Genetic Background of Patients from a University Medical Center in Manhattan: Implications for Personalized Medicine

Background: The rapid progress currently being made in genomic science has created interest in potential clinical applications; however, formal translational research has been limited thus far. Studies of population genetics have demonstrated substantial variation in allele frequencies and haplotype structure at loci of medical relevance and the genetic background of patient cohorts may often be complex. Methods and Findings: To describe the heterogeneity in an unselected clinical sample we used the Affymetrix 6.0 gene array chip to genotype self-identified European Americans (N = 326), African Americans (N = 324) and Hispanics (N = 327) from the medical practice of Mount Sinai Medical Center in Manhattan, NY. Additional data from US minority groups and Brazil were used for external comparison. Substantial variation in ancestral origin was observed for both African Americans and Hispanics; data from the latter group overlapped with both Mexican Americans and Brazilians in the external data sets. A pooled analysis of the African Americans and Hispanics from NY demonstrated a broad continuum of ancestral origin making classification by race/ethnicity uninformative. Selected loci harboring variants associated with medical traits and drug response confirmed substantial within-and between-group heterogeneity. Conclusion: As a consequence of these complementary levels of heterogeneity group labels offered no guidance at the individual level. These findings demonstrate the complexity involved in clinical translation of the results from genome-wide association studies and suggest that in the genomic era conventional racial/ethnic labels are of little value.

Starting treatment: caring for patients and their families

The standards presented in this section focus on providing physical, social and psychological care for the patient at the point he or she is diagnosed with tuberculosis (TB) and starts treatment. Detailed guidance is included with regard to organising directly observed treatment (DOT) safely and acceptably for both the patient and the management unit. The aim is to give the patient the best possible chance of successfully completing treatment according to a regimen recommended by the World Health Organization. If the health service where the patient is diagnosed cannot offer ongoing treatment and care due to a lack of facilities, overcrowding or inaccessibility, the patient needs to be referred to a designated TB management unit (BMU) elsewhere. The patient may also receive treatment from a facility outside a BMU. However care is organised, it is essential for all patients who are diagnosed with TB to be registered at an appropriate BMU so that their progress can be routinely monitored and programme performance can be assessed. To avoid the risk of losing contact with the patient at any stage of their care, good communication is essential between all parties involved, from the patient him/herself to the person supervising their DOT to the BMU.

Identifying an active case of tuberculosis

The best practice standards set out in chapter 2 of the Best Practice guide focus on the various aspects of identifying an active case of TB and aim to address some of the challenges associated with case detection. The importance of developing a good relationship with the patient from the start, when he or she is often most vulnerable, is emphasised. The first standard focuses on the assessment of someone who might have TB and the second gives detailed guidance about the collection of sputum for diagnosis. The standards are aimed at the health care worker, who assesses the patient when he or she presents at a health care facility and therefore needs to be familiar with the signs, symptoms and risk factors associated with TB. Having suspected TB, the health care worker then needs to ensure that the correct tests are ordered and procedures are followed so that the best quality samples possible are sent to the laboratory and all documentation is filled out clearly and correctly. The successful implementation of these standards can be measured by the accurate and prompt reporting of results, the registration of every case detected and the continued attendance of every patient who needs treatment.

Glulam beams reinforced with FRP externally-bonded: theoretical and experimental evaluation

The glued- laminated lumber (glulam) technique is an efficient process for the rational use of wood. Fiber-reinforced polymer (FRPs) associated with glulam beams provide significant improvements in strength and stiffness and alter the failure mode of these structural elements. In this context, this paper presents guidance for glulam beam production, an experimental analysis of glulam beams made of Pinus caribea var. hondurensis species without and with externally-bonded FRP and theoretical models to evaluate reinforced glulam beams (bending strength and stiffness). Concerning the bending strength of the beams, this paper aims only to analyze the limit state of ultimate strength in compression and tension. A specific disposal was used in order to avoid lateral buckling, once the tested beams have a higher ratio height-to-width. The results indicate the need of production control so as to guarantee a higher efficiency of the glulam beams. The FRP introduced in the tensile section of glulam beams resulted in improvements on their bending strength and stiffness due to the reinforcement thickness increase. During the beams testing, two failure stages were observed. The first was a tensile failure on the sheet positioned under the reinforcement layer, while the second occurred as a result of a preliminary compression yielding on the upper side of the lumber, followed by both a shear failure on the fiber-lumber interface and a tensile failure in wood. The model shows a good correlation between the experimental and estimated results.

Robust Control of Flight Simulator Motion Base

The purpose of this study is to apply robust inverse dynamics control for a six-degree-of-freedom flight simulator motion system. From an implementation viewpoint, simplification of the inverse dynamics control law is introduced by assuming control law matrices as constants. The robust control strategy is applied in the outer loop of the inverse dynamic control to counteract the effects of imperfect compensation due this simplification. The control strategy is designed using the Lyapunov stability theory. Forward and inverse kinematics and a full dynamic model of a six-degree-of-freedom motion base driven by electromechanical actuators are briefly presented. A describing function, acceleration step response and some maneuvers computed from the washout filter were used to evaluate the performance of the controllers.

Learning about knowledge management for improving environmental impact assessment in a government agency: The Western Australian experience

How does knowledge management (KM) by a government agency responsible for environmental impact assessment (EIA) potentially contribute to better environmental assessment and management practice? Staff members at government agencies in charge of the EIA process are knowledge workers who perform judgement-oriented tasks highly reliant on individual expertise, but also grounded on the agency`s knowledge accumulated over the years. Part of an agency`s knowledge can be codified and stored in an organizational memory, but is subject to decay or loss if not properly managed. The EIA agency operating in Western Australia was used as a case study. Its KM initiatives were reviewed, knowledge repositories were identified and staff surveyed to gauge the utilisation and effectiveness of such repositories in enabling them to perform EIA tasks. Key elements of KM are the preparation of substantive guidance and spatial information management. It was found that treatment of cumulative impacts on the environment is very limited and information derived from project follow-up is not properly captured and stored, thus not used to create new knowledge and to improve practice and effectiveness. Other opportunities for improving organizational learning include the use of after-action reviews. The learning about knowledge management in EIA practice gained from Western Australian experience should be of value to agencies worldwide seeking to understand where best to direct their resources for their own knowledge repositories and environmental management practice. (C) 2011 Elsevier Ltd. All rights reserved.

Planejamento para o fechamento prematuro de minas

Several mining companies operating in Brazil have been preparing mine closure plans describing end of life actions to ensure long term physical stability, land rehabilitation and, to a certain extent, socioeconomic measures. Most Brazilian and international guidelines, however, skip early closure and only feature guidance to closure planning after reserve depletion. In this paper, two cases of early closure in Australia are reviewed, causes for early closure are explored, criteria to evaluate preparedness to early mine closure are proposed and tested in two mines. It concludes that, despite recent advances, planning for mine closure seldom take account of early closure risks.

Sustainability certification of bioethanol: how is it perceived by Brazilian stakeholders?

This paper investigates whether initiatives for sustainability certification of Brazilian ethanol can be expected to stimulate a change among producers toward more sustainable production - and, if so, what those changes would likely be. Connected to this, several questions are raised including whether producers might prefer to target other markets with less stringent demands, and if certification might lead to structural changes in the sector because producers who lack the capacity to meet the new requirements cannot remain competitive. The analysis of interviews with a diverse group of stakeholders under the guidance of the Technological Innovation Systems framework allowed us identify different actions taken by the Brazilian sugarcane ethanol sector in response to requirements of sustainability. The interviewees agreed that sustainability certification is an important element for the expansion of biofuel production in Brazil. Brazilian stakeholders have created a platform for more competitive sustainable production and have initiated relevant processes in response to the development connected to sustainability certification. Yet, the certification activities have had a limited impact in terms of the number of involved stakeholders. But interview responses indicate that the sector may adapt to new certification requirements rather than leave markets where such requirements become established. Structural changes can be expected if certification requirements as they exist in many initiatives are introduced in unflexible ways. The social importance of the ethanol industry is large in Brazil and some adjustments for certification may be required. The paper concludes by suggesting some actions for the industry. (C) 2010 Society of Chemical Industry and John Wiley & Sons, Ltd

Letters and cities: reading the urban environment with the help of perception theories

When wandering around a city such as Sao Paulo, we are surrounded by letters, numbers and symbols. These elements form part of an environment full of signs in many shapes and sizes that compete for our attention. Our perception of these elements contributes towards our spatial guidance and sense of place. The idea of `reading` the city, or urban environment, was introduced by Kevin Lynch, for whom reading the urban structure follows on from recognizing or identifying its numerous visual elements, not necessarily verbal ones. Beginning with a brief bibliographic review of perception theories, this article combines concepts from environmental psychology with concerns brought up by the fields of information design and epigraphy studies, setting out the basis of a methodological proposal for the study of typography and lettering in the urban environment.

Deconstructing sport history: The postmodern challenge

The crisis in the historical profession today is both conceptual and political, both methodological and practical. To the crises of the decline of great narrative history for the popular audience, the multiculturalist challenge to Eurocentric history, and the loss of faith in grand themes of progress and liberation that provided moral and political guidance through history’s lessons, must be added the crisis created by the implications of literary and rhetorical theory for the very practice of history itself.

Undergraduate teaching of ideal and real fluid flows: The value of real-world experimental projects

This study describes the pedagogical impact of real-world experimental projects undertaken as part of an advanced undergraduate Fluid Mechanics subject at an Australian university. The projects have been organised to complement traditional lectures and introduce students to the challenges of professional design, physical modelling, data collection and analysis. The physical model studies combine experimental, analytical and numerical work in order to develop students’ abilities to tackle real-world problems. A first study illustrates the differences between ideal and real fluid flow force predictions based upon model tests of buildings in a large size wind tunnel used for research and professional testing. A second study introduces the complexity arising from unsteady non-uniform wave loading on a sheltered pile. The teaching initiative is supported by feedback from undergraduate students. The pedagogy of the course and projects is discussed with reference to experiential, project-based and collaborative learning. The practical work complements traditional lectures and tutorials, and provides opportunities which cannot be learnt in the classroom, real or virtual. Student feedback demonstrates a strong interest for the project phases of the course. This was associated with greater motivation for the course, leading in turn to lower failure rates. In terms of learning outcomes, the primary aim is to enable students to deliver a professional report as the final product, where physical model data are compared to ideal-fluid flow calculations and real-fluid flow analyses. Thus the students are exposed to a professional design approach involving a high level of expertise in fluid mechanics, with sufficient academic guidance to achieve carefully defined learning goals, while retaining sufficient flexibility for students to construct there own learning goals. The overall pedagogy is a blend of problem-based and project-based learning, which reflects academic research and professional practice. The assessment is a mix of peer-assessed oral presentations and written reports that aims to maximise student reflection and development. Student feedback indicated a strong motivation for courses that include a well-designed project component.

Glow worms as a tourist attraction in Springbrook National Park: Visitor attitudes and economic issues

nsect-based tourism mainly caters to a niche market, but its popularity has been growing in recent years. Despite its popularity this form of tourism has remained under-researched and in a sense its contribution to the tourism industry has gone mostly unnoticed. This paper reports the results of a study undertaken on one form of popular insect-based tourism, namely glow worms. The study was undertaken in Springbrook National Park (Natural Bridge section) southeast Queensland, which has one of the largest glow worm colonies in Australia that attracts thousands of visitors each year. A study of this form of tourism is important and useful for several reasons. It is important to understand this hitherto under-studied tourism activity to determine the type of visitors, their socio-economic attributes, economic benefits to the local economy, visitors’ knowledge of glow worms, education imparted, visitor satisfaction of glow worm viewing and visitor attitudes for the introduction of a user fee system to view glow worms. An understanding of these issues could not only help to better manage this valuable biological resource, but can be used to develop the industry to cater to a growing number of visitors. Tourism in glow worms can potentially be used not only to educate the public on the threats affecting glow worms and their colonies, but could also be used to conserve them. Lessons learnt from glow worms as an attraction to Springbrook National Park can be used to better manage and further develop other existing and new glow worm sites in Australia and elsewhere for tourism. Furthermore, it could provide some guidance for the management and development of other forms of current insect-based tourism activities (eg. butterflies) and develop new tourism ventures based on species such as stick insects and jewel beetles for which Australia is well known (Reader’s Digest, 1997)

Response (re-)programming in aging: A kinematic analysis

Background. Age-related motor slowing may reflect either motor programming deficits, poorer movement execution, or mere strategic preferences for online guidance of movement. We controlled such preferences, limiting the extent to which movements could be programmed. Methods. Twenty-four young and 24 older adults performed a line drawing task that allowed movements to he prepared in advance in one case (i.e., cue initially available indicating target location) and not in another (i.e., no cue initially available as to target location). Participants connected large or small targets illuminated by light-emitting diodes upon a graphics tablet that sampled pen tip position at 200 Hz. Results. Older adults had a disproportionate difficulty initiating movement when prevented from programming in advance. Older adults produced slower, less efficient movements, particularly when prevented from programming under greater precision requirements. Conclusions. The slower movements of older adults do not simply reflect a preference for online control, as older adults have less efficient movements when forced to reprogram their movements. Age-related motor slowing kinematically resembles that seen in patients with cerebellar dysfunction.

In vivo dynamics of axon pathfinding in the Drosophila CNS: A time-lapse study of an identified motoneuron

We developed a system for time-lapse observation of identified neurons in the central nervous system (CNS) of the Drosophila embryo. Using this system, we characterize the dynamics of filopodia and axon growth of the motorneuron RP2 as it navigates anteriorly through the CNS and then laterally along the intersegmental nerve (ISN) into the periphery. We find that both axonal extension and turning occur primarily through the process of filopodial dilation. In addition, we used the GAL4-UAS system to express the fusion protein Tau-GFP in a subset of neurons, allowing us to correlate RP2's patterns of growth with a subset of axons in its environment. In particular, we show that RP2's sharp lateral turn is coincident with the nascent ISN. (C) 1998 John Wiley & Sons, Inc.