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As the IAU heads towards its second century, many changes have simultaneously transformed Astronomy and the human condition world-wide. Amid the amazing recent discoveries of exoplanets, primeval galaxies, and gravitational radiation, the human condition on Earth has become blazingly interconnected, yet beset with ever-increasing problems of over-population, pollution, and never-ending wars. Fossil-fueled global climate change has begun to yield perilous consequences. And the displacement of people from war-torn nations has reached levels not seen since World War II.
If it were not for the great variability among individuals, medicine might as well be a science, not an art.
Sir William Osler, Physician 1892
If the nineteenth century was the Industrial Age and the twentieth the Atomic Age, it seems likely that the twenty-first century will be remembered as the Genomics Age. While this may seem presumptuous given that we have yet to experience a fifth of the century, the dramatic breakthroughs in genomics, culminating in the announcement by President Obama at the 2015 State of the Union address that called for investment in a large-scale precision medicine initiative, – an initiative that garnered bipartisan support and initial funding to the tune of $200 million – would seem to make this assertion plausible if the investment pays off. The use of the term “precision medicine” perhaps suggests that Precision Medicine might be the moniker attached to the age. This will depend on how successfully genoics and other ’omics will be integrated into medicine to improve outcomes and control cost, a question that will be explored in depth later in the chapter. Given the proliferation of prophetic and provocative terms in a world where knowledge and the ways in which it might be applied are changing rapidly, we need terms that have precise and fixed meanings, ones that are not stretched to fit every twist and turn in discovery and fashion.
The first to examine is the difference between genetic and genomic. The WHO defines genetics as “the study of heredity,” while genomics is defined as “as the study of genes and their functions, and related techniques.” The distinction that is most commonly made is that genetics concerns itself with the functioning and composition of the single gene whereas genomics addresses all genes and their interrelationships. This general distinction in biology is a bit clearer when applied to medicine. The specialty of clinical genetics has emerged, been identified, and been primarily limited to the diagnosis of so-called single gene disorders, also known as Mendelian disorders as for the most part they follow the rules of inheritance elucidated by Gregor Mendel in the nineteenth century.
Objectives: Validated treatments for adults with bulimia nervosa (BN) and related presentations are scarce, and the current most evidenced treatment — cognitive behaviour therapy for eating disorders — is resource intensive and has suboptimal remission rates; there is, therefore, a need to evaluate the effectiveness of other approaches for treating such conditions in routine NHS services. Design: Data from nine patients in an NHS eating disorder service who received compassion-focused therapy (CFT) for BN or bulimic presentations were analysed retrospectively. Methods: Patients routinely completed a validated scale of eating disorder severity (the EDE-Q) at baseline and end of treatment. Results: All five scales of the EDE-Q showed a mean significant reduction (N = 9), indicating a significant reduction in eating disorder symptomatology, and individual analyses showed clinically reliable reduction in seven out of nine patients’ EDE-Q scores. Conclusions: This is the first article to report a case series of patients who benefitted significantly from receiving CFT for their eating disorder. Limitations of this study are considered along with future directions for research into effective treatments for eating disorders.
Euclid is a Europe-led cosmology space mission dedicated to a visible and near infrared survey of the entire extra-galactic sky. Its purpose is to deepen our knowledge of the dark content of our Universe. After an overview of the Euclid mission and science, this contribution describes how the community is getting organized to face the data analysis challenges, both in software development and in operational data processing matters. It ends with a more specific account of some of the main contributions of the Swiss Science Data Center (SDC-CH).
We report on the analysis of virtual powder-diffraction patterns from serial femtosecond crystallography (SFX) data collected at an X-ray free-electron laser. Different approaches to binning and normalizing these patterns are discussed with respect to the microstructural characteristics which each highlights. Analysis of SFX data from a powder of Pr0.5Ca0.5MnO3 in this way finds evidence of other trace phases in its microstructure which was not detectable in a standard powder-diffraction measurement. Furthermore, a comparison between two virtual powder pattern integration strategies is shown to yield different diffraction peak broadening, indicating sensitivity to different types of microstrain. This paper is a first step in developing new data analysis methods for microstructure characterization from serial crystallography data.
Field emission (FE) measurements are reported from carbon nanotube (CNT) fibers and laser-patterned free standing films fabricated by direct online condensation from a floating catalyst chemical vapor deposition reactor. Fiber and film cathodes showed stable emission in the 1–2 mA current (I) range at maximum cathode temperatures less than 1000 °C; film cathodes show localized heating at the triangular tips and higher maximum temperatures than the fibers. Fowler–Nordheim (FN) analysis indicated a change in the morphology of the emitters with increasing external electrical field (Eext). Fiber cathode I–Eext data are interpreted as FN emission from the fiber tip which is eventually limited by space-charge effects. At higher Eext, FN emission from the fiber sidewall occurs. The single fiber cathode stopped emitting abruptly when field induced self-heating effects became significant. For CNT films, self-heating effects can destroy a portion of the film, but FE can still occur from other areas.
Assessments of infectious disease spread in hospitals seldom account for interfacility patient sharing. This is particularly important for pathogens with prolonged incubation periods or carrier states.
We quantified patient sharing among all 32 hospitals in Orange County (OC), California, using hospital discharge data. Same-day transfers between hospitals were considered “direct” transfers, and events in which patients were shared between hospitals after an intervening stay at home or elsewhere were considered “indirect” patient-sharing events. We assessed the frequency of readmissions to another OC hospital within various time points from discharge and examined interhospital sharing of patients with Clostridium difficile infection.
In 2005, OC hospitals had 319,918 admissions. Twenty-nine percent of patients were admitted at least twice, with a median interval between discharge and readmission of 53 days. Of the patients with 2 or more admissions, 75% were admitted to more than 1 hospital. Ninety-four percent of interhospital patient sharing occurred indirectly. When we used 10 shared patients as a measure of potential interhospital exposure, 6 (19%) of 32 hospitals “exposed” more than 50% of all OC hospitals within 6 months, and 17 (53%) exposed more than 50% within 12 months. Hospitals shared 1 or more patient with a median of 28 other hospitals. When we evaluated patients with C. difficile infection, 25% were readmitted within 12 weeks; 41% were readmitted to different hospitals, and less than 30% of these readmissions were direct transfers.
In a large metropolitan county, interhospital patient sharing was a potential avenue for transmission of infectious agents. Indirect sharing with an intervening stay at home or elsewhere composed the bulk of potential exposures and occurred unbeknownst to hospitals.