Adaptive evolution among socially parasitic allodapine bees

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Predictors of fixation failure in peri-trochanteric fractures

Introduction: Successful treatment of hip fractures during the first operative episode is paramount in minimizing patient morbidity and socio-economic costs. Peri-trochanteric hip fractures are a subtype of unstable intertrochanteric hip fractures which experience an increased rate of fixation failure. Although current literature suggests that successful surgical treatment of peri-trochanteric fractures is dependent on fracture pattern, quality of fracture reduction, implant choice and implant position, there is no agreement either to the relative importance of each or their inter-relationship. Consequently, the overall aim of this thesis was to assess the predictors of fixation failure and their relationship to each other in the treatment of peri-trochanteric fractures. Methods: A retrospective review of 796 patients with peri-trochanteric fractures treated at a tertiary referral trauma centre between 2008 and 2012 was undertaken. Analysis of pre-operative, intra-operative and post-operative radiographs was performed using Centricity PACS. Analysis of potential confounding factors included age, gender, fracture classification, reduction quality, Cleveland zone, tip-apex distance, implant type (DHS versus short Gamma nail versus long Gamma nail), and fixation points in Gamma nails, specifically the lateral cortex, greater trochanter, and fit of the nail in the intramedullary canal at its narrowest point. Results: Unstable fractures had a 7.6 (OR 3.0-19.6) times increased risk of fixation failure (p 20 mm incurred a 2.2 (OR 1.7-2.73) increased risk of failure (p<0.001), it was not powerful enough to mitigate against fixation failure in the event of poor fracture reduction (p<0.004). Nail fit was noted to be a predictor of fixation failure, with a 10.3 (OR 8.1-28.4) times increased risk of failure if the nail filled < 70% of the intramedullary canal (p<0.001). There was no significant difference in choice of implant or increased rate of failure when using a DHS or Gamma nail except in reverse oblique type factures. Fixation points of the lateral cortex and greater trochanter were not associated with successful osteosynthesis. Discussion: Unstable fracture type, poor fracture reduction, non optimal cephalomedullary screw positioning, and inadequate fit of IM recon nails in the intramedullary canal were predictors of fixation failure. These factors are closely interrelated: unstable fractures may be difficult to reduce which in turn leads to difficulty in achieving correct positioning of implants. A poorly reduced fracture will not be mitigated from fixation failure by correct positing of implants. Treatment of peri-trochanteric fractures should therefore be aimed at obtaining a high quality of fracture reduction prior to ensuring optimal lag screw position and intramedullary nail fit to maximize the success rate of osteosynthesis

Autism and theory of mind in interactive spaces.

How is an Interactive Media Arts practice placed to explore what is often considered a scientific field of research? This paper is a discussion on the main areas of study situating an observational PhD study on non-verbal children with autism. The author suggests that in fact an arts practice allows for more sensitive research and allows natural emergence to explore and facilitate the expression of Theory of Mind and physical consciousness

Relapsing hepatitis due to cytomegalovirus?

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Vision and refraction in Australian preschool children : measures, prevalence, and associated factors

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Characterization of seedling and adult-plant resistance to stem rust race Ug99 in Iranian bread wheat landraces

The full-length infectious cDNA clone was constructed and sequenced from the strain DM of echovirus 9, which was recently isolated from a 6-week-old child at the clinical onset of type 1 diabetes. Parallel with the isolate DM, the full-length infectious cDNA clone of the prototype strain echovirus 9 Barty (Barty-INF), was constructed and sequenced. Genetic relationships of the sequenced echo 9 viruses to the other members of the human enterovirus type B species were studied by phylogenetic analyses. Comparison of capsid protein sequences showed that the isolate DM was closely related to both prototype strains: Hill and Barty-INF. The only exception was the inner capsid protein VP4 where serotype specificity was not evident and the isolate DM clustered with the strain Hill and the strain Barty-INF with echovirus 30 Bastianni. Likewise, the nonstructural protein coding region, P2P3, of isolate DM was more similar to strain Hill than to strain Barty-INF. However, like echovirus 9 Barty, the isolate DM contained the RGD-motif in the carboxy terminus of capsid protein VP1. By blocking experiments using an RGD-containing peptide and a polyclonal rabbit antiserum to the alpha(v)beta(3)-integrin, it was shown that this molecule works as a cellular receptor for isolate DM. By using primary human islets, it was shown that the isolate DM is capable of infecting insulin-producing beta-cells like the corresponding prototype strains did. However, only isolate DM was clearly cytolytic for beta-cells. The infectious clones that were made allow further investigations of the molecular features responsible for the diabetogenicity of the isolate DM

Dimensional assessment of chronic fatigue syndrome

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Development of soft tissue regenerative scaffold with antibacterial activity

With increasingly aging and sedentary populations, and with the rising incidence of diabetes and the associated diabetic ulcers, chronic wounds have been reported to be approaching pandemic proportions. Accumulation of wound bacteria forms a biofilm that can inhibit wound healing and the action of antibiotics. Conventional skin grafts can readily harbor bacterial and fungal cells while excluding penetration of larger immune cells and essential neo-vascularization. Soft tissue regenerative scaffolds with highly interconnected porosity have been developed for wound healing. In this research, scaffolds were fabricated with bioactive components to impart antibacterial activity. The interconnective porosity of the scaffold was preserved through using thermally forming composite scaffolds. Bioactive glass (45S5), bulk metallic glass (MgZnCa), and infused antibiotic (Cephazolin sodium) were utilised to form the composite antibiotic eluting scaffolds. A novel in vivo wound model was generated to simulate the wound environment. A confluent biofilm of Staphylococcus aureus was generated on polymer coupons using a bioreactor. The coupons were placed within nutrient agar dishes (simulating tissue) underneath scaffold specimens. Gravity fed perfusion flow was set up using a drip-set kit.The model successfully replicated the planktonic phase of the Staph. aureus life-cycle and infection of the scaffold from the wound model. Bioactive glass by itself did not contribute any detectable Staph.antibacterial activity whether on the scaffold or fused to a silicone substrate. However, when bioactive glass was present with MgZnCa and antibiotic, a mild synergistic improvement in antibacterial activity was observed. This strategy may facilitate soft tissue adhesion and further militate against bacterial infection. This study is the first report of an in-vitro wound model with an infusion method and planktonic bacteria phase, applied to assess antibacterial synthetic scaffold

The measurement of fatigue in patients with multiple sclerosis. A multidimensional comparison with patients with chronic fatigue syndrome and healthy subjects

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Nurse Practitioner Led Services in Primary Health Care in Rural NSW– Two Case Studies

Background Nurse Practitioners (NPs) are a relatively new advanced nursing role. It was hoped that NPs would reduce some of the challenges facing health care, address workforce shortages and improve access to services for rural populations. The most recent census of Australian NPs showed that just twelve of 208 working NPs were located in primary health care settings. It also showed the majority of NPs were employed in metropolitan areas. Few previous studies describe NP roles in detail, or in rural primary health care settings. Aims This study aims to describe, in detail, the roles of two NPs in rural New South Wales in primary health care settings. One case study focuses on the delivery of an integrated mental health service and the other on leadership in aged care. Methods A case study methodology was employed, using multiple data sources. Data were gathered using semi-structured interviews with 31 key stakeholders, the examination of key documentation, and observation of the NPs within these settings. In the first case study, quantitative data were also analysed. Interview data were analysed thematically. Results The case studies offer an in-depth description of why and how these roles were established, what the NPs do and their impact within the context of small rural towns. They illustrate how NPs established intersectoral partnerships, new service delivery models and advocacy regarding the way health care was provided. The case studies also provide valuable information on how to best incorporate NPs into rural primary health care. Conclusion This study details the complexity of two NP roles within rural primary health care settings. The two case studies show that in these settings, NPs are providing leadership, supporting other services, helping to address workforce shortages, improving access to services for rural populations, and therefore demonstrating the positive impact of NPs working in these settings