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Provision of pain care services for people with Parkinson's disease from the perspective of healthcare providers: A qualitative descriptive study
No full textOnlinePublPurpose:
Pain is a common, complex, and debilitating non-motor symptom of Parkinson's disease that often requires a multidisciplinary and multimodal approach to care. However, little is known about how healthcare providers experience and navigate pain care provision in Parkinson's disease, particularly within the Australian healthcare context. This study aimed to explore the perspectives of Australian healthcare providers involved in the management of pain in people with Parkinson's disease. Methods: A qualitative descriptive research methodology was used to underpin this study. Healthcare providers involved in the management of pain in people with Parkinson's disease were recruited using a quota sampling strategy. Data were collected using semi-structured interviews and analyzed thematically. Results: Nineteen healthcare providers participated, including five from nursing, five from neurology, five from physiotherapy, three from exercise physiology, and one from general practice. Analysis of the data resulted in six themes: (1) collaborating for holistic pain management; (2) determining etiology; (3) screening and managing the non-motor symptoms of Parkinson's disease that interact with pain and its treatment; (4) provider focus drives nuanced pain therapy; (5) involving carers in the assessment and treatment of pain; and (6) educating patients and healthcare providers to achieve effective pain management. Within these themes, participants highlighted the central role of Parkinson's nurse specialists in coordinating care, facilitating communication across disciplines, and supporting both patients and healthcare providers through education and guidance. Conclusion: This study offers the first in-depth exploration of healthcare providers' perspectives on pain care in Parkinson's disease within Australia. The findings highlight the need for a collaborative, multidisciplinary approach supported by targeted patient and healthcare provider education to enhance communication and continuity of care, with Parkinson's nurse specialists playing a pivotal role in coordinating services and serving as a resource across the care network. Strengthening these elements presents a clear pathway for advancing the provision of pain care services in people with Parkinson's disease.Anthony Mezzinia, Saravana Kumar, Sue Sharrad, Joanne Harmon and Marion Ecker
Enhanced Detection of Splice-Altering Variants in Hematologic Malignancies Using Targeted RNA-Sequencing Data
No full textRNA-based targeted sequencing aids the detection of several types of variants in hematologic and other malignancies, including splice-altering variants. However, accurately identifying clinically relevant mis-splicing events remains challenging because of the inherent complexity of the human transcriptome and the high prevalence of false-positive splice junctions in deep RNA-sequencing data. To address these challenges, SpliceChaser and BreakChaser were developed, which are bioinformatics tools designed to enhance the detection and characterization of relevant splice-altering events. SpliceChaser improves the identification of clinically relevant atypical splicing by analyzing read length diversity within flanking sequences of the mapped reads around the splice junctions. BreakChaser processes soft-clipped sequences and alignment anomalies to enhance the detection of targeted deletion breakpoints associated with atypical splice isoforms generated from intrachromosomal gene deletions. These tools were developed and validated using a cohort of >1400 RNA-sequencing samples from patients with chronic myeloid leukemia. Collectively, SpliceChaser and BreakChaser achieved a positive percentage agreement of 98% and a positive predictive value of 91% for the detection of clinically relevant atypical splice-altering variants or gene deletions in the targeted regions. By integrating splicing and breakpoint detection with robust filtering strategies, these tools facilitate precise identification of clinically relevant variants, paving the way for improved diagnostics and therapeutic strategies in chronic myeloid leukemia and other malignancies.Muneeza Maqsood, John Toubia, Carol Wadham, Naranie Shanmuganathan, Nur Hezrin Shahrin, Adelina Fernandes, Joe McConnell, Verity Saunders, Dominik Kaczorowski, Rosalie R. Kenyon, Ming Lin, Timothy P. Hughes, Chung Hoow Kok, Susan Branfor
Will Dynamic Evaluation of Cardiogenic Shock Using Machine Learning Models Lead to Improved Survival?
No full textCardiogenic shock (CS) is characterised by tissue hypoxia as a result of circulatory failure arising from inadequate cardiac output and is commonly a complication of acute myocardial infarction (AMI). Despite improvement in reperfusion strategies for AMI, the survival among patients with CS remains poor. While mechanical circulatory support (MCS) technologies in AMI-CS offer promise, they have not translated to consistent improvements in patient survival, which may reflect an inability to recognise evolving CS at a reversible stage. Hence, reducing the mortality from CS requires solutions focused on timely diagnosis. CS is heterogenous, being dependent on interpreting acute haemodynamics and biomarkers, which often delays diagnosis and intervention. The continued digitisation of health information, particularly within the emergency and acute care environments has made the development of artificial intelligence (AI)-driven diagnostic decision support for the acutely deteriorating patient feasible. Such approaches have been effectively deployed in hospitals to alert frontline staff or “shock teams” to patient deterioration, with evidence of reductions in mortality. Further, these integrated systems that can “dynamically phenotype” patients and their clinical deterioration within the flow of data not only support clinical decision-making but also allow the establishment of virtual clinical registries assimilated within real-world practice, continuously evaluating clinical practice and outcomes. This review aims to delineate CS pathophysiology, limitations within our current diagnostic approach, understand the difficulties in conducting randomised clinical trials and explores the role of an integrated AI-based approach for early diagnosis and intervention in patients with CS.Vishal Goel, William Chan, Jack Tan, Sidney Lo, Adam J. Nelson, Dion Stub, Derek Che
Energy Security: Developments, Challenges and Opportunities
No full textFor most of the world, achieving energy security while reducing global warming and climate change has become a key political goal of the 21st century. Energy security, like many social science constructs, is a nebulous and contested concept, and can be interpreted in a wide variety of ways depending on one’s worldview or paradigm. Traditional theorists have tended to focus on securing the energy needs of the state while critical energy security approaches have shifted the lens to focus on securing sufficient energy access for marginalized individuals and communities. Energy consumption from the burning of fossil fuels has driven global industrial development since the late 19th century. The burning of fossil fuels accounts for over three quarters of global greenhouse gas emissions and nearly 90 percent of all carbon dioxide emissions. Over the last two decades, national and global efforts to promote energy security through the use of low carbon technologies have increased. Electricity networks in some jurisdictions, such as South Australia, have seen fossil fuels almost entirely replaced by variable renewable energy sources – solar and wind – backed up with battery storage. Despite these successes, climate deniers and right-wing populists in Australia, for example, and elsewhere continue to undermine the rollout of renewable technologies to delay the closure of fossil fuel power stations and industries, regardless of the climate impacts.Adam Simpso
The Double-Edged Sword of Entrepreneurial Orientation: Product Recalls and the Role of COO Power
No full textOnlinePublThis study examines how entrepreneurial orientation (EO) influences firms’ likelihood of product recalls. Integrating EO and upper echelons theory, we first argue that EO’s bold, variance-enhancing actions increase a firm’s product recall risk by diverting managerial attention away from quality control. Using 23 years of data on U.S. public firms, we find that EO increases recall likelihood. Second, we argue that this relationship is moderated by chief operating officer (COO) power, and the effectiveness of COO power is contingent on the firm’s product life cycle context. Empirical analyses support our theory and offer new insights about EO’s potential downsides.Pide Lun, Ralf Zurbruegg, Matthew P. Mount, and Chee Seng Cheon
Transparent reporting is central to reproducible radiological AI research: A call to action
No full textBackground Artificial intelligence (AI) is increasingly embedded in radiology research and practice, yet concerns about the reproducibility of AI studies remain a key barrier to regulatory acceptance and clinical translation. Transparent reporting across the analytic pipeline is essential for independent verification, evidence synthesis, and safe implementation. Purpose To examine major barriers to transparent reporting in radiological AI research and propose practical solutions to strengthen reproducibility. Results We identify four interrelated challenges undermining reporting quality. First, reporting is often treated as a final-stage manuscript requirement rather than a prospectively embedded component of study design, leading to loss of methodological detail. Second, inconsistent operationalization of reporting standards by journals and funders makes it difficult to assess reporting completeness. Third, fragmentation and overlapping complexity of AI-specific reporting guidelines increase interpretive burden for authors and reviews and contribute to heterogeneity in reporting. Fourth, limited availability and usability of data and code restrict independent verification, even when resources are nominally shared. These issues are amplified by the methodological complexity and heterogeneity of radiological AI pipelines. For each challenge, we outline actionable strategies including prospective documentation of methods, mandatory and consistently applied reporting standards, harmonized reporting principles, and clearer requirements for data and code availability with structured alternatives when sharing is constrained. Conclusions Strengthening transparent reporting is a prerequisite for reproducible and clinically translatable radiological AI research. Embedding reporting within study design, aligning stakeholder expectations, and improving access to reproducibility-enabling resources are essential to enhance credibility, facilitate independent evaluation, and support safe clinical implementation of AI in radiology.Samuel J. White, Kasper L. Yaxley, Minh-Son To, Minh Cha
Spectroelectrochemical insight into copper cobalt catalysts for CO(2) and nitrite co-electroreduction to urea
No full textpublished online 17 January 2026Electrochemical CO₂ and nitrite co-reduction provides a sustainable urea synthesis route but remains limited by low selectivity and an undecided C–N coupling mechanism. Here, we report co-sputtered bimetallic Cu–Co catalysts that facilitate urea formation via a tandem relay mechanism. The optimal Cu:Co ratio of 1:1 achieves a urea yield rate of 61 ± 6 mmol h¹⁻gcat¹⁻ at –1.2 V vs. RHE under neutral pH, emphasizing the importance of proton balance in sustaining proton-coupled electron transfer. In situ synchrotron-based infrared and Raman spectroscopy monitor the dynamic evolution of *CO, *NH₂, and C‒N intermediates. In situ X-ray absorption spectroscopy indicates the structural stability of metallic Cu and Co active sites. Density functional theory calculations suggest that *COOH + *NH₂ coupling initiates urea pathway, with *NH₂CO formation as the potential-determining step. This study integrates rational catalyst design and in situ spectroelectrochemical analysis to advance understanding of electrochemical C–N coupling for urea synthesis.Putri Ramadhany, Thành Trần-Phú, Jodie A. Yuwono, Rosalie K. Hocking, Zhipeng Ma, Xuan Minh Chau Ta, Priyank Kumar, Denny Gunawan, Bernt Johannessen, Antonio Tricoli, Alexandr N. Simonov, Rose Amal & Rahman Daiya
Research prioritization and societal accountability in corporatised healthcare services-What can Responsible Innovation offer?
No full textIn many parts of the world, an increasing number of clinical healthcare services are delivered through corporations. These corporations are also increasingly required to shape and undertake vital medical research. In this paper we outline the challenges of setting research priorities in corporatised clinics and ensuring that researchers are accountable to society and alert to the broader societal impacts of their work. We propose that the approach to research governance known as “Responsible Innovation” might provide a useful framework for selecting and shaping corporate research priorities so that they are grounded in population health priorities and wider social benefit. Responsible innovation also provides guidance for engaging patients, consumers, regulators and payers in constructive collaboration with researchers; encouraging ethical reflection by both corporations and individual scientists; and promoting responsiveness to contingencies in the processes, outcomes, and reception of research.Siun Gallaghera, Sara Attingera, Ian Kerridgeb, Robert J Normanc and Wendy Lipwort
Compressive stress–driven Piezo1 activation and Rho-ROCK mechanotransduction promote tumor progression via epigenetic mechanical memory
No full textRapidly growing tumors experience high tissue-level forces, particularly when growing within a restricted space. These require counteracting by intracellular forces to prevent tissue damage. Here, we reveal the ion channel Piezo1 as a mechanosensor of compressive force, activating Rho–Rho kinase (ROCK) mechanotransduction to generate intracellular forces and enhancing malignant characteristics of tumors. Compressive stress promoted cancer growth in vivo in a Rho-ROCK–dependent manner. Silencing Piezo1 abolished compression-induced Rho-ROCK activation and tumor progression in this model. Accordingly, elevated PIEZO1 is associated with 35% poorer survival of patients with breast cancer. We show that acute compressive forces engender epigenetic mechanical memory via Piezo1-activated Rho-ROCK signaling, promoting tumor growth in vivo. Compressive stress promoted ROCK-dependent histone modifications associated with open chromatin, including acetylation of key histone 3–lysine residues, regulating the expression of cancer-related genes across cell, explant, and in vivo tumor models. Our observations suggest that the PIEZO1-RHO-ROCK axis links tissue-level forces to persistent tumor-promoting epigenetic changes and merits evaluation as a mechanotherapy target in cancer.Sarah T. Boyle, David Gallego-Ortega, Edward J. Buckley, Emmanuelle Cognard, M. Zahied Johan, Zahra Esmaeili, Makoto Kamei, Kate Poole, Michael S. Samue
A Core Outcome Set for Studies of Intrahepatic Cholestasis of Pregnancy: Results of International e-Delphi and Consensus Processes
No full textPublished online 09 January 2026
OnlinePublTo define standardised outcomes, the Core Outcome Set (COS) for reporting in studies of Intrahepatic Cholestasis of Pregnancy (ICP). e-Delphi survey and consensus process. International. 155 individuals from Asia, Europe, Oceania, North and South America: 31 patients (20%), 121 clinicians (78%), and 3 researchers (2%). Maternal and perinatal outcomes reported in studies of ICP were collated. Stakeholders in ICP research and clinical care scored the importance of each outcome using a 9-point Likert scale over three rounds; short-listed outcomes were ranked during face-to-face consensus meetings. The final COS was agreed by the Study Steering Committee. The study was registered prospectively with Core Outcome Measures in Effectiveness Trials. Ethical approval was granted by the King's College London Research Ethics Committee (KCL MRA-23/24-39574). From 54 manuscripts, 97 individual clinical outcomes were attributed to ICP. Twenty three outcomes were shortlisted by the e-Delphi surveys, the ranking of which enabled selection of 10 core outcomes. Maternal core outcomes comprise: total maternal bile acid (BA) concentration (maximum), gestational age at peak BA concentration, and itch impact on maternal wellbeing. Birth core outcomes comprise: stillbirth, gestational age at birth, and spontaneous preterm birth versus induced preterm birth. Neonatal core outcomes comprise: perinatal death within 7 days of birth, perinatal asphyxia, neonatal unit admission, and mechanical ventilation. Given the heterogeneity of reported outcomes, we have confirmed the need for a COS in ICP, standardising the minimum reported outcomes to reduce outcome reporting bias and research wastage.Nadejda Capatina, William Hague, Jenny Chambers, Catherine Williamson, Caroline Ovadi