Improved surgical safety after laparoscopic compared to open surgery for apparent early stage endometrial cancer : results from a randomised controlled trial

AIM: To compare Total Laparoscopic Hysterectomy (TLH) and Total Abdominal Hysterectomy (TAH) with regard to surgical safety. METHODS: Between October 2005 and June 2010, 760 patients with apparent early stage endometrial cancer were enroled in a multicentre, randomised clinical trial (LACE) comparing outcomes following TLH or TAH. The main study end points for this analysis were surgical adverse events (AE), hospital length of stay, conversion from laparoscopy to laparotomy, including 753 patients who completed at least 6 weeks of follow-up. Postoperative AEs were graded according to Common Toxicity Criteria (V3), and those immediately life-threatening, requiring inpatient hospitalisation or prolonged hospitalisation, or resulting in persistent or significant disability/incapacity were regarded as serious AEs. RESULTS: The incidence of intra-operative AEs was comparable in either group. The incidence of post-operative AE CTC grade 3+ (18.6% in TAH, 12.9% in TLH, p 0.03) and serious AE (14.3% in TAH, 8.2% in TLH, p 0.007) was significantly higher in the TAH group compared to the TLH group. Mean operating time was 132 and 107 min, and median length of hospital stay was 2 and 5 days in the TLH and TAH group, respectively (p<0.0001). The decline of haemoglobin from baseline to day 1 postoperatively was 2g/L less in the TLH group (p 0.006). CONCLUSIONS: Compared to TAH, TLH is associated with a significantly decreased risk of major surgical AEs. A laparoscopic surgical approach to early stage endometrial cancer is safe.

Defining and describing what we do : doctrinal legal research

The practitioner lawyer of the past had little need to reflect on process. The doctrinal research methodology developed intuitively within the common law — a research method at the core of practice. There was no need to justify or classify it within a broader research framework. Modern academic lawyers are facing a different situation. At a time when competition for limited research funds is becoming more intense, and in which interdisciplinary work is highly valued and non-lawyers are involved in the assessment of grant applications, lawyer-applicants who engage in doctrinal research need to be able to explain their methodology more clearly. Doctrinal scholars need to be more open and articulate about their methods. These methods may be different in different contexts. This paper examines the doctrinal method used in legal research and its place in recent research dialogue. Some commentators are of the view that the doctrinal method is simply scholarship rather than a separate research methodology. Richard Posner even suggests that law is ‘not a field with a distinct methodology, but an amalgam of applied logic, rhetoric, economics and familiarity with a specialized vocabulary and a particular body of texts, practices, and institutions ...’.1 Therefore, academic lawyers are beginning to realise that the doctrinal research methodology needs clarification for those outside the legal profession and that a discussion about the standing and place of doctrinal research compared to other methodologies is required.

Solving tri-diagonal linear systems using field programmable gate arrays

In this paper, we present the outcomes of a project on the exploration of the use of Field Programmable Gate Arrays(FPGAs) as co-processors for scientific computation. We designed a custom circuit for the pipelined solving of multiple tri-diagonal linear systems. The design is well suited for applications that require many independent tri diagonal system solves, such as finite difference methods for solving PDEs or applications utilising cubic spline interpolation. The selected solver algorithm was the Tri Diagonal Matrix Algorithm (TDMA or Thomas Algorithm). Our solver supports user specified precision thought the use of a custom floating point VHDL library supporting addition, subtraction, multiplication and division. The variable precision TDMA solver was tested for correctness in simulation mode. The TDMA pipeline was tested successfully in hardware using a simplified solver model. The details of implementation, the limitations, and future work are also discussed.

Plant made anti-HIV microbicides-A field of opportunity

HIV remains a significant global burden and without an effective vaccine, it is crucial to develop microbicides to halt the initial transmission of the virus. Several microbicides have been researched with various levels of success. Amongst these, the broadly neutralising antibodies and peptide lectins are promising in that they can immediately act on the virus and have proven efficacious in in vitro and in vivo protection studies. For the purpose of development and access by the relevant population groups, it is crucial that these microbicides be produced at low cost. For the promising protein and peptide candidate molecules, it appears that current production systems are overburdened and expensive to establish and maintain. With recent developments in vector systems for protein expression coupled with downstream protein purification technologies, plants are rapidly gaining credibility as alternative production systems. Here we evaluate the advances made in host and vector system development for plant expression as well as the progress made in expressing HIV neutralising antibodies and peptide lectins using plant-based platforms. © 2012 Elsevier Inc.

Navigating the field of contemporary performance

This Chapter introduces Compass Points: The Landscapes, Locations and Coordinates of Identities in Contemporary Performance Making, a volume which collects papers from the Australasian Association for Theatre, Drama and Performance Studies (ADSA) Conference 2012.

Working with actors in open disclosure simulations

A key strategy in facilitating learning in Open Disclosure training is the use of hypothetical, interactive scenarios called ‘simulations’. According to Clapper (2010), the ‘advantages of using simulation are numerous and include the ability to help learners make meaning of complex tasks, while also developing critical thinking and cultural skills’. Simulation, in turn, functions largely through improvisation and role-play, in which participants ‘act out’ particular roles and characters according to a given scenario, without recourse to a script. To maximise efficacy in the Open Disclosure training context, role-play requires the specialist skills of professionally trained actors. Core capacities that professional actors bring to the training process include (among others) believability, an observable and teachable skill which underpins the western traditions of actor training; and flexibility, which pertains to the actor’s ability to vary performance strategies according to the changing dynamics of the learning situation. The Patient Safety and Quality Improvement Service of Queensland Health utilises professional actors as a key component of their Open Disclosure Training Program. In engaging actors in this work, it is essential that Facilitators of Open Disclosure training have a solid understanding of the acting process: what acting is; how actors work to a brief; how they improvise; and how they sustainably manage a wide range of emotional states. In the simulation context, the highly skilled actor can optimise learning outcomes by adopting or enacting – in collaboration with the Facilitator - a pedagogical function.

Open in art, nature and emergence

The interactive art system +-now is modelled on the openness of the natural world. Emergent shapes constitute a novel method for facilitating this openness. With the art system as an example, the relationship between openness and emergence is discussed. Lastly, artist reflections from the creation of the work are presented. These describe the nature of open systems and how they may be created.

End-expiratory lung volume recovers more slowly after closed endotracheal suctioning than after open suctioning : a randomized crossover study

Purpose Endotracheal suctioning causes significant lung derecruitment. Closed suction (CS) minimizes lung volume loss during suction, and therefore, volumes are presumed to recover more quickly postsuctioning. Conflicting evidence exists regarding this. We examined the effects of open suction (OS) and CS on lung volume loss during suctioning, and recovery of end-expiratory lung volume (EELV) up to 30 minutes postsuction. Material and Methods Randomized crossover study examining 20 patients postcardiac surgery. CS and OS were performed in random order, 30 minutes apart. Lung impedance was measured during suction, and end-expiratory lung impedance was measured at baseline and postsuctioning using electrical impedance tomography. Oximetry, partial pressure of oxygen in the alveoli/fraction of inspired oxygen ratio and compliance were collected. Results Reductions in lung impedance during suctioning were less for CS than for OS (mean difference, − 905 impedance units; 95% confidence interval [CI], − 1234 to –587; P < .001). However, at all points postsuctioning, EELV recovered more slowly after CS than after OS. There were no statistically significant differences in the other respiratory parameters. Conclusions Closed suctioning minimized lung volume loss during suctioning but, counterintuitively, resulted in slower recovery of EELV postsuction compared with OS. Therefore, the use of CS cannot be assumed to be protective of lung volumes postsuctioning. Consideration should be given to restoring EELV after either suction method via a recruitment maneuver.

Institutional and individual labor market discrimination based on hukou status : an artefactual field experiment

We study discrimination based on the hukou system that segregates citizens in groups of migrants and locals in urban China. We use an artefactual field experiment with a labor market framing. We recruit workers on their real labor market as experimental participants and investigate if official discrimination motivates individual discrimination based on hukou status. In our experimental results we observe discrimination based on the hukou characteristic: however, statistical discrimination does not seem to be the source of this, as status is exogeneous for our participants and migrants and locals behave similarly. Furthermore, discrimination increases between two experimental frameworks when motives for statistical discrimination are removed.

Solving tri-diagonal linear systems using field programmable gate arrays

In this paper, we present the outcomes of a project on the exploration of the use of Field Programmable Gate Arrays (FPGAs) as co-processors for scientific computation. We designed a custom circuit for the pipelined solving of multiple tri-diagonal linear systems. The design is well suited for applications that require many independent tri-diagonal system solves, such as finite difference methods for solving PDEs or applications utilising cubic spline interpolation. The selected solver algorithm was the Tri-Diagonal Matrix Algorithm (TDMA or Thomas Algorithm). Our solver supports user specified precision thought the use of a custom floating point VHDL library supporting addition, subtraction, multiplication and division. The variable precision TDMA solver was tested for correctness in simulation mode. The TDMA pipeline was tested successfully in hardware using a simplified solver model. The details of implementation, the limitations, and future work are also discussed.

Open access to judgments : Creative Commons licences and the Australian courts

Internet technologies have fundamentally changed the way we obtain access to legal documents and information about the law. However, for judgments of courts and tribunals, copyright management and licensing practices have not kept pace with the digital and online technologies which are now ubiquitous in the web 2.0 era. Under the provisions of the Copyright Act 1968 and the licensing statements on the Australian courts’ websites, judgments may generally be read online, downloaded, reproduced and printed out for personal, non-commercial use or ”in house” use by an organisation. However, beyond these permitted acts, the extent to which judgments can be copied and distributed in digital form online remains unclear. Open content licences (in particular, the Creative Commons (CC) licences) offer an effective mechanism for managing copyright in judgments in a manner that supports their wide public dissemination and reuse while also protecting their integrity and accuracy.