Upper-body morbidity following breast cancer treatment is common, may persist longer-term and adversely influences quality of life

Background: Impairments in upper-body function (UBF) are common following breast cancer. However, the relationship between arm morbidity and quality of life (QoL) remains unclear. This investigation uses longitudinal data to describe UBF in a population-based sample of women with breast cancer and examines its relationship with QoL. ---------- Methods: Australian women (n = 287) with unilateral breast cancer were assessed at three-monthly intervals, from six- to 18-months post-surgery (PS). Strength, endurance and flexibility were used to assess objective UBF, while the Disability of the Arm, Shoulder and Hand questionnaire and the Functional Assessment of Cancer Therapy- Breast questionnaire were used to assess self-reported UBF and QoL, respectively. ---------- Results: Although mean UBF improved over time, up to 41% of women revealed declines in UBF between sixand 18-months PS. Older age, lower socioeconomic position, treatment on the dominant side, mastectomy, more extensive lymph node removal and having lymphoedema each increased odds of declines in UBF by at least twofold (p < 0.05). Lower baseline and declines in perceived UBF between six- and 18-months PS were each associated with poorer QoL at 18-months PS (p < 0.05). ---------- Conclusions: Significant upper-body morbidity is experienced by many following breast cancer treatment, persisting longer term, and adversely influencing the QoL of breast cancer survivors.

No longer Singaporean

From communal politics and internet governance to language policies, the tiny speck that is Singapore is known for doing things its own way, with an innovative if patriarchal government kneading a hungry, migrant mass into one of the most well-disciplined, efficient, and diligent working populations in Southeast Asia. Much has also been made of its success at multiculturalism though some, like sociologist Chua Beng Huat, argue it to be multiracialism. Using Chua's argument as a platform for departure, and taking a cue from Stratton's notion of ‘everyday multiculturalism’ I argue through a reflexive exploration of Singapore as a lived experience, that rather than conflict, the two theories complement each other with the former paving the way for the latter.

A highway for research in science education that no longer leads to the frontier

A review of "Progressing science education: constructing the scientific research programme into the contingent nature of learning science", by Keith S. Taber, Dordrecht, Springer, 2009.

No longer Singaporean : visibilising the everyday contestations of identities

In the past decade or so, the citizens of Singapore have been vigorously urged by the state to turn their cultural and linguistic affinities with China to economic advantage. At the same time, the city-state has opened its doors to selected, skilled migrants from Asia including many of those from mainland and Greater China. These concurrent emphases have coincided with the trend and growing numbers of Singaporeans heading overseas for one reason or another. Through a reflexive journey sparked by a recent visit, I argue in this paper that the resultant change in the makeup of its population produces tensions that may well have important repercussions for a nation that is constitutionally multiethnic though pragmatically meritocratic. However, because these frictions find form only in everyday, pedestrian practices, they are often dismissed or ignored. It is my contention that as the stage on which innocuous, creeping shifts in social identities are enacted, finessed and (re)embedded into social imaginaries, these everyday contestations of identities need to studied for indications of what is at stake.

Commentary on Spence et al. : "Problem solving programme implemented by teachers may prevent depression in the short term, but longer term benefits are unclear"

This is a methodologically exemplary trial of a population based (universal) approach to preventing depression in young people. The programme used teachers in a classroom setting to deliver cognitive behavioural problem solving skills to a cohort of students. We have little knowledge about “best practice” to prevent depression in adolescence. Classroom-based universal approaches appear to offer advantages in recruitment rates and lack of stigmatisation over approaches that target specific groups of at risk students. Earlier research on a universal school-based approach to preventing depression in adolescents showed promise, but employed mental health professionals to teach cognitive behavioural coping skills in small groups.1 Using such an approach routinely would be economically unsustainable. Spence’s trial, with teachers as facilitators, therefore represents a “real world” intervention that could be routinely disseminated.

Full compensation no longer sacrosanct : reflections on the past and future economic loss ‘cap’ for high income earners

The civil liability provisions relating to the assessment of damages for past and future economic loss have abrogated the common law principle of full compensation by imposing restrictions on the damages award, most commonly by a “three times average weekly earnings” cap. This consideration of the impact of those provisions is informed by a case study of the Supreme Court of Victoria Court of Appeal decision, Tuohey v Freemasons Hospital (Tuohey) , which addressed the construction and arithmetic operation of the Victorian cap for high income earners. While conclusions as to operation of the cap outside of Victoria can be drawn from Tuohey, a number of issues await judicial determination. These issues, which include the impact of the damages caps on the calculation of damages for economic loss in the circumstances of fluctuating income; vicissitudes; contributory negligence; claims per quod servitum amisit; and claims by dependants, are identified and potential resolutions discussed.

Response to chemotherapy is predictive in relation to longer overall survival in an individual patient combined-analysis with pleural mesothelioma

Background: There is currently no early predictive marker of survival for patients receiving chemotherapy for malignant pleural mesothelioma (MPM). Tumour response may be predictive for overall survival (OS), though this has not been explored. We have thus undertaken a combined-analysis of OS, from a 42 day landmark, of 526 patients receiving systemic therapy for MPM. We also validate published progression-free survival rates (PFSRs) and a progression-free survival (PFS) prognostic-index model. Methods: Analyses included nine MPM clinical trials incorporating six European Organisation for Research and Treatment of Cancer (EORTC) studies. Analysis of OS from landmark (from day 42 post-treatment) was considered regarding tumour response. PFSR analysis data included six non-EORTC MPM clinical trials. Prognostic index validation was performed on one non-EORTC data-set, with available survival data. Results: Median OS, from landmark, of patients with partial response (PR) was 12·8 months, stable disease (SD), 9·4 months and progressive disease (PD), 3·4 months. Both PR and SD were associated with longer OS from landmark compared with disease progression (both p < 0·0001). PFSRs for platinum-based combination therapies were consistent with published significant clinical activity ranges. Effective separation between PFS and OS curves provided a validation of the EORTC prognostic model, based on histology, stage and performance status. Conclusion: Response to chemotherapy is associated with significantly longer OS from landmark in patients with MPM. © 2012 Elsevier Ltd. All rights reserved.

Automatic surveillance in transportation hubs: No Longer just about catching the bad guy

As critical infrastructure such as transportation hubs continue to grow in complexity, greater importance is placed on monitoring these facilities to ensure their secure and efficient operation. In order to achieve these goals, technology continues to evolve in response to the needs of various infrastructure. To date, however, the focus of technology for surveillance has been primarily concerned with security, and little attention has been placed on assisting operations and monitoring performance in real-time. Consequently, solutions have emerged to provide real-time measurements of queues and crowding in spaces, but have been installed as system add-ons (rather than making better use of existing infrastructure), resulting in expensive infrastructure outlay for the owner/operator, and an overload of surveillance systems which in itself creates further complexity. Given many critical infrastructure already have camera networks installed, it is much more desirable to better utilise these networks to address operational monitoring as well as security needs. Recently, a growing number of approaches have been proposed to monitor operational aspects such as pedestrian throughput, crowd size and dwell times. In this paper, we explore how these techniques relate to and complement the more commonly seen security analytics, and demonstrate the value that can be added by operational analytics by demonstrating their performance on airport surveillance data. We explore how multiple analytics and systems can be combined to better leverage the large amount of data that is available, and we discuss the applicability and resulting benefits of the proposed framework for the ongoing operation of airports and airport networks.

Evidence that dicot-infecting mastreviruses are particularly prone to inter-species recombination and have likely been circulating in Australia for longer than in Africa and the Middle East

Viruses of the genus Mastrevirus (family Geminiviridae) are transmitted by leafhoppers and infect either mono- or dicotyledonous plants. Here we have determined the full length sequences of 49 dicot-infecting mastrevirus isolates sampled in Australia, Eritrea, India, Iran, Pakistan, Syria, Turkey and Yemen. Comprehensive analysis of all available dicot-infecting mastrevirus sequences showed the diversity of these viruses in Australia to be greater than in the rest of their known range, consistent with earlier studies, and that, in contrast with the situation in monocot-infecting mastreviruses, detected inter-species recombination events outnumbered intra-species recombination events. Consistent with Australia having the greatest diversity of known dicot-infecting mastreviruses phylogeographic analyses indicating the most plausible scheme for the spread of these viruses to their present locations, suggest that most recent common ancestor of these viruses is likely nearer Australia than it is to the other regions investigated.

Number of prior episodes and the presence of depressive symptoms are associated with longer length of stay for patients with acute manic episodes

Background: Few studies have analyzed predictors of length of stay (LOS) in patients admitted due to acute bipolar manic episodes. The purpose of the present study was to estimate LOS and to determine the potential sociodemographic and clinical risk factors associated with a longer hospitalization. Such information could be useful to identify those patients at high risk for long LOS and to allocate them to special treatments, with the aim of optimizing their hospital management. Methods: This was a cross-sectional study recruiting adult patients with a diagnosis of bipolar disorder (Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR) criteria) who had been hospitalized due to an acute manic episode with a Young Mania Rating Scale total score greater than 20. Bivariate correlational and multiple linear regression analyses were performed to identify independent predictors of LOS. Results: A total of 235 patients from 44 centers were included in the study. The only factors that were significantly associated to LOS in the regression model were the number of previous episodes and the Montgomery-Åsberg Depression Rating Scale (MADRS) total score at admission (P < 0.05). Conclusions: Patients with a high number of previous episodes and those with depressive symptoms during mania are more likely to stay longer in hospital. Patients with severe depressive symptoms may have a more severe or treatment-resistant course of the acute bipolar manic episode.

Inter-regional correlation in tree-growth variations in the western United States, 1513-1964, at ENSO, sunspot, and longer frequency bands

Cross-spectral analysis of regional tree-ring data suggests the spatial pattern of correlation between moisture variations in the Sierra Nevada of central California and in other parts of the western United States is frequency dependent. Short wavelengths (2.8 to 10.7 years), perhaps associated with El Niño/Southern Oscillation, are strongly coherent both to the north (Oregon) and to the south (Southern California). Longer wavelengths (45 to 75 years) are strongly coherent only to the north. Frequency bands corresponding to annual sunspot series were associated with relatively weak patterns of spatial correlation.

A 139-year dendroclimatic cycle, cultural/environmental history, sunspots, and longer-term cycles

Higher resolution time-stratigraphic records suggest correlation of lower frequency paleoclimatic events with Milankovitch obliquity/precessional cycles and of higher frequency events with the evidently resonance-related Pettersson maximum tidal force (MTF) model. Subsequently published records, mainly pollen, seemingly confirm that atmospheric resonances may have modulated past climatic changes in phase with average MTF cycles of 1668, 1112, and 556 years, as calculated in anomalistic years from planetary movements by Stacey. Stacey accepts Pettersson's dating of AD 1433 (517 YBP) for the last major perihelian spring tide based solely on calculations of moon- and earth-orbital relations to the sun. Use of AD 1433 as an origin for the tidal resonance model seemingly continues to provide a best fit for the timing of cyclical patterns in the presented paleoclimate time series.

Effects of longer heavy vehicles on traffic congestion

Two-lane, "microscopic" (vehicle-by-vehicle) simulations of motorway traffic are developed using existing models and validated using measured data from the M25 motorway. An energy consumption model is also built in, which takes the logged trajectories of simulated vehicles as drive-cycles. The simulations are used to investigate the effects on motorway congestion and fuel consumption if "longer and/or heavier vehicles" (LHVs) were to be permitted in the UK. Baseline scenarios are simulated with traffic composed of cars, light goods vehicles and standard heavy goods vehicles (HGVs). A proportion of conventional articulated HGVs is then replaced by a smaller number of LHVs carrying the same total payload mass and volume. Four LHV configurations are investigated: an 18.75 m, 46 t longer semi-trailer (LST); 25.25 m, 50 t and 60 t B-doubles and a 34 m, 82 t A-double. Metrics for congestion, freight fleet energy consumption and car energy consumption are defined for comparing the scenarios. Finally, variation of take-up level and LHV engine power for the LST and A-double are investigated. It is concluded that: (a) LHVs should reduce congestion particularly in dense traffic, however, a low mean proportion of freight traffic on UK roads and low take-up levels will limit this effect to be almost negligible; (b) LHVs can significantly improve the energy efficiency of freight fleets, giving up to a 23% reduction in fleet energy consumption at high take-up levels; (c) the small reduction in congestion caused by LHVs could improve the fuel consumption of other road users by up to 3% in dense traffic, however in free-flowing traffic an opposite effect occurs due to higher vehicle speeds and aerodynamic losses; and (d) underpowered LHVs have potential to generate severe congestion, however current manufacturers' recommendations appear suitable. © 2013 IMechE.