Ls Magazine Issue 16 (Trinity)
22. These problems are closely linked to a throwaway culture which affects the excluded just as it quickly reduces things to rubbish. To cite one example, most of the paper we produce is thrown away and not recycled. It is hard for us to accept that the way natural ecosystems work is exemplary: plants synthesize nutrients which feed herbivores; these in turn become food for carnivores, which produce significant quantities of organic waste which give rise to new generations of plants. But our industrial system, at the end of its cycle of production and consumption, has not developed the capacity to absorb and reuse waste and by-products. We have not yet managed to adopt a circular model of production capable of preserving resources for present and future generations, while limiting as much as possible the use of non-renewable resources, moderating their consumption, maximizing their efficient use, reusing and recycling them. A serious consideration of this issue would be one way of counteracting the throwaway culture which affects the entire planet, but it must be said that only limited progress has been made in this regard.
Ls Magazine Issue 16 (Trinity)
28. Fresh drinking water is an issue of primary importance, since it is indispensable for human life and for supporting terrestrial and aquatic ecosystems. Sources of fresh water are necessary for health care, agriculture and industry. Water supplies used to be relatively constant, but now in many places demand exceeds the sustainable supply, with dramatic consequences in the short and long term. Large cities dependent on significant supplies of water have experienced periods of shortage, and at critical moments these have not always been administered with sufficient oversight and impartiality. Water poverty especially affects Africa where large sectors of the population have no access to safe drinking water or experience droughts which impede agricultural production. Some countries have areas rich in water while others endure drastic scarcity.
30. Even as the quality of available water is constantly diminishing, in some places there is a growing tendency, despite its scarcity, to privatize this resource, turning it into a commodity subject to the laws of the market. Yet access to safe drinkable water is a basic and universal human right, since it is essential to human survival and, as such, is a condition for the exercise of other human rights. Our world has a grave social debt towards the poor who lack access to drinking water, because they are denied the right to a life consistent with their inalienable dignity. This debt can be paid partly by an increase in funding to provide clean water and sanitary services among the poor. But water continues to be wasted, not only in the developed world but also in developing countries which possess it in abundance. This shows that the problem of water is partly an educational and cultural issue, since there is little awareness of the seriousness of such behaviour within a context of great inequality.
121. We need to develop a new synthesis capable of overcoming the false arguments of recent centuries. Christianity, in fidelity to its own identity and the rich deposit of truth which it has received from Jesus Christ, continues to reflect on these issues in fruitful dialogue with changing historical situations. In doing so, it reveals its eternal newness.[98]
135. Certainly, these issues require constant attention and a concern for their ethical implications. A broad, responsible scientific and social debate needs to take place, one capable of considering all the available information and of calling things by their name. It sometimes happens that complete information is not put on the table; a selection is made on the basis of particular interests, be they politico-economic or ideological. This makes it difficult to reach a balanced and prudent judgement on different questions, one which takes into account all the pertinent variables. Discussions are needed in which all those directly or indirectly affected (farmers, consumers, civil authorities, scientists, seed producers, people living near fumigated fields, and others) can make known their problems and concerns, and have access to adequate and reliable information in order to make decisions for the common good, present and future. This is a complex environmental issue; it calls for a comprehensive approach which would require, at the very least, greater efforts to finance various lines of independent, interdisciplinary research capable of shedding new light on the problem.
160. What kind of world do we want to leave to those who come after us, to children who are now growing up? This question not only concerns the environment in isolation; the issue cannot be approached piecemeal. When we ask ourselves what kind of world we want to leave behind, we think in the first place of its general direction, its meaning and its values. Unless we struggle with these deeper issues, I do not believe that our concern for ecology will produce significant results. But if these issues are courageously faced, we are led inexorably to ask other pointed questions: What is the purpose of our life in this world? Why are we here? What is the goal of our work and all our efforts? What need does the earth have of us? It is no longer enough, then, simply to state that we should be concerned for future generations. We need to see that what is at stake is our own dignity. Leaving an inhabitable planet to future generations is, first and foremost, up to us. The issue is one which dramatically affects us, for it has to do with the ultimate meaning of our earthly sojourn.
188. There are certain environmental issues where it is not easy to achieve a broad consensus. Here I would state once more that the Church does not presume to settle scientific questions or to replace politics. But I am concerned to encourage an honest and open debate so that particular interests or ideologies will not prejudice the common good.
Layout table for study information Study Type : Interventional (Clinical Trial) EstimatedEnrollment : 545 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: None (Open Label) Primary Purpose: Treatment Official Title: Limited Stage Small Cell Lung Cancer (LS-SCLC): A Phase III Randomized Study of Chemoradiation Versus Chemoradiation Plus Atezolizumab Actual Study Start Date : May 28, 2019 Estimated Primary Completion Date : December 28, 2026 Estimated Study Completion Date : December 28, 2026 Resource links provided by the National Library of Medicine MedlinePlus Genetics related topics: Lung cancer MedlinePlus related topics: Lung Cancer Drug Information available for: Atezolizumab Genetic and Rare Diseases Information Center resources: Small Cell Lung Cancer U.S. FDA Resources Arms and Interventions Go to Top of Page Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information Arm Intervention/treatment Experimental: Arm I (etoposide, cisplatin, carboplatin, radiation therapy)Patients receive etoposide IV on days 1-3 and cisplatin IV or carboplatin IV on day 1. Cycles repeat every 21 days for 3 cycles in the absence of disease progression or unacceptable toxicity. Patients also undergo 3D-CRT or IMRT BID for approximately 3 weeks or QD for approximately 6-7 weeks in the absence of disease progression or unacceptable toxicity. Patients undergo blood specimen collection throughout the trial. Radiation: 3-Dimensional Conformal Radiation TherapyUndergo 3D-CRTOther Names:3-dimensional radiation therapy
3D Conformal
3D CONFORMAL RADIATION THERAPY
3D CRT
3D-CRT
Conformal Therapy
Radiation Conformal Therapy
Radiation, 3D Conformal
Procedure: Biospecimen CollectionCorrelative studiesOther Names:Biological Sample Collection
Biospecimen Collected
Specimen Collection
Drug: CarboplatinGiven IVOther Names:Blastocarb
Carboplat
Carboplatin Hexal
Carboplatino
Carboplatinum
Carbosin
Carbosol
Carbotec
CBDCA
Displata
Ercar
JM-8
Nealorin
Novoplatinum
Paraplatin
Paraplatin AQ
Paraplatine
Platinwas
Ribocarbo
Drug: CisplatinGiven IVOther Names:Abiplatin
Blastolem
Briplatin
CDDP
Cis-diammine-dichloroplatinum
Cis-diamminedichloridoplatinum
Cis-diamminedichloro Platinum (II)
Cis-diamminedichloroplatinum
Cis-dichloroammine Platinum (II)
Cis-platinous Diamine Dichloride
Cis-platinum
Cis-platinum II
Cis-platinum II Diamine Dichloride
Cismaplat
Cisplatina
Cisplatinum
Cisplatyl
Citoplatino
Citosin
Cysplatyna
DDP
Lederplatin
Metaplatin
Neoplatin
Peyrone's Chloride
Peyrone's Salt
Placis
Plastistil
Platamine
Platiblastin
Platiblastin-S
Platinex
Platinol
Platinol- AQ
Platinol-AQ
Platinol-AQ VHA Plus
Platinoxan
Platinum
Platinum Diamminodichloride
Platiran
Platistin
Platosin
Drug: EtoposideGiven IVOther Names:Demethyl Epipodophyllotoxin Ethylidine Glucoside
EPEG
Lastet
Toposar
Vepesid
VP 16
VP 16-213
VP-16
VP-16-213
VP16
Radiation: Intensity-Modulated Radiation TherapyUndergo IMRTOther Names:IMRT
Intensity Modulated RT
Intensity-Modulated Radiotherapy
Radiation, Intensity-Modulated Radiotherapy
Other: Quality-of-Life AssessmentAncillary studiesOther Name: Quality of Life Assessment Other: Questionnaire AdministrationAncillary studies Active Comparator: Arm II (etoposide, cisplatin, carboplatin, radiation therapy)Patients receive treatment as in Arm I. Patients also receive atezolizumab IV over 30-60 minutes on day 1 or 2 of each chemotherapy cycle. Cycles repeat every 3 weeks for 17 cycles (1 year) in the absence of disease progression or unacceptable toxicity. Patients undergo blood specimen collection throughout the trial. Radiation: 3-Dimensional Conformal Radiation TherapyUndergo 3D-CRTOther Names:3-dimensional radiation therapy
3D Conformal
3D CONFORMAL RADIATION THERAPY
3D CRT
3D-CRT
Conformal Therapy
Radiation Conformal Therapy
Radiation, 3D Conformal
Drug: AtezolizumabGiven IVOther Names:MPDL 3280A
MPDL 328OA
MPDL-3280A
MPDL3280A
MPDL328OA
RG7446
RO5541267
Tecentriq
Procedure: Biospecimen CollectionCorrelative studiesOther Names:Biological Sample Collection
Biospecimen Collected
Specimen Collection
Drug: CarboplatinGiven IVOther Names:Blastocarb
Carboplat
Carboplatin Hexal
Carboplatino
Carboplatinum
Carbosin
Carbosol
Carbotec
CBDCA
Displata
Ercar
JM-8
Nealorin
Novoplatinum
Paraplatin
Paraplatin AQ
Paraplatine
Platinwas
Ribocarbo
Drug: CisplatinGiven IVOther Names:Abiplatin
Blastolem
Briplatin
CDDP
Cis-diammine-dichloroplatinum
Cis-diamminedichloridoplatinum
Cis-diamminedichloro Platinum (II)
Cis-diamminedichloroplatinum
Cis-dichloroammine Platinum (II)
Cis-platinous Diamine Dichloride
Cis-platinum
Cis-platinum II
Cis-platinum II Diamine Dichloride
Cismaplat
Cisplatina
Cisplatinum
Cisplatyl
Citoplatino
Citosin
Cysplatyna
DDP
Lederplatin
Metaplatin
Neoplatin
Peyrone's Chloride
Peyrone's Salt
Placis
Plastistil
Platamine
Platiblastin
Platiblastin-S
Platinex
Platinol
Platinol- AQ
Platinol-AQ
Platinol-AQ VHA Plus
Platinoxan
Platinum
Platinum Diamminodichloride
Platiran
Platistin
Platosin
Drug: EtoposideGiven IVOther Names:Demethyl Epipodophyllotoxin Ethylidine Glucoside
EPEG
Lastet
Toposar
Vepesid
VP 16
VP 16-213
VP-16
VP-16-213
VP16
Radiation: Intensity-Modulated Radiation TherapyUndergo IMRTOther Names:IMRT
Intensity Modulated RT
Intensity-Modulated Radiotherapy
Radiation, Intensity-Modulated Radiotherapy
Other: Quality-of-Life AssessmentAncillary studiesOther Name: Quality of Life Assessment Other: Questionnaire AdministrationAncillary studies Outcome Measures Go to Top of Page Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information Primary Outcome Measures : Overall survival (OS) [ Time Frame: From randomization to date of death due to any cause, assessed up to 5 years ]Hazard ratios will be estimated using a stratified Cox regression model. Event rates over time will be estimated within each treatment group using the Kaplan-Meier method. Secondary Outcome Measures : Progression free survival (PFS) [ Time Frame: Time from randomization to any documented progression or death due to any cause, whichever occurs first, assessed up to 5 years ]Hazard ratios will be estimated using a stratified Cox regression model. Event rates over time will be estimated within each treatment group using the Kaplan-Meier method. Incidence of adverse events [ Time Frame: Up to 5 years ]For each patient, the maximum severity reported for both immune mediated and non-immune mediated adverse events will be used in the summaries. Adverse events will be summarized regardless of relationship to protocol treatment as assessed by the investigator. All adverse events, adverse events leading to withdrawal, interruption or modification of protocol treatment, Grade >= 3 adverse events, and serious adverse events will be summarized. Deaths and cause of death will be summarized. The rate of treatment-related adverse events using NCI Common Terminology Criteria for Adverse Events (CTCAE, v.5.0) will be reported with the frequency and severity (e.g., type, grade, and attribution) by arm; the analysis will be performed at the time of the primary endpoint analyses. All adverse events will be classified as either immune or non-immune mediated. Objective response rate (ORR) [ Time Frame: Up to 5 years ]Will be defined as the proportion of all randomized subjects whose best overall response (BOR) is either a complete response (CR) or partial response (PR) per RECIST 1.1 criteria. ORR will be compared using a two-sided 5% level Cochran-Mantel Haenszel (CMH) test stratified by the same stratification factors used for randomization. An associated odds ratio and 95% CI will be calculated. The ORR and its corresponding 95% exact CI will also be calculated by Clopper-Pearson for each treatment arm. The difference in ORR between the two treatment arms along with the two-sided 95% CI will be estimated using the following CMH method of weighting, adjusting for the stratification factors. Time to progression [ Time Frame: Up to 5 years ]Will be defined as freedom from local progression, in which a failure is defined as intrathoracic tumor progression by RECIST 1.1 criteria. Local control will be analyzed as competing risks data based on cause-specific hazards approaches, where deaths without local failure will be considered as a competing event and analyzed as "censoring" of local failure. The rates at various timepoints (e.g., every 6 months after randomization) and medians of PFS for each arm will be estimated using the Kaplan-Meier method (1958). The associated 95% CI will be calculated using Greenwood's formula and based on a log-log transformation applied on the survival function. Results from an unstratified analysis will also be provided. Distant metastases-free survival (DMFS) [ Time Frame: Time between the date of randomization and the first date of documented distant metastases or death due to any cause, whichever occurs first, assessed up to 5 years ]Will compare the distributions of DMFS between treatment arms using a one-sided stratified log-rank test in all randomized eligible patients. The rates at various timepoints (e.g., every 6 months after randomization) and medians of DMFS for each arm will be estimated using the Kaplan-Meier method (1958). The associated 95% CI will be calculated using Greenwood's formula and based on a log-log transformation applied on the survival function. Results from an unstratified analysis will also be provided. Quality of life (QoL) [ Time Frame: Up to 15 months after the end of the 4th cycle of chemotherapy ]Will be measured by the Functional Assessment of Cancer Therapy-Trial Outcome Index (FACT-TOI). Fisher's exact test will be used to compare the proportions of patients experiencing clinically meaningful deterioration (CMD) between the two arms. FACT-TOI deterioration rates and associated 95% confidence interval will be calculated for each treatment group, based on all randomized subjects. Clopper-Pearson method will be used for calculating 95% CI. The deterioration rates of each arm will also be compared using the CMH test, stratified by histology. FACT-TOI at baseline and at each subsequent assessment, as well as their change from baseline will be summarized using descriptive statistics by treatment group as randomized. The scores at baseline and subsequent time points, as well the changes from baseline at each time point for each treatment group will be compared using the two-sample t-test. Quality-adjusted survival [ Time Frame: Up to 2 years ]Assessed using score from the 5-level EuroQol 5-dimensional questionnaire (EQ-5D-5L). Defined as the weighted sum of different time episodes added up to a total quality-adjusted life-year. Subjects' overall health state on a visual analog scale (VAS) at each assessment time point will be summarized using descriptive statistics by treatment group, as randomized. Proportion of subjects reporting problems for the five EQ-5D-5L dimensions at each assessment time point will be summarized by level of problem and by treatment group, as randomized. Percentages will be based on number subjects assessed at assessment time point. Subjects' overall health state on a visual analog scale (EQ-VAS) at each assessment time point will be summarized using descriptive statistics by treatment group, as randomized. Proportion of subjects reporting problems for the five EQ-5D dimensions at each assessment time point will be summarized by level of problem and by treatment group, as randomized. Level of fatigue [ Time Frame: Up to 2 years ]Will be measured by the Patient-Reported Outcomes Measurement Information System (PROMIS). Baseline and PROMIS at each subsequent assessment, as well as their change from baseline will be summarized using descriptive statistics by treatment group as randomized. The change from baseline to subsequent timepoints may be compared between treatment arms using a t-test, or Wilcoxon test if the data is non-normal. Blood based tumor mutational burden (bTMB) and tissue-based tumor mutational burden (tTMB) [ Time Frame: Up to 5 years ]Co