are no technical measures which can prevent the crime occurring. Therefore the emphasis in legislation has been on detecting and punishing perpetrators in the hope that it will deter others. One area of rapid growth in this field has been Internet surveillance, with the draft Communications Data Bill being the UK government's latest and most privacy-intrusive proposal yet. This law, if enacted, would allow public bodies to order ISPs to record their customers' activities, even when the customer is not suspected of having committed a crime and where there has been no judicial oversight of the order. The costs of implementing …","PeriodicalId":350627,"journal":{"name":"From Mandate to Blueprint","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129943182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1515/9781503628687-009
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