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There is an ongoing debate in medicine about whether patients have a 'right not to know' pertinent medical information, such as diagnoses of life-altering diseases. While this debate has employed various ethical concepts, probably the most widely-used by both defenders and detractors of the right is autonomy. Whereas defenders of the right not to know typically employ a 'liberty' conception of autonomy, according to which to be autonomous involves doing what one wants to do, opponents of the right not to know often employ a 'duty' understanding, viewing autonomy as involving an obligation to be self-governing. The central contribution of this paper is in showing that neither view of autonomy can reasonably be said to support the extreme stances on the right not to know that they are sometimes taken to. That is, neither can a liberty view properly defend a right not to know without limits, nor can a duty view form the basis of an absolute rejection of the right not to know. While there is still theoretical distance between these two approaches, we conclude that the views are considerably closer on this issue than they first appear, opening the way for a possible compromise.Nitrate leaching is an important yet difficult to manage contribution to groundwater and surface water contamination in agricultural areas. We examine 14 farm fields over a four year period (2014-2017) in the southern Willamette Valley, providing 53 sets of annual, field-level agricultural performance metrics related to nitrogen (N), including fertilizer inputs, crop harvest outputs, N use efficiency (NUE), nitrate-N leaching and surplus N. Crop-specific nitrate-N leaching varied widely from 10 kg N ha-1yr-1 in hazelnuts to >200 kg N ha-1yr-1 in peppermint. Averaging across all sites and years, most leaching occurred during fall (60%) and winter (32%). Overall NUE was 57%. We used a graphical approach to explore the relationships between N inputs, surplus, crop N harvest removal and NUE by crop type. The blueberry site had high inputs and surplus, peppermint had high inputs but also high crop N removal and NUE and thus lower surplus, and most wheat crops had high NUE and evidence of using soil N. Annual N surplus was not well correlated with leaching, and leaching varied more by crop type and inputs. Grass seed and hazelnuts, which are dominant crop types in the southern Willamette Valley, were intermediate in terms of NUE, leaching and surplus. Of all performance metrics, N input was most closely aligned with field-level crop N harvest and nitrate leaching, therefore optimizing N inputs may well inform local efforts to reduce groundwater nitrate contamination.
Standard therapy for localized soft tissue sarcoma (STS) is wide, limb-sparing resection. For intermediate- or high-grade tumors, (neo)adjuvant therapies are frequently added to the treatment plan. In this study, data from a Dutch nationwide database are used to (1) assess whether perioperative management of STS follows ESMO guidelines, (2) characterize prognostic factors for overall survival (OS), and (3) assess the association between perioperative treatment and survival.
All intermediate- or high-grade, localized STS cases, who have undergone surgery and diagnosed between 2000 and 2017, were identified in the Netherlands Cancer Registry (NCR) database. Variables with demographic, treatment, and survival data were obtained. Survival curves were estimated by Kaplan-Meier's method, and the effect of prognostic factors on OS was assessed in a multivariable Cox regression analysis.
A total of 4957 patients were identified. There were slightly more males (54.7%). Median age at diagnosis was 64 years, and 5ed in recent years. Identified baseline characteristics and treatment factors predicting OS may aid in future treatment decisions.
Preoperative RT is gradually replacing postoperative RT for localized STS in the Netherlands. The use of perioperative chemotherapy is rare and has slightly decreased in recent years. Identified baseline characteristics and treatment factors predicting OS may aid in future treatment decisions.Emissions from a stand replacement prescribed burn were sampled using an unmanned aircraft system (UAS, or "drone") in Fishlake National Forest, Utah, U.S.A. Sixteen flights over three days in June 2019 provided emission factors for a broad range of compounds including carbon monoxide (CO), carbon dioxide (CO2), nitric oxide (NO), nitrogen oxide (NO2), particulate matter less then 2.5 microns in diameter (PM2.5), volatile organic compounds (VOCs) including carbonyls, black carbon, and elemental/organic carbon. To our knowledge, this is the first UAS-based emission sampling for a fire of this magnitude, including both slash pile and crown fires resulting in wildfire-like conditions. The burns consisted of drip torch ignitions as well as ground-mobile and aerial helicopter ignitions of large stands comprising over 1,000 ha, allowing for comparison of same-species emission factors burned under different conditions. The use of a UAS for emission sampling minimizes risk to personnel and equipment, allowing flexibility in sampling location and ensuring capture of representative, fresh smoke constituents. PM2.5 emission factors varied 5-fold and, like most pollutants, varied inversely with combustion efficiency resulting in lower emission factors from the slash piles than the crown fires.The coronavirus disease 2019 (COVID-19) induced a lockdown that has resulted in a sharp reduction in air and motor traffic and industrial activities. This in turn led to a reduction in air pollution around the world. It is important to quantify the extent of that reduction in order to estimate the weight of the impact of air and motor traffic and industrial activities over the total variation of air quality. 1-PHENYL-2-THIOUREA molecular weight An assessment of the extent of air pollution is aimed at facilitating the crafting of policies toward the reduction of pollution and the improvement in air quality. The aim of this paper is to evaluate the impact of the COVID-19 outbreak on air pollution in Israel. Particularly, we focus on Haifa and Greater Tel-Aviv (Gush-Dan), two regions with high air pollution, while examining different types of air monitoring stations. The period to which we refer to is March 8, 2020, to May 2, 2020. The results reveal two main findings (1) During the COVID-19 lockdown, pollution emissions decreased relative to the same period in 2019. The biggest reduction was observed in NO x , which, on average, was 41%. Surprisingly, ground-level ozone (O 3) increased, and appeared to behave similarly to the ozone weekend effect. (2) The total percentage variation in pollution emission that was explained by the lockdown was at most 26%. By adding the meteorological conditions (which included measures of wind direction, wind speed, and temperature) as a factor in addition to the lockdown effect, this percent increased to 47%.In her commentary, Xu (2020) admonishes the reader that "To have a full understanding of the cognitive mechanisms underlying VWM [visual working memory], both behavioral and neural evidence needs to be taken into account. This is a must, and not a choice, for any study that attempts to capture the nature of VWM" (p. 11). Although we don't disagree with this statement, our overall assessment of this commentary is that it, itself, fails to satisfy several "musts" and, consequently, does not pose a serious challenge for the sensory recruitment framework for understanding visual working memory. These "musts" include accurately characterizing the framework being critiqued, not favoring verbal models and intuition at the expense of formal quantitative models, and providing even-handed interpretation of the work of others. We'll conclude with a summary of how the sensory recruitment framework can be incorporated into a broader working model of visual working memory.
The Kingdom of Saudi Arabia has exerted great efforts to prevent the spread of COVID-19. This research aims to scrutinize the outlook, awareness, and customs of Saudi undergraduate students regarding COVID-19.
The current cross-sectional study comprises 178 undergraduate students in the Faculty of Applied Medical Sciences. The data were collected from online Google form questionnaires. The differences were picked out of the questionnaires, and the mean scores of the differences were duly assessed. The variables associated with knowledge, attitude, and practice toward COVID-19 were evaluated; moreover, a comparative study was conducted on these variables in different faculty departments. ANOVA, Student's
-test, and binary logistic regression analysis were used to assess the data on knowledge, attitude, and practice.
Most of the undergraduate students were well acquainted with COVID-19. We obtained the mean knowledge score for COVID-19 to be 3.08 ± .82 (range 1-5), indicating good knowledge. The attitudand hygiene awareness programs must be conducted for undergraduate students. Infection control should be part of the undergraduate applied for medical sciences curriculum program.
Schizophrenia is associated with alterations in neural structure and function of the retina that are similar to changes seen in the retina and brain in multiple neurodegenerative disorders. Preliminary evidence suggests that retinal microvasculature may also be compromised in schizophrenia. The goal of this study was to determine, using optical coherence tomography angiography (OCTA), whether 1) schizophrenia is associated with alterations in retinal microvasculature density; and 2) microvasculature reductions are associated with retinal neural layer thinning and performance on a measure of verbal IQ.
Twenty-eight outpatients with schizophrenia or schizoaffective disorder and 37 psychiatrically healthy control subjects completed OCT and OCTA exams, and the Wechsler Test of Adult Reading.
Schizophrenia patients were characterized by retinal microvasculature density reductions, and enlarged foveal avascular zones, in both eyes. These microvascular abnormalities were generally associated with thinning of retinal neural (macular and peripapillary nerve fiber layer) tissue (but the data were stronger for the left than the right eye) and lower scores on a proxy measure of verbal IQ. First- and later-episode patients did not differ significantly on OCTA findings.
The retinal microvasculature impairments seen in schizophrenia appear to be a biomarker of overall brain health, as is the case for multiple neurological conditions. Additional research is needed, however, to clarify contributions of social disadvantage and medical comorbidities to the findings.
The retinal microvasculature impairments seen in schizophrenia appear to be a biomarker of overall brain health, as is the case for multiple neurological conditions. Additional research is needed, however, to clarify contributions of social disadvantage and medical comorbidities to the findings.With growing interest in the use of acoustic stimuli in sleep research and acoustic interventions used therapeutically for sleep enhancement, there is a need for an overview of the current lines of research. This paper summarizes the various ways to use acoustic input before sleep or stimulation during sleep. It thereby focuses on the respective methodological requirements, advantages, disadvantages, potentials and difficulties of acoustic sleep modulation. It highlights differences in subjective and objective outcome measures, immediate and whole night effects and short versus long term effects. This recognizes the fact that not all outcome parameters are relevant in every research field. The same applies to conclusions drawn from other outcome dimensions, consideration of mediating factors, levels of stimulation processing and the impact of inter-individual differences. In addition to the deliberate influences of acoustic input on sleep, one paragraph describes adverse environmental acoustic influences. Finally, the possibilities for clinical and basic research-related applications are discussed, and emerging opportunities are presented.
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