Era Of Surveillance Research Articles

Cytomegalovirus Post-Prophylaxis Surveillance in High-Risk Kidney and Liver Recipients Prevents CMV End-Organ Disease and Ganciclovir-Resistance.

Evaluate cytomegalovirus (CMV) post-prophylaxis surveillance in high-risk (D+/R-) kidney and liver transplant recipients. Adult D+/R- patients were included if transplanted between 6/1/15 and 11/30/22 and divided into a pre-CMV-stewardship-era (6/1/15-5/31/18), CMV-stewardship-era (6/1/18-6/30/20), and a surveillance-era (7/1/2020-11/30/2022) then followed through 12 months. The primary objective was to evaluate CMV-related outcomes. The secondary objective was to assess graft and patient survival by era. There were 328 patients in the study period; 133 in the pre-stewardship-era, 103 in the stewardship-era, and 92 in the surveillance-era. Replication rates in the surveillance-era were significantly higher, as anticipated due to increased sampling (pre 38.4%, stewardship 33.0%, surveillance 52.2%, p=0.02). Time from transplant to first replication was similar (pre 214.0±79.0 days, stewardship 231.1±65.5, surveillance 234.9±61.4, p=0.29). CMV viral load (VL) at first detection, maximum-VL, and incidence of VL > 100 000 IU/mL were numerically lower in the surveillance era, although not statistically significant. CMV end-organ disease (p < 0.0001) and ganciclovir-resistance (p=0.002) were significantly lower in the surveillance era than in both previous eras. Rejection was not different between eras (p=0.4). Graft (p=0.0007) and patient survival (p=0.008) were significantly improved in the surveillance era. Post-prophylaxis surveillance significantly reduced CMV end-organ disease and resistance. Despite observing increased replication rates in the surveillance era, rejection was not significantly different and there was no graft loss or patient mortality at 12 months.

Evolution of Initial Treatment for Desmoid Tumors.

Desmoid tumors (DTs) are rare, fibroblastic cell proliferations that can exhibit locally aggressive behavior but lack metastatic potential. Initial management has traditionally involved upfront resection; however, contemporary guidelines and expert panels have increasingly advocated for prioritizing active surveillance strategies. A single-institution, retrospective chart review identified all patients diagnosed with a primary DT at any site from 2007 to 2020. The primary outcome was the initial management strategy over time. Secondary outcomes included treatment-free survival (TFS) and time to treatment (TTT) for those undergoing active surveillance, as well as recurrence-free survival (RFS) and time to recurrence for those undergoing resection. Overall, 103 patients were included, with 68% female and a median follow-up of 44 months [24-74]. The most common tumor locations included the abdominal wall (27%), intra-abdominal/mesenteric (25%), chest wall (19%), and extremity (10%). Initial management included resection (60%), systemic therapy (20%), active surveillance (18%), and cryoablation (2%). Rates of surgical resection significantly decreased (p<0.001) over time, from 69.6% prior to 2018 to 29.2% after 2018. For those treated with upfront resection, 5-year RFS was 41.2%, and for patients undergoing initial active surveillance, TFS was 66.7% at 2 years, with a median TTT of 4 months [4-10]. This single-institution cohort at a tertiary medical center spanning over a decade demonstrates the transition to active surveillance for initial management of DTs, and highlights salient metrics in the era of surveillance. This trend mirrors recommended treatment strategies by expert panels and consensus guidelines.

Contemporary risk of biochemical recurrence after radical prostatectomy in the active surveillance era

ObjectivesTo assess whether contemporary risks of biochemical recurrence (BCR) after radical prostatectomy (RP) in the AS era differ from historical estimates due to changes in tumor risk case mix and improvements in risk stratification. Materials and methodsWe sampled 6,682 men who underwent RP for clinically localized disease between 2000 and 2017 from the VA SEARCH database. Kaplan Meier analysis was used to calculate incidence of BCR before and after 2010 overall and within tumor risk subgroups. Multivariable Cox proportional hazard regression analysis including an interaction term between era and tumor risk was used to compare risk of BCR before and after 2010 overall and across tumor risk subgroups. ResultsAbout 3,492 (52%) and 3,190 (48%) men underwent RP before and after 2010, respectively. In a limited multivariable model excluding tumor risk, overall BCR risk was higher post-2010 vs. pre-2010 (HR: 1.15, 95%CI: 1.05–1.25; 40% vs 36% at 8 years post-RP). However, this effect was eliminated after correcting for tumor risk (HR: 0.95, 95%CI: 0.87–1.04), suggesting that differences in tumor risk between eras mediated the change. Yet, within tumor-risk subgroups, BCR risk was significantly lower for favorable intermediate-risk (HR: 0.76, 95%CI:0.60–0.96) and unfavorable intermediate-risk PC (HR: 0.78, 95%CI: 0.67–0.90), but significantly higher for high-risk PC (HR: 1.22, 95%CI: 1.07–1.38) in the post-2010 era. 8-year risks of BCR in the post-2010 era were 21% (95%CI: 16%–25%), 25% (95%CI: 20%–30%), 41% (95%CI: 37%–46%), and 60% (95%CI: 56%–64%) for low-, FIR-, UIR-, and high-risk disease, respectively. Limitations include limited long-term follow-up in the post-2010 subgroup. ConclusionsOverall BCR risk has increased in the AS era, driven by a higher risk case mix and increased BCR risk among high-risk patients. Physicians should quote contemporary estimates of BCR when counseling patients.

Human Rights in the Era of Surveillance: Balancing Security and Privacy Concerns

In today's rapidly evolving digital landscape, the delicate equilibrium between security imperatives and the protection of individual privacy is under intense scrutiny. This abstract explores the multifaceted challenges posed by the proliferation of surveillance technologies and their impact on human rights. As governments and corporations harness the power of surveillance for security purposes, concerns over privacy violations, data breaches, and potential abuses of power have come to the forefront. This abstract delves into the evolving legal and ethical frameworks governing surveillance practices, highlighting key debates and global perspectives. It also examines the implications for fundamental human rights such as freedom of expression, privacy, and assembly. By examining case studies, emerging technologies, and international efforts to strike a balance between security and privacy, this abstract seeks to shed light on the complex dynamics of this contemporary issue and proposes potential avenues for reconciling these often conflicting interests. Ultimately, it calls for a thoughtful and inclusive dialogue that can guide the development of responsible surveillance policies that respect individual rights and uphold the principles of a free and democratic society.

MP77-15 INCREASED RISK OF BIOCHEMICAL RECURRENCE AFTER RADICAL PROSTATECTOMY IN THE ACTIVE SURVEILLANCE ERA

You have accessJournal of UrologyCME1 Apr 2023MP77-15 INCREASED RISK OF BIOCHEMICAL RECURRENCE AFTER RADICAL PROSTATECTOMY IN THE ACTIVE SURVEILLANCE ERA Sanjay Das, Michael Luu, Stephen Freedland, and Timothy Daskivich Sanjay DasSanjay Das More articles by this author , Michael LuuMichael Luu More articles by this author , Stephen FreedlandStephen Freedland More articles by this author , and Timothy DaskivichTimothy Daskivich More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003351.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In the active surveillance (AS) era, radical prostatectomy (RP) has become more often used for intermediate- and high-risk disease and less for low-risk disease. AS/conservative management became the most common treatment for low-risk disease in the VA in 2010. However, the impact of this shift on risk of biochemical recurrence (BCR) after RP is unknown. We sought to determine how risk of BCR has changed before and after 2010 and to provide contemporary projections for BCR by tumor risk. METHODS: We sampled men who underwent RP for clinically localized disease between 2000 and 2017 from the VA SEARCH database. Kaplan Meier analysis was used to calculate incidence of BCR before and after 2010 overall and across tumor risk subgroups. Multivariable Cox proportional hazard regression analysis including an interaction term between epoch and tumor risk was used to compare risk of BCR before and after 2010 overall and across tumor risk subgroups. RESULTS: Of 5,648 patients, 3,276 (58%) underwent RP in 2010 or prior and 2,372 (42%) after 2010. Of those who underwent RP in 2010 or prior, 1,266 (39%), 503 (15%), 655 (20%), and 712 (22%) had low-, favorable intermediate-, unfavorable intermediate-, and high-risk disease, respectively, compared with 335 (14%), 488 (21%), 768 (32%), and 749 (32%) among those who underwent RP after 2010 (p<0.001). The 7-year risk of BCR in the post-2010 was 43%, compared with 33% in the pre-2010 era (HR 1.15, 95%CI 1.04–1.28). In a multivariable Cox model adjusting for tumor risk, there was a significant interaction between tumor risk and epoch in predicting BCR (p<0.001). Men with favorable intermediate risk (HR 0.71, 95%CI 0.53–0.96) and unfavorable intermediate risk disease (HR 0.74, 95%CI 0.61–0.90) had a lower risk of BCR in the post-2010 era. Men with high-risk disease (HR 1.24, 95%CI 1.06–1.45) had higher risk of BCR in the post-2010 (vs. pre-2010) era. The 5-year risk of BCR in the pre- vs. post-2010 eras were 17% vs. 15%, 23% vs. 20%, 40% vs. 33%, and 46% vs. 52% for low, favorable intermediate, unfavorable intermediate, and high-risk disease, respectively. CONCLUSIONS: Trends toward using RP for higher risk disease have increased the 7-year risk of BCR from 33% to 43% in the pre- vs. post-AS eras, primarily driven by increased risk of BCR in high-risk patients. Source of Funding: This research was supported by Cedars-Sinai Cancer at Cedars-Sinai Medical Center through the Biostatistics Core Voucher Program. Dr. Das was supported by the Patient Centered Outcomes in Urologic and Gynecologic Cancers (PCORT: UroGynCan) © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1108 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sanjay Das More articles by this author Michael Luu More articles by this author Stephen Freedland More articles by this author Timothy Daskivich More articles by this author Expand All Advertisement PDF downloadLoading ...

Focal osteolysis and corrosion at the junction of Precice Stryde intramedullary lengthening device : preliminary clinical, radiological, and metallurgic analysis of 57 lengthened segments.

AimsThis study aims to enhance understanding of clinical and radiological consequences and involved mechanisms that led to corrosion of the Precice Stryde (Stryde) intramedullary lengthening nail in the post market surveillance era of the device. Between 2018 and 2021 more than 2,000 Stryde nails have been implanted worldwide. However, the outcome of treatment with the Stryde system is insufficiently reported.MethodsThis is a retrospective single-centre study analyzing outcome of 57 consecutive lengthening procedures performed with the Stryde nail at the authors’ institution from February 2019 until November 2020. Macro- and microscopic metallographic analysis of four retrieved nails was conducted. To investigate observed corrosion at telescoping junction, scanning electron microscopy (SEM) and energy dispersive x-ray spectroscopy (EDX) were performed.ResultsAdjacent to the nail’s telescoping junction, osteolytic changes were observed in bi-planar radiographs of 20/57 segments (35%) after a mean of 9.5 months (95% confidence interval 7.2 to 11.9) after surgery. A total of 8/20 patients with osseous alterations (40%) reported rest and ambulation pain of the lengthened segment during consolidation.So far, 24 Stryde nails were retrieved and in 20 (83%) macroscopic corrosion was observed at the nail’s telescoping junction. Before implant removal 11/20 radiographs (55%) of lengthened segments with these 20 nails revealed osteolysis. Implant retrieval analysis by means of SEM showed pitting and crevice corrosion. EDX detected chromium as the main metallic element of corrosion.ConclusionPatients are exposed to the risk of implant-related osteolysis of unclear short- and long-term clinical consequences. The authors advocate in favour of an early implant removal after osseous consolidation.Cite this article: Bone Joint Res 2021;10(7):425–436.

Regulation in an Era of Surveillance and Other Threats to Privacy

Given the dramatic rise in the mechanisms through which governments, private industry, and other interests can access, gather, analyze, and employ information on citizens, we offer a theory of coevolving disruptions in the technological, business, and policy spheres. We then consider competing conceptions of privacy in a world of ever-evolving norms; we also assay public opinion on matters of surveillance and privacy focusing on points of consensus and conflict. We find that public opinion on privacy matters is a more complex phenomenon than most regulation scholars may assume. Finally, we consider theoretical guideposts for policy actors in their attempt to reconcile public demands for privacy with competing interests.

Beyond Moral Coupling: Analysing Politics of Privacy in the Era of Surveillance

The article calls into question the prevailing discursive construction in contemporary debate on privacy and surveillance. At the core of this discourse is a moral coupling wherein surveillance is perceived as enemy and privacy as friend. Even if this binary approach renders arguments for democratising data more persuasive, a political cost accompanies it. As this discourse situates political struggle at the level of digital infrastructure and political structures, the moral coupling largely overlooks the ambiguities of how people in their various activities in a digital environment experience surveillance and privacy. Such a framing may discourage users at large from engagement with politics of privacy. Edward Snowden’s autobiography is taken as a prominent example of the prevailing discourse. While analysing Snowden’s descriptions of privacy and surveillance critically, the author points out the specific value of life stories in describing what privacy means and why it matters. While we cannot assume all people to be equally capable of considering how their own life intersects with the history of their society, we can presume that varying life stories should contribute to the public knowledge of privacy. To provide the framework necessary for appropriately contextualising empirical evidence, the author presents a model wherein privacy is composed of five dimensions: solitude, anonymity, secrecy, intimacy, and dignity.

Desmoid tumours in the surveillance era: What are the remaining indications for surgery?

The treatment of desmoid tumours (DTs) has greatly evolved in recent years, and surgery is no longer considered a first-line treatment. Percutaneous biopsy with molecular analysis for beta-catenin or APC gene mutation provides a certain diagnosis. After imaging, a specialized multidisciplinary tumour board (MDT) addresses the following therapeutic strategy. As more than half of patients stabilize or regress, despite initial progression, active surveillance is offered to most patients as the first option. Surgery is proposed for complications such as perforation and occlusion, which sometimes are the first manifestations of the disease. In these cases, limiting surgery to the treatment of complications and leaving the tumour in place is possible if significant bowel sacrifice is needed, especially in patients with previous colectomy for polyposis. Medical therapy is discussed by the MDT in cases of functional or life-threatening masses and is preferred to local treatments that could be mutilating and often incomplete. First-line surgery is now contraindicated in cases of incomplete unplanned surgery, recurrence, pregnancy or DTs occurring in familial adenomatous polyposis (FAP). The best indications of second-line surgery are significantly progressing disease when morbidity is acceptable, such as parietal locations. Medical and other locoregional treatments (radiotherapy, isolated limb perfusion and cryotherapy) should be considered by the MTB when surgery might cause sequelae.

Privacy trading in the surveillance capitalism age viewpoints on 'privacy-preserving' societal value creation

In the modern era of the mobile apps (part of the era of surveillance capitalism , a famously coined term by Shoshana Zuboff), huge quantities of data about individuals and their activities offer a wave of opportunities for economic and societal value creation. However, the current personal data ecosystem is mostly de-regulated, fragmented, and inefficient. On one hand, end-users are often not able to control access (either technologically, by policy, or psychologically) to their personal data which results in issues related to privacy, personal data ownership, transparency, and value distribution. On the other hand, this puts the burden of managing and protecting user data on profit-driven apps and ad-driven entities (e.g., an ad-network) at a cost of trust and regulatory accountability. Data holders (e.g., apps) may hence take commercial advantage of the individuals' inability to fully anticipate the potential uses of their private information, with detrimental effects for social welfare. As steps to improve social welfare, we comment on the the existence and design of efficient consumer-data releasing ecosystems aimed at achieving a maximum social welfare state amongst competing data holders. In view of (a) the behavioral assumption that humans are 'compromising' beings, (b) privacy not being a well-boundaried good, and (c) the practical inevitability of inappropriate data leakage by data holders upstream in the supply-chain, we showcase the idea of a regulated and radical privacy trading mechanism that preserves the heterogeneous privacy preservation constraints (at an aggregate consumer, i.e., app, level) upto certain compromise levels, and at the same time satisfying commercial requirements of agencies (e.g., advertising organizations) that collect and trade client data for the purpose of behavioral advertising. More specifically, our idea merges supply function economics , introduced by Klemperer and Meyer, with differential privacy, that, together with their powerful theoretical properties, leads to a stable and efficient, i.e., a maximum social welfare, state, and that too in an algorithmically scalable manner. As part of future research, we also discuss interesting additional techno-economic challenges related to realizing effective privacy trading ecosystems.

Prostate cancer meeting the Japanese active surveillance criteria and diagnosed by community‐based prostate‐specific antigen screening: A 21‐year follow‐up study

To evaluate the oncological outcomes of Japanese patients with prostate cancer diagnosed by community-based prostate-specific antigen screening during a 21-year period who satisfied the criteria for active surveillance. Active surveillance candidates were extracted from the community-based screening registry of Otokuni district in Kyoto prefecture. The frequency of active surveillance candidates before and after publication of the active surveillance criteria in Japan was analyzed. In addition, we examined the frequency of switching to curative intervention and treatment failure among active surveillance candidates, including the patients who selected active surveillance. During the study period, 868 patients were diagnosed with prostate cancer and 780 of these patients were analyzed. Among them, 190 patients (24%) satisfied our active surveillance criteria (21 and 169 in the pre-active surveillance era and active surveillance era, respectively). Of the 169 patients in the active surveillance era, 74 initially selected active surveillance. The number of active surveillance candidates increased with increasing age, and the proportion of active surveillance candidates among prostate cancer patients also increased significantly each year (P<0.001). In the active surveillance group, the median follow-up period was 4years and 35% switched to curative intervention. Among the 190 active surveillance candidates, seven died of other causes, but there were no deaths from prostate cancer. Changes of active surveillance candidates in one district of Japan were successfully analyzed by using consistent active surveillance selection criteria and data obtained by a single pathologist. Oncological outcomes were good among active surveillance candidates in the low-risk group.

Late biochemical recurrence after radical prostatectomy is associated with a slower rate of progression.

To characterise the pattern of late biochemical recurrence (BCR) in the largest contemporary cohort of patients with localised prostate cancer treated with radical prostatectomy (RP) in the active surveillance era. Consecutive patients who underwent RP for localised prostate cancer between 2003 and 2017 were identified from a prospectively recorded, dedicated prostate cancer database. Patients who received neoadjuvant androgen-deprivation therapy were excluded. These patients were categorised into the following groups: no BCR, BCR at <12months (early), BCR at 12-60months (intermediate), and BCR at >60months (late), after RP. Clinicopathological characteristics were analysed using the Student's t-test, Mann-Whitney U-test, or chi-squared test where appropriate. Multivariable binomial logistic regression models were used to assess predictors of BCR at various time-points. In all, 2312 patients were included in the final analysis with up to 12years of follow-up data. The average patient had clinically localised prostate cancer, an elevated PSA level, and International Society of Urological Pathology (ISUP) Grade Group 2 on biopsy. In all, 88.7% of patients had ISUP Grade Group ≥2 at RP. A subgroup of 446 patients had undetectable PSA levels at 5years after RP; 11.7% of them progressed to experience BCR. In this subgroup, late recurrers had significantly higher-grade tumours on ISUP and Gleason sum (P <0.001 and P = 0.001, respectively), higher rates of extraprostatic extension (P = 0.022), and larger tumour volumes (P = 0.032). Logistic regression showed that RP ISUP Grade Group was a significant predictor of BCR (odds ratio 2.14, 95% confidence interval 1.43-3.20; P <0.001). This study characterises the pattern of late BCR in the largest contemporary active surveillance era cohort. We have identified that RP ISUP Grade Group is a strong predictive indicator for late BCR. We also propose that timing of BCR resides on a continuum of risk and that the potential concept of dormant micrometastatic involvement requires further research and evaluation.

Impact of rotavirus vaccine introduction and genotypic characteristics of rotavirus strains in children less than 5 years of age with gastroenteritis in Ethiopia: 2011–2016

IntroductionA monovalent rotavirus vaccine was introduced in the Ethiopian Expanded Program on Immunization from November 2013. We compared impact of rotavirus vaccine introduction on rotavirus associated acute diarrhea hospitalizations and genotypic characteristics of rotavirus strains pre-and post-vaccine introduction. MethodsSentinel surveillance for diarrhea among children <5 years of age was conducted at 3 hospitals in Addis Ababa, Ethiopia from 2011 to 2017. Stool specimens were collected from enrolled children and tested using an antigen capture enzyme immunoassay. Rotavirus positive samples (156 from pre- and 141 from post-vaccination periods) were further characterized by rotavirus genotyping methods to identify the predominant G and P types circulating during the surveillance era. ResultsA total of 788 children were enrolled during the pre- (July 2011-June 2013) and 815 children during the post-vaccination (July 2014-June 2017) periods. The proportion of diarrhea hospitalizations due to rotavirus among children <5 years of age declined by 17% from 24% (188/788) in the pre-vaccine period and to 20% (161/185) in post-vaccine introduction era. Similarly, a reduction of 18% in proportion of diarrhea hospitalizations due to rotavirus in children <12 months of age in the post (27%) vs pre-vaccine (33%) periods was observed. Seasonal peaks of rotavirus declined following rotavirus vaccine introduction. The most prevalent circulating strains were G12P[8] in 2011 (36%) and in 2012 (27%), G2P[4] (35%) in 2013, G9P[8] (19%) in 2014, G3P[6] and G2P[4] (19% each) in 2015, and G3P[8] (29%) in 2016. DiscussionFollowing rotavirus vaccine introduction in Ethiopia, a reduction in rotavirus associated hospitalizations was seen in all age groups with the greatest burden in children <12 months of age. A wide variety of rotavirus strains circulated in the pre- and post-vaccine introduction periods.

New genomic markers for improved decision making in the prostate cancer active surveillance era

Active surveillance (AS) for men with low risk prostate cancer (PCa) has emerged as one of the accepted management options over the last decade. Even though it has been widely implemented, the process of selecting appropriate patients remains somewhat ambiguous due to lack of unanimously established criteria.

Recognizing Dignity

An enduring finding is that marginalized young men of color aggressively seek “respect,” or masculine status. Drawing on ethnographic fieldwork at an all-boys public high school, the author found that respect—a desire to “be known”—offers an incomplete explanation for how young black men claim recognition in an era of surveillance. These findings reveal an alternative and more complex portrait of criminalized young black men in search of multiple dignities. With the help of adults, the young men in this study made claims to the right to grow as individuals. They also continued to yearn for a form of respect that rejected a sexually victimized identity, in a manner rarely captured in previous research. Their yearnings also highlight claims to a third form of dignity: to “be unknown,” or the privilege of anonymity.

Acute Kidney Injury in Hospitalized Children With Cystic Fibrosis

Background: Children hospitalized for cystic fibrosis related pulmonary exacerbation are at risk of acute kidney injury (AKI); yet the incidence of AKI using contemporary definitions has yet to be investigated. Methods: A retrospective chart review was performed for two era’s of about 2 years each. During the former era SCr was measured as per clinician. In the latter era, a standardized heightened surveillance program was implemented. Using the 2012 KDIGO AKI definition, we compared the incidence, severity of AKI, hospital costs and length of hospital stay between the two eras. Results: AKI was more common after surveillance implementation (23.8% vs. 15.2%; p < .001). The number of SCr measurements per each admission was increased in the surveillance era (. 3.4 ± 5.4 vs 2.1 ± 2.1; p < .001). Cost and length of stay were highest in those with AKI in the heightened surveillance era (p<0.001). Conclusions: We found that approximately one-quarter of hospitalized patients with CF will develop AKI. Those with AKI have higher hospital costs and length of stay. Prospective studies to better understand surveillance practices, risk factors, outcomes and strategies to decrease the incidence of AKI are greatly needed.

ICT ethics bibliography 2012–2014: a select list of recent books

Forty-five recent books that examine ethical, social, legal and policy issues in information and communication technology (ICT) are identified and annotated below. Each work has a publisher’s date of 2011 or later. For information about books published between 1997 and 2011, see the ICT-ethics bibliographies included in nine previous issues of Ethics and Information Technology: Vol. 1, No. 1 (1999); Vol. 2, No. 1 (2000); Vol. 3, No. 1 (2001); Vol. 4, No. 2 (2002); Vol. 5, No. 3 (2003); Vol. 6, No. 2 (2004); Vol. 7, No. 4 (2005); Vol. 10, No. 2 (2008); and Vol. 12, No. 4 (2010). A comprehensive list of books and articles published before 1997 is included in my Bibliography of Computing, Ethics, and Social Responsibility (http:// cyberethics.cbi.msstate.edu/biblio/index.htm). Janet Abbate. Recoding Gender: Women’s Changing Participation in Computing. Cambridge, MA: MIT Press, 2012; 247 pages. ISBN 978-0262018067. Includes five chapters: 1. Breaking Codes and Finding Trajectories: Women at the Dawn of the Digital Age; 2. Seeking the Perfect Programmer: Gender and Skill in Early Data Processing; 3. Software Crisis or Identity Crisis? Gender, Labor, and Programming Methods; 4. Female Entrepreneurs: Reimagining Software as a Business; 5. Gender in Academic Computing: Alternative Career Paths and Norms. Also includes an Introduction (titled ‘‘Rediscovering Women’s History in Computing’’) and an Appendix (titled ‘‘Oral History Interviews Conducted for This Project’’). Christina Akrivopoulou and Athanasios-Efstratios Psygkas, editors. Personal Data Privacy and Protection in a Surveillance Era: Technologies and Practices. Hershey, PA: IGI Global, 2013; 402 pages. ISBN: 978-1609600839. Includes eighteen readings that cover a wide range of topics and issues affecting privacy and surveillance in the context of various emerging technologies. Anita Allen. Unpopular Privacy: What Must We Hide? New York: Oxford University Press, 2011; 281 pages. ISBN 978-0195141375. Includes eight chapters organized into two main parts: Part I: Physical Privacies—Place and Body, and Part II: Information Privacies. Also includes an Introduction and an Afterword. [This book is reviewed in Ethics and Information Technology (Vol. 15, No. 1, 2013).] Michael Anderson and Susan Leigh Anderson, editors. Machine Ethics. Cambridge, MA: Cambridge University Press, 2011; 546 pages. ISBN: 978-0521112352. Includes thirty-one chapters organized into five main parts: Part I. The Nature of Machine Ethics; Part II. The Importance of Machine Ethics; Part III. Issues Concerning Machine Ethics; Part IV. Approaches to Machine Ethics; and Part V. Visions for Machine Ethics. Also includes a ‘‘General Introduction’’ contributed by the editors. Sara Baase. A Gift of Fire: Social, Legal, and Ethical Issues for Computing and the Internet. Englewood Cliffs, NJ: Prentice Hall, 2013; 496 pages. ISBN: 0132492679. Organized into nine chapters: (1) Unwrapping the Gift; (2) Privacy; (3) Freedom of Speech; (4) Intellectual Property; (5) Crime; (6) Work; (7) Evaluating and Controlling Technology; (8) Errors, Failures, and Risk; and (9) Professional Ethics and Responsibilities. Also includes an Epilogue. Mark Bauerlein, editor. The Digital Divide: Arguments for and Against Facebook, Google, Texting, and the Age of Social Networking. New York: Jeremy P. Tarcher/Penguin, 2011; 368 pages. ISBN 978-1101547526. Includes twentyseven articles organized into three main sections: Section H. T. Tavani (&) Department of Philosophy, Rivier University, Nashua, NH 03060, USA e-mail: htavani@rivier.edu

Oncologic outcomes following radical prostatectomy in the active surveillance era

In this study, we examine the oncologic outcomes of men with low, intermediate and high preoperative risk for prostate cancer treated with radical prostatectomy prior to and during the active surveillance era. We analyzed records from patients who underwent radical prostatectomy at our Canadian tertiary care facility from 2000 to 2012. Patients were stratified by D'Amico preoperative risk category and by year of treatment. Biochemical recurrence-free survival was estimated using the Kaplan-Meier method. We included 2643 consecutive patients in our analysis. The proportion of men with low-risk disease undergoing radical prostatectomy decreased from 2007 onwards coincident with the implementation of an active surveillance strategy in our institution. Men with low-risk and high-risk disease showed significantly worse biochemical outcomes from 2007 to 2012 compared to 2000 to 2006 (p < 0.05), while men with intermediate-risk prostate cancer showed no significant differences (p = 0.27). Within the low-risk cohort, the later treatment group displayed significantly lower age, pre-treatment prostate specific antigen and tumour volume and significantly higher testosterone and body mass index. The time period corresponding with the implementation of active surveillance at our institution corresponded with significant deterioration of biochemical outcomes in the low- and high-risk groups. This suggests that the men with most favourable disease deferred treatment, whereas men with worse preoperative disease characteristics were increasingly treated with radical prostatectomy in the past 6 years perhaps to their benefit.

Personal data privacy and protection in a surveillance era

No abstract available.

Pre-transplant cytomegalovirus (CMV) serostatus remains the most important determinant of CMV reactivation after allogeneic hematopoietic stem cell transplantation in the era of surveillance and preemptive therapy

Between January 2001 and June 2008, 315 adult patients (median age 43 years, range 16-65) including 203 males and 112 females undergoing hematopoietic stem cell transplantation (HSCT) had serial monitoring for cytomegalovirus (CMV) followed by initiation of preemptive therapy. The majority (62.1%) had a conventional myeloablative transplant with 116 (36.9%) having a reduced-intensity conditioning (RIC) transplant, using either matched sibling/family (63.3%) or unrelated donors (36.7%). Graft source was peripheral blood stem cells in 257 (81.5%), bone marrow in 41 (13.1%), and cord blood in 16 (5.4%). T-cell depletion with anti-thymocyte globulin or alemtuzumab was used in 35%. Based upon CMV serostatus, patients were classified into low risk (donor [D]-/recipient [R]-), intermediate risk (D+/R-), or high risk (D-/R+ or D+/R+). Serial weekly monitoring for CMV viremia was performed using a qualitative polymerase chain reaction (PCR) and when positive, quantification was done using either pp65 antigen or a quantitative PCR. CMV reactivation was seen in 123 patients (39.1%) at a median of 50 days post HSCT (range 22-1978). CMV serostatus was the most important risk factor with incidence of 53% in the high-risk group (53.3%) compared with 10.2% in the intermediate risk and 0% in the low-risk group (P<0.0001). Other significant risk factors identified included use of alemtuzumab during conditioning (P=0.03), RIC transplants (P=0.06), and the presence of acute graft-versus-host disease (GVHD) (P<0.0001). On a multivariate analysis, CMV serostatus, RIC transplants, and acute GVHD remained independent predictors of CMV reactivation. All were treated with antiviral therapy with responses seen in 109 (88.6%). Sixteen patients (13%) developed CMV disease at a median of 59 days post HSCT (range 26 days-46 months), 8 of whom died. At a median follow up of 43 months (range 6-93), 166 patients (52.6%) are alive with a significantly higher survival among patients without CMV reactivation (57.2%) as compared with patients with CMV reactivation (45.5%; P=0.049). CMV reactivation and disease remains a major problem in high-risk patients undergoing allogeneic HSCT. Novel prophylactic measures such as immunotherapy and drug prophylaxis need to be considered in this specific group of patients.