Introducing First Year Medical Students to Personalized Medicine Concepts in a Small Group Activity

Presented as a Poster Presentation at 2020 IUSM Education Day.An individuals’ genetic profile is becomingly an increasingly important parameter in healthcare decisions. This small group activity was developed to introduce first year medical students in the Molecules to Cells and Tissues course to the concept and significance of Pharmacogenomics and personalized medicine. Additionally, this activity provided students with an opportunity to work with a large dataset and use the information to impact clinical decision making. This activity has two cases, takes student groups approximately 2 hours to complete, and requires internet access. Case materials are available through the learning management system Canvas, and include open-ended questions to guide students through the cases. In these cases students explore the functional significance of different alleles of a panel of cytochrome P450 genes. The group activity has the students examine a large data set of cytochrome P450 genes and cognate alleles to determine their prevalence in the local population and calculate the individuals’ gene scores. The students are then asked to explain the impact of the genotype (or gene score) on the resulting patient phenotype (i.e. the functional significance of the genotype). The first case involves a breast cancer survivor support group in which patients taking Taxol discuss lack of adequate pain relief from opioids and the potential impact of concomitant use of natural compounds/supplements on drug metabolism. The second case involves a patient presenting with recurrent stroke-like symptoms despite being on the anticoagulant medication clopidogrel. The patient is initially suspected to be non-compliant, but is later determined to be a poor metabolizer of the anticoagulant clopidogrelto its active form thus decreasing its efficacy. The expertise of the IUSM Medical Genetics research faculty was leveraged to provide a large data set of cytochrome P450 genes and cognate alleles. The selection of cytochrome P450 was based upon delivering content focused on the biochemistry of the enzyme system and provided an opportunity to highlight the drug interaction database available through IUSM Clinical Pharmacology (The FlockhartTable™ ; https://drug-interactions.medicine.iu.edu/). The addition of natural compounds was to draw students’ attention to the Natural Medicines database, which is the recommended source for evidence-based data on complementary and alternative medicine. Natural Medicines is available through the Ruth Lilly Medical Library and can be searched by substance or condition. It provides both a summary of the literature available on substances as well as the level of evidence or quality of studies done on the substance

BLITZEN: A highly integrated massively parallel machine

The architecture and VLSI design of a new massively parallel processing array chip are described. The BLITZEN processing element array chip, which contains 1.1 million transistors, serves as the basis for a highly integrated, miniaturized, high-performance, massively parallel machine that is currently under development. Each processing element has 1K bits of static RAM and performs bit-serial processing with functional elements for arithmetic, logic, and shifting

Gamma Knife Radiosurgery for Acromegaly

Acromegaly is debilitating disease occasionally refractory to surgical and medical treatment. Stereotactic radiosurgery, and in particular Gamma Knife surgery (GKS), has proven to be an effective noninvasive adjunct to traditional treatments, leading to disease remission in a substantial proportion of patients. Such remission holds the promise of eliminating the need for expensive medications, along with side effects, as well as sparing patients the damaging sequelae of uncontrolled acromegaly. Numerous studies of radiosurgical treatments for acromegaly have been carried out. These illustrate an overall remission rate over 40%. Morbidity from radiosurgery is infrequent but can include cranial nerve palsies and hypopituitarism. Overall, stereotactic radiosurgery is a promising therapy for patients with acromegaly and deserves further study to refine its role in the treatment of affected patients

Observations on the vibration of axially-tensioned elastomeric pipes conveying fluids

A study of the effect of axial tension on the vibration of a single-span elastomeric pipe clamped at both ends conveying fluid has been carried out both experimentally and theoretically. A new mathematical model using a penalty function technique and the method of kinematic correction and fictitious loads has been developed. The influence of flowing fluid and axial tension on natural frequencies and mode shapes of the system has been described using this model and compared with experimental observations. Linear and non-linear dynamic response of the harmonically excited pipe has also been investigated for varying flow velocities and initial axial tensions

Exhaust Nozzle Plume Effects on Sonic Boom Test Results for Vectored Nozzles

Reducing or eliminating the operational restrictions of supersonic aircraft over populated areas has led to extensive research at NASA. Restrictions were due to the disturbance of the sonic boom, caused by the coalescence of shock waves formed off the aircraft. Recent work has been performed to reduce the magnitude of the sonic boom N-wave generated by airplane components with a focus on shock waves caused by the exhaust nozzle plume. Previous Computational Fluid Dynamics (CFD) analysis showed how the shock wave formed at the nozzle lip interacts with the nozzle boat-tail expansion wave. An experiment was conducted in the 1- by 1-foot Supersonic Wind Tunnel (SWT) at the NASA Glenn Research Center. Results show how the shock generated at the nozzle lip affects the near field pressure signature, and thereby the potential sonic boom contribution for a nozzle at vector angles from 3 to 8 . The experiment was based on the NASA F-15 nozzle used in the Lift and Nozzle Change Effects on Tail Shock experiment, which possessed a large external boat-tail angle. In this case, the large boat-tail angle caused a dramatic expansion, which dominated the near field pressure signature. The impact of nozzle vector angle and nozzle pressure ratio are summarized

Spectral geometry, homogeneous spaces, and differential forms with finite Fourier series

Let G be a compact Lie group acting transitively on Riemannian manifolds M and N. Let p be a G equivariant Riemannian submersion from M to N. We show that a smooth differential form on N has finite Fourier series if and only if the pull back has finite Fourier series on

Time-Gated Topographic LIDAR Scene Simulation

The Digital Imaging and Remote Sensing Image Generation (DIRSIG) model has been developed at the RochesterInstitute of Technology (RIT) for over a decade. The model is an established, first-principles based scene simulationtool that has been focused on passive multi- and hyper-spectral sensing from the visible to long wave infrared (0.4 to 14 µm). Leveraging photon mapping techniques utilized by the computer graphics community, a first-principles based elastic Light Detection and Ranging (LIDAR) model was incorporated into the passive radiometry framework so that the model calculates arbitrary, time-gated radiances reaching the sensor for both the atmospheric and topographicreturns. The active LIDAR module handles a wide variety of complicated scene geometries, a diverse set of surface and participating media optical characteristics, multiple bounce and multiple scattering effects, and a flexible suite of sensormodels. This paper will present the numerical approaches employed to predict sensor reaching radiances andcomparisons with analytically predicted results. Representative data sets generated by the DIRSIG model for a topographical LIDAR will be shown. Additionally, the results from phenomenological case studies including standard terrain topography, forest canopy penetration, and camouflaged hard targets will be presented

Aerodynamic Characterization of a Modern Launch Vehicle

A modern launch vehicle is by necessity an extremely integrated design. The accurate characterization of its aerodynamic characteristics is essential to determine design loads, to design flight control laws, and to establish performance. The NASA Ares Aerodynamics Panel has been responsible for technical planning, execution, and vetting of the aerodynamic characterization of the Ares I vehicle. An aerodynamics team supporting the Panel consists of wind tunnel engineers, computational engineers, database engineers, and other analysts that address topics such as uncertainty quantification. The team resides at three NASA centers: Langley Research Center, Marshall Space Flight Center, and Ames Research Center. The Panel has developed strategies to synergistically combine both the wind tunnel efforts and the computational efforts with the goal of validating the computations. Selected examples highlight key flow physics and, where possible, the fidelity of the comparisons between wind tunnel results and the computations. Lessons learned summarize what has been gleaned during the project and can be useful for other vehicle development projects

Understanding ethical dilemmas in the military workplace factors that influence the decision to take action

This study examines ethical dilemmas in the workplace and how organizational members move to resolve these challenges. Existing research was reviewed to gain insight and determine current views of ethical dilemmas experienced at work. A study was then conducted with Supply Corps Officers in the U.S. Navy to better understand the dilemmas they face in their daily work life. Officers were asked to think of a critical incident when they faced a moral challenge and how they responded. Data procured from critical incident interviews is suggestive of how officers describe ethical dilemmas, how they identify options for action, and finally how they select a course of action. The dilemmas generally involved issues with financial accountability, fairness in performance evaluations, fraternization, homosexuality in the service, employee drug and alcohol abuse, fraudulent use of government property and funds, conflict between personal and military values, and managing important relationships. This initiative, supported by the Chief of the Supply Corps, is designed to be a promising start toward creating an informed strategy, one that will ultimately lead to the design of enhanced educational programming regarding moral behavior in the military.http://archive.org/details/understandingeth109451312Lieutenant Commander, Supply Corps, United States NavyApproved for public release; distribution is unlimited

Improving productivity through work measurement : a cooperative approach; Management advisory services practice aids. Technical consulting practice aid, 09

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