The Canengusian Connection: The Kaleidoscope of Tort Theory

In the course of our teaching and research, we uncovered a recent decision of the Supreme Court of Canengus. The judgment in Allan v. Derek was handed down on 1st April, 1984. We reproduce it here in the hope that it will be of some interest to tort lawyers and legal scholars generally

Learning to Be: A Narrative Inquiry into the Identity Making and Curriculum Making of Individuals Positioned by Dominant Stories of Gender and Sexuality

This narrative inquiry explores the composition of diverse stories to live by, a narrative conception of identity (Connelly & Clandinin, 1999), of four participants positioned by social and familial understandings of gender and sexuality. The research, conducted over an 18-month period, told of multiple and diverse stories around gender and sexuality and the shaping influences of relationships and context for educative experience (Dewey, 1938/1997). Drawing on a view of curriculum as a course of life (Clandinin & Connelly, 1992), this inquiry sought to better understand the complexities of identity making in the process of curriculum making (Schwab, 1969). Research literature on individuals positioned differently by understandings of gender and sexuality in schools are bounded by simplex categorical understandings of gender and sexuality and are focused on the negative experiences and consequences for lesbian, gay, bisexual, and transgendered (LGBT) youth in heteronormative contexts. However, these studies have provided little understanding for the complexities of diverse identities around gender and sexuality and the varied experiences that lead to the composition of diverse identities around gender and sexuality. Through the inquiry, several narrative threads emerged; diverse stories to live by around gender and sexuality are: (a) complex, multiple, and diverse; (b) negotiated through social dominant stories of gender and sexuality; (c) shaped by context; (d) negotiated through relationship; and (e) interwoven and nested with the stories of others

Periodic Patterns and Energy States of Buckled Films on Compliant Substrates

Thin stiff films on compliant elastic substrates subject to equi-biaxial compressive stress states are observed to buckle into various periodic mode patterns including checkerboard, hexagonal and herringbone. An experimental setting in which these modes are observed and evolve is described. The modes are characterized and ranked by the extent to which they reduce the elastic energy of the film–substrate system relative to that of the unbuckled state over a wide range of overstress. A new mode is identified and analyzed having nodal lines coincident with an equilateral triangular pattern. Two methods are employed to ascertain the energy in the buckled state: an analytical upper-bound method and a full numerical analysis. The upper-bound is shown to be reasonably accurate to large levels of overstress. For flat films, except at small states of overstress where the checkerboard is preferred, the herringbone mode has the lowest energy, followed by the checkerboard, with the hexagonal, triangular, and one-dimensional modes lowering the energy the least. At low overstress, the hexagonal mode is observed in the experiments not the square mode. It is proposed that a slight initial curvature of the film may play role in selecting the hexagonal pattern accompanied by a detailed analysis. An intriguing finding is that the hexagonal and triangular modes have the same energy in the buckled state and, moreover, a continuous transition between these modes exists involving a linear combination of the two modes with no change in energy. Experimental observations of various periodic modes are discussed with reference to the energy landscape. Discrepancies between observations and theory are identified and open issues are highlighted.Engineering and Applied Science

Innate immune cell instruction using micron-scale 3D objects of varied architecture and polymer chemistry: The ChemoArchiChip

To design effective immunomodulatory implants, innate immune cell interactions at the surface of biomaterials need to be controlled and understood. The architectural design freedom of two-photon polymerization is used to produce arrays of surface-mounted, geometrically diverse 3D polymer objects. This reveals the importance of the interplay between architecture and materials chemistry in determining human macrophage fate in vitro. The ChemoArchiChip identifies key structure-function relationships and design rules from machine learning models to build a mechanistic understanding of cell attachment and polarization. Object shape, vertex/cone angle, and size are key drivers of attachment. Particular shapes are found to heavily modulate pro- or anti-inflammatory cell polarization, while triangular pyramids drastically reduce or even eliminate attachment. Caveola-dependent endocytosis is a principal mechanism by which cells respond to objects with sharp points; i.e., low vertex/cone angles. The discovery of these putative design rules points to surfaces decorated with architectures to augment implant performance

Mammary Involution and Breast Cancer Risk: Transgenic Models and Clinical Studies

Postlactational involution is the process following weaning during which the mammary gland undergoes massive cell death and tissue remodeling as it returns to the pre-pregnant state. Lobular involution is the process by which the breast epithelial tissue is gradually lost with aging of the mammary gland. While postlactational involution and lobular involution are distinct processes, recent studies have indicated that both are related to breast cancer development. Experiments using a variety of rodent models, as well as observations in human populations, suggest that deregulation of postlactational involution may act to facilitate tumor formation. By contrast, new human studies show that completion of lobular involution protects against subsequent breast cancer incidence

Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans.

BACKGROUND: The COVID-19 pandemic has disrupted routine hospital services globally. This study estimated the total number of adult elective operations that would be cancelled worldwide during the 12 weeks of peak disruption due to COVID-19. METHODS: A global expert response study was conducted to elicit projections for the proportion of elective surgery that would be cancelled or postponed during the 12 weeks of peak disruption. A Bayesian β-regression model was used to estimate 12-week cancellation rates for 190 countries. Elective surgical case-mix data, stratified by specialty and indication (surgery for cancer versus benign disease), were determined. This case mix was applied to country-level surgical volumes. The 12-week cancellation rates were then applied to these figures to calculate the total number of cancelled operations. RESULTS: The best estimate was that 28 404 603 operations would be cancelled or postponed during the peak 12 weeks of disruption due to COVID-19 (2 367 050 operations per week). Most would be operations for benign disease (90·2 per cent, 25 638 922 of 28 404 603). The overall 12-week cancellation rate would be 72·3 per cent. Globally, 81·7 per cent of operations for benign conditions (25 638 922 of 31 378 062), 37·7 per cent of cancer operations (2 324 070 of 6 162 311) and 25·4 per cent of elective caesarean sections (441 611 of 1 735 483) would be cancelled or postponed. If countries increased their normal surgical volume by 20 per cent after the pandemic, it would take a median of 45 weeks to clear the backlog of operations resulting from COVID-19 disruption. CONCLUSION: A very large number of operations will be cancelled or postponed owing to disruption caused by COVID-19. Governments should mitigate against this major burden on patients by developing recovery plans and implementing strategies to restore surgical activity safely

Case Reports1. A Late Presentation of Loeys-Dietz Syndrome: Beware of TGFβ Receptor Mutations in Benign Joint Hypermobility

Background: Thoracic aortic aneurysms (TAA) and dissections are not uncommon causes of sudden death in young adults. Loeys-Dietz syndrome (LDS) is a rare, recently described, autosomal dominant, connective tissue disease characterized by aggressive arterial aneurysms, resulting from mutations in the transforming growth factor beta (TGFβ) receptor genes TGFBR1 and TGFBR2. Mean age at death is 26.1 years, most often due to aortic dissection. We report an unusually late presentation of LDS, diagnosed following elective surgery in a female with a long history of joint hypermobility. Methods: A 51-year-old Caucasian lady complained of chest pain and headache following a dural leak from spinal anaesthesia for an elective ankle arthroscopy. CT scan and echocardiography demonstrated a dilated aortic root and significant aortic regurgitation. MRA demonstrated aortic tortuosity, an infrarenal aortic aneurysm and aneurysms in the left renal and right internal mammary arteries. She underwent aortic root repair and aortic valve replacement. She had a background of long-standing joint pains secondary to hypermobility, easy bruising, unusual fracture susceptibility and mild bronchiectasis. She had one healthy child age 32, after which she suffered a uterine prolapse. Examination revealed mild Marfanoid features. Uvula, skin and ophthalmological examination was normal. Results: Fibrillin-1 testing for Marfan syndrome (MFS) was negative. Detection of a c.1270G > C (p.Gly424Arg) TGFBR2 mutation confirmed the diagnosis of LDS. Losartan was started for vascular protection. Conclusions: LDS is a severe inherited vasculopathy that usually presents in childhood. It is characterized by aortic root dilatation and ascending aneurysms. There is a higher risk of aortic dissection compared with MFS. Clinical features overlap with MFS and Ehlers Danlos syndrome Type IV, but differentiating dysmorphogenic features include ocular hypertelorism, bifid uvula and cleft palate. Echocardiography and MRA or CT scanning from head to pelvis is recommended to establish the extent of vascular involvement. Management involves early surgical intervention, including early valve-sparing aortic root replacement, genetic counselling and close monitoring in pregnancy. Despite being caused by loss of function mutations in either TGFβ receptor, paradoxical activation of TGFβ signalling is seen, suggesting that TGFβ antagonism may confer disease modifying effects similar to those observed in MFS. TGFβ antagonism can be achieved with angiotensin antagonists, such as Losartan, which is able to delay aortic aneurysm development in preclinical models and in patients with MFS. Our case emphasizes the importance of timely recognition of vasculopathy syndromes in patients with hypermobility and the need for early surgical intervention. It also highlights their heterogeneity and the potential for late presentation. Disclosures: The authors have declared no conflicts of interes

Global wealth disparities drive adherence to COVID-safe pathways in head and neck cancer surgery

Peer reviewe