A framework for clinical evaluation of diagnostic technologies.

Most new diagnostic technologies have not been adequately assessed to determine whether their application improves health. Comprehensive evaluation of diagnostic technologies includes establishing technologic capability and determining the range of possible uses, diagnostic accuracy, impact on the health care provider, therapeutic impact and impact on patient outcome. Guidelines to determine whether each of these criteria have been met adequately are presented. Diagnostic technologies should be disseminated only if they are less expensive, produce fewer untoward effects and are at least as accurate as existing methods, if they eliminate the need for other investigations without loss of accuracy, or if they lead to institution of effective therapy. Establishing patient benefit often requires a randomized controlled trial in which patients receive the new test or an alternative diagnostic strategy. Other study designs are logistically less difficult but may not provide accurate assessment of benefit. Rigorous assessment of diagnostic technologies is needed for efficient use of health care resources.     

Informing cancer patient in relation his type of personality: the emotional-hypothymic (depressive) patient

Informing patients with cancer has been a subject of great scientific interest. Initially the research was aimed at quantity evaluation, in other words, the number of doctors who break the news to the patient, the number of patients seeking informing etc. Since the 1980s to present, research has shifted its focus equally on quality evaluation. In other words, serious efforts are being made to answer the question: "Is it possible to determine who should be told what, when and how?" It seems that deepening on the patient s character traits offers the best starting point for understanding the patient. The aim of this paper was to describe the character of personality types based on the question: "How could characters or personality types be used in informing patients with cancer?" As method of research was used the qualitative method through groups with doctors and nurses, while research within groups lasted for 5 years. The degree of informing is similar to the degree of the hyperthymic personality; initially, is "minimal, then "small" until it reaches "medium". The degree of denial varies between "large" and "very large" to sometimes "medium". Family: similar to the emotional-hyperthymic person, with the added difficulty of introversy. There is a discordance between what the patient shows and what the family reports about him, especially when the compensation mechanism is that of a controlling - orderly patient.     

Bonobos apparently search for a lost member injured by a snare

This is the first report to demonstrate that a large mixed-sex party of bonobos travelled a long distance to return to the location of a snare apparently to search for a member that had been caught in it. An adult male was caught in a metallic snare in a swamp forest at Wamba, Luo Scientific Reserve, Democratic Republic of the Congo. After he escaped from the snare by breaking a sapling to which the snare was attached, other members of his party assisted him by unfastening the snare from lianas in which it was caught and licked his wound and tried to remove the snare from his fingers. In the late afternoon, they left him in the place where he was stuck in the liana and travelled to the dry forest where they usually spend the night. The next morning, they travelled back 1.8 km to revisit the location of the injured male. When they confirmed that he was no longer there, they returned to the dry forest to forage. This was unlike the usual ranging patterns of the party, suggesting that the bonobos travelled with the specific intention of searching for this injured individual who had been left behind. The incident described in this report likely occurred because bonobos usually range in a large mixed-sex party and try to maintain group cohesion as much as possible.     

THE NON-IDENTITY PROBLEM AND GENETIC HARMS – THE CASE OF WRONGFUL HANDICAPS

The Human Genome Project will produce information permitting increasing opportunities to prevent genetically transmitted harms, most of which will be compatible with a life worth living, through avoiding conception or terminating a pregnancy. Failure to prevent these harms when it is possible for parents to do so without substantial burdens or costs to themselves or others are what J call "wrongful handicaps". Derek Parfit has developed a systematic difficulty for any such cases being wrongs — when the harm could be prevented only by preventing the existence of the individual who would have a worthwhile life even with the handicap, then bringing him into existence with the handicap does not make him worse off and so does not wrong him. I argue that a non "person-affecting" principle requiring the avoidance of suffering and limited opportunity correctly accounts for cases of wrongful handicaps without requiring that the individuals with the handicap have been made worse off and therefore wronged. It is an advantage, not a difficulty, of this account that it does not imply that the person with the handicap has been wronged or is a victim with a special moral complaint.     

The non-identity problem and genetic harms -- the case of wrongful handicaps

The Human Genome Project will produce information permitting increasing opportunities to prevent genetically transmitted harms, most of which will be compatible with a life worth living, through avoiding conception or terminating a pregnancy. Failure to prevent these harms when it is possible for parents to do so without substantial burdens or costs to themselves or others are what I call "wrongful handicaps". Derek Parfit has developed a systematic difficulty for any such cases being wrongs -- when the harm could be prevented only by preventing the existence of the individual who would have a worthwhile life even with the handicap, then bringing him into existence with the handicap does not make him worse off and so does not wrong him. I argue that a non "person-affecting" principle requiring the avoidance of suffering and limited opportunity correctly accounts for cases of wrongful handicaps without requiring that the individuals with the handicap have been made worse off and therefore wronged. It is an advantage, not a difficulty, of this account that it does not imply that the person with the handicap has been wronged or is a victim with a special moral complaint.     

Savants rêveurs et rêveurs savants: Freud lecteur de la science française des rêves

This paper sets out to place The Interpretation of Dreams within an historical context. It argues that it is impossible to have complete confidence in Freud’s words when, in his letters to Wilhelm Fliess, he characterized himself as a mere discoverer. In reality, Freud also felt he belonged to a learned community of dream specialists, whom I call “dreaming scientists” and “scientific dreamers”. Here, I offer, as example, a portrait of Freud as a reader of two French authors, Alfred Maury, and, indirectly, Léon Hervey de Saint-Denys. I analyze how Freud positioned himself as Maury’s successor and sometimes experienced dreams like Hervey de Saint-Denys. The premise of this work is that we must set aside Freud if we want to venture into the learned dream culture peculiar to the 19th century. Only afterwards can we return to Freud and place him in this context as a creative heir.     

Economic evaluation of the effects of planting date and application rate of imidacloprid for management of cereal aphids and barley yellow dwarf in winter wheat

The effects of planting date and application rate of imidacloprid for control of Schizaphis graminum Rondani, Rhopalosiphum padi L. (Homoptera: Aphididae), and barley yellow dwarf virus (BYDV) in hard red winter wheat were studied. The first experiment was conducted from 1997 to 1999 at two locations and consisted of three planting dates and four rates of imidacloprid-treated seed. The second experiment was conducted from 2001 to 2002 in Stillwater, OK, and consisted of two varieties of hard red winter wheat seed and four rates of imidacloprid. Aphid densities, occurrence of BYDV, yield components, and final grain yield were measured, and yield differences were used to estimate the economic return obtained from using imidacloprid. In the first study, aphid populations responded to insecticide rate in the early and middle plantings, but the response was reduced in the late planting. Yields increased as insecticide rate increased but did not always result in a positive economic return. In the second study, imidacloprid seed treatments reduced aphid numbers and BYD occurrence, protected yield, and resulted in a positive economic return. The presence of aphids and BYDV lowered yield by reducing fertile head density, total kernel weight, and test weight. Whereas the application of imidacloprid seed treatments often provided positive yield protection, it did not did not consistently provide a positive economic return. A positive economic return was consistently obtained if the cereal aphid was carrying and transmitting BYDV and was more likely to occur if wheat was treated with a low rate if imidacloprid and planted in a "dual purpose" planting date window.     

What would have happened if Darwin had known Mendel (or Mendel's work)?

The question posed by the title is usually answered by saying that the "synthesis" between the theory of evolution by natural selection and classical genetics, which took place in 1930s-40s, would have taken place much earlier if Darwin had been aware of Mendel and his work. What is more, it nearly happened: it would have been enough if Darwin had cut the pages of the offprint of Mendel's work that was in his library and read them! Or, if Mendel had come across Darwin in London or paid him a visit at his house in the outskirts! (on occasion of Mendel's trip in 1862 to that city). The aim of the present paper is to provide elements for quite a different answer, based on further historical evidence, especially on Mendel's works, some of which mention Darwins's studies.     

Greatness and tribulations of Zeiss and Leitz, two famous German optic companies III. Zeiss Ikon and elimination of Emanuel Goldberg

Gathering archival documents to trace the history of the Zeiss company presents no difficulty : they are abundant… except for a period from 1932 to 1945, systematically ignored, and that corresponds to the Nazi period. On the website Zeiss Historica, among the outstanding personalities of the Zeiss company, we note that, for Professor Emanuel Goldberg, the web page ? is still under development but an early picture of the professor is available. ?. But fortunately, Mickael Buckland, a Professor at the UC Berkeley School of Information brought the life and the work of Emanuel Goldberg to light. Thanks to him, his works and innovations, who had disappeared from our cultural and scientific heritage, return to light after being erased during fifty years. Goldberg had published dozens of articles, obtained patents, developed cameras, microdots, movie cameras, and he designed what he called a "Statistical Machine ", the first electronic document retrieval machine. In France, if this rediscovery was made known to the world of information science, it has not had the impact it deserved in the scientific world. Therefore it is time to reconstruct his career and his work, and to analyse the reasons why some attempted to erase definitively his name and memory.     

Lysogenization of Escherichia coli him+, himA, and himD hosts by bacteriophage Mu.

The possible outcomes of infection of Escherichia coli by bacteriophage Mu include lytic growth, lysogen formation, nonlysogenic surviving cells, and perhaps simple killing of the host. The influence of various parameters, including host himA and himD mutations, on lysogeny and cell survival is described. Mu does not grow lytically in or kill him bacteria but can lysogenize such hosts. Mu c+ lysogenizes about 8% of him+ bacteria infected at low multiplicity at 37 degrees C. The frequency of lysogens per infected him+ cell diminishes with increasing multiplicity of infection or with increasing temperature over the range from 30 to 42 degrees C. In him bacteria, the Mu lysogenization frequency increases from about 7% at low multiplicity of infection to approach a maximum where most but not all cells are lysogens at high multiplicity of infection. Lysogenization of him hosts by an assay phage marked with antibiotic resistance is enhanced by infection with unmarked auxiliary phage. This helping effect is possible for at least 1 h, suggesting that Mu infection results in formation of a stable intermediate. Mu immunity is not required for lysogenization of him hosts. We argue that in him bacteria, all Mu genomes which integrate into the host chromosome form lysogens.     

Rapid microspectrofluorometric studies in EL2 cells following intracellular accumulation of dibenzocarbazoles

Summary Microspectrofluorometric observations were carried out in EL2 ascites cancer cells and dibenzo(a,e)fluoranthene (diB(a,e)F)-grown EL2 cells, following treatment (5 min) with three dibenzocarbazoles (1,2,7,8; 1,2,5,6 and 3,4,5,6). After microinjection of glucose-6-P leading to reduction of NAD(P), a sequence of difference spectra (after substrate minus before) is recorded. In dibenzocarbazole-untreated cells, maximum NAD(P) reduction (emission maximum at 465–475 nm) is attained within 5 s, followed by a gradual return to initial fluorescence within 20 to 200 s (faster in the diB(a,e)F-grown). In dibenzocarbazole-treated cells there is a rather regular increase in the intensity of the difference spectrum up to 300–500 s. Initially the increase is more predominant in the region around 460–470 nm, but it gains later prominence in the shorter wavelength region (420–430 nm) characteristic of the hydrocarbon (higher and steadier increase in the 3,4,5,6, dibenzocarbazole-treated diB(a,e)F-grown). Subsequently there is a gradual decrease of fluorescence which may or may not return to initial level. The observed increase spectra require evaluation in terms of possible components (e.g. a mixture of NAD(P)H and hydrocarbon, binding changes, succession of fluorescent metabolites).     

“Robin Hood” of Techno-Turkey or Organ Trafficking in the State of Ethical Beings

Dr S. is a famous transplant surgeon in the Middle East. He operates "underground" on wealthy patients in different countries, from Israel to Turkey to Russia. The media refer to him as the "Organ Mafia doctor," and patients diagnosed with renal failure speak of him sardonically as "Robin Hood," acknowledging that he takes organs from the poor to give to the rich. But ethical issues of organ trafficking are not limited to marginal private clinics and "Mafia" doctors. All-living related organ transplants in Turkey involve similar ethical dilemmas: many related or nonrelated organ recipients pay their donors, and demand continues to rise. This paper explores practices in state and university hospitals and the ethical dilemmas doctors encounter to understand where and how judicial, cultural, and social categories of "human rights" and "crime" are constructed in our high-tech world.     

Neither a mentalist nor a reductionist be!

There is basis for concern that applied psychophysiology, if not the field of biofeedback, is being coopted by, and merged into, a reborn "inner" model, with the return of "cognition" to preeminence in the "psych" and "neuro" disciplines. Despite currently fashionable views that such mentalistic inventions and neuro/psychological developments somehow illuminate behavior or offer simpler accounts of behavioral facts, there is little or no evidence that any such construction has ever told us anything new about behavior.     

Science for the common good

A smile comes easily to the face of Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases, as he encounters visitors to his offices at the Institute. He does not, however, allow himself to be distracted from his duties for longer than it takes to nod warmly. The sense of discipline and the determination and preparedness that were instilled in him through a Jesuit course of education are apparent. He is as direct and as clear spoken in person as you've seen him on television, speaking on innumerable occasions over the past two decades about the pathology and treatment of AIDS, and more recently, delineating the public health from the national security issues precipitated by the bioterrorist events of the past year. The three office assistants who occupy his reception area have been particularly taxed in the management of Fauci's schedule since 9/11; as they pause briefly from their work to share photographs of a friend's recent wedding, Fauci is there to admonish them, semi-good-naturally, as government employees, to return to their official duties. He has been meeting with high government officials and has been courted by the media for interviews regularly since the tragedies began. Given his high profile, it is easy to forget that Fauci is, foremost, a clinical immunobiologist and physician. His dedication to science is part of his commitment to public service, also a value instilled in him by the Jesuits. Fortunately for all of us, Fauci was pursuing this combination of interests--within the venue of bioterrorism--in his official capacity at the NIAID well before the general public had awaken to the threat.     

Shape discrimination by wasps (<Emphasis Type="Italic">Paravespula germanica</Emphasis>) at the food source: generalization among various types of contrast

Wasps (Paravespula germanica) were trained and tested at an artificial feeding site, using convex shapes that produced colour contrast, luminance contrast, or motion contrast against the background. With each of the three types of contrast, we tested the wasps capacity to discriminate the learned shape from novel shapes. In addition, in each experiment we tested the wasps capability to recognize the learned shape when it offered a different type of contrast than that it had during the training. With the coloured shapes, a side-glance at the colour discrimination performance of the wasps was possible in addition. Wasps are found to discriminate between a variety of convex shapes regardless of the type of contrast that they produce against the background. Mainly, they discriminate the learned shape from novel shapes even if the colour of the shapes or the type of contrast they produce against the background is altered in the test. Thus, wasps generalize the learned shape from one colour to another, as well as between colour contrast, luminance contrast, and motion contrast.     

The predicaments of "dangerous safety": living with juvenile diabetes in 20th century America

Remedies are not useless because they fall short of their full scope. It is better to keep a man on the edge of a precipice, if you cannot pluck him away from it, than to let him fall over. And many diabetic patients are kept in this predicament of dangerous safety. Lectures on the Principles and Practice of Physic, 1836-1837 SirThomas Watson     

A possible correlation of electro-optic changes with the deformability of erythrocytes.

A novel electro-optical technique for deformability measurement is described. This method is faster and more convenient than "standard" procedures. Erythrocytes (RBC, 10(6) cells/mL suspended in isotonic sucrose 10%, ionic strength 10(-4) M/L, pH 6.5) are ordered in an electric field (E = 10(4) Vp-p/m, v = 10(3) Hz) following the field direction, as a result of an induced electric dipole moment. After the switching off of the electric field, a certain time is required for the electro-optic effect to subside. Under the action of thermal motion, the suspended erythrocytes virtually return to their initial unordered state. The decay time (return time) is the investigated parameter. Results show that if erythrocyte deformability is reduced, the return time is longer than in control RBC. Suspensions of erythrocytes with reduced deformability, achieved by treatment with glutaraldehyde at concentrations ranging from 10(-8) to 10(-1) M/L, are measured. The suggested electro-optic method has good precision and requires a very small quantity of blood (about 0.1 mL), which makes it potentially useful in clinical practice.     

Structure, synthesis and orientation of microfibrils. V. On the recovery of Oocystis solitaria from microtubule inhibitor treatment

Depending on the type of the inhibitor and its concentration one can experimentally induce two forms of aberrant microfibril orientations in O. solitaria cell walls through microtubule inhibitor application. The first form, designated "Intermediate", is characterized by the presence of cortical microtubules together with a spiral arrangement of microfibrils. The second form, designated "Parrallel", shows a wall with bundles of parallel oriented microfibrils without cortical microtubules. Taking colchicine as an example for a microtubule-inhibitor the "Parallel" form may be obtained with 10mM and the "Intermediate" with 5 to 1 mM solutions. Some microtubule-inhibitors such as methylbenzimidazole-2yl-carbamate (MBC) produce the "intermediate" form only. The recovery of normal microfibril orientation after inhibitor treatment is dependent on three factors: a) the developmental stage--young autospores just beginning to synthesize a wall are absolutely necessary; b) the application of inhibitors with the lowest effective concentration for c) the shortest possible time. Minimal concentrations for obtaining a "Full" effect range from 10 mM for colchicine to 1 micrometer for amiprophosmethyl (APM) with incubation periods from 3 to 9 hours. The return to the normal microfibril orientation has been achieved in all cases except after podophyllotoxin treatment. Since APM has been claimed to act selectively on tubulin synthesis in Chlamydomonas it was decided to compare the effects of this compound with cycloheximide (10 microgram/ml) on the recovery of microfibril orientation after colchicine treatment. In both cases no orientation recovery is possible although in the case of cycloheximide, synthesis of cellulose is drastically inhibited. This cycloheximide inhibition is fully reversible. During cycloheximide, but not APM, inhibition cortical microtubules return; however, due to the inhibition of cellulose synthesis itself, they cannot exert their orienting influence.     

Utility of ADL index for partially dependent older people: discriminating the functional level of an older population

In the present study, the ADL index for the partially dependent older people (Demura et al., 1999) was applied to 218 bedridden (BED), 466 partially dependent (PD) and 245 independent living (IL) people in older groups. The purposes of this study were to clarify the meaning of the evaluation of this index and to examine how ADL items are useful in determining each older group. It is suggested that a perfect score with our ADL index means independent living level, and a score of zero means bedridden level. The results of discriminant analysis indicated that four items with low-difficulty, such as "eating," "going to the toilet," "tossing about in bed" and "writing," are useful in determining if the PD is becoming bedridden. While five items with high-difficulty, such as "putting on slacks," "putting on trousers," "standing up from a sitting posture," "going up stairs" and "washing the whole body," are useful in determining if the PD is becoming independent living. Furthermore, it is inferred that the possibility of falling into a bedridden situation increases when the total score is 5 or less, while the functional level is close to independent living when the total score is 13 or more. These findings make clear the meaning of the evaluation of our ADL index. Furthermore, the functional level of older population may be screened using evaluation of total and item scores of this ADL index.     

Continuous outmigration and sequential encountering of environmental cues are important for successful homing of hatchery-reared,anadromous brown trout Salmo trutta

When rehabilitating and reintroducing trout Salmo trutta in rivers, it is a goal that as many as possible survive, home and form self-sustaining populations. Hatchery-reared, anadromous S. trutta have significant lower ability to return to the area where they were raised if (a) transported in a closed tank to sea and released 5 km from the River Imsa, relative to those that were (b) transported when swimming in a partly submerged tank with sea water run-through, while being slowly towed by a boat the same distance or (c) released at the outlet of the River Imsa. Thus, if deprived from environmental cues during part of the way, they lose their ability to home.