Ethical issues in autologous stem cell transplantation (ASCT) in advanced breast cancer: A systematic literature review

BACKGROUND: An effectiveness assessment on ASCT in locally advanced and metastatic breast cancer identified serious ethical issues associated with this intervention. Our objective was to systematically review these aspects by means of a literature analysis. METHODS: We chose the reflexive Socratic approach as the review method using Hofmann's question list, conducted a comprehensive literature search in biomedical, psychological and ethics bibliographic databases and screened the resulting hits in a 2-step selection process. Relevant arguments were assembled from the included articles, and were assessed and assigned to the question list. Hofmann's questions were addressed by synthesizing these arguments. RESULTS: Of the identified 879 documents 102 included arguments related to one or more questions from Hofmann's question list. The most important ethical issues were the implementation of ASCT in clinical practice on the basis of phase-II trials in the 1990s and the publication of falsified data in the first randomized controlled trials (Bezwoda fraud), which caused significant negative effects on recruiting patients for further clinical trials and the doctor-patient relationship. Recent meta-analyses report a marginal effect in prolonging disease-free survival, accompanied by severe harms, including death. ASCT in breast cancer remains a stigmatized technology. Reported health-related-quality-of-life data are often at high risk of bias in favor of the survivors. Furthermore little attention has been paid to those patients who were dying. CONCLUSIONS: The questions were addressed in different degrees of completeness. All arguments were assignable to the questions. The central ethical dimensions of ASCT could be discussed by reviewing the published literature

Effects of RNAi on SAUR gene expression [abstract]

Abstract only availableAuxin is a plant hormone that controls many aspects of growth and development. At the molecular level, auxin has been shown to rapidly induce the transcription of specific genes. A family of auxin responsinve genes, called the SAUR (Small Auxin Up RNAs) gene family, contains at least 70 genes in Arabidopsis. Based on sequence homology, these genes can be grouped into several sub-families. The function of these genes is currently unknown. To investigate SAUR gene function, we are taking an RNAi approach to study the effects of silencing gene expression of several SAUR sub-families. We have constructed SAUR RNAi plasmids and introduced them into Arabidopsis plants by vacuum filtration. Seed from these plants have been plated on selection medium, and we currently have numerous plants that have survived the selection. These putative transformants will be transferred to soil, and monitored for any growth phenotypes that differ from wild type plants. Candidate plants will be analyzed to confirm silencing of SAUR gene expression.Burch Agriculture Internship Endowmen

Useful Models of the Student Sector of a University

The world\u27s demands on planners of education have led almost inevitably to consideration of the problems characteristic of operations analysis. Of particular importance and interest are problems of planning, decision, and control as they apply to university systems