The meaningful consideration of cultural practices, values and beliefs is a necessary component in the effective translation of advancements in neuroscience to clinical practice and public discourse. Society’s immense investment in biomedical science and technology, in conjunction with an increasingly diverse socio-cultural landscape, necessitates the study of how potential discoveries in neurodegenerative diseases such as Alzheimer disease are perceived and utilized across cultures. Building on the work of neuroscientists, ethicists and philosophers, we argue that the growing field of neuroethics provides a pragmatic and constructive pathway to guide advancements in neuroscience in a manner that is culturally nuanced and relevant. Here we review a case study of one issue in culturally oriented neuroscience research where it is evident that traditional research ethics must be broadened and the values and needs of diverse populations considered for meaningful and relevant research practices. A global approach to neuroethics has the potential to furnish critical engagement with cultural considerations of advancements in neuroscience. In an interdisciplinary effort bridging the clinical neurosciences, ethics, and geriatric services, we are engaged in community-based research with a First Nation population in Canada, in which a large family carries a presenilin-1 (PS1) gene mutation leading to early onset familial Alzheimer Disease (EOFAD). Our primary research goals are to explore the intersections of Western knowledge, traditional teachings, and culturally specific understandings about EOFAD. Through the evolution of this work, we have been faced with and have addressed unexpected internal and external challenges related to community-wide confidentiality. The internal challenges involve the Nation’s competing interests to guard against the possibility of stigma that may be associated with a predisposition to an incurable neurodegenerative disease, while also championing the benefits of research participation in a manner that fosters autonomy and self-determination. The external challenges involve achieving comprehensive outreach to individuals at rural and dispersed regions of the country, varying biological and cultural definitions of family, and the interconnectedness of family, community, and Nation. Both the internal and external challenges are of scholarly and procedural importance to the research team and Nation, and of personal significance to the community members.There are ample existing research principles and guidelines that underscore the importance of protecting Indigenous communities; however, their scope is limited and they do not fully address the practical and conceptual challenges of community confidentiality when engaged in community-based research with a First Nation population. The unique and precarious circumstances described here highlight the importance of continuously revisiting issues in confidentiality, community-engaged discovery in the protection of Indigenous peoples in research, and the importance of seeking solutions that are mutually beneficial and supportive. Further, these challenges highlight the requirements for a global approach to neuroethics, which must strive to broaden traditional Western research ethics and grapple with these complex considerations of culture in neuroscience research.The intersections of neuroscience, neurotechnology, and society raise challenging ethical questions about how related developments may be perceived and utilized across cultures. The field of neuroethics addresses the ethical and legal issues of these innovations and their wide-ranging implications in the public sphere . WhetherThrough the advancement of a community-based research study about the experiences of a First Nations population with EOFAD, challenges of confidentiality have elucidated the need to broaden traditional Western understandings of research ethics and the integral role that neuroethics has in addressing these complex issues. While the case-study provided here offers only a limited scope of the ethical challenges in culturally relevant research, it will allow for further investigation into the complex interactions between research in neuroscience and the diverse populations affected by this research.a populations that deals with confidentiality at the level of the community presents an array of unique challenges warranting additional attention. Confidentiality in health research has traditionally focused on the individual, with the patient/research participant at the center of ethical and privacy concerns  their physical, social, economic and cultural environments, where applicable, as well as concern for the community to which participants belong”  variables and differences are manifest, and … adopt a more dialectical approach” . Thus, aWeijer, Gold and Emanuel write, “Codifying protections for communities in research is a dialectical process that will require addressing these issues by proposing and refining potential safeguards based on conceptual reflection and practical experience” . ResearcaWe use the term Indigenous to refer to the First peoples of North America, Australia and New Zealand. Within Canada, these populations include First Nations, Métis and Inuit peoples. We use the term First Nation when referring to the specific Indigenous population with which we are working. The term Indigenous is akin to Aboriginal or Native American.The authors declare that they have no competing interests.Concept and design: SS, JI, BLB. Collection and assembly of the data: JI, SS, BLB, LB. Data analysis and interpretation: SS, JI, BLB, ED, RV, LB, Drafting of the article: SS, JI, BLB. Critical revision of the article: BLB, JI, RV, ED, LB, SS. Final approval of the article: all authors. Obtaining of funding: JI, BLB. All authors read and approved the final manuscript.SS is the Project Director on Cross Cultural Understandings of Aging and Dementia at UBC’s National Core for Neuroethics.BLB is Professor Emeritus, Division of Geriatrics, Department of Medicine, UBC.RV, Secwepemc First Nation, is Associate Professor, School of Social Work, UBC.ED is a genetic counsellor at the UBC Hospital Clinic for Alzheimer Disease and Related Disorders and Clinical Instructor in the UBC Faculty of Medicine, Department of Medical Genetics.LB is a PhD student in the Interdisciplinary Studies Graduate Program and National Core for Neuroethics, UBC.JI is Canada Research Chair in Neuroethics, Director of the National Core for Neuroethics, and Professor of Neurology, Division of Neurology, Department of Medicine, UBC.


Twenty years ago, and still in some textbooks, allergy was regarded as a "disease of the rich," with a rising prevalence only in industrialized or western countries. This has changed: allergy has become a major health problem in almost all countries of the world, both in terms of individual suffering, medical management, and quality of life, as well as a socio-economic burden. People in Papua New Guinea or Tanzania are experiencing very similar allergic diseases and symptoms as patients from São Paulo, New York, Moscow, or Tokyo. Yet there are considerable differences in management, diagnostic and therapeutic modalities, and especially with regard to eliciting allergens and modifying environmental factors. Globalization is not only an economic phenomenon. In addition, the world has grown together in science and in the medical field.There is a need for more information, exchange of experience, and for a discussion forum at an international level. Allergy with its interdisciplinary character involves the expertise of various fields both in clinical medicine and in research and experimental science. Allergy manifests itself as various conditions with a colorful spectrum affecting different organs and following quite variable pathomechanisms.The World Allergy Organization (WAO), as a global federation of 74 national and regional societies for allergology and immunology, is launching the new journal "WAO Journal," addressing this need for information, exchange of experience, and international discussion.The journal will be practice-oriented and offer the highest level of information in a strictly peer-reviewed system. It offers space for reviews both at the postgraduate education as at the advanced research level, originals, and letters, where exceptional case studies, concise reports on study findings, or expression of opinions and discussion of recent topics of controversy will be published.The journal has established an excellent group of experts in the editorial board who represent at the same time the various features of clinical and experimental allergology and relevant subdisciplines and the various geographic areas of the world.The WAO Journal will reach over 30,000 allergists all over the world directly online; it will be available for free for the first year for all individual members of national allergy societies as well as nonmember subscribers. The new journal is in direct tradition grown on the basis of Allergy and Clinical Immunology International--The Journal of the World Allergy Organization, which has been the official organ of WAO for 19 years and has been discontinued by December 2007. This decision never was caused by dissatisfaction; Allergy and Clinical Immunology International--The Journal of the World Allergy Organization was one of the most successful allergy journals, at one time reaching 17,000 allergists, with editions in several languages. At this place, special thanks should go to the founding editor, Alain De Weck, and to the long-time editor, Allen Kaplan, who have done an excellent job together with Hogrefe Huber publishers, Dr Christiane Hogrefe, Dr Rob Dimbleby, and Christina Sarembe. The decision for a new journal reflects a new philosophy of publication, concentrating on the electronic way, with many advantages starting from the speed with which articles can be accepted, reviewed, and published, decreased costs, the opportunity for digital content (including videos and animation), easy searching of contents, and independence from postal services, just to name a few.Coeditor in Chief Lanny Rosenwasser and myself are eager to push "WAO Journal" to become one of the premium international journals in allergy in a truly global endeavor!Johannes RingEditor-in-ChiefMunich, Germany, January 2008


Frank John Fenner , one of Frank was born in Ballarat, Victoria, Australia, but his family moved to Adelaide, South Australia, when he was 2 years old. He received a bachelor of medicine and surgery degree (1938) and a doctor of medicine degree (1942) at the University of Adelaide. During 1940–1946, he was an officer  in the Australian Army Medical Corps and served in Australia, Palestine, Egypt, New Guinea, and Borneo. At various times, he worked as a medical officer in a field ambulance and casualty clearing station, a pathologist in a general hospital, and, most prominently, as a malariologist. For his work in combating malaria in Papua New Guinea, he was made Member of The Order of the British Empire. As Frank noted later, the highlight of his military service was meeting and marrying a nurse, his wonderful wife, Ellen, known to all as Bobbie. Bobbie died in 1995, but ever after Frank said that his marriage was the most important part of his life. Frank is survived by his daughter, Marilyn, grandson, Simon, granddaughter Sally, and great-grandson Jasper.Mycobacterium tuberculosis, Frank worked on M. ulcerans, the etiologic agent of Buruli ulcer, the third most common mycobacterial disease worldwide after tuberculosis and leprosy.After his war-time service, Frank was recruited to work at The Walter and Eliza Hall Institute of Medical Research in Melbourne by Sir Frank Macfarlane Burnet. Initially, they worked on ectromelia virus infection in mice . In 1949, he received a fellowship to study at the Rockefeller Institute for Medical Research in New York City, where he worked in the laboratory of René Dubos. While Dubos worked on Returning to Australia in 1949, Frank was appointed Professor of Microbiology at the new John Curtin School of Medical Research (JCSMR), a unit of the Australian National University (ANU), in Canberra. He then began studying myxoma virus infection in rabbits. Throughout the 1940s and 1950s, Australia had severe rabbit plagues. Frank’s classic work on myxomatosis culminated in his classic 1948 paper  such greats as Gordon Ada, Alan Bellett, Bob Blanden, Stephen Boyden, John Cairns, Peter Cooper, Colin Courtice, Peter Doherty, Jack Eccles, Stephen Fazekas de St. Groth, Adrian Gibbs, Alfred Gottschalk, Royal Hawkes, Dick Johnson, Bill Joklik, Kevin Lafferty, Graeme Laver, Fritz Lehmann-Grube, George Mackaness, Barrie Marmion, Ian Marshall, Brian McAuslan, Peter McCullagh, Cedric Mims, Bede Morris, Chris Parrish, Ian Ramshaw, Rob Webster, David White, and Gwen Woodroofe.And on the side, Frank published 23 books, of which 4 have become symbols of the march of virology through one of its most expansive eras: The Biology of Animal Viruses (2 editions)  named Frank the chairman of the Global Commission for the Certification of Smallpox Eradication. The last known case of naturally transmitted smallpox occurred in Somalia in 1977, and WHO set in place a comprehensive global program to make sure that pockets of infection had not been overlooked. Eradication of the disease has been regarded as one of the greatest achievements in human history, and it was Frank’s great honor to officially pronounce global eradication to the World Health Assembly in May 1980. He later said that making this pronouncement stood out most among his many achievements: “[The pronouncement] was accepted unanimously by the World Health Assembly on that day.”Frank had an abiding interest in the environment, and in 1973 was appointed foundation director of the Centre for Resources and Environmental Studies at ANU; he held this position until his retirement in 1979. The Centre became part of the Fenner School of Environment and Society in 2007. It was in this role, late in his career, that Frank publicly expressed a gloomy prospect for the future of humankind: environmental degradation, global warming, overpopulation. In retrospect, this view now seems at odds with Frank’s otherwise positive view of life, especially in regard to the grand prospects of advances in medical science in support of human welfare.Frank played many national and international leadership roles  as it was established by Sir Christopher Andrewes, André Lwoff, and Peter Wildy at the International Congress of Microbiology in Moscow in 1966. Frank was unable to attend the next Congress in Mexico City in 1970, but in his absence was elected the second president of the committee (the first president was Peter Wildy). These were formative days; the basic structure of virus taxonomy as we know it today emerged from the work of the committee, under the presidencies of Peter Wildy and Frank Fenner, as the committee met at the first 3 International Congresses of Virology  . This memory can start with Frank’s vignette in his autobiography . The bottle eventually was emptied and we lamented its passing, but the next evening as I perchance opened the cupboard, there was a new bottle. Frank had mysteriously found a place to replenish the elixir, but of course he never explained his action. I must admit that as we sat and sipped that scotch the topic of conversation was often virology. Afterward, my son Rick sent Frank a copy of his video of the trip, so there was much email traffic back-and-forth reliving each adventure. Life at its fullest.Does all this capture Frank Fenner, the man, the friend who has died? If not, then words cannot serve what memories can. Whenever we think of the rise of virology from its roots in pathology and the infectious disease sciences, to its flowering in the first laboratory experiments in viral biology and pathogenesis, and to the beginnings of molecular virology, the name Frank Fenner will be remembered. Whenever we who knew him as a friend think of the emergence of virology as a distinct discipline, at the time of the first International Congresses of Virology (1968 forward), his role will be remembered with great fondness. Whenever we extend these memories to the more personal aspects of life, Frank’s quiet, unassuming character, a character with a steel spine and great insight and understanding of people, will be recalled, again with fondness mixed with great respect. He will never be forgotten.


After publication of this work , we noteThe authors declare that they have no competing interests.WS and DB jointly designed the study and supervised all fieldwork. Additionally, WS analyzed and interpreted the data and drafted the manuscript. VC and AG co-supervised WS during study design, analysis and interpretation of data. VC gave further input in manuscript preparation, which was also contributed to by AG. HZ participated in the design and management of fieldwork. JZ and GC conceptualized the project, managed the coordination and oversaw all implementation activities. MS participated in the design of the study, providing technical and administrative support throughout the entire implementation of the research project. All authors read and approved the final manuscript.


The State of the Science of Endocrine Disrupting Chemicals - 2012 (WHO/UNEP 2013), an extensive update of an earlier document, Global Assessment of the State-of-the-Science of Endocrine Disruptors  and the World Health Organization (WHO) released sruptors . Over thFirst, as described in the new report (WHO/UNEP 2013), the convergence of wildlife, laboratory animal, and epidemiology data suggests a greater role for EDCs in disease, even more than was predicted just 10 years ago. Taking the animal and human evidence together, the report demonstrates a strong likelihood that exposure to EDCs during fetal life and/or puberty plays a role in the proliferation of male and female reproductive problems, endocrine-related cancers, infections, asthma, obesity, diabetes, and behavioral and learning disorders, including attention deficit/hyperactivity disorder (ADHD).The incidences of these conditions have increased significantly not only in the United States but across the globe. Because genes do not change fast enough to explain this increase, environ-mental causes must be involved. The environmental contribution to disease is estimated to be 24–33% of the global disease burden . Althougin utero and the first years of life) is a very sensitive time for EDC-induced health effects , EDCs are a global problem and will require global solutions. EDCs have contaminated the world via the natural flow of air and water. Several hundred EDCs have been measured in humans and wildlife, even in remote places such as the Arctic. Thus, it is now impossible to examine an -unexposed population anywhere on Earth. To improve health, environmental health scientists and toxicologists need to work more closely with colleagues in endocrinology, genetics, developmental biology, epigenetics, and clinical medicine to bring EDC research into the mainstream of science.The State of the Science of Endocrine Disrupting Chemicals - 2012 (WHO/UNEP 2013). I commend WHO/UNEP and the scientists who worked for more than 2 years to produce this report. It is an important source of data on EDCs and should be mandatory reading for everyone who is interested in protecting and improving human health.These and other important topics related to EDCs and their effects are detailed in


The Indian Diaspora, especially in North America, is a visible force in the field of psychiatric medicine. An estimated 5000 persons of Indian origin practice psychiatry in the USA and Canada, and an estimated 10% of these are in academic psychiatry. Wide ranging contributions, from molecular biology of psychiatric disorders to community and cultural psychiatry, are being made by this vibrant group of researchers. This article is a brief summary and work-in-progress report of the contributions by Indian – American psychiatric researchers. Although not exhaustive in coverage, it is meant to give the reader an overview of the contributions made by three waves of researchers over a span of 50 years. The Indian diaspora that has migrated to North America over the last 50 years, from 1960 until now, has established itself as a formidable intellectual force in Science, Engineering, Technology, Medicine, Education, Literature, and other fields. – a publThe first wave of immigrants who pursued academic psychiatry arrived in the 1960s, to settle in the largest cities of Canada and the USA. This was the period when biological psychiatry and psychopharmacology were developing. Psychoanalytic psychiatry was on the wane and University Departments were transforming. Deinstitutionalization was in progress, community and social psychiatry were on the ascent, and biopsychosocial models of psychiatric disorders were being formulated. Foremost among this first wave of researchers was the Montreal group, which worked out of Douglas Hospital and Allan Memorial Institute of the Department of Psychiatry at McGill University. Jambur Ananth who had trained at the All India Institute of Mental Health, in Bangalore,  began his research career here in 1968. His collaborators included eminent researchers such as Samarthji Lal and NP Vasavan Nair. After a 13-year productive research career, Ananth moved to the University of California, Los Angeles in 1981. Ananth was a prodigious researcher and published over 400-articles, several books, and many book chapters. There are several themes to Ananth’s research, including, but not limited to, the biology and psychopharmacology of Schizophrenia and Depression. It would not be an exaggeration to say that until the year 2005, Ananth tested and helped develop virtually all psychopharmaceutical agents of the previous three decades. Noteworthy among his contributions are the role of nicotinic acid in psychoses, studies of the first and second generation antipsychotics, and antidepressants, and treatments for tardive dyskinesia. He edited the first text book on psychopharmacology authored predominantly by Indians.[In Chicago, Illinois, USA, another group of Indian researchers had formed in the late 1960s. Dr. Nedathur Narasimhachari, an organic chemist and faculty in the Department of Psychiatry at the University of Illinois and Illinois State Psychiatric Institute, worked closely with psychiatrists Harold Himwich and later John Davis. Their studies on the role of serotonin and its toxic variants in psychosis, and the presence of phenylethylamine in the human brain, are an important part of the history of biological psychiatry. Another stalwart psychiatric researcher from this institution, also not a psychiatrist is Ghanshyam Pandey. He is a professor of pharmacology in psychiatry at the University of Illinois Chicago and the Psychiatry Institute under the umbrella of the Illinois State Psychiatric Institute. Dr Pandey is a versatile researcher in many aspects of neurotransmitter function and is best known for his ground breaking research on the role of serotonin receptors in suicide. This institute has served as the formative and sustaining ground for many second-wave Indian psychiatrists and scientists, including psychiatrists Prakash Desai , Nagamani Pavaluri (Pediatric mood disorder), and Rajiv Sharma  who are all currently on its staff. Another pioneer from the ‘first wave’ with a lasting contribution to neuropsychiatric disorders is Dr. Harbans Lal, who promoted the concept of neuroprotection well before it became a fashionable term. Lal, a pharmacologist, held various teaching and research positions at the University of Kansas, University of Chicago, and University of Rhode Island, and eventually settled as Chair of Pharmacology and Neurosciences at the Medical College of the University of North Texas Health Science Center. Dr Sachin Pradhan, also a pharmacologist has contributed to our understanding of the effects of psychomimetic drugs such as PCP and inhalants. He has had a long tenure at Howard University in Washington DC, and edited a text book of pharmacology. Separately, he also published a book on the contribution of Indians in USA.[The second wave of researchers consist of those that began their research careers in USA or Canada between approximately 1985 and throughout the 1990s. By now, some of these academicians have nearly 30 years of contributions to their credit and occupy endowed chairs and leadership positions in academic psychiatry. Although no exact count exists, it is estimated that there are at least 50 such researchers forming a solid core of psychiatric academicians of Indian origin. Geographically, they have spread their wings across the span of USA and Canada, and are at leading academic centers of the two countries. This group has accumulated an impressive record of contributions from the bench to the remote corners of the community, and has deservedly acquired a reputation for intelligence, originality, diligence, collegiality, collaboration, and leadership, nationally and internationally. There are too many individuals in this cadre to mention all, and it is beyond the scope of this article to review their work individually. See Dr. Rohan and Dr. Mary Ganguli, Dr. Dilip Jeste, Dr. Matcheri Keshavan, Dr. Shitij Kapur, Dr. Ranga R Krishnan, Dr. Madhukar Trivedi and Dr. Lakshmi Yatham epitomize the cream of this crop. Jeste developed his research career at the National Institute of Health (USA) before moving to the University California at San Diego. The first phase of his research focused on the biology and treatment of schizophrenia, and subsequently on the identification and treatment of tardive dyskinesia (TD). TD had become a major challenge in the treatment of schizophrenia and it was important to know through systematic studies, its prevalence, cause, and potential treatment. Dr. Jeste rose up to this challenge and provided researchers and practitioners reliable data on the prevalence of TD over the short and long term. In the second phase of his research career, which started at UCSD, Dr. Jeste shifted his attention to geriatric psychiatry, and quickly assumed the mantle of an undisputed research leader in this field. Especially noteworthy is his work on psychoses in the elderly. Jeste also took on various leadership roles including being President of the Association of Geriatric Psychiatry and an editor of its flagship journal. Dr. Ranga Rama Krishnan of the Duke University is a prolific biological researcher of international fame. His group at Duke has conducted numerous investigations on the biology of depression, and championed the concept of vascular depression in the elderly, based on their original findings of excessive hyperintensity lesions demonstrated by magnetic resonance imaging. They are also considered leaders in the development of technology for psychiatric brain imaging. Ranga Krishnan became the first chair of Indian origin in a major private university such as Duke, and has gone on to International leadership in medical education by leading the development of the Duke Graduate Medical School in Singapore under the aegis of the Duke University and the National University of Singapore. Both Dr. Jeste and Dr. Krishnan were inducted into the Institute of Medicine, an honor bestowed on very select academicians. This speaks for the high stature they hold in the medical academia. Matcheri Keshavan is an alumni of NIMHANS, Bangalore. Dr. Keshavan received advanced research training in Vienna and worked at the Maudsley in London. In USA, his career began at Wayne State University, although the majority of his work occurred during his tenure at the Western Psychiatric Institute and Clinic (WPIC) of the University of Pittsburgh. Of late, he was appointed as an endowed professor and one of the Vice Chairs at the Harvard University. Keshavan’s contribution to the understanding of the first episode of psychoses, especially the integrity (or lack thereof) in the neuronal energy mechanisms, demonstrated by magnetic resonance spectroscopy is an excellent example of his incisive insights into the biology of psychosis. Another area of much clinical and biological research by Keshavan and his group has been in the neurodevelopmental origins of schizophrenia. The WPIC in Pittsburgh serves as the psychiatry department of the University of Pittsburgh. With prominent Indian academicians such as Rohan Ganguli, Mary Ganguli, and Keshavan generously offering their expertise and mentoring early career psychiatrists, it has been a nidus for many budding psychiatric researchers of Indian origin. Although often mentioned together, Rohan and Mary Ganguli have made very different and specialized contributions in their fields of expertise, respectively. Rohan Ganguli has conducted extensive studies in the immunology of schizophrenia, and in more recent years has concentrated his efforts on the metabolic burden in this disease, especially that associated with atypical antipsychotics. Mary Ganguli is a geriatric psychiatrist, best known for her work in the epidemiology and assessment of dementia, including a cross-national study between the Monongahela valley in Pennsylvania, USA, and Ballabgarh, Haryana, India. The nidus effect is also visible in many prominent universities where a researcher of Indian origin has excelled, attracting younger researchers to the department. Duke University is one such where Ranga Krishnan’s presence and leadership has led to a nexus of both senior and mid-level Indian psychiatrists, such as, Prakash Masand , Meera Narsimhan , Ashvin Patkar (Addiction Psychiatry), Murali Doraiswamy , and others have gone to establish niche areas of research and onto academic leadership roles in their own right. Two other examples are (1) University of Texas, South Western Medical Center (UTSW), where MadhuKar Trivedi leads an internationally acclaimed mood disorders institute. Trivedi’s leadership role in the largest, publicly supported algorithmic treatment research program of depression, is well-recognized. This study (STAR-D) provides an excellent roadmap for treating depression for clinicians and researchers, alike. UTSW has 10 psychiatrists of Indian origin on its full-time faculty roster, with wide ranging academic specializations; (2) University of California at San Diego (UCSD) where Dilip Jeste has served as the magnet, with recent early-career psychiatric researchers Ipsit Vahia and Gowri Savla Nayak. These selective examples serve as powerful evidence of how brilliant individuals with research excellence transform programs and departments to the benefit of many. Institutions in India and elsewhere aspiring for their own excellence would be well advised to emulate this.In reviewing the first wave of researchers, the work of Indo-Canadian investigators at McGill was mentioned. Within the second wave, the work of what might be termed the bipolar group is especially note worthy. Vivek Kusumakar at Dalhousie University, until he moved to Johnson and Johnson Company in the USA – he had an untimely death in 2009, and Lakshmi Yatham at University of British Columbia, Vancouver, both alumni of NIMHANS have lead major research in the treatment of bipolar disorders. They co-chaired the Canadian Network for Mood & Anxiety Treatments (CANMAT) and developed the bipolar treatment guidelines in Canada; Yatham is president of the International Society for Bipolar Disorders. The University of Western Ontario, University of British Columbia – Vancouver, University of Toronto and its affiliates have served as fertile grounds for the pursuit of academic careers by Indo-Canadian Psychiatrists , D. Devanand , Sanjay Dube (psychopharmacology), Choudhary Jampala (phenomenology and biology of schizophrenia), Geeta Jayaram , Shitij Kapur , Arifulla Khan , Vivek Kusumakar , Ashok Malla (early psychosis), Anil Malhotra , Rahul Manchanda , Sukdeb Mukherjee , Viswajit Nimgaonkar (psychiatric genetics), Phillip Ninan , Uma Rao (pediatric mood disorders and addictions), Rajiv Tandon , Gunwant Thaker (biology of schizophrenia), Lakshmi Yatham (bipolar disorder treatment), and Vikram Yeragani .Lest the reader get the impression that Indo-American psychiatric academicians have focused their careers only on biological psychiatry, it should be emphasized that many noteworthy contributions have been made in the psychological aspects as well . CV RamaThere are three other important modalities of scholarly contributions made by psychiatrists of Indian origin in the USA and Canada. The first modality is through book writing or editing. Although sometimes a book is a culmination and summary of many years of an individual researcher’s work, it may also be a compilation of the research of many authors in one place, and at other times it is a more user-friendly, narrative of one’s experiences and observation of a subject in depth. Tables The third modality has focused on the other dimension of academic psychiatry, namely, psychiatric education and has attracted some of the brightest minds among Indian–American psychiatrists. Mantosh Dewan was one of the earliest to chair a University Department of Psychiatry at the State University of New York in Syracuse , followed by Ranga Krishnan at Duke University. Since then, and especially in the last decade, many Indian–American academicians have been appointed to this coveted leadership position including Nutan-Atre-Vaidya, Anand Kumar, and Murali Rao, in Chicago. Many psychiatry residency directorships are (have been) occupied by Indo-Americans, including Chetan Haldipur, Bhaskar Dave, Nyapati Rao, Nalini Juthani, and others. Among the recipients of the Nancy Roeske Certificate for Teaching Excellence awarded by the American Psychiatric Association (APA), is a long list of psychiatrists of Indian origin. Nyapati Rao has especially played a strong role in the development of the residency curriculum, and the newer methods of examination for the American Boards. Geeta Jayaram distinguished herself by becoming the first (and so far only) Indo-American psychiatrist to have been the Scientific Program Director of the Annual APA meetings for four years, and Dilip Jeste and Prakash Desai are the only Indo-American psychiatrists to have won the national elections to important positions within organized psychiatry. These accomplishments although not traditional research are mentioned, as the reader will no doubt appreciate the impact of such accomplishments on the training opportunities, including research training, and on the academic recruitment, career development, and productivity of younger Indian psychiatrists migrating to America.Significant scholarly contributions have also been made in specialties such as child and adolescent psychiatry by Shashi Elongovan (foster care), Vivek Kusumar , Uma Rao , Aradhana Sood , and others. Women’s mental health has benefited from the dedication and research of several Indian psychiatrists including Shaila Misri at the University of Vancouver in Canada, Shamsa Sonawalla in Harvard, and Lilian Gonsalves at the Cleveland Clinic. Ashok Srinivasaraghavan  has been a leader in Law and Psychiatry. Asha Mishra  in Community Psychiatry, Ramakrishna Shenoy (VCU) and Jaisimha Rao  in Developmental Disorders, and Chetan Haldipur  to the history of psychiatry, especially as it pertains to ancient India, to name only a few, have made unique contributions.In the twenty-first century, a new and much larger group of academicians of Indian origin is emerging to carry on the good work of their predecessors. Of the 5000+ psychiatrists of Indian origin in North America, it is estimated by this author that over 500 are now in academic psychiatry. A small sampling of names is included in There can be no question that Indian American psychiatrists have woven strong threads in the fabric of American Psychiatry and that this experience has been a mutually advantageous relationship. Indian–American psychiatrists form a strong and integral part of American psychiatry, and it is hard to imagine the latter without the former. The growth of the IAPA and recognition of its formidable strengths is one indicator of this core role and strength.The challenges confronting psychiatrists in India wishing to migrate and pursue a research career are uphill requirements of the American licensure system, limited availability of mentors, lack of strong networking within the Indo–American academic community, extremely competitive nature of federal funding, and the occasional glass ceiling that one confronts in career advancement. From the perspective of contributions in India by the Indian-American psychiatric research community, we should add that the absence of clear and user-friendly mechanisms in India for academic collaborations, joint appointments, restrictions on overseas travel for Indian collaborators, restrictions on research with DNA and biological tissues, and limited research infrastructure in most Indian institutions, have all worked to limit such contributions. The potential is indeed unlimited, and the benefit to advancement of knowledge and the care of our patients is tremendous, if only we can effectively address these challenges, and harness the full potential of the proven current generation and the extremely talented next generation in both countries. The Indo-US and Global Health Care Summits and the recent Indo-Global Psychiatry Initiative are good examples of current efforts to do so. On balance though, the accomplishments have far outweighed the challenges. We may comfortably and confidently declare this natural experiment of immigration to the USA / Canada a colossal success for the psychiatrist, psychiatry, and most importantly our patients.


In the 1960s, there was a growing awareness of the need to develop closer ties between radiologists in the various nations of Asia and Oceania. Not only would this provide opportunities to learn from one another, but more importantly, it would contribute towards furthering harmonious regional and international relationships. To this end, in the northern hemisphere of this region consideration was given to forming a Far Eastern Society, whilst in the southern hemisphere of the region, national radiological societies in Australia, New Zealand and some South-East Asian countries had similar ideas.Since 1923 the International Society of Radiology (ISR) had provided leadership as the world authority in radiology by way of the International Congress of Radiology (ICR) held every 4 years, and by establishing important standing committees such as the International Commission on Radiological Protection. With representation from the majority of the world’s nations, ISR was a suitable forum to discuss matters of general interest for members as well as the wider community.However with the passage of the years, the influence of ISR waned as a result of the emergence of large regional societies. By the mid-1960s a zonal pattern was developing.In the Americas, the Radiological Society of North America (RSNA), begun in 1928, brought together Canada and the United States and was growing from strength to strength due much to its considerable available financial resources to promote training and research. Another society, the Inter-American Society of Radiology, embracing both North and South America, characterised by being multilingual, had been established in 1933, and continued to the present, but has not reached the level of significance of RSNA. The yearly RSNA congress thus became the main focus for manufacturers and the trade industry to exhibit their latest wares and radiologists from worldwide flocked to Chicago to see what was on offer as well as to attend the excellent academic programmes.In the European zone, there was the European Association of Radiology (EAR), a federation of national societies founded in 1962, and the European Congress of Radiology (ECR), the organising body of the eponymous congress, which was founded in 1967 and conducted congresses every four years. Over time, no doubt stimulated by the success of RSNA, European radiologists set about to improve the stature of their Society through the European Congress of Radiology. This was well under way by the 1960s and today, ECR is held every year in Vienna.Another important factor which encouraged the development of regional congresses came from the trade houses. With the exponential escalation of radiology as expected, individual countries, with increasing numbers of radiologists, established their own national annual congresses and looked to the various firms and trade houses for financial and other support. In addition subspecialty societies and meetings evolved, placing further burdens on the resources of companies. Understandably, the commercial world saw that supporting only large regional congresses was a way to rationalise their commitments. By the late 1960s, there was a trend towards the large company headquarters supporting only major congresses, leaving the question of assisting national meetings to their local agents. This was the state of affairs when the thought of setting up a regional society in the Asia and Pacific region was contemplated.The idea of setting up the Asian-Oceanian Society of Radiology (AOSR) came about in the late 1960s when questionnaires were circulated to 13 constituent nations/territories and opinions were sought . Then in 2010, Korean Society of Radiology (KSR) took over the management and AOSR was registered in Korea.The original chain was donated by Dr. Principe of Philippine, but regrettably, it later become lost. It was remade and was donated by Korean Radiological Society under the leadership of Professor Man Chung Han  was the News Sheet, which was mailed to contacts of National Societies . These seminars were held in different countries to allow more area coverage and to enhance fellowship between Asian radiologists. To further promote radiological education in the region, the teachers and speakers of ASDIR were nominated from the local organisers and from the region  and members were SK Aggarwal (India), KS Cho (Korea), HM Liu (Chinese Taipei) and S Suthipongchai (Thailand). AOSR has always been active in educational activities and continues to be so, represented in various forums organised by RSNA, ISR/ICR, International Radiology Quality Network (IRQN) and sharing its experience and progress with other regional radiological organisations.th year of Anniversary of AOSR. There are 23 Member Societies comprising of Bangladesh Society of Radiology & Imaging, Chinese Society of Radiology, Chinese Taipei Society of Radiology, College of Radiology Academy of Medicine of Malaysia, Fiji Radiology, Hong Kong College of Radiologists, Indian Radiological & Imaging Association, Indonesian Radiological Society, Japan Radiological Society, Korean Society of Radiology, Macau Radiology Association, Mongolian Radiological Society, Nepal Radiologists' Association, Philippine College of Radiology, Radiological Society of Pakistan, Radiologist Ministry of Health Tonga, Royal College of Radiology of Thailand, Samoa Society of Radiology, Singapore Radiological Society, Sri Lanka College of Radiologists, The Royal Australian & New Zealand College of Radiologists, Uzbekistan Radiology Society and Vietnam Society of Radiology and Nuclear Medicine. AOSR is now registered in Korea and managed by the Korean Society of Radiology. The website is http://www.theaosr.org. The Asian Oceanian Journal of Radiology (AOJR) is affiliated with the Biomedical Imaging & Intervention Journal (BIIJ).This year marks the 40With the support of the Member Societies and healthcare professionals, one can anticipate the continual growth of AOSR with the rapid advancement of radiology in our region.


Macroglossia is a morphological and volumetric alteration of the tongue, caused by muscular hypertrophy, vascular malformation, metabolic diseases, and idiopathic causes and also associated with Down and Beckwith-Wiedemann syndromes. This alteration can cause dental-muscle-skeletal deformities, orthodontic instability, masticatory problems, and alterations in the taste and speech. In this paper we present a case of true macroglossia diagnosed in a female patient, 26 years, melanoderma, no family history of disease, with a history of relapse of orthodontic treatment for correction of open bite, loss of the lower central incisors, and complaint of difficulty in phonation. The patient was submitted to glossectomy under general anesthesia using the “keyhole” technique, with objective to provide reduction of the lingual length and width. The patient developed with good repair, without taste and motor alterations and discrete paresthesia at the apex of the tongue. Macroglossia is an uncommon condition that can lead to several alterations like dental-muscle-skeletal deformities, orthodontic treatment instability, masticatory, and breathing and phonation problems, characterized by increased size of the tongue, can be caused by congenital malformations or acquired diseases. The most common causes are muscle hypertrophy and congenital vascular malformations, such as lymphangioma and hemangioma, they are also characteristics found in the Beckwith-Wiedemann syndrome, and can be present in the Down syndrome –14. It cAccurate diagnosis of true macroglossia is obtained through the signs and symptoms of this alteration, which is of fundamental importance for the correct indication for surgical treatment, in order to restore proper function and provide stability for orthodontic treatment .The surgical treatment indicated for the true macroglossia is the reductive glossectomy. Several techniques have been proposed in the literature to enable the reduction of the tongue. Peripheral incisions with marginal resection of tissue have as complications hipomobility and change in the form of the tongue that becomes globular , 20, 22.This paper aims to present a case of true macroglossia treated surgically using the keyhole technique.Female patient, 26 years, melanoderma, was referred by the Department of phonoaudiology with complain of difficulty in speech and history of orthodontic treatment for correction of anterior open bite that resulted in complete recurrence. No history of systemic diseases or drug allergies or family history of her disease. On physical examination, the tongue was increased both in length and in width, with anterior open bite and interposition of the tongue, impression of the lingual surface of mandible molars on the edges of the tongue, loss of the tooth 31 and 41, occlusion in Class I of Angle, reversion Spee curve in the mandible and marked in the maxilla Figures , with diThe technique chosen for reduction glossectomy was the “keyhole” technique with the goal of reducing the tongue in width and length. The patient underwent general anesthesia nasotracheal intubation, and the tongue was pulled out of the oral cavity through three repairs with nylon suture 3-0 fixed to the surgical field to maintain the symmetry between the sides and facilitate the demarcation of the incisions, which was performed with methylene blue Figures . After iTo determine the real need of surgical treatment is of fundamental importance to define the signs and symptoms of true macroglossia. The diagnosis must be based on clinical findings .In cases of true macroglossia, as presented, in the literature several reductive glossectomy techniques are suggested. Each technique has a purpose in accordance with the clinical aspect.In the presented case the keyhole technique was used which is indicated for reduction of length and width of the tongue, preserving the vasculonervous bundle and with few reports of sensory and functional deficits , 25, 28.Surgical reduction of the tongue is an uncommon procedure, being indicated in specific cases; the keyhole technique allows anterior and median partial resection, technically simple, minimal morbidity, and good functional result.


The expanding list of antiretroviral drugs, the increasing possibilities in therapy of HCV and other co-infections represent an attractive setting for individualized prescription. However, there has been considerable hype, and limited impact of pharmacogenetics in care.The development of pharmacogenetic tools would be of interest considering the complexity of treatment, the cost, and the expectation of long-term exposure. It would also be desirable given the possibility of serious toxicity, but also treatment intolerance, cumulative toxicity or the unfavorable interaction of drugs and aging, metabolic, cardiovascular and bone disease processes.This presentation will review available tests, the position of agencies on the inclusion of pharmacogenetic information in labels, and a perspective on developments in genomic medicine.


Study of healthy aging of the hypothalamic-pituitary-thyroid axis is difficult, since aging is accompanied by the increased frequency of various thyroid diseases and of extrathyroidal disease, as well as by the increased intake of medicines modulating the function of this axis. Nevertheless, researchers managed to determine that in the paraventricular nucleus of aged humans the number of neurons synthesizing TRH is increased. In the pituitary, the number of thyrotrophs also increases, and the cells are commonly hypertrophic. In the thyroid, epithelial cells are smaller, the amount of colloid decreases, and the whole gland becomes smaller and denser. It is still not known how aging affects secretion of TRH. Healthy aging is accompanied by the slight increase of concentration of TSH (highest concentrations of this hormone were detected in centenarians), and the night peak of its secretion is lower. In healthily aging humans, concentrations of T3 and of fT3 decrease, concentration of rT3 increases, and concentrations of T4 and of fT4 remain stable.According to the current theory of aging, the direct cause of aging is the accumulation of stochastic damage to DNA, and to proteins and lipids. The most important  damaging factors are the reactive oxygen species (ROS), by-products of the cellular metabolism, especially of the respiratory chain in mitochondria. Most likely, the function of the hypothalamic-pituitary-thyroid axis influences the rate of aging, since the function of the respiratory chain and, therefore, the rate of production of ROS, remain under the control of T3. Consequently, slowdown of the T3-dependent metabolism might promote longer life through slower production of ROS. This hypothesis is supported by the above described epidemiological observations showing that healthy aging is accompanied by the decreased activity of the hypothalamic-pituitary-thyroid axis and by the fact that in long-lived humans  the activity of this axis is lowest compared to younger age groups. Because of this, subclinical hypothyroidism in 65 years old or older humans might be, in fact, a manifestation of healthy aging of the thyroid gland, and this is why in these individuals this condition should not be “automatically” treated. Instead, the patient should be regularly examined (if we do not want to omit the overt hypothyroidism), and decision to treat should be taken individually, based on the biological age, the clinical state, the presence of other diseases, the results of biochemical tests, etc.The percentage of aged humans with anti-TPO and anti-TG auto-antibodies is much higher compared to young individuals, but above the age of 80 the percentage of such individuals decreases. Aging is accompanied by the increased frequency of hypothyroidism, hyperthyroidism, and of thyroid cancers. Their symptoms are commonly untypical and, because of this, might be confused with signs of aging per se or with symptoms of other diseases. Nevertheless, all these diseases should be adequately diagnosed and treated.


For years, emerging infectious diseases have appeared worldwide and threatened the health of people. The emergence and spread of an infectious-disease outbreak are usually unforeseen, and have the features of suddenness and uncertainty. Timely understanding of basic information in the field, and the collection and analysis of epidemiological information, is helpful in making rapid decisions and responding to an infectious-disease emergency. Therefore, it is necessary to have an unobstructed channel and convenient tool for the collection and analysis of epidemiologic information in the field.Baseline information for each county in mainland China was collected and a database was established by geo-coding information on a digital map of county boundaries throughout the country. Google Maps was used to display geographic information and to conduct calculations related to maps, and the 3G wireless network was used to transmit information collected in the field to the server. This study established a decision support system for the response to infectious-disease emergencies based on WebGIS and mobile services (DSSRIDE). The DSSRIDE provides functions including data collection, communication and analyses in real time, epidemiological detection, the provision of customized epidemiological questionnaires and guides for handling infectious disease emergencies, and the querying of professional knowledge in the field. These functions of the DSSRIDE could be helpful for epidemiological investigations in the field and the handling of infectious-disease emergencies.The DSSRIDE provides a geographic information platform based on the Google Maps application programming interface to display information of infectious disease emergencies, and transfers information between workers in the field and decision makers through wireless transmission based on personal computers, mobile phones and personal digital assistants. After a 2-year practice and application in infectious disease emergencies, the DSSRIDE is becoming a useful platform and is a useful tool for investigations in the field carried out by response sections and individuals. The system is suitable for use in developing countries and low-income districts. For years, emerging infectious diseases (EIDs) have appeared worldwide and not only threatened the health of people, but also a significant burden on global economic and public health With the development of communications, the Internet, intelligent mobile-phone services and WebGIS, new technologies have been widely used in the domain of the prevention and control of infectious diseases, use of unstructured event-based reports, internet media report and XML forms for infectious disease reporting and surveillance is a new application http://www.geoepi.com for personal computer (PC) users and http://m.geoepi.com for mobile-phone users. DSSRIDE is a semi-open system, and used in infectious disease surveillance and response to emergencies industry, users who want using this system could contact the administrator of the system and send E-mail to yapin0215@163.com to sign a “User service agreement” and obtain user name and password. The permission of the user would describe in the agreement.In recent years, there have been outbreaks of several emerging infectious diseases in China; i.e., the SARS epidemic in 2003 We collected baseline information including the spatial distribution of notifiable infectious diseases and information relating to natural foci, hosts, vectors, medical services, the population census, and the characteristics of the geographical environment, transportation and climate for each county in mainland China. These data were obtained from the Chinese Center for Disease Control and Prevention, the National Bureau of Statistics of China, the National Meteorological Bureau of China, and projects of natural foci investigation The system structure of the DSSRIDE comprised a user interface, server service and control interface with a B/S (Browser/Server) structure. The user interface included the functions and permissions and could be accessed by PC, PDA or mobile phone. Additionally, the location information in fields was obtained by keyword enquiry or Global Positioning System (GPS) tracking, and the function of the DSSRIDE was then performed according to the location information. The server service provides a map and data service. In this study, Google Maps was used to display geographic information and to make calculations related to maps. In addition, a control interface was designed for the manager of the system; administrative users were permitted to carry out actions such as creating or deleting usernames, and adding or revising data of the system .The system was mainly designed with four modules of function. Firstly, the system was designed to collect epidemiologic data in the field and to send the data to a database via a wireless Internet service. Secondly, an enquiry module was designed to display the baseline information of the spatial distribution of infectious diseases, natural foci, hosts, vectors, medical services, and population, and the characteristics of the geographic environment, transportation and climate. In addition, a customized epidemiologic questionnaire was designed for users to use in real time and online. Lastly, a query tool for handling different types of public health emergencies and obtaining associated professional knowledge was designed to assist medical workers and decision makers.Information including questionnaire results, text, pictures, voice recordings and video recorded in the field can be collected and sent to the database via wireless internet services from PCs, PDAs and mobile phones in real time by different users. Experts and officials can analyze the data to understand the dynamics of the infectious disease emergency, the temporal and spatial distributions of patients, the population at risk, the susceptible population, and probable influencing factors. More than 200 types of questionnaires including individual-case questionnaires and epidemic-case questionnaires are provided by the DSSRIDE. The system also provides epidemiological questionnaires customized according to users’ actual demands in the field. In addition, the geographic location is important for field investigations. In the DSSRIDE, location information is collected by a GPS unit or keyword enquiry, and the information of longitude and latitude is then integrated into the report data. The spatial distribution maps, figures of the epidemic curve, and patterns of gender, age and occupation can be created quickly, and epidemiologic analyses are conducted in real time. Additionally, users can export these additional data to an Excel spreadsheet for further epidemiology analysis in professional software, such as SPSS or STATA, which are not included in the DSSRIDE system.To understand the transmission risk of infectious diseases in decision making during emergencies, the baseline information of infectious diseases, hosts, vectors, medical services, the geographic environment and climate in the field is needed, and it is important to raise the efficiency of handling emergencies. This information can be determined from the location information in the DSSRIDE. Queries and spatial research can be carried out using Google Maps on a PC, PDA or mobile phone. The DSSRIDE provides 10 categories of 206 epidemiological questionnaires for users. The system also provides the function that novel questionnaires can be customized in the field by users. Administrative users have the permission to manage questionnaires, including new questionnaires that are customized and optimized versions of existing questionnaires. Common users have the permission to put in, browse, modify, enquire about, and analyze questionnaire data and to export the information in a table format. Investigation and disposal workers can use the existing questionnaires or create novel questionnaires using the custom-tailor according to their needs in the field. Options for filling out questionnaires are readily provided by the system, and include uni-selections, multiple-selections, text, tables, and times. Users can choose the format of the questionnaire according to whether they are using a PC or PDA, and they are able to fill out, send, or review questionnaires online. The data of reported questionnaires are written to the database directly. Permitted users can analyze the data and transmit the results to the investigation worker in real time. The DSSRIDE integrates flow diagrams for the handling of an emergency, including handling cases of severe infectious diseases, emerging infectious diseases, food poisoning, nuclear, chemical and biologic hazards and other public health emergencies. Disposal workers and decision makers can be assisted by the flow diagrams in different emergencies, and can also be provided with information relating to the emergency, information for the prevention and control of infectious diseases, information relating to laboratory diagnosis, information relating to law, and information relating to medical services, disinfection, insecticides and sterilization, and case analyses.The users of the DSSRIDE are classified into super administrators, administrators and general users. These users have the same permissions in terms of epidemiological detection, epidemiological statistical analysis, guidance for handling infectious disease and professional knowledge enquiries. However, there are different permissions for epidemiological investigations in the field and data collection. Besides having the permissions of the administrator, the super administrator can create an administrator and add, modify and delete data in the system. The administrator can create a general user and browse the data reported by the general users.In 2009, pandemic influenza A (H1N1) emerged and spread globally. We collected information relating to cases in the early stage of the epidemic in mainland China from May 10 to June 22 using the DSSRIDE and analyzed the characteristics of these cases. This study established a decision support system for response to infectious disease emergencies using WebGIS and mobile services (DSSRIDE). The DSSRIDE provides functions including data collection, communication and analyses in real time, epidemiological detection, the provision of customized epidemiological questionnaires and guides for handling infectious disease emergencies, and professional knowledge querying in the field. These functions of the DSSRIDE could be helpful for epidemiological investigation in the field and the disposal of materials in an infectious disease emergency.The DSSRIDE is an integrated decision support system to aid the response to infectious disease emergencies and it is accessed easily by PCs, PDAs and mobile phones. It is thus suitable for use in the field, which is its main difference when compared with other information systems of infectious disease surveillance. In addition, most surveillance systems of infectious disease focus on data collection, communication, and display; e.g., the surveillance system for infectious diseases of pets in Chile and the surveillance systems for the distribution of mosquito species and global HPAI The successful application of the DSSRIDE requires investments including those in software and hardware. There are three types of hardware: the data and map server, PCs, and mobile phones (including PDAs). The servers are used to run the DSSRIDE and provide the service to the users. Users use PCs, mobile phones and PDAs to access the system to collect, transmit, browse and analyze data in the field and in offices. In the market, many brands and models of mobile phones support access of the DSSRIDE; e.g., Nokia, Motorola, HTC, and Blackberry. Considering the low cost of application, normal-configuration hardware is suitable for using the DSSRIDE, and low-income districts can be included in the system. The interface and database of the DSSRIDE were designed in Chinese, and apply to Chinese language districts and populations. The system is designed flexibly, and it can be easily adapted to not only the response to animal infectious disease emergences but also to the response to bioterrorism, earthquakes, flood and other natural disasters.The DSSRIDE is a decision support system used in infectious disease emergencies. The system includes functions for field investigations, data collection, transmission and analyses in real time, epidemiological detection, customizing questionnaires, and querying professional knowledge. The DSSRIDE provides a geographic information platform based on the Google Maps application programming interface to display information of infectious disease emergencies, and transfers information between workers in the field and decision makers through wireless transmission based on PCs, mobile phones and PDAs. Users can gain the baseline information at sites of emergencies, such as the baseline information of infectious diseases, hosts, vectors, medical services, geographic environment and climate. The DSSRIDE is simple, flexible and cheap, and is suitable to use in developing countries and low-income districts. The DSSRIDE can be used by different users such as international organizations, nations and provinces, hospitals, and survey groups. The DSSRIDE can easily be extended to adapt other domains such as animal infectious diseases, plant diseases and insect pests in agriculture, bioterrorism, earthquakes, floods and other natural disasters. It could be helpful for handling infectious disease emergencies or other public health events.Ethics is a key problem in the system application, and we attach great importance to this issue. The users of the system may be health agencies, hospitals, temporary teams of investigators or other agencies or organizations. Before such groups begin using the system, we will sign an agreement with the appropriate ethics committee to avoid ethical problems.The patient’s private information must be kept confidential. Anyone wanting to use the data must be reviewed by the appropriate ethical committee and sign a confidentiality agreement. All individuals need to comply with the relevant laws and regulations in using the data.


Vinci, a small town near Florence, Italy, dates back to Roman times, when it was inhabited by the Etruscans. "But this town is even more renowned for having given its name to the famous Leonardo da Vinci, who, in any discipline of science and art he dedicated himself to, surpassed all his contemporaries" wrote Emanuele Repetti in his geographic dictionary of Tuscany , the languid eyes, the puzzling backdrop of nature, the intricate loops of the neckline, the calm hands, even the absence of visible facial hair (eyebrows and eyelashes were not the style) add to the mysterious, semi-abstract quality of the face.The enigma of Leonardo's creation and the intrigue surrounding its origin, identity, and meaning can only be a metaphor for his own life and ideas and, by extension, ours. An archetype of the Renaissance, this man who would and could do everything must have peered inside himself for answers he had sought far afield. And just as he dissected and outlined the physical body, he sought to find and paint the spirit. Always the scientist, he knew that a portrait alone, no matter how exacting, would not do. Rejecting the flat background of tradition, he added the landscape. Part dream, part romantic reality, it provided perspective and connected the figure to the world, adding to the enigma and possibly holding the definitive interpretation.The puzzles of our era, unknown pathogens, many of them vectorborne, emerging biological threats, ecologic disasters, antimicrobial drug resistance can also benefit from meticulous observation, accurate recording, added perspective, and the interdisciplinary approach to knowledge. Just as with Leonardo, the art is in the science.


Sir,The concern about male reproductive and sexual health and, concomitantly, the health of their sexual partners is set in the context of rapid spread of human immunodeficiency virus (HIV) and increasing rate of sexually transmitted infections (STIs) in India. In the context of HIV prevention, a reduction in the prevalence of other STIs can help in decreasing the rate of transmission of HIV.In the present scenario, men, in general, do not feel comfortable seeking services from family planning clinics and young people, in particular, often feel embarrassed. Men’s reUnder the Research and Intervention in Sexual Health: Theory to Action (RISHTA) project at the International Institute for Population Sciences, a male health clinic was established in one of the three experimental communities. RISHTA interventions successfully demonstrated the strategies of effective community health education programmes and also the efficacy of engaging Ayurveda, Unani, Siddha, Homeopathy and Allopathic providers in HIV/STI risk reduction among men. PROFAMILThe choice of the paradigm in a community will depend on the pattern of utilization of health services by males, type of services already existing and the resources available. The exclusive male health clinic model poses a challenge of intensive resource requirement for establishment and maintenance. Being in the era of integrated health programmes, a similar model shall thus be a practicable choice.


The aim of the current study was to explore the relationship between housework and health of retired older adults, and to provide new evidences and clues for the effects of housework on health.The data came from the baseline survey of the Tongji-Dongfeng Cohort Study with 25,501 participants. The independent variable was housework including child care, elder care, grocery shopping & cooking, and washing clothes & cleaning house. The dependent variable was self-reported two-week illness. Age, education, marital status, smoking and drinking were used as potential confounding variables. There are gender differences in the four types of housework, with higher prevalence among women than among men. The prevalence of two-week illness in women was higher than that in men. After adjusting for potential confounding variables, the four types of housework had almost no significant effects on two-week illness, except for washing clothes & cleaning house with a negative effect for women .The association of housework with health, especially of child care, elder care, and grocery shopping & cooking without significance and of washing clothes & cleaning house with significance for women, would provide a valuable clue for in-depth study of housework, namely the effects of housework on health would be subdivided into the dimensions of psychological and social activity besides physical activity, and it may not be suitable to simply classify housework as a kind of exercise. Population aging, longer life expectancy, and relatively earlier retirement ages have enhanced interest in research on lifestyle and health for older adults In recent decades, most of the studies on housework have focused on gender inequality in young married couples and prime-age adults. Several sociological theories have been developed as explanations of gender inequality, including the relative resource model, the gender ideology model, the time availability model and so on Some studies suggest a positive association between perceived unfairness in the division of housework and depressive symptoms for women In research on the health of older adults, most of the studies have focused on socio-economic status, utilization of health services and health care, and health-risk behaviors, including smoking, alcohol consumption and physical activity. A solid evidence base supports the positive relationship between regular physical activity and health, and studies have largely examined the effects of brisk walking, leisure time exercise, or occupational activity rather than domestic activities In China, due to traditional Confucian ideology To address the above issues, the current study offers empirical evidence about housework and retired older adults in China. The aim of the current study was to explore the relationship between housework and health of retired older adults, and to provide new evidences and clues for the effects of housework on health.n = 27,009) of the invited participants agreed and provided baseline blood samples and questionnaire information between September 2008 and June 2010. Among those who did not participate in this study, most moved to other cities. The Medical Ethics Committee of the School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, HUST, and Dongfeng General Hospital, DMC, has approved this study. All participants provided written informed consent. The effective questionnaire of the current study was 25,501, and the valid rate was 94.42% .The data came from the baseline survey of Tongji-Dongfeng Cohort Study The independent variable was housework in the last six months. Most researchers agree that major housework includes cooking, cleaning, shopping for groceries and household goods, doing dishes, and laundry. In addition, comparing China’s traditional family with families in modern Western countries, there was this large difference: many Chinese older adults lived together with their children (including married adult children), and even their parents, which was due to both socio-economic status and the Chinese culture of filial piety of which the latter may be the more important. Combined with previous studies on housework in China The dependent variable was self-reported two-week illness, which was continuously used in the China National Health Services Survey from the first (1993) to the fourth (2008) with a cycle of every five years Data was analyzed using the SAS statistics package, release 8.2 . We constructed logistic regression models to analysis the effects of housework on prevalence of two-week illness. Unadjusted and adjusted OR and 95% CI were calculated using univariable and multivariable regression analysis, respectively. Two logistic regression models were conducted separately for male and female. Two-sided tests were used for all analyses, and p-values of 0.05 or less were considered statistically significant.The socio-demographic characteristics of the 25,501 subjects are shown in In addition, age and education level had significant associations with two-week illness, whether in men or in women. For men, former smokers and former drinkers are more likely to report two-week illness in comparison with never smokers and never drinkers ; for women, both current and former drinkers were more likely to report two-week illness , but there was no association with smoking.To our knowledge, the current study provided the first empirical data about housework and its associations with self-reported two-week illness in retired older adults in China. The results showed that there are gender differences in the four types of housework, with higher prevalence among women than among men. The prevalence of two-week illness in women was higher than that in men. However, the association of the four types of housework with self-reported health was almost not significant, except for washing clothes & cleaning house with a negative effect for women.As to gender differences in housework, the results of the current study confirmed those of the previous studies Regarding the effects of housework on health, there are few studies at present, and the existing studies mainly targeted at prime-age adult women In addition and perhaps more importantly, the association of housework with health in the current study, especially of child care, elder care, and grocery shopping & cooking (which were not significant) and of washing clothes & cleaning house (which were significant for women), would provide a valuable clue for in-depth study of housework. In fact, it is not difficult to perceive that the three types of housework without significant association have the common feature of interpersonal interactions; on the contrary, washing clothes & cleaning house involve almost no communication with others, and to some extent are boring. Perhaps the physical activity in housework would benefit health, but the interpersonal/social and psychological activity , were not used in the current study housework and its associations with health, especially of child care, elder care, and grocery shopping & cooking (which were not significant) and of washing clothes & cleaning house (which were significant for women), which would provide a valuable clue for in-depth study of housework. The effects of housework on health would be subdivided into the dimensions of psychological and social activity besides physical activity, and it may not be suitable to simply classify housework as a kind of exercise.Despite these limitations, the current study provides initial evidence of


Evidence of the role of hand hygiene (HH) in reducing morbidity and mortality rates associated with infection stimulated the creation of the "Clean Hands" project.To present the experiences and outcomes of the project "Clean Hands" that, over the past seven years, has developed a program to encourage hand hygiene.The project is based at the Center for Studies and Nursing Research for the Prevention and Control of Healthcare Associated Infections (NEPIH) at the School of Nursing, Federal University of Goiás/Brazil, and has developed activities to encourage HH since 2006 within the healthcare establishment, with professionals, academics, patients and caregivers; municipal daycare centers, with children, parents, and workers; and in scientific events, with academics and healthcare professionals. Strategies that have incentivized compliance with HH procedures: informative stylized banners depicting HH; educational brochures, a song parody CD, demonstration of proper HH technique, using poster paints on children’s hands; a puppet theater and face-to-face discussions about the importance of, obstacles to, and benefits of HH. Annually, the project hosts a festival of parodies about HH, called "CANTAFEN", which brings together academics and healthcare professionals.The project’s day-to-day operations are normally run by five students, supported by the other members of NEPIH, currently 33 staff members , participating in the activities. The project has performed about 180 campaigns (45 were for children) reaching approximately 8.000 people.Participation in the project has contributed to development skills and competencies with regard to the implementation of health promotion strategies with different audiences and requires that students constantly stay up to date on the subject. The festival of parodies has helped to empower its members to conduct scientific and cultural events and promote emphasis of the subject in a playful manner. Although the nature of the project as an extension program hinders the assessment of the impact on adherence to HH, it is possible to infer a much larger number of beneficiaries than those directly benefitted by the actions of the group.None declared


The importance of strong science, technology, engineering, and mathematics education continues to grow as society, medicine, and the economy become increasingly focused and dependent upon bioscientific and technological innovation. New advances in frontier sciences  generate ethical issues and questions regarding the use of novel technologies in medicine and public life.In light of current emphasis upon science, technology, engineering, and mathematics education , the pace and extent of advancements in science and biotechnology, the increasingly technological orientation and capabilities of medicine, and the ways that medicine – as profession and practice – can engage such scientific and technological power upon the multi-cultural world-stage to affect the human predicament, human condition, and perhaps nature of the human being, we argue that it is critical that science, technology, engineering, and mathematics education go beyond technical understanding and directly address ethical, legal, social, and public policy implications of new innovations. Toward this end, we propose a paradigm of integrative science, technology, ethics, and policy studies that meets these needs through early and continued educational exposure that expands extant curricula of science, technology, engineering, and mathematics programs from the high school through collegiate, graduate, medical, and post-graduate medical education. We posit a synthetic approach that elucidates the historical, current, and potential interaction of scientific and biotechnological development in addition to the ethico-legal and social issues that are important to educate and sustain the next generation of medical and biomedical professionals who can appreciate, articulate, and address the realities of scientific and biotechnological progress given the shifting architectonics of the global social milieu.We assert that current trends in science, technology, medicine, and global politics dictate that these skills will be necessary to responsibly guide ethically sound employment of science, technology, and engineering advancements in medicine so as to enable more competent and humanitarian practice within an increasingly pluralistic world culture. Scientific knowledge and technological tools have enabled the heuristics and advancements that have led to rapid progress in several fields  that are constituent to the profession and practices of modern medicine. Indeed, much of the current scope, tenor, and capability of medicine have been expanded, if not defined, by scientific and technological capabilities . Yet, meIf we are to prioritize science, technology, engineering, and mathematics  pursuant to medical and biomedical education, training, and practice, then it is essential to do so in ways that genuinely appreciate and apprehend these pursuits as human enterprises that are devised and articulated, and impact the boundaries of human culture and its societies. In other words, we must ground STEM education to the reality that STEM – as contributory to medicine, and like medicine itself – are human endeavors for and within the sphere of humanity, human conduct, and human ecology. We opine that to meet the opportunities, benefits, challenges, and burdens generated by the study, development, and use of STEM in real-world scenarios, education must not only be multi-disciplinary, but must engage the natural, physical, and social sciences as well as the humanities in an integrative model that 1) obtains a solid foundation in humanitarian sensitivities, 2) engages knowledge of STEM to address the challenges of modern medicine enacted on a global scale, and 3) entails the humanities and social sciences to assess and direct the value and utility of STEM  within current culture, and as means to shape health, culture, and societies of the future.Fortification of STEM education is important if we are to train medical and biomedical professionals to possess the knowledge, skills, and innovative acumen that will be required to keep pace with – and within – the worldwide groundswell of scientific and technological (S/T) progress. To be sure, S/T advancement requires significant economic support, and in turn, can elicit tremendous economic growth. Much of S/T research is conducted by, and subsidized through, the infrastructure of the so-called “triple helix” of academic, government, and commercial research institutions . For exaOn many levels, the triple helix model provides a viable framework for STEM education and training . As hybrIn-STEPS) that provides a framework upon and through which to build competencies in the content, constructs, and applications of convergent sciences, as well as the knowledge and skill sets necessary to realistically observe, and meaningfully address and guide, the conduct and uses of science and technology as human enterprises [In-STEPS paradigm are to integrate scientific and humanitarian disciplines at all levels from high school through undergraduate, graduate, medical and post-graduate medical education. This will 1) provide an early exposure to issues and social implications of scientific and technological research and applications; 2) generate a deep understanding of specific ethical, legal, and policy issues that are relevant to those ways that frontier domains of science and technology can be used or misused in medicine to alter the human condition, human predicament, and various aspects of social action; and 3) develop insights and capabilities to enable more thorough and valid deliberation and direction of the ways that science and technology should be employed within clinical care to sustain the values and goods of individuals, communities, and societies [Toward this end, we have proposed a model of integrative science, technology, ethics, and policy studies  within the fabric of STEM-based pre-medical and medical education will be important to developing the abilities to responsibly (and arguably more effectively) work in and lead science, biotechnology, and medicine as well as those fields that inform and develop the policies and laws that steer and regulate science, technology, and medicine as socio-public resources, services, and good(s) ,8,9. In Currently, both the United States’ National Science Foundation (NSF) and the National Institutes of Health (NIH) require training in the responsible conduct of research  for all students involved in projects and programs that are pursuing or have been awarded (NSF or NIH) grant funding ,14. Despquid pro quo such that ethics education would be required for potential and/or sustained funding of S/T research. It is possible that the addition of ethics coursework could be seen as a mere “check in the box” to secure ongoing fiscal support in the face of widespread university and federal budgetary cuts. Even so, this can still be seen as a plus-sum situation: if an adequate level of NSF and/or NIH funding were to be provided to support such ethics coursework (or curricula), appropriated monies could be used to re-fortify humanities’ programs that could be specifically designed to more authentically and effectively inter-digitate with the sciences and medicine.While NSF and NIH requirements stop short of mandating that institutions develop and provide full coursework to all students in S/T majors – inclusive of medicine – we maintain that such a dictate might in fact be defensible (and laudable). This would establish both a defined necessity for the purposeful conjoinment of ELSI-STEM, and do so as a In-STEPS as proposed herein. The importance of integrating ethics and policy into STEM education increases as S/T innovation outpaces the development of policy and law. To wit, the rate of scientific discovery and technological product development has increased over the past two decades. Using neuroscience and neurotechnology as an example, a mean increase of 73% across sub-disciplines  can be seen by assessing the indexed, peer-reviewed literature of the past ten years [However, while necessary, simply providing training in, or a course on RCR is not, to our view, in and of itself sufficient to meet either the full scope of NSF and NIH intent, or, more specifically the idea and agenda of en years . As scieKnowledge about the process of politics is crucial as a variety of private entities  and political factions are exerting increasing influence on standards, regulations, and laws that bear upon the viability of the development and use of biomedical S/T advances as public good(s) . In thisceteris paribus stance and incurring frank ethical imperialism as western precepts and standards are enforced (or perhaps more accurately inflicted) upon other groups with dissimilar needs, values, and norms. On the other hand, there is the risk of treating any and all situations as prima facie contingencies, and defaulting to laissez faire ethical relativism. Both cases pose a potential risk for exertion of biopower and biopolitics [This diversity necessitates more than a mere superficial appreciation, as there are risks of negatively bi-modal ethical consequences if socio-cultural considerations are less than thorough. On one hand there is the risk of assuming an exclusively western politics : the forpolitics . It may politics . But, hopolitics ?st century world stage [To be sure, any such bioethics must recognize cultural, if not some level of moral plurality . At veryld stage . If, in ld stage ,9,23-25.The goal will be to establish an educational system – if not paradigm – that will develop, enable, and empower actors upon the new world stage who will be able to direct the use of S/T innovation through an understanding of both science, and “…principles which represent the full moral experience and concerns of real human beings” , p.18. IIn overview, this integrated system would progressively weave historicity, ethics, and policy studies into STEM courses over the course of students’ educational career. Early on, at the high school level, course content-specific examples could and should be integrated into regular class work. High school level curricula are generally more prescribed than those at higher levels of education and as such, integration would best be facilitated through collaborative initiatives connecting STEM teachers with those in the humanities. An increase in grant funding from organizations such as NSF and NIH, or through university outreach opportunities, would provide substantial support for such initiatives, particularly since individual grants at this educational level are often smaller in amount.In-STEPS curriculum could be supported in a number of different ways. University funding should support representatives of academic departments collaborating toward both the integration of ELSI into STEM courses and STEM applications into classes in the humanities. Similarly, ELSI should be integrated into medical school curricula as an expansion of the current ethical coursework and training. Increased grants from NSF and NIH in scientific ethics education—as an expansion of funding programs that support the current RCR initiatives—should support the development of new interdisciplinary seminars group-taught by professors in multiple departments and schools so as to guide study of the reciprocity of STEM and ELSI; such interdisciplinary courses could also access funding sources in the humanities, thereby enhancing overall fiscal support as well. Combined funding initiatives that encourage collaboration between humanities and STEM-related organizations would also facilitate integration in the professional realm and encourage the bilateral translation of academic coursework to the professional scenarios.At the undergraduate, graduate, and medical school levels, an In-STEPS paradigm extend beyond the educational sphere to impact and encompass the scope and tenor of interdisciplinary professional development. Working within the In-STEPS approach, each field would foster and encompass its own particular means of integrating related STEM-ELSI issues. Opportunities for trans-professional collaboration could be supported through intra- and inter-organizational networking opportunities. By developing and sustaining cross-professional relationships, consideration, and communication between medicine, the sciences, engineering, and the humanities can be focused both upon understanding how science and technology offers—and provides—potential to improve the human condition, as well as upon acknowledging and bearing the responsibility to define, prevent, and/or mitigate the ethical, legal, and social burdens, risks, and harms that such S/T advances might yield upon the current and future world stage.The effect(s) of such an In-STEPS paradigm to affect a more scientifically capable, yet sustainably humanitarian, ethos and telos of medicine.Just as research is fostered, supported, and sustained through the structure and function of the “triple helix” conjoining academia, government, and private industry, so too must be the educational training of future biomedical professionals who will bear responsibility for the effects that an ever-expanding fund of scientific and biotechnological knowledge and capability will yield upon the practice of medicine, humanity, world culture, and global environments, writ both small and large. These professionals must put to use their integrated knowledge of the ethical, legal, and social issues and how they work within and inform the continued development and application of scientific and technological advances in the medical diagnoses and care. The model we propose is specifically aimed at addressing this need, and our ongoing work is dedicated to collaborating with multidisciplinary, international colleagues and institutions to further develop and realize the The authors declare that they have no competing interests.MA conducted primary research and drafted the manuscript. JG developed the core constructs, advised research and helped to draft the manuscript. Both authors read and approved the final manuscript.At the time of this work, MA was a graduate student at Georgetown University and Visiting Scholar at the Potomac Institute for Policy Studies. MA currently serves as a Research Analyst at the Presidential Commission for the Study of Bioethical Issues, however, this article was written in her private capacity. No official support or endorsement by the Presidential Commission for the Study of Bioethical Issues or the Department of Health and Human Services is intended, nor should be inferred.JG is Chief of the Neuroethics Studies Program at the Edmund D. Pellegrino Center for Clinical Bioethics, and Professor in the Division of Integrative Physiology, Department of Biochemistry, and Graduate Liberal Studies Program of Georgetown University, Washington, DC. He is Clark Fellow in Neurosciences and Ethics at the Human Science Center of the Ludwig-Maximilians Universität, Munich, Germany; William H. and Ruth Crane Schaefer Distinguished Visiting Professor of Neuroscience and Ethics at Gallaudet University, Washington, DC, USA, and a Senior Fellow of the Potomac Institute for Policy Studies, Washington, DC, USA.The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1472-6920/13/58/prepub


Stomach cancer is the most common cancer in Japan, China and Korea, and is the second leading cause of deaths from cancer globally, although the incidence and mortality have been declining over the years . DietaryMore interestingly, when stratified by country (Japan versus China) in the subgroup analyses performed by Kang et al. , a signiIt should be noted that there are some limitations regarding the interpretation of the meta-analysis. First, as green tea is consumed mainly in Asian countries, such as China, Japan, Korea, and a few countries in the Middle East and North Africa , we are


Due to an error introduced during the production process, the Funding statement is incorrect. The correct Funding statement is: This work was funded by Centers for Disease Control, Department of Health, Taiwan, Republic of China. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.


The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript."A grant was assigned incorrectly to the third author. The grant was issued to the second author, Yong-ming Yao. The correct funding statement is: "This study was supported, in part, by grants from the National Natural Science Foundation of China (


Annals of Occupational and Environmental Medicine (AOEM). The AOEM is an open access, peer-reviewed, online journal that considers original research in occupational and environmental medicine. The online manuscript submission has been successfully implemented for the journal and is now open for new submissions at http://www.aoemj.com.On behalf of the editorial board, I am pleased to announce the launch of a new international journal – The AOEM is aimed at clinicians and researchers in the wide-ranging discipline of occupational and environmental medicine and health. The topics include but are not limited to the interactions between work and health, that is, subjects like occupational and environmental epidemiology, toxicology, hygiene, diagnosis & treatment of diseases, management, organization and policy.the Korean Journal of Occupational and Environmental Medicine (KJOEM) as the official journal of the Korean Society of Occupational and Environmental Medicine (KSOEM). The KJOEM has been published only in Korean every year since 1989, started biannual publication in 1989, triannual publication in 1996, and quarterly publication in 1998. The KSOEM has endeavored to make the KJOEM a high-quality journal in occupational and environmental medicine mainly for researchers, workers, employers, and the government in Korea.The AOEM under its new name, will succeed In line with recently changes in research boundaries and recommendations of the National Research Foundation (NRF) of Korea, we made the important decision to transform the KJOEM into an English language, high quality, international journal in occupational and environmental medicine. In order to meet the goal, we have created the Advisory Editorial Board of the AOEM, consisting of world-class, excellent and experienced professors and researchers in occupational and environmental medicine. We have also implemented a very efficient administrative system in the AOEM for streamlining the whole process from manuscript submission to on-line publication for authors.Annals of Occupational and Environmental Medicine for your newest and most interesting research.I would like to thank my colleagues for their support and suggestions to make the launch of this new journal possible. I hope you will consider the The author, Sang Baek Ko, has given permission for his photo to be used as the cover page.