Is the two hour recommended maximum driving time appropriate for both healthy older and treated obstructive sleep apnoea drivers?

Objectives The UK Department for Transport recommends taking a break from driving every 2 h. This study investigated: (i) if a 2 h drive time on a monotonous road is appropriate for OSA patients treated with CPAP, compared with healthy age matched controls, (ii) the impact of a night’s sleep restriction (with CPAP) and (iii) what happens if these patients miss one nights’ CPAP treatment. Methods About 19 healthy men aged 52–74 y (m = 66.2 y) and 19 OSA participants aged 50–75 y (m = 64.4 y) drove an interactive car simulator under monotonous motorway conditions for 2 h on two afternoons, in a counterbalanced design; (1) following a normal night’s sleep (8 h). (2) following a restricted night’s sleep (5 h), with normal CPAP use (3) following a night without CPAP treatment. (n = 11) Lane drifting incidents, indicative of falling asleep, were recorded for up to 2 h depending on competence to continue driving. Results Normal sleep: Controls drove for an average of 95.9 min (s.d. 37 min) and treated OSA drivers for 89.6 min (s.d. 29 min) without incident. 63.2% of controls and 42.1% of OSA drivers successfully completed the drive without an incident. Sleep restriction: 47.4% of controls and 26.3% OSA drivers finished without incident. Overall: controls drove for an average of 89.5 min (s.d. 39 min) and treated OSA drivers 65 min (s.d. 42 min) without incident. The effect of condition was significant [F(1.36) = 9.237, P < 0.05, eta2 = 0.204]. Stopping CPAP: 18.2% of drivers successfully completed the drive. Overall, participants drove for an average of 50.1 min (s.d. 38 min) without incident. The effect of condition was significant [F(2) = 8.8, P < 0.05, eta2 = 0.468]. Conclusion 52.6% of all drivers were able to complete a 2 hour drive under monotonous conditions after a full night’s sleep. Sleep restriction significantly affected both control and OSA drivers. We find evidence that treated OSA drivers are more impaired by sleep restriction than healthy control, as they were less able to sustain safely the 2 h drive without incidents. OSA drivers should be aware that non-compliance with CPAP can significantly impair driving performance. It may be appropriate to recommend older drivers take a break from driving every 90 min especially when undertaking a monotonous drive, as was the case here.

Stored blood products augment inflammation in a two-event model of Transfusion Related Acute Lung Injury (TRALI)

Aim/Background TRALI is hypothesised to develop via a two-event mechanism involving both the patieint's underlying morbidity and blood product factors. The storage of cellular products has been implicated in cases of non-antibody mediated TRALI, however the pathophysiological mechanisms are undefined. We investigated blood product storage-related modulation of inflmmatory cells and medicators involved in TRALI. Methods In an in vitro mode, fresh human whole blood was mixed with culture media (control) or LPS as a 1st event and "transfused" with 10% (v/v) pooled supernatant (SN) from Day 1 (d1, n=75) or Day 42 (D42, n=113) packed red blood cells (PRBCs) as a 2nd event. Following 6hrs, culture SN was used to assess the overall inflammatory response (cytometric bead array) and a duplicate assay containing protein transport inhibitor was used to assess neutrophil- and monocyte-specific inflmamatory responses using multi-colour flow cytometry. Panels: IL-6, IL-8, IL-10, IL-12, IL-1, TNF, MCP-1, IP-10, MIP-1. One-way ANOVA 95% CI. Results In the absence of LPS, exposure to D1 or D42 PRBC-SN reduced monocyte expression of IL-6, IL-8 and Il-10. D42 PRBC-SN also reduced monocyte IP-10, and the overall IL-8 production was increased. In the presence of LPS, D1-PRBC SN only modified overall IP-10 levels which were reduced. However, cf LPS alone, the combination of LPS and D42 PRBC-SN resulted in increased neutrophil and monocyte productionof IL-1 and IL-8 as well as reduced monocyte TNF production. Additionally, LPS and D42 PRBC-SN resulted in overall inflmmatory changes: elevated IL-8,

Evaluation of two-view geometry methods with automatic ground-truth generation

A large number of methods have been published that aim to evaluate various components of multi-view geometry systems. Most of these have focused on the feature extraction, description and matching stages (the visual front end), since geometry computation can be evaluated through simulation. Many data sets are constrained to small scale scenes or planar scenes that are not challenging to new algorithms, or require special equipment. This paper presents a method for automatically generating geometry ground truth and challenging test cases from high spatio-temporal resolution video. The objective of the system is to enable data collection at any physical scale, in any location and in various parts of the electromagnetic spectrum. The data generation process consists of collecting high resolution video, computing accurate sparse 3D reconstruction, video frame culling and down sampling, and test case selection. The evaluation process consists of applying a test 2-view geometry method to every test case and comparing the results to the ground truth. This system facilitates the evaluation of the whole geometry computation process or any part thereof against data compatible with a realistic application. A collection of example data sets and evaluations is included to demonstrate the range of applications of the proposed system.

Flexible design of decoupling and matching networks for two strongly coupled antennas

The flexible design of decoupling and matching networks for coupled antennas is introduced. The network includes three parts: circuits for impedance transformation, an element for odd-mode decoupling and conventional matching networks. It is found that all three parts are determined by one parameter of the ABCD matrix of the impedance transformation circuit. Thus a large variety of circuits with different element values can be used for decoupling which relaxes the practical design constraints.

Calligraphy and causation : two obstetric management cases

Child born with gross hydrocephalus - cerebral palsy - questions surrounding obstetrician's notes - ultrasound not ordered - illegible handwriting - importance of legible, accurate and detailed medical records - causation - child born with congenital varicella syndrome (CVS) - chicken pox - forseeability of risk.

Scepticism and trust: two counterpoint essentials in science education for complex socio-scientific issues

In this response to Tom G. K. Bryce and Stephen P. Day’s (Cult Stud Sci Educ. doi:10.1007/s11422-013-9500-0, 2013) original article, I share with them their interest in the teaching of climate change in school science, but I widen it to include other contemporary complex socio-scientific issues that also need to be discussed. I use an alternative view of the relationship between science, technology and society, supported by evidence from both science and society, to suggest science-informed citizens as a more realistic outcome image of school science than the authors’ one of mini-scientists. The intellectual independence of students Bryce and Day assume, and intend for school science, is countered with an active intellectual dependence. It is only in relation to emerging and uncertain scientific contexts that students should be taught about scepticism, but they also need to learn when, and why to trust science as an antidote to the expressions of doubting it. Some suggestions for pedagogies that could lead to these new learnings are made. The very recent fifth report of the IPCC answers many of their concerns about climate change.

Getting there, being there, staying and belonging: a case study of two indigenous Australian children’s transition to school

Indigenous Australians are among the most unhealthy populations in the world and yet they reside in a country where the non-Indigenous population enjoys high standards of well-being. Education has been identified as the key mechanism for closing this equity gap. At school commencement many Indigenous children are already at risk of disengagement. This four-year longitudinal study of two Indigenous boys from a socially marginalised community examined key factors affecting transitional trajectories into school. While child characteristics affected level of achievement the critical factors in sustaining positive educational engagement were social support, school practices, inclusion of family and positive expectation.

The Nagle Royal Commission 25 years on : gaining perspective on two and a half decades of NSW prison reform

This article attempts an audit of changes in the NSW penal system over the last nearly 30 years. Taking the 1978 Nagle Royal Commission findings and analysis as the starting point a comparison is made between the Nagle era and the contemporary scene across a range of practices including imprisonment rates, violence, drug use, deaths in custody, prison conditions, prisoners rights, legal regulation, and others. It is suggested that developments since Nagle are mixed and cannot be attributed to a single logic or force. Major changes include a doubling of imprisonment rates, significant increases in Indigenous and women's imprisonment rates, the apparent ending of institutionalised bashings and the centrality of drug use to imprisonment and to the culture, health and security practices which characterise the current prison experience. The article may constitute a useful starting point for broader attempts to relate current penal practices to far wider changes in the conditions of life under late modernity.

In vitro assessment of migratory behavior of two cell populations in a simple multichannel microdevice

Recent literature suggests that mesenchymal stem/stromal cells (MSC) could be used as Trojan Horses to deliver “death-signals” to cancer cells. Herein, we describe the development of a novel multichannel cell migration device, and use it to investigate the relative migration rates of bone marrow-derived MSC and breast cancer cells (MCF-7) towards each other. Confluent monolayers of MSC and MCF-7 were established in adjacent chambers separated by an array of 14 microchannels. Initially, culture chambers were isolated by air bubbles (air-valves) contained within each microchannel, and then bubbles were displaced to initiate the assay. The MCF-7 cells migrated preferentially towards MSC, whilst the MSC did not migrate preferentially towards the MCF-7 cells. Our results corroborate previous literature that suggests MSC migration towards cancer cells in vivo is in response to the associated inflammation rather than directly to signals secreted by the cancer cells themselves.

A practical and theoretical definition of very small field size for radiotherapy output factor measurements

Purpose This work introduces the concept of very small field size. Output factor (OPF) measurements at these field sizes require extremely careful experimental methodology including the measurement of dosimetric field size at the same time as each OPF measurement. Two quantifiable scientific definitions of the threshold of very small field size are presented. Methods A practical definition was established by quantifying the effect that a 1 mm error in field size or detector position had on OPFs, and setting acceptable uncertainties on OPF at 1%. Alternatively, for a theoretical definition of very small field size, the OPFs were separated into additional factors to investigate the specific effects of lateral electronic disequilibrium, photon scatter in the phantom and source occlusion. The dominant effect was established and formed the basis of a theoretical definition of very small fields. Each factor was obtained using Monte Carlo simulations of a Varian iX linear accelerator for various square field sizes of side length from 4 mm to 100 mm, using a nominal photon energy of 6 MV. Results According to the practical definition established in this project, field sizes < 15 mm were considered to be very small for 6 MV beams for maximal field size uncertainties of 1 mm. If the acceptable uncertainty in the OPF was increased from 1.0 % to 2.0 %, or field size uncertainties are 0.5 mm, field sizes < 12 mm were considered to be very small. Lateral electronic disequilibrium in the phantom was the dominant cause of change in OPF at very small field sizes. Thus the theoretical definition of very small field size coincided to the field size at which lateral electronic disequilibrium clearly caused a greater change in OPF than any other effects. This was found to occur at field sizes < 12 mm. Source occlusion also caused a large change in OPF for field sizes < 8 mm. Based on the results of this study, field sizes < 12 mm were considered to be theoretically very small for 6 MV beams. Conclusions Extremely careful experimental methodology including the measurement of dosimetric field size at the same time as output factor measurement for each field size setting and also very precise detector alignment is required at field sizes at least < 12 mm and more conservatively < 15 mm for 6 MV beams. These recommendations should be applied in addition to all the usual considerations for small field dosimetry, including careful detector selection.

Child sex scandal in two countries rocks Anglican church

A CHILD sex scandal involving victims in Australia and Britain has hit the top echelon of the Anglican Church, with allegations that some of its most senior clergymen failed to respond properly to complaints of horrific abuse. The former archbishop of York, now Lord (David) Hope of Thornes, yesterday expressed regret over failing to report to police allegations in 1999 and 2003 about a former Queensland Anglican school principal, who rose to become the head of education for the church in Britain. The late reverend Robert Waddington has been accused of beating and sexually abusing students during the 1960s at St Barnabas boarding school in Ravenshoe, north Queensland, and later, when he was in charge of the choir as dean of Manchester. A joint investigation by The Australian and The Times newspaper in London has revealed that church officials, including Lord Hope, failed to report the 1999 allegations of abuse made by a former Queensland student and similar claims made in 2003 by the family of a choirboy in Manchester. The alleged victims were never told of the existence of the other allegations.

Capturing the ‘authentic voice’ : challenges and opportunities for voice and self-representation in two ABC storytelling projects

This paper discusses the opportunities and challenges that arise within storytelling projects that are facilitated by public service broadcasters and that aim to amplify the voices of ‘ordinary people’. In particular, it focuses on two of the Australian Broadcasting Corporation’s current life storytelling projects: ABC Open and Heywire.

Diporphyrins linked by two-atom bridges synthestic, structural and theoretical studies

The syntheses, properties and electronic structures of a series of porphyrin dimers connected by two-atom bridges were compared. The study found that an azo linker results in the most efficient electronic communication between the two porphyrin rings, and is the superior connector for dimers, trimers and oligomers in the design of nonlinear optical materials. This has implications for the design of molecular probes and sensors, photodynamic therapy, microfabrication, and three-dimensional optical data storage. The research led to the synthesis of a number of new porphyrin monomers and dimers, which were characterised using structural, spectroscopic and spectrometric techniques.

A bricoleur (or two) in the consulting room

In popular contemporary use, the French term bricolage refers to the activities of the home handyman. It is sometimes used in a disparaging way to refer to work that is improvised, uninformed by expertise or specialist knowledge, and probably inferior in its results when compared with the work of a tradesman or professional. In 1962, anthropologist and philosopher Claude Lévi-Strauss argued that bricolage is a modality of human thought. Since then, the importance of bricolage as a mental activity has been identified in relation to art and architecture, as well as other fields of cultural activity. In this paper I consider bricolage as an activity of the ego and explore its role in the consulting room. I argue that by necessity the psychoanalytic work undertaken between patient and analyst relies on this modality of thought and, furthermore, that the use of bricolage is entirely compatible with evidence-based practice.