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Characterising acute and chronic care needs:insights from the Global Burden of Disease Study 2019
No full textChronic care manages long-term, progressive conditions, while acute care addresses short-term conditions. Chronic conditions increasingly strain health systems, which are often unprepared for these demands. This study examines the burden of conditions requiring acute versus chronic care, including sequelae. Conditions and sequelae from the Global Burden of Diseases Study 2019 were classified into acute or chronic care categories. Data were analysed by age, sex, and socio-demographic index, presenting total numbers and contributions to burden metrics such as Disability-Adjusted Life Years (DALYs), Years Lived with Disability (YLD), and Years of Life Lost (YLL). Approximately 68% of DALYs were attributed to chronic care, while 27% were due to acute care. Chronic care needs increased with age, representing 86% of YLDs and 71% of YLLs, and accounting for 93% of YLDs from sequelae. These findings highlight that chronic care needs far exceed acute care needs globally, necessitating health systems to adapt accordingly.</p
Intraoperative Coronal Alignment Safe Zones Influence Patient Outcomes Following Total Knee Arthroplasty:A Systematic Review and Network Meta-Analysis
No full textBackground: Despite surgically successful total knee arthroplasties, up to 20% of patients are dissatisfied postoperatively. A factor thought to influence dissatisfaction is the alignment strategy utilized. Inconsistencies in safe zone definitions between neutral and kinematic alignment strategies have limited previous systematic reviews. The systematic review aimed to identify whether different intraoperative coronal alignment safe zones influence patient-reported and functional outcomes. Methods: A literature search in Medline, Scopus, PubMed, Web of Science, CINAHL, and Cochrane databases was conducted in November 2024. Articles reporting patient outcomes at a minimum 12-month postoperatively, and coronal alignment safe zones were included. The Methodological Index for Non-Randomized Studies was used to conduct a quality assessment for each article. The Forgotten Joint Score pain measures, the Oxford Knee Score, and knee flexion were compared between safe zones. Random-effects network meta-analyses were conducted with treatment rankings, and a back-calculation method determined consistency between direct and indirect measures. A publication bias analysis was conducted for each outcome measure. Of the 26 studies eligible, 13 (knees n = 1,653, approximately 57% women) were included in the network meta-analysis. Results: There were four coronal safe zones identified: 0° (neutral), ± 3°, 6° varus to 3° valgus (6VR-3VL), and unrestricted. The 6VR-3VL was superior for the Forgotten Joint Score (standardized mean difference [SMD] = 1.59, 95% confidence interval [95% CI] = 0.25 to 2.92), pain measures (SMD = −0.85, 95% CI = −1.64 to −0.05), and knee flexion (SMD = −1.04, 95% CI = 0.08 to 1.99). There was significant publication bias in studies reporting pain. Unrestricted alignment was associated with greater knee flexion (SMD = 0.28, 95% CI = 0.02 to 0.53). Conclusions: The outcomes suggest 6VR-3VL had consistently better patient outcomes, and unrestricted alignment had better functional outcomes, than neutral alignment. This was potentially due to better restoration of the patient's prearthritic alignment.</p
What Does the Non-Party Sector Think About Far-Right Political Parties? Understanding the Place of Parties in the Australian Far Right
Get PDFFar-right political parties form an integral component of the broader far-right landscape globally. While these parties have received extensive scholarly attention, less is known about how they are perceived within the wider far-right milieu – a relationship with significant implications for understanding movement-party dynamics in contemporary democracies. This article investigates the relationship between far-right political parties and the non-party sector through a mixed-methods approach, combining keyword frequency analysis, sentiment analysis, and qualitative content analysis. Drawing on large-scale data sets from Telegram, X (formerly Twitter), 8kun, and far-right alternative media outlets in Australia, we explore two key research questions: How does the non-party sector perceive far-right parties and politicians? And what role do these parties play within the broader far-right ecosystem? Our findings reveal a complex and often contradictory relationship, with non-party actors expressing views that reflect deeper ideological, organisational, and strategic divisions within far-right movements. These patterns of conditional support, strategic adaptation, and ideological tension offer insights applicable beyond Australia, contributing to theoretical understanding of how extra-parliamentary actors evaluate electoral politics across democratic settings
Multi-omics analysis of potential metabolic networks linking peripheral metabolic changes to inflammatory retinal conditions in STZ-induced early diabetic retinopathy
Get PDFBackground: Diabetic retinopathy (DR), a leading cause of blindness among working-age adults, lacks targeted therapies besides glucose management. Early retinal lesions are linked to serum metabolites, but the underlying peripheral regulatory networks is unclear. Methods: We first established a streptozotocin (STZ)-induced mouse model of early DR exhibiting retinal inflammation characteristics. This study employed an integrative approach, combining retinal and serum transcriptomic and metabolomic profiles with genome-wide association study (GWAS) data, to identify peripheral metabolites potentially linking early retinal lesions. Results: STZ-induced mice exhibited retinal inflammation and metabolic dysregulation. Metabolites including glucose, sorbitol, and mannitol were altered in both serum and retina, implicating their potential involvement in retinal inflammation. Utilizing GWAS data of diabetic patients, we further explore the potential the upstream regulation of shared metabolites and their peripheral pathways potentially instigating early retinal inflammation through metabolite-related genes correlated with single nucleotide polymorphisms. Key enzyme genes including HK1, HKDC1, AKR1B1 in hyperglycemic pathway, CEL and HMGCR in cholesterol pathway, and ACSL1, PPT2 in palmitic acid pathway, may connect the metabolic network of hyperglycemia, hyperfructosemia and disrupted lipid metabolism to retinopathy. Conclusion: This study elucidates the upstream regulatory network of peripheral serum metabolites associated with early retinal lesions. Specifically, the SNPs in key peripheral enzyme genes may exert remote effects on retinal inflammation in DR. This finding provides insights into the systemic metabolic management and offering peripheral precise early detection and treatment.</p
Graded Lithium-Ion Battery Pouch Cells to Homogenise Current Distributions and Reduce Lithium Plating
Get PDFSpatial distributions in current, temperature, state-of-charge and degradation across the plane of large format lithium-ion battery pouch cells can significantly impact their performance, especially at high C-rates. In this paper, a method to smooth out these spatial distributions by grading the electrode microstructure in-the-plane is proposed. A mathematical model of a large format pouch cell is developed and validated against both temperature and voltage experimental data. An analytical solution for the optimal graded electrode that achieves a uniform current distribution across the pouch cell is then derived. The model predicts that the graded electrodes could significantly reduce the likelihood of lithium plating in large format pouch cells, with grading increasing the C-rate at which plating occurs from 2.4C to 4.3C. These results indicate the potential of designing spatially varying electrode architectures to homogenise the response of large format pouch cells and improve their high rate performance.</p
Exercise in cancer care for people with lung cancer:A narrative synthesis
Get PDFObjectives: Lung cancer is the second most common cancer diagnosed worldwide, resulting in significant physical and psychological consequences. In this narrative review, we explore the role of exercise as an adjunct therapy to counteract health issues experienced by people before, during and after treatment for lung cancer, and offer recommendations for exercise prescription and future research. Design: Narrative cornerstone review. Methods: A narrative review was conducted to explore the role of exercise in cancer care for people diagnosed with lung cancer. Results: Improvements in fitness, strength and quality of life have been demonstrated in people with lung cancer following participation in exercise programmes before, during and post treatment. Whilst combined aerobic (50–100 % heart rate maximum) and resistance (50–85 % of 1 repetition maximum) training, 2–5 times per week across the cancer continuum is typically prescribed, few people with lung cancer currently access exercise services. ‘Optimal’ exercise prescription is unclear, although is likely individual-specific. The immediate priority is to identify a tolerable starting exercise dosage, with the side effects of lung cancer and its treatment on the respiratory system, particularly shortness of breath (dyspnoea), likely driving the initial maximum threshold for session mode, duration and intensity. To date, exercise safety for people with lung cancer has been poorly evaluated and reported — few trials report it, but those that do report small numbers of serious adverse events. Conclusions: Recommendations for health professionals prescribing exercise therapy to people with lung cancer are provided, with consideration of the strengths and limitations of the current evidence base.</p
Beyond the ban: a theoretical framework for integrating Generative AI in assessment
No full textUniversities can neither ban nor ignore generative AI (GenAI); they must govern and design for it. This paper argues that the core challenge is not “cheating” per se but the misalignment between legacy assessment designs and AI-mediated learning. We contribute (1) a practical, tiered governance model that aligns policy, pedagogy, and assessment operations; (2) an assessment redesign heuristic that integrates authenticity, cognitive demand, and evidence provenance; and (3) a risk-mitigation view adapted from the Swiss-cheese model that places student learning, rather than surveillance, at the centre of integrity work. Building on recent philosophical critiques of instrumental responses to GenAI in education (Peters et al., 2024), we position assessment as a socio-technical system where teacher judgement, student agency, and tool affordances co-evolve. We illustrate the approach with ready-to-adopt patterns (e.g., oral defence with artefact trail; cohort-specific data briefs; constrained-tools practicals) and specify implementable governance levers (role clarity, template language, moderation workflows, analytics). The result is a coherent pathway “beyond bans” toward trustworthy assessment that is educative, fair, and feasible at scale
Investment and EU International Agreements
Get PDFThis chapter considers the implications of the EU’s legal framework for its treaty-making practice and policy choices in the field of foreign investment. The scope of the EU’s powers in relation to investment was partially clarified in Opinion 2/15, confirming shared competence of the EU and its Member States for the conclusion of modern international investment agreements. This chapter examines the competences and legal bases for the conclusion of different types of EU international agreements with investment provisions. Based on this analysis, the EU treaty-making practice and related policy outcomes in the field of foreign investment are considered, demonstrating internal constraints of the EU legal framework for the efficiency of the EU international investment policy. With uncertainty about EU investor-state dispute settlement (ISDS) reforms, and sustainability at the core of EU external action, the focus of EU international agreements in the field of investment is shifting towards improving investment regulatory governance beyond ISDS, with a view to align trade and investment efforts in promoting sustainable development
Circular Data Diagnostics in Regression and Time Series Models
Get PDFCircular data and their applications are pervasive across numerous disciplines. In the field of circular data analytics and statistical learning, distributional studies, regression and time series models have played crucial roles. In this paper, we present a comprehensive framework for circular regression and time series models. We employ the maximum likelihood estimation approach coupled with local and global influence methods to provide a robust methodology. Furthermore, we explore several specific models for analysing circular data and investigate techniques to identify influential observations within these models. To demonstrate the effectiveness of our proposed methods, we provide simulated and real data examples
Influence of Trail Running Footwear Foam on Running Economy and Perceptual Metrics
No full textAdvanced footwear technologies (AFT) improve road running performance. AFT have been incorporated into trail running footwear despite little evidence of their benefits in this context. In this study, we compared the effect of traditional (TRADI-f) and AFT foam (AFT-f) on running economy and perceptual measures across different gradients. Fourteen well-trained athletes completed assessments on a treadmill at gradients of FLAT (0% gradient, 14 km.h -1), UP (+10%, 8 km.h -1) and DOWN (-10%, 14 km.h -1). Two shoes were randomly allocated in a counterbalanced order. The shoes were matched in construction but differed in midsole foam performance, where the AFT-f shoe included a more compliant and resilient foam than the TRADI-f shoe. Oxygen consumption and heart rate were collected for 6 min, twice with each shoe at each gradient, alongside perceived effort and affective measures. Across the three gradients, oxygen consumption was 1.2% lower (p = 0.008) when participants were wearing the AFT foam compared to the TRADI foam. The effect of the AFT-f shoes on oxygen consumption appeared to be more pronounced in the FLAT (+2.1%) and UP (+1.0%) conditions compared to DOWN (+0.2%). This interaction effect was, however, not statistically significant (p = 0.050). RPE was lower (p = 0.008) and affective valence more positive (p = 0.027) in AFT-f compared to TRADI-f. No differences in arousal were reported between TRADI-f and AFT-f (p = 0.728). The findings of this study suggest that an AFT foam in trail running shoes can improve running economy, reduce perceived effort and increase pleasure while running in a trained athlete population. </p