Common Ethical Challenges in End of Life Care

Conflict is common in end-of-life situations. This session will be an interactive session in which we explore common conflicts that emerge between caregivers, patients, and care providers, and apply ethical principles to trying to approach these conflicts. At the end of the session, participants will be able to: Discuss an ethical framework for approaching conflict in health care Discuss the ethical challenges in balancing a patient or family’s hope for a miracle with health care providers’ concerns about providing care that is likely to be non-beneficial Discuss an approach to addressing families’ request not to provide pain medication to a person who appears to be sufferin

Understanding Motivations for IOS Adoption

Inter-organisational systems (IOS) are of great importance to businesses as these systems enable different organisations to work together through the exchange of information. Despite this significance, the diffusion of IOS is disappointingly slow. There have been a number of studies of the factors affecting IOS adoption but they have yielded inconsistent results. We argue that adoption of IOS is also contingent upon the motivations of organisations. In this paper, we develop a model that explains the variation in motivations for IOS adoption. The model categorises motivation to adopt IOS along two dimensions; type of motivation and locus of motivation. The model also provides four scenarios for IOS adoption and identifies typical tasks for each scenario. The model can help practitioners and researchers to better understand the differences in motivations between particular organisations involved in IOS implementations

Polynomial time algorithms to determine weakly reversible realizations of chemical reaction networks

Weak reversibility is a crucial structural property of chemical reaction networks (CRNs) with mass action kinetics, because it has major implications related to the existence, uniqueness and stability of equilibrium points and to the boundedness of solutions. In this paper, we present two new algorithms to find dynamically equivalent weakly reversible realizations of a given CRN. They are based on linear programming and thus have polynomial time-complexity. Hence, these algorithms can deal with large-scale biochemical reaction networks, too. Furthermore, one of the methods is able to deal with linearly conjugate networks, too. © 2014 Springer International Publishing Switzerland

Understanding IOS Implementation Process in an Automotive Manufacturing Company: An Organisational Motivation Perspective

A leading Australian automotive manufacturing company has introduced an internet-enabled electronic data interchange (EDI) system recently that links the company with its small suppliers. In this paper, we use a scientific case study approach to examine the internet-enabled EDI implementation experience of the automotive company, and explain its implementation process by referring to a theoretical model known as the IOS Motivation Model (IMM) which we have developed based on the notion of ‗organizational motivation‘ for IOS adoption [16]. The case study findings highlight the key role of organisational motivation as a determinant of IOS implementation process undertaken by the company. This finding is useful to e-business practitioners because it provides them with a means of assessing IOS implementation related activities, and for researchers, because it provides a theoretical framework for understanding the role of motivation in the activities conducted when implementing a system

Molecular and Clinical Analyses of Greig Cephalopolysyndactyly and Pallister-Hall Syndromes: Robust Phenotype Prediction from the Type and Position of GLI3 Mutations

Mutations in the GLI3 zinc-finger transcription factor gene cause Greig cephalopolysyndactyly syndrome (GCPS) and Pallister-Hall syndrome (PHS), which are variable but distinct clinical entities. We hypothesized that GLI3 mutations that predict a truncated functional repressor protein cause PHS and that functional haploinsufficiency of GLI3 causes GCPS. To test these hypotheses, we screened patients with PHS and GCPS for GLI3 mutations. The patient group consisted of 135 individuals: 89 patients with GCPS and 46 patients with PHS. We detected 47 pathological mutations (among 60 probands); when these were combined with previously published mutations, two genotype-phenotype correlations were evident. First, GCPS was caused by many types of alterations, including translocations, large deletions, exonic deletions and duplications, small in-frame deletions, and missense, frameshift/nonsense, and splicing mutations. In contrast, PHS was caused only by frameshift/nonsense and splicing mutations. Second, among the frameshift/nonsense mutations, there was a clear genotype-phenotype correlation. Mutations in the first third of the gene (from open reading frame [ORF] nucleotides [nt] 1-1997) caused GCPS, and mutations in the second third of the gene (from ORF nt 1998-3481) caused primarily PHS. Surprisingly, there were 12 mutations in patients with GCPS in the 3\u27 third of the gene (after ORF nt 3481), and no patients with PHS had mutations in this region. These results demonstrate a robust correlation of genotype and phenotype for GLI3 mutations and strongly support the hypothesis that these two allelic disorders have distinct modes of pathogenesis

Molecular Analysis Expands the Spectrum of Phenotypes Associated with GLI3 Mutations

A range of phenotypes including Greig cephalopolysyndactyly and Pallister-Hall syndromes (GCPS, PHS) are caused by pathogenic mutation of the GLI3 gene. To characterize the clinical variability of GLI3 mutations, we present a subset of a cohort of 174 probands referred for GLI3 analysis. Eighty-one probands with typical GCPS or PHS were previously reported, and we report the remaining 93 probands here. This includes 19 probands (12 mutations) who fulfilled clinical criteria for GCPS or PHS, 48 probands (16 mutations) with features of GCPS or PHS but who did not meet the clinical criteria (sub-GCPS and sub-PHS), 21 probands (6 mutations) with features of PHS or GCPS and oral-facial-digital syndrome, and 5 probands (1 mutation) with nonsyndromic polydactyly. These data support previously identified genotype-phenotype correlations and demonstrate a more variable degree of severity than previously recognized. The finding of GLI3 mutations in patients with features of oral-facial-digital syndrome supports the observation that GLI3 interacts with cilia. We conclude that the phenotypic spectrum of GLI3 mutations is broader than that encompassed by the clinical diagnostic criteria, but the genotype-phenotype correlation persists. Individuals with features of either GCPS or PHS should be screened for mutations in GLI3 even if they do not fulfill clinical criteria

Virtual Biopsy in Soft Tissue Sarcoma. How Close Are We?

A shift in radiology to a data-driven specialty has been unlocked by synergistic developments in imaging biomarkers (IB) and computational science. This is advancing the capability to deliver "virtual biopsies" within oncology. The ability to non-invasively probe tumour biology both spatially and temporally would fulfil the potential of imaging to inform management of complex tumours; improving diagnostic accuracy, providing new insights into inter- and intra-tumoral heterogeneity and individualised treatment planning and monitoring. Soft tissue sarcomas (STS) are rare tumours of mesenchymal origin with over 150 histological subtypes and notorious heterogeneity. The combination of inter- and intra-tumoural heterogeneity and the rarity of the disease remain major barriers to effective treatments. We provide an overview of the process of successful IB development, the key imaging and computational advancements in STS including quantitative magnetic resonance imaging, radiomics and artificial intelligence, and the studies to date that have explored the potential biological surrogates to imaging metrics. We discuss the promising future directions of IBs in STS and illustrate how the routine clinical implementation of a virtual biopsy has the potential to revolutionise the management of this group of complex cancers and improve clinical outcomes