How is rebellion portrayed in Frankenstein?

Rebellion is portrayed as a pretty powerful tool in Frankenstein. The monster's "father," Victor, is a negligent and selfish parent.  He created a (humanish) being and then abandoned it to fend for itself, providing it with no knowledge or resources or instruction.  Victor gave no thought to what his "son's" life would be like; he only thought about his own glory and achievement. As a result, this being resented his creator, his parent, and when he grew up enough to understand how he should have been provided for, he rebelled against this parent in anger, killing his creator's brother, and requesting the one thing that could make him less miserable: a companion. 

Ultimately, having been denied every opportunity for happiness by his creator, this creature rebelled further and made every attempt to render his parent as miserable as he felt himself to be. He succeeds in this, although, even at the end of his life, his creator never fully understands how he failed in his responsibility as a parent.

Is it better to be sporty or academic? And why?

The short answer is, it depends! The world needs both good athletes and good academics, and choosing to emphasize one over the other is a personal choice. However, aspects of both physical activity (sport) and intellectual activity (academics) are imperative to a balanced and healthy life.

There are great health benefits to being sporty, or active, even if you aren't good at it. Physical activity wards off a number of chronic health problems, such as cardiovascular disease and Type 2 diabetes. It also increases endorphins and blood serotonin levels, which helps with mood elevation. If one chooses to become a professional athlete, the physical demands are intense, but the rewards can be well worth the sacrifice.

The same is true of academia. Even if you choose not to pursue a college education or any schooling beyond high school, the United States requires a certain level of education for its citizens for two major reasons: it is good for the student, and it is good for society. There are some things that everyone should know, like how to read and write, and do basic math. These things (and probably others) are necessary to getting along in the world. Education is good for society as well because it prepares students for the workforce and enables them to live productively. Higher academia can be a fulfilling vocation as well.

Therefore, whether you choose to emphasize sports or academics in your life is a very personal choice, but a minimal level of both activities is necessary for a good life.

Which is one of the largest metropolitan areas in the world?

All but one of the top ten largest metropolitan areas in the world are located in the continent of Asia.  The only city which is not located in Asia is New York City in the United States.

Tokyo, Japan, has the largest metropolitan area in the world.  The area includes over five thousand square miles.  The population of the metro area is almost forty million people.  

Jakarta, Indonesia, is the second largest metropolitan area in the world.  The population is just over thirty million people.  Delhi, India, is the third largest metropolitan area in the world.  The population of the metro area is approximately twenty-five million people.

Asian cities and metropolitan areas are structured differently than those in many other regions.  High rise apartment complexes and condominiums are characteristic of large Asian cities.  These types of buildings allow for more people to live per square mile. 

What is veterinary oncology?

Subspecialties: Veterinary oncology is divided into two specialties: veterinary medical oncology and veterinary radiation oncology. Medical oncologists are diplomates of the American College of Veterinary Internal Medicine. Radiation oncologists are diplomates of the American College of Veterinary Radiology. An unofficial specialty is surgical oncology. There is no diplomate status in this field, but these veterinarians are trained in special surgical procedures and techniques to remove cancerous tissue from animals (mostly dogs and cats).

Cancers treated: The increase in life expectancy in companion animals due to vaccines, antiparasitic medications, and general improvements in health care has resulted in increased cancer incidence associated with advanced age. Some cancers are more prevalent in certain species and more responsive to treatment than in others.

One of the most common blood cancers in all domestic animals is lymphoma (lymphosarcoma), which is comparable to non-Hodgkin lymphoma in people. In dogs, the incidence rate varies depending on the breed, with Airedales, basset hounds, boxers, bulldogs, bullmastiffs, golden retrievers, Saint Bernards, and Scottish terriers believed to be among the most susceptible and dachshunds and Pomeranians among the least. Incidence is estimated to be about 0.1 percent in susceptible breeds, making it is the most common blood cancer in this species. This disease can generally be managed for a few years, if caught early, but not cured.

Lymphoma is even more prevalent in cats than in dogs or people, accounting for about 90 percent of feline blood cancers and 33 percent of all feline tumors, and is believed to be associated with the feline leukemia virus (FeLV) and the feline immunodeficiency virus (FIV). Since the late 1990s, the use of the FeLV vaccine has lowered the incidence of certain forms of lymphoma in cats. However, feline lymphoma is generally less responsive to treatment than the canine variety.

Mast cell tumors are among the most common canine cancers; they are most often found on the skin and are the most common skin malignancy in dogs. Certain breeds, such as boxers, bulldogs, and Boston terriers, have shown increased incidence of this disease, which is amenable to treatment if caught early. An internal form of the disease is less responsive to treatment.

Other veterinary cancers treated include hemangiosarcoma, which is a very aggressive tumor of endothelial origin that affects the blood vessels and is seen mainly in dogs, most commonly in the heart, skin, or spleen. Higher prevalence has been noted in German shepherds, golden retrievers, and poodles, among others. This condition generally has a very poor prognosis, despite treatment.

Another cancer with a very poor prognosis is vaccine-associated feline sarcoma. This is an unusually aggressive, but relatively rare, sarcoma that is believed to be promoted by inflammation accompanying the administration of certain vaccines and possibly other injected medications in cats. It has proven to be unresponsive to most treatment modalities, including surgery, and the location of the growth is a key prognostic factor. Vaccination-site guidelines issued by the American Association of Feline Practitioners (AAFP) have decreased the likelihood that an inoperable growth will develop on the trunk. If an aggressive sarcoma develops on the leg, the limb can be amputated, increasing the chance of a cure.

Another aggressive cancer, osteosarcoma, occurs primarily in large-breed dogs. It is also most successfully treated with surgery, generally amputation of the affected limb, but it is difficult to catch before it metastasizes, usually to the lungs.

Mammary cell tumors are the most common neoplasia in female dogs and are third after skin tumors and lymphoma in cats. About 40 to 50 percent of canine mammary tumors are benign, while about 80 to 90 percent of feline mammary tumors are malignant. The best treatment for dogs is prevention, since spaying before the first heat virtually eliminates the risk of development of this tumor. Treating cats with progestin drugs increases their risk of developing mammary cancer. Complete surgical resection offers the best chance of a cure in dogs, while in cats the disease has usually metastasized to the lungs by the time of diagnosis.

Other cancers commonly treated by veterinary oncologists are bladder cancers (transitional cell carcinoma most commonly), prostate cancer (dogs are the only nonhuman species with a significant occurrence of this neoplasia), melanomas, oral and cutaneous squamous cell carcinoma (common in cats), transmissible venereal tumors, and various other sarcomas, carcinomas, and round-cell tumors in cats, dogs, and other species.

Training and certification: For medical oncology, candidates for certification and diplomate status must apply for membership in the American College of Veterinary Internal Medicine (ACVIM). The college requires these candidates to be graduates of an accredited or approved veterinary school, licensed to practice veterinary medicine in a state, province, or other country; to be in satisfactory moral and ethical standing; and to pass both the general medicine and oncology certification examinations.

The general exam for medical oncology consists of two parts: comprehensive, which tests knowledge of general medicine common to all species, and a more specialized section oriented toward the individual’s field of interest that is, small animals (mostly dogs and cats) or large animals (mostly horses and ruminant species). To take the general exam, qualified veterinarians must have completed an approved one-year internship (or equivalent) in either small- or large-animal medicine and surgery and a two-year residency in veterinary oncology under the direct supervision of a diplomate of the ACVIM. To take the certification exam in veterinary medical oncology, veterinarians must additionally submit a letter from the supervisor of their oncology training program, other letters of recommendation, a case log, and publications.

For radiation oncology, a candidate for certification must be a graduate of an accredited or approved veterinary school, maintain proper ethical and moral standing, be licensed to practice veterinary medicine and surgery in one or more states, and have completed a one-year internship in either small- or large-animal medicine and surgery. The candidate must also have successfully completed a program in veterinary radiation oncology approved by the executive council of the American College of Veterinary Radiology (ACVR). Additionally, the candidate must have completed a two-year residency training program in veterinary oncology, submit references, and pass the written and oral exams in general and radiation oncology. The written exam tests the candidate’s knowledge of general veterinary oncology, radiation physics and dose calculations, radiation biology, and clinical aspects of radiation oncology.

Surgical oncologists are diplomates of the American College of Veterinary Surgeons (ACVS). The unofficial designation of “surgical oncologist” follows successful completion of a fellowship in surgical excision of tumors and cancerous tissue from animals.

Services and procedures performed: Veterinary oncologists diagnose, stage, and plan treatment strategies for their animal patients. Most of the time, they are not expecting or planning a cure for the malignant or metastatic conditions. Rather, they are looking to effect a remission or control the tumor’s growth to provide a good quality of life for the animal. Generally, extremely toxic treatment modalities are avoided in animals because of their shorter life spans, high costs, inconvenience to owners (traveling to distant treatment centers, caring for a sick pet, and so on), and the fact that animals primarily live in the moment and cannot rationalize discomfort.

For diagnosis and staging, veterinary oncologists examine blood work (complete blood count, blood chemistries); employ various imaging modalities, depending on need, availability, and cost (x-rays, magnetic resonance imaging, computed tomography); and analyze the results of biopsies, cytologies, and bone-marrow aspirates. For some conditions, such as mast cell tumors, the cancer cells are graded by a histopathologist. Not all tests are conducted in all animals. Staging is an extremely important part of planning the treatment process and forming a prognosis. Once this is completed, the veterinary oncologist will often work with a surgeon if the tumor is resectable.

If the cancer has metastasized or spread to distant lymph nodes, most medical oncologists will plan adjunctive chemotherapy. Chemotherapy is also prescribed for diffuse cancers, such as lymphoma, that are not amenable to surgical intervention. Growths that cannot be resected or can be only partially resected are often treated with local radiation therapy directed by a radiation oncologist. Some veterinary referral or academic centers offer their own orthovoltage or megavoltage (linear accelerator, cobalt, or cesium) units. However, others outsource these therapies to human cancer treatment clinics that work directly with the veterinary oncologist. Other forms of radiotherapy, such as brachytherapy or systemic radiotherapy (offered for thyroid tumors in cats) are also offered to veterinary patients.

Animal oncology employs just about every chemotherapeutic agent used for human chemotherapy, and specially trained veterinary nurses often administer the drugs under the direct supervision of the oncologist. The veterinary oncologist can also offer therapy for pain and the side effects of treatment, such as nausea and vomiting following chemotherapy, or oral mucositis following radiation therapy. The oncologist follows the animal’s progress over the course of treatment and modifies the protocol in the event of complications such as severe bone marrow suppression. The veterinary oncologist should ultimately provide a good idea of the animal’s prognosis and help the client make informed decisions about treatment options while considering costs and quality of life for the animal and owner.

Related specialties and subspecialties: Veterinary oncologists and clients work closely with practitioners in the fields of veterinary pathology, veterinary clinical pathology, veterinary dermatology, veterinary emergency and critical care, veterinary small-animal internal medicine, veterinary large-animal internal medicine, and veterinary surgery for the treatment and diagnosis of neoplastic conditions.

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Downing, Robin. Pets Living with Cancer: A Pet Owner’s Resource. Lakewood: AAHA, 2000. Print.

Eldredge, Debra, and Margaret H. Bonham. Cancer and Your Pet: The Complete Guide to the Latest Research, Treatments, and Options. Herndon: Capital, 2005. Print.

Elmslie, Robyn. "The Controversy Surrounding the Melanoma Vaccine for Dogs." Veterinary Cancer Specialists. Veterinary Cancer Specialists, 31 Jan. 2014. Web. 29 Jan. 2015.

Ettinger, Stephen J., and Edward C. Feldman, eds. Textbook of Veterinary Internal Medicine. 7th ed. 2 vols. Saint Louis: Saunders, 2010. Print.

"Lymphoma in Cats." PetMD. PetMD, n.d. Web. 29 Jan. 2015.

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What is macular degeneration?

Causes and Symptoms

The macula is located in the center of the retina, the light-sensitive tissue at the back of the eye. The retina instantly converts light, or an image, into electrical impulses. The retina then sends these impulses, or nerve signals, to the brain. One of the earliest signs of age-related macular degeneration (ARMD) seen by physicians during a dilated eye examination is deposits of tiny, bright yellow material called drusen, which is harder as a result of aging or softer and larger if associated with ARMD and vision loss. As parts of the eye in the retina and choroid become thinner or lose tissue, central vision and/or peripheral vision is affected, depending on the area of damage. Central vision is needed to see clearly and to perform everyday activities such as reading, writing, driving, and recognizing people and things.
Peripheral vision, needed for walking, is much less commonly affected.

There are two forms of ARMD: early and advanced. About 90 percent of cases are early ARMD, although the advanced type affects 7 percent of those seventy-five years or older. Advanced ARMD is further categorized into two distinct types based on their clinical features: dry and wet. The dry form involves thinning of the macular tissues and disturbances in its pigmentation. About 70 percent of patients have the dry form. The remaining 30 percent have the wet form, which can involve bleeding within and beneath the retina, opaque deposits, and eventually scar tissue. The wet form accounts for 90 percent of all cases of legal blindness
in macular degeneration patients.

Neither dry nor wet macular degeneration causes pain. The most common early sign of dry macular degeneration is blurring vision
that prevents people from seeing details clearly that are in front of them, such as faces or words in a book. In the early stages of wet macular degeneration, straight lines appear wavy or crooked. This is the result of fluid leaking from blood vessels and lifting the macula, distorting vision.

A number of risk factors can affect the initial development of ARMD: age, smoking, genetic predisposition, and ethnicity. Two risk factors have also been studied and suggested in causing a progression of ARMD: nutrition and high blood pressure. Age is the most important risk factor for macular degeneration: The older the patient, the higher the risk. Studies have shown that having a family with a history of macular degeneration raises the risk factor. Because macular degeneration affects most patients later in life, however, it has proven difficult to study cases in successive generations of a family. Heavy smoking, at least a pack of cigarettes a day, can double a person’s risk of developing ARMD. The more a person smokes, the higher the risk of macular degeneration. Moreover, the adverse effects of smoking persist, even fifteen to twenty years after quitting. Those with a family history of ARMD are more likely to develop the disease due to a genetic mutation of part of a gene called the complement factor H gene. With a family history of the disease, the risk is greater for developing the wet type than the dry type of ARMD. Studies have shown that non-Hispanic Caucasians have a greater risk of developing ARMD than do African Americans or Hispanics.

Poor dietary habits contribute to ARMD as well. A diet high in saturated fats may clog the vessels leading to the eyes, thus reducing the flow of nutrient-rich blood. Excess fat may deposit itself directly in the membrane behind the retina. In this case, nutrients might not be able to reach the cells that nourish the retina. High blood pressure has also been shown to increase the risk of developing ARMD in the second eye in those having ARMD in one eye.

An effective test to determine if a person has wet macular degeneration is fluorescent angiography. A special dye is injected into a vein in the patient’s arm and then flows to the blood vessels in the eye. Photographs are taken of the retina. The dye highlights any problems in the blood vessels and allows the doctor to determine if they can be treated. Annual eye examinations that include dilation of the pupils are also useful in early detection. Early detection is important because a person destined to develop macular degeneration can sometimes be treated before symptoms appear, which may delay or reduce the severity of the disease. Anyone who notices a change in vision should contact an ophthalmologist immediately.

Treatment and Therapy

New and exciting treatments are in development for ARMD as extensive research is being done. Currently, there is no cure, and no treatment recommendations exist for those with dry type ARMD, the type that is much less threatening to vision. Some treatments, however, can slow the progression of wet type ARMD. Research has shown that stopping smoking is the most effective preventive measure in regard to developing ARMD and slowing its progression.

Antioxidants have proved promising in recent studies which show that they can lower the risk of progression to more advanced ARMD in those who have moderate or advanced disease. In a major clinical trial called the Age-Related Disease Study (AREDS), it was shown that patients with moderate or severe ARMD taking antioxidants vitamin C, vitamin E, and beta carotene plus zinc and copper had a lower risk of progression among both nonsmokers and smokers. Since the group of smokers who took zinc alone had the same lowered risk of progression as those smokers taking antioxidants plus zinc and copper, it was recommended that smokers with ARMD take zinc alone, as some antioxidants have shown to increase the risk of lung cancer and coronary heart disease when used at high doses.

Although no treatments can reverse the actual pathologic process of the disease of wet type ARMD, some treatments used by ophthalmologists are aimed at containing the damaged vessels that cause the loss of vision. They include laser photocoagulation, photodynamic therapy, intravitreous injections, and, as a last resort, macular translocation surgery.

Laser photocoagulation involves using a high-intensity thermal laser to burn off the blood supply to abnormal choroidal membranes. The benefits of this treatment are that it is done in the outpatient setting using only topical anesthetic drops and that it prevents the formation of new abnormal vessels associated with ARMD for two or three years. It is limited, however, to only those patients with well-defined abnormal areas (only about 15 percent of patients with ARMD). It cannot restore lost vision and may actually destroy normal retinal tissue along with the neovascular formation that is targeted.

Photodynamic therapy involves the injection of a dye called verteporfin which, when activated by a photo laser, forms substances that destroy the abnormal newly formed vessels associated with wet type ARMD. Thus, by the use of this dye and laser combination, the normal vessels are protected and the abnormal vessels are destroyed. It has also been shown that this treatment can be repeated safely.

The vascular endothelial growth factor (VEGF) inhibitors are a class of agents that block a factor involved in the disease process of ARMD. VEGF is essential for the formation of the new abnormal vessels that cause the loss of vision and the anatomic destruction associated with ARMD. The VEGF inhibitors block this factor, thereby limiting those destructive effects. Studies involving these agents have shown that a majority of patients showed improvement in their vision and marked anatomic improvement of their retinas.

Macular translocation surgery involves surgically removing the macula from a diseased area and attaching it to a healthier area of the retina. Although currently an experimental therapy and not well studied, it can be used for those patients in which no other treatment options are left. If performed successfully, macular translocation surgery can improve central vision and allow a majority of patients to read. Great risks are associated with this type of treatment, however, including detachment of the retina and the development of double vision. In addition, use of a steroid injection into the vitreous and/or the posterior sub-Tenon’s space has shown short-term improvement in vision.

Many visual aids have been developed for patients with ARMD to make the most of their remaining vision, including magnifying glasses, powerful special lenses, and large-print books and reading materials. Voice synthesizers in electronic devices such as calculators, clocks, and phones are also very helpful. Maximizing room lighting by the use of stronger lights, opening windows, and painting walls brighter colors can help patients see better at home.

Perspective and Prospects

Blindness or low vision affects 2.6 million Americans aged forty and over, according to the National Eye Institute. This figure is projected to reach 7.1 million by the year 2030 and 13 million by 2050. The study reports that low vision and blindness increase significantly with age, particularly in people over age sixty-five. People eighty years of age and older account for 67 percent of blindness. ARMD affects about 15 percent of the US population by age fifty-five and more than 30 percent by age seventy-five. It is the most common cause of legal blindness in people over the age of fifty-five.

Although there is no cure for ARMD, many treatments are available to curtail progression of the disease. As extensive research continues in this area, advances in the diagnosis and treatment of this debilitating condition are anticipated by many in the field of ophthalmology. Currently, the National Eye Institute is studying the possibility of transplanting healthy cells into a diseased retina, evaluating families with a history of ARMD to understand genetic and hereditary factors that may cause the disease, and looking at certain anti-inflammatory treatments for the wet form of ARMD.

Bibliography

American Macular Degeneration Foundation. http://www.macular.org.

D’Amato, Robert, and Joan Snyder. Macular Degeneration: The Latest Scientific Discoveries and Treatments for Preserving Your Sight. New York: Walker, 2000.

Heier, Jeffrey S. One Hundred Questions and Answers About Macular Degeneration. Sudbury, Mass.: Jones and Bartlett, 2011.

Ho Allen C., and Carl D. Regillo. Age-Related Macular Degeneration Diagnosis and Treatment. New York: Springer, 2011.
Kansai, Jack. Diseases of the Macula. New York: Elsevier, 2002.

Macular Degeneration Foundation. http://www.eye sight.org.

MayoClinic.com. “Macular Degeneration.” http://www.mayoclinic.com/health/macular-degeneration/DS00284.

Samuel, Michael A. Macular Degeneration: A Complete Guide for Patients and Their Families. Laguna Beach, Calif.: Basic Health, 2008.

Sardegna, Jill, et al. The Encyclopedia of Blindness and Vision Impairment. 2d ed. New York: Facts On File, 2002.

Sutton, Amy L., ed. Eye Care Sourcebook: Basic Consumer Health Information About Eye Care and Eye Disorders. 3d ed. Detroit, Mich.: Omnigraphics, 2008.

In "The Sniper" what are some text examples that indicate the title character feels remorse?

Throughout the beginning of Liam O'Flaherty's short story "The Sniper" the title character is portrayed as dispassionate and a brutally efficient killing machine. He is a "fanatic" who apparently has no feelings for the enemies he kills. He even kills a civilian woman without the slightest hesitation. During his cat and mouse game with the Free State sniper he retains his composure even after being wounded. He devises a plan to draw his enemy into the open, and when it works, he coldly kills the man with his revolver from fifty yards. It is as he sees the body falling to the street below that he is struck with horror and remorse in the face of death. O'Flaherty writes,

The lust of battle died in him. He became bitten by remorse. The sweat stood out in beads on his forehead. Weakened by his wound and the long summer day of fasting and watching on the roof, he revolted from the sight of the shattered mass of his dead enemy. His teeth chattered, he began to gibber to himself, cursing the war, cursing himself, cursing everybody.

After throwing the revolver to the ground and it firing accidentally, the sniper is brought back to his senses: "The cloud of fear scattered from his mind and he laughed." When he gets to the street he cannot resist taking a look at the enemy sniper and has to avoid machine gun fire to do so. He then discovers that it was his brother. O'Flaherty ends the story here, but, judging by his earlier bout of regret, the reader must assume that he would feel even more remorse at realizing the ultimate horror of war. 

On what page of Fitzgerald's The Great Gatsby does Tom tell Wilson that Gatsby was the one who killed Myrtle?

We do not have a page number for this because we do not see the scene in which Tom tells Wilson who was driving the car, or at least, who he thinks was driving the car.  We learn from Nick almost at the end of the story that Tom told Wilson when Nick asks him directly.  He claims that Wilson came to their house while they were preparing to leave and threatened to force his way in. He had a gun. It is at this point that he told Wilson that it was Gatsby's car.  Speaking of Gatsby, he says, "'That fellow had it coming to him.... He ran over Myrtle like you'd run over a dog...'" (187).  In spite of Tom's responsibility in all of this, Nick shakes hands with him, realizing that Tom and Daisy and their kind were not capable of being any other than what they were, so it was pointless to try to change them. It is very shortly after this that Nick leaves to go back to the midwest, a sadder but wiser man.