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Role of neoadjuvant peptide receptor radionuclide therapy in unresectable and metastatic gastro-entero-pancreatic neuroendocrine neoplasms: A scoping review
No full textPeptide receptor radionuclide therapy (PRRT) is an established therapy for metastatic neuroendocrine neoplasms (NEN). The role of PRRT as a neoadjuvant treatment prior to surgery or other local therapies is uncertain. This scoping review aimed to define the landscape of evidence available detailing the utility of PRRT in the neo-adjuvant setting, including the clinical contexts, efficacy, and levels of evidence. A comprehensive literature search of PUBMED, SCOPUS, and EMBASE through to December 2022 was performed to identify reports of PRRT use as neoadjuvant therapy prior to local therapies. Observational studies and clinical trials were included. A total of 369 records were identified by the initial search, and 17 were included in the final analysis, comprising 179 patients treated with neoadjuvant PRRT. Publications included case reports, retrospective cohort series and a phase 2 trial. Definitions of unresectable disease were variable. Radioisotopes used included 177Lu (n = 142) and 90Y (n = 36), used separately (n = 178) or in combination (n = 1). A combination of PRRT with chemotherapy was also explored (n = 2). Toxicity data was reported in 11/17 studies. Survival analysis was reported in 3/17 studies. Surgical resection following PRRT was reported for both the primary tumor (n = 71) and metastases (n = 12). Resection rates could not be calculated as not all publications reported whether resection was completed. Published literature exploring the use of PRRT in the neoadjuvant setting is mostly limited to case reports and retrospective cohort studies. From these limited data there is reported to be a role of PRRT in neoadjuvant setting in the literature. However, the low quality of evidence precludes any definite conclusion on the grade of disease, site of primary, isotope used or use of concomitant chemotherapy that can benefit from this application. Further prospective studies will require collaboration between multiple centers to gain sufficient high-quality evidence
The gendered framing of language impairments in criminalised young people
No full textYoung people whose language performance does not meet socially expected standards are overrepresented in the criminal justice system. Pragmatic language skills encompass the social aspects of language, which include constructing narratives, the rules of conversations, turn-taking, topic management, and non-verbal communication. Current research on pragmatic language impairments in criminalised young people – that is, on their symptomatic difficulties with social communication and language – remains inconclusive. The purpose of this study is to uncover the perceptions and framing of pragmatic language impairments in a sample of studies involving boys and girls from Australia and the United States. Drawing on content analysis of a sample of pertinent research, we expose the deeply gendered framing of pragmatic language performance and associated behaviours of criminalised young people. We demonstrate that available studies often represent female participants’ problematised use of pragmatic language as a personal choice, thus locating the problem within the individual and responsibilising girls and young women. However, for male participants, current research often presents problematised use of pragmatic language as a consequence of institutional failures. We argue that this gendered framing has political implications for criminalised young people and future research
Beyond conventional critique in education: embracing the affirmative
No full textThis article provides new insight into the potentialities of critique. Drawing on posthuman critical theory and the Spinozan concept of power to act, we explore the limits of critique that centrally depends on making explicit power relations that are frequently hidden. Set within the context of inequalities surrounding sexuality, gender and mental health, this exploration involves two Australian government schools and critique as practised. The interdependence of affective, discursive and material relations as they play into these inequalities is shown. Affect and material forces emerge as constitutive aspects of critique with the capacity to address these inequalities and do so in generative ways. Critique presents as more than exposing power structures and power manifests as potentialising, as well as normalising. The argument is made that we might with profit move beyond human-centred and exclusively critical modes of critique. A de-centering of human subjects and re-centering of human and more-than-human relations augments received views of critique and reflects the immanent and productive power to act that underpins it. In bringing an enacted ontology of power to bear, what counts as critique is complex relational positioning with both criticality and affirmation at its core
Quality of Refractive Error Care in Cambodia: An Unannounced Standardized Patient Study
No full textPURPOSE: Quality-of-care in refractive error services is essential, as it directly affects vision outcomes, wellbeing, educational attainment, and workforce participation. In Cambodia, uncorrected refractive error is a leading cause of mild and moderate vision impairment in adults. We evaluated the quality of refractive error care in Cambodia by estimating the proportion of prescribed and dispensed spectacles appropriate for people's refractive error needs and factors associated with spectacle quality. METHODS: A cross-sectional protocol was employed with 18 Khmer-speaking adult participants observing testing procedures in 156 optical services across six provinces in 2022. A total of 496 dispensed spectacles were assessed against spectacle quality indicators. RESULTS: The analysis revealed that 35.1% of dispensed spectacles were of optimal quality. The most common error observed in sub-optimal spectacles was the presence of horizontal prism outside of tolerance limits. The study also found that 44.0% of emmetrope visits involved unnecessary prescription spectacle recommendations, and 18.3% of written prescriptions did not correspond with dispensed spectacles. Sex differences were observed, with men predominantly providing refractive error care and women more likely to be unnecessarily recommended prescription spectacles. CONCLUSION: The findings highlight the importance of prioritizing quality-of-care in refractive error services. A key recommendation is to consider regulatory mechanisms to ensure optical services employ appropriately qualified staff. Additionally, efforts should be made to eliminate unnecessary prescriptions -- especially for emmetropes and females -- standardize written prescriptions, ensure consistent pupil distance measurements, reduce reliance on autorefraction, and address the gender imbalance in the refractive error workforce
Does Higher Compliance With American College of Sports Medicine Exercise Prescription Guidelines Influence Exercise Outcomes in Knee Osteoarthritis? A Systematic Review With Meta-Analysis
No full textOBJECTIVE: We wanted to determine if higher compliance with American College of Sports Medicine (ACSM) exercise prescription guidelines influences exercise outcomes in knee osteoarthritis (OA). METHODS: We conducted a systematic review. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, and Embase up to January 4, 2024, for randomized controlled trials evaluating resistance and/or aerobic exercise for knee OA. Interventions were classified as higher compliance (meeting ≥60% of ACSM guideline recommendations for frequency, intensity, and duration) or lower compliance (meeting <60% of recommendations). Effects on pain and function were evaluated via meta-analysis, stratified by compliance. RESULTS: Twenty-five trials (3,290 participants) evaluated combined resistance and aerobic programs, with no differences in outcomes between those with higher and lower compliance (standardized mean difference [SMD] pain: -0.38 [95% confidence interval (CI) -0.59 to -0.17] vs -0.31 [95% CI -0.45 to -0.16], respectively; SMD function: -0.43 [95% CI -0.64 to -0.21] vs -0.36 [95% CI -0.58 to -0.14]). Sixty-six trials (5,231 participants) evaluated resistance exercise, with no differences between interventions with higher and lower compliance (SMD pain: -0.60 [95% CI -0.81 to -0.39] vs -0.93 [95% CI -1.27 to -0.59]; SMD function: -0.64 [95% CI -0.83 to -0.44] vs -0.85 [95% CI -1.20 to -0.49]). Twelve trials (958 participants) evaluated aerobic exercise, with no differences between interventions with higher and lower compliance (SMD pain: -0.79 [95% CI -1.20 to -0.38] vs -1.00 [95% CI -2.52 to 0.53]; SMD function: -0.83 [95% CI -1.27 to -0.38] vs -0.76 [95% CI -2.02 to 0.50]). CONCLUSION: Higher or lower compliance with ACSM exercise prescription guidelines did not influence exercise outcomes. Given there was substantial heterogeneity and many publications were at risk of bias, our results should be interpreted with caution
Prenatal opioid exposure and the early life epigenome: results from ECHO
No full textBACKGROUND: Prenatal opioid exposure has been associated with adverse child health outcomes. Changes to the epigenome provide a plausible mechanism through which effects may be elicited. We investigated whether prenatal opioid exposure was associated with locus-specific changes in umbilical cord blood DNA methylation (DNAm) and gestational epigenetic age. METHODS: We leveraged data from the Environmental influences on Child Health Outcomes cohort. Prenatal opioid data was obtained from maternal self-report and/or medical record data. DNAm measures were generated from blood biospecimens collected at birth. Linear regression models tested associations between prenatal maternal opioid exposure and epigenetic outcomes in crude and fully adjusted models. RESULTS: We tested the association between prenatal opioid exposure and cord blood DNAm at 15 CpG sites in 385 (n = 25 exposed, n = 360 unexposed) individuals from three cohorts. We identified a single CpG site (cg14303187) that was nominally associated with prenatal opioid exposure (p = 0.02, β = -0.012; 95% CI, -0.023 to -0.0012). No significant associations between exposure and gestational epigenetic age were found (n = 716 individuals from eight cohorts; n = 29 exposed, n = 687 unexposed). CONCLUSIONS: We identified a nominally significant association between prenatal opioid exposure and DNAm at one CpG site. Future studies should continue investigating the effect of this exposure on the epigenome
Essays on the Design of Efficient Trade and Bargaining Mechanisms
No full text© 2025 Toan Vo Khanh LeThis thesis examines fundamental challenges in the design of centralized markets with privately informed buyers and sellers, focusing on efficiency, surplus division, and bargaining mechanisms. It analyzes the impossibility of efficient trade using standard demand-and-supply framework, its connection to the core of market games, and the selection of trading institutions for dividing economic surplus. Furthermore, it studies the sensitivity of monopoly surplus division to demand curvature assumptions and establishes the transfer variance-minimizing property of the AGV mechanism. Organized into six chapters, the thesis develops a unifying framework that integrates modern information economics with classical economic theory, providing novel insights through the lenses of general equilibrium and cooperative game theory
The Making Is the Story: Sovereignty, Sharing, and the Seven Sisters Cloak
No full textIn spring 2022, the authors co-led an experimental course and artists’ residency called “Decolonizing Museums.” The major outcomes were a possum-skin cloak (the first of its kind made in the United States) and a series of high-art photographs of project participants wearing the cloak. This project is part of an initiative to imagine and forge a Living Archive of Aboriginal Art, based in Australia. The objective: to radically reimagine what archives are and what they do, from Indigenous perspectives. The authors argue that photography-as-documentary practice (artists reflexively take photographs to document every aspect of their work) and photography-as-high-art-practice (a way of insisting on Indigenous forms of knowledge transmission and aesthetic expression) are inextricable from each other. These understandings of photography are also inextricable from cloak making: all of the making is all part of the story. The making is the story. In a collaborative visual essay, the authors mobilize photographs as an invitation to readers/viewers to be in relation with Indigenous knowledge holders and to join in the work of amplifying Indigenous sovereignty. The authors emphasize matriarchal knowledge transmission: women are leading efforts to reclaim autonomy over bodies and lands. The authors also call attention to intercultural collaboration as a source of innovation in both contemporary culture making and in pedagogy
World TB Day 2025 Theme "Yes! We Can End TB: Commit, Invest, Deliver" can be made a reality through concerted global efforts to advance diagnosis, treatment and research of tuberculosis infection and disease.
No full textWorld TB Day is observed annually on March 24th to raise awareness of tuberculosis (TB), a preventable and treatable disease [1]. However, despite being treatable for over 65 years, there are approximately 10.8 million new TB cases annually, predominantly in low- and middle-income countries. Drug-resistant and multidrug-resistant (MDR)-TB significantly contributes to deaths, impacting an estimated 400,000 individuals each year. TB-HIV coinfection remains a major concern, with an estimated 660,000 individuals affected by the dual infection. TB is an important cause of maternal, child and adolescent morbidity and mortality
Genomic and functional assessments of the invasion trajectory of common ragweed (Ambrosia artemisiifolia) in Australia
No full text© 2025 Andhika Rizky PutraIntroduced species can cause substantial ecological and economic damage if they become invasive and spread uncontrollably. Determining whether introduced species will become invasive is challenging because the circumstances of each invasion are unique. Genetic variation undergoing stochastic, demographic, and evolutionary processes can be informative predictors of invasion trajectory because of their effect on organismf unctioning and population dynamics.
This thesis investigates the role of genetic variation on the invasion trajectory of common ragweed (Ambrosia artemisiifolia), a North American native that has spread globally. Australian ragweed is found in a narrow stretch of eastern Australia, contrasting with the widespread distribution reported in its native range and older invasive range in Europe. Its equivocal success makes ragweed an ideal system for investigating the effect of genetic diversity on invasion outcomes.
My research begins by assessing ragweed’s invasive potential in Australia. Chapter 2 focuses on predicting the potential distribution of ragweed in Australia. By correlating natural genetic diversity to environmental predictors at their origin, I built genetically informed ecological niche models to predict habitat suitability across genetic clusters. Predicted distribution depended on genetic cluster identity and range of origin, with plants from North America and Europe having larger potential distributions than Australian plants. These results highlight the potential of introducing standing genetic variation to facilitate invasions.
Chapter 3 characterises the functional effects of genetic diversity on trait variation. Using data from a previous common garden experiment, I found that both the genetic architecture and the pattern of trait correlations vary among plants from different ranges. Interestingly, traits were less correlated in plants from Australia than North America or Europe, suggesting a lack of adaptive evolution or response to selection post-introduction.
The final research chapter (Chapter 4) confronts the findings of the previous chapters by directly investigating the dynamics of Australian populations. Under the hypothesis that the ragweed distribution is narrower than initially modelled and trait functioning was not optimal, I conducted field surveys and climate manipulation experiments to reconcile these results with the fact that Australian ragweed has persisted for over a century. I found evidence Australian populations may be ephemeral, as management would often clear an entire generation of ragweed, causing different genotypes to have no clear selective advantage. At the same time, climate manipulation experiments showed that Australian plants performed worse under conditions experienced at the northern and southern extremes of the range. These findings suggest Australian populations are sufficiently fit to remain established within their current range, but that their evolutionary potential is limited by low levels of functional genetic diversity combined with no clear selection pressure.
Understanding the invasive potential of an introduced population is valuable for determining the most effective management strategy. In the case of Australian ragweed, its future invasiveness is contingent on external or unpredictable factors. Ragweed range expansion requires adaptation to novel habitats, necessitating either a reduction in management to enable selection or human-assisted introductions of novel genetic variation. Barring the spontaneous appearance of adaptive mutations, the current intensity of management appears sufficient for preventing further expansion