Inspiring Womanhood: A re-interpretation of The Dawn

This thesis explores the diversity of content and ideas found in Louisa Lawson’s The Dawn, Australia’s first successful magazine ‘by women and for women’, showing that every element of the journal promoted a womanhood ideal for Australian women. Though remembered for the challenging arguments it made for women’s rights, most of the journal was taken up by beauty tips, household hints, recipes, women’s stories, health ideas, fashion articles and the like. This thesis examines such elements, noting how they served to help readers progress towards its womanhood ideal. It highlights the way that The Dawn’s discourse on women’s right was integrated into this ideal. It also analyses some of the key themes and ideas central to the ideal constructed in The Dawn, such as motherhood, beauty, and success in work and study

The Association of Computed Tomography-Assessed Body Composition with Mortality in Patients with Necrotizing Pancreatitis

Background: Identification of patients with necrotizing pancreatitis at high risk for a complicated course could facilitate clinical decision-making. In multiple diseases, several parameters of body composition are associated with impaired outcome, but studies in necrotizing pancreatitis are lacking. Methods: A post hoc analysis was performed in a national prospective cohort of 639 patients with necrotizing pancreatitis. Skeletal muscle mass, skeletal muscle density, and visceral adipose tissue were measured at the third lumbar vertebra level (L3) on contrast-enhanced computed tomography (CT) within 10 days after initial admission and 1 month thereafter. Results: In total, 496 of 639 patients (78%) were included. Overall mortality rate was 14.5%. Skeletal muscle mass and density and visceral adipose tissue on first CT were not independently associated with in-hospital mortality. However, low skeletal muscle density was independently associated with increased mortality in patients ≥65 years (OR 2.54 (95%CI 1.12–5.84, P = 0.028). Skeletal muscle mass and density significantly decreased within 1 month, for both males and females, with a median relative loss of muscle mass of 12.9 and 10.2% (both P < 0.001), respectively. Skeletal muscle density decreased with 7.2 and 7.5% (both P < 0.001) for males and females, respectively. A skeletal muscle density decrease of ≥10% in 1 month was independently associated with in-hospital mortality: OR 5.87 (95%CI 2.09–16.50, P = 0.001). Conclusion: First CT-assessed body composition parameters do not correlate with in-hospital mortality in patients with necrotizing pancreatitis. Loss of skeletal muscle density ≥10% within the first month after initial admission, however, is significantly associated with increased mortality in these patients

Guest-Dependence on Spin Crossover and Thermal Expansion in Nanoporous Coordination Framework Materials

Coordination framework materials have attracted much interest in modern chemistry due to the plethora of properties that they may possess. The frameworks described in this thesis demonstrate the properties of spin crossover, anomalous thermal expansion, and nanoporosity, which enables guest-dependent studies into the material behaviour. The first frameworks described are the [Fe(bpac)M(CN)4]•x(bpac){guest} (M = Ni, Pd, Pt; bpac = 1,4-bis(4′-pyridyl)acetylene) family. The properties of the alcohol-solvated [Fe(bpac)Pd(CN)4]•x(bpac) (x = 0.4, 0.5) frameworks were studied, and the major guest influence on the resulting spin crossover behaviour was determined to be due to an internal pressure effect produced by the kinetic volume and compressibility of the guest. By obtaining a variety of EtOH adsorption isotherms and isobars, a Temperature-Pressure phase diagram of SCO was produced for the [Fe(bpac)Pd(CN)4]•0.4(bpac){EtOH} material. In addition to these frameworks, the behaviour of the [Fe(bpac)(Au(CN)2)2)]•{guest} framework material was also investigated. This framework demonstrated unprecedented multifunctional behaviour, with a synergistic interplay between the spin crossover, lattice structure and host–guest properties. The framework lattice was exceptionally flexible, and displayed a facile ‘scissor-type’ motion of the {Fe(Au(CN)2)2} (4,4) grids. Due to the extreme conformational flexibility of the {Fe(Au(CN)2)2} (4,4)-grids of this material, the [Fe(bpac)(Au(CN)2)2)]•{EtOH} sample displayed colossal uniaxial thermal expansion behaviour. Below the spin transition, the a parameter displayed a maximum thermal expansion coefficient of −1070 × 10−6 K−1, which is an order of magnitude greater than any yet reported for this quantity. Guest-dependent studies on this framework demonstrate the strong effect of guest properties on the conformation of the framework lattice and the spin transition behaviour

Age and prognosis in patients with pancreatic cancer:a population-based study

BACKGROUND: The diagnosis of pancreatic ductal adenocarcinoma (PDAC) has an enormous impact on patients, and even more so if they are of younger age. It is unclear how their treatment and outcome compare to older patients. This study compares clinicopathological characteristics and overall survival (OS) of PDAC patients aged <60 years to older PDAC patients. METHOD: This is a retrospective, population-based cohort study using Netherlands Cancer Registry data of patients diagnosed with PDAC (1 January 2015-31 December 2018). Kaplan-Meier curves and Cox proportional hazards models were used to assess OS. RESULTS: Overall, 10,298 patients were included, of whom 1551 (15%) were <60 years. Patients <60 years were more often male, had better performance status, less comorbidities and less stage I disease, and more often received anticancer treatment (67 vs. 33%, p < 0.001) than older patients. Patients <60 years underwent resection of the tumour more often (22 vs. 14%p < 0.001), more often received chemotherapy, and had a better median OS (6.9 vs. 3.3 months, p < 0.001) compared to older patients. No differences in median OS were demonstrated between both age groups of patients who underwent resection (19.7 vs. 19.4 months, p = 0.123), received chemotherapy alone (7.8 vs. 8.5 months, p = 0.191), or received no anticancer treatment (1.8 vs. 1.9 months, p = 0.600). Patients <60 years with stage-IV disease receiving chemotherapy had a somewhat better OS (7.5 vs. 6.3 months, p = 0.026). CONCLUSION: Patients with PDAC <60 years more often underwent resection despite less stage I disease and had superior OS. Stratified for treatment, however, survival was largely similar

Neoadjuvant Treatment for Resectable and Borderline Resectable Pancreatic Cancer:Chemotherapy or Chemoradiotherapy?

Worldwide, there is a shifting paradigm from immediate surgery with adjuvant treatment to a neoadjuvant approach for patients with resectable or borderline resectable pancreatic cancer (RPC or BRPC). Comparison of neoadjuvant and adjuvant studies is extremely difficult because of a great difference in patient selection. The evidence from randomized studies shows that overall survival by intention-to-treat improves after neoadjuvant gemcitabine-based chemoradiotherapy or chemotherapy (various regimens), as compared to immediate surgery followed by adjuvant chemotherapy. Radiotherapy appears to play an important role in mediating locoregional effects. Yet, since more effective chemotherapy regimens are currently available, in particular FOLFIRINOX and Gemcitabine/Nab-paclitaxel, these chemotherapy regimens should be investigated in future randomized trials combined with (stereotactic) radiotherapy to further improve outcomes of RPC and BRPC

Increased long-term mortality after open colorectal cancer surgery:A multicentre population-based study

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Natural Course and Treatment of Pancreatic Exocrine Insufficiency in a Nationwide Cohort of Chronic Pancreatitis

Objectives Pancreatic exocrine insufficiency (PEI) is a common complication of chronic pancreatitis. However, little is known about the natural course of PEI and the effect of pancreatic enzyme replacement therapy on symptoms. The aim of this study was to evaluate the natural course and treatment of PEI in a nationwide cohort of patients with chronic pancreatitis. Methods Patients with chronic pancreatitis were selected from the multicenter Dutch Chronic Pancreatitis Registry. Patients were classified in 3 groups: Definite PEI, potential PEI, and no PEI. Definite PEI and no PEI were compared regarding the course of disease, symptoms, treatment, and quality of life. Results Nine hundred eighty-seven patients were included from 29 centers, of which 304 patients (31%) had definite PEI; 451 (46%), potentially PEI; and 232 (24%), no PEI. Patients with definite PEI had significantly more malabsorption symptoms, a lower body mass index, and aberrant defecation. Lowered quality of life was not independently associated with PEI. Of the PEI patients using pancreatic enzyme replacement therapy, 47% still reported steatorrhea. Conclusions Pancreatic exocrine insufficiency is associated with malabsorption symptoms and a lower body mass index. Some form of pancreatic enzyme replacement therapy is reasonably effective in alleviating malabsorption symptoms, but improvement of treatment is needed