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124-418: Ayn Rand Institute Other Objectivist periodicals are a variety of academic journals , magazines , and newsletters with an editorial perspective explicitly based on Ayn Rand 's philosophy of Objectivism . Several early Objectivist periodicals were edited by Rand. She later endorsed two periodicals edited by associates, and a number of others have been founded since her death. From 1961 to 1976, Rand

248-437: A biopsy of the suspected tissue be histologically examined for cancer cells. Given the location of lung cancer tumors, biopsies can often be obtained by minimally invasive techniques: a fiberoptic bronchoscope that can retrieve tissue (sometimes guided by endobronchial ultrasound ), fine needle aspiration , or other imaging-guided biopsy through the skin. Those who cannot undergo a typical biopsy procedure may instead have

372-490: A biopsy of the suspected tumor be examined by a pathologist under a microscope . In addition to recognizing cancerous cells, a pathologist can classify the tumor according to the type of cells it originates from. Around 15% of cases are small-cell lung cancer (SCLC), and the remaining 85% (the non-small-cell lung cancers or NSCLC) are adenocarcinomas , squamous-cell carcinomas , and large-cell carcinomas . After diagnosis, further imaging and biopsies are done to determine

496-551: A liquid biopsy taken (that is, a sample of some body fluid) which may contain circulating tumor DNA that can be detected. Imaging is also used to assess the extent of cancer spread. Positron emission tomography (PET) scanning or combined PET-CT scanning is often used to locate metastases in the body. Since PET scanning is less sensitive in the brain, the National Comprehensive Cancer Network recommends magnetic resonance imaging (MRI) – or CT where MRI

620-453: A brief dispute arose between Rand and Nathaniel Branden, over the use of some of his articles from The Objectivist . The copyrights for the articles had been registered in the name of the magazine. When Branden signed over his interest in the company to Rand, he believed they had an understanding that he could re-use the material in his articles for his planned book, The Psychology of Self-Esteem . Rand threatened to withhold her consent to use

744-406: A chest radiograph or CT scan. In lung cancer screening studies as many as 30% of those screened have a lung nodule, the majority of which turn out to be benign. Besides lung cancer many other diseases can also give this appearance, including hamartomas , and infectious granulomas caused by tuberculosis , histoplasmosis , or coccidioidomycosis . At diagnosis, lung cancer is classified based on

868-505: A free copy of the book from the journal in exchange for a timely review. Publishers send books to book review editors in the hope that their books will be reviewed. The length and depth of research book reviews varies much from journal to journal, as does the extent of textbook and trade book review. An academic journal's prestige is established over time, and can reflect many factors, some but not all of which are expressible quantitatively. In each academic discipline , some journals receive

992-412: A high number of submissions and opt to restrict how many they publish, keeping the acceptance rate low. Size or prestige are not a guarantee of reliability. In the natural sciences and in the social sciences , the impact factor is an established proxy, measuring the number of later articles citing articles already published in the journal. There are other quantitative measures of prestige, such as

1116-433: A high-volume surgery clinic improve chances of survival. Those who are unable or unwilling to undergo surgery can instead receive radiation therapy. Stereotactic body radiation therapy is best practice, typically administered several times over 1–2 weeks. Chemotherapy has little effect in those with stage I NSCLC, and may worsen disease outcomes in those with the earliest disease. In those with stage II disease, chemotherapy

1240-428: A journal article will be available for download in two formats: PDF and HTML, although other electronic file types are often supported for supplementary material. Articles are indexed in bibliographic databases as well as by search engines. E-journals allow new types of content to be included in journals, for example, video material, or the data sets on which research has been based. With the growth and development of

1364-439: A mass inside the lung. The X-ray may reveal an obvious mass, the widening of the mediastinum (suggestive of spread to lymph nodes there), atelectasis (lung collapse), consolidation ( pneumonia ), or pleural effusion ; however, some lung tumors are not visible by X-ray. Next, many undergo computed tomography (CT) scanning , which can reveal the sizes and locations of tumors. A definitive diagnosis of lung cancer requires

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1488-716: A new Objectivist Book Service began selling the reprints. The Objectivist Book Service later sold reprints from The Ayn Rand Letter until shortly after that publication was discontinued. In addition to pamphlets, many articles from these periodicals also appeared in books. Articles from The Objectivist Newsletter by Rand and Nathaniel Branden made up most of the content for The Virtue of Selfishness . Rand's next book, Capitalism: The Unknown Ideal , included articles from her and Branden, plus Greenspan and Hessen. Reprints of Rand's articles also appeared in The Romantic Manifesto , The New Left (later revised as Return of

1612-607: A new cough, or an increase in the frequency or strength of a pre-existing cough. Around one in four cough up blood , ranging from small streaks in the sputum to large amounts. Around half of those diagnosed with lung cancer experience shortness of breath, while 25–50% experience a dull, persistent chest pain that remains in the same location over time. In addition to respiratory symptoms, some experience systemic symptoms including loss of appetite , weight loss , general weakness, fever , and night sweats . Some less common symptoms suggest tumors in particular locations. Tumors in

1736-573: A newsletter for the Objectivist Club of Eastern Michigan. In 1990 the newsletter became Full Context , which billed itself as "An International Objectivist Publication." The magazine was published until October 2000. Contributors included Chris Matthew Sciabarra and Tibor Machan , and the magazine published a number of interviews with people associated with Objectivism, including Barbara Branden , Nathaniel Branden , Erika Holzer , and David Kelley . Academic journal Content usually takes

1860-440: A number of the journals on this list, threatened to sue Beall in 2013 and Beall stopped publishing in 2017, citing pressure from his university. A US judge fined OMICS $ 50 million in 2019 stemming from an FTC lawsuit. Some academic journals use the registered report format, which aims to counteract issues such as data dredging and hypothesizing after the results are known. For example, Nature Human Behaviour has adopted

1984-453: A print journal in structure: there is a table of contents which lists the articles, and many electronic journals still use a volume/issue model, although some titles now publish on a continuous basis. Online journal articles are a specialized form of electronic document : they have the purpose of providing material for academic research and study, and they are formatted approximately like journal articles in traditional printed journals. Often,

2108-468: A profit. They often accept advertising, page and image charges from authors to pay for production costs. On the other hand, some journals are produced by commercial publishers who do make a profit by charging subscriptions to individuals and libraries. They may also sell all of their journals in discipline-specific collections or a variety of other packages. Journal editors tend to have other professional responsibilities, most often as teaching professors. In

2232-586: A sister she believed to have died was in fact still alive and in the Soviet Union . Rand worked hard to arrange a visit to the United States for her sister. When her sister finally arrived, their reunion turned into fighting over political and philosophical differences. As Hessen described it, "This incident, stretching across eight months, took a heavy toll on her writing and publication schedule, which allocated no time for unexpected interruptions." Several issues of

2356-563: A sixteen-page magazine format in place of the previous newsletter format. The number of subscribers continued to climb, reaching 21,000 by the end of 1966. Contributors during this period included economists Alan Greenspan and George Reisman , historian Robert Hessen , neurophysiologist Robert Efron, novelists Erika Holzer and Kay Nolte Smith , and philosopher Leonard Peikoff . In August 1968, Rand broke off her relationships with both Nathaniel and Barbara Branden. Nathaniel Branden resigned from The Objectivist and signed over his half of

2480-506: A societal level, smoking cessation can be promoted by tobacco control policies that make tobacco products more difficult to obtain or use. Many such policies are mandated or recommended by the WHO Framework Convention on Tobacco Control , ratified by 182 countries, representing over 90% of the world's population. The WHO groups these policies into six intervention categories, each of which has been shown to be effective in reducing

2604-437: A study in a given field, or for current awareness of those already in the field. Reviews of scholarly books are checks upon the research books published by scholars; unlike articles, book reviews tend to be solicited. Journals typically have a separate book review editor determining which new books to review and by whom. If an outside scholar accepts the book review editor's request for a book review, he or she generally receives

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2728-491: A symptom tend to have worse outcomes. Tumor mutations in KRAS are associated with reduced survival. The uncertainty of lung cancer prognosis often causes stress, and makes future planning difficult, for those with lung cancer and their families. Those whose cancer goes into remission often experience fear of their cancer returning or progressing, associated with poor quality of life, negative mood, and functional impairment. This fear

2852-427: A tumor, and eventually spreading within and then beyond the lung. Rampant tumor growth and spread causes the symptoms of lung cancer. If unstopped, the spreading tumor will eventually cause the death of affected individuals. Tobacco smoking is by far the major contributor to lung cancer, causing 80% to 90% of cases. Lung cancer risk increases with quantity of cigarettes consumed. Tobacco smoking's carcinogenic effect

2976-520: A variety of other toxic chemicals – typically encountered in certain occupations – is associated with an increased risk of lung cancer. Occupational exposures to carcinogens cause 9–15% of lung cancer. A prominent example is asbestos , which causes lung cancer either directly or indirectly by inflaming the lung. Exposure to all commercially available forms of asbestos increases cancer risk, and cancer risk increases with time of exposure. Asbestos and cigarette smoking increase risk synergistically – that is,

3100-541: A work for potential publication without directly being asked to do so. Upon receipt of a submitted article, editors at the journal determine whether to reject the submission outright or begin the process of peer review . In the latter case, the submission becomes subject to review by outside scholars of the editor's choosing who typically remain anonymous. The number of these peer reviewers (or "referees") varies according to each journal's editorial practice – typically, no fewer than two, though sometimes three or more, experts in

3224-513: A younger age, and in women compared to men. Most lung cancer cases are caused by tobacco smoking . The remainder are caused by exposure to hazardous substances like asbestos and radon gas, or by genetic mutations that arise by chance. Consequently, lung cancer prevention efforts encourage people to avoid hazardous chemicals and quit smoking. Quitting smoking both reduces one's chance of developing lung cancer and improves treatment outcomes in those already diagnosed with lung cancer. Lung cancer

3348-1202: Is hypercalcemia (high blood calcium) caused by over-production of parathyroid hormone-related protein or parathyroid hormone . Hypercalcemia can manifest as nausea, vomiting, abdominal pain, constipation, increased thirst , frequent urination , and altered mental status. Those with lung cancer also commonly experience hypokalemia (low potassium) due to inappropriate secretion of adrenocorticotropic hormone , as well as hyponatremia (low sodium) due to overproduction of antidiuretic hormone or atrial natriuretic peptide . About one of three people with lung cancer develop nail clubbing , while up to one in ten experience hypertrophic pulmonary osteoarthropathy (nail clubbing, joint soreness, and skin thickening). A variety of autoimmune disorders can arise as paraneoplastic syndromes in those with lung cancer, including Lambert–Eaton myasthenic syndrome (which causes muscle weakness), sensory neuropathies , muscle inflammation , brain swelling , and autoimmune deterioration of cerebellum , limbic system , or brainstem . Up to one in twelve people with lung cancer have paraneoplastic blood clotting, including migratory venous thrombophlebitis , clots in

3472-480: Is a malignant tumor that begins in the lung . Lung cancer is caused by genetic damage to the DNA of cells in the airways, often caused by cigarette smoking or inhaling damaging chemicals. Damaged airway cells gain the ability to multiply unchecked, causing the growth of a tumor. Without treatment, tumors spread throughout the lung, damaging lung function. Eventually lung tumors metastasize , spreading to other parts of

3596-641: Is also a risk of radiation-induced cancer . The United States Preventive Services Task Force recommends yearly screening using low-dose CT in people between 55 and 80 who have a smoking history of at least 30 pack-years . The European Commission recommends that cancer screening programs across the European Union be extended to include low-dose CT lung scans for current or previous smokers. Similarly, The Canadian Task Force for Preventative Health recommends that people who are current or former smokers (smoking history of more than 30 pack years) and who are between

3720-567: Is associated with the development of the rare lung cancer lymphoepithelioma-like carcinoma in people from Asia, but not in people from Western nations . A role for several other infectious agents – namely human papillomaviruses , BK virus , JC virus , human cytomegalovirus , SV40 , measles virus , and Torque teno virus – in lung cancer development has been studied but remains inconclusive as of 2020. Particular gene combinations may make some people more susceptible to lung cancer. Close family members of those with lung cancer have around twice

3844-413: Is due to various chemicals in tobacco smoke that cause DNA mutations, increasing the chance of cells becoming cancerous. The International Agency for Research on Cancer identifies at least 50 chemicals in tobacco smoke as carcinogenic , and the most potent is tobacco-specific nitrosamines . Exposure to these chemicals causes several kinds of DNA damage: DNA adducts , oxidative stress , and breaks in

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3968-528: Is exacerbated by frequent or prolonged surveillance imaging, and other reminders of cancer risks. Lung cancer is caused by genetic damage to the DNA of lung cells. These changes are sometimes random, but are typically induced by breathing in toxic substances such as cigarette smoke. Cancer-causing genetic changes affect the cell's normal functions , including cell proliferation , programmed cell death ( apoptosis ), and DNA repair . Eventually, cells gain enough genetic changes to grow uncontrollably, forming

4092-497: Is impractical are treated with combination chemotherapy and radiotherapy along with the immunotherapy durvalumab . Combined chemotherapy and radiation enhances survival compared to chemotherapy followed by radiation, though the combination therapy comes with harsher side effects. Those with stage IV disease are treated with combinations of pain medication, radiotherapy, immunotherapy, and chemotherapy. Many cases of advanced disease can be treated with targeted therapies depending on

4216-485: Is necessary due to the length of time it can take for lung cancer to develop following an exposure to carcinogens. The smoking of non-tobacco products is not known to be associated with lung cancer development. Marijuana smoking does not seem to independently cause lung cancer – despite the relatively high levels of tar and known carcinogens in marijuana smoke. The relationship between smoking cocaine and developing lung cancer has not been studied as of 2020. Exposure to

4340-506: Is not targetable by current molecular therapies instead can be treated with combination chemotherapy plus immune checkpoint inhibitors, which prevent cancer cells from inactivating immune T cells . The chemotherapeutic agent of choice depends on the NSCLC subtype: cisplatin plus gemcitabine for squamous cell carcinoma, cisplatin plus pemetrexed for non-squamous cell carcinoma. Immune checkpoint inhibitors are most effective against tumors that express

4464-407: Is present in many lung cancers, but absent from squamous cell carcinomas. Lung cancer staging is an assessment of the degree of spread of the cancer from its original source. It is one of the factors affecting both the prognosis and the treatment of lung cancer. SCLC is typically staged with a relatively simple system: limited stage or extensive stage. Around a third of people are diagnosed at

4588-402: Is stage IV. Each stage is further subdivided based on the combination of T, N, and M scores. Some countries recommend that people who are at a high risk of developing lung cancer be screened at different intervals using low-dose CT lung scans. Screening programs may result in early detection of lung tumors in people who are not yet experiencing symptoms of lung cancer, ideally, early enough that

4712-405: Is the most diagnosed and deadliest cancer worldwide, with 2.2 million cases in 2020 resulting in 1.8 million deaths. Lung cancer is rare in those younger than 40; the average age at diagnosis is 70 years, and the average age at death 72. Incidence and outcomes vary widely across the world, depending on patterns of tobacco use. Prior to the advent of cigarette smoking in the 20th century, lung cancer

4836-442: Is typically treated with a combination of chemotherapy and radiotherapy. For chemotherapy, the National Comprehensive Cancer Network and American College of Chest Physicians guidelines recommend four to six cycles of a platinum-based chemotherapeutic – cisplatin or carboplatin – combined with either etoposide or irinotecan . This is typically combined with thoracic radiation therapy – 45 Gray (Gy) twice-daily – alongside

4960-420: Is unavailable – to scan the brain for metastases in those with NSCLC and large tumors, or tumors that have spread to the nearby lymph nodes. When imaging suggests the tumor has spread, the suspected metastasis is often biopsied to confirm that it is cancerous. Lung cancer most commonly metastasizes to the brain, bones, liver, and adrenal glands . Lung cancer can often appear as a solitary pulmonary nodule on

5084-564: Is usually initiated six to twelve weeks after surgery, with up to four cycles of cisplatin – or carboplatin in those with kidney problems, neuropathy , or hearing impairment – combined with vinorelbine , pemetrexed , gemcitabine, or docetaxel . Treatment for those with stage III NSCLC depends on the nature of their disease. Those with more limited spread may undergo surgery to have the tumor and affected lymph nodes removed, followed by chemotherapy and potentially radiotherapy. Those with particularly large tumors (T4) and those for whom surgery

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5208-458: The Letter published during this period bore a postscript: "This Letter was written later than the date that appears on its heading." Rand attempted to bring the Letter back on schedule, but further delays occurred when she was diagnosed with lung cancer . Each issue continued to bear the date when it should have appeared on the original fortnightly schedule, with the "written later" postscript. By

5332-533: The Letter' s higher subscription price. The newsletter was usually four or six pages long with a single major article per issue, plus occasional announcements and the continuing "Objectivist Calendar" entries. Rand wrote most of the articles herself, in addition to acting as editor and publisher. Leonard Peikoff served as a contributing editor and wrote the articles for six of the newsletter's eighty-one issues. Beginning in 1973, outside circumstances began to cause delays in production. In March 1973, Rand discovered that

5456-722: The Royal Society established Philosophical Transactions of the Royal Society in March 1665, and the Académie des Sciences established the Mémoires de l'Académie des Sciences in 1666, which focused on scientific communications. By the end of the 18th century, nearly 500 such periodicals had been published, the vast majority coming from Germany (304 periodicals), France (53), and England (34). Several of those publications, in particular

5580-621: The SCImago Journal Rank , CiteScore , Eigenfactor , and Altmetrics . In the Anglo-American humanities , there is no tradition (as there is in the sciences) of giving impact-factors that could be used in establishing a journal's prestige. Recent moves have been made by the European Science Foundation (ESF) to change the situation, resulting in the publication of preliminary lists for the ranking of academic journals in

5704-584: The cell division cycle , cellular stress responses , and chromatin remodeling . Some rare genetic disorders that increase the risk of various cancers also increase the risk of lung cancer, namely retinoblastoma and Li–Fraumeni syndrome . As with all cancers, lung cancer is triggered by mutations that allow tumor cells to endlessly multiply, stimulate blood vessel growth , avoid apoptosis (programmed cell death), generate pro-growth signalling molecules, ignore anti-growth signalling molecules, and eventually spread into surrounding tissue or metastasize throughout

5828-508: The spinal cord . Metastasis into the bone marrow can deplete blood cells and cause leukoerythroblastosis (immature cells in the blood). Liver metastases can cause liver enlargement , pain in the right upper quadrant of the abdomen , fever, and weight loss. Lung tumors often cause the release of body-altering hormones , which cause unusual symptoms, called paraneoplastic syndromes . Inappropriate hormone release can cause dramatic shifts in concentrations of blood minerals . Most common

5952-450: The thorax can cause breathing problems by obstructing the trachea or disrupting the nerve to the diaphragm ; difficulty swallowing by compressing the esophagus ; hoarseness by disrupting the nerves of the larynx ; and Horner's syndrome by disrupting the sympathetic nervous system . Horner's syndrome is also common in tumors at the top of the lung , known as Pancoast tumors , which also cause shoulder pain that radiates down

6076-595: The Ayn Rand Institute, such as Yaron Brook , Andrew Bernstein , Tara Smith , Elan Journo, and Alex Epstein , have written for the journal. The Undercurrent was founded in 2005 but has been inactive since 2019. It was available at college campuses and other outlets. It was a student-run, 8-page quarterly that applied the philosophy of Objectivism to current events. Other Objectivist periodicals include Full Context , Objectivity , and The New Individualist . In 1988, Karen Reedstrom (later Minto) began publishing

6200-469: The DNA strands. Being around tobacco smoke – called passive smoking – can also cause lung cancer. Living with a tobacco smoker increases one's risk of developing lung cancer by 24%. An estimated 17% of lung cancer cases in those who do not smoke are caused by high levels of environmental tobacco smoke. Vaping may be a risk factor for lung cancer, but less than that of cigarettes, and further research as of 2021

6324-524: The German journals, tended to be short-lived (under five years). A.J. Meadows has estimated the proliferation of journals to reach 10,000 journals in 1950, and 71,000 in 1987. Michael Mabe wrote that the estimates will vary depending on the definition of what exactly counts as a scholarly publication, but that the growth rate has been "remarkably consistent over time", with an average rate of 3.46% per year from 1800 to 2003. In 1733, Medical Essays and Observations

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6448-674: The Internet, there has been a growth in the number of new digital-only journals. A subset of these journals exist as Open Access titles, meaning that they are free to access for all, and have Creative Commons licences which permit the reproduction of content in different ways. High quality open access journals are listed in Directory of Open Access Journals . Most, however, continue to exist as subscription journals, for which libraries, organisations and individuals purchase access. Lung cancer Lung cancer , also known as lung carcinoma ,

6572-518: The Primitive ), Philosophy: Who Needs It , and The Voice of Reason . The content of Rand's Introduction to Objectivist Epistemology was serialized in The Objectivist , and the published book also includes an article by Leonard Peikoff reprinted from that same magazine. Peikoff's articles for The Ayn Rand Letter were material later incorporated into his book The Ominous Parallels . In 1969,

6696-458: The Royal Society (March 1665), and Mémoires de l'Académie des Sciences (1666). The first fully peer-reviewed journal was Medical Essays and Observations (1733). The idea of a published journal with the purpose of "[letting] people know what is happening in the Republic of Letters " was first conceived by François Eudes de Mézeray in 1663. A publication titled Journal littéraire général

6820-624: The US, China, South Korea, Taiwan, Israel, Latvia, Iceland, Sweden, Austria, and Switzerland. SCLC is particularly aggressive. 10–15% of people survive five years after a SCLC diagnosis. As with other types of lung cancer, the extent of disease at diagnosis also influences prognosis. The average person diagnosed with limited-stage SCLC survives 12–20 months from diagnosis; with extensive-stage SCLC around 12 months. While SCLC often responds initially to treatment, most people eventually relapse with chemotherapy-resistant cancer, surviving an average 3–4 months from

6944-426: The affected individual loses the ability to swallow. Coughing is also common, and can be managed with opioids or cough suppressants . Some experience terminal delirium – confused behavior, unexplained movements, or a reversal of the sleep-wake cycle – which can be managed by antipsychotic drugs, low-dose sedatives, and investigating other causes of discomfort such as low blood sugar , constipation , and sepsis . In

7068-593: The ages of 55–74 years be screened for lung cancer. Treatment for lung cancer depends on the cancer's specific cell type, how far it has spread , and the person's health. Common treatments for early stage cancer includes surgical removal of the tumor, chemotherapy , and radiation therapy . For later-stage cancer, chemotherapy and radiation therapy are combined with newer targeted molecular therapies and immune checkpoint inhibitors . All lung cancer treatment regimens are combined with lifestyle changes and palliative care to improve quality of life. Limited-stage SCLC

7192-399: The aspects common to all academic field journals. Scientific journals and journals of the quantitative social sciences vary in form and function from journals of the humanities and qualitative social sciences; their specific aspects are separately discussed. The first academic journal was Journal des sçavans (January 1665), followed soon after by Philosophical Transactions of

7316-821: The author deposits a paper in a disciplinary or institutional repository where it can be searched for and read, or via publishing it in a free open access journal , which does not charge for subscriptions , being either subsidized or financed by a publication fee . Given the goal of sharing scientific research to speed advances, open access has affected science journals more than humanities journals. Commercial publishers are experimenting with open access models, but are trying to protect their subscription revenues. The much lower entry cost of on-line publishing has also raised concerns of an increase in publication of "junk" journals with lower publishing standards. These journals, often with names chosen as similar to well-established publications, solicit articles via e-mail and then charge

7440-468: The author to publish an article, often with no sign of actual review . Jeffrey Beall , a research librarian at the University of Colorado , has compiled a list of what he considers to be "potential, possible, or probable predatory scholarly open-access publishers"; the list numbered over 300 journals as of April 2013, but he estimates that there may be thousands. The OMICS Publishing Group , which publishes

7564-515: The average person's lifespan by around 2 months. For stage I and stage II NSCLC the first line of treatment is often surgical removal of the affected lobe of the lung. For those not well enough to tolerate full lobe removal, a smaller chunk of lung tissue can be removed by wedge resection or segmentectomy surgery. Those with centrally located tumors and otherwise-healthy respiratory systems may have more extreme surgery to remove an entire lung ( pneumonectomy ). Experienced thoracic surgeons , and

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7688-399: The blocking tissue by bronchoscopy, sometimes aided by thermal or laser ablation . Other causes of lung cancer-associated shortness of breath can be treated directly, such as antibiotics for a lung infection, diuretics for pulmonary edema , benzodiazepines for anxiety, and steroids for airway obstruction. Up to 92% of those with lung cancer report pain, either from tissue damage at

7812-473: The body. Early lung cancer often has no symptoms and can only be detected by medical imaging . As the cancer progresses, most people experience nonspecific respiratory problems: coughing , shortness of breath , or chest pain . Other symptoms depend on the location and size of the tumor. Those suspected of having lung cancer typically undergo a series of imaging tests to determine the location and extent of any tumors. Definitive diagnosis of lung cancer requires

7936-753: The body. Different tumors can acquire these abilities through different mutations, though generally cancer-contributing mutations activate oncogenes and inactivate tumor suppressors . Some mutations – called "driver mutations" – are particularly common in adenocarcinomas, and contribute disproportionately to tumor development. These typically occur in the receptor tyrosine kinases EGFR, BRAF, MET, KRAS , and PIK3CA . Similarly, some adenocarcinomas are driven by chromosomal rearrangements that result in overexpression of tyrosine kinases ALK, ROS1, NTRK, and RET. A given tumor will typically have just one driver mutation. In contrast, SCLCs rarely have these driver mutations, and instead often have mutations that have inactivated

8060-534: The cancer's stage based on how far it has spread. Treatment for early stage lung cancer includes surgery to remove the tumor, sometimes followed by radiation therapy and chemotherapy to kill any remaining cancer cells. Later stage cancer is treated with radiation therapy and chemotherapy alongside drug treatments that target specific cancer subtypes. Even with treatment, only around 20% of people survive five years on from their diagnosis. Survival rates are higher in those diagnosed at an earlier stage, diagnosed at

8184-410: The case of the largest journals, there are paid staff assisting in the editing. The production of the journals is almost always done by publisher-paid staff. Humanities and social science academic journals are usually subsidized by universities or professional organization. The cost and value proposition of subscription to academic journals is being continuously re-assessed by institutions worldwide. In

8308-739: The center of the lungs, in the major airways. Their cells appear small with ill-defined boundaries, not much cytoplasm , many mitochondria , and have distinctive nuclei with granular-looking chromatin and no visible nucleoli . NSCLCs comprise a group of three cancer types: adenocarcinoma , squamous-cell carcinoma , and large-cell carcinoma . Nearly 40% of lung cancers are adenocarcinomas. Their cells grow in three-dimensional clumps, resemble glandular cells, and may produce mucin . About 30% of lung cancers are squamous-cell carcinomas. They typically occur close to large airways. The tumors consist of sheets of cells, with layers of keratin . A hollow cavity and associated cell death are commonly found at

8432-438: The center of the tumor. Less than 10% of lung cancers are large-cell carcinomas, so named because the cells are large, with excess cytoplasm, large nuclei, and conspicuous nucleoli . Around 10% of lung cancers are rarer types. These include mixes of the above subtypes like adenosquamous carcinoma , and rare subtypes such as carcinoid tumors , and sarcomatoid carcinomas . Several lung cancer types are subclassified based on

8556-612: The context of the big deal cancellations by several library systems in the world, data analysis tools like Unpaywall Journals are used by libraries to estimate the specific cost and value of the various options: libraries can avoid subscriptions for materials already served by instant open access via open archives like PubMed Central. The Internet has revolutionized the production of, and access to, academic journals, with their contents available online via services subscribed to by academic libraries . Individual articles are subject-indexed in databases such as Google Scholar . Some of

8680-405: The extent of local spread: with the cancer metastasized to no lymph nodes (N0), pulmonary or hilar nodes (along the bronchi) on the same side as the tumor (N1), mediastinal or subcarinal lymph nodes (in the middle of the lungs, N2), or lymph nodes on the opposite side of the lung from the tumor (N3). Metastases are staged as no metastases (M0), nearby metastases (M1a; the space around the lung or

8804-545: The first two chemotherapy cycles. First-line therapy causes remission in up to 80% of those who receive it; however most people relapse with chemotherapy-resistant disease. Those who relapse are given second-line chemotherapies. Topotecan and lurbinectedin are approved by the US FDA for this purpose. Irinotecan, paclitaxel , docetaxel , vinorelbine , etoposide, and gemcitabine are also sometimes used, and are similarly efficacious. Prophylactic cranial irradiation can reduce

8928-592: The form of articles presenting original research , review articles , or book reviews . The purpose of an academic journal, according to Henry Oldenburg (the first editor of Philosophical Transactions of the Royal Society ), is to give researchers a venue to "impart their knowledge to one another, and contribute what they can to the Grand design of improving natural knowledge, and perfecting all Philosophical Arts, and Sciences." The term academic journal applies to scholarly publications in all fields; this article discusses

9052-444: The foundation of arXiv in 1991 for the dissemination of preprints to be discussed prior to publication in a journal, and the establishment of PLOS One in 2006 as the first megajournal . There are two kinds of article or paper submissions in academia : solicited, where an individual has been invited to submit work either through direct contact or through a general submissions call, and unsolicited, where an individual submits

9176-687: The genetic makeup of the cancerous cells. Up to 30% of tumors have mutations in the EGFR gene that result in an overactive EGFR protein; these can be treated with EGFR inhibitors osimertinib , erlotinib , gefitinib , afatinib , or dacomitinib – with osimertinib known to be superior to erlotinib and gefitinib, and all superior to chemotherapy alone. Up to 7% of those with NSCLC harbor mutations that result in hyperactive ALK protein, which can be treated with ALK inhibitors crizotinib , or its successors alectinib , brigatinib , and ceritinib . Those treated with ALK inhibitors who relapse can then be treated with

9300-487: The growth characteristics of the cancer cells. Adenocarcinomas are classified as lepidic (growing along the surface of intact alveolar walls), acinar and papillary , or micropapillary and solid pattern. Lepidic adenocarcinomas tend to be least aggressive, while micropapillary and solid pattern adenocarcinomas are most aggressive. In addition to examining cell morphology, biopsies are often stained by immunohistochemistry to confirm lung cancer classification. SCLCs bear

9424-465: The heart , arrhythmia (irregular heartbeat), and heart failure . About one in three people diagnosed with lung cancer have symptoms caused by metastases in sites other than the lungs. Lung cancer can metastasize anywhere in the body, with different symptoms depending on the location. Brain metastases can cause headache , nausea , vomiting , seizures , and neurological deficits . Bone metastases can cause pain, bone fractures , and compression of

9548-409: The heart, and disseminated intravascular coagulation (clots throughout the body). Paraneoplastic syndromes involving the skin and kidneys are rare, each occurring in up to 1% of those with lung cancer. A person suspected of having lung cancer will have imaging tests done to evaluate the presence, extent, and location of tumors. First, many primary care providers perform a chest X-ray to look for

9672-423: The heart, or the opposite lung), a single distant metastasis (M1b), or multiple metastases (M1c). These T, N, and M scores are combined to designate a stage grouping for the cancer. Cancer limited to smaller tumors is designated stage I. Disease with larger tumors or spread to the nearest lymph nodes is stage II. Cancer with the largest tumors or extensive lymph node spread is stage III. Cancer that has metastasized

9796-539: The hope that this would allow her to reach a larger audience. The final issue of The Objectivist was published in September 1971. In October 1971, Rand began publishing The Ayn Rand Letter . This new publication was produced in the style of a typewritten letter and was published fortnightly . Rand's initial hopes for reaching a wider audience with the newsletter format were not fulfilled. The Letter actually lost subscribers compared to The Objectivist , largely because of

9920-424: The humanities. These rankings have been severely criticized, notably by history and sociology of science British journals that have published a common editorial entitled "Journals under Threat". Though it did not prevent ESF and some national organizations from proposing journal rankings , it largely prevented their use as evaluation tools. In some disciplines such as knowledge management / intellectual capital ,

10044-694: The lack of a well-established journal ranking system is perceived by academics as "a major obstacle on the way to tenure, promotion and achievement recognition". Conversely, a significant number of scientists and organizations consider the pursuit of impact factor calculations as inimical to the goals of science, and have signed the San Francisco Declaration on Research Assessment to limit its use. Three categories of techniques have developed to assess journal quality and create journal rankings: Many academic journals are subsidized by universities or professional organizations, and do not exist to make

10168-473: The last few days of life, many develop terminal secretions – pooled fluid in the airways that can cause a rattling sound while breathing. This is thought not to cause respiratory problems, but can distress family members and caregivers. Terminal secretions can be reduced by anticholinergic medications . Even those who are non-communicative or have reduced consciousness may be able to experience cancer-related pain, so pain medications are typically continued until

10292-500: The limited stage, meaning cancer is confined to one side of the chest, within the scope of a single radiotherapy field. The other two thirds are diagnosed at the "extensive stage", with cancer spread to both sides of the chest, or to other parts of the body. NSCLC – and sometimes SCLC – is typically staged with the American Joint Committee on Cancer 's Tumor, Node, Metastasis (TNM) staging system . The size and extent of

10416-403: The little-finger side of the arm as well as destruction of the topmost ribs . Swollen lymph nodes above the collarbone can indicate a tumor that has spread within the chest. Tumors obstructing bloodflow to the heart can cause superior vena cava syndrome (swelling of the upper body and shortness of breath), while tumors infiltrating the area around the heart can cause fluid buildup around

10540-1057: The lower levels of radon that seep into residential spaces can increase occupants' risk of lung cancer. Like asbestos, cigarette smoking and radon exposure increase risk synergistically. Radon exposure is responsible for between 3% and 14% of lung cancer cases. Several other chemicals encountered in various occupations are also associated with increased lung cancer risk including arsenic used in wood preservation , pesticide application, and some ore smelting ; ionizing radiation encountered during uranium mining ; vinyl chloride in papermaking ; beryllium in jewelers , ceramics workers, missile technicians, and nuclear reactor workers; chromium in stainless steel production, welding , and hide tanning ; nickel in electroplaters , glass workers, metal workers, welders, and those who make batteries, ceramics, and jewelry; and diesel exhaust encountered by miners. Exposure to air pollution , especially particulate matter released by motor vehicle exhaust and fossil fuel -burning power plants, increases

10664-550: The lung increase one's risk of lung cancer. This association is strongest for chronic obstructive pulmonary disorder – the risk is highest in those with the most inflammation, and reduced in those whose inflammation is treated with inhaled corticosteroids . Other inflammatory lung and immune system diseases such as alpha-1 antitrypsin deficiency , interstitial fibrosis , scleroderma , Chlamydia pneumoniae infection, tuberculosis , and HIV infection are associated with increased risk of developing lung cancer. Epstein–Barr virus

10788-574: The magazine to her. In the May 1968 issue, which appeared at this time because the magazine was then behind schedule, Rand issued a public statement denouncing the Brandens and disassociating herself from them. From this point forward, Rand acted as the sole editor for the magazine, bringing in Peikoff as an associate editor. In 1971, Rand decided on another format change, going back to a newsletter style publication, in

10912-528: The majority of the articles were written by either Ayn Rand or Nathaniel Branden. In 1965, Rand and Branden decided to change the format of the publication. In October 1965, they announced that The Objectivist Newsletter would become The Objectivist . This was purely a change of name and format, with business operations, including subscriptions, continuing unchanged. In January 1966, The Objectivist replaced The Objectivist Newsletter , with Rand and Branden continuing as co-editors. The renamed publication used

11036-410: The markers of neuroendocrine cells , such as chromogranin , synaptophysin , and CD56 . Adenocarcinomas tend to express Napsin-A and TTF-1 ; squamous cell carcinomas lack Napsin-A and TTF-1 , but express p63 and its cancer-specific isoform p40. CK7 and CK20 are also commonly used to differentiate lung cancers. CK20 is found in several cancers, but typically absent from lung cancer. CK7

11160-492: The material, but took no action when Branden's publisher decided to go forward anyway. All three of the periodicals edited by Rand were later published in hardcover collections by Palo Alto Book Service. In 2001, all the articles by Rand and Peikoff were incorporated into the Objectivism Research CD-ROM , a searchable e-book of their writings (which was subsequently discontinued). The Intellectual Activist (TIA)

11284-480: The middle of 1975, issues were appearing eight months behind schedule, with the issue dated August 26, 1974 actually being written in May 1975. In that issue, Peikoff announced that the Letter would become a monthly publication, rather than fortnightly. Rand was unable to sustain this schedule either, and announced at the end of 1975 that the newsletter would cease publication. The final issue appeared in February 1976. It

11408-512: The most-advanced stage, IVB, have a two-year survival of 10% and a five-year survival of 0%. Five-year survival is higher in women (22%) than men (16%). Women tend to be diagnosed with less-advanced disease, and have better outcomes than men diagnosed at the same stage. Average five-year survival also varies across the world, with particularly high five-year survival in Japan (33%), and five-year survival above 20% in 12 other countries: Mauritius, Canada,

11532-431: The nicotine replacement varenicline as first-line therapies to aid in smoking cessation. Clonidine and nortriptyline are recommended second-line therapies. The majority of those diagnosed with lung cancer attempt to quit smoking; around half succeed. Even after lung cancer diagnosis, smoking cessation improves treatment outcomes, reducing cancer treatment toxicity and failure rates, and lengthening survival time. At

11656-611: The overall number of citations, how quickly articles are cited, and the average " half-life " of articles. Clarivate Analytics ' Journal Citation Reports , which among other features, computes an impact factor for academic journals, draws data for computation from the Science Citation Index Expanded (for natural science journals), and from the Social Sciences Citation Index (for social science journals). Several other metrics are also used, including

11780-456: The paper resulting from this peer-reviewed procedure will be published, regardless of the study outcomes." Some journals are born digital in that they are solely published on the web and in a digital format. Though most electronic journals originated as print journals, which subsequently evolved to have an electronic version, while still maintaining a print component, others eventually became electronic-only. An e-journal closely resembles

11904-616: The previous success of the Nathaniel Branden Institute (NBI), which Branden had founded in 1958 (originally as Nathaniel Branden Lectures) to promote Objectivism. By late 1961, NBI had accumulated a mailing list of over 10,000 people, which was used to announce the newsletter. A number of different writers contributed articles to The Objectivist Newsletter , including Martin Anderson , Barbara Branden , Edith Efron , Alan Greenspan , Robert Hessen , and Leonard Peikoff . However,

12028-526: The protein PD-L1 , but are sometimes effective in those that do not. Treatment with pembrolizumab , atezolizumab , or combination nivolumab plus ipilimumab are all superior to chemotherapy alone against tumors expressing PD-L1. Those who relapse on the above are treated with second-line chemotherapeutics docetaxel and ramucirumab . Integrating palliative care (medical care focused on improving symptoms and lessening discomfort) into lung cancer treatment from

12152-495: The registered report format, as it "shift[s] the emphasis from the results of research to the questions that guide the research and the methods used to answer them". The European Journal of Personality defines this format: "In a registered report, authors create a study proposal that includes theoretical and empirical background, research questions/hypotheses, and pilot data (if available). Upon submission, this proposal will then be reviewed prior to data collection, and if accepted,

12276-511: The research published in journals. Some journals are devoted entirely to review articles, some contain a few in each issue, and others do not publish review articles. Such reviews often cover the research from the preceding year, some for longer or shorter terms; some are devoted to specific topics, some to general surveys. Some reviews are enumerative , listing all significant articles in a given subject; others are selective, including only what they think worthwhile. Yet others are evaluative, judging

12400-412: The risk of brain metastases and improve survival in those with limited-stage disease. Extensive-stage SCLC is treated first with etoposide along with either cisplatin or carboplatin. Radiotherapy is used only to shrink tumors that are causing particularly severe symptoms. Combining standard chemotherapy with an immune checkpoint inhibitor can improve survival for a minority of those affected, extending

12524-400: The risk of developing lung cancer as an average person, even after controlling for occupational exposure and smoking habits. Genome-wide association studies have identified many gene variants associated with lung cancer risk, each of which contributes a small risk increase. Many of these genes participate in pathways known to be involved in carcinogenesis, namely DNA repair , inflammation ,

12648-420: The risk of lung cancer. Indoor air pollution from burning wood , charcoal , or crop residue for cooking and heating has also been linked to an increased risk of developing lung cancer. The International Agency for Research on Cancer has classified emission from household burning of coal and biomass as "carcinogenic" and "probably carcinogenic" respectively. Several other diseases that cause inflammation of

12772-455: The risk of someone who smokes and has asbestos exposure dying from lung cancer is much higher than would be expected from adding the two risks together. Similarly, exposure to radon , a naturally occurring breakdown product of the Earth's radioactive elements , is associated with increased lung cancer risk. Radon levels vary with geography. Underground miners have the greatest exposure; however even

12896-413: The same lobe of the lung, or invade the chest wall , diaphragm (or the nerve that controls it ), or area around the heart. Tumors that are larger than 7 cm, have nodules spread in different lobes of a lung, or invade the mediastinum (center of the chest cavity), heart, largest blood vessels that supply the heart, trachea , esophagus , or spine are designated T4. Lymph node staging depends on

13020-429: The smallest, most specialized journals are prepared in-house, by an academic department, and published only online – this has sometimes been in the blog format, though some, like the open access journal Internet Archaeology , use the medium to embed searchable datasets, 3D models, and interactive mapping. Currently, there is a movement in higher education encouraging open access, either via self archiving , whereby

13144-440: The state of progress in the subject field. Some journals are published in series, each covering a complete subject field year, or covering specific fields through several years. Unlike original research articles, review articles tend to be solicited or "peer-invited" submissions, often planned years in advance, which may themselves go through a peer-review process once received. They are typically relied upon by students beginning

13268-658: The subject matter of the article produce reports upon the content, style, and other factors, which inform the editors' publication decisions. Though these reports are generally confidential, some journals and publishers also practice public peer review . The editors either choose to reject the article, ask for a revision and resubmission, or accept the article for publication. Even accepted articles are often subjected to further (sometimes considerable) editing by journal editorial staff before they appear in print. The peer review can take from several weeks to several months. Review articles, also called "reviews of progress", are checks on

13392-678: The third-generation ALK inhibitor lorlatinib . Up to 5% with NSCLC have overactive MET , which can be inhibited with MET inhibitors capmatinib or tepotinib . Targeted therapies are also available for some cancers with rare mutations. Cancers with hyperactive BRAF (around 2% of NSCLC) can be treated by dabrafenib combined with the MEK inhibitor trametinib ; those with activated ROS1 (around 1% of NSCLC) can be inhibited by crizotinib, lorlatinib, or entrectinib ; overactive NTRK (<1% of NSCLC) by entrectinib or larotrectinib ; active RET (around 1% of NSCLC) by selpercatinib . People whose NSCLC

13516-442: The time of death. Around 19% of people diagnosed with lung cancer survive five years from diagnosis , though prognosis varies based on the stage of the disease at diagnosis and the type of lung cancer. Prognosis is better for people with lung cancer diagnosed at an earlier stage; those diagnosed at the earliest TNM stage, IA1 (small tumor, no spread), have a two-year survival of 97% and five-year survival of 92%. Those diagnosed at

13640-419: The time of diagnosis improves the survival time and quality of life of those with lung cancer. Particularly common symptoms of lung cancer are shortness of breath and pain. Supplemental oxygen, improved airflow, re-orienting an affected person in bed, and low-dose morphine can all improve shortness of breath. In around 20 to 30% of those with lung cancer – particularly those with late-stage disease – growth of

13764-443: The time of relapse. Those with limited stage SCLC that go into complete remission after chemotherapy and radiotherapy have a 50% chance of brain metastases developing within the next two years – a chance reduced by prophylactic cranial irradiation. Several other personal and disease factors are associated with improved outcomes. Those diagnosed at a younger age tend to have better outcomes. Those who smoke or experience weight loss as

13888-531: The tumor (T), spread to regional lymph nodes (N), and distant metastases (M) are scored individually, and combined to form stage groups. Relatively small tumors are designated T1, which are subdivided by size: tumors ≤ 1 centimeter (cm) across are T1a; 1–2 cm T1b; 2–3 cm T1c. Tumors up to 5 cm across, or those that have spread to the visceral pleura (tissue covering the lung) or main bronchi , are designated T2. T2a designates 3–4 cm tumors; T2b 4–5 cm tumors. T3 tumors are up to 7 cm across, have multiple nodules in

14012-494: The tumor can narrow or block the airway , causing coughing and difficulty breathing. Obstructing tumors can be surgically removed where possible, though typically those with airway obstruction are not well enough for surgery. In such cases the American College of Chest Physicians recommends opening the airway by inserting a stent , attempting to shrink the tumor with localized radiation ( brachytherapy ), or physically removing

14136-1309: The tumor site(s) or nerve damage. The World Health Organization (WHO) has developed a three-tiered system for managing cancer pain. For those with mild pain (tier one), the WHO recommends acetominophen or a nonsteroidal anti-inflammatory drug . Around a third of people experience moderate (tier two) or severe (tier three) pain, for which the WHO recommends opioid painkillers. Opioids are typically effective at easing nociceptive pain (pain caused by damage to various body tissues). Opioids are occasionally effective at easing neuropathic pain (pain caused by nerve damage). Neuropathic agents such as anticonvulsants , tricyclic antidepressants , and serotonin–norepinephrine reuptake inhibitors , are often used to ease neuropathic pain, either alone or in combination with opioids. In many cases, targeted radiotherapy can be used to shrink tumors, reducing pain and other symptoms caused by tumor growth. Individuals who have advanced disease and are approaching end-of-life can benefit from dedicated end-of-life care to manage symptoms and ease suffering. As in earlier disease, pain and difficulty breathing are common, and can be managed with opioid pain medications, transitioning from oral medication to injected medication if

14260-529: The tumor suppressors p53 and RB . A cluster of tumor suppressor genes on the short arm of chromosome 3 are often lost early in the development of all lung cancers. Those who smoke can reduce their lung cancer risk by quitting smoking – the risk reduction is greater the longer a person goes without smoking. Self-help programs tend to have little influence on success of smoking cessation, whereas combined counseling and pharmacotherapy improve cessation rates. The US FDA has approved antidepressant therapies and

14384-478: The tumors can be successfully treated and result in decreased mortality. There is evidence that regular low-dose CT scans in people at high risk of developing lung cancer reduces total lung cancer deaths by as much as 20%. Despite evidence of benefit in these populations, potential harms of screening include the potential for a person to have a 'false positive' screening result that may lead to unnecessary testing, invasive procedures, and distress. Although rare, there

14508-417: The type of cells the tumor is derived from; tumors derived from different cells progress and respond to treatment differently. There are two main types of lung cancer, categorized by the size and appearance of the malignant cells seen by a histopathologist under a microscope : small cell lung cancer (SCLC; 15% of cases) and non-small-cell lung cancer (NSCLC; 85% of cases). SCLC tumors are often found near

14632-453: Was a rare disease. In the 1950s and 1960s, increasing evidence linked lung cancer and tobacco use, culminating in declarations by most large national health bodies discouraging tobacco use. Early lung cancer often has no symptoms. When symptoms do arise they are often nonspecific respiratory problems – coughing , shortness of breath , or chest pain – that can differ from person to person. Those who experience coughing tend to report either

14756-553: Was an Objectivist bimonthly journal published from February 1980 through December 1987. Rand helped establish it and served as its philosophic consultant until her death in 1982. Harry Binswanger was publisher and editor; Peikoff served as consulting editor. The Objective Standard is a quarterly journal on culture and politics founded by Craig Biddle and Sidney J. Gunst Jr. in 2006, which describes itself as providing "commentary from an Objectivist perspective." Biddle serves as editor for The Objective Standard . Several fellows from

14880-470: Was established by the Medical Society of Edinburgh as the first fully peer-reviewed journal. Peer review was introduced as an attempt to increase the quality and pertinence of submissions. Other important events in the history of academic journals include the establishment of Nature (1869) and Science (1880), the establishment of Postmodern Culture in 1990 as the first online-only journal ,

15004-575: Was founded in 1979 by Peter Schwartz . It was subsequently edited by Robert Stubblefield (1991–1996) and then by Robert Tracinski. From 1985 onward, TIA was aligned with the Ayn Rand Institute , but in 2005 Tracinski stopped working for the institute, citing internal disputes about political issues as one of his reasons. TIA ceased publishing as a print issue and published only as an online newsletter called TIA Daily . In 2012, Tracinski changed its name to The Tracinski Letter . The Objectivist Forum

15128-495: Was publisher and editor (sometimes co-editor) for three different periodicals: The Objectivist Newsletter , The Objectivist , and The Ayn Rand Letter . In addition to editing, Rand wrote many articles for these publications. The first Objectivist periodical was The Objectivist Newsletter , a four-page newsletter that began publishing in January 1962. The newsletter was co-published by Ayn Rand and Nathaniel Branden and grew out of

15252-496: Was supposed to be published to fulfill that goal, but never was. Humanist scholar Denis de Sallo (under the pseudonym "Sieur de Hédouville") and printer Jean Cusson took Mazerai's idea, and obtained a royal privilege from King Louis XIV on 8 August 1664 to establish the Journal des sçavans . The journal's first issue was published on 5 January 1665. It was aimed at people of letters , and had four main objectives: Soon after,

15376-488: Was the last periodical that Rand edited, although she did serve as an adviser to The Objectivist Forum when that magazine began in 1980. The articles from Rand's three periodicals did not appear only in their respective pages. They were frequently reprinted as pamphlets. Initially these were sold by the NBI Book Service, an affiliate of the Nathaniel Branden Institute . When NBI and its affiliates were closed in 1968,

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