Smoking as Communication in Rastafari: Reasonings with 'Professional" Smokers and 'Plant Teachers'

In Rastafari smoking herbs (cannabis) and tobacco is central to spiritual practices, including grounding (the process of initiation into Rastafari) and reasoning (ritual discussions). This paper presents ethnographic research with Rastafari smokers in England. It shows that smoking is considered a ‘professional’ activity that communicates dedication to the movement, aids in learning different dialects, and facilitates experiences of communication with herbs ‘herself’. Through rituals that ‘professional’ smokers engage in herbs becomes a ‘plant teacher’, which Tupper [2008. The Globalization of Ayahuasca: Harm Reduction or Benefit Maximization? International Journal of Drug Policy, 19:300] defines as ‘a natural divinatory mechanism that can provide esoteric knowledge to adepts skilled in negotiating its remarkable effects’. Appreciation of smoking as a form of multispecies communication between ‘professional’ smokers and ‘plant teachers’ recasts the role of agency in anthropological studies of smoking and contributes to our understanding of consciousness and intentionality in both humans and plants

Strahlentherapie und Onkologie / Postoperative radiotherapy for prostate cancer : Morbidity of local-only or local-plus-pelvic radiotherapy

Ziel Ziel der vorgestellten Arbeit ist es, die Häufigkeit früher und später Nebenwirkungen nach postoperativer Bestrahlung von Prostatakarzinompatienten zu analysieren. Verglichen wurden dabei die Nebenwirkungen von lokaler Bestrahlung mit denen nach lokaler Bestrahlung plus Beckenbestrahlung (4-Felder-Box-Technik). Material und Methoden Basierend auf einem risikoadaptierten Protokoll erhielten 575 Patienten nach Prostatektomie entweder eine konventionelle lokale Bestrahlung (n = 447) oder eine Beckenbestrahlung (n = 128). Gastrointestinale und urogenitale Nebenwirkungen Grad 2 wurden prospektiv anhand der RTOG/EORTC-Klassifikation erhoben. Verglichen wurden die maximale Morbidität sowie die aktuarischen Inzidenz- und Prävalenzraten in beiden Gruppen. Ergebnisse Bei lokaler Bestrahlung waren die mediane Nachsorgezeit 68 Monate und die mittlere Dosis 66,7 Gy, bei Beckenbestrahlung waren die mediane Beobachtungszeit 49 Monate und die lokale Dosis bzw. die Beckendosis 66,9 und 48,3 Gy. Frühe gastrointestinale Nebenwirkungen wurden bei 26 % (lokal) bzw. bei 42 % (Becken) beobachtet (p < 0,001), eine späte gastrointestinale Morbidität bei jeweils 14 % in beiden Gruppen (p = 0,77). Die aktuarischen Fünfjahresinzidenzraten waren 14 bzw. 14 %, die Prävalenz lag bei 2 bzw.Purpose The aim of this work was to characterise actuarial incidence and prevalence of early and late side effects of local versus pelvic three-dimensional conformal postoperative radiotherapy for prostate cancer. Materials and methods Based on a risk-adapted protocol, 575 patients received either local (n = 447) or local-plus-pelvic (n = 128) radiotherapy. Gastrointestinal (GI) and genitourinary (GU) side effects (grade 2 RTOG/EORTC criteria) were prospectively assessed. Maximum morbidity, actuarial incidence rate, and prevalence rates were compared between the two groups. Results For local radiotherapy, median follow-up was 68 months, and the mean dose was 66.7 Gy. In pelvic radiotherapy, the median follow-up was 49 months, and the mean local and pelvic doses were 66.9 and 48.3 Gy respectively. Early GI side effects G2 were detected in 26% and 42% of patients respectively (p < 0.001). Late GI adverse events were detected in 14% in both groups (p = 0.77). The 5year actuarial incidence rates were 14% and 14%, while the prevalence rates were 2% and 0% respectively. Early GU G2 side effects were detected in 15% and 16% (p = 0.96), while late GU morbidity was detected in 18% and 24% (p = 0.001). The 5year actuarial incidence rates were 16% and 35% (p = 0.001), while the respective prevalence rates were 6% and 8%. Conclusions Despite the low prevalence of side effects, postoperative pelvic radiotherapy results in significant increases in the actuarial incidence of early GI and late GU morbidity using a conventional 4field box radiotherapy technique. Advanced treatment techniques like intensity-modulated radiotherapy (IMRT) or volumetric modulated arc radiotherapy (VMAT) should therefore be considered in pelvic radiotherapy to potentially reduce these side effects.(VLID)364358

Impact of SSTR PET on Inter-Observer Variability of Target Delineation of Meningioma and the Possibility of Using Threshold-Based Segmentations in Radiation Oncology

Aim: The aim of this study was to assess the effects of including somatostatin receptor agonist (SSTR) PET imaging in meningioma radiotherapy planning by means of changes in inter-observer variability (IOV). Further, the possibility of using threshold-based delineation approaches for semiautomatic tumor volume definition was assessed. Patients and Methods: Sixteen patients with meningioma undergoing fractionated radiotherapy were delineated by five radiation oncologists. IOV was calculated by comparing each delineation to a consensus delineation, based on the simultaneous truth and performance level estimation (STAPLE) algorithm. The consensus delineation was used to adapt a threshold-based delineation, based on a maximization of the mean Dice coefficient. To test the threshold-based approach, seven patients with SSTR-positive meningioma were additionally evaluated as a validation group. Results: The average Dice coefficients for delineations based on MRI alone was 0.84 &plusmn; 0.12. For delineation based on MRI + PET, a significantly higher dice coefficient of 0.87 &plusmn; 0.08 was found (p &lt; 0.001). The Hausdorff distance decreased from 10.96 &plusmn; 11.98 mm to 8.83 &plusmn; 12.21 mm (p &lt; 0.001) when adding PET for the lesion delineation. The best threshold value for a threshold-based delineation was found to be 14.0% of the SUVmax, with an average Dice coefficient of 0.50 &plusmn; 0.19 compared to the consensus delineation. In the validation cohort, a Dice coefficient of 0.56 &plusmn; 0.29 and a Hausdorff coefficient of 27.15 &plusmn; 21.54 mm were found for the threshold-based approach. Conclusions: SSTR-PET added to standard imaging with CT and MRI reduces the IOV in radiotherapy planning for patients with meningioma. When using a threshold-based approach for PET-based delineation of meningioma, a relatively low threshold of 14.0% of the SUVmax was found to provide the best agreement with a consensus delineation