Gait and electromyographic analysis of patients recovering after limb-saving surgery

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An extendable modular endoprosthetic system for bone tumour management in the leg

A modular endoprosthetic system has been developed at the Groningen University Hospital and the University of Twente. The system can bridge a defect resulting from the resection of a malignant bone tumour which has developed around the knee joint of a child. Since the other healthy leg continues to grow, the system includes an element whose length can be adjusted non-invasively by using an external magnetic field. In addition to this lengthening element, there are one hip and two knee components, connectors of various lengths, and fixation elements. The paper describes the elements of the modular endoprosthetic system. Tables are created by means of which the elemental composition of such an endoprosthesis can be determined for each individual patient

Health scares: professional priorities

Currently, many health scholars are concerned about health scares. But what do they mean by the term ‘health scare’ – are health scares an identifiable phenomenon, and how do we currently understand their causation and consequences? By collecting and analyzing published articles about events considered to be health scares, this paper maps the current views of scholars on their characteristics and causes. Results show that health scares are generally understood as events characterized by fears of catastrophic consequences but little actual mortality. However, the social and economic impacts of these events have often been severe. This survey shows that health scares can be usefully sorted into 6 categories, each with identifiable internal dynamics, suggesting different communications strategies to achieve resolution in each category. Using the social amplification of risk framework, the conditions under which risk signals were amplified were traced in general terms among major stakeholders. Simple causes for health scare events could not be identified, though some triggers did emerge. Importantly, public ignorance of real risk, media scaremongering, and political inaction could be dismissed as primary explanations, though they were sometimes factors in scare events. Implications for risk communication and for future research on risk and public health are discussed. Keywords: Health scare, Social amplification of risk, Expert, Media, Risk controversyfunded by the Sidney Sax Travelling Postdoctoral Research Fellowship in Public Health, National Health and Medical Research Council, Australia

Refractive and visual outcomes of femtosecond laser-assisted cataract surgery

Objective: To compare refractive and visual acuity outcomes of femtosecond laser-assisted cataract surgery (FLACS) to manual surgery. Participants: Consecutive series of patients in a private ophthalmic practice in Sydney, with 337 eyes undergoing FLACS on the LenSx platform and 230 eyes manual cataract surgery. Main Outcome Measures: Astigmatism, surgically-induced corneal astigmatism, achievement of target refraction and corrected and uncorrected distance visual acuity (UDVA). Results: The FLACS group had statistically less mean residual post-operative astigmatism by 0.18D (p<0.001) than the manual group. The femtosecond laser produced equivalent mean magnitude and variability of surgically-induced corneal astigmatism compared to manual cataract surgery. Both surgical methods had equivalent achievement of target spherical equivalent (69% within 0.5 D of target refraction, p=0.911). In eyes with good visual potential and an emmetropic target, post-operative UDVA was statistically better in the femtosecond group with an average improvement of 2.4 logMAR letters (p=0.020). Conclusions: Femtosecond cataract surgery produced less residual post-operative refractive astigmatism and better unaided distance visual acuity compared to manual cataract surgery. However there was no improvement in the achievement of target post-operative refraction

Design and analysis of coupling methods for modular endoprosthetic systems as an alternative to the conical coupling

Modular endoprostheses are often used in bone tumor management. However, the conical coupling that connects the various modules has several shortcomings. As an alternative, four new couplings have been developed. To find out if they have sufficient strength and show no movement during loading, each coupling was analysed using the finite element method. Bolt force and friction coefficient was varied to examine their influence. From the analysis it was concluded that coupling B, a dovetail coupling, meets all requirements and is the best alternative to the conical coupling. Sensitivity to bolt force and friction coefficient is very limited

Safeguarding resettlement: global expectations and local experiences in Cambodia

Planned community relocation or “resettlement” is not new, however the contexts in which people are being relocated and the safeguards in place to protect them are changing. Multilateral development banks are under competing pressures to minimise the negative impacts of community resettlement without over-burdening the governments of borrowing countries. Intensive debates are underway about what rights should be afforded to resettled people and what safeguards are most effective. Similar concerns are being voiced by policy-makers working on climate change adaptation, who are looking to the World Bank and Asian Development Bank (ADB) to identify ways to safeguard communities being resettled in response to climate change. One of the most important tensions shaping these debates, is how resettlement safeguards developed at an international or “global” level can cater to the needs and aspirations of affected people in different local settings. As a contribution to this debate, this thesis explores a resettlement scheme for an ADB co-financed railway project in Cambodia in which advocacy interventions resulted in improvements in the resettlement sites over the eight years of the project from 2006 to 2014. Drawing on the railway project as a case study, the research focuses on understanding how safeguards, developed at a “headquarter level”, aligned and misaligned with community needs and aspirations at different points in time. It investigates how advocacy interventions altered the course of the project and considers the implications of relying on resettlement safeguards in a country where domestic legal protections are otherwise not well-established

Design and Topology Optimisation of Tissue Scaffolds

Tissue restoration by tissue scaffolding is an emerging technique with many potential applications. While it is well-known that the structural properties of tissue scaffolds play a critical role in cell regrowth, it is usually unclear how optimal tissue regeneration can be achieved. This thesis hereby presents a computational investigation of tissue scaffold design and optimisation. This study proposes an isosurface-based characterisation and optimisation technique for the design of microscopic architecture, and a porosity-based approach for the design of macroscopic structure. The goal of this study is to physically define the optimal tissue scaffold construct, and to establish any link between cell viability and scaffold architecture. Single-objective and multi-objective topology optimisation was conducted at both microscopic and macroscopic scales to determine the ideal scaffold design. A high quality isosurface modelling technique was formulated and automated to define the microstructure in stereolithography format. Periodic structures with maximised permeability, and theoretically maximum diffusivity and bulk modulus were found using a modified level set method. Microstructures with specific effective diffusivity were also created by means of inverse homogenisation. Cell viability simulation was subsequently conducted to show that the optimised microstructures offered a more viable environment than those with random microstructure. The cell proliferation outcome in terms of cell number and survival rate was also improved through the optimisation of the macroscopic porosity profile. Additionally artificial vascular systems were created and optimised to enhance diffusive nutrient transport. The formation of vasculature in the optimisation process suggests that natural vascular systems acquire their fractal shapes through self-optimisation

Pap smear rates among Australian lesbian and bisexual women: some good news but disparities persist

ACO

The treatment of primary tumors of the femur with chemotherapy (if indicated), resection and reconstruction with an endoprosthesis

The treatment protocol of 15 patients with a primary tumor of the femur, including osteosarcoma, malignant fibrous histiocytoma and chondrosar-coma is presented. All patients had been selected for resection and reconstruction with an endoprosthesis. An endoprothesis was implanted in 12 patients. \ud The results of this type of treatment appear to be satisfactory. In eight osteosarcoma cases resection and reconstruction with an endoprosthesis combined with preoperative and postoperative chemotherapy, according to Rosen, were performed. Follow-up in all 15 patients, varying from 1.4 to 6.0 years, showed no evidence of disease in 12 patients. Three patients had died. Function of the involved leg was satisfactory in most cases. \ud The advantage and disadvantages of the use of an endoprosthesis are discussed as well as complications in this series of patients

Treatment of pathological fractures, secondary to tumours

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