Taking Care of the Symbolic Order. How Converging Technologies Challenge our Concepts

In this article we briefly summarize how converging technologies challenge elements of the existing symbolic order, as shown in the contributions to this special issue. We then identify the vision of ‘life as a do it yourself kit’ as a common denominator in the various forms of convergence and proceed to show how this vision provokes unrest and debate about existing moral frameworks and taboos. We conclude that, just as the problems of the industrial revolution sparked off the now broadly established ideal of sustainability the converging technologies should be governed by the ideal of ‘human sustainability’. The essence of this ideal is formed by the ongoing discussion about the extent to which we may, or should want to, ‘make’ our environment and ourselves, and when it is better to simply accept what is given and what happens to us

The Broad Challenge of Public Engagement in Science: Commentary on: “Constitutional Moments in Governing Science and Technology”

Timely public engagement in science presents a broad challenge. It includes more than research into the ethical, legal and social dimensions of science and state-initiated citizen’s participation. Introducing a public perspective on science while safeguarding its public value involves a diverse set of actors: natural scientists and engineers, technology assessment institutes, policy makers, social scientists, citizens, interest organisations, artists, and last, but not least, politicians

Prescribing an equilibrated intermittent hemodialysis dose in intensive care unit acute renal failure

Prescribing an equilibrated intermittent hemodialysis dose in intensive care unit acute renal failure.BackgroundProspective, formal, blood-side, urea kinetic modeling (UKM) has yet to be applied in intermittent hemodialysis for acute renal failure (ARF). Methods for prescribing a target, equilibrated Kt/V (eKt/V) are described for this setting.MethodsSerial sessions (N = 108) were studied in 28 intensive care unit ARF patients. eKt/V was derived using delayed posthemodialyis urea samples and formal, double-pool UKM (eKt/Vref), and by applying the Daugirdas-Schneditz venous rate equation to pre- and posthemodialysis samples (eKt/Vrate). Individual components of prescribed and delivered dose were compared. Prescribed eKt/V values were determined using in vivo dialyzer clearance estimates and anthropometric (Watson and adjusted Chertow) and modeled urea volumes.ResultseKt/Vref (mean ± SD = 0.91 ± 0.26) was well-approximated by eKt/Vrate (0.92 ± 0.25), R = 0.92. Modeled V exceeded Watson V by 25% ± 29% (P < 0.001) and Adjusted Chertow V by 18%± 28% (P < 0.001), although the degree of overestimation diminished over time. This difference was influenced by access recirculation (AR) and use of saline flushes. The median % difference between Vdprate and Watson V was reduced to 1% after adjusting for AR for the 22 sessions with ≤1 saline flush. The median coefficients of variation for serial determinations of Adjusted Chertow V, modeled V, urea generation rate, and eKt/Vref were 2.7%, 12.2%, 30.1%, and 16.4%, respectively. Because of comparatively higher modeled urea Vs, delivered eKt/Vref was lower than prescribed eKt/V, based on Watson V or Adjusted Chertow V, by 0.13 and 0.08 Kt/V units. The median absolute errors of prescribed eKt/V vs. delivered therapy (eKt/Vref) were not large and were similar in prescriptions based on the Adjusted Chertow V (0.127) vs. those based on various double-pool modeled urea volumes (∼0.127).ConclusionEquilibrated Kt/V can be derived using formal, double-pool UKM in intensive care unit ARF patients, with the venous rate equation providing a practical alternative. A target eKt/V can be prescribed to within a median absolute error of less than 0.14 Kt/V units using practical prescription algorithms. The causes of the increased apparent volume of urea distribution appear to be multifactorial and deserve further investigation

Dietary supplement use and colorectal cancer risk: A systematic review and meta-analyses of prospective cohort studies

Use of dietary supplements is rising in countries where colorectal cancer is prevalent. We conducted a systematic literature review and meta-analyses of prospective cohort studies on dietary supplement use and colorectal cancer risk. We identified relevant studies in Medline, Embase and Cochrane up to January 2013. Original and peer-reviewed papers on dietary supplement use and colorectal cancer, colon cancer, or rectal cancer incidence were included. "Use-no use"(U-NU), "highest-lowest"(H-L) and "dose-response"(DR) meta-analyses were performed. Random-effects models were used to estimate summary estimates. In total, 24 papers were included in the meta-analyses. We observed inverse associations for colorectal cancer risk and multivitamin (U-NU: RR = 0.92; 95% CI: 0.87,0.97) and calcium supplements (U-NU: RR = 0.86; 95% CI: 0.79,0.95; H-L: RR = 0.80; 95% CI: 0.70,0.92; DR: for an increase of 100 mg/day, RR = 0.96; 95% CI: 0.94,0.99). Inconsistent associations were found for colon cancer risk and supplemental vitamin A and vitamin C, and for colorectal cancer risk and supplemental vitamin D, vitamin E, garlic and folic acid. Meta-analyses of observational studies suggest a beneficial role for multivitamins and calcium supplements on colorectal cancer risk, while the association with other supplements and colorectal cancer risk is inconsistent. Residual confounding of lifestyle factors might be present. Before recommendations can be made, an extensive assessment of dietary supplement use and a better understanding of underlying mechanisms is needed