Extra-pleural pneumonectomy versus no extra-pleural pneumonectomy for patients with malignant pleural mesothelioma : clinical outcomes of the Mesothelioma and Radical Surgery (MARS) randomised feasibility study

Background The effects of extra-pleural pneumonectomy (EPP) on survival and quality of life in patients with malignant pleural mesothelioma have, to our knowledge, not been assessed in a randomised trial. We aimed to assess the clinical outcomes of patients who were randomly assigned to EPP or no EPP in the context of trimodal therapy in the Mesothelioma and Radical Surgery (MARS) feasibility study. Methods MARS was a multicentre randomised controlled trial in 12 UK hospitals. Patients aged 18 years or older who had pathologically confirmed mesothelioma and were deemed fit enough to undergo trimodal therapy were included. In a prerandomisation registration phase, all patients underwent induction platinum-based chemotherapy followed by clinical review. After further consent, patients were randomly assigned (1:1) to EPP followed by postoperative hemithorax irradiation or to no EPP. Randomisation was done centrally with computer-generated permuted blocks stratified by surgical centre. The main endpoints were feasibility of randomly assigning 50 patients in 1 year (results detailed in another report), proportion randomised who received treatment, proportion eligible (registered) who proceeded to randomisation, perioperative mortality, and quality of life. Patients and investigators were not masked to treatment allocation. This is the principal report of the MARS study; all patients have been recruited. Analyses were by intention to treat. This trial is registered, number ISRCTN95583524. Findings Between Oct 1, 2005, and Nov 3, 2008, 112 patients were registered and 50 were subsequently randomly assigned: 24 to EPP and 26 to no EPP. The main reasons for not proceeding to randomisation were disease progression (33 patients), inoperability (five patients), and patient choice (19 patients). EPP was completed satisfactorily in 16 of 24 patients assigned to EPP; in five patients EPP was not started and in three patients it was abandoned. Two patients in the EPP group died within 30 days and a further patient died without leaving hospital. One patient in the no EPP group died perioperatively after receiving EPP off trial in a non-MARS centre. The hazard ratio [HR] for overall survival between the EPP and no EPP groups was 1·90 (95% CI 0·92-3·93; exact p=0·082), and after adjustment for sex, histological subtype, stage, and age at randomisation the HR was 2·75 (1·21-6·26; p=0·016). Median survival was 14·4 months (5·3-18·7) for the EPP group and 19·5 months (13·4 to time not yet reached) for the no EPP group. Of the 49 randomly assigned patients who consented to quality of life assessment (EPP n=23; no EPP n=26), 12 patients in the EPP group and 19 in the no EPP group completed the quality of life questionnaires. Although median quality of life scores were lower in the EPP group than the no EPP group, no significant differences between groups were reported in the quality of life analyses. There were ten serious adverse events reported in the EPP group and two in the no EPP group. Interpretation In view of the high morbidity associated with EPP in this trial and in other non-randomised studies a larger study is not feasible. These data, although limited, suggest that radical surgery in the form of EPP within trimodal therapy offers no benefit and possibly harms patients. Funding Cancer Research UK (CRUK/04/003), the June Hancock Mesothelioma Research Fund, and Guy's and St Thomas' NHS Foundation Trust. © 2011 Elsevier Ltd.

Prevalence of childhood sexual abuse among 2508 college students in 6 provinces of China [中国6省市2508名大学生儿童期性虐待经历回顾性调查]

OBJECTIVE To assess the prevalence of childhood sexual abuse (CSA) in college students and to explore the association of CSA with youth mental health problem. METHODS A retrospective survey was conducted among 2508 students (females 1360, males 1148) in Nov. 2003 to Mar. 2004. The students were from 6 colleges/universities in Beijing, Hebei, Shanxi, Jiangsu, Shaanxi and Anhui provinces of China. RESULTS Of the 2508 students, 24.8% of females and 17.6% of males reported one or more types of nonphysical contact CSA (females 20.0% vs. males 14.6%) or/and physical contact CSA (females 14.1% vs. males 7.8%) before the age of 16 years. Risk of any CSA was not associated with the existence of siblings (one-child vs. two-or more child families), rural/non-rural residence during childhood, or parental education. Compared with their peers who had no CSA, the students with CSA showed significantly higher mean scores of psychological symptoms of somatization, obsessiveness, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation and psychoticism. CONCLUSION The problem of CSA was not uncommon and there was a significant correlation between CSA experience and students mental health problems. More attention should be paid on CSA prevention and provision of health services for the victims.

Long-term azithromycin for Indigenous children with non-cystic-fibrosis bronchiectasis or chronic suppurative lung disease (Bronchiectasis Intervention Study) : a multicentre, double-blind, randomised controlled trial

Background Indigenous children in high-income countries have a heavy burden of bronchiectasis unrelated to cystic fibrosis. We aimed to establish whether long-term azithromycin reduced pulmonary exacerbations in Indigenous children with non-cystic-fibrosis bronchiectasis or chronic suppurative lung disease. Methods Between Nov 12, 2008, and Dec 23, 2010, we enrolled Indigenous Australian, Maori, and Pacific Island children aged 1—8 years with either bronchiectasis or chronic suppurative lung disease into a multicentre, double-blind, randomised, parallel-group, placebo-controlled trial. Eligible children had had at least one pulmonary exacerbation in the previous 12 months. Children were randomised (1:1 ratio, by computer-generated sequence with permuted block design, stratified by study site and exacerbation frequency [1—2 vs ≥3 episodes in the preceding 12 months]) to receive either azithromycin (30 mg/kg) or placebo once a week for up to 24 months. Allocation concealment was achieved by double-sealed, opaque envelopes; participants, caregivers, and study personnel were masked to assignment until after data analysis. The primary outcome was exacerbation (respiratory episodes treated with antibiotics) rate. Analysis of the primary endpoint was by intention to treat. At enrolment and at their final clinic visits, children had deep nasal swabs collected, which we analysed for antibiotic-resistant bacteria. This study is registered with the Australian New Zealand Clinical Trials Registry; ACTRN12610000383066. Findings 45 children were assigned to azithromycin and 44 to placebo. The study was stopped early for feasibility reasons on Dec 31, 2011, thus children received the intervention for 12—24 months. The mean treatment duration was 20·7 months (SD 5·7), with a total of 902 child-months in the azithromycin group and 875 child-months in the placebo group. Compared with the placebo group, children receiving azithromycin had significantly lower exacerbation rates (incidence rate ratio 0·50; 95% CI 0·35—0·71; p<0·0001). However, children in the azithromycin group developed significantly higher carriage of azithromycin-resistant bacteria (19 of 41, 46%) than those receiving placebo (four of 37, 11%; p=0·002). The most common adverse events were non-pulmonary infections (71 of 112 events in the azithromycin group vs 132 of 209 events in the placebo group) and bronchiectasis-related events (episodes or investigations; 22 of 112 events in the azithromycin group vs 48 of 209 events in the placebo group); however, study drugs were well tolerated with no serious adverse events being attributed to the intervention. Interpretation Once-weekly azithromycin for up to 24 months decreased pulmonary exacerbations in Indigenous children with non-cystic-fibrosis bronchiectasis or chronic suppurative lung disease. However, this strategy was also accompanied by increased carriage of azithromycin-resistant bacteria, the clinical consequences of which are uncertain, and will need careful monitoring and further study.

"Candidatus Similichlamydia laticola", a novel Chlamydia-like agent of epitheliocystis in seven consecutive cohorts of farmed Australian barramundi, lates calcarifer (Bloch)

Six consecutively hatched cohorts and one cohort of pre-hatch eggs of farmed barramundi (Lates calcarifer) from south Australia were examined for Chlamydia-like organisms associated with epitheliocystis. To identify and characterise the bacteria, 59 gill samples and three pre-hatch egg samples were processed for histology, in situ hybridisation and 16S rRNA amplification, sequencing and comprehensive phylogenetic analysis. Cases of epitheliocystis were observed microscopically and characterised by membrane-enclosed basophilic cysts filled with a granular material that caused hypertrophy of the epithelial cells. In situ hybridisation with a Chlamydiales-specific probe lead to specific labelling of the epitheliocystis inclusions within the gill epithelium. Two distinct but closely related 16S rRNA chlamydial sequences were amplified from gill DNA across the seven cohorts, including from pre-hatch eggs. These genotype sequences were found to be novel, sharing 97.1 - 97.5% similarity to the next closest 16S rRNA sequence, Ca. Similichlamydia latridicola, from Australian striped trumpeter. Comprehensive phylogenetic analysis of these genotype sequences against representative members of the Chlamydiales order and against other epitheliocystis agents revealed these Chlamydia-like organisms to be novel and taxonomically placed them within the recently proposed genus Ca. Similichlamydia. Following Fredricks and Relman's molecular postulates and based on these observations, we propose the epitheliocystis agents of barramundi to be known as "Candidatus Similichlamydia laticola" (sp. nov.).

Development of polymers for Non-CAR resists for EUV lithography

Three strategies for approaching the design and synthesis of non-chemically amplified resists (non-CARs) are presented. These are linear polycarbonates, star polyester-blk-poly(methyl methacrylate) and comb polymers with polysulfone backbones. The linear polycarbonates were designed to cleave when irradiated with 92 eV photons and high Tg alicyclic groups were incorporated into the backbone to increase Tg and etch resistance. The star block copolymers were designed to have a core that is sensitive to 92 eV photons and arms that have the potential to provide properties such as high Tg and etch resistance. Similarly the polysulfone comb polymers were designed to have an easily degradable polymer backbone and comb-arms that impart favorable physical properties. Initial patterning results are presented for a number of the systems.

Sustaining social innovation enterprises through a design led innovation framework

Constant changes in the global economic environment require companies to revisit traditional assumptions about how businesses create and capture value (Teece, 2010). In recent years, management practice literature has focused largely on better understanding business models and business model innovation (Amit, Zott and Massa, 2010; Johnson, Christensen and Kagermann, 2008). Much has been written on the benefits of linking design and design thinking to organisational strategies and business transformation. However, very little has been researched and reported on regarding the impact of design led approaches to triple bottom-line opportunities such as, social innovation enterprise. In the context of this paper Design Led Innovation is defined as the tools and approaches which enable design thinking to be embedded as an element of cultural transformation within a business. Being Design Led requires a company to have a vision for top line growth founded on deep customer insights and expanded through customer and stakeholder engagements. The outcomes of this are then mapped to all aspects of the business, enabling the vision to be successfully implemented and achieved. It is the latter part of this definition where we believe Design Led Innovation has the greatest value in transforming social innovation enterprise into a sustainable business venture. However, we also acknowledge that enabling these firms to think strategically about their business model is difficult given the unique operational and funding challenges that often characterize many social enterprises. The purpose of this paper, therefore, is to pose the question, do sustainable innovation enterprise innovate their business model? And if so, how? It is the authors’ opinion that such enterprises only innovate at the product or system level without a complete understanding of the business model structure, which underpins the long term viability. However, in this paper we challenge this notion and explore if such firms can overcome their size and operational constraints to become sustainable enterprises using a design led approach. This is achieved through contextualizing business model innovation, briefly defining social innovation enterprise and profiling a new and emerging industry in Australia – Clean Technology. Future research challenges and opportunities are also presented.

Removal of methyl orange from aqueous solutions through adsorption by calcium aluminate hydrates

Methyl orange (MO) is a kind of anionic dye and widely used in industry. In this study, tricalcium aluminate hydrates (Ca-Al-LDHs) are used as an adsorbent to remove methyl orange (MO) from aqueous solutions. The resulting products were studied by X-ray diffraction (XRD), infrared spectroscopy (MIR), thermal analysis (TG-DTA) and scanning electron microscope (SEM). The XRD results indicated that the MO molecules were successfully intercalated into the tricalcium aluminate hydrates, with the basal spacing of Ca-Al-LDH expanding to 2.48 nm. The MIR spectrum for CaAl-MO-LDH shows obvious bands assigned to the N@N, N@H stretching vibrations and S@O, SO_ 3 group respectively, which are considered as marks to assess MO_ ion intercalation into the interlayers of LDH. The overall morphology of CaAl-MOLDH displayed a ‘‘honey-comb���’ like structure, with the adjacent layers expanded.

Australian species of spore-feeding Thysanoptera in the genera Carientothrips and Nesothrips (Thysanoptera : Idolothripinae)

The species from Australia in the genera Carientothrips and Nesothrips are reviewed and an illustrated key is provided. Carientothrips is distinguished based on the unusual form of the maxillary palps. Two species, badius Hood comb.n. and capricornis Mound comb.n., are transferred to Nesothrips from Carientothrips; and Nesothrips melinus Mound syn.n. is synonymised with Carientothrips miskoi Mound. In Carientothrips the following six new species are described: alienatus sp.n., calami sp.n., horni sp.n., palumai sp.n., snowi sp.n., tasmanica sp.n.; while flavitibia Moulton stat.rev. is recalled from synonymy with C. mjobergi (Karny). In Nesothrips four new species are described: barrowi sp.n., brigalowi sp.n., coorongi sp.n., rossi sp.n.; while rhizophorae (Girault) syn.n. is placed as a synonym of minor Bagnall.

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.

We need to talk (MCA picnic)

This collaborative, participatory work by feminist collective LEVEL took place at the Museum of Contemporary Art (MCA) as part of the official program of activities surrounding the exhibition 'War is over: (If you want it!): Yoko Ono', 2013. It took the form of a public picnic where women and their friends were invited to share food and discuss what they wanted to see in the world. Groups discussed their desires before a public declaration of these outside the museum at Circular Quay in Sydney.

How can partnerships between the universities and schools exploit new opportunities for pedagogies at the intersection of the arts/design and the sciences?

Driven by information accessibility-on-demand provided by the internet, education modes are changing from a teacher-led approach focused on content delivery and assessible outcomes, to a learner-based approach encouraging self-directed, peer-tutored, and cooperative learning. New pedagogies are required to extend learning beyond the classroom and traditional subject areas such as contemporary arts, in alignment with the cross disciplinary priorities of the Australian Curriculum and values of the International Baccalaureate Organisation. This research explores how partnerships with universities and cultural organisations are implicated in the generation of these new forms of pedagogy and contribute to the field of educational research within the context of Education Queensland’s Framework For Gifted Education. In particular, this paper explores a new pedagogical framework for highly capable year five to nine Queensland state school students at the intersection of arts, design and the sciences, which has arisen from an explicit secondary/ tertiary partnership between the Queensland University of Technology Creative Industries Faculty and Precincts and the Queensland Academies Young Scholars Program. The Young Scholars Program offers experiences in the International Baccalaureate and Australian Curriculum contexts to enhance outcomes via global understanding, unique industry partnerships and 21st century pedagogical innovation based not on 'content' but tacit/experiential learning concepts including immersive, creative, intellectual and social strategies. These strategies for highly capable students are centred around authentic opportunities, primary resources, transdisciplinary learning and relationships with likeminded peers including tertiary arts, design and STEM educators and students, professionals and researchers. The presentation details case studies which are hands-on real time workshops involving inquiry based challenges in the arts, design and sciences, mathematics, history, creative writing and other disciplines, with content drawn from collections from public institutions, academic research and tertiary pedagogy. Both programs implicate student collaboration and creative production as methodology/data capture for ongoing action research, in alignment with the Framework For Gifted Education’s emphasis on evidence-based practices. They also challenge gifted students “to continue their development through curricular activities that require depth of study, complexity of thinking, fast pace of learning, high-level skills development and/or creative and critical thinking (e.g. through independent investigations, tiered tasks, diverse real-world applications, mentors)”(Education Queensland, 2011:3). This presentation highlights the strengths of the ongoing collaboration between QUT Creative industries Faculty and Queensland Academies, which not only provides successful extra curricular activities for gifted students towards a place in the International Baccalaureate Program, but also provides mentoring opportunities for tertiary students in their field of endeavor to assist with their own learning, and unique research opportunities for the Faculty as it focuses on excellence in arts, design and creative education and research. Education Queensland.(2011). Framework For Gifted Education Revised Edition 2011 (accessed Nov 19 2011)

How many fake Sandy pictures were really shared on social media?

Many dramatic images of hurricane Sandy hitting the east coast of the US have been captured but which have been tweeted the most and which are real?

Effect of mobile phone use and aggression on speed selection by young drivers : a driving simulator study

Aggressive driving has been associated with engagement in other risky driving behaviours, such as speeding; while drivers using their mobile phones have an increased crash risk, despite the tendency to reduce their speed. Research has amassed separately for mobile phone use and aggressive driving among younger drivers, however little is known about the extent to which these behaviours may function independently and in combination to influence speed selection behaviour. The main aim of the current study was to investigate the effect of driver aggression (measured by the Driving Anger Expression Inventory) and mobile phone use on speed selection by young drivers. The CARRS-Q advanced driving simulator was used to test the speed selection of drivers aged 18 to 26 years (N = 32) in a suburban (60kph zone) driving context. A 2 (level of driving anger expression: low, high) X 3 (mobile phone use condition: baseline, hands-free, hand-held) mixed factorial ANOVA was conducted with speed selection as the dependent variable. Results revealed a significant main effect for mobile phone use condition such that speed selection was lowest for the hand-held condition and highest for the baseline condition. Speed selection, however, was not significantly different across the levels of driving anger expression; nor was there a significant interaction effect between the mobile phone use and driving anger expression. As young drivers are over-represented in road crash statistics, future research should further investigate the combined impact of driver aggression and mobile phone use on speed selection.

Barbadocladius Cranston & Krosch, a new genus of Orthocladiinae (Diptera : Chironomidae) from South America.

Barbadocladius n. gen. is erected and described in larval, pupal and adult stages for two species: B. andinus sp. nov. and B. limay sp. nov., from Andean streams. The larva is distinctive by virtue of the very large ventromental 'beard' and the anterior parapods with a 'sleeve' of hooklets in addition to apical pectinate claws. The pupa has hooklets on some tergal and sternal intersegmental membranes. The adult, reported only in teneral specimens has hairy eyes, no antennal apical strong seta, no acrostichals, bare and unmarked wings, cylindrical 4th tarsomere subequal in length to the 5th, pulvilli about half the claw length, and hypopygium with anal point, lacking a virga. Molecular phylogenetic analysis eliminates relationships directly to the Eukiefferiella complex (which also have pupal hooklets), or to the Cricotopus group (adults also with hairy eyes), suggesting instead a sister group relationship to a suite of predominantly austral genera of Orthocladiinae.