Great Questions Research Articles

Calculation of doses to the public in contact with patients underwent radiopharmaceutical therapy with 177Lu: model multi-factor study

INTRODUCTION: Associated with the development of radiopharmaceutical therapy with 177Lu (177Lu-DOTA-TATE, 177Lu-PSMA-617), the issue of radiation protection of the public becomes important. Nowadays, national regulatory and methodological documents on radiation safety do not contain release criteria of patients after radiopharmaceutical therapy with 177Lu. Existing approaches to determining the release criteria after radiopharmaceutical therapy do not consider radiation exposure from the patient during long-term contact with the patient (up to several days in a confined space) and possible of generation of biological waste containing 177Lu in public transport during the first hours and days after release. In order to choose an optimal approach to determine release criteria, it is necessary to assess the radiation exposure from the patient on different categories of people from the public.OBJECTIVE: Estimation of radiation exposure of people from public from patient after radiopharmaceutical therapy with 177Lu considering the radioactive biological waste containing 177Lu.MATERIALS AND METHODS: The time of patient release from the hospital was determined upon reaching the previously proposed release criteria based on the patient dose rate. The ambient dose equivalent rate for the patient after therapy with 177Lu labeled radiopharmaceuticals were determined based on the experimental data available in the literature. Various scenarios of exposure of individuals in contact with the patient after release from the hospital were developed; effective doses after contact with the patient were estimated based on the developed scenarios. The activity of 177Lu generated in patient biological waste after therapy was determined as well. Based on the assessments, activity concentration of 177Lu was determined in wastewater of residential sewage systems and in transport during patient traveling to the place of residence. Using specialized MCNP software, the doses of public exposure in transport from 177Lu generated in wastewater in tanks of transport biotoilets were modeled and estimated.RESULTS: Doses to some categories of people from the public after the contact with a patient released immediately after administration of a radiopharmaceutical with 177Lu may exceed the dose limit of 1 mSv, but release in 4–6 hours after therapy when the release criterion is reached, established in accordance with the approach of NRB-99/2009, will not lead to dose limit exceedance. The activity concentration of 177Lu, generated in transport biotoilet tanks after the patient with 177Lu travelling, exceeds the limit value for classifying liquid waste as radioactive (0.025 kBq/g). Doses to passengers and crew members may be higher than 100 μSv. Doses from a patient may be higher than 1 mSv after release of patient in 4–6 hours in the case of a long-distance travel (several days on a train).DISCUSSION: Exceeding the dose limit to the public is unacceptable and therefore the patient cannot be released immediately after 177Lu administration. Due to the likelihood of exceeding passenger and crew dose limits in transport during long-distance travel of a patient with administered 177Lu, it is necessary to limit the travel of patients by long-distance trains.CONCLUSION: To ensure radiation safety of the public, the optimal approach is the previously used approach when establishing release criteria in NRB-99/2009 for other radionuclides. According to this approach, the value of the release criterion for the dose rate at 1 meter from the patient after therapy with 177Lu is 29 μSv/h. The greatest questions in terms of radiation safety arise when releasing non-residence patients who will have to get to their place of residence in distant regions. Thus, it is reasonable to limit the patient traveling after radiopharmaceutical therapy with 177Lu using long-distance trains (instead of it is recommended to use air transport).

High myopia and atrophy complication: Multimodal study and prospects

Aims/Purpose: This multimodal study of High Myopia with Atrophy areas, patchy atrophies of retina to analyze retina layers structure, focusing on outer retinal layers, particularly photoreceptor and Retinal pigment epithelium layers, their evolution, their impact on visual fonction. So the prospects of High Myopia's Atrophy complications.Methods: A total of 84 eyes from 44 patients, with High Myopia. Multimodal study includes mainly OCT, notably OCT en Face (Spectralis HRA‐OCT, spectral domain OCT), combined with Autofluorescence, IR imaging, Fluorescein (FA) and Infracyanine (ICG) angiography (SLO Spectralis HRA‐OCT) (mainly when suspicion of subretinal neovascular complication). ETDRS visual acuity (VA), complete ophthalmic examination with Fundus exam were added. Follow‐up was done every year during 8 years.Results: VA remain stable in 42% cases, impaired in 58% cases. Multimodal analyze highlight 15% stable, 85% Atrophy area increase, (patchy atrophies: 74% cases, peripapillary atrophy: 26% cases). Development of Atrophy include: increase of width, surface, perimeter of atrophic areas, thinning, fragmentation of retinal layers, particularly photoreceptor and retinal pigment epithelium layers. Combined Neovascular complication occurred in 27% cases (series of 3 IVT of Anti VEGF were done when neovascular activity was confirmed). Visual function condition depends on Topography of Atrophy, Atrophic areas, patchy atrophies too, Morphology of Atrophy, Atrophic areas, patchy atrophies too (width and length), their Evolution, and Macular Sparing. Atrophy complication of High Myopia leads to ask involvement of collagen, fibroelastic tissues physiopathology, genetic factors, way of life, key role of Age Macular Degeneration in High Myopia Elderly eyes. Those are the Prospects.Conclusions: High Myopia with ATROPHY complication is a great question to better consider follow‐up protocol, screening, particularly of and when neovascular complication sometimes here with. Multimodal analysis enables better precision, discrimination in Atrophy assessment, evolution, so, issue to preserve visual function and allows to better manage the prospects.

Butler and Hume on Religion

ABSTRACT For over a century now, Hume’s work on religion has been better known than Butler’s. To understand the full significance of Butler and Hume in relation to each other, it is necessary to be clear about what the historical record shows. Once we have established what the record shows, we are faced with the question of what we are to make of the record. Butler, obviously, was speaking as a widely admired priest of the Church of England. Hume was speaking primarily for himself as an aspiring man of letters. If Butler and Hume are read as adversaries, then history has already delivered its verdict. Hume’s opinion became better known, even though Butler enjoyed a long run of dominance in the nineteenth century. Finally, we must consider what we are to say to a public who remain as confused and distracted as ever on the great questions of God, freedom, and immortality. Hume and Butler advised that the public be presented with the evidence and then draw their own conclusions. There are many gaps in the record, but it is now possible to understand Butler and Hume as active in a dialectical process continued by Paley, Darwin, and their successors.

Double Disillusion: Legal and Political Aspects of the 1974 Double Dissolution

One of the great unanswered questions of the Commonwealth Constitution is whether the House of Representatives and Senate are equal or whether one ultimately has more power than the other. The Whitlam Labor government elected in 1972 faced a Senate elected in 1967 and 1970. Despite Senate obstruction, Whitlam proceeded with an ambitious legislative programme through 1973 and into 1974. By April 1974, six bills appeared to provide a “trigger” for the use of the Section 57 deadlock resolution procedure in the Constitution. Section 57 provides that if a bill has been twice passed by the House of Representatives and twice rejected by the Senate, the Governor‐General can dissolve both houses and an election is held. If the government is returned and wishes to proceed with the trigger bills, it can again pass them through the House and if they are again rejected by the Senate, the Governor‐General can convene a joint sitting of the two houses at which, if the bill is approved by an absolute majority, it is deemed to be passed. Major obstruction in the Senate, including a threat by the Opposition to block supply, led Whitlam to seek a double dissolution, hoping to gain a majority in both houses or, failing that, the opportunity to pass the trigger bills at a joint sitting. The ensuing election saw the return of the Whitlam government in the House but continuing to lack a majority in the Senate. This led to the only joint sitting in federal history, in which all six trigger bills were passed. But there was a constitutional sting in the tail when the Petroleum and Minerals Authority Act was subsequently found by the High Court not to have been validly passed. This case is argued to have made s57 potentially unworkable. The 1974 double dissolution stands in stark contrast to the 1975 double dissolution, which is argued here to be its “Evil Twin.” There have been three further double dissolutions since 1975: 1983, 1987, and 2016, but no more joint sittings. In 1987, there was set to be a joint sitting on the proposal for an identity card, but this was thwarted on a technicality. So the 1974 double dissolution achieved the objective of breaking a deadlock but at the cost of revealing a way for a determined Senate to make s57 unworkable.

“She did make defect perfection”—The Perfection of the Female Monster: Shakespeare’s Cleopatra and the Querelle des Femmes

“She did make defect perfection” (Antony and Cleopatra 2.2.242): by this formula, Enobarbus sums up the essence of Cleopatra’s inimitable charm. Shakespeare’s Cleopatra is a study of women and women: in other words, Shakespeare’s Cleopatra is less fiction than an investigation of the other sex. “Was will das Weib?” asked Freud (if we are to believe Marie Bonaparte’s testimony), thus admitting that the great question psychoanalysis has been unable to answer is the enigma of feminine desire. Shakespeare’s Cleopatra represents this enigma, which takes the form of a perfection resulting from a series of paradoxes: beauty and maturity, cunning and folly, fidelity and betrayal, jealousy and indifference, majesty and debauchery, expense and economy, audacity and fragility, truth and lies. Cleopatra’s perfection is the sum of all possible paradoxes. What is the point of this dizzying interplay of paradoxes? What is the resulting perfection?

Male and female selection effects on gender wage gaps in three countries

A vast literature on gender wage gaps has examined the importance of selection into employment. However, most analyses have focused only on female labour force participation and gaps at the median. The Great Recession questions this approach because of the major shift in male employment that it implied. This paper uses the methodology proposed by Arellano and Bonhomme (2017) to estimate a quantile selection model over the period 2007–2018. Using a tax and benefit microsimulation model, I compute an instrument capturing both male and female decisions to participate in the labour market: the potential out-of-work income. Since my instrument is crucially determined by the welfare state, I consider three countries with notably different benefit systems – the UK, France and Finland. My results imply different selection patterns across countries and a sizeable male selection in France and the UK. Correction for selection bias lowers the gender wage gap and reveals a substantial glass ceiling with different magnitudes. Findings suggest that disparities between these countries are driven by occupational segregation and public spending on families.

Guide spirituel ou voleur de miel ? La figure de l’apiculteur dans la pensée occidentale

The bee is not an animal like any other. Remaining wild even when it may have seemed domesticated by accepting to be housed by man, it seems to naturally have the appearance of the most elaborate cultures, whether in the spontaneous organization of the hive evoking sophisticated human societies, or in the geometric perfection of the hexagonal cells of the rays displaying astonishing architectural talents. Furthermore, the two main products produced in the hive are not like the others either. Honey and wax, naturally free from any process of putrefaction without having to undergo the slightest transformation, appeared not only as linking nature and culture, but also as symbols of immortality. The bee, which already through its way of life unified the plant and the animal, blurs the limits between the animal and the human, while linking the latter to a form of “beyond”. These particularities of the bee are the basis of a considerable symbolic production which could only permeate those who benefited from it and took care of it, a symbolic dimension which should make it possible to deepen and go beyond a first duality between two images of the beekeeper, that of the greedy predator and destroyer of nature or that of the carer, breeder and protector. The bee being at the heart of the great existential questions, the beekeeper could be perceived not only as a producer of honey or wax, but as a passer, as one who, initiated by his foragers, could transmit to other humans an understanding of the mysteries of the world, such as the transition from chaos to the harmony of the cosmos, from nature to culture, the link between humans and the divine, between the earth and the sky. One of the first myths dedicated to bees depicts this dual function of the beekeeper, productive and symbolic; it is the story of Aristaeus and the disappearance of the bees as told by Virgil in the IVth Georgic. We see the hero Aristaeus, initiator of beekeeping, having to resolve (already) the first disappearance of bees, caused by his confrontation with the fusional couple that constitutes Orpheus the poet and the nymph Eurydice. This myth allows us to go beyond the simple opposition between a "good person", the protector of bees, and a "bad person", the greedy predator, the ideal beekeeper being the one who manages to reconcile the productive bee and the symbolic bee, work and poetry, Aristaeus and Orpheus.

The Platonic-Biblical Origins of Apophatic Theology: Philo of Alexandria’s Philosophical Interpretation of the Pentateuchal Theophanies

This article examines Philo’s philosophical interpretation of the three theophanies in Exodus, which would, centuries later, continue to be considered by the great thinkers responsible for developing negative theology, such as Gregory of Nyssa and Dionysius the Areopagite. Although Exod 33:11 clearly states that the Lord spoke to Moses face to face, as if someone were to speak to his own friend, according to Philo, the lawgiver neither saw the face of God, nor learned the proper name of God, nor was he able to comprehend the essence of God. These very statements became the inspiration for later apophaticism. The present article seeks to establish to what extent Philo’s theses were influenced by Plato’s philosophy or by later Middle Platonism, and to what extent Philo, by commenting allegorically on the Pentateuch, becomes the initiator of new ideas hitherto unknown in philosophical discourse. In the course of the analyses, three great questions of apophatic theology are discussed: 1. the unnameability of God; 2. the unknowability of God’s essence; and 3. the knowability of God’s nature by grace.

The Effect of Unfolding Scientific Discoveries on Visual Images of the Beginning of the Universe

Explanations of ‘The Beginning’ or ‘Creation’ have varied from primitive accounts to complex theological, philosophical and scientific arguments. Myths and ideas providing answers to the great questions of how the universe was created, and where we all came from, have circulated in the near east and the Mediterranean since ancient times, from early legends to ancient, medieval and Renaissance manuscripts, to modern scientific theory. Such ideas have also been expressed in visual images ranging from the great Creation cycles in St Mark's Venice and Michelangelo’s Sistine Chapel ceiling, to the works of William Blake, Brancusi's 'egg' or technical and scientific diagrams, such as the famous NASA image ‘The Big Bang and the Expansion of the Universe’ of 2012. Visual representations of the Beginning have changed over time and may be either in line with or contrary to contemporary scientific thought.

Still part of the game—corporatism and political exchanges in two small states

AbstractThis study of Danish and Dutch work and welfare policies since the Great Recession questions the dominant picture of trade unions as being too weak and irrelevant for tripartite regulation. The frequency of tripartite agreements has not decreased, and social partners are still able to obtain important concessions. In addition to well‐described resources, the article shows that trade unions and employers' organizations offer governments financial resources and access to workplaces in political exchanges, which helps explain corporatist resilience. Only limited support was found for well‐known drivers other than economic crises as explanations for changes over time in tripartism.

Evolution and palaeoanthropology in Hans Blumenberg’s Nachlaß

Hans Blumenberg wrote, in an unpublished manuscript entitled Ein Betrug? / Der böse Dämon (UNF 532-534), that «the whole world and human intelligence were hidden beneath the earth, where the relics of the precursors of life rest». The German philosopher was not a palaeoanthropologist in the strict sense but dedicated much of his life to excavating in the ground, in search of replies to the great questions about the human condition. This paper is the result of a work compiling and classifying a series of unpublished texts about palaeoanthropology to be found dotted throughout his Nachlaß. The aim is to show the interest that disciplines such as palaeoanthropology aroused in the German thinker, and that his understanding of the matter, reflected in part in his anthropological-philosophical theses, has not yet been systematised.

Black on Black on Black on Black: An interview with Artist-Scholar Dr. Blair Ebony Smith

Black on Black on Black on Black: An interview with Artist-Scholar Dr. Blair Ebony Smith

“That’s a great question!” instructors’ positive responses to students’ questions improve STEM-related outcomes

ABSTRACT How instructors respond to students’ questions may serve as an important cue that shapes students’ self-perceptions and motivation. Across five studies, when participants imagined asking questions in a STEM context and receiving a positive (vs. neutral or negative) response from instructors, they felt greater self-efficacy and belonging, which predicted greater intentions to join the lab and to recruit other students. Positive verbal responses were effective regardless of whether they were directed toward participants or other students, occurred in public or private, in STEM or non-STEM settings, and when they came from warm/friendly versus cold/critical professors. Women especially benefitted from receiving positive instructor responses. Instructors’ positive responses to students’ questions may thus be a powerful cue that boosts students’ academic-related outcomes.

5 Questions for Aaron Caycedo-Kimura

5 Questions for Aaron Caycedo-Kimura Michelle Johnson (bio) and Aaron Caycedo-Kimura (bio) Beacon Press published Aaron Caycedo-Kimura's collection Common Grace in 2022. A poet and visual artist, his paintings have appeared in galleries across Connecticut. Click for larger view View full resolution Q Who are the poets we should be reading now and artists whose work we should be watching? A I always advise people to read far and wide. The same goes for looking at art. There's so much out there to soak up and appreciate. Among my favorite poets working today are Matthew Thorburn, Jennifer Franklin, Ben Grossberg, Tara Skurtu, Debbie Kwon, Chloe Martinez, Darla Himeles, Skye Jackson, and Joan Kwon Glass. And of course my wife, Luisa Caycedo-Kimura, who's doing some important work. I want to add that Matt, Jennifer, and Debbie have new books out this year, which is exciting. There are many other brilliant poets I would love to include, but the list would be too long. As for visual artists, some of my favorite working artists include Ann Gale, Alex Kanevsky, and Stuart Shils, just to name a few. Q Under the nom de cartoon INFJoe, you wrote Text, Don't Call: An Illustrated Guide to the Introverted Life, which sets the record straight on introverts. Which misconception most needs debunking? A That's a great question. Among many misconceptions about introverts is the notion that introversion is the same as being shy or antisocial, but that's not the case. Shyness is insecurity or fear of social embarrassment, and "antisocial" describes someone who has hostile or harmful feelings toward society. While some introverts may be shy or antisocial, there are also extroverts who fall into those categories. Introversion is a preference that has more to do with where you direct your energy (inward) and what level of outside stimulation you're comfortable with. Introverts aren't necessarily shy or antisocial. They do, however, need more time alone and less outward stimulation. Q What cultural offerings or trends have recently captured your attention? A Interestingly, being forced to communicate virtually by the pandemic has created new opportunities for poetry. While I know many people prefer in-person events rather than Zoom readings, I find virtual platforms convenient and a great way to hear authors from all over the country and the world. They're also wonderful for people who wouldn't normally go to an in-person poetry reading. They can try it out, even with their camera off, and if they don't like it, they can leave quietly without disruption or embarrassment. Q You live in Bloomfield, Connecticut. Can you share a few favorite spots? A Bloomfield is a great place to live. It's safe, quiet, diverse, and full of trees, hiking spots, and wildlife. If I had to choose one place for hiking, it would probably be Talcott Mountain State Park with its beautiful views. If you're looking for more open space, Auerfarm State Park is a great place to go, but, honestly, on any given day, you're more likely to find me at Starbucks writing or, when the weather is warm, in my breezeway doing the same thing. Q The news is often bleak. On the darkest days, what picks you up? A Nothing makes me happier than getting lost in working on a poem or a painting. It's problem-solving and under my control, for the most part. It's an optimistic, hopeful discovery and what I have to give back to the world. [End Page 23] Michelle Johnson Michelle Johnson is WLT's managing and culture editor. Aaron Caycedo-Kimura Aaron Caycedo-Kimura is the author of two poetry collections. His honors include a MacDowell Fellowship, Robert Pinsky Global Fellowship in Poetry, and Pushcart Prize nominations, among others. He earned an MFA in creative writing from Boston University. Copyright © 2023 World Literature Today and the Board of Regents of the University of Oklahoma

Editor's Spotlight/Take 5: The Price-Quality Mismatch: Are Negotiated Prices for Total Joint Arthroplasty Associated With Hospital Quality in a Large California Health System?

Editor's Spotlight/Take 5: The Price-Quality Mismatch: Are Negotiated Prices for Total Joint Arthroplasty Associated With Hospital Quality in a Large California Health System?

Telmisartan and losartan: The marked differences between their chemical and pharmacological properties may explain the difference in therapeutic efficacy in hospitalized patients with COVID‐19

Telmisartan and losartan: The marked differences between their chemical and pharmacological properties may explain the difference in therapeutic efficacy in hospitalized patients with COVID‐19

Mentorship and Scientific Writing

Mentorship and Scientific Writing

Mentorship and Scientific Writing

Mentorship and Scientific Writing

The construction of the character and her speeches: an analysis of Mafalda's strips from Bakhtin

This article aims to analyze how we can verify Bakhtin's concepts of inner dialogue, exotopy, vision surplus, finishing, material emotive-volitional orientation and axiological surplus in the construction of characters and their speeches in Mafalda's comic strips, created by Argentine cartoonist, Quino. For this, we selected two strips, the first being a dialogue between Mafalda and a crab, in which it is possible to observe Mafalda's dialogical articulation with her own; and the second strip, in turn, brings a dialogue between Mafalda, her best friend – Susanita – and her colleague Filipe, in a conversation full of discordant points of view and discourses established from conceptions constructed by references coming from social classes, context political and economic in which the characters are inserted. After the analysis, it was possible to perceive the analysis carried out shows that several of the concepts coined by Bakhtin can be verified in the strips, from the construction of the (anti) heroine Mafalda, with her irony and ideological alignment inherited from the author, to the elaborations of the characters' statements loaded with opinions that call to reflection on the great human questions.

Discussion

Discussion