Interrogatories - Who may be interrogated

In Pacific Century Production Pty Ltd v Netafirm Australia Pty Ltd [2004] QSC 043 the court was asked for the first time to consider the application of rule 229(1)(b) of the Uniform Civil Procedure Rules 1999 (the UCPR)

The preacher : a discourse shewing, what are the particular offices and employments of those of that character in the church with a free censure of the most common failings and miscarriages of persons in that sacred employment : to which is added, a catalogue of some authors who may be beneficial to young preachers and students in divinity /

Mode of access: Internet.

Modern Shakespearean criticism : as exhibited in a letter, which was published in The Stratford-on-Avon Herald, of Friday, the 9th November, 1888, and which is here separately reprinted for the consideration of those who may be interested in the character of Shakespearean controversy.

In manuscript on verso of fly-leaf: "Only ten copies printed, J.G. Bishop."

Fecal microbiota in patients receiving enteral feeding are highly variable and may be altered in those who develop diarrhea

Background: The pathogenesis of diarrhea in patients receiving enteral feeding includes colonic water secretion, antibiotic prescription, and enteropathogenic colonization, each of which involves an interaction with the gastrointestinal microbiota. Objective: The objective was to investigate temporal changes in the concentrations of fecal microbiota and short-chain fatty acids (SCFAs) in patients starting 14-d of enteral feeding and to compare these changes between patients who do and do not develop diarrhea. Design: Twenty patients starting exclusive nasogastric enteral feeding were monitored for 14 d. Fecal samples were collected at the start, middle, and end of this period and were analyzed for major bacterial groups by using culture independent fluorescence in situ hybridization and for SCFAs by using gas-liquid chromatography. Results: Although no significant changes in fecal microbiota or SCFAs were observed during enteral feeding, stark alterations occurred within individual patients. Ten patients (50%) developed diarrhea, and these patients had significantly higher concentrations of clostridia (P = 0.026) and lower concentrations (P = 0.069) and proportions (P = 0.029) of bifidobacteria. Patients with and without diarrhea had differences in the proportion of bifidobacteria (median: 0.4% and 3.7%; interquartile range: 0.8 compared with 4.3; P = 0.035) and clostridia (median: 10.4% and 3.7%; interquartile range: 14.7 compared with 7.0; P = 0.063), respectively, even at the start of enteral feeding. Patients who developed diarrhea had higher concentrations of total fecal SCFAs (P = 0.044), acetate (P = 0.029), and butyrate (P = 0.055). Conclusion: Intestinal dysbiosis occurs in patients who develop diarrhea during enteral feeding and may be involved in its pathogenesis. Am J Clin Nutr 2009; 89: 240-7.

Short nomenclator or vocabular in English and Hebrew: composed alphabetically for the use and benefit of my pupils in particular and for the advantage of those who are desirous to obtain the knowledge of the Hebrew tongue in general, which may be that great help to understand not only ye sacred oracles in their original, but even any Jewish author (so far as concern owns) as also it may give great insight in ye tongue to those, as to compose it, a work altogether new, [ca. 1735]

Headed on the first page with the words "Nomenclatura hebraica," this handwritten volume is a vocabulary with the Hebrew word in the left column, and the English translation on the right. While the book is arranged in sections by letter, individual entries do not appear in strict alphabetical order. The small vocabulary varies greatly and includes entries like enigma, excommunication, and martyr, as well as cucumber and maggot. There are translations of the astrological signs at the end of the volume. Poem written at the bottom of the last page in different hand: "Women when good the best of saints/ that bright seraphick lovely/ she, who nothing of an angel/ wants but truth & immortality./ Verse 2: Who silken limbs & charming/ face. Keeps nature warm."

Sir Francis Drake revived : who is or may be a pattern to stirre up all heroicke and active spirits of these times, to benefit their countrey and eternize their names by like noble attempts : Being a summary and true relation of foure severall voyages made by the said Sir Francis Drake to the West-Indies ... His voyage made with Chistopher Carleill, Martin Frobusher, Francis Knollis, and others, Their taking the townes of Saint Jago, Sancto Domingo, Carthagena and Saint Augustine : His last voyage (in which he dyed) being accompanied with Sir John Hawkins, Sir Thomas Baskerfield, Sir Nicholas Clifford, with others : His manner of buriall /

La primera obra relata el viaje de 1572-1573, la segunda el viaje de 1577-1580, la tercera el de 1585-1586 y la última del viaje de 1595-1596, en el que murió.

A guide to Christ, or, The way of directing souls that are under the work of conversion : compiled for the help of young ministers, and may be serviceable to private Christians who are inquiring the way to Zion /

"Two sermons by the Reverend Mr. Stoddard": p. [155]-196.

What the problem may be with family intervention . . . and with dissemination more generally: A commentary

While the two decades since the study by Kavanagh et al. (1993) has given additional insights into effective dissemination of family interventions, the accompanying papers show that progress remains limited. The effectiveness trial that triggered this series of papers offers a cautionary tale. Despite management support, 30–35 hr of workshop training and training of local supervisors who could act as champions, use of the full intervention was limited. In part, this seemed due to the demanding nature of the intervention and its incompatibility with practitioners’ roles, in part, to limitations in the training, among other factors. While the accompanying papers note these and other barriers to dissemination, they miss a more disturbing finding in the original paper: Practitioners said they were using several aspects in routine care, despite being unable to accurately describe what they were. This finding highlights the risks in taking practitioners’ reports of their practice in files or supervision sessions at face value and potentially has implications for reports of other clinical work. The fidelity of disseminated treatments can only be assured by audits of practice, accompanied by affirming but also corrective feedback.

Immune-derived PD-L1 gene expression defines a subgroup of stage II/III colorectal cancer patients with favorable prognosis that may be harmed by adjuvant chemotherapy

A recent phase 2 study of metastatic colorectal carcinoma (CRC) patients showed that mismatch repair gene status was predictive of clinical response to PD-1-targeting immune checkpoint blockade. Further examination revealed strong correlation between PD-L1 protein expression and microsatellite instability (MSI) in stage IV CRC, suggesting that the amount of PD-L1 protein expression could identify late stage patients who may benefit from immunotherapy. To assess whether the clinical associations between PD-L1 gene expression and MSI identified in metastatic CRC are also present in stage II/III CRC, we used in silico analysis to elucidate the cell types expressing the PD-L1 gene. We found a significant association of PD-L1 gene expression with MSI in early stage CRC (P < 0.001) and show that unlike in non-CRC tumors, PD-L1 is derived predominantly from the immune infiltrate. We demonstrate that PD-L1 gene expression has positive prognostic value in the adjuvant disease setting (PD-L1low v PD-L1high HR = 9.09; CI, 2.11-39.10). PD-L1 gene expression had predictive value, as patients with high PD-L1 expression appear to be harmed by standard-of-care treatment (HR = 4.95; CI,1.10-22.35). Building on the promising results from the metastatic CRC PD-1-targeting trial, we provide compelling evidence that PD-L1high/MSI/immunehigh stage II/III CRC patients should not receive standard chemotherapy. This conclusion supports the rationale to clinically evaluate this patient subgroup for PD-1 blockade treatment.

Independence referendums: who should vote and who should be offered citizenship?

In this EUDO CITIZENSHIP Forum Debate, several authors consider the interrelations between eligibility criteria for participation in independence referendum (that may result in the creation of a new independent state) and the determination of putative citizenship ab initio (on day one) of such a state. The kick-off contribution argues for resemblance of an independence referendum franchise and of the initial determination of the citizenry, critically appraising the incongruence between the franchise for the 18 September 2014 Scottish independence referendum, and the blueprint for Scottish citizenship ab initio put forward by the Scottish Government in its 'Scotland's Future' White Paper. Contributors to this debate come from divergent disciplines (law, political science, sociology, philosophy). They reflect on and contest the above claims, both generally and in relation to regional settings including (in addition to Scotland) Catalonia/Spain, Flanders/Belgium, Quebec/Canada, Post-Yugoslavia and Puerto-Rico/USA.

Improving the communication between care providers of individuals who may require joint replacement surgery (JRS) a framework for referral

Aims & rationale/Objectives : The objective of the project was to specify the information required in referrals to public hospital orthopaedic outpatient departments in order to streamline the care and prioritisation of individuals who may require JRS. It was envisaged that an evidence-based GP-Orthopaedic derived referral system would assist in ensuring that the right person accessed the right care at the right time.

Methods : In collaboration with the RACGP and the Commonwealth Department of Health and Ageing, a national stakeholder working group was convened. A scoping document was prepared with input from key stakeholders. A review of primary research was undertaken as well as a review of relevant guidelines. Information on the implementation and evaluation of similar programs in Australia and overseas also informed the referral specification.

Principal findings : The initial scoping processes with key stakeholders provided clear information on core components of the referral. These were the use of standardised and respected assessment tools to determine the severity of arthritis, fitness for surgery and willingness of affected individuals to undergo surgery.

Discussion : About 20,000 JRS occur each year in public hospitals which emanate from 5 to 10 fold number of referrals. Arthritis and musculoskeletal diseases are a national health priority area reflecting the high burden of disease associated with these conditions. Various initiatives are being undertaken to address the quality of life of affected individuals. This project has revealed areas of potential improvement in the communication between care providers of individuals who may need JRS.

Implications : The project will result in the development of a standard referral form and guidelines to assist referring practitioners to communicate more effectively with the multidisciplinary care team, in particular orthopaedic care providers. The guidelines will be piloted in a large rural setting.

Achieving diversity : pathways may be the solution!

This paper examines the role of pathways in increasing the diversity of higher education student cohorts. The Commonwealth Government has as its higher education reform agenda the increased participation of under-represented groups to a 20% diversity target for Australian universities. Yet for many universities, reaching this target will require significant changes to entry and access conditions. This paper examines two case studies of construction education pathways and evaluates their effectiveness in addressing diversity using the DEMO matrix developed by the National Centre for Student Equity in Higher Education (NCSEHE). The first case study was based on a VET in Schools model that articulates school students into construction courses in TAFE and higher education. The second case study targets mature aged people who do not have formal qualifications in construction, but wish to participate in higher education. The results indicate that pathways into construction degrees can improve student equity ratios, but element such as learner engagement, confidence, resources and collaboration are critical features of successful pathways. These results have important implications for future decision making regarding university articulation models in light of higher education diversity targets.

Diminished Mycophenolic Acid Exposure Caused by Omeprazole May Be Clinically Relevant in the First Week Posttransplantation

Background: Some studies have reported a decreased absorption of mycophenolic acid (MPA) from mycophenolate mofetil (MMF) in renal transplanted (RTx) patients under proton-pump inhibitors (PPIs). There is still a lack of information regarding (1) whether this effect occurs when MMF is administered with either tacrolimus or cyclosporine A [calcineurin inhibitors (CNIs)], (2) whether the effect has the same amplitude during the first year after RTx, and finally (3) whether this decrease in exposure is clinically relevant. Methods: We retrospectively analyzed the omeprazole effect in 348 12-hour pharmacokinetic samplings [area under the curve (AUC) 0-12h] performed on days 7, 14, 30, 60, 180, and 360 after RTx in 77 patients who participated in previous trials. Results: For all periods, the groups with and without PPI did not differ in all variables. By mixed-model analysis of variance, PPI reduced the MPA AUC(0-12h) (P < 0.0008) in the patients under both CNIs mainly due to decreased absorption (P = 0.049). In the tacrolimus group, a lower exposure seemed also due to a decreased MPA reabsorption at 10-12 hours. The PPI effect remains throughout the first year but was clinically more important on day 7. By Cox analysis, the use of PPI was associated with a 25% less chance of being adequately exposed to MPA (95% confidence interval 0.58-0.99, P = 0.04). Similarly, the number of patients underexposed to MPA (AUC < 30 ng.h/mL) was higher at most periods in the PPI group but again not statistically significant. Conclusions: These data indicate that PPI decreases the MPA exposure when associated with both CNIs but particularly in the first week after RTx. In this period, the MMF dose should be increased. This effect lasts throughout the first year but does not seem to be clinically relevant after the first week.

Driving and emergency braking may be impaired after tibiotalar joint arthrodesis: conclusions after a case series.

PURPOSE To assess whether reaction time (RT) and movement time (MT), as the two components of the total brake response time (TBRT) and brake force (BF) are different in patients with a foot joint arthrodesis in comparison to controls. METHODS The study was a comparative case series in a driving simulator under realistic driving conditions. Mobile patients without a walker, ≥6 months after surgery who were driving a car and had no neurological co-morbidity, knee or hip joint prosthesis were included in the study. The selection criteria resulted in 12 patients with right tibiotalar joint arthrodesis (TTJA) and 12 patients with another right foot joint arthrodesis (OFJA), who were compared to 17 individuals without any ankle-joint pathology. For TBRT, an empirical safe driving threshold of 700 ms was used. The outcome measures were RT, MT, TBRT, BF and McGuire score. RESULTS MT (p = 0.034) and TBRT (p = 0.026) were longer in TTJA patients in comparison with the controls. Also, more patients with TTJA than patients with OFJA and controls exceeded the safe driving threshold (p = 0.028). The outcomes in OFJA patients and in controls were comparable. The McGuire score was similar between the TTJA and OFJA patients (p = 0.26). CONCLUSIONS Significantly slower MT and TBRT, and significantly more patients exceeding the safe driving threshold, were observed after a tibiotalar-joint arthrodesis in comparison to the controls. Patients with OFJAs were not significantly different from the controls. Driving and emergency braking may be impaired after tibiotalar-joint arthrodesis.

Movement analysis in infancy may be useful for early diagnosis of autism

All of the 17 autistic children studied in the present paper showed disturbances of movement that with our methods could be detected clearly at the age of 4–6 months, and sometimes even at birth. We used the Eshkol–Wachman Movement Analysis System in combination with still-frame videodisc analysis to study videos obtained from parents of children who had been diagnosed as autistic by conventional methods, usually around 3 years old. The videos showed their behaviors when they were infants, long before they had been diagnosed as autistic. The movement disorders varied from child to child. Disturbances were revealed in the shape of the mouth and in some or all of the milestones of development, including, lying, righting, sitting, crawling, and walking. Our findings support the view that movement disturbances play an intrinsic part in the phenomenon of autism, that they are present at birth, and that they can be used to diagnose the presence of autism in the first few months of life. They indicate the need for the development of methods of therapy to be applied from the first few months of life in autism.