Systematic review: non-endoscopic surveillance for colorectal neoplasia in individuals with Lynch syndrome

Background: Individuals with Lynch syndrome are at high risk for colorectal cancer (CRC). Regular colonoscopies have proven to decrease CRC incidence and mortality. However, colonoscopy is burdensome and interval CRCs still occur. Hence, an accurate, less-invasive screening method that guides the timing of colonoscopy would be of important value.Aim: To outline the performance of non-endoscopic screening modalities for Lynch-associated CRC and adenomas.Methods: Systematic literature search in MEDLINE and EMBASE to identify studies investigating imaging techniques and biomarkers for detection of CRC and adenomas in Lynch syndrome. The QUADAS-2 tool was used for the quality assessment of included studies.Results: Seven of 1332 screened articles fulfilled the inclusion criteria. Two studies evaluated either CT colonography or MR colonography; both techniques were unable to detect CRC and (advanced) adenomas <10 mm. The other five studies evaluated plasma methylated-SEPTIN9, faecal immunochemical test (FIT), faecal tumour DNA markers (BAT-26, hMLH1, p53, D9S171, APC, D9S162, IFNA and DCC) and faecal microbiome as screening modalities. Sensitivity for CRC varied from 33% (BAT-26) to 70% (methylated-SEPTIN9) to 91% (hMLH1). High specificity (94-100%) for CRC and/or adenomas was observed for methylated-SEPTIN9, FIT and BAT-26. Desulfovibrio was enriched in the stool of patients having adenomas. However, all these studies were characterised by small populations, high/unclear risk of bias and/or low prevalence of adenomas.Conclusions: Imaging techniques are unsuitable for colon surveillance in Lynch syndrome, whereas biomarkers are understudied. Having outlined biomarker research in Lynch-associated and sporadic CRC/adenomas, we believe that these non-invasive markers may hold potential (whether or not combined) for this population. As they could be of great value, (pre-)clinical studies in this field should be prioritised.Cellular mechanisms in basic and clinical gastroenterology and hepatolog

Environmental consciousness and choice of bulb for lighting in a developing country

Background: Most countries in the world especially those in Asia and Africa have been undertaking policies meant to help promote science, technology and innovation towards meeting some provisions of the Sustainable Development Goals. However, there is still a sizable number of households who have not yet fully embraced energy-saving technologies. This study provides highlights on the economic and environmental benefits for investing in energy-saving light bulbs. Methods: Using a survey and a multistage random sampling approach, we administered questionnaires to 1650 households in Ghana. The relevant diagnostic tests associated with cross-sectional data were undertaken. We estimated a maximum-likelihood probit model with its associated marginal effects to find out how the choice of energy-saving light bulb (behaviour) is influenced by environmental consciousness (both local knowledge and global knowledge) and other demographic factors. Results: Our results are consistent with economic theory as well as what earlier empirical evidence found in literature. That is, environmental consciousness, education, income, etc. are very important in explaining the choice of buying energy-saving light bulbs in Ghana. Conclusions: Besides advocating for information that will make society more environmentally conscious, we further recommend the use of fiscal policies (i.e. subsidies) to support lower income brackets who are predominant in developing countries

Machine Learning in Automated Text Categorization

The automated categorization (or classification) of texts into predefined categories has witnessed a booming interest in the last ten years, due to the increased availability of documents in digital form and the ensuing need to organize them. In the research community the dominant approach to this problem is based on machine learning techniques: a general inductive process automatically builds a classifier by learning, from a set of preclassified documents, the characteristics of the categories. The advantages of this approach over the knowledge engineering approach (consisting in the manual definition of a classifier by domain experts) are a very good effectiveness, considerable savings in terms of expert manpower, and straightforward portability to different domains. This survey discusses the main approaches to text categorization that fall within the machine learning paradigm. We will discuss in detail issues pertaining to three different problems, namely document representation, classifier construction, and classifier evaluation.Comment: Accepted for publication on ACM Computing Survey

Discovery of Rare Variants via Sequencing: Implications for the Design of Complex Trait Association Studies

There is strong evidence that rare variants are involved in complex disease etiology. The first step in implicating rare variants in disease etiology is their identification through sequencing in both randomly ascertained samples (e.g., the 1,000 Genomes Project) and samples ascertained according to disease status. We investigated to what extent rare variants will be observed across the genome and in candidate genes in randomly ascertained samples, the magnitude of variant enrichment in diseased individuals, and biases that can occur due to how variants are discovered. Although sequencing cases can enrich for casual variants, when a gene or genes are not involved in disease etiology, limiting variant discovery to cases can lead to association studies with dramatically inflated false positive rates

Wild Animals in Our Backyard. A Contextual Approach to the Intrinsic Value of Animals

As a reflection on recent debates on the value of wild animals we examine the question of the intrinsic value of wild animals in both natural and man-made surroundings. We examine the concepts being wild and domesticated. In our approach we consider animals as dependent on their environment, whether it is a human or a natural environment. Stressing this dependence we argue that a distinction can be made between three different interpretations of a wild animal’s intrinsic value: a species-specific, a naturalistic, and an individualistic interpretation. According to the species-specific approach, the animal is primarily considered as a member of its species; according to the naturalistic interpretation, the animal is seen as dependent on the natural environment; and according to the individualistic approach, the animal is seen in terms of its relationship to humans. In our opinion, the species-specific interpretation, which is the current dominant view, should be supplemented—but not replaced by—naturalistic and individualistic interpretations, which focus attention on the relationship of the animal to the natural and human environments, respectively. Which of these three interpretations is the most suitable in a given case depends on the circumstances and the opportunity for the animal to grow and develop according to its nature and capabilities