Role of radiography, MRI and FDG-PET/CT in diagnosing, staging and therapeutical evaluation of patients with multiple myeloma

Multiple myeloma is a malignant B-cell neoplasm that involves the skeleton in approximately 80% of the patients. With an average age of 60 years and a 5-years survival of nearly 45% Brenner et al. (Blood 111:2516–2520, 35) the onset is to be classified as occurring still early in life while the disease can be very aggressive and debilitating. In the last decades, several new imaging techniques were introduced. The aim of this review is to compare the different techniques such as radiographic survey, multidetector computed tomography (MDCT), whole-body magnetic resonance imaging (WB-MRI), fluorodeoxyglucose positron emission tomography- (FDG-PET) with or without computed tomography (CT), and 99mTc-methoxyisobutylisonitrile (99mTc-MIBI) scintigraphy. We conclude that both FDG-PET in combination with low-dose CT and whole-body MRI are more sensitive than skeleton X-ray in screening and diagnosing multiple myeloma. WB-MRI allows assessment of bone marrow involvement but cannot detect bone destruction, which might result in overstaging. Moreover, WB-MRI is less suitable in assessing response to therapy than FDG-PET. The combination of PET with low-dose CT can replace the golden standard, conventional skeletal survey. In the clinical practise, this will result in upstaging, due to the higher sensitivity

Using a game to engage stakeholders in extreme event attribution science

The impacts of weather and climate-related disasters are increasing, and climate change can exacerbate many disasters. Effectively communicating climate risk and integrating science into policy requires scientists and stakeholders to work together. But dialogue between scientists and policymakers can be challenging given the inherently multidimensional nature of the issues at stake when managing climate risks. Building on the growing use of serious games to create dialogue between stakeholders, we present a new game for policymakers called Climate Attribution Under Loss and Damage: Risking, Observing,co-Negotiating (CAULDRON). CAULDRON aims to communicate understanding of the science attributing extreme events to climate change in a memorable and compelling way, and create space for dialogue around policy decisions addressing changing risks and loss and damage from climate change. We describe the process of developing CAULDRON, and draw on observations of players and their feedback to demonstrate its potential to facilitate the interpretation of probabilistic climate information and the understanding of its relevance to informing policy. Scientists looking to engage with stakeholders can learn valuable lessons in adopting similar innovative approaches. The suitability of games depends on the policy context but, if used appropriately, experiential learning can drive co-produced understanding and meaningful dialogue

‘The presentation of self in the online world’: Goffman and the study of online identities

This paper presents an exemplification and discussion of the contemporaneity of Erving Goffman’s work and of its applicability to the analysis of identity and presentation of self in the blogging and Second Life (SL) contexts. An analysis of online identity and interaction practices in 10 different cases of bloggers and SL inhabitants and of their online spaces is presented in terms of: expressions given; embellishment as a minor form of persona adoption; dividing the self; conforming and ‘fitting in’; and masking, anonymity and pseudonimity. The key finding of the research is that, contrary to engaging with the process of whole persona adoption, participants were keen to re-create their offline self online, but engaged in editing facets of self. This emphasizes the key premise in Goffman’s work that, when in ‘front stage’, people deliberately chose to project a given identity. It is concluded that Goffman’s original framework is of great usefulness as an explanatory framework for understanding identity through interaction and the presentation of self in the online world. Equally, the online environment, with its enhanced potential for editing the self, can offer opportunities to contribute to the further development of the Goffman framework

The aesthetic motives of play

Why do people enjoy playing games? The answer, in its most general form, is that there are aesthetic pleasures offered by games and other play experiences that meet powerful and profound human and animal needs. As such, we can identify specific aesthetic motives of play, and one of the clearest ways of characterizing these motives is in terms of the emotional experiences associated with them