A dosimetric retrospective planning study comparing volumetric arc therapy (VMAT) and stereotactic body radiotherapy (SBRT) treatment plans for non-small cell lung cancer (NSCLC)

Purpose A retrospective planning study comparing volumetric arc therapy (VMAT) and stereotactic body radiotherapy (SBRT) treatment plans for non-small cell lung cancer (NSCLC). Methods and materials Five randomly selected early stage lung cancer patients were included in the study. For each patient, four plans were created: the SBRT plan and three VMAT plans using different optimisation methodologies. A total of 20 different plans were evaluated. The dose parameters of dose conformity results and the target dose constraints results were compared for these plans. Results The mean planning target volume (PTV) for all the plans (SBRT and VMAT) was 18·3 cm3, with a range from 15·6 to 20·1 cm3. The maximum dose tolerance to 1 cc of all the plans was within 140% (84 Gy) of the prescribed dose, and 95% of the PTV of all the plans received 100% of the prescribed dose (60 Gy). In all the plans, 99% of the PTV received a dose >90% of the prescribed dose, and the mean dose in all the plans ranged from 67 to 72 Gy. The planning target dose conformity for the SBRT and the VMAT (0°, 15° collimator single arc plans and dual arc) plans showed the tightness of the prescription isodose conformity to the target. Conclusions SBRT and VMAT are radiotherapy approaches that increase doses to small tumour targets without increasing doses to the organs at risk. Although VMAT offers an alternative to SBRT for NSCLC and the potential advantage of VMAT is the reduced treatment times over SBRT, the statistical results show that there was no significant difference between the SBRT and VMAT optimised plans in terms of dose conformity and organ-at-risk sparing.

Under the skin: Wearable technology futures

Artist statement – Artisan Gallery I have a confession to make… I don’t wear a FitBit, I don’t want an Apple Watch and I don’t like bling LED’s. But, what excites me is a future where ‘wearables’ are discreet, seamless and potentially one with our body. Burgeoning E-textiles research will provide the ability to inconspicuously communicate, measure and enhance human health and well-being. Alongside this, next generation wearables arguably will not be worn on the body, but rather within the body…under the skin. ‘Under the Skin’ is a polemic piece provoking debate on the future of wearables – a place where they are not overt, not auxiliary and perhaps not apparent. Indeed, a future where wearables are under the skin or one with our apparel. And, as underwear closets the skin and is the most intimate and cloaked apparel item we wear, this work unashamedly teases dialogue to explore how wearables can transcend from the overt to the unseen. Context Wearable Technology, also referred to as wearable computing or ‘wearables’, is an embryonic field that has the potential to unsettle conventional notions as to how technology can interact, enhance and augment the human body. Wearable technology is the next-generation for ubiquitous consumer electronics and ‘Wearables’ are, in essence, miniature electronic devices that are worn by a person, under clothing, embedded within clothing/textiles, on top of clothing, or as stand-alone accessories/devices. This wearables market is predicted to grow somewhere between $30-$50 billion in the next 5 years (Credit Suisse, 2013). The global ‘wearables’ market, which is emergent in phase, has forecasted predictions for vast consumer revenue with the potential to become a significant cross-disciplinary disruptive space for designers and entrepreneurs. For Fashion, the field of wearables is arguably at the intersection of the second and third generation for design innovation: the first phase being purely decorative with aspects such as LED lighting; the second phase consisting of an array of wearable devices, such as smart watches, to communicate areas such as health and fitness, the third phase involving smart electronics that are woven into the textile to perform a vast range of functions such as body cooling, fabric colour change or garment silhouette change; and the fourth phase where wearable devices are surgically implanted under the skin to augment, transform and enhance the human body. Whilst it is acknowledged the wearable phases are neither clear-cut nor discreet in progression and design innovation can still be achieved with first generation decorative approaches, the later generation of technology that is less overt and at times ‘under the skin’ provides a uniquely rich point for design innovation where the body and technology intersect as one. With this context in mind, the wearable provocation piece ‘Under the Skin’ provides a unique opportunity for the audience to question and challenge conventional notions that wearables need to be a: manifest in nature, b: worn on or next to the body, and c: purely functional. The piece ‘Under the Skin’ is informed by advances in the market place for wearable innovation, such as: the Australian based wearable design firm Catapult with their discreet textile biometric sports tracking innovation, French based Spinali Design with their UV app based textile senor to provide sunburn alerts, as well as opportunities for design technology innovation through UNICEF’s ‘Wearables for Good’ design challenge to improve the quality of life in disadvantaged communities. Exhibition As part of Artisan’s Wearnext exhibition, the work was on public display from 25 July to 7 November 2015 and received the following media coverage: WEARNEXT ONLINE LISTINGS AND MEDIA COVERAGE: http://indulgemagazine.net/wear-next/ http://www.weekendnotes.com/wear-next-exhibition-gallery-artisan/ http://concreteplayground.com/brisbane/event/wear-next_/ http://www.nationalcraftinitiative.com.au/news_and_events/event/48/wear-next http://bneart.com/whats-on/wear-next_/ http://creativelysould.tumblr.com/post/124899079611/creative-weekend-art-edition http://www.abc.net.au/radionational/programs/breakfast/smartly-dressed-the-future-of-wearable-technology/6744374 http://couriermail.newspaperdirect.com/epaper/viewer.aspx RADIO COVERAGE http://www.abc.net.au/radionational/programs/breakfast/wear-next-exhibition-whats-next-for-wearable-technology/6745986 TELEVISION COVERAGE http://www.abc.net.au/radionational/programs/breakfast/wear-next-exhibition-whats-next-for-wearable-technology/6745986 https://au.news.yahoo.com/video/watch/29439742/how-you-could-soon-be-wearing-smart-clothes/#page1

Short biceps femoris fascicles and eccentric knee flexor weakness increase the risk of hamstring injury in elite football (soccer): A prospective cohort study

Background/Aim: To investigate the role of eccentric knee flexor strength, between-limb imbalance and biceps femoris long head (BFlh) fascicle length on the risk of a future hamstring strain injury (HSI). Methods: Elite soccer players (n=152) from eight different teams participated. Eccentric knee flexor strength during the Nordic hamstring exercise and BFlh fascicle length were assessed at the beginning of pre-season. The occurrences of a HSI following this were recorded by the team medical staff. Relative risk (RR) was determined for univariate data, and logistic regression was employed for multivariate data. Results: Twenty-seven new HSIs were reported. Eccentric knee flexor strength below 337N (RR = 4.4; 95% CI = 1.1 to 17.5) and BFlh fascicles shorter than 10.56cm (RR = 4.1; 95% CI=1.9 to 8.7) significantly increased the risk of a subsequent HSI. Multivariate logistic regression revealed significant effects when combinations of age, previous history of HSI, eccentric knee flexor strength and BFlh fascicle length were explored. From these analyses the likelihood of a future HSI in older athletes or those with a previous HSI history was reduced if high levels of eccentric knee flexor strength and longer BFlh fascicles were present. Conclusions: The presence of short BFlh fascicles and low levels of eccentric strength in elite soccer players increase the risk of a future HSI. The greater risk of a future HSI in older players or those with a previous HSI is reduced when they possess longer BFlh fascicles and high levels of eccentric strength.

Porn, censorship, classification and free speech: Global paradoxes in the governance of media content

In this presentation, I reflect upon the global landscape surrounding the governance and classification of media content, at a time of rapid change in media platforms and services for content production and distribution, and contested cultural and social norms. I discuss the tensions and contradictions arising in the relationship between national, regional and global dimensions of media content distribution, as well as the changing relationships between state and non-state actors. These issues will be explored through consideration of issues such as: recent debates over film censorship; the review of the National Classification Scheme conducted by the Australian Law Reform Commission; online controversies such as the future of the Reddit social media site; and videos posted online by the militant group ISIS.

Independent replication and meta-analysis for endometriosis risk loci

Endometriosis is a complex disease that affects 6-10% of women in their reproductive years and 20-50% of women with infertility. Genome-wide and candidate-gene association studies for endometriosis have identified 10 independent risk loci, and of these, nine (rs7521902, rs13394619, rs4141819, rs6542095, rs1519761, rs7739264, rs12700667, rs1537377, and rs10859871) are polymorphic in European populations. Here we investigate the replication of nine SNP loci in 998 laparoscopically and histologically confirmed endometriosis cases and 783 disease-free controls from Belgium. SNPs rs7521902, rs13394619, and rs6542095 show nominally significant (p <.05) associations with endometriosis, while the directions of effect for seven SNPs are consistent with the original reports. Association of rs6542095 at the IL1A locus with 'All' (p =.066) and 'Grade-B' (p =.01) endometriosis is noteworthy because this is the first successful replication in an independent population. Meta-analysis with the published results yields genome-wide significant evidence for rs7521902, rs13394619, rs6542095, rs12700667, rs7739264, and rs1537377. Notably, three coding variants in GREB1 (near rs13394619) and CDKN2B-AS1 (near rs1537377) also showed nominally significant associations with endometriosis. Overall, this study provides important replication in a uniquely characterized independent population, and indicates that the majority of the original genome-wide association findings are not due to chance alone. © The Author(s) 2015.

Polypharmacy among inpatients aged 70 years or older in Australia

Objectives To investigate medication changes for older patients admitted to hospital and to explore associations between patient characteristics and polypharmacy. Design Prospective cohort study. Participants and setting Patients aged 70 years or older admitted to general medical units of 11 acute care hospitals in two Australian states between July 2005 and May 2010. All patients were assessed using the interRAI assessment system for acute care. Main outcome measures Measures of physical, cognitive and psychosocial functioning; and number of regular prescribed medications categorised into three groups: non-polypharmacy (0–4 drugs), polypharmacy (5–9 drugs) and hyperpolypharmacy (≥ 10 drugs). Results Of 1220 patients who were recruited for the study, medication records at admission were available for 1216. Mean age was 81.3 years (SD, 6.8 years), and 659 patients (54.2%) were women. For the 1187 patients with complete medication records on admission and discharge, there was a small but statistically significant increase in mean number of regular medications per day between admission and discharge (7.1 v 7.6), while the prevalence of medications such as statins (459 [38.7%] v 457 [38.5%] patients), opioid analgesics (155 [13.1%] v 166 [14.0%] patients), antipsychotics (59 [5.0%] v 65 [5.5%] patients) and benzodiazepines (122 [10.3%] v 135 [11.4%] patients) did not change significantly. Being in a higher polypharmacy category was significantly associated with increase in comorbidities (odds ratio [OR], 1.27; 95% CI, 1.20–1.34), presence of pain (OR, 1.31; 1.05–1.64), dyspnoea (OR, 1.64; 1.30–2.07) and dependence in terms of instrumental activities of daily living (OR, 1.70; 1.20–2.41). Hyperpolypharmacy was observed in 290/1216 patients (23.8%) at admission and 336/1187 patients (28.3%) on discharge, and the proportion of preventive medication in the hyperpolypharmacy category at both points in time remained high (1209/3371 [35.9%] at admission v 1508/4117 [36.6%] at discharge). Conclusions Polypharmacy is common among older people admitted to general medical units of Australian hospitals, with no clinically meaningful change to the number or classification (symptom control, prevention or both) of drugs made by treating physicians.

Meta-analysis of 28,141 individuals identifies common variants within five new loci that influence uric acid concentrations

Elevated serum uric acid levels cause gout and are a risk factor for cardiovascular disease and diabetes. To investigate the polygenetic basis of serum uric acid levels, we conducted a meta-analysis of genome-wide association scans from 14 studies totalling 28,141 participants of European descent, resulting in identification of 954 SNPs distributed across nine loci that exceeded the threshold of genome-wide significance, five of which are novel. Overall, the common variants associated with serum uric acid levels fall in the following nine regions: SLC2A9 (p = 5.2x10(-201)), ABCG2 (p = 3.1x10(-26)), SLC17A1 (p = 3.0x10(-14)), SLC22A11 (p = 6.7x10(-14)), SLC22A12 (p = 2.0x10(-9)), SLC16A9 (p = 1.1x10(-8)), GCKR (p = 1.4x10(-9)), LRRC16A (p = 8.5x10(-9)), and near PDZK1 (p = 2.7x10(-9)). Identified variants were analyzed for gender differences. We found that the minor allele for rs734553 in SLC2A9 has greater influence in lowering uric acid levels in women and the minor allele of rs2231142 in ABCG2 elevates uric acid levels more strongly in men compared to women. To further characterize the identified variants, we analyzed their association with a panel of metabolites. rs12356193 within SLC16A9 was associated with DL-carnitine (p = 4.0x10(-26)) and propionyl-L-carnitine (p = 5.0x10(-8)) concentrations, which in turn were associated with serum UA levels (p = 1.4x10(-57) and p = 8.1x10(-54), respectively), forming a triangle between SNP, metabolites, and UA levels. Taken together, these associations highlight additional pathways that are important in the regulation of serum uric acid levels and point toward novel potential targets for pharmacological intervention to prevent or treat hyperuricemia. In addition, these findings strongly support the hypothesis that transport proteins are key in regulating serum uric acid levels.

Development and preliminary validation of the Drinking Expectancy Sexual Vulnerabilities Questionnaire (DESV-Q): A purpose-specific instrument for rape-perception research

Background Alcohol expectancies likely play a role in people’s perceptions of alcohol-involved sexual violence. However, no appropriate measure exists to examine this link comprehensively. Objective The aim of this research was to develop an alcohol expectancy measure which captures young adults’ beliefs about alcohol’s role in sexual aggression and victimization. Method Two cross-sectional samples of young Australian adults (18–25 years) were recruited for scale development (Phase 1) and scale validation (Phase 2). In Phase 1, participants (N = 201; 38.3% males) completed an online survey with an initial pool of alcohol expectancy items stated in terms of three targets (self, men, women) to identify the scale’s factor structure and most effective items. A revised alcohol expectancy scale was then administered online to 322 young adults (39.6% males) in Phase 2. To assess the predictive, convergent, and discriminant validity of the scale, participants also completed established measures of personality, social desirability, alcohol use, general and context-specific alcohol expectancies, and impulsiveness. Results Principal axis factoring (Phase 1) and confirmatory factor analysis (Phase 2) resulted in a target-equivalent five-factor structure for the final 66-item Drinking Expectancy Sexual Vulnerabilities Questionnaire (DESV-Q). The factors were labeled: - (1) Sexual Coercion - (2) Sexual Vulnerability - (3) Confidence - (4) Self-Centeredness - (5) Negative Cognitive and Behavioral Changes The measure demonstrated effective items, high internal consistency, and satisfactory predictive, convergent, and discriminant validity. Conclusions The DESV-Q is a purpose-specific instrument that could be used in future research to elucidate people’s attributions for alcohol-involved sexual aggression and victimization.

Emotional climate of a pre-service science teacher education class in Bhutan

This study explored pre-service secondary science teachers’ perceptions of classroom emotional climate in the context of the Bhutanese macro-social policy of Gross National Happiness. Drawing upon sociological perspectives of human emotions and using Interaction Ritual Theory this study investigated how pre-service science teachers may be supported in their professional development. It was a multi-method study involving video and audio recordings of teaching episodes supported by interviews and the researcher’s diary. Students also registered their perceptions of the emotional climate of their classroom at 3-minute intervals using audience response technology. In this way, emotional events were identified for video analysis. The findings of this study highlighted that the activities pre-service teachers engaged in matter to them. Positive emotional climate was identified in activities involving students’ presentations using video clips and models, coteaching, and interactive whole class discussions. Decreases in emotional climate were identified during formal lectures and when unprepared presenters led presentations. Emotions such as frustration and disappointment characterized classes with negative emotional climate. The enabling conditions to sustain a positive emotional climate are identified. Implications for sustaining macro-social policy about Gross National Happiness are considered in light of the climate that develops in science teacher education classes.

Some empirical evidence on offender time discount rates

The conventional wisdom is that offenders have very high discount rates not only with respect to income and fines but also with respect to time incarcerated. These rates are difficult to measure objectively and the usual approach is to ask subjects hypothetical questions and infer time preference from their answers. In this article, we propose estimating rates at which offenders discount time incarcerated by specifying their equilibrium plea, defined as the discount rate, which equates the time and expected time spent in jail following a guilty plea and a trial. Offenders are assumed to exhibit positive time preference and discount time spent in jail at a constant rate. Our choice of sample is interesting because the offenders are not on bail, punishment is not delayed and the offences are planned therefore conforming to Becker’s model of the decision to commit a crime. Contrary to the discussion in the literature, we do not find evidence of consistently high time discount rates, and therefore cannot unequivocally infer that the prison experience always results in low levels of specific deterrence.

Surveying the field: Primary school teachers’ conceptions of the literacy capabilities of recently graduated primary school teachers

In 2015, ALEA National Council provided funds to support the implementation of a research project which was undertaken by a group of teacher educators and researchers from a range of universities across three Australian states. Stage one of the project, which is reported on here, examined primary school teachers’ perceptions of the personal and professional literacy capabilities of recently graduated primary school teachers. This stage of the project also examined primary school teachers’ perceptions of the impact of initial teacher education on the personal and professional literacy capabilities of recently graduated primary school teachers. The project team, led by Associate Professor Beryl Exley (Queensland University of Technology), included Chief Investigators Dr Eileen Honan (The University of Queensland), Associate Professor Lisa Kervin (University of Wollongong), Associate Professor Alyson Simpson (University of Sydney) and Dr Muriel Wells (Deakin University), with Dr Sandy Muspratt as the Statistical Analyst and Lesley Friend as the Research Assistant with primary responsibility for the publication of the online survey.

Safety impacts of alcohol and other drugs in construction

Estimated 638,400 persons suffered a work-related injury or illness in 2009-2010 and 337 lost their lives as a result in 2009-2010. In 2013-2014, there were 186 fatalities with 29 (16%) occurring in construction. Very little is known about what proportion of accidents are directly attributable to the effects of AOD. Anecdotal evidence highlights issues of AOD and its association with safety risk on construction sites. Research Objective: • To scientifically evaluate the relationship between the use of AOD and the safety impacts within the Australian construction industry to engender a cultural change in the workforce • A nationally consistent and collaborative approach involving government, employers and employees, unions and other key industry stakeholders

Ratios of T-cell immune-effectors with tumour associated macrophages and PD-1/PD-L1 axis immune-checkpoint molecules, as prognosticators in diffuse large B cell lymphoma: A population-based study

Background Risk-stratification of diffuse large B-cell lymphoma (DLBCL) requires identification of patients with disease that is not cured despite initial R-CHOP. Although the prognostic importance of the tumour microenvironment (TME) is established, the optimal strategy to quantify it is unknown. Methods The relationship between immune-effector and inhibitory (checkpoint) genes was assessed by NanoString™ in 252 paraffin-embedded DLBCL tissues. A model to quantify net anti-tumoural immunity as an outcome predictor was tested in 158 R-CHOP treated patients, and validated in tissue/blood from two independent R-CHOP treated cohorts of 233 and 140 patients respectively. Findings T and NK-cell immune-effector molecule expression correlated with tumour associated macrophage and PD-1/PD-L1 axis markers consistent with malignant B-cells triggering a dynamic checkpoint response to adapt to and evade immune-surveillance. A tree-based survival model was performed to test if immune-effector to checkpoint ratios were prognostic. The CD4*CD8:(CD163/CD68)*PD-L1 ratio was better able to stratify overall survival than any single or combination of immune markers, distinguishing groups with disparate 4-year survivals (92% versus 47%). The immune ratio was independent of and added to the revised international prognostic index (R-IPI) and cell-of-origin (COO). Tissue findings were validated in 233 DLBCL R-CHOP treated patients. Furthermore, within the blood of 140 R-CHOP treated patients immune-effector:checkpoint ratios were associated with differential interim-PET/CT+ve/-ve expression.

Grand challenges for public health

What is the future for public health in the twenty-first century? Can we glean an idea about the future of public health from its past? As Winston Churchill once said: ‘[T]he further backward you look, the further forward you can see.’ What can we see in the history of public health that gives us an idea of where public health might be headed in the future? (Gruszin et al. 2012). In the twentieth century there was substantial progress in public health in Australia. These improvements were brought about through a number of factors. In part, improvements were due to increasing knowledge about the natural history of disease and its treatment. Added to this knowledge was a shifting focus from legislative measures to protect health, to the emergence of improved promotion and prevention strategies, and a general improvement in social and economic conditions for people living in countries such as Australia. Gruszin et al. (2012) consider the range of social and economic reforms of the twentieth century as the most important determinants of the public’s health at the start of the twenty-first century (Gruszin et al. 2012 p 201). The same could not, however, be said for second or third world countries, many of whom have the most fundamental of sanitary and health protection issues still to deal with. For example, in sub-Saharan Africa and in Russia the decline in life expectancy can be said to be related to a range of interconnected factors. In Russia, issues such as alcoholism, violence, suicide, accidents and cardiovascular disease could be contributing to the falling life expectancy (McMichael & Butler 2007). In sub-Saharan Africa, a range of factors, such as HIV/AIDS, poverty, malaria, tuberculosis, undernutrition, totally inadequate infrastructure, gender inequality, conflict and violence, political taboos and a complete lack of political will, have all contributed to a dramatic drop in life expectancy (McMichael & Butler 2007).

Relationship between quality certification and financial and non-financial performance of organizations

At present, many countries have either embraced ISO9001 or used it as the basis of their national quality certification systems. However, few studies have been conducted to examine the benefits companies’ gain from achieving and implementing ISO9001 standards (Chikuku et al. 2012; Psomas et al. 2013; Sampaio et al. 2011a,b). Analysis has brought much more confused and uneven results across the countries. Turning to the experience of Malaysia, this country has witnessed a spectacular growth at an average rate of 9.89% per annum of ISO certificates issued to companies operating within its borders (ISO Survey 2012). While many companies rush to be ISO 9001 certified whether this brings about better benefits (both the financial and the non-financial) is still an open question. In this study, the research problems were first formulated from the literature and then a questionnaire survey was conducted to test the hypotheses. A survey was administered to chief executives officers and managers across manufacturing and service organizations in Malaysia. Multivariate analysis and SPSS macro developed by Preacher and Hayes were used as statistical techniques to the financial and non-financial benefits of ISO9001 certification. The survey instrument was a two-page questionnaire comprising three sections. The first section of the questionnaire covered the company’s profile. The second section consisted of 25 items on internal benefits and third section consisted of 7 items on external benefits measured on 1–5 Likert scale to assess the benefits of ISO9001 certification. Total 201 valid responses were received. Results of the study indicate that there was no significant direct relationship between ISO9001 certification and organizational financial performance, while strong statistical evidence was found to support the direct relationship between ISO9001 certification and non-financial performance. The findings of the study discovered that financial performance is actually directly related to two non-financial measures, namely quality performance and local and international business performance, which are directly and significantly influenced by ISO9001 certification. Therefore non-financial performance measures are involved in the mediational process. The findings will assist practitioners in taking right courses of action that make the implementation of this standard more effective. For example, the study findings study suggests that companies should put emphasize on nonfinancial factors to improve their financial performance.