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Multi-Directional Crosswalk of the Harris Hip Score and the Hip Disability and Osteoarthritis Outcome Score
No full textDespite the popularity of the modified Harris Hip Score (mHHS) to monitor patient-reported outcome measures (PROMs) following Total Hip Arthroplasty (THA) over the last 5 decades, International Joint Registries have recently favoured the Hip disability and Osteoarthritis Outcome Score (HOOS). The ability to convert mHHS collected in historical and ongoing studies would be beneficial to benchmark more recent HOOS reports. Hence, this study aimed to create multi-directional crosswalks between mHHS and HOOS. Methods: Forty-nine patients undergoing primary THA prospectively completed both HHS and HOOS forms pre-operatively and at either 3, 6 and/or 12 months postoperatively. The Equipercentile (EQ) and Linear Regression (LR) crosswalk methodology were used. The Mean Absolute Error (MAE) of the crosswalk-derived scores was established against patient-derived (PD) scores. Results: There was a strong correlation between PD mHHS and HOOS (0.90) and HOOS-12 (0.90). The MAE of mHHS-to-HOOS-12 crosswalk was 10.4 (EQ) and 10.1 (LR). Subcategory activity had a larger contribution towards the error in the crosswalks than pain. Conclusions: This is the first crosswalk to facilitate conversion of mHHS and HOOS scores, which are required in long-term THA quality-assurance and research studies, which often span 2 decades of expected implant survivorship.Chan Hee Cho, Kerry Costi, Deepti Sharma, Dominic Thewlis, Lucian B. Solomon, and Stuart A. Callar
Modernising the Torrens system in South Australia: Reform challenges and opportunities in the Real Property Act 1886 (SA)
No full textThis article examines potential reforms to South Australia’s Real Property Act 1886 (SA) based on extensive consultations with legal practitioners, academics, representative bodies, and government officials conducted in 2023–2024. While the Act continues to serve its core functions effectively, this article identifies critical areas requiring modernisation to ensure the legislation remains fit for purpose in the twenty-first century. We argue that reform is particularly needed in three key areas: first, the current practice of using the rent-charge as the vehicle to register and so protect restrictive covenants is problematic and artificial.We propose statutory reform similar to that found in the Northern Territory. Second, the legislative framework for electronic conveyancing requires strengthening, particularly regarding verification of identity requirements and vertical integration of Electronic Lodgment Network Operators; and third, the protection of equitable interests as exceptions to indefeasibility would be more effective if consolidated in one part of the Act. This article concludes that reform should proceed in a manner that modernises the legislation while maintaining the fundamental Torrens principles and philosophy of security of title, clarity of interests, and efficiency of transactions.
this article identifies critical areas requiring modernisation to ensure the legislation remains fit for purpose in the twenty-first century. We argue that reform is particularly needed in three key areas: first, the current practice of
using the rent-charge as the vehicle to register and so protect restrictive covenants is problematic and artificial. We propose statutory reform similar to that found in the Northern Territory. Second, the legislative framework for
electronic conveyancing requires strengthening, particularly regarding verification of identity requirements and vertical integration of Electronic Lodgment Network Operators; and third, the protection of equitable interests
as exceptions to indefeasibility would be more effective if consolidated in one part of the Act. This article concludes that reform should proceed in a manner that modernises the legislation while maintaining the fundamental Torrens
principles and philosophy of security of title, clarity of interests, and efficiency of transactions.P T Babie, Peter D Burdon, and Michail S Ivano
Nursing and midwifery workforce expansion as a strategic lever to reduce maternal mortality: Global evidence and policy implications from an ecological study
No full textBackground: This global cross-sectional study analyzed data from 266 “countries” and territories to evaluate the relationship between the nursing and midwifery workforce size (NMWS) and maternal mortality ratios (MMR). Drawing from five major United Nations and World Bank databases, the study offers robust and generalizable insights across diverse health systems and economic settings. Methods: The study examined the association between the NMWS and MMR using scatterplots, bivariate and partial Pearson correlation coefficients, and multiple and stepwise linear regression models. Key confounding variables, including economic affluence measured by the gross domestic product (GDP) per capita adjusted for purchasing power parity, total fertility rate, and urbanization, were included to isolate the independent contribution of the NMWS to maternal health outcomes at the global and regional levels. Results: The NMWS accounted for 49.13 percent of the global variation in maternal mortality ratios, which indicates a strong inverse relationship. After adjusting for economic and demographic variables, the NMWS remained a significant independent predictor and explained 11.09 percent of the variance. A stepwise regression identified the NMWS as the second most influential predictor of maternal mortality after economic affluence and the fertility rate. The association was strongest in low- and middle-income countries, where workforce shortages and the maternal mortality rates are highest. Conclusions: This study identifies the NMWS as a critical and measurable factor in reducing maternal mortality worldwide. This study’s findings provide compelling evidence for a strategic investment in the nursing and midwifery workforce. Expanding this workforce is essential to improve the maternal health outcomes, especially in countries with limited resources, and should be prioritized in global maternal health and workforce planning strategies.Wenpeng Yo
Evaluating Nebulisation and Nasal Irrigation Efficiency in Post-Operative Chronic Rhinosinusitis Patients Through Computational Fluid Dynamics Simulation
No full textAvailable online 2 March 2025Background and Objective: Chronic rhinosinusitis (CRS) is a prevalent inflammatory condition that substantially affects patients’ quality of life. Functional endoscopic sinus surgery (FESS) is commonly performed in cases where medical therapy fails. Effective post-operative drug delivery is crucial for improving outcomes. This study uses computational fluid dynamics (CFD) to compare nebulisation and nasal irrigation (bottle wash) in postoperative sinonasal models and to evaluate how anatomical alterations affect drug deposition across various paranasal sinuses. Methods: Eight post-FESS models were generated from the CT scans of a 29-year-old female CRS patient. These models included variations in maxillary ostium sizes, both with and without partial middle turbinectomy. Using 3D Slicer®, images were segmented, and Ansys SpaceClaim® prepared the final geometries. CFD simulations then examined drug delivery efficiency for both nebulisation and nasal irrigation. Results: Nebulisation faces considerable challenges due to sinus complexity; however, surgical modifications improved nebuliser deposition in the maxillary and sphenoid sinuses. In contrast, nasal irrigation showed higher efficiency in delivering drugs to the frontal sinuses. The residual liquid layer on sinus walls after irrigation significantly impacts comparative evaluations of these methods. Conclusions: These findings emphasise the importance of adapting drug delivery strategies to specific surgical and anatomical factors. Tailored post-operative protocols may enhance outcomes in CRS, potentially improving patient comfort and compliance, and reducing recurrence rates. Further investigations are warranted to precisely quantify the liquid layer thickness remaining after irrigation, particularly as head movements can result in medication flowing back from sinuses into the nasal cavity.Oveis Pourmehran, Alkis Psaltis, Sarah Vreugde, Kavan Zarei, Yidan Shang, Kiao Inthavong, Peter-John Wormal
Genetic and environmental contributions to the development of dental arch traits – a longitudinal twin study
No full textObjective: This study aimed to estimate the relative contributions of genetic and environmental factors to phenotypic variations of dental arch traits from primary to permanent dentition stages. Methods: Digital dental models of 188 Australian twin pairs (90 monozygotic and 98 dizygotic) in the primary dentition stage, followed up through the mixed and permanent dentition stages, were included in the study. Landmarks were identified on both maxillary and mandibular dental arches in MeshLab for measuring intercanine widths, intermolar widths, arch lengths, overjet, overbite and molar relationships. Genetic structural equation modelling was performed on the quantitative twin data of dental arch traits. Results: The phenotypic variance of dental arch traits was generally best explained by a model incorporating additive genetic (A) and non-shared environmental (E) components, an AE model. However, the variance of overjet in the primary dentition was best explained by shared environmental (C) and non-shared environmental (E) components. Heritability estimates were high for intra-arch traits (0.65–0.88), but low to moderate for inter-arch traits (0.21–0.51). While heritability estimates fluctuated for most traits from primary to permanent dentition stages, the estimates for arch lengths and intermolar widths were mostly above 0.8 throughout development. Limitation Only twins of European descent were included in this study. Conclusions: Dental arch traits were mostly influenced by additive genetic and non-shared environmental factors during development. Except for arch lengths and intermolar widths, genetic and environmental influences on dental arch traits fluctuated during development, with the genetic influence at its lowest during the mixed dentition stage.Jamal Giri, Michelle Bockmann, Alan Brook, Angela Gurr, Lyle Palmer, and Toby Hughe
Shaping future deprescribing priorities: outcomes of a World Café stakeholder workshop
No full textOnlinePublIntroduction: Medicine-related harm associated with polypharmacy is a pertinent global health chal - lenge. Deprescribing (reducing or stopping) medicines that cause more potential harm than benefit could mitigate the risk of medicine-related harm. However, the existing deprescribing research-to- practice gap threatens the long-term sustainability and scalability of deprescribing efforts. Research design and methods: To address this, key stakeholders including healthcare practitioners, academics, policymakers and representatives of peak professional organizations, gathered at a World Café workshop to reflect on progress achieved in the deprescribing research and practice landscape while exploring the top future priorities for deprescribing. Results: Thirty participants agreed on three top priorities: improving the clinical management of deprescribing; engaging consumers and gaining their perspectives; and raising awareness to enhance communication. Emerging themes and related barriers and catalysts were derived and mapped to a socio-ecological model offering a bird-eye’s view of these factors on an individual, interpersonal, organizational, and societal level. Conclusions: Our World Cafe’ highlights opportunities for future deprescribing research and practice. To promote the uptake of deprescribing in practice, catalysts could include leveraging new technology, promoting deprescribing via social media and optimizing workforce staff and knowledge. Ultimately, this knowledge may motivate deprescribing efforts and bridge the research-to-practice gapWilliam Manning Olsen, Kitty St Pierre, Wade Thompson, Kristie Rebecca Weir, Christopher Robert Freeman, Ruth Bohill, Barbara Farrell, Aili Veronica Langford, Lisa Kouladjian O, Donnell, Emily Reeve, Shin J Liau, Aisling Mary McEvoy, Shakti Shrestha, Wubshet Tesfaye, Juanita Breen, Christopher Etherton-Beer, Jerry Yik, Justin Turner and Nagham J Ailaboun
Search for an axion-like particle in B -> K(*)a(-> gamma gamma) decays at Belle
No full textWe report a search for an axion-like particle a in B -> K(*)a decays using data collected with the Belle detector at the KEKB asymmetric-energy electron-positron collider. The search is based on a 711 fb -1 data sample collected at the Upsilon(4S) resonance energy, corresponding to a sample of 772 x 106 Upsilon(4S) events. In this study, we search for the decay of the axion-like particle into a pair of photons, a -> gamma gamma. We scan the two-photon invariant mass in the range 0.16 GeV-4.50 GeV for the K modes and 0.16 GeV-4.20 GeV for the K* modes. No significant signal is observed in any of the modes, and 90% confidence level upper limits are established on the coupling to the W boson, gaW, as a function of a mass. The limits range from 3 x 10-6 GeV-1 to 3 x 10-5 GeV-1, improving the current constraints on gaW by a factor of two over the most stringent previous experimental results
Factors associated with employment outcomes in cancer survivors: a systematic scoping review spanning a decade of international research
No full textPurpose Employment for cancer survivors impacts psychological, physical, and financial wellbeing. Existing systematic reviews of factors associated with employment outcomes are limited to specific cancer types, determinants, outcomes, and/ or settings. This scoping review spanning one decade of international research aimed to provide a comprehensive overview of factors associated with employment outcomes in cancer survivors. Methods Systematic scoping review methodology was used to identify primary studies conducting multivariate analysis of factors associated with any employment outcome (negative: reduced or less timely, productive, sustained, or satisfying employment or positive: maintained/return or more timely, productive, sustained, or satisfying employment) in adult cancer survivors (January 2014 to March 2024). Data were extracted on population, setting, outcomes, and associated factors. Results Across 185 included studies, factors frequently associated with negative employment outcomes included older age, female sex, advanced cancer stage, some cancer types, and receipt of chemotherapy. Factors frequently associated with positive employment outcomes included higher education, more advantaged insurance status, some cancer types, and higher physical function. Research gaps were identified in specific populations/settings at risk of poorer outcomes. Conclusions Modifiable and nonmodifiable factors associated with employment outcomes require screening and targeted interventions in clinical settings as well as the development of healthcare delivery, workplace, and national policies and resources. Future research should address gaps in people with advanced cancer, vulnerable groups, and lower resource settings. Implications for cancer survivors Survivors at risk for negative outcomes should be identified and offered relevant, tailored information and resources regarding the impact of cancer and treatment on employment outcomes.Emma Kemp, Anna Ugalde, Skye Marshall, Lisa Grech, Imogen Ramsey, Deborah Kirk, Georgia Halkett, Cherith Semple, Cristiane Bergerot, Yu Ke, Hannah Jongebloed, Nicolas H. Hart, Darren Haywood, Ian Olver, Carolyn Taylor, Sue Woodall, Nirmala Bhoo-Pathy, Larissa Nekhlyudov, Suvam Banerjee, Wendy W. T. Lam, Juhee Cho, Bogda Koczwar
Exploring Pulmonary Rehabilitation Programs Implemented and Conducted in Latin America for People With Chronic Respiratory Conditions: A Scoping Review
No full textAbstract
Background: Although pulmonary rehabilitation (PR) has demonstrated remarkable efficacy in improving exercise tolerance, physical function and alleviating perceived dyspnea in individuals with chronic respiratory conditions, there is little understanding on the delivery of PR research programs in the Latin American region. This review analyzed 1) the implementation of PR research in Latin America, 2) adherence to established ATS criteria and 3) the evaluation of PR program effectiveness in the region. Methods: The literature search was conducted in six databases (CINAHL, Medline, Embase, Scielo, Web of Science and Health and Medical Collection) up to January 2024, including studies published in English, Spanish, or Portuguese. This review was reported and summarized using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations extension for scoping reviews (PRISMA-ScR, 2022). The protocol was registered in OSF. Studies with adults from Latin America with any respiratory condition longer than three months, participating in any PR program were included. Results: Of the 1508 articles identified, 45 studies involving a total of 2067 individuals were analysed. The studies were conducted in Brazil (n=28), Colombia (n=9), Cuba (n=4), Chile (n=3) and Argentina (n=1). Most PR participants were individuals with COPD (86%). PR programs included aerobic exercise, resistance training, respiratory exercises and educational programs involving a multidisciplinary team. Quality of life, dyspnea, aerobic capacity and muscle strength were the main assessments included in the programs. Aerobic training was included in 39 studies (87%) and strength training in 32 studies (71%). Outcome measures included quality of life in 29 studies (64%), dyspnea in 40 studies (89%), aerobic capacity in 37 studies (82%) and muscle strength in 20 studies (44%). Twenty-six studies (58%) followed international recommendations for PR. Conclusion: A significant progress has been made in the implementation of pulmonary rehabilitation research programs in Latin America However, disparities remain, particularly in the exercise modalities, assessments, professional team and adherence to international guidelines.
W. Sepulveda Loyola, C.Y. Tang, A. Alvarez-Buistos, I. Cuyul-Vasquez, S.M. Smith, N. Chadha, F. Blackstock, P. Camp, N. Ensor, A. Winter, G. Grzelkovsk
Single- and dual-band quantum dot-based nanoporous solid-state lasers for gas sensing
No full textOnlinePublA laser-based nitrogen dioxide (NO₂) gas sensing system was engineered by combining nanoporous anodic alumina random laser (NAA–RL) platforms and quantum dots (QDs). Core–shell CdSe/ZnS QDs were embedded within optimized NAA–RL structures with controlled pore diameter and length, enabling highly efficient lasing systems characterized by narrow emission bandwidths, high intensity, and low lasing thresholds. Unlike conventional spectroscopic detection techniques that operate external to the laser medium, NO₂ sensing is achieved via in situ quenching of lasing emissions induced by the selective interaction of gas with the QD–NAA–RL matrix. Single-QD platforms demonstrated strong gas sensing performance, with the most sensitive platform achieving a sensitivity of 220.48 a.u. ppmv⁻¹ and a limit of detection of 0.367 ppmv. The dual-QD system incorporating two types of QDs into a single NAA–PL platform provided enhanced selectivity and a broader spectral response for NO₂ detection, achieving a sensitivity of 238.47 a.u. ppmv⁻¹ and a limit of detection of 0.340 ppmv. Selectivity tests with ETOH vapor confirmed the specificity of the QD–NAA–RL platforms to NO₂ gas. The system also exhibited reversible lasing quenching behavior, demonstrating its suitability for real-time detection of harmful gases. These findings highlight the potential of QD–NAA–RL platforms as highly sensitive and selective tools for gas sensing, offering a promising solution for environmental monitoring and industrial safety applications.Khoa Nhu Tran, Satyathiran Gunenthiran, Huong Nguyen Que Tran, Zichu Zhao, Zeyad T. Alwahabi, Andrew D. Abell, Cheryl Suwen Law, Abel Santo