Total systems intervention and human inquiry: The search for a common ground

Total Systems Intervention (TSI) is an approach to intervening in problem situations which has much to offer where complex interacting issues need to be addressed by the complementary use of intervention methodologies. That such an approach has much in common with Action Research (AR) has been recognized, with much recent effort being devoted to the relationship between AR and Critical Systems Thinking (CST), the theoretical endeavor underpinning TSI. This paper further develops this line of debate and relates AR or Human Inquiry (HI) more directly to TSI, using an information systems intervention to enhance the study. The outcome is a demonstration of how TSI implicitly uses techniques informed from the field of Action Research, and how a more thorough synthesis of HI with TSI might serve to improve the overall intervention process.     

Exome sequencing of liver fluke-associated cholangiocarcinoma

Opisthorchis viverrini-related cholangiocarcinoma (CCA), a fatal bile duct cancer, is a major public health concern in areas endemic for this parasite. We report here whole-exome sequencing of eight O. viverrini-related tumors and matched normal tissue. We identified and validated 206 somatic mutations in 187 genes using Sanger sequencing and selected 15 genes for mutation prevalence screening in an additional 46 individuals with CCA (cases). In addition to the known cancer-related genes TP53 (mutated in 44.4% of cases), KRAS (16.7%) and SMAD4 (16.7%), we identified somatic mutations in 10 newly implicated genes in 14.8-3.7% of cases. These included inactivating mutations in MLL3 (in 14.8% of cases), ROBO2 (9.3%), RNF43 (9.3%) and PEG3 (5.6%), and activating mutations in the GNAS oncogene (9.3%). These genes have functions that can be broadly grouped into three biological classes: (i) deactivation of histone modifiers, (ii) activation of G protein signaling and (iii) loss of genome stability. This study provides insight into the mutational landscape contributing to O. viverrini-related CCA.