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Synchronous telehealth and face-to-face administration of the Alberta Infant Motor Scale
No full textAIM: To determine the agreement between the Alberta Infant Motor Scale (AIMS), when delivered via synchronous telehealth compared with face-to-face administration to assess gross motor development of infants. METHOD: In this prospective cross-sectional study, 123 infants (gestational age: mean 38.8 weeks (SD 1.8); range 31-42 weeks; male n = 65) were assessed at 4 months, 8 months, or 12 months old with two AIMS assessments: face-to-face and via synchronous telehealth. The agreement between the assessments was examined using intraclass correlation coefficient (ICC) and the Bland-Altman method with 95% limits of agreement. RESULTS: Agreement between AIMS assessments administered face-to-face and via synchronous telehealth had an overall ICC of 0.99 (95% confidence interval [CI] 0.98, 0.99) and within age group: 4 months ICC 0.72 (95% CI 0.58, 0.83), 8 months ICC 0.97 (95% CI 0.96, 0.98), and 12 months ICC 0.98 (95% CI 0.96, 0.99). INTERPRETATION: The AIMS assessment delivered via synchronous telehealth shows excellent agreement with face-to-face assessment. Telehealth is a good alternative to face-to-face AIMS assessment, particularly for older infants
Inherited retinal disease in global Indigenous populations: A scoping review
No full textAccurate diagnosis is essential for accessing emerging gene-targeted treatments for inherited retinal diseases (IRDs), but many minoritised communities face additional barriers to diagnosis. This scoping review synthesised clinical studies on the prevalence and diagnosis of IRDs among Indigenous Peoples worldwide. Medline, Embase, Global Health, Informit and CINAHL were searched on December 4, 2023. We included articles reporting Indigenous Peoples with IRDs from all global regions published between 1974 and 2023; 73 studies (581 cases) of IRDs in Indigenous Peoples from 24 countries were included, mostly reporting participants indigenous to the Middle East (34 %), Oceania (27 %) and North America (23 %). Studies of specific IRD cases showed geographical or cultural group associations, such as rod-cone dystrophy among the Diné (Navajo Nation) or Bardet-Biedl syndrome in Bedouin populations of the Middle East. With dedicated programs, population-specific IRD gene variants in the Middle Eastern Bedouin populations, New Zealand Māori and other Pacific peoples are the most well-characterised, and this has enabled improved diagnostic approaches. There is limited knowledge of the relative prevalence and support needs for IRDs among most other global Indigenous groups. Engagement, co-designed approaches and collective efforts, including raising awareness, may address challenges limiting equitable access to IRD diagnosis for Indigenous Peoples, facilitating access to emerging treatments
Celestial Harmonies of Sky Country in Australia and Oceania
No full textFor First Nations cultures across the world, particularly in Australia and Oceania, the land and sky are intertwined in a complex harmony. The movements of the Sun, Moon, planets and stars inform processes on the land and sea, such as seasonal change, ceremony, navigation, as well as informing identity and spirituality. We explore the complexities of Indigenous Knowledge Systems and how the harmony of spheres relates to culture, music, and ceremony through two primary Australian case studies: the Venus (Morning Star) ceremony in Arnhem Land and the Lunar eclipse ceremony of the western Torres Strait. These case studies reveal a knowledge complexity that is poorly recognised or understood outside of those communities, revealing new ways of understanding and conceptualising our place in the cosmos.For First Nations cultures across the world, particularly in Australia and Oceania, the land and sky are intertwined in a complex harmony. The movements of the Sun, Moon, planets and stars inform processes on the land and sea, such as seasonal change, ceremony, navigation, as well as informing identity and spirituality. We explore the complexities of Indigenous Knowledge Systems and how the harmony of spheres relates to culture, music, and ceremony through two primary Australian case studies: the Venus (Morning Star) ceremony in Arnhem Land and the Lunar eclipse ceremony of the western Torres Strait. These case studies reveal a knowledge complexity that is poorly recognised or understood outside of those communities, revealing new ways of understanding and conceptualising our place in the cosmos
Non-PFAS-Based Magnetic Polymer Sorbents for Efficient Removal of Perfluorinated Compounds from Landfill Leachate
No full textPer- and polyfluoroalkyl substances (PFAS) are carcinogenic and environmentally persistent contaminants, necessitating their efficient removal to protect environmental and human health. In this study, a series of fluorinated, non-PFAS-based magnetic polymer sorbents is developed for the selective removal of multiple PFAS from landfill leachate containing high levels of co-contaminants. Crosslinked polymer networks are shown to enhance both magnetic separation and PFAS sorption performance. The magnetic sorbent with a higher proportion of quaternary ammonium groups and a lower proportion of fluorinated segments shows improved sorption kinetics for most PFAS and greater sorption capacity for perfluorobutanesulfonic acid (PFBS), the most abundant compound in the tested landfill leachate. However, this formulation exhibits lower sorption selectivity and reduced equilibrium removal efficiencies when PFAS are present at low initial concentrations. A compact and portable treatment device is constructed to simulate practical deployment. The system achieves high PFAS removal efficiencies (>90% for the majority of PFAS) and maintains good regeneration and reusability over five sorption-desorption cycles at environmentally relevant concentrations. Compared to four commercially available sorbents, the developed magnetic polymer sorbents exhibit superior performance in PFAS removal, indicating their potential as efficient candidates for remediating PFAS from landfill leachate
Bioengineered polymeric mesh with imaging contrast for enhanced urogynaecological applications
No full textPelvic floor disorders affect up to 50 % of women, with prevalence increasing significantly in those over 65. While transvaginal mesh (TVM) implantation remains a common treatment, its use has been associated with complications, including inflammation, infection, and poor integration, prompting the need for safer alternatives. This study introduces a novel composite mesh designed to enhance clinical outcomes by significantly improving the mechanical properties of the TVM, its biocompatibility, and enabling its visibility. The mesh consists of polymethylmethacrylate and thermoplastic polyurethane, with embedded iodine-doped carbon nanoparticles for contrast-enhanced computed tomography (CT) imaging and coated with a phosphorylcholine-based polymer to reduce protein adsorption and hence support tissue regeneration. The composite mesh showed a tensile modulus of approximately 2.7 MPa, closely matching vaginal tissue, and reduced non-specific protein adsorption by ~78 %. In vitro analysis confirmed high biocompatibility and minimal protein adsorption. Conducted in vivo mouse studies showed no adverse overall health effects or systemic inflammation based on spleen weight; however, elevations in some cytokine levels in the iodinated mesh group indicate a potential area for optimisation of mesh properties. Fecal microbiome diversity was stable in both sham and iodinated groups. Further, the mesh mimics native tissue mechanics and enables clear CT visibility for at least 14 days post-implantation, allowing non-invasive monitoring. This novel TVM presents a multifunctional platform able to address key limitations of conventional TVMs by improving CT imaging, minimising inflammation, and supporting integration, offering a promising solution for safer and more effective pelvic floor repair
Food, Built and Socio-Economic Environments and Maternal–Infant Outcomes: A Geospatial and Structural Equation Modelling of 163 000 Births
No full textOBJECTIVES: To examine the combined influence of food environment, built environment, socio-economic status and individual factors (maternal age, parity, smoking status and need for an interpreter) on maternal overweight, gestational diabetes mellitus (GDM) and large-for-gestational age (LGA) births in Australia. DESIGN: Retrospective cohort study. SETTING: Melbourne, Australia. POPULATION: 163 760 singleton pregnancies/births. MAIN OUTCOMES MEASURES: Primary outcomes: maternal overweight, GDM and LGA births. METHODS: Structural equation modelling (SEM) assessed direct and indirect associations, with maternal overweight as a mediator. LCA was used to classify risk variation across socio-economic strata. RESULTS: Among 163 760 births, a higher density of unhealthy food outlets, lower liveability scores and greater socio-economic disadvantage were associated with maternal overweight. Maternal overweight strongly predicted GDM (c = 0.118, 95% CI: 0.113-0.124; p < 0.001) LGA births (c = 0.058, 95% CI: 0.053-0.059; p < 0.001), while higher liveability and walkability environments were protective against maternal overweight (c = -0.011, 95% CI: -0.019 to -0.002; p < 0.05). LCA identified a high-risk subgroup (85.1% overweight, 34.4% GDM) concentrated in socio-economically disadvantaged areas with poor access to healthy food and more walkable neighbourhoods. CONCLUSIONS: Environmental and socio-economic factors have significant independent influences on maternal overweight, GDM and LGA births. Addressing food access disparities, improving the walkability and liveability of residential areas and ensuring equitable healthcare infrastructure could reduce maternal health risks and promote better pregnancy outcomes
Genetically determined body mass index is associated with diffuse large B-cell lymphoma in polygenic and Mendelian randomization analyses
No full textObesity has been associated with non-Hodgkin lymphoma (NHL), but the evidence is inconclusive. We examined the association between genetically determined adiposity and four common NHL subtypes: diffuse large B-cell lymphoma (DLBCL), follicular lymphoma, chronic lymphocytic leukemia, and marginal zone lymphoma, using eight genome-wide association studies of European ancestry (N = 10,629 cases, 9505 controls) and constructing polygenic scores for body mass index (BMI), waist-to-hip ratio (WHR), and waist-to-hip ratio adjusted for BMI (WHRadjBMI). Higher genetically determined BMI was associated with an increased risk of DLBCL [odds ratio (OR) per standard deviation (SD) = 1.18, 95% confidence interval (95% CI): 1.05-1.33, p = .005]. This finding was consistent with Mendelian randomization analyses, which demonstrated a similar increased risk of DLBCL with higher genetically determined BMI (ORper SD = 1.12, 95% CI: 1.02-1.23, p = .03). No significant associations were observed with other NHL subtypes. Our study demonstrates a positive link between a genetically determined BMI and an increased risk of DLBCL, providing additional support for increased adiposity as a risk factor for DLBCL
Protecting nature in diverse ways: The socio-demographic spread of benefits from connecting with nature
No full textNature connection and its relationships with stewardship vary across social and environmental contexts. Through a nationally representative survey in Australia, this study examined engagement in four different pro-environmental behaviours (PEBs) (advocacy, consumer-conscious, conservation, and gardening), their socio-demographic correlates, and the associations with both nature connection and well-being. We found strong associations between nature connection and all examined PEBs; however, different groups were more likely to engage in different types of PEBs. For example, younger adults are more likely to engage in advocacy and conservation behaviours, while older Australians are more likely to engage in consumer-conscious behaviours and gardening. All PEBs were significantly associated with well-being; however, only the advocacy behaviours variable remained significant when including nature connection as a control variable. These findings highlight the importance of biodiversity policies that holistically enhance nature connection for a range of people, alongside sustainability measures to support the well-being of both people and planet
Withdrawal of heart failure therapy after atrial fibrillation rhythm control with ejection fraction normalization: the WITHDRAW-AF trial
No full textBACKGROUND AND AIMS: Atrial fibrillation-mediated cardiomyopathy (AFCM) represents an important reversible cause of left ventricular systolic dysfunction. Current clinical practice is indefinite heart failure (HF) pharmacotherapy despite left ventricular ejection fraction (LVEF) normalization. However, whether this is necessary to maintain normal LVEF, in addition to rhythm control, is uncertain. METHODS: This multi-centre, randomized trial conducted between 2021 and 2024 examined the impact of staged withdrawal of HF therapy following AF rhythm control and LVEF normalization in AFCM. Participants were randomized (1:1) to early withdrawal (Group A) or continued therapy for 6 months followed by delayed withdrawal (Group B), in a crossover design. The primary endpoint was the randomized comparison of cardiac magnetic resonance (CMR) LVEF maintenance ≥50% at 6 months, during which time Group A had withdrawn therapy and Group B remained on treatment. Secondary outcomes included cardiac remodelling, functional status, biomarkers, quality of life, and arrhythmia recurrence on vs off HF therapy. The total follow-up duration was 12 months. RESULTS: Between July 2021 and May 2024, 60 patients were enrolled (age 60 [55-65] years, previous persistent AF <1 year and maintaining sinus rhythm for minimum 6 months following AF rhythm control [catheter ablation in 97%]). All participants completed treatment withdrawal and 12-month follow-up. In the initial randomized comparison, LVEF was maintained ≥50% at 6 months in 90% of participants undergoing HF therapy withdrawal (Group A), compared with 100% who continued medical therapy (Group B) (odds ratio [OR] 1.18, 95% confidence interval [CI] 0.27-2.82, P = .47). CMR LVEF was similar between randomization groups at the end of the randomization phase (Group A: LVEF 58% [95% CI 54-60] vs Group B: LVEF 59% [95% CI 55-64], P = .236) and across study time points (mixed effects P = .37). Transthoracic echocardiography characteristics, N-terminal pro-B-type natriuretic peptide, functional status, quality of life and AF burden were similar on vs off HF therapy in the overall population. CONCLUSIONS: Withdrawal of HF therapy following AF rhythm control for prior AFCM and recovered LVEF was not associated with a decline in LVEF for most patients in the following 6 months
An experimental study of ion diffusivity in graphene oxide membranes in single and binary salt solutions
No full textGraphene oxide membranes (GOMs) are a promising material for next-generation membrane technologies. However, the mechanisms underlying their ion transport remain unclear, limiting the ability to optimise their design for specific applications. In this study, we systematically quantify ion transport by calculating the individual ion diffusion coefficients of GOMs equilibrated in LiCl, NaCl, KCl, and MgCl2 and binary mixtures of the monovalent salts across varied external salt concentrations. We demonstrate that counter-ion diffusion coefficients generally remain unaffected by external salt concentration, while chloride co-ion diffusion coefficients increase with concentration up to ∼0.3 M before plateauing, primarily influenced by electrostatic interactions between the membrane fixed charge groups and ions, rather than membrane water content. Interestingly, the diffusion coefficients of Na+ and Cl− ions in the GOMs are comparable to those in polymeric membranes, challenging previous reports of significantly enhanced ion transport in GOMs. Rather, our analysis reveals that ion permeability in GOMs is predominantly dictated by solubility effects rather than diffusion. In monovalent binary salt systems, counter-ion diffusion coefficients were generally lower than those of single-salt systems, while chloride diffusion coefficients remained comparable, reflecting the influence of ion interactions and membrane hydration on ion transport. We also find that the water permeability of the GOMs is low and does not show the promise of ultrafast water transport identified in early studies