Endobronchial resection as a bridge to curative resection in patient with poor preoperative lung function secondary to an airway blocking endobronchial carcinoid tumour

We present a 70-year-old gentleman with chronic cough with haemoptysis found to have left lower zone collapse on imaging. The bronchoscopy showed an endobronchial mass histologically of a non-secreting atypical carcinoid. Poor baseline lung function excluded surgical resection, and instead, he successfully underwent a bronchoscopic debulking procedure which improved his FEV1 to 84% and DLCO 83% predicted. Unfortunately, the tumour regrew, but the calculated percentage predicted postoperative for FEV1 (64%), and DLCO (65%) enabled definitive surgical resection to take place. Surgical resection remains the definite curative option for localised endobronchial atypical carcinoid tumours. Achieving this in proximal endobronchial carcinoid tumour is a challenge. We described an endoscopic tumour debulking procedure as a bridge for curative surgical resection in a patient with an inoperable proximal atypical carcinoid tumour due to poor predicted postoperative lung function. We highlighted the need to assess predicted postoperative lung function with functional and quantitative perfusion methods to aid surgical planning. Debulking the tumour by endoscopy can be used as a conduit to curative surgical resection in bronchial carcinoid tumour. The choice of calculating the percentage predicted values by either or both methods must be individualised based on tumour location and the probability of converting a lobectomy to a pneumonectomy. This precautionary approach could evaluate the postoperative lung function and morbidity and mortality risk if considering a pneumonectomy. Endoscopic debulking can be a successful bridge to a curative surgical resection aided by comprehensive preoperative lung function tests to predict postoperative lung values

The Contribution of the International Tribunal for the Law of the Sea to the Protection of the Marine Environment

In its 25 years’ history, the International Tribunal for the Law of the Sea has dealt with a number of environmental cases. This has primarily occurred in the context of proceedings relating to the prescription of provisional measures and in advisory proceedings. This article explains how the Tribunal has reaffirmed and developed the basic environmental principles in Part XII of the Law of the Sea Convention, including the obligation to protect and preserve the marine environment, the precautionary approach, the duty to conduct environmental impact assessments, and the duty to cooperate, as well as the duty of due diligence, thereby contributing to the protection of the marine environment. Part XII of the Convention is a product of the 1970s and its provisions therefore reflect the state of international environmental law at that time. However, the Tribunal has interpreted and applied the aforementioned principles consistently with the contemporary state of international environmental law.

Demographics of Etmopterus lucifer (Lucifer dogfish)

<p>This study provides the first comprehensive description of the demographics of lucifer dogfish (Etmopterus lucifer) from the Chatham Rise, New Zealand during January 2012. Lucifer dogfish is a non-QMS species commonly taken as bycatch in New Zealand deepwater trawl fisheries, where it has low commercial value and is usually discarded. Sexual maturity of females was determined by assessing the condition of the ovary and uterus, and the width of the uterus and oviducal gland. Male maturity was assessed by determining clasper and testes condition, inner clasper length, testes length, and testes weight. A sample of lucifer dogfish was aged by counting growth bands on the internal section of the dorsal fin spine (n = 97), assuming annual deposition of bands. Intra- and inter-reader bias in age estimates was estimated, but count precision was high within (CV = 12.71 %) and between reader age estimates (11.98 %). A number of growth models were fitted to the length-at-age data, including the traditional and modified Von Bertalanffy growth formula (VBGF) and four cases of the Schnute growth model. Selection of the best growth model was based on the Akaike Information Criterion (AIC). The fourth case of the Schnute growth model best represented growth. Lucifer dogfish had an estimated age and length at maturity of 10.4 years and 34.0 cm respectively for males, and 13.0 years and 41.0 cm for females. The oldest observed fish were 17 and 14 years for males and females respectively. The total mortality estimates were in the range of 0.14 to 0.35 yr ⁻¹. Lucifer dogfish fed primarily upon mesopelagic fishes, with Hector’s lanternfish (Lampanyctodes hectoris) identified as being the most common prey. Lucifer dogfish had late maturity relative to its longevity. Although sampling of the population was likely to be incomplete, and biases in age estimates may have occurred, these observed life history characteristics indicate that productivity will be low, and as a consequence, the precautionary approach should be applied, as the potential impact of commercial fishing on this species is high.</p>

Demographics of Etmopterus lucifer (Lucifer dogfish)

<p>This study provides the first comprehensive description of the demographics of lucifer dogfish (Etmopterus lucifer) from the Chatham Rise, New Zealand during January 2012. Lucifer dogfish is a non-QMS species commonly taken as bycatch in New Zealand deepwater trawl fisheries, where it has low commercial value and is usually discarded. Sexual maturity of females was determined by assessing the condition of the ovary and uterus, and the width of the uterus and oviducal gland. Male maturity was assessed by determining clasper and testes condition, inner clasper length, testes length, and testes weight. A sample of lucifer dogfish was aged by counting growth bands on the internal section of the dorsal fin spine (n = 97), assuming annual deposition of bands. Intra- and inter-reader bias in age estimates was estimated, but count precision was high within (CV = 12.71 %) and between reader age estimates (11.98 %). A number of growth models were fitted to the length-at-age data, including the traditional and modified Von Bertalanffy growth formula (VBGF) and four cases of the Schnute growth model. Selection of the best growth model was based on the Akaike Information Criterion (AIC). The fourth case of the Schnute growth model best represented growth. Lucifer dogfish had an estimated age and length at maturity of 10.4 years and 34.0 cm respectively for males, and 13.0 years and 41.0 cm for females. The oldest observed fish were 17 and 14 years for males and females respectively. The total mortality estimates were in the range of 0.14 to 0.35 yr ⁻¹. Lucifer dogfish fed primarily upon mesopelagic fishes, with Hector’s lanternfish (Lampanyctodes hectoris) identified as being the most common prey. Lucifer dogfish had late maturity relative to its longevity. Although sampling of the population was likely to be incomplete, and biases in age estimates may have occurred, these observed life history characteristics indicate that productivity will be low, and as a consequence, the precautionary approach should be applied, as the potential impact of commercial fishing on this species is high.</p>

Radioactive waste management ethics and public policy: a precautionary approach

The focus of the project is on how to regulate risky technologies, both old (such as nuclear waste management) and new (such as geoengineering). Thus, the project is aimed at contributing to a better understanding of the ethical, political, and socio-economic aspects of radioactive waste management-related risks. The goal of the project is to contribute to the current discussions on the case of the expansion of the Hungarian Nuclear Power Plant. The Paks II project allows us to present how to set up procedures where some radioactive waste-related risks will not derail decision-makers and how they can be held accountable by the public. The case of Paks II is also compelling; as of today there are only 19 countries in the world that are in the process of new reactor building (World Nuclear Association, 2021). The project is aimed at providing and defending a precautionary approach to radioactive waste management because it involves high levels of uncertainty and the possibility of causing irreversible harm on a global scale. When investigating procedural principles of radioactive waste management policies by three types of precautionary approaches, the project will look at risks that stem from the displacement of politics in public consultations in relation to large infrastructural projects. The practices of the emerging era of public engagement tap into the current debates on democratic politics in political theory with the emergence of deliberative democracy (Bohman and Rehg, 1997; Dryzek, 2000; Gutmann and Thompson, 2009), and radical democracy (Laclau and Mouffe, 2001; Mouffe, 1999, 2000). Specific attention will be paid to the fragmentation of public along with technical and non-technical, local and national, site-specific and general issues, and the role of different political platforms (public exhibition events, consultation documents, and public engagement sessions) in the way in which the political is displaced from the arena of public inquiries to legal challenges and debates about boundaries and geographies.

Online exams and the COVID-19 pandemic: a hybrid modified FMEA, QFD, and k-means approach to enhance fairness

COVID-19 pandemic caused an increasing demand for online academic classes, which led to the demand for effective online exams with regards to limitations on time and resources. Consequently, holding online exams with sufficient reliability and effectiveness became one of the most critical and challenging subjects in higher education. Therefore, it is essential to have a preventive algorithm to allocate time and financial resources effectively. In the present study, a fair test with sufficient validity is first defined, and then by analogy with an engineering product, the design process is implemented on it. For this purpose, a hybrid method based on FMEA, which is a preventive method to identify potential failure modes and prioritize their risk, is employed. The method's output is provided to the QFD algorithm as the needs of product customers. Then, the proposed solutions to prevent failures are weighted and prioritized as the product's technical features. Some modifications are made to the classic form of FMEA in the proposed method to eliminate its deficiencies and contradictions. Therefore, our proposed algorithm is a precautionary approach that works to prevent breakdowns instead of fixing them following their occurrence. This issue is very effective in increasing the efficiency of activities in times of crisis. Eventually, a prioritized list of preventive actions is provided, allowing us to choose from available solutions in the circumstances with limited time and budgetary, where we cannot take all possible actions.

Combined Abundance of All Vulnerable Marine Ecosystem Indicator Taxa Inadequate as Sole Determiner of Vulnerability, Antarctic Peninsula

In order to achieve conservation objectives and preserve the biodiversity of the Southern Ocean, a variety of ecosystems must be protected. This holds especially true for the benthic communities of this region that are characteristically mosaic in their spatial distributions. As such, disparate communities cannot be comprehensively assessed by a single blanket methodology. Herein, evidence appropriate to the diverse characteristics of the communities encountered during a submarine expedition demonstrates the particular vulnerability of four sites that exemplify VMEs as defined by the Commission for the Conservation of Antarctic Marine Living Resources (CCAMLR) and the UN’s Fisheries and Agriculture Organization (FAO). Three sites are identified as VMEs based on highly significant abundances of indicator taxa. A fourth is identified based on a high density of cold-water coral taxa, many of which were not observed in abundance at the sites that were triggered as vulnerable by a significantly high abundance of all indicator taxa. The VME at this latter site was richly diverse in coral taxa, many of which are considered particularly vulnerable to climate change, as well as critical for their potential for genuine blue carbon sequestration. As of November, 2018, all four sites are now registered with CCAMLR as VMEs and thus, are afforded protection from all bottom fishing activities. However, if consideration isn’t given to the composition and/or diversity of VME indicator taxa present, in addition to overall abundance/density, some of the most vulnerable communities are left at risk. A blanket threshold for all VME taxa adhered to in fisheries management of the Southern Ocean, and other high seas areas, is grossly insufficient. Without taking a more precautionary approach to identifying and protecting VMEs, CCAMLR will not be able to meet its conservation objectives and may even be putting Antarctic fisheries at risk.

Assessment of Regional Fisheries Management Organizations Efforts toward the Precautionary Approach and Science-Based Stock Management and Compliance Measures

The sustainable management of the ocean as a global food source has been prominent in recent debates due to the disproportionate rate of human consumption, depletion of fish stocks and shortcomings in conservation efforts. Criticisms from various sectors on the effectiveness of Regional Fisheries Management Organizations (RFMO) in relation to their mandates have prompted performance reviews (PRs) to evaluate their efforts in fisheries management. Among concerns are slow implementation of comprehensive harvest strategies which use science-based indicators and management principles. Moreover, RFMOs are expected to apply the precautionary approach, in the hopes of anticipating, monitoring, preventing and mitigating potential threats. The emergent themes are revealed through content analysis pertaining to cooperation and compliance being essential to fisheries management activities in conjunction with choosing the right operational approaches and the proper implementation of various fisheries regulations. Government mandates and stakeholder’s recommendations support fisheries management organizations to function more effectively. This article discusses the role of coercive, normative and mimetic pressures in RFMOs activities, as described in recent performance reviews. It then analyses how RFMOs have implemented the precautionary approach together with science-based stock management and compliance measures, utilizing recent PRs to assess progress on relevant recommendations.