Neuroendocrine Liver Metastases and Orthotopic Liver Transplantation: The US Experience

Liver transplantation remains a controversial therapy for Neuroendocrine liver metastases (NLM), with coflicting suvival data reported. The aim was to assess the evolution of outcomes for patients transplanted for NLM in the US, both before and after the introduction of the MELD scoring system in 2002. The UNOS/OPTN database was reviewed to identify patients diagnosed with NLM who subsequently underwent a liver transplantation from 1988 to March 2011 (n = 184); Patient survival was determined using Kaplan-Meier methods and log-rank tests, and cox regression analysis was performed, using SPSS 15.0 (SPSS, Inc, Chicago, IL). The overall NLM patient survivals in the pre-MELD era were 79.5%, 61.4%, and 49.2% at 1, 3, and 5 years, respectively. After the introduction of the MELD score, NET/NLM patients had improved overall patient survivals at 1, 3, and 5 years of 84.7%, 65%, and 57.8%. Patients transplanted after 2002 had an improved survival outcome. Notably, the overall patient survival for NET is not significantly different when compared to the outcomes of patients transplanted for HCC, in the current era. This progress acknowleges the significant improvement in outcomes for NLM patients after liver transplantation and the potential for further gain in the survival of otherwise nonsurgical, terminal patients

Is There a Causal Association between Genotoxicity and the Imposex Effect?

There is a growing body of evidence that indicates common environmental pollutants are capable of disrupting reproductive and developmental processes by interfering with the actions of endogenous hormones. Many reports of endocrine disruption describe changes in the normal development of organs and tissues that are consistent with genetic damage, and recent studies confirm that many chemicals classified to have hormone-modulating effects also possess carcinogenic and mutagenic potential. To date, however, there have been no conclusive examples linking genetic damage with perturbation of endocrine function and adverse effects in vivo. Here, we provide the first evidence of DNA damage associated with the development of imposex (the masculinization of female gastropods considered to be the result of alterations to endocrine-mediated pathways) in the dog-whelk Nucella lapillus. Animals (n = 257) that displayed various stages of tributyltin (TBT)-induced imposex were collected from sites in southwest England, and their imposex status was determined by physical examination. Linear regression analysis revealed a very strong relationship (correlation coefficient of 0.935, p < 0.0001) between the degree of imposex and the extent of DNA damage (micronucleus formation) in hemocytes. Moreover, histological examination of a larger number of dog-whelks collected from sites throughout Europe confirmed the presence of hyperplastic growths, primarily on the vas deferens and penis in both TBT-exposed male snails and in females that exhibited imposex. A strong association was found between TBT body burden and the prevalence of abnormal growths, thereby providing compelling evidence to support the hypothesis that environmental chemicals that affect reproductive processes do so partly through DNA damage pathways

Citizens Show Strong Support for Climate Policy, But Are They Also Willing to Pay?

To what extent citizens are willing not only to support ambitious climate policy, but also willing to pay for such policy remains subject to debate. Our analysis addresses three issues in this regard: whether, as is widely assumed but not empirically established, willingness to support (WTS) is higher than willingness to pay (WTP); whether the determinants of the two are similar; and what accounts for within-subject similarity between WTS and WTP. We address these issues based on data from an original nationally representative survey (N=2500) on forest conservation in Brazil, arguably the key climate policy issue in the country. The findings reveal that WTP is much lower than WTS. The determinants differ to some extent as well; regarding the effects of age, gender, and trust in government. The analysis also provides insights into factors influencing how much WTS and WTP line up within individuals, with respect to age, education, political ideology, salience of the deforestation issue, and trust in government. Our findings provide a more nuanced picture of how strong public support for climate change policy is, and a starting point for more targeted climate policy communication

Individualisierungsbarrieren in der schulischen Sozialisation – Die Bildungsaspirationen von Hauptschülerinnen und Hauptschülern im Kontext des Unterstützungspotenzials des sozialen Nahraums.

Harring M, Böhm-Kasper O. Individualisierungsbarrieren in der schulischen Sozialisation – Die Bildungsaspirationen von Hauptschülerinnen und Hauptschülern im Kontext des Unterstützungspotenzials des sozialen Nahraums. In: Heitmeyer W, Mansel J, Olk T, eds. Individualisierung von Jugend. Jugend zwischen kreativer Innovation, Gerechtigkeitssuche und gesellschaftlichen Reaktionen. Juventa; 2011: 43-65