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Caring for carers of people with advanced cancer at hospital discharge (CARENET): A single-arm open label feasibility trial.
No full textOBJECTIVES: Carers are critical to support discharge home from hospital at end of life yet remain under-represented in health service initiatives to assist this transition. A carer-focused intervention embedded into practice may facilitate hospital discharge. This open-labeled, single-arm phase 2 study aimed to determine the feasibility of (1) delivering a multi-staged intervention (CARENET) to carers of advanced cancer patients in a hospital setting and (2) the study design to inform a phase 3 trial. METHODS: CARENET, delivered before and after discharge to address carer support needs, was tested in an Australian specialist cancer hospital. Eligible participants included carers of advanced cancer inpatients with planned discharge home. The primary outcome was intervention and trial feasibility (recruitment and adherence). Secondary outcomes were eligibility and effects of intervention on outcomes including carer preparedness. RESULTS: Of the 382 potential patient-carer dyads, 25 were recruited within required time frames. The intervention adherence outcome feasibility threshold of 80% of carer participants completing all 3 core components of CARENET was not achieved (60% completion). Trends in improvement in overall carer levels of preparedness were observed from baseline to discharge home (n = 12; mean [95% CI]) 0.5 [-0.0007, 1.007]). However, a downward trend in preparedness to provide emotional care after discharge was observed (n = 12; mean [95% CI] 0.25 [-0.30, 0.80]). SIGNIFICANCE OF RESULTS: Delivering all elements of the CARENET intervention to address carers' needs in the discharge planning context was not feasible. However, some elements were feasible, including identifying and responding to carer need, whilst completing elements after discharge were less feasible. Findings can be explained by problems with adherence, eligibility, and clinician barriers to fitting a multi-staged carer intervention into an acute healthcare setting. Future research should test a more adaptable intervention and delivery model that is accessible to all carers across and compatible with acute care settings
Tangled Connection of Gut Microbiome and Alzheimer’s Disease
No full textSeveral preclinical and clinical investigations have proved that the human gut microbiome plays a crucial role in the pathobiology of central nervous system (CNS) disorders. Recent studies suggest correlations between the altered gut microbiota and major Alzheimer’s Disease (AD). AD is characterized by the formation of Aβ plaques and neurofibrillary tangles. It is proposed that normalization of the gut microbiota alleviates AD. The imbalance in levels of normal gut microbiota has a crucial role in the pathogenesis of AD. Treatment strategies with certain antibiotics lead to the depletion of useful microbes and thereby induce AD-like effects in subjects. The microbiota is also involved in the synthesis of various neurotransmitters (NTs) like acetylcholine (ACh), 5-hydroxytryptamine (5-HT; serotonin), norepinephrine (NE), and dopamine (DA). Probiotics, prebiotics, synbiotics, and a healthy diet have been found to have positive benefits in controlling the etiology of AD. The control of brain-gut microbiota is developing as a potential AD therapy approach in light of the history of the limited therapeutic advantages of cholinesterase inhibitors. The importance of the brain-gut-microbiota axis in the development of AD is discussed in detail in this review, with an emphasis on the regulation of the gut microbiota as an important intervention for the treatment of AD
Preclinical research models for evaluating the biocompatibility of bioresorbable metallic cardiovascular stents: A comparative review.
Get PDFCardiovascular stents are widely used to treat atherosclerosis by relieving vascular obstruction and providing structural support after coronary angioplasty. Bioresorbable metallic stents represent a promising alternative to conventional corrosion-resistant stents, which are linked to late-stage complications such as in-stent restenosis and thrombosis. Due to the diversity of stent materials and designs, rigorous evaluation of their interactions with the vascular environment in relevant preclinical models is essential before clinical translation. However, current studies employ highly variable in vitro cell systems, in vivo animal models, and experimental assays to assess biocompatibility, making it difficult to draw definitive conclusions about candidate designs. This review outlines the current landscape of bioresorbable metallic stents, critically examines the strengths and limitations of preclinical models described in the literature and in international guidelines, and provides recommendations to guide future research in this rapidly evolving field
Mario at EXIST 2025: A Simple Gateway to Effective Multilingual Sexism Detection
Get PDFThis paper presents our approach to EXIST 2025 Task 1, addressing text-based sexism detection in English and Spanish tweets through hierarchical Low-Rank Adaptation (LoRA) of Llama 3.1 8B. Our method introduces conditional adapter routing that explicitly models label dependencies across three hierarchically structured subtasks: binary sexism identification, source intention detection, and multilabel sexism categorization. Unlike conventional LoRA applications that target only attention layers, we apply adaptation to all linear transformations, enhancing the model’s capacity to capture task-specific patterns. In contrast to complex data processing and ensemble approaches, we show that straightforward parameter-efficient fine-tuning achieves strong performance. We train separate LoRA adapters (rank=16, QLoRA 4-bit) for each subtask using unified multilingual training that leverages Llama 3.1’s native bilingual capabilities. The method requires minimal preprocessing and uses standard supervised learning. Our multilingual training strategy eliminates the need for separate language-specific models, achieving 1.7-2.4% F1 improvements through cross-lingual transfer. With only 1.67% trainable parameters compared to full fine-tuning, our approach reduces training time by 75% and model storage by 98%, while achieving competitive performance across all subtasks (ICM-Hard: 0.6774 for binary classification, 0.4991 for intention detection, 0.6519 for multilabel categorization)
Magnetic Resonance Imaging Markers of Brain Health Improve Assessment of Functional Outcome After Acute Ischemic Stroke: A Quantitative Comparison Study
Get PDFOBJECTIVES: To compare quantitative MRI markers of brain health in their ability to predict functional outcome after acute ischemic stroke (AIS). METHODS: We included AIS survivors from the international MRI-GENIE study (multicenter; 2003-2011) with acute T2-FLAIR imaging. Automated pipelines estimated white matter hyperintensity volume (WMHv), brain volume, and intracranial volume (ICV). Assessed brain health markers included: brain parenchymal fraction (brain volume relative to ICV); radiomics derived brain age; brain reserve (normal appearing brain volume relative to ICV), and effective Reserve (eR, latent variable based on age, WMH load and brain volume). We added the markers to a clinical reference model, comparing model performances between separate multivariable regression models in their prediction of unfavorable outcome (90-day modified Rankin Scale score 3-5), using Bayesian Information Criterion (BIC). RESULTS: We analyzed 2,223 patients (median age 67 years, 45% female, 24% unfavorable outcome). All models using brain health markers outperformed the clinical reference model (ΔBIC > 10). The eR model showed the lowest BIC value (BIC=2171.8), providing strong statistical evidence to outperform the brain age model (BIC=2179.5, ΔBIC > 6), and very strong (ΔBIC > 10) statistical evidence to outperform all other models. DISCUSSION: Quantitative MRI markers of brain health, especially eR, enhance personalized outcome prognostication after AIS
THE ROLES OF REFLECTION IN PROFESSIONAL PRACTICE DOCTORATES
No full textThis chapter explores the integral role of reflection in professional practice doctorates. It underscores the evolution of professional practice doctorates which have expanded into various fields such as healthcare, business, engineering and the performing arts. These programmes are tailored to meet the needs of professional fields by integrating rigorous scholarship with practical application, preparing candidates for advanced professional roles and leadership. Central to these doctorates is the concept of reflection, which transcends introspection to encompass a systematic critique of professional experiences through a theoretical lens. This reflective process is pivotal for curriculum design, delivery and assessment of professional practice doctorates, promoting continuous learning and ethical practice. The chapter examines how these doctorates foster a culture of critical inquiry and adaptability through active learning and workplace-based experiences, enabling candidates to apply theoretical insights to real-world challenges. By examining the multifaceted nature of reflection within these programmes, the chapter highlights its significance in shaping robust educational frameworks that not only enhance professional practice but also contribute to societal advancement through informed, reflective practitioners. Criticisms of the role of reflection, its enactment and assessment are also discussed
A Simple Yet Powerful Hybrid Machine Learning Approach to Aid Decision-Making in Laboratory Experiments
Get PDFHigh-dimensional experimental spaces and resource constraints challenge modern science. We introduce a hybrid machine-learning (ML) framework that combines Ordinary Least Squares (OLS) for global surface estimation, Gaussian Process (GP) regression for uncertainty modelling, expected improvement (EI) for active learning, and K-means clustering for diversifying conditions. We applied this approach to published growth-rate data of the diatom Thalassiosira pseudonana, originally measured across 25 phosphate–temperature conditions. Using the nutrient–temperature model as a simulator, our ML framework located the optimal growth conditions in only 25 virtual experiments—matching the original study’s outcome. Sensitivity analyses further revealed that fewer iterations and controlled batch sizes maintain accuracy even with higher data variability. This demonstrates that ML-guided experimentation can achieve expert-level decision-making without extensive prior data, reducing experimental burden while preserving rigour. Our results highlight the promise of algorithm-assisted experimentation in biology, agriculture, and medicine, marking a shift toward smarter, data-driven scientific workflows
Walking coral: Complex phototactic mobility in the free-living coral Cycloseris cyclolites.
Get PDFNot all corals are attached to the substrate; some taxa are solitary and free-living, allowing them to migrate into preferred habitats. However, the lifestyle of these mobile corals, including how they move and navigate for migration, remains largely obscure. This study investigates the specific biomechanics of Cycloseris cyclolites, a free-living coral species, during phototactic behaviour in response to blue and white light stimuli. Our results indicate a strong positive phototactic response to blue light with 86.7% (n = 15) of samples moving towards the light source, while only 20% (n = 15) samples responded similarly to white light (400-700 nm). Locomotion, characterised by periodic pulses lasting 1-2 hours, involved distances up to 220 mm in blue light trials, whereas significantly shorter distances were observed in white light trials (2, 5 and 8 mm). Trails with two light sources reinforced the preference for blue light over white, with all samples consistently moving towards the blue light and away from the white (11, 15 and 3mm). High-resolution time-laps captured the biomechanics of forward motion that appeared driven by three key factors: tissue inflation, which increased contact surface area for lift and friction; the ventral foot/pads, adjusting substrate interaction/friction; and the contraction and twisting of lateral peripheral tissues, which propelled the coral forward in a coordinated manner resembling the pulsed swimming motion of jellyfish. Our findings provide new insights into coral mobility mechanisms, emphasising the role of tissue inflation in active locomotion, with potential implications for coral neural systems, vision and habitat selection
Oral Health in Palliative Care: An Exploratory Study of Public Dental Practitioners' Perceptions in Sydney, Australia.
Get PDFIntroduction: Oral health problems are prevalent among people receiving palliative care, affecting their quality of life. However, little is known about dental practitioners' perspectives in this setting. Thus, this study aimed to explore the perceptions of public dental practitioners regarding the provision of dental care for people who receive palliative care. Methods: An exploratory focus group with 21 public dental practitioners, with a mean of 8.24 years of experience, was conducted in a public oral health service in Sydney, Australia. The focus group was transcribed and analysed using thematic analysis. Results: Three themes were identified: (1) enhancing quality of life in palliative care through improved oral health; (2) navigating the systemic and practical challenges of palliative dental care; (3) competent, collaborative, and optimised: a palliative oral care model. Participants highlighted the importance of oral health to quality of life while receiving palliative care. Nevertheless, there were several systematic and practical challenges to delivering appropriate dental care, which included competing priorities among clients, disconnects and gaps in care coordination with palliative care providers, limited training, and adapting treatment planning during appointments. Participants highlighted the need for a new model of care in the future that improved dental practitioners' competence through comprehensive palliative dental training, included protocols to facilitate interdisciplinary collaboration, and optimised dental treatment planning and appointment scheduling. Conclusions: Public dental practitioners in this study demonstrated positive attitudes, but systemic barriers and limited training restrict their care provision. A palliative oral health care model for this setting should include palliative dental training, foster interdisciplinary collaboration, and optimise dental treatment planning
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