Controversial Research Articles

Perioperative immunotherapy for non-small cell lung cancer: consensus and controversy (2024 edition)

Lung cancer is the malignant tumour with the highest morbidity and mortality rate in China, among which non-small cell lung cancer (NSCLC) is the main pathological type of lung cancer, accounting for about 80% to 85%. Radial surgery is the standard treatment for early-stage NSCLC, but postoperative recurrence is an inevitable problem in clinical practice. Adding perioperative chemotherapy to surgery can only increase the 5-year overall survival rate by about 5%. There is an urgent need for better systemic treatments. In recent years, immunotherapeutic drugs, represented by PD-1/PD-L1 monoclonal antibodies, have brought breakthroughs from subsequent-line treatment to front-line treatment for NSCLC. Several Phase III studies on perioperative immunotherapy have shown that adding immunotherapy during the neoadjuvant and adjuvant treatment can significantly improve survival outcomes for patients, leading to the development of a new standard treatment for resectable NSCLC. In January 2024, the first PD-1 monoclonal antibodies (Toripalimab) were approved for perioperative treatment of NSCLC in China, starting a new era of perioperative immunotherapy. At present, there is still a lack of unified consensus on the application of perioperative immunotherapy at all levels of medical institutions. In order to privide diagnostic and treatment guidance for clinicians, promote the standardization of clinical practice for immunotherapy in resectable NSCLC, and clarify the controversial opinions regarding perioperative immunotherapy, Lung Cancer Expert Committee of the Chinese Anti-Cancer Association, Chinese Thoracic Oncology Group, Lung Cancer Expert Committee of the Chinese Medical Association Oncology Society jointly published this Consensus and Controversy to provide a guidance for the standardized management of perioperative immunotherapy for NSCLC.

Redesigning an AI bill of rights with/for young people: Principles for exploring AI ethics with middle and high school students

“AI ethics” has become a popular term for signaling concerns with the development and application of artificial intelligence, and a hot-button issue in both academic and public discourse. The current work tends to center adult-oriented, adult-generated, and issues-based conceptions of ethics. This paper reports on an alternative model for “doing ethics” via co-design with young people, highlighting the need for students to engage in AI ethics work, especially as AI is increasingly used in their education and social lives. In particular, we focus on developing a rights-based approach, using the White House Blueprint for an AI Bill of Rights as a starting point for redesigning core AI ethics principles and their conveyance to be accessible and relevant to young people, in collaboration with young people. In this manuscript, we describe our empirical work in a series of three studies on AI ethics teaching and learning with middle and high school students, which culminated in redesigning pieces of the AI Bill of Rights. We present lessons learned, implications for responsible AI in education from student perspectives, and conclude with our suggested principles for integrating student insight and perspectives into the ethics frameworks that guide AI applications.

Elucidation of Dividend Payout Determinants on Manufacturing Companies: A Systematic Review

Controversy issues in dividend policy have not been solved so far in modern corporate finance. Dividend payout is a puzzle in the contemporary financing system, as it was a traditional puzzle. Besides, conflict of interest between shareholders and managers of the corporation leads to a dramatic approach in the recent business environment. The main objective of this review was to identify and elucidate dividend payout determinants in manufacturing companies. Manufacturing is an industry that often uses manual labour or machinery to create goods from raw materials. Manufacturing industries include metal, automotive, electronics, textile, chemical, food and beverage, and so on sectors. This review carried out from 2004 to 2022 published studies in indexed journals. The review has assessed 62 journals with different databases through a vigilant review process concretely. The journals have been selected and systematically elucidated as relevant to the subject matter. The review depicts that dividend payout determinants differ from company to company. This shows that the dividend issue is still a puzzle in contemporary corporate finance.

Confronting Core Issues: A Critical Assessment of Attitude Polarization Using Tailored Experiments

A long-standing debate in political psychology considers whether individuals update their beliefs and attitudes in the direction of evidence or grow more confident in their convictions when confronted with counter-attitudinal arguments. Though recent studies have shown that instances of the latter tendency, which scholars have termed attitude polarization and “belief backfire,” are rarely observed in settings involving hot-button issues or viral misinformation, we know surprisingly little about how participants respond to information targeting deeply held attitudes, a key condition for triggering attitude polarization. We develop a tailored experimental design that measures participants’ core issue positions and exposes them to personalized counter-attitudinal information using the large language model GPT-3. We find credible evidence of attitude polarization, but only when arguments are contentious and vitriolic. For lower valence counter-attitudinal arguments, attitude polarization is not detected. We conclude by discussing implications for the study of political cognition and the measurement of attitudes.

On Swami Vivekananda and Caste Prejudice: Ethical Implications of the Experience of Non-Duality

The well-known modern Hindu reformer and pioneer of Vedānta in the West, Swami Vivekananda (1863–1902), based his ethical vision on mysticism: specifically, on the direct experience of non-duality and the ultimate unity and organic interconnectedness of all beings. This paper will explore the implications of this experientially based ethos for caste prejudice. Caste remains a hot-button issue in India to the present day and was no less so in the time of Swami Vivekananda. This system of social organization is rightly criticized by social justice advocates for the inequities it enshrines and enforces in Indian society. Because it has historically been justified by reference to Hindu textual sources—specifically such Dharma Śāstras as the Manusmṛti—prejudice based on caste, or casteism, has frequently been depicted, especially by critics of Hinduism, as essential or inherent to Hindu traditions. The implication of this identification of caste with Hinduism, and caste with social injustice, is that Hinduism is an intrinsically wicked and unjust religion. Such simplistic equations fail to consider the extent to which caste prejudice has been condemned by authoritative Hindu teachers, not least, by Swami Vivekananda himself. It is thus important to rearticulate Swami Vivekananda’s rejection of caste prejudice—and indeed, of all prejudice—based on Advaita Vedānta both to make the case against such prejudice in today’s world and to address criticisms of Hinduism as inherently or essentially casteist. Finally, it will be noted that Vivekananda’s criticisms of caste anticipate those of a contemporary anti-casteist voice from the Advaita tradition: that of Hindu theologian Anantanand Rambachan, who has also argued against prejudices of various kinds, including caste prejudice, based on Advaita Vedānta.

Noneffectiveness of cryostorage duration on clinical and neonatal outcomes after single vitrified-warmed blastocyst transfers

BackgroundIn the current era of assisted reproductive technology, the strategy of single vitrified-warmed blastocyst transfer (SVBT) is acknowledged for positively impacting clinical outcomes and preventing the risk of multiple conceptions. Previous studies have indicated that blastocyst grade and the day of blastocyst positively correlate with outcomes. Moreover, storage duration has no significant effect on survival rates, clinical outcomes, and neonatal outcomes. However, some researchers express controversial opinions on cryostorage duration, and their findings suggest a negative impact on clinical outcomes. These results remain subject to controversy, and limited studies exist regarding the outcomes after SVBT. Therefore, our study aims to investigate the impact of the day of blastocyst, blastocyst grade, and blastocyst cryostorage duration on clinical and neonatal outcomes following SVBT in patients who underwent clomiphene-citrate-based minimal stimulation.Material and methodsIn this study, retrospective cohort study data collected from June 2015 to April 2023 included 2107 patients with first SVBT cycles who underwent a clomiphene-based minimal ovarian stimulation protocol or a drug-free natural protocol at the Ojinmed IVF Center. Patients were categorized into four groups based on blastocyst cryostorage duration: group 1 (< 2 months, n = 882), group 2 (3–6 months, n = 794), group 3 (7–12 months, n = 187), group 4 (13–24 months, n = 126), and group 5 (25–81 months, n = 118). The patient’s clinical and neonatal outcomes were compared with cryostorage duration after the propensity score matched.ResultMultivariable logistic regression analysis revealed that prolonged cryostorage duration insignificantly correlated with clinical outcomes. Additionally, neonatal outcomes are not correlated with cryostorage duration.ConclusionsThe patient must consider several parameters when selecting embryos for transfer, including the duration of cryostorage. Our study results show that for the first single vitrified-warmed blastocyst transfer of patients who underwent clomiphene citrate-based minimal stimulation, cryostorage duration does not affect outcomes.

Facility management in gated settlements: challenges in Turkey-Istanbul experience

ABSTRACT Over the last four decades, gated settlements have become widespread and managing them has become a controversial issue. In such estates, where homeowners’ associations are active in management, facility management companies (FM companies) and facility managers (FM managers) have become effective in providing professional support to private management. Parallel to this, the growing FM industry in developed countries has led to FM becoming institutionalised. However, unlike in developed countries, in Turkey, despite the existence of gated settlements around the city and the increase in the number of FM providers in these areas, institutionalisation has not been achieved. This has a direct impact on the management of gated settlements. The main purpose of this article is to examine FM practices, and their impact on the management of gated settlements in Istanbul, Turkey. The main method used to obtain data in the study is the in-depth interview technique. Eight semi-structured interviews were carried out with managers of large and well-known FM companies. The emerging issues are grouped under two headings: the failure of adaptation of FM and the nature of relationships between FM practitioners and others. The results show that the lack of institutionalisation makes it difficult for FM to gain legitimacy. Informal relationships increase, and the state is needed to regulate the system.

Schuldenbremse und öffentliche Investitionen: Erwiderung auf Mühlenweg et al. (2024)

Abstract The political debate regarding the consequences of the German “debt brake” continues. The arguments against its current design are similar to the arguments brought forward in 2009, when the rule was first introduced. One hot-button issue has always been whether the German debt brake constrains public investment. A recent study by Feld et al. (2024) applies the synthetic control method to address this question. Mühlenweg et al. (2024) criticise their approach, building on well-known arguments against the German debt brake. This article counters their arguments.

Moral panics on social media are fueled by signals of virality.

Moral panics have regularly erupted in society, but they appear almost daily on social media. We propose that social media helps fuel moral panics by combining perceived societal threats with a powerful signal of social amplification-virality. Eight studies with multiple methods test a social amplification model of moral panics in which virality amplifies perceptions of threats posed by deviant behavior and ideas, prompting moral outrage expression. Three naturalistic studies of Twitter (N = 237,230) reveal that virality predicts moral outrage in response to tweets about controversial issues, even when controlling for specific tweet content. Five experiments (N = 1,499) reveal the causal impact of virality on outrage expression and suggest that feelings of danger mediate this effect. This work connects classic ideas about moral panics with ongoing research on social media and provides a perspective on the nature of moral outrage. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Relevant Issues Which Delayed The Achievement of African Unity From Nkrumah’s Struggle To The Present Day

This Article investigates on relevant issues which delayed the achievement of African unity from Nkrumah’s struggle to the present time. The aim is to determine the way Nkrumah did not succeed in realizing his vision for the unification of Africa. Using the historical approach, the study reveals that Nkrumah’s dream to saw African unity was failed because of controversial opinions and oppositions the first generation of the African leaders had not vigorously pursued the goal of unifying Africa, courage, will, dedication, determination and the loyalty that it deserved. They saw Nkrumah too radical and too ambitious as the one seeking to make Ghana a Black paradise. They therefore refused to follow his initiatives in the quest for unification in Africa because just fear of losing their power. The study also agrees that today it is the same scenario about African union. There are many debates among us, and there is no consensus on how to achieve African union; and Africa’s current generation of heads of States do not show their courage, will, action, and determination to the issue of African union, because they lack the methods and initiatives to apply in the search for African unity. Thus, their powerless in reflexions delays Nkrumah’s dream of African union at all levels. This Article concludes that we (the African people) must make the choice for our destiny, either to unite or disunite, because it will be a waste of time to look for the things which were not destined to us.

Thrombus extraction in acute ischemic stroke: three years of experience at the regional vascular center

From a modern perspective, the key to successful treatment of ischemic stroke is early reperfusion with systemic thrombolytic therapy and thrombus extraction. Thrombectomy is the only reliable method of recanalization in patients with thrombosis of a large cerebral artery. Despite the fact that thrombus extraction has proven its effectiveness in the treatment of acute ischemic stroke in a number of large randomized trials, there are still issues that have not been fully studied, on which there are controversial opinions among specialists. For instance, there is different information about whether direct thrombectomy or thrombus extraction after systemic thrombolysis is more effective and safer. Moreover, in accordance with modern procedures for providing care to patients with acute cerebral circulatory disorders, patients admitted in the «therapeutic window» should receive intravenous thrombolytic therapy even if thrombectomy is planned. Based on the analysis of 164 thrombus extractions in patients with acute ischemic stroke admitted to the regional vascular center in 2020–2023, the results of direct thrombus extraction and staged reperfusion (systemic thrombolytic therapy + thrombectomy) were compared. It has been found that compared to direct thrombus extraction, staged reperfusion provides more frequent achievement of 2b-3 recanalization (71.83 % and 78.49 %, respectively), accompanied by lower mortality (45 % and 23.66 %, respectively) and more frequent achievement of Rankin 0–2 functional status at the time of discharge (48.72 % and 61.96 %, respectively). The worst results were observed among patients with vascular occlusion in the vertebrobasilar basin, at TICI 0-2a and the age of patients over 80 years.

Men's attitudes toward third party casual sex

AbstractThe reproductive self-interest model of morality (RSIMM) is a framework for understanding moral judgments associated with sexual behavior. This model posits that individual differences in sexual strategies, mediated by one's religiosity and political orientation, casually influence people's moral judgments toward social hot-button issues. Previous work on the RSIMM has explained individual differences in attitudes toward abortion, prostitution, and contraception. Individuals more interested in long-term mating judged these behaviors as morally wrong. In this preregistered study, we proposed the RSIMM would account for individual differences in rape myth acceptance (RMA). RMA is the phenomenon of endorsing beliefs or stereotypes about rape that diminish the severity of assaults or shift blame from perpetrators to victims. We examined the relationship between political orientation, attitudes toward third-party casual sex, and RMA in a convenience sample of 308 participants (137 women). We predicted that more negative attitudes toward third parties' casual sex would correlate with increased RMA. Our hypothesis was supported for men but not women: Men who condemned others' casual sex, had more unrestricted attitudes about their own casual sex, and desired more casual sex were statistically more likely to accept more rape myths. In the discussion, we speculate that sex differences in the relationship between attitudes towards casual sex and RMA may be due to the costs of rape incurred by women but not men.

From Confrontation To Coexistence: An Appeal Opt-Out Arrangement As An Inclusive Approach To Revive The WTO Dispute Settlement System?

Resolving the crisis in the dispute settlement system is a priority issue for the reform of the World Trade Organization (WTO), and Members have made sustained efforts in this regard. Since the Twelfth Ministerial Conference (MC12), discussions on the dispute settlement system have entered a new phase, focusing on facilitator-organized meetings and proposals from Members. The reform negotiations have made some progress, but still face a number of significant challenges, in particular with regard to the appellate procedures. It is highly uncertain whether a comprehensive solution can be reached by 2024 as mandated by the MC12. Taking into account the different positions of Members and the imminent approach of the Thirteenth Ministerial Conference (MC13), this paper recommends that Members show more pragmatism and flexibility, puts forward a compromise proposal to establish a multilateral arrangement that would allow Members to opt out of the appellate review process under the Understanding on Rules and Procedures Governing the Settlement of Disputes ( DSU), and argues that this could be conducive to restoring a fully and well-functioning dispute settlement system. WTO, Appellate Body Crisis, Dispute Settlement Reform, Opt-out Arrangement

WTO Dispute Settlement and Trade Sanctions as Permissible Third-Party Countermeasures under Customary International Law

Abstract The requirements for invoking WTO security exceptions as expounded in recent WTO dispute settlement cases are notably stricter than previously thought by WTO members. Consequently, not all WTO members who have imposed trade sanctions against Russia will be able to invoke these exceptions to justify their actions when accused by Russia of violations of their WTO obligations. This article considers whether WTO members who may be unsuccessful in invoking security exceptions may nonetheless be able to justify their measures within the context of WTO dispute settlement under the customary international law on third-party countermeasures. It does so by exploring the scope of the relevant provisions within the Understanding on Rules and Procedures Governing the Settlement of Disputes (DSU) as well as competence of WTO adjudicative bodies (i.e., WTO panels and the Appellate Body) to look beyond the four corners of the WTO covered agreements.

Minimizing Blood Loss in Laparotomic Myomectomy through the Tourniquet Use: Insights from Our Clinical Experience and Literature Review

The uterine tourniquet is often not used to reduce intraoperative blood loss due to controversial opinions in the literature. The objective was to evaluate the effectiveness of this procedure in laparotomic myomectomy. This is a retrospective, monocentric case-control study, including patients who underwent laparotomic myomectomy and were categorized into the Tourniquet Group (A) and No Tourniquet Group (B). The blood loss outcomes were compared. Intra-operative blood loss in Group A was 275 ± 200 mL, while in Group B was 410 ± 390 mL (p = 0.11). Notably, five patients in the No Tourniquet Group lost more than 1000 mL of blood and required blood transfusion, while no such cases were reported in the Tourniquet Group. Furthermore, the decrease in hemoglobin post-procedure was statistically significant, favoring Group A with a decrease of 1.9 ± 0.7 g/dL compared to Group B’s 2.8 ± 2.2 g/dL (p = 0.04). The use of the Foley catheter as a tourniquet during laparotomic myomectomy may represent a remarkable tool that profoundly impacts the surgical process by substantially reducing blood loss. Its use may play a role in significantly diminishing the likelihood of requiring blood transfusions, enhancing patient safety and outcomes, and should be systematically adopted.

The Fundamental Concept of Death-Controversies and Clinical Relevance: The UDDA Revision Series.

When the Uniform Law Commission (ULC) was recently in the process of revising the Uniform Determination of Death Act (UDDA), Neurology® ran a series of debates over certain controversial issues being deliberated. Omitted was a debate over the fundamental concept underlying brain death. In his introductory article, Bernat offered reasons for this omission: "It is not directly relevant to practicing neurologists who largely accept brain death, do not question its conceptual basis, …." In this article I argue the opposite: the fundamental concept of death is highly relevant to the clinical criteria and tests used to diagnose it. Moreover, most neurologists in fact disagree with the conceptual basis articulated by Bernat. Basically, there are 3 competing concepts of death: (1) biological: cessation of the integrative unity of the organism as a whole (endorsed by Bernat and the 1981 President's Commission), (2) psychological: cessation of the person, equated with a self-conscious mind (endorsed by half of neurologists), and (3) the vital work concept proposed by the 2008 President's Council on Bioethics. The first actually corresponds to a circulatory, not a neurologic, criterion. The second corresponds to a "higher brain" criterion. The third corresponds loosely to the UK's "brainstem death" criterion. In terms of the biological concept, current diagnostic guidelines entail a high rate of false-positive declarations of death, whereas in terms of the psychological concept, the same guidelines entail a high rate of false-negative declarations. Brainstem reflexes have nothing to do with any death concept (their role is putatively to guarantee irreversibility). By shining a spotlight on the deficiencies of the UDDA through attempting to revise it, the ULC may have unwittingly opened a Pandora's box of fresh scrutiny of the concept of death underlying the neurologic criterion-particularly on the part of state legislatures with irreconcilably opposed worldviews.

Random genetic drift sets an upper limit on mRNA splicing accuracy in metazoans

Most eukaryotic genes undergo alternative splicing (AS), but the overall functional significance of this process remains a controversial issue. It has been noticed that the complexity of organisms (assayed by the number of distinct cell types) correlates positively with their genome-wide AS rate. This has been interpreted as evidence that AS plays an important role in adaptive evolution by increasing the functional repertoires of genomes. However, this observation also fits with a totally opposite interpretation: given that ‘complex’ organisms tend to have small effective population sizes (Ne), they are expected to be more affected by genetic drift, and hence more prone to accumulate deleterious mutations that decrease splicing accuracy. Thus, according to this ‘drift barrier’ theory, the elevated AS rate in complex organisms might simply result from a higher splicing error rate. To test this hypothesis, we analyzed 3496 transcriptome sequencing samples to quantify AS in 53 metazoan species spanning a wide range of Ne values. Our results show a negative correlation between Ne proxies and the genome-wide AS rates among species, consistent with the drift barrier hypothesis. This pattern is dominated by low abundance isoforms, which represent the vast majority of the splice variant repertoire. We show that these low abundance isoforms are depleted in functional AS events, and most likely correspond to errors. Conversely, the AS rate of abundant isoforms, which are relatively enriched in functional AS events, tends to be lower in more complex species. All these observations are consistent with the hypothesis that variation in AS rates across metazoans reflects the limits set by drift on the capacity of selection to prevent gene expression errors.

Random genetic drift sets an upper limit on mRNA splicing accuracy in metazoans.

Most eukaryotic genes undergo alternative splicing (AS), but the overall functional significance of this process remains a controversial issue. It has been noticed that the complexity of organisms (assayed by the number of distinct cell types) correlates positively with their genome-wide AS rate. This has been interpreted as evidence that AS plays an important role in adaptive evolution by increasing the functional repertoires of genomes. However, this observation also fits with a totally opposite interpretation: given that 'complex' organisms tend to have small effective population sizes (Ne), they are expected to be more affected by genetic drift, and hence more prone to accumulate deleterious mutations that decrease splicing accuracy. Thus, according to this 'drift barrier' theory, the elevated AS rate in complex organisms might simply result from a higher splicing error rate. To test this hypothesis, we analyzed 3496 transcriptome sequencing samples to quantify AS in 53 metazoan species spanning a wide range of Ne values. Our results show a negative correlation between Ne proxies and the genome-wide AS rates among species, consistent with the drift barrier hypothesis. This pattern is dominated by low abundance isoforms, which represent the vast majority of the splice variant repertoire. We show that these low abundance isoforms are depleted in functional AS events, and most likely correspond to errors. Conversely, the AS rate of abundant isoforms, which are relatively enriched in functional AS events, tends to be lower in more complex species. All these observations are consistent with the hypothesis that variation in AS rates across metazoans reflects the limits set by drift on the capacity of selection to prevent gene expression errors.

Engaging the many-hands problem of generative-AI outputs: a framework for attributing credit

AbstractThe recent wave of generative AI (GenAI) systems like Stable Diffusion or ChatGPT that can produce images, text and code from human prompts raises controversial issues about creatorship, originality, creativity and copyright. This paper focuses on creatorship: who creates and should be credited with the outputs made with the help of GenAI? There is currently significant moral, legal and regulatory uncertainty around these questions. We develop a novel framework, called CCC (collective-centered creation), that helps resolve this uncertainty. According to CCC, GenAI outputs are created by collectives in the first instance. Claims to creatorship come in degrees and depend on the nature and significance of individual contributions made by the various agents and entities involved, including users, GenAI systems, developers, producers of training data and others. We demonstrate how CCC can help navigate a range of ongoing controversies around the responsible development and deployment of GenAI technologies and help more accurately attribute credit where it is due.

Legitimacy, issue management, and gun debate

This study examined how two opposing advocacy organizations, National Rifle Association and Moms Demand Action, legitimize issues related to gun violence. Through topic modeling and social network analysis of tweets from both organizations, this study analyzed how advocacy organizations dealing with controversial issues use communication to achieve certain types of legitimacy. With the consistent outbreak of school mass shootings, this study also explored the communication strategies employed by advocacy organizations to manage issues and enhance legitimacy to garner policy initiatives. The theoretical and practical implications of the findings were discussed.