In-hospital mortality rates after a cemented femoral component for displaced neck of femur fractures

Aim This prospective cohort study investigated whether the use of preoperative anticoagulants is an independent risk factor for the outcomes of surgical treatment of patients with a neck of femur fracture. Methods Data was obtained from a prospectively collected database. All patients admitted for a neck of femur fracture between Nov 2010 and Oct 2011 were included. This resulted in three hundred twenty-eight patients with 330 neck of femur fractures. Four groups were defined; patients preoperatively (i) on aspirin (n = 105); (ii) on clopidogrel (n = 28); (iii) on warfarin (n = 30), and; (iv) without any anticoagulation history (n = 167, the control group). The non-warfarin group included the aspirin group, clopidogrel group and the control group. Primary outcome was the in-hospital mortality. Secondary outcomes were the postoperative complications, return to theatre and length of stay. Results Thirteen in-hospital deaths were identified, 4 deaths in the aspirin group, 1 death in the clopidogrel group, 2 deaths in the warfarin group and 6 deaths in the control group. No significant difference in the mortality rates was found between the different groups. Also in the secondary outcomes, no significant difference was found between the four groups. A trend to a higher wound complication rate for the warfarin group was detected. Conclusion The use of clopidrogel or aspirin pre operatively is not an influence on short term patient outcome for patients with a neck of femur fracture. Surgical procedures should not be delayed to reverse their influence.

Fracture load for short versus standard cemented hip stems : an experimental in vitro study

Introduction: In an attempt to reduce stress shielding in the proximal femur multiple new shorter stem design have become available. We investigated the load to fracture of a new polished tapered cemented short stem in comparison to the conventional polished tapered Exeter stem. Method: A total of forty-two stems, twenty-one short stems and twenty-one conventional stems both with three different offsets were cemented in a composite sawbone model and loaded to fracture. Results: study showed that femurs will break at a significantly lower load to failure with a shorter compared to conventional length Exeter stem. Conclusion: This Both standard and short stem design are safe to use as the torque to failure is 7–10 times as much as the torques seen in activities of daily living.

Proximal femoral morphology in regions of hard and soft water

This study compared proximal femoral morphology in patients living in soft and hard water regions. The proximal femoral morphology of two groups of 70 patients living in hard and soft water regions with a mean age of 72.3 (range 50 to 87 years) were measured using an antero-posterior radiograph of the non-operated hip with magnification adjusted. The medullary canal diameter at the level of the lesser trochanter (LT) was significantly wider in patients living in the hard water region (mean width 1.9 mm wider; p= 0.003). No statistical significant difference was found in the medullary canal width at 10 cm below the level of LT, Dorr index, or Canal Bone Ratio (CBR). In conclusion, the proximal femoral morphology does differ in patients living in soft and hard water areas. These results may have an important clinical bearing in patients undergoing total hip replacement surgery. Further research is needed to determine whether implant survivorship is affected in patients living in hard and soft water regions.

Human CD141(+) (BDCA-3)(+) dendritic cells (DCs) represent a unique myeloid DC subset that cross-presents necrotic cell antigens

The characterization of human dendritic cell (DC) subsets is essential for the design of new vaccines. We report the first detailed functional analysis of the human CD141(+) DC subset. CD141(+) DCs are found in human lymph nodes, bone marrow, tonsil, and blood, and the latter proved to be the best source of highly purified cells for functional analysis. They are characterized by high expression of toll-like receptor 3, production of IL-12p70 and IFN-beta, and superior capacity to induce T helper 1 cell responses, when compared with the more commonly studied CD1c(+) DC subset. Polyinosine-polycytidylic acid (poly I:C)-activated CD141(+) DCs have a superior capacity to cross-present soluble protein antigen (Ag) to CD8(+) cytotoxic T lymphocytes than poly I:C-activated CD1c(+) DCs. Importantly, CD141(+) DCs, but not CD1c(+) DCs, were endowed with the capacity to cross-present viral Ag after their uptake of necrotic virus-infected cells. These findings establish the CD141(+) DC subset as an important functionally distinct human DC subtype with characteristics similar to those of the mouse CD8 alpha(+) DC subset. The data demonstrate a role for CD141(+) DCs in the induction of cytotoxic T lymphocyte responses and suggest that they may be the most relevant targets for vaccination against cancers, viruses, and other pathogens.

Surveying the Wide Bay Burnett : changing lifestyles and the implications for regional transport planning

Significant lifestyle and demographic changes in Queensland are beginning to alter the landscape of regional transport planning. In 2006, Queensland Transport undertook a study to understand the implications of these changes on the transport planning task in regional Queensland. The study focused on the current travel characteristics of three Local Government Areas in the Wide Bay Burnett Region. Hervey Bay City represented the ‘sea change’ phenomenon; Wondai Shire represented the growing ‘tree change’ lifestyle; and Monto Shire represented communities which were either experiencing limited change or a decrease in population. The results of this research will be used to inform long term integrated regional transport planning in the region.

Noise is the outsider to be expelled

This was a catalogue essay for the emerging Brisbane artist Sarah Byrne's exhibition Trenchmouth at MetroArts from 31st October until 21st November 2009. The essay contextualised her practice in the history of experimental soundart and discussed her methods of practice and approach to sound from the postion of a multi-discplinary artist.The essay also discussed the way in which her practice engages with and recontextualises camp, trash, and lo-fi aspects of popular culture

Sing fox to me : an investigation into the "use" of Down Syndrome in both the Down Syndrome and Gothic novel

This project investigates the current borders around and within, what I have in this exegesis termed, "the Down Syndrome novel", using a close reading analysis of literary texts containing characters with Down syndrome and contextualised by theoretical works drawn from both disability and literary theory. This practice-led thesis introduces and discusses select fictional characters with Down syndrome from numerous genres, revealing them as highly contained, or "boundaried", spoken for, and generally used for narrative conflict rather than included as individuals with agency and a legitimate, autonomous voice and narrative point of view. In reframing the Australian landscape as "disabled" this exegesis illustrates that the Australian Gothic novel can shift, and sometimes even remove, the boundary around characters with intellectual disabilities, allowing a space where the stories of characters with Down syndrome can emerge.

Rough Seas

Favel Parrett’s second novel, When the Night Comes, opens with its teenage protagonist Isla lying awake in her bunk on a night ferry to Tasmania in the mid-1980s, ‘waiting for the rough seas’. Her younger brother sleeps beside her, and her distracted, emotionally distant mother – the kind of woman who is ‘always sitting places by herself in the night’ – is smoking on deck. Together, the three are weathering the roiling overnight passage in order to escape a violent past and make a new life in Hobart. The rough seas the novel goes on to navigate are, as one might expect, both literal and metaphorical...

Transcriptional pathway signatures predict MEK addiction and response to selumetinib (AZD6244)

Selumetinib (AZD6244, ARRY-142886) is a selective, non-ATP-competitive inhibitor of mitogen-activated protein/extracellular signal-regulated kinase kinase (MEK)-1/2. The range of antitumor activity seen preclinically and in patients highlights the importance of identifying determinants of response to this drug. In large tumor cell panels of diverse lineage, we show that MEK inhibitor response does not have an absolute correlation with mutational or phospho-protein markers of BRAF/MEK, RAS, or phosphoinositide 3-kinase (PI3K) activity. We aimed to enhance predictivity by measuring pathway output through coregulated gene networks displaying differential mRNA expression exclusive to resistant cell subsets and correlated to mutational or dynamic pathway activity. We discovered an 18-gene signature enabling measurement of MEK functional output independent of tumor genotype. Where the MEK pathway is activated but the cells remain resistant to selumetinib, we identified a 13-gene signature that implicates the existence of compensatory signaling from RAS effectors other than PI3K. The ability of these signatures to stratify samples according to functional activation of MEK and/or selumetinib sensitivity was shown in multiple independent melanoma, colon, breast, and lung tumor cell lines and in xenograft models. Furthermore, we were able to measure these signatures in fixed archival melanoma tumor samples using a single RT-qPCR-based test and found intergene correlations and associations with genetic markers of pathway activity to be preserved. These signatures offer useful tools for the study of MEK biology and clinical application of MEK inhibitors, and the novel approaches taken may benefit other targeted therapies.

“My hands are plunged in oranges”…: an experiential account of a working process

This presentation incorporated the live performance throughout, by the author, of movement from “The All Weather Project” by Liz Roche. Movement sections are indicated by italics. “I am going to start by dancing for you… Movement: Live performance of solo approximately 10 minutes in duration This is the introduction... Through my PhD research, I am examining the choreographic process from the perspective of the independent contemporary dancer, through embodying this role as a researcher/participant. My methodological frameworks, which utilise video documentation and journal writing, could be characterised as ethnographic, multi-modal embodied theorising, leading to “multi-dimensional theorising” (I adopt this term from Susan Melrose). In this way, I am unwinding the embodied practice of dancing, through the co-existent layers of experience, towards forming a theoretical understanding of the issues that arise for the dancer. The issues that I have identified as relevant to my research are those relating to the dancer’s ‘moving identity’ or way of moving, as a mutable and adaptable form that must alter and re-adjust to each different choreographic engram or movement vocabulary, that she/he encounters. I am examining this interplay between stability and change. I also reflect on the impact of destabilisation and flux on the dancer’s identity in a wider sense, as she/he relates outwardly to signifying factors within the social strata. Today I am going to bring you through a reflection on the working process of a dance piece as experienced from the inside. By doing so, I hope to capture and elucidate the multi-dimensional layers which existed for me within this process. Through displaying these fragments together, I endeavour to invoke the ‘totality’ of the experience...

Approaching paradise

Poem

Lago Nicaraguense

Poem

Late Hammershoi

Poem