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Time Biases and Rationality
No full textThis dissertation offers a partial defense of the rationality of future-bias and near-bias
The influence of second-generation antipsychotics and cannabidiol on sphingolipid metabolism
No full textSchizophrenia is a severe psychiatric disorder marked by positive, negative, and cognitive symptoms, resulting in substantial disability and socioeconomic burden. Second-generation antipsychotics (SGAs) are the mainstay of treatment but are limited by adverse metabolic effects such as weight gain, dyslipidaemia, and glucose dysregulation, highlighting the need for safer alternatives. Cannabidiol (CBD) has shown antipsychotic efficacy comparable to SGAs but without these metabolic side effects. Although the mechanisms behind CBD’s effects remain unclear, emerging evidence points to a role for lipid signalling pathways.
To date, no clinical studies have examined lipidomic changes in healthy volunteers treated with SGAs, nor the lipid profile effects of CBD alone or in combination with SGAs. This study investigated CBD’s impact on lipid responses triggered by SGAs in a randomized phase I safety trial. Serum samples were collected at baseline, after three days of SGA monotherapy (amisulpride 150 mg/day, quetiapine 300 mg/day, olanzapine 10 mg/day, or risperidone 3 mg/day), and following six days of combined SGA and CBD (800 mg/day) treatment.
Our findings highlight sphingolipid metabolism as a key pathway in SGA-induced metabolic disturbances and CBD’s potential ameliorative effects. Results suggest that SGAs may enhance sphingolipid catabolism, while adjunctive CBD promotes sphingolipid synthesis, potentially countering metabolic dysregulation. Additionally, we developed and validated an LC-MS/MS method for quantifying amisulpride, olanzapine, quetiapine, risperidone, and their metabolites in serum, supporting future studies on pharmacokinetics and drug interactions
Teratogenic effects of larval low salinity experience in development of the juvenile body in Acanthaster sp
No full textThis item is the dataset and the Rscript supporting the manuscript titled - Teratogenic effects of larval low salinity experience in development of the juvenile body in Acanthaster sp.
This dataset captures experimental results investigating the effects of reduced salinity during the larval stage on the morphological development of juvenile crown-of-thorns starfish (Acanthaster sp.). The data reflect teratogenic outcomes such as abnormal body plans, arm number deviations, and survival metrics under different salinity and exposure durations.
The Excel file contains five sheets:
Juvenile growth
Measurements of juvenile body diameter (µm) by larval salinity treatment, exposure duration, and age (1 or 5 days). Includes replicate IDs.
Proportion normal
Proportions and percentages of juveniles categorized as "normal" or "abnormal" based on morphology, by treatment and exposure time.
Proportional arm count
Relative frequencies of different arm numbers (e.g., 4, 5 arms) in juveniles across treatments and ages.
Arm#
Detailed arm count data per individual juvenile, including counts of individuals with 0, 4, or 5 arms and corresponding treatment metadata.
Juvenile morphology scores
Individual-level scoring of morphological abnormalities (e.g., fleshy body, swelling) by treatment, replicate, and juvenile ID.
Key Variables:
Larval salinity treatment (‰)
Larval salinity exposure duration (e.g., 2 or 4 days)
Juvenile age (days post-settlement)
Morphological traits (arm number, body diameter, abnormality scores)
Proportional outcomes (normal vs. abnormal development)
This R Markdown file contains all statistical analyses and data visualizations supporting the manuscript "Teratogenic effects of larval low salinity experience in development of the juvenile body in Acanthaster sp." (Clements et al., 2025). The code enables full reproducibility of the analyses, including data import, summary statistics, linear and generalized linear mixed models, and diagnostic assessments.
Contents:
Packages used: readxl, dplyr, ggplot2, cowplot, lme4, car, emmeans, DHARMa, lattice, arm
Main analyses include:
Juvenile growth (1- and 5-day-old)
Body and arm morphometrics
Normal vs. abnormal morphology scoring
Five-arm development likelihood
Residual and random effects diagnostics
Data linkage: External Excel file (.xlsx) referenced for input data
Usage:
This file is intended for transparent and reproducible research. Users can rerun all analyses and regenerate figures by updating the file paths to match their system.Adult Acanthaster spp. (crown-of-thorns sea stars) were collected from the Great Barrier Reef and spawned in aquaria at 26–27 °C. Larvae were cultured under controlled conditions and exposed to reduced salinity treatments (22, 25, 30, 34‰) for two or four days to simulate runoff conditions. After exposure, competent larvae were settled in standard salinity using coralline algae as a cue, and resulting juveniles were monitored for five days. Morphometrics (body size, arm number) and morphology scores (normal vs. abnormal) were recorded on days 1 and 5. Statistical analyses included linear and generalized linear mixed models with salinity and exposure time as fixed effects, and replicate vial as a random effect. Model assumptions were validated using diagnostic tools in R
Advances in the role of ultrasound in the diagnosis of adhesive capsulitis (frozen shoulder)
No full textAdhesive capsulitis (AC), also called frozen shoulder (FS), is a debilitating condition characterised by a gradual onset of shoulder pain followed by a loss of range of motion (ROM). Diagnosis is currently based on clinical assessment, which can be challenging due to similarities in symptoms with other shoulder problems. To assist in the diagnosis, ultrasound studies have shown a thickened inferior glenohumeral capsule (IGHC) as one of the characteristics of patients with AC. However, a systematic review conducted for this thesis demonstrated inconsistencies in the methods and results of prior studies. The accuracy of this diagnostic marker also had not been established, without which its clinical utility was limited. The aim of this thesis was to explore the role of this ultrasound marker in the diagnosis of AC by analysing the IGHC thicknesses in various shoulder pathologies including AC. This was achieved through three phases of an experimental study. An analysis of the asymptomatic shoulders in the first phase confirmed that males have thicker IGHC, and showed that the normal IGHC thickness reduces similarly in both sexes as the shoulder is abducted. To overcome variability in the IGHC thickness, IGHC ratios, obtained by side to side comparison between symptomatic and asymptomatic sides, were investigated in the second phase. The IGHC ratios were found to be significantly larger in the FS group compared to the group with other shoulder pathologies when measured at 90° shoulder abduction. The ratio ≥ 1.8 was 92% specific to the FS group. To elaborate on the clinical utility of this marker, participants whose IGHC ratios did not correlate with their clinical status of FS at the first visit, and those who had not improved in their clinical impairment at their first follow-up visit were followed at six,12 and 24 months. With no clear evidence found to explain the discrepancies, limitations of this study and directions for future studies are provided
Childhood Behavioural Disorders: Partnerships between the Health and Education Sectors
No full textBackground
Mental health and behavioural disorders affect 20% of children yet only 30% access appropriate care. An integrated school-based health care (SBHC) model was co-designed at a specialised behavioural school to improve access and engagement with health services.
Aims and Methods
The purpose of this thesis was to describe the need for and the co-design, evaluation and potential for scale-up of an SBHC program called Ngaramadhi Space. Using mixed methods, the quantitative phase described the population. The qualitative phases explored the model’s development and implementation facilitators and barriers.
Findings
Quantitative phase
• Multiple unmet needs
• Most students (76%) known to child protection services
• High attendance at school clinic (86%)
• Significant behavioural improvements (Strengths and Difficulty Questionnaire—teacher)
Qualitative themes
a) Integrated People-Centred Health Service framework
Strategy 1: Engaging and empowering people and communities—community driven, improved access, positive outcomes, ‘connection’ and culturally safe
Strategy 2: Strengthening governance and accountability—system integration and evidence base
Strategy 3: Reorienting model of care—reduces inequity
Strategy 4: Coordinating services—multidisciplinary and stable workforce
Strategy 5: Enabling environment—leadership, stakeholder commitment and adequate resourcing
b) Looman’s implementation strategies
Applying collaborative governance
Distribution of leadership
Building positive team culture
Incremental growth models
Balancing flexible and formal structures
‘Integrators’
Conclusion
Support for the SBHC model from community and stakeholders was significant. Using the insights gained from this thesis, a framework called Kalgal Burnbona has been proposed for SBHC implementation across Sydney Local Health District. Future research requires inclusion of education, social and implementation outcomes. Policy needs to reflect integrated care for children across sectors.
Molecular Determinants of Treatment Response and Outcomes in Acute Myeloid Leukaemia with mutated NPM1
No full textMutations in the nucleophosmin (NPM1) gene occur in ~30% of adult AML, where they define a distinct disease subtype associated with relatively favourable prognosis. Outcomes are impacted by age, mutations in FLT3-ITD and DNMT3A, and adverse karyotype. Measurable residual disease (MRD) after induction chemotherapy is strongly associated with relapse and survival, but its interaction with baseline prognostic factors and their combined impact on treatment decisions is not well established. Chapter 1 of this thesis describes a large cohort of younger patients with NPM1 mutated AML, comprehensively analysing the relationship between clinical features, genomic abnormalities and MRD response. Factors associated with poor MRD responses are identified, as are those remaining prognostic in patients achieving MRD negativity. Chapter 2 demonstrates that blood MRD results can identify patients who benefit from allogeneic transplant in first remission. For MRD negative patients, survival is not improved by transplant regardless of baseline prognostic factors. Chapter 3 is the first description of the impact of molecular MRD in patients receiving venetoclax-based therapies for NPM1 mutated AML. MRD is highly prognostic, with patients achieving MRD negativity in bone marrow having excellent outcomes, including those who electively stopped therapy. Chapter 4 and appendix 1 explore the treatment of molecular relapse, which is known to predict impending haematological relapse, demonstrating high response rates and low toxicity with FLT3 inhibitors and venetoclax-based therapies. Chapter 5 addresses another unresolved issue in classification of NPM1 mutated AML, showing that therapy-related and de novo disease have similar clinical and genomic features, suggesting they should be considered the same disease. In conclusion, the results described in this thesis provide practice-influencing clarification of the molecular determinants of treatment response and outcomes in NPM1 mutated AML
Profiling future passenger transport initiatives that garner community support as a guide to identify the growing role of active and micro-mobility modes: a MDCEV model
No full textThis paper examines the factors influencing the adoption and frequency of use of sustainable transport modes including walking, cycling, electric bicycles, electric vehicles, and public transport, for different trip purposes. Using a two-stage stated preference experiment in metropolitan Australia, we use a mixed multinomial logit model (MML) model to estimate the probability of adopting door-to-door travel alternatives, followed by a multiple discrete-continuous extreme value (MDCEV) model to capture the number of weekly trips taken by mode and purpose. Results show that trip purpose plays a significant role in mode selection, with commuting trips associated with greater willingness to shift to active and electric modes, especially when infrastructure quality is high. In contrast, shopping and personal business trips are more sensitive to access mode and mode experience. E-bikes emerge as a flexible option for both commuting and recreational trips, while walking is mainly preferred for short, non-commute travel. The findings underscore the importance of purpose-specific strategies and high-quality infrastructure in promoting sustainable and integrated mobility futures
Predictors of Healing in Foot Ulceration
No full textThe role of dietary intake, micronutrient deficiencies, cognitive function, and smoking in foot ulceration remains inadequately understood. The aim of this thesis is to explore whether certain variables can predict healing or presence of foot ulcers.
In multiple chapters, variables such as smoking, cognitive function, dietary intake, micronutrient deficiencies, and supplementation were investigated. Data was collected using cognition testing tools, blood tests, and dietary recalls. Foot ulcer outcomes were tracked throughout multiple chapters to correlate any variables with the healing or presence of foot ulceration.
Vitamin C, D, and zinc deficiencies were highly prevalent among foot ulcer patients with deficiency rates of 75%, 50%, and 38%, respectively. Despite the high deficiency rates, no significant association was found between deficiency or supplementation and healing trajectory. However, those with a deficiency of vitamin D had a 1.20-fold increased risk of non-healing. Current smokers were significantly younger when presenting for care for their foot ulcer. Cognitive impairment was significantly higher in DFU patients, compared to controls, and correlated with QoL scores. Supplementation with vitamin C may improve cognitive function, but ulcer healing was unaffected.
While there were high rates of micronutrient deficiencies amongst patients, the impact on healing of foot ulcers was inconclusive, however cognition and circulation both have a significant role. Ulcer clinics may benefit from implementing micronutrient testing and cognitive assessments. Future studies should be large multi-centre trials investigating nutritional interventions, smoking cessation, and cognitive therapy on healing
How are meal delivery applications disrupting food environments and affecting population diets and health?
No full textBackground: Meal delivery applications (‘apps’) enable convenient access to takeaway foods, typically high in sodium, saturated fats, and sugars. These apps may further promote unhealthy diets and elevate risk for diet-related chronic diseases. The aim of this thesis was to investigate how meal delivery apps are disrupting food environments and affecting population diets and health.
Methods: Critical synthesis of evidence in a perspective article (Ch 2); Systematic review (Ch 3); Mobile Ecological Momentary Assessment pilot study (Ch 4), Development of the DIGIFOOD dashboard, a data-driven tool to monitor the digitalisation of food environments (Ch 5); Analysis of the DIGIFOOD dashboard using quasi-Poisson regression models to assess socioeconomic disparities in hybrid food environments (Ch 6); Systematic mapping review of evidence to inform nutrition-related policies (Ch 7).
Results: Meal delivery apps increased in use during COVID-19 (Ch 3). Of concern, meal delivery apps may impede progress towards a sustainable and healthy future (Ch 2). Chapter 4 obtained evidence on the consumption and context around meal delivery events, indicating that a bulk of orders are comprised of ‘junk foods’. In an Australian context, online food outlets were most accessible in areas experiencing the least socioeconomic disadvantage (Ch 5 and 6). Existing nutrition-related policies to regulate meal delivery apps is limited (Ch 7).
Conclusion: This thesis provides evidence that meal delivery apps have transformed food environments and pose significant opportunities and challenges, to population health and diets. Research and policy must keep pace with this new digital frontier which may compromise any progress to-date in improving food environments
Consumer Motivation to Collaborate in Last Mile Logistics
No full textThe rapid growth of online shopping has created significant challenges for retailers, particularly in last
mile logistics, where the transfer of goods from retailer to consumer often leads to delivery delays,
missed orders, or high costs. One way to address these challenges is through consumer
collaboration, where shoppers assist in the process by using services such as click-and-collect,
parcel lockers, or location-aware delivery apps. This study explores what motivates consumers to
engage in such collaboration, drawing on supply chain collaboration and consumer cocreation
literature. A framework of three potential motivators perceived value, brand relationships, and self-efficacy,
was developed and tested through a survey of 374 online shoppers using structural
equation modelling.
The findings show that perceived value and self-efficacy significantly influence consumer motivation
to collaborate, while brand relationships were less important than expected. Building on these results,
a revised two-stage model was proposed, showing that consumers first recognise the value of
collaboration before becoming regular collaborators. This research contributes to theory by extending
supply chain collaboration into the consumer domain and highlights practical strategies for retailers,
including simplifying collaboration processes, expanding value propositions, and targeting younger,
more educated consumers most likely to adopt such practices