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Determination of penicillamine in an unsegmented continuous flow analyzer
No full textA kinetic spectrophotometric method for the determination of penicillamine (PEN) in pharmaceuticals has been developed. It utilizes a one-step reduction of the Cu(II)-bathocuproine complex by PEN, which results in a yellow-orange-colored Cu(I)-bathocuproine complex with maximum absorbance at 483 nm. Under optimal conditions, the method is characterized by a linear calibration range of 3.0 × 10-6–6.0 × 10-4 mol L-1 (Amax = 8.65×103CPEN; R2 = 1.00), a limit of detection of 9.0 × 10-7 mol L-1, and an analysis time of 2 min. Using an unsegmented continuous flow analyzer, it has been established that in the linear calibration range, the analytical reaction is of pseudo-first order. The method has been applied to the determination of PEN in samples of pharmaceutical PEN tablets, and the results obtained have been found to be statistically indistinguishable from those produced by the standard Pharmacopoeia method
Co-Designing Aphasia Services: Evaluation of Involvement and Processes to Support Inclusion of People With Post Stroke Aphasia
No full textBackground: People with aphasia (PWA, impaired language/communication) are often excluded from research that concerns them due to a lack of methodological adaptations to support communication. This paper describes adaptations to support their involvement in experience-based codesign (EBCD). Aims: To describe the involvement of PWA in EBCD and critically evaluate adaptations required to support involvement. Methods: Mixed methods process evaluation and reflexive critical appraisal with PWA, significant others (SO), and speech pathologists (SP). Using surveys, stakeholders (n = 127) and a consumer advisory group (CAG; n = 6) provided feedback on involvement in five stages of the research: (1) online interviews and focus groups; (2) online surveys; (3) consensus meetings; (4) codesign workshops; and (5) the CAG. Critical reflections (lead researcher) informed the analysis. Descriptive statistics and inductive content analysis were used. Results: Most PWA (79%) liked sharing their experiences online, and contributed as much as desired in group meetings (64%). A modified touchpoint film approach (use of voice actors, still images, and subtitles) supported reflexive discussions and collaborative understanding. All PWA and SO, and most SPs (78%) thought the touchpoint film helped them to understand experiences of care and areas for change. Long-term engagement in the project was perceived to help build relationships, reduce hierarchical power differentials and support equal sharing of ideas. Conclusions: Meaningful involvement of PWA was supported through long-term engagement, a modified touchpoint film approach, and hybrid methods of data collection. EBCD is a suitable approach for exploring experiences of care, identifying leading priorities, and co-designing areas for change with PWA. Patient or Public Contribution: This evaluation is informed by the reflections of the research team. This team included the consumer advisory group (public involvement team members) comprising PWA (n = 3), SOs (n = 2) and a Cultural Capability Officer. Research team members (LNA, DAC, VJP, and SJW) designed the study (including research questions, data analysis processes and assessment measures). Public involvement guided study procedures and recruitment (e.g., methods for engaging with people with lived experience of aphasia), and the interpretation and dissemination of results (e.g., co-authors on papers). A Cultural Capability Officer advised on culturally safe practices for Aboriginal and Torres Strait Islander participants. Aboriginal and Torres Strait Islander Peoples, are the First Nations people of Australia. Cultural Capability Officer support refers to the support provided to ensure behaviours, systems and processes are conducted in a way that is culturally respectful. Research is reported in line with the GRIPP-2 guidelines for reporting patient and public involvement
Co-designing with community for net zero: Case study of a housing estate
No full textTo meet the UK’s 2050 net zero carbon targets, Whole Life Carbon Assessment (WLCA) is used to calculate the lifetime carbon emissions of building projects. This paper aims to compare different estate regeneration scenarios for meeting the interim 2030 benchmarks for the 2050 target. The research consists of a case study employing co-design and WLCA experiments, and impact evaluation surveys. The results of the WLCA demonstrate the lower operational impacts of fossil-fuel-free scenarios, and lower embodied and overall carbon emissions of retrofitting scenarios. To make an informed decision towards the future of the estates, different regeneration scenarios need to be studied, and the stakeholders should understand the carbon emissions of different materials and systems. The findings of this study can be used to compare regeneration schemes of other building types.
Practical application: This study underscores the critical role of early-stage design decisions and engaging with the communities in minimising the carbon footprint of building projects and making informed decisions. The study reinforces the potential superiority of retrofitting over new builds, which serves as a clear call for the inclusion of retrofit options in the analysis of diverse regeneration and redevelopment scenarios. The study’s outcomes also highlight the pivotal role of stakeholder engagement in comprehending the Global Warming Potential (GWP) of materials and systems, influencing the participatory development and evaluation of regeneration scenarios. This approach is paramount to devising strategies that align with net zero ambitions, thereby ensuring environmentally and socially responsible estate regeneration
‘Splintered selves’: teachers’ online fragmented identities navigating the personal, political and professional
No full textMuch research into teachers’ use of social media has focused upon framing it as a professional learning tool and exploring the challenges and benefits of interacting online. Less research has been undertaken in the way these interactions present and also shape the identity of the participating teachers, especially across multiple social media sites. This paper examines precisely this issue, analysing the way that teachers have navigated various sites and online communities using social media as a means to shape their personal, political and professional identity, in ways that are sometimes empowering
Nutrition characteristics and clinical outcomes of hospitalised patients with COVID-19: A large retrospective cohort study
No full textBackground & Aims Nutrition-related comorbidities and malnutrition contribute to adverse clinical outcomes in patients with COVID-19. This study aimed to describe the nutrition characteristics of hospitalised patients with COVID-19 throughout 2020-2021 and report associations with patient outcomes, including in-hospital mortality, Intensive Care Unit (ICU) admission and length of hospital stay (LOS). Methods Single-centre, retrospective cohort study including all patients who tested positive for COVID-19, admitted to an inpatient ward for >24 hours. Data were obtained by review of electronic medical records of adults (≥18-years) admitted over the study period. For subset analysis, patients were categorised in two ways: year (2020 vs. 2021) and those assessed by dietitian vs. not. Results 869 patients met inclusion criteria. Mean age was 56.1 (standard deviation ±19.4) years, majority (54%) were male, and median LOS was 6 days [interquartile range 3-11]. Where height and weight were available (n=222), mean Body Mass Index (BMI) was 32.1kg/m2 (±7.7). Diabetes (odds ratio (OR): 2.2, p=0.01) and risk of malnutrition or malnutrition (OR 2.1, p=0.04) were both associated with in-hospital mortality. Odds of admission to ICU for individuals classed as obese were 3.5 times greater than those with a BMI <30 kg/m2 (p<0.001). Dietitians assessed 291 (34%) patients with COVID-19, of which 108 (36.7%) were identified as either t risk of malnutrition or malnourished. There was no significant difference in LOS for those assessed as at risk of malnutrition or malnourished across the whole cohort. However, subset analysis of the 2020 cohort, highlighted that median LOS was significantly longer (15 [7-21] vs. 4 [3-8] days, p<0.001) in those who were assessed as at risk of malnutrition or malnourished. Conclusions Presence of diabetes, obesity and risk of malnutrition or malnutrition in individuals with COVID-19 were associated with worse clinical outcomes in this cohort. Nutrition assessment, with subsequent integrated metabolic and nutrition management is fundamental for prognostic and potentially disease-modification purposes
Foreign Judgments and the Relationship between Direct and Indirect Jurisdiction
No full textAbstract
A key issue in the recognition and enforcement of foreign judgments is jurisdiction, with a distinction drawn between ‘direct’ jurisdictional rules, which are applied by the court of origin at the time of initial adjudication, and ‘indirect’ rules applied by a court at the recognition and enforcement stage. While some commentators and national laws suggest that no jurisdictional ‘gap’ should exist between direct and indirect rules, in this article it is contended that, outside the context of a federal system or international convention with uniform rules, no compelling justification exists for eliminating the gap
Spaceborne LiDAR-derived height-variable forest wind reduction factors (WRF) for improved wildfire spread modelling
No full textSub-canopy windspeed is a critical input variable in fire simulation modelling, having a strong effect on the predicted rate of spread (ROS). In vegetated landscapes, windspeed reduction occurs due to the structural properties of vegetation, with the canopy height and forest density being key structural attributes driving this effect. Wind reduction factors (WRFs) are used to represent this phenomenon in fire behaviour modelling. Significant variability in WRFs exist both laterally and vertically; however, this variation has been poorly represented in operational models for two key reasons: i) a lack of an operational-scale spatial dataset to characterise the key forest attributes and parameterise a WRF model spatially and vertically; and ii) the lack of a method to integrate these spatial parameters into an operational WRF model. We address these challenges by developing a novel WRF model using spatial inputs from the Global Ecosystem Dynamics Investigation (GEDI) spaceborne LiDAR dataset. This model relies on the Plant Area Index (PAI) vertical distribution and canopy height derived from GEDI to predict WRFs at different heights within the forest profile and across landscapes. Model validation is conducted using observed vertical WRF profile across 11 sites. This model represents an advancement in operational WRF modelling by explicitly integrating large-scale spatial datasets that characterise vertical forest structure. It demonstrates, using an Australian case study, the feasibility of using GEDI data to model WRFs operationally, providing spatially and vertically explicit predictions. This proof-of-concept establishes a scalable method to bridge critical gaps in WRF modelling for wildfire prediction
Farm transformation in the context of climate change: Beyond the incremental-transformational divide
No full textEffectively supporting farm transformation in the face of climate change requires improved understanding of the processes involved in the practices of farm transformation or farm system redesign. This paper presents a case study of farm transformations in the dairy sector in Australia. We interviewed twenty-three dairy farmers (from nineteen farms) and nineteen service providers in two regions about their decisions to move from a grazing-based to more intensified feeding systems including permanently housed production systems. These farm system transformations are highly contentious; however, we use these transformations as an explanatory case from which to develop theory about what the practices of transformation entail. Located in the socio-ecological resilience literature and applying a conceptual framework that integrates social practice theory and the multi-level perspective on socio-technical transitions, we explore the practices involved in transformational processes and what accelerates or stalls them. We found that transformation is a phased process with each phase having different features and challenges. ‘Starting’ processes were catalysed by water resource policy, extreme weather events, milk market conditions or farm succession and other workforce changes. These conditions also influenced whether changes, having been explored, were put on hold, terminated, revised or put in motion. ‘Redesigning the farm system’ involved reshaping an established network or system of dairy farming practices, while ‘Sustaining the transformation’ was influenced by what was relevant and possible within the regional context. While a dairy farming system that has been transformed retains similar practices such as cow care and feeding, the practice elements and links to other practices outside dairying, including the key actors and sociocultural conditions, change significantly. Our findings contribute to an improved conceptualisation of the transformative process in farming. Firstly, by showing that processes commonly defined as incremental adaptation are not separate or lesser to transformative processes but integral to transformation. Secondly, that understanding change through the lens of practice within a multi-level perspective allows policy makers to better anticipate farm changes and their consequences
Population structure and antimicrobial resistance of Corynebacterium diphtheriae in Victoria, Australia
No full textCorynebacterium diphtheriae, the main aetiological agent of diphtheria, is a re-emerging bacterial pathogen of public health concern, yet remains largely understudied globally. In this study, we analysed the population structure and antimicrobial resistance (AMR) of 210 C. diphtheriae isolates from Victoria, Australia, including 103 historical (1950-1970) and 107 contemporary clinical isolates (2004-2023), using whole-genome sequencing and phenotypic susceptibility testing. The diphtheria toxin gene (tox) was detected in 89 isolates, the majority of which (n=83; 93.3%) were historical. Population structure comprised two primary phylogenetic lineages, Mitis and Gravis, each containing multiple sublineages. Multi-locus sequence type (MLST) analysis revealed a highly diverse population structure with multiple novel MLST profiles and alleles. When placed within a global phylogenetic framework, Australian isolates were broadly distributed, reflecting substantial genetic diversity. Phenotypic susceptibility testing against 11 antimicrobials revealed that several contemporary isolates were resistant to multiple agents, including penicillin and erythromycin, first-line treatments of Corynebacterium infections. Eight contemporary isolates were multidrug-resistant (resistant to ≥3 antimicrobial classes), including five with resistance to both penicillin and erythromycin. Genomic analysis identified multiple genes and mutations conferring resistance among contemporary isolates. In contrast, no AMR phenotypes or genotypes were observed in historical isolates. Analysis of historical genomes provides valuable insights into a period of heightened diphtheria activity in Victoria prior to widespread immunization. Overall, these findings establish a baseline for ongoing genomic surveillance in the face of increasing global outbreaks, support informed empiric treatment strategies and contribute to the knowledge of the global population structure of C. diphtheriae
Impact of mild hypercapnia on renal function after out-of-hospital cardiac arrest
No full textBACKGROUND: Acute kidney injury (AKI) is a serious complication of out-of-hospital cardiac arrest (OHCA). Post-resuscitation cardiogenic shock (CS) is a key contributing factor. Targeting a higher arterial carbon dioxide tension may affect AKI after OHCA in patients with or without CS. METHODS: Pre-planned exploratory study of a multi-national randomised trial comparing targeted mild hypercapnia or targeted normocapnia. The primary outcome was AKI defined by Kidney Disease: Improving Global Outcomes (KDIGO) criteria with modifications. Secondary outcomes included use of renal replacement therapy (RRT) and favourable neurological outcome (Glasgow Outcome Scale Extended, score 5-8) at six-months according to AKI. Exploratory objectives included evaluation of secondary outcomes in patients with both CS and AKI. RESULTS: We studied 1668 of 1700 TAME patients. AKI occurred in 1203 patients (72.1%) with 596 (49.6%) in the targeted mild hypercapnia group and 607 (50.4%) in the targeted normocapnia group. Stage 3 AKI occurred in 193 patients (23.3%) and 196 patients (23.4%), respectively and RRT in 82 (9.9%) vs 75 patients (8.9%), respectively. At six-months, 237 of 429 no-AKI patients (55.2%) had a favourable neurological outcome compared to 445 of 1111 AKI patients (40.1%) (p < 0.0001). AKI occurred more frequently (P < 0.001) in patients with CS, affecting 936 patients (77.8%). For CS and AKI patients, there were no significant differences any secondary outcome. CONCLUSIONS: AKI occurred in approximately two-thirds and RRT in approximately one in ten TAME patients without differences according to treatment allocation. CS significantly increased the prevalence of AKI but this effect was not modified by carbon dioxide allocation