Comorbidities only account for a small proportion of excess mortality after fracture: A record linkage study of individual fracture types

Background: Non-hip non-vertebral fractures (NHNV) constitute the majority of osteoporotic fractures but few studies have examined the association between these fractures, co-morbidity and mortality. Objective: To examine the relationship between individual non-hip non-vertebral fractures, co-morbidities and mortality. Methods: Prospective population-based cohort of 267,043 subjects (45 and Up Study, Australia) had baseline questionnaires linked to hospital administrative and all-cause mortality data from 2006 - 2013. Associations between fracture and mortality examined using multivariate, time dependent Cox models, adjusted for age, prior fracture, body mass index, smoking and co-morbidities (cardiovascular disease, diabetes, stroke, thrombosis and cancer) and survival function curves. Population attributable fraction calculated for each level of risk exposure. Results: During 1,490,651 person-years, women and men experienced 7,571 and 4,571 fractures and 7,064 deaths and 11,078 deaths, respectively. In addition to hip and vertebral fractures, pelvis, humerus, clavicle, rib, proximal tibia/fibula, elbow and distal forearm fractures in both sexes, and ankle fractures in men, were associated with increased multivariable adjusted mortality hazard ratios ranging from 1.3 to 3.4. Co-morbidity independently added to mortality such that a woman with a humeral fracture and one co-morbidity had a similarly reduced 5 year survival to that of a woman with a hip fracture and no co-morbidities. Population mortality attributable to any fracture without co-morbidity was 9.2% in women and 5.3% in men. Conclusion: All proximal non-hip, non-vertebral fractures in women and men were associated with increased mortality risk. Co-existent co-morbidities independently further increased mortality. Population attributable risk for mortality for fracture was similar to cardiovascular disease and diabetes, highlighting their importance and potential benefit for early intervention and treatment

Reply to: New Meta- and Mega-analyses of Magnetic Resonance Imaging Findings in Schizophrenia: Do They Really Increase Our Knowledge About the Nature of the Disease Process?

This work was supported by National Institute of Biomedical Imaging and Bioengineering Grant No. U54EB020403 (to the ENIGMA consortium)

The Lost History of Organic Farming in Australia

It has not been previously reported that the world’s first “organic” farming society was the Australian Organic Farming and Gardening Society (AOFGS) which was founded in Australia in October 1944. The association was based in Sydney, New South Wales, and the first issue of its journal, the Organic Farming Digest (OFD), was dated April 1946. This was Australia’s first, and the world’s second, “organic” farming journal. The eighteen month delay between the founding of the society and the first publication of the journal was because paper was unavailable in Australia for that purpose during WWII. The society published a total of 378 articles in 29 issues from 1946 to 1954. Articles from Australia, UK, USA, New Zealand, South Africa, Germany and Denmark were published. Topics included: farming and gardening; health; environment; politics and economics; and animal welfare. More than 190 authors were published. British authors published included Sir Albert Howard, Lady Louise Howard, Lady Eve Balfour, and Friend Sykes. American authors published included Dr. Ehrenfried Pfeiffer, Jerome Rodale, Gaylord Hauser, and Louis Bromfield. Australian authors from the states of New South Wales, Victoria, South Australia, Tasmania and Queensland were published. These included Sir Stanton Hicks, then Professor of Physiology and Pharmacology at Adelaide University, NSW grazier Colonel Harold White, and Tasmanian hop grower Henry Shoobridge. More than 130 original articles were published, and other articles were reproduced from many sources including: Organic Gardening (USA); Bio-Dynamic (USA); Soil and Health (UK); Health and the Soil (UK); Mother Earth, (UK); Trees and the Earth (UK); Farmers Weekly (South Africa) and Compost Magazine (NZ). The Society was wound up in 1955, due to lack of financial support. The digests published by the AOFGS document a decade of the thoughts, aspirations, focus, theory and practice of Australia’s first practitioners and proponents of organic farming, from the mid-1940s to the mid-1950s

Integration of overseas-trained doctors into the Australian medical workforce

The document attached has been archived with permission from the editor of the Medical Journal of Australia. An external link to the publisher’s copy is included. See page 7 of PDF for this item.Linsey S Hart, Jane Vernon-Robert

Longitudinal quantum plasmons in copper, gold, and silver

The propagation of plasmonic waves in various metallic quantum nanostructures have considered attention for their applications in technology. The quantum plasmonic properties of metallic nanostructures in the quantum size regime have been difficult to describe by an appropriate model. Here the nonlocal quantum plasmons are investigated in the most important metals of copper, gold, and silver. Dispersion properties of these metals and propagation of longitudinal quantum plasmons in the high photon energy regime are studied by a new model of nonlocal quantum dielectric permittivity. The epsilon near zero properties are investigated and the spectrum and the damping rate of the longitudinal quantum plasmons are obtained in these metals. The quantum plasmon s wave function is shown for both classical and quantum limits. It is shown that silver is the most appropriate for quantum metallic structures in the development of next generation of quantum optical and sensing technologies, due to low intrinsic loss

Dusty Disks Around Central Stars of Planetary Nebulae

Only a few percent of cool, old white dwarfs (WDs) have infrared excesses interpreted as originating in small hot disks due to the infall and destruction of single asteroids that come within the star's Roche limit. Infrared excesses at 24 micron were also found to derive from the immediate vicinity of younger, hot WDs, most of which are still central stars of planetary nebulae (CSPN). The incidence of CSPN with this excess is 18%. The Helix CSPN, with a 24 micron excess, has been suggested to have a disk formed from collisions of Kuiper belt-like objects (KBOs). In this paper, we have analyzed an additional sample of CSPN to look for similar infrared excesses. These CSPN are all members of the PG 1159 class and were chosen because their immediate progenitors are known to often have dusty environments consistent with large dusty disks. We find that, overall, PG 1159 stars do not present such disks more often than other CSPN, although the statistics (5 objects) are poor. We then consider the entire sample of CSPN with infrared excesses, and compare it to the infrared properties of old WDs, as well as cooler post-AGB stars. We conclude with the suggestion that the infrared properties of CSPN more plausibly derive from AGB-formed disks rather than disks formed via the collision of KBOs, although the latter scenario cannot be ruled out. We finally remark that there seems to be an association between CSPN with a 24 micron excess and confirmed or possible binarity of the central star.Comment: 11 pages, 5 figures, AJ, in pres

Compositional Synthesis via a Convex Parameterization of Assume-Guarantee Contracts

We develop an assume-guarantee framework for control of large scale linear (time-varying) systems from finite-time reach and avoid or infinite-time invariance specifications. The contracts describe the admissible set of states and controls for individual subsystems. A set of contracts compose correctly if mutual assumptions and guarantees match in a way that we formalize. We propose a rich parameterization of contracts such that the set of parameters that compose correctly is convex. Moreover, we design a potential function of parameters that describes the distance of contracts from a correct composition. Thus, the verification and synthesis for the aggregate system are broken to solving small convex programs for individual subsystems, where correctness is ultimately achieved in a compositional way. Illustrative examples demonstrate the scalability of our method

A retrospective study of admission trends of koalas to a rehabilitation facility over 30 years

To identify threats to the survival of koalas (Phascolarctos cinereus) in coastal New South Wales, Australia, we compared 3,781 admission records of koalas, admitted between 1 January 1975 and 31 December 2004 to a koala rehabilitation facility on the midnorthern coast of New South Wales, against local wild population demographics, with the use of multinomial logistic regression and chi-square analyses. Trauma, the most frequent reason for admission, affected young and male animals more frequently than other groups. Seasonal differences in the probability of males presenting as trauma cases suggest behavioral factors as an important risk factor for this group. An increasing probability of koalas presenting as a result of motor vehicle accident since 1985 strongly supports the enhanced action of local authorities to pursue traffic-calming strategies if urban koala populations are to be maintained in this area. Koalas with clinical signs of chlamydiosis made up the second most frequent admission group, and these animals were more likely to be aged. This study highlights the potential usefulness of wildlife rehabilitation centers in detailing threats to local wildlife populations, provided record keeping is efficient and focused, and the role of such studies in providing evidence for focusing threat-mitigation efforts. Continual community engagement by koala researchers is important to ensure that maximum benefit is obtained from activities of special interest groups. Keywords: Koala, Phascolarctos cinereus, New South Wales, threats, wildlife rehabilitationARC Linkage Grant LP0560572

Curved Gratings as Plasmonic Lenses for Linearly Polarised Light

The ability of curved gratings as sectors of concentric circular gratings to couple linearly polarized light into focused surface plasmons is investigated by theory, simulation and experiment. Curved gratings, as sectors of concentric circular gratings with four different sector angles, are etched into a 30-nm thick gold layer on a glass coverslip and used to couple linearly-polarised free space light at nm into surface plasmons. The experimental and simulation results show that increasing the sector angle of the curved gratings decreases the lateral spotsize of the excited surface plasmons, resulting in focussing of surface plasmons which is analogous to the behaviour of classical optical lenses. We also show that two faced curved gratings, with their groove radius mismatched by half of the plasmon wavelength (asymmetric configuration), can couple linearly-polarised light into a single focal spot of concentrated surface plasmons with smaller depth of focus and higher intensity in comparison to single-sided curved gratings. The major advantage of these structures is the coupling of linearly-polarised light into focused surface plasmons with access to and control of the plasmon focal spot, which facilitates potential applications in sensing, detection and nonlinear plasmonics.Comment: 15 pages and 12 figure

Tay Sachs Disease: Analysis Of Australian Screening Strategies (1995-2013)

Introduction: Tay Sachs Disease (TSD) is a fatal genetic disorder with autosomal recessive inheritance, occurring more frequently in Ashkenazi Jewish (AJ) populations. No cure or effective treatment exists. Carrier couples have a 1 in 4 risk that a baby will have TSD. The desire to prevent TSD inspired the first pre-conception genetic screening programs. The development of assisted reproductive technologies and pre-implantation genetic diagnosis of embryos has broadened reproductive options available for carrier-couples to avoid having a child with a serious genetic condition. Aim: My aims were to discover: • The allelic distribution of HEXA mutations in the Australian AJ community • The accuracy of TSD carrier risk self-determination in AJ individuals aged 20 to 40 years when questioned by health professionals • Evidence that TSD carrier screening prevents cases • Evidence of reported access to TSD screening • Evidence to make recommendations for primary care clinicians about TSD screening. • Clinical impacts and ethical issues raised by expanded genetic screening strategies. Methods: This thesis by publication represents my research work with Australian TSD screening programs (2008-2013). Results: A high TSD carrier frequency exists amongst Australian AJ individuals currently aged 20-40 years. Disclosure of AJ heritage can accurately predict TSD carrier risk. Screening programs have been effective in preventing TSD cases. Systematic review of the international literature on TSD screening formed NHMRC graded evidence-based best practice recommendations for primary care clinicians. Australasian clinical practice guidelines for genetic screening in Ashkenazi Jews are presented. Conclusion: Preconception genetic screening is effective in rare recessive disease prevention, with important implications for Australian health-economic policy