Summary Background Excess bodyweight, expressed as increased body-mass index (BMI), is associated with the risk of some common adult cancers. We did a systematic review and meta-analysis to assess ...the strength of associations between BMI and different sites of cancer and to investigate differences in these associations between sex and ethnic groups. Methods We did electronic searches on Medline and Embase (1966 to November 2007), and searched reports to identify prospective studies of incident cases of 20 cancer types. We did random-effects meta-analyses and meta-regressions of study-specific incremental estimates to determine the risk of cancer associated with a 5 kg/m2 increase in BMI. Findings We analysed 221 datasets (141 articles), including 282 137 incident cases. In men, a 5 kg/m2 increase in BMI was strongly associated with oesophageal adenocarcinoma (RR 1·52, p<0·0001) and with thyroid (1·33, p=0·02), colon (1·24, p<0·0001), and renal (1·24, p <0·0001) cancers. In women, we recorded strong associations between a 5 kg/m2 increase in BMI and endometrial (1·59, p<0·0001), gallbladder (1·59, p=0.04), oesophageal adenocarcinoma (1·51, p<0·0001), and renal (1·34, p<0·0001) cancers. We noted weaker positive associations (RR <1·20) between increased BMI and rectal cancer and malignant melanoma in men; postmenopausal breast, pancreatic, thyroid, and colon cancers in women; and leukaemia, multiple myeloma, and non-Hodgkin lymphoma in both sexes. Associations were stronger in men than in women for colon (p<0·0001) cancer. Associations were generally similar in studies from North America, Europe and Australia, and the Asia–Pacific region, but we recorded stronger associations in Asia–Pacific populations between increased BMI and premenopausal (p=0·009) and postmenopausal (p=0·06) breast cancers. Interpretation Increased BMI is associated with increased risk of common and less common malignancies. For some cancer types, associations differ between sexes and populations of different ethnic origins. These epidemiological observations should inform the exploration of biological mechanisms that link obesity with cancer.
There are a number of opportunities for collaboration, within and between universities, locally, internationally, with industry and with other education providers. University graduates are likely to ...be placed in a work environment where collaboration is required. Collaboration within higher education institutions has been shown to enhance student learning, and collaborative learning to improve student outcomes. A proposal has been made to add ‘collaborate’ to Bloom’s taxonomy of educational objectives, to emphasise the importance of collaboration and to encourage its inclusion in the educational process and assessment. Collaborate is sited between ‘apply’ and ‘analyse’ in the revised Bloom’s taxonomy hierarchy, and the new version named the New Bloom. This opinion piece expands on the concept and adds the specific objective of ‘work or share with others’ with keywords ‘share, cooperate, reciprocate, achieve consensus’. It also offers a non-hierarchical representation of the taxonomy, with collaborate as an important feature of each of the other components. Adding collaborate to Bloom’s taxonomy is recommended to emphasise the importance of collaboration and its contribution to each of the other components of the taxonomy.
In terms of number of beneficiaries, Medicaid is the single largest health insurance program in the US. Along with the Children’s Health Insurance Program (CHIP), Medicaid covers nearly half of all ...births and provides health insurance to nearly half of the children in the country. This article provides a broad introduction to Medicaid and CHIP for the pediatric radiologist with a special focus on topics relevant to pediatric imaging and population health. This includes an overview of Medicaid’s structure and eligibility criteria and how it differs from Medicare. The paper examines the means-tested programs within the context of pediatric radiology, reviewing pertinent topics such as the rise of Medicaid managed care plans, Medicaid expansion, the effects of Medicaid on child health, and COVID-19. Beyond the basics of benefits coverage, pediatric radiologists should understand how Medicaid and CHIP financing and reimbursement affect the ability of pediatric practices, radiology groups, and hospitals to provide services for children in a sustainable manner. The paper concludes with an analysis of future opportunities for Medicaid and CHIP.
This book is open access and discusses the re-imagining of the higher education sector. It exposes problems that relate to the way that universities have become over-managed business enterprises ...which may not reflect societal, national, or global educational needs. From there, it proposes some solutions, including three innovative programs, that make universities more responsive to needs, as well as reduce their impact on the environment. The central idea of this book is developing the ‘Distributed University,’ which distributes education to where it is needed, reducing local and global inequalities in access, and emphasizing local relevance in place of large centralized campuses, with a low impact on the environment. It emphasizes the distribution of trust in place of managerialism and collaboration in place of competition. By focusing on distributing education online, this book discusses how the higher education sector can be set up to adapt to the changes in the ways we work and learn today, and which will be required to adapt to and take advantage of the Fourth Industrial Revolution.
Plan E for Education is my proposal that a proportion of the educational resources generated in publicly funded universities be made freely available for sharing and use by others. Thus, high quality ...education, produced through public funding, could be made available to other universities and individual autodidacts and for the development of innovative educational delivery methods. This would be the educational equivalent of initiatives that require publicly funded research to be published in open access journals or platforms. Available educational resources would involve whole or sections of courses including assessments, not just isolated resources. Plan E would require the establishment and curation of open repositories and might consider a peer review system for educational materials to mirror that already used for research publications. Academic credit could then flow to those who publish and review educational resources and extend to other academic input such as updating the work and creating instructional materials. There is considerable expertise and enthusiasm for, as well as successful examples of, open access education globally, but this is unevenly spread, and its adoption is hindered by factors at institutional and individual educator levels. Most university-generated educational material is still kept behind institutional paywalls. If we accept the need for change so that, as for research outputs, educational resources become open to access, Plan E might provide the global impetus for such change and make a contribution to reducing inequality in access to higher education. Keywords: open access, open educational resources, open educational practices, Plan S, universities, paywall
In vivo electroporation (EP) is a versatile delivery method for gene transfer which can be applied to any accessible tissue. Delivery of plasmid DNA encoding therapeutic genes or cDNAs with in vivo ...EP has been tested extensively in preclinical melanoma models. Direct delivery to the tumor has been shown to generate a direct antitumor effect. Delivery to alternative sites may generate additional therapeutic options, for example the production of cancer vaccines, the reduction of tumor angiogenesis, or the induction of tumor cell apoptosis. Several of the preclinical therapies tested have a demonstrated therapeutic effect against melanomas. Two immunotherapies have advanced to melanoma clinical trials. Delivery of a plasmid DNA encoding interleukin-12 (IL-12) or interleukin-2 (IL-2) using electroporation was demonstrated to be a safe with no grade 3 or 4 toxicities reported. Delivery of IL-12 with electroporation resulted in significant necrosis of melanoma cells in the majority of treated tumors and significant lymphocytic infiltrate in biopsies from patients in several cohorts. In addition, clinical evidence of responses in untreated lesions suggested the induction of a systemic response following therapy. This review discusses preclinically tested electroporation gene therapies for melanoma with clinical potential and the conversion of these therapies to clinical trials.
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