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Recommendations for the use of functional medical imaging in the management of cancer of the cervix in New Zealand: a rapid review
No full textAimWe aimed to review the role of functional imaging in cervical cancer to underscore its significance in the diagnosis and management of cervical cancer and in improving patient outcomes.MethodsThis rapid literature review targeting the clinical guidelines for functional imaging in cervical cancer sourced literature from 2017 to 2023 using PubMed, Google Scholar, MEDLINE and Scopus. Keywords such as cervical cancer, cervical neoplasms, functional imaging, stag*, treatment response, monitor* and New Zealand or NZ were used with Boolean operators to maximise results. Emphasis was on English full research studies pertinent to New Zealand. The study quality of the reviewed articles was assessed using the Joanna Briggs Institute critical appraisal checklists.ResultsThe search yielded a total of 21 papers after all duplicates and yields that did not meet the inclusion criteria were excluded. Only one paper was found to incorporate the New Zealand context. The papers reviewed yielded results that demonstrate the important role of functional imaging in cervical cancer diagnosis, staging and treatment response monitoring. Techniques such as dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), diffusion-weighted magnetic resonance imaging (DW-MRI), computed tomography perfusion (CTP) and positron emission tomography computed tomography (PET/CT) provide deep insights into tumour behaviour, facilitating personalised care. Integration of artificial intelligence in image analysis promises increased accuracy of these modalities.ConclusionFunctional imaging could play a significant role in a unified approach in New Zealand to improve patient outcomes for cervical cancer management. Therefore, this study advocates for New Zealand's medical sector to harness functional imaging's potential in cervical cancer management
Exploring MSM blood donor profiles: a descriptive analysis of demographics, risk characteristics, and donation behaviors
No full textBackgroundThe importance of addressing the blood donor population among men who have sex with men (MSM) is increasing with the global liberalization of blood donor deferral policies. Effective donor management, especially retaining existing donors and recruiting new donors, is essential for a safe and sufficient blood supply. Strategies to engage the broader blood donation population are well-established. However, the historical exclusion of MSM from blood donation, based on heightened HIV risk, has limited the understanding of MSM's unique behavioral and risk characteristics as potential donors. Characterizing these donors (and non-donors) will be useful for blood services to tailor outreach and engagement strategies effectively as deferral policies continue to evolve.Materials and methodsData from a national behavioral surveillance program of MSM in New Zealand were examined. We explored differences in demographic and risk characteristics associated with an increased risk of HIV across three groups (i.e., profiles) sorted by their donation history and recency: non-donors, non-active donors, and active donors.ResultsClear characteristics associated with each donor profile emerged among the 3,225 MSM participants. Active donors (4.2%) were younger, students, less engaged with the LGBTQI+ community, reported fewer risk behaviors and were less sexually active. Non-active donors (36.9%) typically exhibited more characteristics associated with an increased risk of HIV. However, non-donor profiles (56.7%) were less clear in comparison, sharing demographic similarities with active donors but displaying risk characteristics similar to those of non-active donors.DiscussionIn this first study to describe MSM blood donor profiles, we have identified unique characteristics specific to MSM which blood services can use to pinpoint targets for engaging current, new, and previous donors. Future research should examine the factors affecting non-donor status among MSM, as they do not appear to be solely driven by demographic and recent behavioral risk factors
National report on doctors eight years after graduating from New Zealand medical schools in 2011-2015
No full textThis report provides the findings from New Zealand Medical Schools Outcomes Database (MSOD)
analysing questionnaire data (2019 and 2023) from doctors eight years after they graduated from a
New Zealand medical school (between 2011 and 2015). The response rate to these PGY8 questionnaires
was 48.6% (942/1947) but linkage to workforce outcome data is 92.3% (1797/1947)
Purinergic Signalling in Sheep and Human Cochlea. A translational study
No full textPurinergic receptors (P1R and P2R) have been identified in virtually all mammalian tissues and regulate many fundamental cellular processes. This has led to an increasing focus on the therapeutic potential of purinergic signalling. In the rodent cochlea, P2 (P2X1-7; P2Y1, 2, 4, 6, 12) and P1 (adenosine A1, A2A, A3) receptors are expressed and have been suggested to play roles in cochlear function. However, the expression of these receptors in other mammalian species including humans remains as a knowledge gap. The aim of this thesis is to characterise the expression of purinergic receptor subtypes in the sheep and human cochlea to contribute to understanding the potential roles in cochlear (patho)physiology. Fixed, decalcified adult sheep temporal bones and celloidin-embedded adult human temporal bone sections were used for immunoperoxidase-histochemistry and multiplex immunofluorescence in parallel. First, in the sheep and human cochlea, screening of P1/P2 receptor subtype expression was conducted for P2X1-4, 7, P2Y1, 2, 6, 12 and adenosine A1, A2A, A3 receptors using commercially available antibodies, focusing on three regions (Rosenthal’s canal, lateral wall, and organ of Corti) Based on findings, antibodies against P2X2, P2X4, and adenosine A1 exhibited most consistent immunolabelling between different methodologies and species, hence were selected for further investigation. The subcellular localisation of P2X2R, P2X4R, and adenosine A1R in the sheep and human using super-resolution confocal imaging revealed, the presence of P2X2R immunolabelling in stereocilia and cytoplasm of inner hair cells (IHCs), outer hair cells (OHCs), Deiters’ cells (DCs), surrounding supporting cells and Reissner’s membrane. Strikingly, a prominent and primarily membranous localisation of P2X2R was observed along the reticular lamina. P2X4R immunolabelling was present in IHCs, OHCs, and DCs with pronounced cytoplasmic localisation in IHCs relative to OHCs. Adenosine A1R immunolabelling was present in DCs, IHCs and OHCs with notable concentrated clusters of cytoplasmic localisation in the basal region of OHCs. Cochlear regions exhibiting conserved subcellular expression patterns for P2X2Rs, P2XRs, and adenosine A1Rs across the adult rodent, sheep and human cochlea, suggest the proposed functional roles of receptors from rodent modes is likely transferrable to humans. Furthermore, parallel use of sheep as a large alternative mammalian model and human cochlear tissue adds great value to advance our understanding of purinergic signalling in the cochlea, with direct relevance for human hearing in health and disease
Establishing Normative Clinical Data for Wideband Tympanometry Measures in the New Zealand Paediatric Population: A Feasibility Study
No full textBackground: Middle ear diseases resulting in conductive hearing loss in children can lead to significant developmental, cognitive, and social challenges. Therefore, early and accurate diagnosis is essential to mitigate these impacts. Wideband Tympanometry (WBT) has emerged as a promising diagnostic tool, offering broader frequency assessment, and improved sensitivity compared to conventional tympanometry. Despite its potential, the clinical utility of WBT is hindered by the lack of robust normative data, especially for preschool and school-aged children in diverse populations like New Zealand (NZ).
Aims: This study aims to establish normative WBT data specific to NZ’s preschool and school-aged population and examine any effects of ear, gender, age, or ethnicity.
Methods: Data was collected cross-sectionally from 50 children (96 ears) aged 3 to 14 years. Participants were required to pass a test battery consisting of otoscopy, pure tone screening, 226 Hz tympanometry, acoustic stapedial reflex and distortion product otoacoustic emission testing before undergoing WBT testing. Absorbance values were extracted at ambient (WBAA) and tympanometric peak pressure (WBATPP), then averaged in one-third octave frequencies from 250 to 8000 Hz. Parameters such as equivalent ear canal volume (ECV), tympanometric peak pressure (TPP) and resonant frequency (RF) were also collected.
Results: Mean WBATPP and WBAA showed increasing absorbance from 250-1000 Hz, followed by two distinct maxima at 1250 Hz and 3150 Hz, before declining at higher frequencies. These findings were consistent with datasets based on Australian children. Analysis of variables showed differences in WBATPP and WBAA patterns between gender, age groups, and across ethnicities. No differences were seen between the left and right ears.
Conclusion: A preliminary WBT normative dataset for NZ children aged 3 to 14 has been established. This includes WBATPP, WBAA, and WBT-estimated RF, ECV and TPP values. While ear-specific data may not be required, gender-, age- or ethnicity-specific normative data may enhance the clinical utility of WBT. However, further statistical analysis is needed to validate these findings, particularly as ECV may be a more reliable predictor for normative data. Significant differences between WBT-generated and 226 Hz tympanometry ECV values reinforce the need for manufacturer equipment-specific normative data
Proposed Retrospective Law Impinges on Principle of Equality under the Law
No full textProfessor Philip A Joseph KC’s rejoinder to my article on the proposed retrospective law in the Credit Contracts and Consumer Finance Amendment Bill 137-1 (Bill) demonstrates that we, as legal academics, are committed to upholding the rule of law and supporting the success of democracy in New Zealand. However, noting where we share common opinions, I firmly disagree with any suggestion that the reasoning contained in the Regulatory Impact Statement (RIS) supporting the Bill’s proposed retrospective law is unobjectionable. As I stated in my original article, there needs to be exceptional circumstances that warrant the enactment of retrospective legislation. Why? Because retrospective legislation that interferes with live litigation by altering the legal consequences of actions already undertaken undermines certainty created by the rule of law. This is particularly important when the proposed retrospective law is for the benefit of formidable institutional defendants in private litigation. In this situation, the exceptional circumstances have not been made out in the RIS. I wish to respond to several points raised by Professor Joseph’s critique in this article
A Meta-Review of New Zealand's Dependence on Imported Bitumen: Exploring Bio-Binder Alternatives for Sustainable Infrastructure
No full textNew Zealand relies heavily on imported bitumen for road infrastructure, creating economic and environmental challenges, especially after the closure of the Marsden Point refinery in 2020. This study reviews 183 publications to explore bio-binders derived from locally sourced biomass as sustainable alternatives to petroleum-based bitumen. Research suggests that bio-binders can reduce the carbon footprint of road construction by up to 50%. Additionally, integrating bio-binders with reclaimed asphalt pavement could decrease bitumen imports by 30%, enhancing resource efficiency. However, several challenges hinder adoption, including the lack of standardized testing methods, limited field performance data, and high production costs. Without established national standards and large-scale implementation trials, the practical viability of bio-binders remains uncertain. Addressing these barriers is crucial to ensuring durability, cost- effectiveness, and widespread industry acceptance. Investing in research, policy development, and pilot projects will be key to overcoming these obstacles. Collaboration between government agencies, industry stakeholders, and researchers can facilitate the transition to bio-based alternatives. Successfully integrating bio- binders into road construction could support New Zealand’s net-zero carbon goals while reducing dependence on fossil fuel imports. By embracing innovative, locally sourced materials, New Zealand can build a more sustainable and resilient transport infrastructure.
Keywords: Bio-binders, Carbon sequestration, Bitumen alternatives, Sustainable roads, Meta-Revie
E-cigarette aerosol deposition efficiency is increased in direct-to-lung, compared to mouth-to-lung, inhalation patterns
No full textDetermining the health effects of vaping is challenging due to the constantly evolving landscape of electronic cigarette (EC) products and modes of use. Studying the effect of EC aerosols on health requires in vivo and in vitro experiments, where dose and deposition of aerosol is important. We present a computational approach to predict aerosol dosimetry throughout a realistic airway tree to support experimental dosimetry, providing the ability to predict dosimetry in different subjects, species, vaping products and inhalation conditions. EC aerosol transport was modelled using advection-diffusion equations, and deposition was estimated via the mechanisms of sedimentation, impaction, and Brownian diffusion. The model was applied to determine the impact of particle size, such as with increasing EC device power settings, and comparison of mouth-to-lung (MTL) and direct-to-lung (DTL) vaping regimens. Results showed a bell-shaped trend in deposition efficiency, ranging from 74 % to 72 % over a particle size range of 20 nm to 3.5 μm, with the lowest deposition (∼15 % in DTL and ∼5 % in MTL vaping) in the mid-particle size range (0.5 μm). Deposition was higher for DTL vaping compared with MTL. MTL vaping resulted in a higher proportion of deposition in the upper airways, while DTL vaping showed greater deposition in the respiratory airways, due to differences in flow rates and puff volume. The mass of particles deposited throughout the airway tree varied from 1 × 10−7 mg to 4 × 10−3 mg indicating large variability and the importance of tailoring dose correctly depending on which part of the airway tree is being studied
A meta-analysis of genetic variant pathogenicity and sex differences in UBQLN2-linked amyotrophic lateral sclerosis and frontotemporal dementia
No full textUbiquilin 2, encoded by the X-linked UBQLN2 gene, is a ubiquitin-binding quality control protein. Pathogenic UBQLN2 genetic variants cause X-linked dominant amyotrophic lateral sclerosis and/or frontotemporal dementia (ALS/FTD), however, clinical phenotypes from these variants show striking inter- and intra-familial heterogeneity. Further, there are many UBQLN2 variants whose significance to disease is uncertain. Here, we examine the pathogenic potential of UBQLN2 variants reported in individuals with ALS/FTD and their non-symptomatic relatives. Meta-analysis from 27 published studies identified 186 affected individuals and 51 asymptomatic carriers, each harbouring one of 43 unique UBQLN2 coding variants. Features of identified variants, including evolutionary conservation, minor allele frequencies, localisation to protein domains, and in silico predictions of pathogenicity were compiled. Per biological sex, clinical features were compared between UBQLN2 variants segregated by pathogenicity. Pathogenic UBQLN2 variant carriers, most of whom are familial ALS cases, showed a sex-specific difference in age at onset wherein males developed disease on average 18.15 years prior to females (29.54 ± 11.9 versus 47.69 ± 13.4 years, p < 0.0001), with no change in disease duration (p = 0.2091). UBQLN2 variants of uncertain significance showed a bimodal distribution of onset age per sex suggesting a mixture of true benign and true pathogenic variants. In human brain tissue, two male UBQLN2 p.Thr487Ile (ALS-FTD and ALS) cases showed a greater burden of ubiquilin 2 aggregates than a related female case (ALS-FTD). These robust sex-specific differences in ALS/FTD presentation in carriers of pathogenic UBQLN2 variants may improve predictions of ALS/FTD risk in carriers, aiding in diagnosis and disease management