Current Controversies in Kidney Nutrition.

Dietetic practice aims to help people modify their diet to slow disease progression and manage disease-related complications while also meeting their nutritional and personal dietary needs. This can be challenging in people with kidney failure undergoing dialysis, particularly in our current food environment and culture. Fortunately, advancements in nutritional-behavioral science and technology are providing new avenues and resources to help meet the challenge. However, progress is slow, and much of dietetic practice in the dialysis population still relies on the interpretation, translation, and application of low-quality, indirect evidence. This Special Issue of Seminars in Dialysis provides readers with an update on and critical insights into some of the major issues and controversies impacting the field of kidney nutrition today.

Performing Platform Governance: Facebook and the Stage Management of Data Relations.

Controversies surrounding social media platforms have provided opportunities for institutional reflexivity amongst users and regulators on how to understand and govern platforms. Amidst contestation, platform companies have continued to enact projects that draw upon existing modes of privatized governance. We investigate how social media companies have attempted to achieve closure by continuing to set the terms around platform governance. We investigate two projects implemented by Facebook (Meta)-authenticity regulation and privacy controls-in response to the Russian Interference and Cambridge Analytica controversies surrounding the 2016 U.S. Presidential Election. Drawing on Goffman's metaphor of stage management, we analyze the techniques deployed by Facebook to reinforce a division between what is visible and invisible to the user experience. These platform governance projects propose to act upon front-stage data relations: information that users can see from other users-whether that is content that users can see from "bad actors", or information that other users can see about oneself. At the same time, these projects relegate back-stage data relations-information flows between users constituted by recommendation and targeted advertising systems-to invisibility and inaction. As such, Facebook renders the user experience actionable for governance, while foreclosing governance of back-stage data relations central to the economic value of the platform. As social media companies continue to perform platform governance projects following controversies, our paper invites reflection on the politics of these projects. By destabilizing the boundaries drawn by platform companies, we open space for continuous reflexivity on how platforms should be understood and governed.

Brave spaces in nursing ethics education: Courage through pedagogy.

BACKGROUND: Nursing students must graduate prepared to bravely enact the art and science of nursing in environments infiltrated with ethical challenges. Given the necessity and moral obligation of nurses to engage in discourse within nursing ethics, nursing students must be provided a moral supportive learning space for these opportunities. Situating conversations and pedagogy within a brave space may offer a framework to engage in civil discourse while fostering moral courage for learners. RESEARCH OBJECTIVE: The aim of this research is to explore the influence of a structured self-assessment tool called the ESA "Engagement Self-Assessment" on the alignment and creation of a brave space in a nursing ethics course. RESEARCH DESIGN: This study used an exploratory, cross-sectional survey design. PARTICIPANTS AND STUDY SETTING: Data from 39 undergraduate nursing students enrolled in a nursing healthcare ethics & law course using the ESA were recruited. ETHICAL CONSIDERATIONS: Participation was voluntary and informed without coercion. Written consent was obtained prior to participation. Research ethics approval was obtained by the Institutional Research Ethics Board of the recruited participants (Ethics # 2022-23-03). FINDINGS: The ESA provided structured self-reflection on the impact of shared vulnerability within a brave space. However, commitment to a brave space was not strongly influenced by the ESA, but rather by a mutual "commitment to others." CONCLUSION: A teaching tool such as an ESA can be used to facilitate instructor expectations of civil discourse and discussion of difficult topics. Rules of engagement such as those found in brave spaces can help transform fear of vulnerability into authentic growth for learners. A morally supportive learning space can support critical opportunities for ethical development. This study provides insight into how self-assessment and the use of a brave space in nursing ethics education can facilitate a morally supportive learning space.

The controversy about interference of photons.

In the 1960s, the demonstration of interference effects using two laser-beams raised the question: can two photons interfere? Its plausibility contested Dirac's dictum, "Interference between two different photons never occurs". Disagreements about this conflict led to a controversy. This paper will chart the controversy's contour and show that it evolved over two phases. Subsequently, I investigate the reasons for its perpetuation. The controversy was initiated and fuelled by several misinterpretations of the dictum. I also argue that Dirac's dictum is not applicable to two photon interference as they belong to different contexts of interference. Recognising this resolves the controversy.

Discussion on the common controversies of Helicobacter pylori infection.

BACKGROUND: Helicobacter pylori ( H. pylori ) can persistently colonize on the gastric mucosa after infection and cause gastritis, atrophy, metaplasia, and even gastric cancer (GC). METHODS: Therefore, the detection and eradication of H. pylori are the prerequisite. RESULTS: Clinically, there are some controversial issues, such as why H. pylori infection is persistent, why it translocases along with the lesser curvature of the stomach, why there is oxyntic antralization, what the immunological characteristic of gastric chronic inflammation caused by H. pylori is, whether H. pylori infection is associated with extra-gastric diseases, whether chronic atrophic gastritis (CAG) is reversible, and what the potential problems are after H. pylori eradication. What are the possible answers? CONCLUSION: In the review, we will discuss these issues from the attachment to eradication in detail.

A critical review of adsorption isotherm models for aqueous contaminants: Curve characteristics, site energy distribution and common controversies.

The quantitative description of the equilibrium data by the isotherm models is an indispensable link in adsorption studies. The previous review papers focus on the underlying assumptions, fitting methods, error functions and practical applications of the isotherm models, usually ignoring their curve characteristics, selection criteria and common controversies. The main contents of this review include: (i) effect of the model parameters on the isotherm curves; (ii) determination of the site energy distribution; (iii) selection criteria of the isotherm models; and (iv) elimination of some common controversies. It is of great significance to reveal the curve characteristics for selecting a proper isotherm model. The site energy distribution is conducive to understanding the physicochemical properties of the adsorbent surface. The complete isotherm is recommended to be correlated with the experimental data. The model parameter qmax should be cautiously adopted for comparison of the adsorbent performance. The residual plot can be used to diagnose the fitting quality of the isotherm models further. This review also addresses some common mistakes and controversies and thereby avoids their propagation in future publications.

A "Mean Quarrelsome Spirit:" Controversy in British Systematics, 1822-1836.

British systematics was distinctly marked by a raft of vituperative controversies around the turn of the 1830s. After the local collapse of broad consensus in the Linnaean system by 1820, the emergence of new schemes of classification-most notably, the "quinarian" system of William Sharp Macleay-brought with it an unprecedented register of public debate among zoologists in Britain, one which a young Charles Darwin would bitterly describe to his friend John Stevens Henslow in October 1836 as possessing a "mean quarrelsome spirit," conducted in "a manner anything but like that of gentlemen." This article aims to provide a social and conceptual account of the remarkable tenor of zoological discourse in Britain in the late 1820s and early 1830s, with joint attention to the philosophical and interpersonal commitments at play. In doing so, it analyzes the three of the period's most striking public controversies, each of which counted key advocates of the quinarian system as central participants.

Evidences for Adult Hippocampal Neurogenesis in Humans.

The rodent hippocampus generates new neurons throughout life. This process, named adult hippocampal neurogenesis (AHN), is a striking form of neural plasticity that occurs in the brains of numerous mammalian species. Direct evidence of adult neurogenesis in humans has remained elusive, although the occurrence of this phenomenon in the human dentate gyrus has been demonstrated in seminal studies and recent research that have applied distinct approaches to birthdate newly generated neurons and to validate markers of adult-born neurons. Our data point to the persistence of AHN until the 10th decade of human life, as well as to marked impairments in this process in patients with Alzheimer's disease. Moreover, our work demonstrates that the methods used to process and analyze postmortem human brain samples can limit the detection of various markers of AHN to the point of making them undetectable. In this Dual Perspectives article, we highlight the critical methodological aspects that should be strictly controlled in human studies and the robust evidence that supports the occurrence of AHN in humans. We also put forward reasons that may account for current discrepancies on this topic. Finally, the unresolved questions and future challenges awaiting the field are highlighted.

The need for formal reflexivity in conservation science.

Conservation issues are often complicated by sociopolitical controversies that reflect competing philosophies and values regarding natural systems, animals, and people. Effective conservation outcomes require managers to engage myriad influences (social, cultural, political, and economic, as well as ecological). The contribution of conservation scientists who generate the information on which solutions rely is constrained if they are unable to acknowledge how personal values and disciplinary paradigms influence their research and conclusions. Conservation challenges involving controversial species provide an opportunity to reflect on the paradigms and value systems that underpin the discipline and practice of conservation science. Recent analyses highlight the ongoing reliance on normative values in conservation. We frame our discussion around controversies over feral horses (Equus ferus caballus) in the Canadian West and New Zealand and suggest that a lack of transparency and reflexivity regarding normative values continues to prevent conservation practitioners from finding resilient conservation solutions. We suggest that growing scrutiny and backlash to many normative conservation objectives necessitates formal reflexivity methods in conservation biology research, similar to those required of researchers in social science disciplines. Moreover, given that much conservation research and action continues to prioritize Western normative values regarding nature and conservation, we suggest that adopting reflexive methods more broadly is an important step toward more socially just research and practice. Formalizing such methods and requiring reflexivity in research will not only encourage reflection on how personal and disciplinary value systems influence conservation work but could more effectively engage people with diverse perspectives and values in conservation and encourage more novel and resilient conservation outcomes, particularly when dealing with controversial species.

La Necesidad de la Reflexividad Formal en las Ciencias de la Conservación Resumen Los temas de conservación se complican con frecuencia debido a las controversias sociopolíticas que reflejan los valores e ideologías contrapuestos relacionados a los sistemas naturales, los animales y las personas. Los resultados efectivos de conservación requieren de administradores que involucren a un sinfín de influencias (social, cultural, política, económica y ecológica). La contribución de los científicos de la conservación, quienes generan la información a partir de la que dependen las soluciones, se ve restringida si no pueden reconocer cómo los valores personales y los paradigmas disciplinarios influyen en sus investigaciones y conclusiones. Los retos para la conservación que involucran a especies controversiales representan una oportunidad para reflexionar sobre los paradigmas y los sistemas de valores que apuntalan la disciplina y la práctica de las ciencias de la conservación. Los análisis recientes resaltan la continua dependencia en los valores normativos en la conservación. Encuadramos nuestra discusión en torno a las controversias que rodean a los caballos ferales (Equus ferus caballus) en el oeste de Canadá y en Nueva Zelanda y sugerimos que la falta de transparencia y reflexividad con respecto a los valores normativos sigue impidiendo que quienes practican la conservación encuentren soluciones de conservación resilientes. Sugerimos que el incremento en el escrutinio y en las reacciones negativas con respecto a muchos objetivos de la conservación normativa necesita métodos formales de reflexividad en la biología de la conservación, similares a aquellos requeridos para los investigadores de las ciencias sociales. Además, dado que la mayoría de la investigación y de las acciones de conservación siguen priorizando los valores normativos occidentales con respecto a la naturaleza y la conservación, proponemos que la adopción de los métodos reflexivos de manera más generalizada es un paso importante hacia investigaciones y prácticas más socialmente justas. La formalización de dichos métodos y la necesidad de tener reflexividad en la investigación no sólo promoverá la reflexión sobre cómo los sistemas personales y disciplinarios influyen en la conservación, pero también podría involucrar de manera más efectiva a las personas con valores y perspectivas diferentes en la conservación y alentaría a tener resultados de conservación más novedosos y resilientes, particularmente cuando se trabaja con especies controversiales.

Tramadol Use in Perioperative Care and Current Controversies.

PURPOSE OF REVIEW: The aim of this review is to discuss the use of tramadol in the perioperative period. There is no doubt that tramadol has revolutionized pain treatment, making it important to understand the pharmacokinetics and pharmacodynamics in order to provide patients with the safest and most effective analgesia. RECENT FINDINGS: Tramadol is a centrally acting synthetic analgesic with a multimode of action used to help treat moderate to severe pain. Pharmacologically, the unique opioid acts as a serotonin-norepinephrine reuptake inhibitor, while its metabolite, O-desmethyltramadol, acts on the µ-opioid receptor. The analgesic strength of tramadol is about one-tenth that of morphine, making it a relatively safe analgesic. Potential side effects of tramadol include nausea, vomiting, constipation, pruritus, and respiratory depression; however, the severity of these symptoms is minimal compared to traditional opioids. Although some of the perioperative uses of tramadol may be rare, it is a pain management option to consider when alternatives have proved ineffective.

Answer to Squier et al.

The author responds to critics formulated by W Squier regarding our paper "The legal challenges to the diagnosis of shaken baby syndrome Or: how to counter 12 common fake news.

Abusive head injuries in infants: from founders to denialism and beyond.

INTRODUCTION: Abusive head injuries is a major cause of severe morbidity and the main cause of mortality by head trauma in infants. MATERIAL AND METHODS: Based on published data and their own clinical and medicolegal practice, the authors review briefly the historical roots and emergence of the concept of abusive head injuries (AHI), until the present scientific understanding of shaken baby syndrome (SBS) and Silverman syndrome. They then discuss the present epidemic of denialism and how this challenge to science should be seen as a stimulus to increase research and improve the accuracy of diagnosis and medical practice. RESULTS: The denial of SBS is especially damaging because it undermines the possibilities of prevention and reparation for victims. The authors expand on AHI being part of a wider context of domestic violence and the prevention of child abuse being part of a broad and long-term endeavor to defend civilization values. CONCLUSIONS: Prevention of AHI is a major challenge for the future. In the fields of science and prevention of child abuse, the input of pediatric neurosurgeons should not be underestimated.

Reviving through human hippocampal newborn neurons.

Recent contradictory data has renewed discussion regarding the existence of adult hippocampal neurogenesis (AHN) in humans, i.e., the continued production of new neurons in the brain after birth. The present review revisits the debate of AHN in humans from a historical point of view in the face of contradictory evidence, analyzing the methods employed to investigate this phenomenon. Thus, to date, of the 57 studies performed in humans that we reviewed, 84% (48) concluded in favor of the presence of newborn neurons in the human adult hippocampus. Besides quality of the tissue (such as postmortem intervals below 26hours as well as tissue conservation and fixation), considerations for assessing and quantify AHN in the human brain require the use of stereology and toxicological analyses of clinical data of the patient.

Kiaer and the rebirth of the representative method: A case-study in controversy management at the International Statistical Institute (1895-1903).

Anders N. Kiaer (1838-1919), the director of Norway's Central Bureau of Statistics between 1877 and 1913, was the foremost promoter, at the turn of the 20th century, of the rebirth of what came to be known as the "representative method" or sample survey. His advocacy of a methodology that had been abandoned at the beginning of the 19th century in favor of complete enumeration (the census) provoked a controversy at the International Statistical Institute (ISI) when he first presented it in 1895. Yet, it was "recommended" in fairly short order, by 1903. This was the result of a convergence of factors that prevented the dispute from degenerating into a full-blown conflict and facilitated continuing the discussion while preventing a potential break-up of the association. To understand how this came about, the paper examines (1) the role of the historical background from which the ISI emerged; (2) the epistemic beliefs that informed the ISI members in their daily professional practice; (3) the social structure of the ISI and its "ethos"; (4) the professional standing Kiaer enjoyed within the international statistical community. This is a case-study in the sociology of how and why some scientific practices initially seen as "dangerous" gain acceptance and become part of science's lore.

Preface to an editorial controversy on α-synuclein: How good are cellular models?: This is a Preface for an Editorial controversy between Hilal A. Lashuel "Monitoring alpha-synuclein oligomerization and aggregation using bimolecular fluorescence complementation assays: What you see is not always what you get" and Tiago F. Outeiro "Alpha-synuclein oligomerization and aggregation: A model will always be a model" Read Hilal A. Lashuel's reply "Alpha-Synuclein oligomerization and aggregation: All models are useful but only if we know what they model".

In many scientific disputes, research evidence may support one side or the other of a working hypothesis, and even in case of largely coherent hypotheses, arguments may be in favor of discrepant points of view. In the case of α-synuclein pathology and specific mechanisms of disease progression, various animal and cellular models have been established to pinpoint the physiological and pathological mechanisms. In the present 'Editorial controversy', two well-reputed researchers, Hilal Lashuel and Tiago F. Outeiro, discuss-with view to findings from their own and others' groups in the context of current status of knowledge-the question of how well models on α-synuclein pathology can reflect actual pathomechanisms, and derive recommendations for future research from it that shall help advance our understanding not only of α-synuclein-related pathologies and its role in the formation of Lewy bodies in particular, but of cellular or animal models in general.

Current dilemmas in the pathological staging of colorectal cancer: the results of a national survey.

AIMS: Accurate and consistent pathological staging of colorectal carcinoma (CRC) in resection specimens is especially crucial to guide adjuvant therapy. The aim of this study was to assess whether certain staging scenarios yield discordant opinions in the setting of current international and UK national guidelines. METHODS AND RESULTS: Members of the UK Gastrointestinal Pathology External Quality Assurance Scheme were invited to complete an anonymous, on-line survey that presented 15 scenarios related to pT or pR staging of CRC, and three questions about the respondent. The survey invitation was e-mailed to 405 pathologists, and 184 (45%) responses were received. The respondents had discordant opinions on whether and how CRC pT or pR staging is affected by: acellular mucin lakes and duration after short-course radiotherapy; the nature of the carcinoma at a resection margin or peritoneal surface; and microscopic evidence of perforation. This discordance was rarely related to the respondent's occupation type, and was not related to duration of work as a consultant or the staging guidelines used. CONCLUSIONS: This survey confirms that there remain several clinically critical but unresolved pT and pR staging issues for CRC. These issues therefore deserve attention in future versions of international and national staging guidelines.

The development and controversy of competitive endogenous RNA hypothesis in non-coding genes.

As a momentous post-transcriptional regulator, microRNAs (miRNAs) are attracting more and more attention. The classical miRNAs regulated mechanism shows it binds to the targets' 3'UTR thus play the role in post-transcription. Meanwhile, single miRNA can target multiple genes, so those should compete to bind that miRNA. Vice versa, single gene can sponge mass of miRNAs as well. Thus the competitive endogenous RNAs (ceRNAs) hypothesis was put forward in 2011. The ceRNA hypothesis has made huge achievements, in particular in non-coding genes, which including long non-coding RNAs (lncRNAs), circle RNAs (circRNAs) and pseudogenes, even viral transcripts. It also contributed greatly to epigenetics development. However, an increasing number of controversies have occurred with applause. Based on this situation, this review introduces something in detail about the ceRNAs hypothesis achieved in lncRNAs, circRNAs, pseudogenes and viral transcripts, respectively. Meanwhile, it also covers controversy of the ceRNAs hypothesis.

Narrow excision margins are appropriate for Merkel cell carcinoma when combined with adjuvant radiation: Analysis of 188 cases of localized disease and proposed management algorithm.

BACKGROUND: Merkel cell carcinoma (MCC) management typically includes surgery with or without adjuvant radiation therapy (aRT). Major challenges include determining surgical margin size and whether aRT is indicated. OBJECTIVE: To assess the association of aRT, surgical margin size, and MCC local recurrence. METHODS: Analysis of 188 MCC cases presenting without clinical nodal involvement. RESULTS: aRT-treated patients tended to have higher-risk tumors (larger diameter, positive microscopic margins, immunosuppression) yet had fewer local recurrences (LRs) than patients treated with surgery only (1% vs 15%; P = .001). For patients who underwent surgery alone, 7 of 35 (20%) treated with narrow margins (defined as ≤1.0 cm) developed LR, whereas 0 of 13 patients treated with surgical margins greater than 1.0 cm developed LR (P = .049). For aRT-treated patients, local control was excellent regardless of surgical margin size; only 1% experienced recurrence in each group (1 of 70 with narrow margins ≤1 cm and 1 of 70 with margins >1 cm; P = .56). LIMITATIONS: This was a retrospective study. CONCLUSIONS: Among patients treated with aRT, local control was superb even if significant risk factors were present and margins were narrow. We propose an algorithm for managing primary MCC that integrates risk factors and optimizes local control while minimizing morbidity.

Toolkit for detecting misused epidemiological methods.

BACKGROUND: Critical knowledge of what we know about health and disease, risk factors, causation, prevention, and treatment, derives from epidemiology. Unfortunately, its methods and language can be misused and improperly applied. A repertoire of methods, techniques, arguments, and tactics are used by some people to manipulate science, usually in the service of powerful interests, and particularly those with a financial stake related to toxic agents. Such interests work to foment uncertainty, cast doubt, and mislead decision makers by seeding confusion about cause-and-effect relating to population health. We have compiled a toolkit of the methods used by those whose interests are not aligned with the public health sciences. Professional epidemiologists, as well as those who rely on their work, will thereby be more readily equipped to detect bias and flaws resulting from financial conflict-of-interest, improper study design, data collection, analysis, or interpretation, bringing greater clarity-not only to the advancement of knowledge, but, more immediately, to policy debates. METHODS: The summary of techniques used to manipulate epidemiological findings, compiled as part of the 2020 Position Statement of the International Network for Epidemiology in Policy (INEP) entitled Conflict-of-Interest and Disclosure in Epidemiology, has been expanded and further elucidated in this commentary. RESULTS: Some level of uncertainty is inherent in science. However, corrupted and incomplete literature contributes to confuse, foment further uncertainty, and cast doubt about the evidence under consideration. Confusion delays scientific advancement and leads to the inability of policymakers to make changes that, if enacted, would-supported by the body of valid evidence-protect, maintain, and improve public health. An accessible toolkit is provided that brings attention to the misuse of the methods of epidemiology. Its usefulness is as a compendium of what those trained in epidemiology, as well as those reviewing epidemiological studies, should identify methodologically when assessing the transparency and validity of any epidemiological inquiry, evaluation, or argument. The problems resulting from financial conflicting interests and the misuse of scientific methods, in conjunction with the strategies that can be used to safeguard public health against them, apply not only to epidemiologists, but also to other public health professionals. CONCLUSIONS: This novel toolkit is for use in protecting the public. It is provided to assist public health professionals as gatekeepers of their respective specialty and subspecialty disciplines whose mission includes protecting, maintaining, and improving the public's health. It is intended to serve our roles as educators, reviewers, and researchers.

Evidence use in E-cigarettes debates: scientific showdowns in a 'wild west' of research.

BACKGROUND: Against a backdrop of declining tobacco use, e-cigarette markets are growing. The UK now has a higher percentage of e-cigarette users than any other European country. These developments have prompted fierce discussions in scientific, advocacy and policy communities about how best to respond. This article is one of the first to examine the role of evidence in these debates. METHODS: We analysed 121 submissions to two Scottish policy consultations on e-cigarettes (in 2014 and 2015) and undertook interviews with 26 key informants in 2015-2016, following up with a sub-set in 2019-2020. All data were thematically coded, and our analysis was informed by insights from policy studies and the sociology of science. RESULTS: First, we affirm previous research in suggesting that e-cigarettes appeared to have triggered a breakdown of old public health alliances. Second, we demonstrate that, amid concerns about research quality and quantity, actors are guided by normative outlooks (and/or economic interests) in their assessments of evidence. Third, we show that, despite describing e-cigarette debates as contentious and polarised, actors engaging in Scottish policy debates exhibit a spectrum of views, with most interviewees occupying an uncertain 'middle ground' that is responsive to new evidence. Fourth, we suggest that the perceived divisiveness of e-cigarette debates is attributed to recurrent media simplifications and tensions arising from the behaviours of some actors with settled positions working to promote particular policy responses (including by strategically enrolling supportive evidence). Fifth, we argue that the actions of these actors are potentially explained by the prospect that e-cigarettes could usher in a new tobacco 'policy paradigm'. Finally, we show how scientific authority is employed as a tool within these debates. CONCLUSIONS: E-cigarette debates are likely to reconcile only if a clear majority of participants in the uncertain 'middle ground' settle on a more fixed position. Our results suggest that many participants in Scottish e-cigarette debates occupy this 'middle ground' and express concerns that can be empirically assessed, implying evidence has the potential to play a more important role in settling e-cigarette debates than previous research suggests.