Incorporating bioenergy into sustainable landscape designs

AbstractThe paper describes an approach to landscape design that focuses on integrating bioenergy production with other components of environmental, social and economic systems. Landscape design as used here refers to a spatially explicit, collaborative plan for management of landscapes and supply chains. Landscape design can involve multiple scales and build on existing practices to reduce costs or enhance services. Appropriately applied to a specific context, landscape design can help people assess trade-offs when making choices about locations, types of feedstock, transport, refining and distribution of bioenergy products and services. The approach includes performance monitoring and reporting along the bioenergy supply chain. Examples of landscape design applied to bioenergy production systems are presented. Barriers to implementation of landscape design include high costs, the need to consider diverse land-management objectives from a wide array of stakeholders, up-front planning requirements, and the complexity and level of effort needed for successful stakeholder involvement. A landscape design process may be stymied by insufficient data or participation. An impetus for coordination is critical, and incentives may be required to engage landowners and the private sector. Hence devising and implementing landscape designs for more sustainable outcomes require clear communication of environmental, social, and economic opportunities and concerns

Imagined gait modulates neuronal network dynamics in the human pedunculopontine nucleus

The pedunculopontine nucleus (PPN) is a part of the mesencephalic locomotor region and is thought to be important for the initiation and maintenance of gait. Lesions of the PPN induce gait deficits, and the PPN has therefore emerged as a target for deep brain stimulation for the control of gait and postural disability. However, the role of the PPN in gait control is not understood. Using extracellular single-unit recordings in awake patients, we found that neurons in the PPN discharged as synchronous functional networks whose activity was phase locked to alpha oscillations. Neurons in the PPN responded to limb movement and imagined gait by dynamically changing network activity and decreasing alpha phase locking. Our results indicate that different synchronous networks are activated during initial motor planning and actual motion, and suggest that changes in gait initiation in Parkinson's disease may result from disrupted network activity in the PPN

International survey of awareness of genetic risk in the clinical sarcoma community

Aim. Integration of clinical genetics into oncology is variable. Sarcomas have a strong genetic component, with up to 1/30 patients carrying germline TP53 mutations. This study aimed to define genetic risk awareness among sarcoma physicians. Outcomes were attitudes toward genetic testing, level of cancer risk and awareness of risk reduction measures. Methods. An online survey was administered to members of the Connective Tissue Oncology Society and the Australasian Sarcoma Study Group. Results. Sarcoma physicians (N = 124) from 21 countries participated, 40% of whom favored TP53 mutation testing in children regardless of family history, increasing to ∼83% for all age groups if a family history was present and ∼85% if multiple primary cancers were present. However, 33% were not aware that risk reduction strategies might identify some cancers at a more curable stage in carriers. Conclusion. Clinical genetics is not yet standard of care for multidisciplinary management of sarcoma. Awareness of genetic risk is important among sarcoma physicians. Attitudes among the sarcoma community were generally positive, but education on genetic risk in sarcoma patients and collaboration with clinical genetics services might improve quality of care. Sarcoma physicians need routine access to clinical genetics services so that potential germline TP53 mutation carriers are recognized

The psychosocial effects of a whole body MRI screening trial in sarcoma patients with a germline TP53 mutation

Germline TP53 mutation carriers have high risk of cancer. Effective management is an important issue. A whole‐body (WB) MRI trial in adults with TP53 mutations has been established. The psychosocial impact of WB‐MRI screening in these individuals is unknown

The psychological impact of a pilot whole-body screening trial (SMOC) on individuals with Li-Fraumeni syndrome

Individuals who have a germline TP53 mutation have Li‐Fraumeni Syndrome (LFS) and a high risk of cancer‐related morbidity and mortality. Effective cancer risk management is an important issue. A whole‐body (WB) surveillance trial (SMOC) in adults with TP53 mutations has been established to estimate the prevalence and incidence of investigable lesions in these carriers. The psychosocial impact of using WB MRI in individuals with LFS is unknown

Psychosocial morbidity in TP53 mutation carriers : is whole-body cancer screening beneficial?

Germline TP53 mutation carriers are at high risk of developing a range of cancers. Effective cancer risk management is an important issue for these individuals. We assessed the psychosocial impact in TP53 mutation carriers of WB-MRI screening as part of the Surveillance in Multi-Organ Cancer (SMOC+) protocol, measuring their unmet needs, anxiety and depression levels as well as cancer worry using psychological questionnaires and in-depth interviews about their experiences of screening. We present preliminary psychosocial findings from 17 participants during their first 12 months on the trial. We found a significant reduction in participants’ mean anxiety from baseline to two weeks post WB-MRI (1.2, 95% CI 0.17 to 2.23 p = 0.025), indicative of some benefit. Emerging qualitative themes show most participants are emotionally supported and contained by the screening program and are motivated by their immediate concern about staying alive, despite being informed about the current lack of evidence around efficacy of screening for people with TP53 mutations in terms of cancer morbidity or mortality. For those that do gain emotional reassurance from participating in the screening study, feelings of abandonment by the research team are a risk when the study ends. For others, screening was seen as a burden, consistent with the relentless nature of cancer risk associated with Li-Fraumeni syndrome, though these patients still declared they wished to participate due to their concern with staying alive. Families with TP53 mutations need ongoing support due to the impact on the whole family system. These findings suggest a comprehensive multi-organ screening program for people with TP53 mutations provides psychological benefit independent of an impact on cancer morbidity and mortality associated with the syndrome. The benefits of a multi-organ screening program will be greater still if the screening tests additionally reduce the cancer morbidity and mortality associated with the syndrome. These findings may also inform the care of individuals and families with other multi-organ cancer predisposition syndromes