The ASAS criteria for axial spondyloarthritis: Strengths, weaknesses, and proposals for a way forward

Classification criteria should facilitate selection of similar patients for clinical and epidemiologic studies, therapeutic trials, and research on etiopathogenesis to enable comparison of results across studies from different centers. We critically appraise the validity and performance of the Assessment of SpondyloArthritis international Society (ASAS) classification criteria for axial spondyloarthritis (axSpA). It is still debatable whether all patients fulfilling these criteria should be considered as having true axSpA. Patients with radiographically evident disease by the ASAS criteria are not necessarily identical with ankylosing spondylitis (AS) as classified by the modified New York criteria. The complex multi-arm selection design of the ASAS criteria induces considerable heterogeneity among patients so classified, and applying them in settings with a low prevalence of axial spondyloarthritis (SpA) greatly increases the proportion of subjects falsely classified as suffering from axial SpA. One of the unmet needs in non-radiographic form of axial SpA is to have reliable markers that can identify individuals at risk for progression to AS and thereby facilitate early intervention trials designed to prevent such progression. We suggest needed improvements of the ASAS criteria for axSpA, as all criteria sets should be regarded as dynamic concepts open to modifications or updates as our knowledge advances.

The Milky Way's Dark Matter Halo Appears To Be Lopsided

The atomic hydrogen gas (H I) disk in the outer region (beyond similar to 10 kpc from the center) of Milky Way can provide valuable information about the structure of the dark matter halo. The recent three-dimensional thickness map of the outer H I disk from the all sky 21 cm line Leiden/Argentine/Bonn survey, gives us a unique opportunity to investigate the structure of the dark matter halo of Milky Way in great detail. A striking feature of this new survey is the north-south (N-S) asymmetry in the thickness map of the atomic hydrogen gas. Assuming vertical hydrostatic equilibrium under the total potential of the Galaxy, we derive the model thickness map of the H I gas. We show that simple axisymmetric halo models, such as softened isothermal halo (producing a flat rotation curve with V-c similar to 220 km s(-1)) or any halo with density falling faster than the isothermal one, are not able to explain the observed radial variation of the gas thickness. We also show that such axisymmetric halos along with different H I velocity dispersion in the two halves, cannot explain the observed asymmetry in the thickness map. Amongst the nonaxisymmetric models, it is shown that a purely lopsided (m = 1, first harmonic) dark matter halo with reasonable H I velocity dispersion fails to explain the N-S asymmetry satisfactorily. However, we show that by superposing a second harmonic (m = 2) out of phase onto a purely lopsided halo, e. g., our best fit and more acceptable model A (with parameters epsilon(1)(h) = 0.2, epsilon(2)(h) = 0.18, and sigma(H I) = 8.5 km s(-1)) can provide an excellent fit to the observation and reproduce the N-S asymmetry naturally. The emerging picture of the asymmetric dark matter halo is supported by the. cold dark matter halos formed in the cosmological N-body simulation.

Morphometric analyses of the hamstring muscles using MRI: What is the best way?

Associations between injury and muscle asymmetries, as determined with magnetic resonance (MR) imaging, have been investigated in a number of sports medicine-based studies. For interventional or prospective studies into musculoskeletal injuries, it is important to determine the repeatability of the morphometric procedures used for quantifying muscle asymmetries. This study examines the intra-observer repeatability of manual segmentation for determining bilateral volumes of the individual hamstring muscles.

The School-Community Integrated Learning pathway: Exploring a new way to prepare and induct final-year preservice teachers

Universities and teacher employment bodies seek new, cost-effective ways for graduating classroom-ready teachers. This study involved 32 final-year preservice teachers in an innovative school-university partnership teacher education program titled, the School-Community Integrated Learning (SCIL) pathway. Data were collected using a five-part Likert scale survey with extended written responses. Survey results showed that preservice teachers involved in the SCIL pathway learnt more about the teaching profession, which extended their usual university coursework. Furthermore, written responses suggested ways for advancing their understandings to ensure preservice teachers receive a quality school experience towards readiness for teaching.

An effective, economic way of monitoring menstrual cycle hormones in at risk female athletes

PURPOSE: Female athletes, in response to intensive training, competition stress and a lean, athletic physique, are at increased risk of altered hypothalamic-pituitary ovarian (HPO) axis function associated with menstrual cycle disturbance and reduced secretion of the ovarian hormones estrogen and progesterone. Because there is evidence suggesting possible detrimental effects on skeletal health associated with deficiencies in these hormones, a suitable means to asses ovarian hormone concentrations in at risk athletes is needed. The aim of this study was to evaluate a simple, economical means to monitor the ovarian hormone production in athletes, in the setting of intensive training. METHODS: Subjects comprised 14 adolescent rowers, 12 lightweight rowers, and two groups of 10 matched control subjects. Ovarian function was monitored during the competition season by estimation of urinary excretion of estrone glucuronide (E1G) and pregnanediol glucuronide (PdG), enabling the menstrual cycles to be classified as ovulatory or anovulatory. RESULTS: Results indicated 35% and 75% of schoolgirl and lightweight rowers had anovulatory menstrual cycles, respectively. These findings were highlighted by significantly lower excretion of E1G and PdG during phases of intensive training in both the lightweight and schoolgirl rowers, compared with the control subjects. CONCLUSION: It was concluded that the urinary E1G and PdG assays were an effective means to assess the influence of intense training on ovarian hormone concentrations in at risk athletes. It is recommended that this technique be applied more widely as a means of early detection of athletes with low estrogen and progesterone levels, in an attempt to avoid detrimental influences on skeletal health.

Costs assessment not an each-way bet: Radich v Kenway [2014] QDC 60

In Radich v Kenway [2014] QDC 60 McGinness DCJ considered issues relating to the assessment of costs under the Legal Profession Act 2007 (Qld). This recent costs assessment case from the District Court clearly illustrates the interplay between the relevant elements of the Legal Profession Act 2007 and Uniform Civil Procedure Rules 1999.

Are we focussing wild dog control the wrong time of the year and going about it the wrong way?

Our evaluation of the predation of calves by wild dogs in the 1990s found that the number of calves killed and frequency of years that calf losses occurred, is higher in baited areas compared to adjoining, non-baited areas of similar size. Calf losses were highest with poor seasonal conditions, low prey numbers and where baited areas were re-colonised by wild dogs soon after baiting. We monitored wild dog “activity” before and after 35 baiting programs in southwest, central west and far north Queensland between 1994 and 2006 and found change in activity depends on the timing of the baiting. Baiting programs conducted between October and April show an increase in dog activity post-baiting (average increase of 219.1%, SEM 100.9, n=9, for programs conducted in October and November; an increase of 82.5%, SEM 54.5, n=7 for programs conducted in March and April; and a decrease in activity of 46.5%, SEM 10.2, n=19 for programs conducted between May and September). We monitored the seasonal activity and dispersal of wild dogs fitted with satellite transmitters 2006 to present. We have found that: • Activity of breeding males and females, whilst rearing and nurturing pups, is focussed around the den between July to September and away from areas of human activity. Activity of breeding groups appears to avoid locations of human activity until juveniles become independent (around late November). • While independent and solitary yearlings often have unstable, elliptically-shaped territories in less favourable areas, members of breeding groups have territories that appear seasonally stable and circular located in more favourable habitats. • Extra-territorial forays of solitary yearlings can be huge, in excess of 200 km. The largest forays we have monitored have occurred when the activity of pack members is focussed around rearing pups and juveniles (August to November). • Where wild dogs have dispersed or had significant territorial expansion, it has occurred within days of baiting programs and onto recently baited properties. • The wild dogs we have tracked have followed netting barrier fences for hundreds of kilometres and lived adjacent to or bypassed numerous grids in the barrier. Based on these studies, we conclude that a proportion of the perceived decline in dog activity between May and September, post baiting, is due to a decline in dog activity in areas associated with human activity. The increase in dog activity post-baiting between October and May (and increased calf predation on baited properties) is likely caused by wild dogs dispersing (juveniles and yearlings) or expanding (adults) their territory into baited, now ‘vacant’, areas. We hypothesise that baiting programs should be focussed in summer and autumn commencing late November as soon as juveniles become independent of adults. We also hypothesise that instead of large, annual or semi-annual baiting programs, laying the same number of baits over 4-6 weeks may be more effective. These hypotheses need to be tested through an adaptive management project.

Ce1-xRuxO2-delta (x=0.05, 0.10): A New High Oxygen Storage Material and Pt, Pd-Free Three-Way Catalyst

Nanocrystalline Ce1-xRuxO2-delta (x = 0.05 and 0.10) of 8-10 nm sizes have been synthesized by hydrothermal method using melamine as complexing agent. Compounds have been characterized by powder X-ray diffraction (XRD), transmission electron microscopy (TEM), X-ray photoelectron spectroscopy (XPS), and energy-dispersive X-ray analysis (EDX) and their structures have been refined by the Rietveld method.The compounds crystallize in fluorite structure and the composition is Ce1-xRuxO2-x/2 where Ru is in +4 state and Ce is in mixed-valence (+3, +4) state. Substitution of Ru4+ ion in CeO2 activated the lattice oxygen. Ce1-xRuxO2-x/2 reversibly releases 0.22[O] and 0.42[O] for x = 0.05 and 0.10, respectively, which is higher than the maximumpossible OSC of 0.22 [O] observed for Ce0.50Zr0.50O2. Utilization of Higher OSC of Ce1-xRuxO2-delta (x = 0.05 and 0.10) is also reflected in terms of low-temperature CO oxidation with these catalysts, both in the presence and absence of feed oxygen. The Ru4+ ion acts as an active center for reducing molecules (CO, hydrocarbon ``HC'') and oxide ion vacancy acts as an active center for O-2 and NO, leading to low-temperature NO conversion to N-2. Thus due to Ru4+ ion, Ce1-xRuxO2-delta is not just a high oxygen storage material but also shows high activity toward CO, hydrocarbon ``HC'' oxidation, and NO reduction by CO at low temperature with high N-2 selectivity for three-way catalysis.

On Way to School

Digital image

Bringing up Children Gran’s Way: Insights from a research project on Indigenous child and youth mental health

Background In 2000, the Mater Child and Youth Mental Health Service Indigenous consultant saw that Indigenous families were isolated from kinship networks following the assimilation policy and clinicians were largely unaware of these socio-cultural histories. Experiences of marginalisation by mainstream society and services were exacerbated by assumptions clinicians made about this population. To enhance Mater’s care the consultant undertook research with Indigenous Elders. The project, “Bringing up Children Gran’s Way”, on which the presenter is the research advisor, was funded by AIATSIS. Aims Increase service quality Improve staff confidence, skills and satisfaction working with this population Promote the wellbeing of Indigenous families Acknowledge the significance of Elders and extended family networks. Methods Over 2006/07 the team used narrative and Indigenous methodologies, (e.g. yarning circles and the use of Indigenous research staff) to arrange and audio-record structured interviews with 19 Aboriginal Elders, on growing up and parenting. The participants were recruited by the Indigenous consultant and gave written consent, following ethical approval and information giving. The team immersed themselves in the material by repeated reading of the transcripts to note recurring themes in Elders’ narratives. Findings The recurring themes included the importance of cultural protocols and extended family; impacts of being ‘under the Act and stories of surviving change; culture, spiritualty and religion; trans-generational impacts; childrearing and the need to reconcile with Elders. Discussion The narratives show Elders resilience in the face of enduring impact of policies of genocide and assimilation. Clinicians need to approach their work with a deeper understanding of the diversity of clients’ social experience and cultural identity. Clinicians need to examine their own cultural assumptions about this population. Conclusion The dissemination of the knowledge and experience of Elders is a matter of social justice and crucial for the well-being of future generations and for improved service access.

Finding My Way: Protocol of a randomised controlled trial evaluating an internet self-help program for cancer-related distress

Background A cancer diagnosis elicits greater distress than any other medical diagnosis, and yet very few studies have evaluated the efficacy of structured online self-help therapeutic programs to alleviate this distress. This study aims to assess the efficacy over time of an internet Cognitive Behaviour Therapy (iCBT) intervention (‘Finding My Way’) in improving distress, coping and quality of life for individuals with a recent diagnosis of early stage cancer of any type. Methods/Design The study is a multi-site Randomised Controlled Trial (RCT) seeking to enrol 188 participants who will be randomised to either the Finding My Way Intervention or an attention-control condition. Both conditions are delivered online; with 6 modules released once per week, and an additional booster module released one month after program-completion. Participants complete online questionnaires on 4 occasions: at baseline (immediately prior to accessing the modules); post-treatment (immediately after program-completion); then three and six months later. Primary outcomes are general distress and cancer-specific distress, with secondary outcomes including Health-Related Quality of Life (HRQoL), coping, health service utilisation, intervention adherence, and user satisfaction. A range of baseline measures will be assessed as potential moderators of outcomes. Eligible participants are individuals recently diagnosed with any type of cancer, being treated with curative intent, aged over 18 years with sufficient English language literacy, internet access and an active email account and phone number. Participants are blinded to treatment group allocation. Randomisation is computer generated and stratified by gender. Discussion Compared to the few prior published studies, Finding My Way will be the first adequately powered trial to offer an iCBT intervention to curatively treated patients of heterogeneous cancer types in the immediate post-diagnosis/treatment period. If found efficacious, Finding My Way will assist with overcoming common barriers to face-to-face therapy in a cost-effective and accessible way, thus helping to reduce distress after cancer diagnosis and consequently decrease the cancer burden for individuals and the health system. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12613000001​796 16.10.13

Lighting the way: Towards reducing misorientation of olive ridley hatchlings due to artificial lighting at Rushikulya, India

Sea-finding behavior in sea turtle hatchlings is modified by the visual cues provided by artificial beach front lighting. The consequent landward movement of hatchlings in response to coastal electric lighting reduces their survival rates. We assessed the potential impact of coastal lighting at Rushikulya, an important mass nesting site of the olive ridley sea turtle (Lepidochelys olivacea) in the Indian Ocean region. We examined the response of hatchlings to light characteristics in an experimental setup, as well as to the existing lighting regimes along the beach, using arena trials. Previous studies on other species indicate preferential orientation towards low wavelength and high intensity light. Our study confirms these preferences among hatchlings from the Indian Ocean population of olive ridleys. In addition we also found that wavelength and intensity could have an interactive effect upon hatchling orientation. Hatchlings at the study site respond both to visible point sources of light and to sheer glows of light. Though beach plantations of introduced Casuarina equisetifolia are generally considered to have negative impacts on sea turtle nesting beaches, we found that they acted as an effective light barrier when planted about 50 m away from the high tide line. We developed a model of the expected impact of artificial lighting on hatchling orientation during mass hatching events of previous years, and predict as much as 50% misorientation in some years. We also developed a map representing the misorientation of hatchlings due to artificial lighting based on arena trials in different regions of the beach. The results of the study helped identify focal areas for light management on the beach, which could be critical for the survival of this population.

Bills received and collected of Mr. Lazarus

Digital image

Interfuel substitution in Australia: A way forward to achieve environmental sustainability

This paper examines the possibilities for interfuel substitution in Australia in view of the need to shift towards a cleaner mix of fuels and technologies to meet future energy demand and environmental goals. The translog cost function is estimated for the aggregate economy, the manufacturing sector and its subsectors, and the electricity generation subsector. The advantages of this work over previous literature relating to the Australian case are that it uses relatively recent data, focuses on energy-intensive subsectors and estimates the Morishima elasticities of substitution. The empirical evidence shown herein indicates weak-form substitutability between different energy types, and higher possibilities for substitution at lower levels of aggregation, compared with the aggregate economy. For the electricity generation subsector, which is at the centre of the CO2 emissions problem in Australia, significant but weak substitutability exists between coal and gas when the price of coal changes. A higher substitution possibility exists between coal and oil in this subsector. The evidence for the own- and cross-price elasticities, together with the results for fuel efficiencies, indicates that a large increase in relative prices could be justified to further stimulate the market for low-emission technologies.

Bills and receipts of Dr. Andrew Judah for attendance on poor of K. K. S. I.

Digital image