Utility of Comorbidity Assessment in Predicting Transplantation-Related Toxicity Following Autologous Hematopoietic Stem Cell Transplantation for Multiple Myeloma

AbstractPatients with coexisting medical problems may suffer increased toxicity and reduced quality of life after autologous hematopoietic stem cell transplantation (HSCT). The benefit of high-dose therapy for some patients with multiple myeloma (MM) is debatable. Decision tools that aid in identifying those patients with MM most suited for autologous HSCT may avoid the risk of excess toxicity. An objective assessment of comorbidities was performed in 126 patients with MM undergoing autologous HSCT using the Charlson comorbidity index (CCI), the hematopoietic cell transplantation comorbidity index (HCT-CI), and a modified pretransplantation assessment of mortality (mPAM) to determine the strength of association with increased transplantation-related toxicity and increased length of hospital stay (LOS). Any comorbidity scored using the CCI or HCT-CI (score > 0) was associated with an increased number of organ systems with serious toxicity (at least grade 2 toxicity using the Seattle criteria), an increased total sum of toxicity grades for all organs, and prolonged LOS. An mPAM score ≥ 24 was associated with increased LOS. When considering autologous HSCT for a patient with MM, assessment of comorbidities using the CCI or HCT-CI may assist in predicting the risk of transplantation-related toxicity as an adjunct to physician judgment and patient preference

RGB generation by four-wave mixing in small-core holey fibers

We report the generation of white light comprising red, green, and blue spectral bands from a frequency-doubled fiber laser by an efficient four-wave mixing process in submicron-sized cores of microstructured holey fibers. A master-oscillator power amplifier (MOPA) source based on Yb-doped fiber is employed to generate 80 ps pulses at 1060 nm wavelength with 32 MHz repetition rate, which are then frequency-doubled in an LBO crystal to generate up to 2 W average power of green light. The green pump is then carefully launched into secondary cores of the cladding of photonic bandgap fibers. These secondary cores with diameters of about 400 to 800 nm act as highly nonlinear waveguides. At the output, we observe strong red and blue sidebands which, together with the remaining green pump light, form a visible white light source of about 360 mW. The generating process is identified as four-wave mixing where phase matching is achieved by birefringence in the secondary cores which arises from non-symmetric deformation during the fiber fabrication. Numerical models of the fiber structure and of the nonlinear processes confirm our interpretation. Finally, we discuss power scaling and limitations of the white light source due to the damage threshold of silica fibers

Autonomy of Nations and Indigenous Peoples and the Environmental Release of Genetically Engineered Animals with Gene Drives

This article contends that the environmental release of genetically engineered (GE) animals with heritable traits that are patented will present a challenge to the efforts of nations and indigenous peoples to engage in self‐determination. The environmental release of such animals has been proposed on the grounds that they could function as public health tools or as solutions to the problem of agricultural insect pests. This article brings into focus two political‐economic‐legal problems that would arise with the environmental release of such organisms. To address those challenges, it is proposed that nations considering the environmental release of GE animals must take into account the underlying circumstances and policy failures that motivate arguments for the use of the modified animals. Moreover, countries must recognize that the UN International Covenant on Civil and Political Rights and the UN International Covenant on Economic, Social and Cultural Rights place on them an obligation to ensure that GE animals with patented heritable traits are not released without the substantive consent of the nations or indigenous peoples that could be affected

Сознание как менеджер когнитивных ресурсов. Эволюционная гипотеза о правильном функционировании сознания

For any biological trait, developing a good evolutionary explanation presents remarkable difficulties in relation to the adopted methodology, or definition of adaptation [1], and the frequent scarcity of empirical data [2; 3]. Furthermore, as far as mental phenomena are concerned, some philosophical theories such as Conscious Inessentialism [4], or the By-product Accident View [5] deny that the property of being conscious could have conferred any real selective advantage to organisms, making its evolutionary explanation even more arduous. Nonetheless, consciousness can reasonably be viewed as a useful tool that, from some point of phylogenesis onwards, contributed in some way to the fitness of its bearers. The main purpose of this paper, therefore, is to propose an evolutionary hypothesis about the proper function of consciousness. We will firstly define the notions of proper function and adaptive value. Then we will examine why having something like a conscious control core, no matter how basic or minimal, could be adaptively valuable, and we will do so through an analogy between this core and a digital resource manager (the operating system of advanced digital electronic devices). Finally, and in conclusion, we will formulate our hypothesis, which suggests that at some point of phylogenesis, cognitive unity emerged, and without it, no handling of complexity — and production of goal-directed behaviours — would appear to be possible.Для любого биологического признака разработка хорошего эволюционного объяснения представляет значительные трудности в связи с принятой методологией или определением адаптации [1] и частой нехваткой эмпирических данных [2; 3]. Кроме того, в том, что касается психических явлений, некоторые философские теории, такие как Сознательный несущественный подход [4] или Взгляд на случайность как побочный продукт [5], отрицают, что свойство быть сознательным могло дать организмам какое-либо реальное избирательное преимущество, что делает его эволюционное объяснение еще более затруднительным. Тем не менее, сознание можно разумно рассматривать как полезный инструмент, который с какого-то момента филогенеза и далее каким-то образом способствовал приспособленности его носителей. Таким образом, основная цель этой статьи состоит в том, чтобы предложить эволюционную гипотезу о правильной функции сознания. Сначала мы определим понятия надлежащей функции и адаптивной ценности. Затем мы рассмотрим, почему наличие чего-то вроде ядра сознательного управления, каким бы базовым или минимальным оно ни было, может быть адаптивно ценным, и мы сделаем это с помощью аналогии между этим ядром и менеджером цифровых ресурсов (операционная система современных цифровых электронных устройств). И наконец, в заключение, мы сформулируем нашу гипотезу, которая предполагает, что в какой-то момент филогенеза возникло когнитивное единство, а без него никакое управление сложностью, равно как и выработка целенаправленного поведения, были бы невозможны

«MADE IN ITALY: КУЛЬТУРНОЕ ОТЧУЖДЕНИЕ ИЛИ КОЛЛЕКТИВНАЯ ПАМЯТЬ?»

ANNOTATION OF THE ROUND TABLE(АННОТАЦИЯ КРУГЛОГО СТОЛА

The Modal Dimension

Space and time are two obvious candidates as dimensions of reality. Yet, are they the only two dimensions of reality? Famously, David Lewis maintained the doctrine o