Known unknowns: building an ethics of uncertainty into genomic medicine

Background Genomic testing has reached the point where, technically at least, it can be cheaper to undertake panel-, exome- or whole genome testing than it is to sequence a single gene. An attribute of these approaches is that information gleaned will often have uncertain significance. In addition to the challenges this presents for pre-test counseling and informed consent, a further consideration emerges over how - ethically - we should conceive of and respond to this uncertainty. To date, the ethical aspects of uncertainty in genomics have remained under-explored. Discussion In this paper, we draft a conceptual and ethical response to the question of how to conceive of and respond to uncertainty in genomic medicine. After introducing the problem, we articulate a concept of ‘genomic uncertainty’. Drawing on this, together with exemplar clinical cases and related empirical literature, we then critique the presumption that uncertainty is always problematic and something to be avoided, or eradicated. We conclude by outlining an ‘ethics of genomic uncertainty’; describing how we might handle uncertainty in genomic medicine. This involves fostering resilience, welfare, autonomy and solidarity. Conclusions Uncertainty will be an inherent aspect of clinical practice in genomics for some time to come. Genomic testing should not be offered with the explicit aim to reduce uncertainty. Rather, uncertainty should be appraised, adapted to and communicated about as part of the process of offering and providing genomic information. Keywords Ethics Uncertainty Genomics Clinical genomics Massively parallel sequencing Genome sequencing Genomic testing Genetic counseling Rare diseases Variants of uncertain significanc

Carcass composition of the giraffe Giraffa camelopardalis giraffa

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Lattice isomorphisms of bisimple monogenic orthodox semigroups

Using the classification and description of the structure of bisimple monogenic orthodox semigroups obtained in \cite{key10}, we prove that every bisimple orthodox semigroup generated by a pair of mutually inverse elements of infinite order is strongly determined by the lattice of its subsemigroups in the class of all semigroups. This theorem substantially extends an earlier result of \cite{key25} stating that the bicyclic semigroup is strongly lattice determined.Comment: Semigroup Forum (published online: 15 April 2011

Quantum Computing with Atomic Josephson Junction Arrays

We present a quantum computing scheme with atomic Josephson junction arrays. The system consists of a small number of atoms with three internal states and trapped in a far-off resonant optical lattice. Raman lasers provide the "Josephson" tunneling, and the collision interaction between atoms represent the "capacitive" couplings between the modes. The qubit states are collective states of the atoms with opposite persistent currents. This system is closely analogous to the superconducting flux qubit. Single qubit quantum logic gates are performed by modulating the Raman couplings, while two-qubit gates result from a tunnel coupling between neighboring wells. Readout is achieved by tuning the Raman coupling adiabatically between the Josephson regime to the Rabi regime, followed by a detection of atoms in internal electronic states. Decoherence mechanisms are studied in detail promising a high ratio between the decoherence time and the gate operation time.Comment: 7 figure

Present day status and future of nature conservation in the Republic of Malawi

When Malawi (formerly Nyasaland) became independent in 1964 the status and future of its game reserves were in jeopardy. The former administration had adopted a policy of benign neglect towards the country's wildlife areas (Anon 1963), and the remnants of the Department of Game, Fish and Tsetse Control had been absorbed by the Forestry Department in 1963. Fortunately the Life President of Malawi, Dr H Kamuzu Banda, took a strong interest in wildlife conservation and it was only his personal intervention, and the advent of independence, that saved the former Lengwe Game Reserve from deproclamation (Hayes 1967) as planned by the colonial administration. With the Life President's encouragement and the dedicated efforts of the staff responsible for wildlife, the tide which had been running strongly against nature conservation was turned, culminating in the establishment of a separate Department of National Parks and Wildlife only a decade after independence

Developing a community-based intervention to improve quality of life in people with colorectal cancer: a complex intervention development study

Objectives: To develop and pilot a theory and evidence-based intervention to improve quality of life (QoL) in people with colorectal cancer. Design: A complex intervention development study. Setting: North East Scotland and Glasgow. Participants: Semistructured interviews with people with colorectal cancer (n=28), cancer specialists (n=16) and primary care health professionals (n=14) and pilot testing with patients (n=12). Interventions: A single, 1 h nurse home visit 6–12 weeks after diagnosis, and telephone follow-up 1 week later (with a view to ongoing follow-up in future). Primary and secondary outcome measures: Qualitative assessment of intervention feasibility and acceptability. Results: Modifiable predictors of QoL identified previously were symptoms (fatigue, pain, diarrhoea, shortness of breath, insomnia, anorexia/cachexia, poor psychological well-being, sexual problems) and impaired activities. To modify these symptoms and activities, an intervention based on Control Theory was developed to help participants identify personally important symptoms and activities; set appropriate goals; use action planning to progress towards goals; self-monitor progress and identify (and tackle) barriers limiting progress. Interview responses were generally favourable and included recommendations about timing and style of delivery that were incorporated into the intervention. The pilot study demonstrated the feasibility of intervention delivery. Conclusions: Through multidisciplinary collaboration, a theory-based, acceptable and feasible intervention to improve QoL in colorectal cancer patients was developed, and can now be evaluated

Energy band structure and intrinsic coherent properties in two weakly linked Bose Einstein Condensates

The energy band structure and energy splitting due to quantum tunneling in two weakly linked Bose-Einstein condensates were calculated by using the instanton method. The intrinsic coherent properties of Bose Josephson junction were investigated in terms of energy splitting. For $E_{C}/E_{J}\ll 1$, the energy splitting is small and the system is globally phase coherent. In the opposite limit, $E_{C}/E_{J}\gg 1$, the energy splitting is large and the system becomes a phase dissipation. Our reslults suggest that one should investigate the coherence phenomna of BJJ in proper condition such as $E_{C}/E_{J}\sim 1$.Comment: to appear in Phys. Rev. A, 2 figure