134125 research outputs found
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Blood–device interactions
No full textManagement of heart and respiratory failure has improved in recent years in parallel with advancements in pharmacological interventions and organ transplant. The advent of mechanical alternatives to biological organs is a burgeoning area available to clinicians in a variety of scenarios, including short-term procedures (e.g., cardiopulmonary bypass), longer and acute management (e.g., percutaneous catheter pumps, extracorporeal membrane oxygenation), and semi-to-permanent therapies (e.g., ventricular assist devices and total artificial hearts). The paradigm shift over the last decades transitioned these technologies from “bridge” therapies toward “destination” therapies, with a resultant increase in clinical utilization. It is clear, however, that whilst mechanical circulatory and respiratory support (MCRS) devices can sustain life, damage to blood and its constituents and/or activation of cellular processes can negatively impact health. These adverse effects may be broadly related to blood exposure to high shear stress and/or interactions between biological and artificial materials or gas interfaces. Only through advances in MCRS to minimize blood damage will complications be overcome and mechanical devices attain their true potential.No Full Tex
Ceftriaxone population pharmacokinetics in plasma and cerebrospinal fluid of neurocritical care patients
Get PDFBackground
Patient outcomes during ventriculitis may be improved by antibiotic dose optimisation strategies that increase the achievement of therapeutic concentrations at the infection site. We performed a population pharmacokinetic (PK) study in neurocritical care patients to define ceftriaxone dosing regimens required to achieve effective cerebrospinal fluid (CSF) exposures.
Methods
Patients receiving ceftriaxone for treatment of ventriculitis or extracerebral infections or for prophylaxis following external ventricular drain insertion were recruited and subject to serial plasma and CSF sampling. Population PK modeling and dosing simulations to achieve the following plasma targets: (a) unbound ceftriaxone concentration above pathogen minimum inhibitory concentration over the dosing interval (100% fT>MIC) and (b) unbound ceftriaxone concentration at least fourfold above pathogen minimum inhibitory concentration over the dosing interval (100% fT>4×MIC), were performed.
Results
Ten patients were recruited; median age, weight, and creatinine clearance were 57 years, 60 kg, and 107 mL/min/1.73m2, respectively. Ceftriaxone PK displayed considerable variability, especially in CSF, with between subject variability ranging from 21% to 794%. Median total ceftriaxone CSF penetration was 1.43% (range 0.33–8.42). Intermittent infusions of 2 g every 8 hours achieved 99.5% and 82% probability of attaining 100% fT>MIC and fT>4×MIC in plasma for an MIC of 1 mg/L, respectively. The model was unable to accurately predict ceftriaxone concentrations in CSF, precluding CSF dosing simulations.
Conclusions
High attainment of plasma target exposures was achieved with higher than standard dosing. Dosing recommendations to optimise targeted CSF ceftriaxone exposures for treatment of ventriculitis could not be made given inadequate model predictability.Full Tex
Distance-Adaptive High-Precision Sensing for Autonomous Modular Buses
No full textTo address the challenges faced by current public transportation systems, researchers have proposed the Autonomous Modular Bus (AMB), in which individual bus units can connect or disconnect while in motion, allowing passengers to transfer between units, significantly improving convenience and transportation efficiency. However, the high precision required for docking on public roads presents a major challenge, as existing autonomous driving systems struggle to achieve centimeter-level accuracy and exhibit sensitivity to target distances, particularly in perception modules where errors are pronounced. This paper introduces a novel distance-adaptive high-precision sensing module that fuses data from LiDAR and cameras. By utilizing an ensemble learning approach based on attention mechanisms, the proposed module enhances the perception accuracy of autonomous systems. Experiments conducted on the publicly available nuScenes dataset and a self-collected dataset show improvements over state-of-the-art methods. Additionally, the proposed method demonstrates strong adaptability across different distances, making it suitable for all docking scenarios in AMB applications and laying the groundwork for the practical implementation of AMB systems.No Full Tex
Linking Conspiracy Beliefs with Violence: A Scoping Review of the Empirical Literature
Get PDFSince the global COVID-19 pandemic, there has been a rapid growth in the study of conspiracy beliefs and their potential link with violence. This study contributes to the literature by systematically consolidating quantitative studies published between 2000 and 2023 that focus on individual-level analysis to examine the extent to which conspiracy theories are associated with violence justifying norms, values, intentions and actions. Electronic databases were searched for relevant publications and charted using the PRISMA flow diagram. After exclusion of ineligible documents, 25 publications were identified for analysis. Results show diverse epistemological approaches and conceptualisation of violence. Hence, violence was categorised as either general, political or extremist in nature. Researchers primarily employed cross-sectional survey data analysing attitudinal measures of violence, with these studies revealing only a weak association between conspiracy theory beliefs and violent attitudes. Analysis of actual violent behaviour was extremely limited and has thus far been confined to extremist offender data. This review outlines further research needed to determine if violence directly stems from conspiracy beliefs, and whether this relationship is conditioned by other risk factors. This review has important implications for understanding the consequences of conspiracy beliefs, and future risk assessment and management of violent extremism.Full Tex
Study protocol for the Australasian Cerebral Palsy Musculoskeletal Health Network (AusCP MSK) prospective cohort study: early detection of musculoskeletal complications in young children with moderate to severe cerebral palsy (GMFCS III–V)
Get PDFBackground Cerebral palsy (CP) is the most common physical disability of childhood, affecting movement and posture, resulting from a neurological insult during pregnancy or the neonatal period. While the brain lesion is static, the musculoskeletal sequelae in CP are often progressive and lifelong, associated with pain and can impact the lives of children with CP, their families and the healthcare system. The Australasian Cerebral Palsy Musculoskeletal Health Network (AusCP MSK) study will conduct comprehensive, population-based surveillance of children with moderate to severe functional mobility limitations (Gross Motor Function Classification System (GMFCS) levels III–V) to explore the early biomarkers of, and interactions between, musculoskeletal complications related to CP, including hip displacement, scoliosis and skeletal fragility.
Methods The AusCP MSK study involves three cohorts of children. Cohort A (n=500) is a multicentre retrospective (3 years) and prospective (4 years) cohort study in children aged 4–9 years that will be implemented at five sites across Australia and New Zealand. Retrospective data will include clinical history, information on CP diagnosis and other investigations (previous X-rays and biochemistry). Primary prospective outcomes will involve measures of hip displacement (migration percentage, acetabular index, femoral head orientation, Hilgenreiner’s epiphyseal angle), scoliosis (Anteroposterior/Posteroanterior and lateral spine X-ray), skeletal fragility (Dual Energy X-ray Absorptiometry, peripheral quantitative computed tomography), motor function (GMFCS, Manual Ability Classification System (MACS) and Communication Function Classification System (CFCS)) and range of movement (lower limb and spine). Cohort B (n=4000) is a retrospective analysis of data to evaluate fractures in children up to 18 years of age with CP (GMFCS I–V) from the New South Wales (NSW)/Australian Capital Territory CP Registers linked with corresponding records from NSW administrative health data (n=3000), and a New Zealand cohort of linked data from the New Zealand Cerebral Palsy Register to the Accident Compensation Corporation data for fracture claims (n=1000). Cohort C (n=30) will cross-sectionally examine bone quality through a transiliac bone biopsy in children undergoing scheduled hip surgery. Relationships between early biomarkers, early brain structure and musculoskeletal complications will be explored using multilevel mixed-effect models.
Ethics and dissemination Ethical approval for this study was granted by Children’s Health Queensland Hospital and Health Service Human Research Ethics Committee, The University of Queensland Human Research Ethics Committee and the New Zealand Health and Disability Ethics Committee.
Research outcomes will be disseminated via scientific conferences and publications in peer-reviewed journals; to the National Bodies and Clinicians; and to people with CP and their families.
Trial registration number Australian New Zealand Clinical Trials Registry number: ACTRN12622000788774pFull Tex
The Quest for Bargallie: Mapping Our Roots and Routes
Get PDFIn the Australian steel city of Wollongong—colloquially known as “The Gong”—during the bustling 1970s, a young girl in a regional suburb became captivated by a singular curiosity: the unusual family name, Bargallie. That girl was me—Debbie Bargallie. The name Bargallie stood out among the common surnames of my classmates, drawing attention with its unique exoticness compared to the usual Anderson, Bell, Smith, Brown, White, and Johnson. Its distinctive quality sparked endless questions from teachers about its origins—“Where are you from? Are you Italian? What’s the story behind that name?”—inviting me to explain and explore my roots from an early age. I frequently had to repeat and spell out my surname for others, and I still do. I vividly remember standing next to my father in a clothing store on Wollongong’s main street, as he arranged alterations for a new pair of trousers. The shop assistant kept stumbling over his name, forcing him to spell it out while enduring a string of mispronunciations. Growing increasingly frustrated, my father carefully enunciated each letter—B-A-R-G-A-L-L-I-E—with deliberate clarity before remarking, his anger barely concealed, “You spell it as it sounds, and you say it the way it’s spelled!”Full Tex
Australian allied health professionals' perspectives on current practice, benefits, challenges, and opportunities in nature-based approaches
Get PDFPurpose: To guide the effective use of nature-based approaches (NBAs), we aimed to determine current practice, challenges and proposed solutions concerning the use of these approaches by allied health professionals (AHPs). We also investigated the signs, symptoms and conditions AHPs believe NBAs may prevent and/or manage, as well as the perceived impact of the COVID-19 pandemic. Materials and methods: Allied health professionals (physiotherapists, occupational therapists, exercise physiologists, psychologists, social workers and speech pathologists) who used or wanted to use NBAs in Australia were invited to complete an online questionnaire. Qualitative data were analysed through inductive coding and categorisation, and paired with descriptive statistics for the quantitative data to develop our understandings. Results: Allied health professionals indicated that exposure to nature could prevent and/or manage a range of physical and mental health, social and developmental outcomes. In addition to using NBAs with patients/clients, AHPs were also engaged with advocacy for or involvement in the provision of natural spaces indicating the broader roles in which AHPs work and utilise NBAs. Perceived challenges were identified, which related to the patients/clients, AHPs themselves, and external factors. Recommended solutions included increasing education for AHPs and the general public about NBAs, advancing related research, implementing relevant governance changes, and legitimising the role(s) of these approaches to allied health practice. Conclusions: Increasing awareness of and evidence about NBAs among AHPs across sectors – particularly those involving policy, education, funding, and health management – will support their legitimacy and potential benefit of NBAs across a range of populations.Full Tex
Global, Regional, and National Burden of Child Growth Failure, 1990–2021: A Systematic Analysis for the Global Burden of Disease Study 2021
Get PDFBackground/Objectives: Child growth failure is a manifestation of chronic malnutrition expressed in stunting, wasting, and underweight in children. This study aimed to analyze global trends in child growth failure disease burden and mortality across children of all age groups on a global, regional, and national level. Methods: This cross-sectional study utilized data from the 1990 and 2021 Global Burden of Disease (GBD) study. Growth failure Disability-adjusted life years (DALYs), years lived with a disability (YLDs), and mortality in children under 20 years of age were analyzed. Average annual percentage change (AAPC) was calculated to determine and identify improvements in growth failure disease burden and mortality in the past 30 years. Results: Greatest reduction in growth failure DALYs (AAPC = −0.96, 95% CI = −0.97 to −0.95), YLDs (AAPC = −0.73, 95% CI = −0.77 to −0.66) and mortality rate (AAPC = −0.96, 95% CI = −0.97 to −0.95) in children under 5 years of age was observed in high-middle SDI countries. In contrast, improvements in the number of growth failure DALYs (AAPC = −0.64, 95% CI = −0.76 to −0.53), YLDs (AAPC = −0.21, 95% CI = −0.25 to −0.13) and mortalities (−0.57, 95% CI = −0.59 to −0.52) are less pronounced in regions with low SDI scores. Improvements in disease burden and mortality are reduced in older age groups, with the lowest reduction observed in children 15–19 years old. Conclusions: Barriers hindering the delivery of nutritional supplements and access to quality healthcare in regions with low SDI scores need to be overcome to address the disproportionately high numbers of growth failure DALYs, YLDs, and mortalities in regions with low SDI.Full Tex
Cross-sectional comparison of risk factors associated with mental illness and learning difficulties in kindergarten and elementary, middle, and high school children in the United States: a socio-ecological resilience framework
No full textAim
Mental illness and learning difficulties in children can be explained using the socio-ecological resilience (SER) model, which states that personal characteristics and an individual’s social relationships coupled with environmental factors of adverse life events influence mental health. We aimed to identify factors associated with anxiety, depression, and learning difficulties in kindergarten and elementary, middle, and high school children.
Subject and methods
This study utilized data collected from the 2019 National Health Interview Survey (NHIS) questionnaire administered across the United States. Children aged 4 to 17 were included. Risk factors were categorized into personal characteristics, lack of peer support, adverse family events, and socioeconomic status (SES). Logistic regression was used to estimate the risk for each risk factor and SER layers for anxiety, depression, and learning difficulties.
Results
In relation to the SER model, factors from personal, relational, and structural layers all influenced the likelihood of anxiety, depression, and learning difficulties in children across all ages. Negative personal characteristics of emotional dysregulation were the most significant risk factor associated with anxiety and depression. For children in kindergarten, relational factors of poor peer relations were more significant in influencing learning difficulties, while behavioural dysregulation measured by hyperactivity had a greater influence on learning difficulties for older children in elementary, middle, and high school. Having experienced adverse family events was significantly associated with worse mental health, while low SES was associated with worse depression and learning difficulties.
Conclusion
Comprehensive interventions that strengthen personal characteristics, peer interactions, and environmental stressors are needed to address mental illness in children.Full Tex
Dolphins share Toxoplasma gondii Type II genotypes with terrestrial animals: Evidence of terrestrial T. gondii contamination in marine environments
Get PDFToxoplasma gondii is a protozoan parasite that can infect all warm-blooded animals, leading to toxoplasmosis. Dolphins are invaluable sentinel species informing potential risks of zoonotic pathogen infection in humans through raw or undercooked seafood consumption. Between 2019 and 2023, 14 dolphins from coastal New South Wales, Australia were examined as part of ongoing marine animal health monitoring programs. Based on the histological lesions of inflammation associated with protozoal structures, Toxoplasma gondii infection is interpreted to have contributed to morbidity and mortality of four of these dolphins as identified via real-time PCR for B1 and REP genes on genetic material extracted from lung and brain samples. Additional genetic characterisation was performed on three T. gondii dolphin samples utilising multiplex multilocus nested PCR-RFLP (Mn-PCR-RFLP) targeting 13 genetic markers: B1, SAG1, 5’ and 3’ SAG2, alt. SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1, and Apico. A Type II variant genotype, also called ToxoDB PCR-RFLP genotype #3, was identified in four tissues. Three of the samples displayed a unique genotype on the SAG3 marker, and one of the samples showed unique genotypes on both B1 and c22-8 markers. Our findings suggest that T. gondii of the same genotype has been circulating in New South Wales for the past decade. Although temporal data is limited, all examined animals were found stranded during multi-year La Niña events. The notable increase in rainfall in 2022 is considered a potential factor leading to T. gondii infections in these dolphins, likely due to run-off containing feline faecal contamination highlighting the widespread impact of invasive species in Australia.Full Tex