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Well-being among people with long and short COVID: a serial cross-sectional study in Victoria, Australia
No full textBACKGROUND: It is critical to disseminate all evidence on long COVID's impact on people's lives to inform policy and practice. We aimed to assess five measures of well-being, before and after SARS-CoV-2 infection between people with long COVID (defined as symptoms lasting more than 1 month) and people with short COVID (defined as symptoms resolving within 1 month). METHODS: Participants from the Optimise Study, a longitudinal cohort study in Victoria, Australia (September 2020-August 2022), had self-reported history of SARS-CoV-2 infection and self-reported long COVID status. Serial cross-sectional analysis compared participants with long and short COVID on Personal Well-being Index, number of COVID-19-like symptoms experienced, number of days exercised and frequency of experiencing positive and negative emotions. RESULTS: 217 participants were included, aged 20-86 years (median age 43, IQR: 31-57), 75% women. Compared with those with short COVID, participants with long COVID had lower well-being before (mean difference (MD)=-8.3, 95% CI (-14.7, -2.0), p-adjusted=0.07), during (MD=-10.3, 95% CI (-16.5, -4.0), p-adjusted=0.03) and after (MD=-9.91, 95% CI (-16.71, -3.11), p-adjusted=0.05) infection and experienced more COVID-19-like symptoms during infection (MD=1.72 (0.72, 2.72), p-adjusted=0.03). In December 2022, 71% (40/56) reported difficulty performing tasks in the past 4 weeks. CONCLUSION: On average, we observed lower well-being among participants with long COVID, including before SARS-CoV-2 infection, suggesting an underlying difference in well-being between groups. Long COVID continued to impact physical functioning, but ongoing changes were not detected by personal well-being scales
A comprehensive longitudinal analysis of changes during Attention Deficit Hyperactive Disorder pharmacological treatments: Relationships between clinical measures, QbCheck and Conners CPT-II
No full textAbstract
Background
This study aims to evaluate the clinical value of using QbCheck in routine Attention Deficit Hyperactive Disorder (ADHD) clinics by investigating longitudinal inter‐domain relationships between objective neurocognitive outcomes of QbCheck and subjective clinical outcomes: ADHD core symptoms, impairment and quality of life (QoL).
Method
The study was conducted alongside the participants' standard pharmacological treatment for their ADHD. Thirty‐four clinically diagnosed participants with ADHD completed baseline and follow‐up neurocognitive assessments. Bayesian paired t‐tests and bivariate correlations were used to examine changes over time and relationships between key variables.
Results
Bayesian analyses showed correlations between QbCheck and continuous performance test (CPT)‐II for the same constructs, except for omission errors. In the test‐retest results of QbCheck, measures remained stable, though moderate evidence supported changes in reaction time variability (BF10 = 5.57) and anecdotal evidence for commission errors (BF10 = 1.72). In measuring treatment effect, there was moderate to extreme evidence for reductions in self‐ and informant‐rated ADHD symptoms and clinician‐rated impairment severity. In contrast, informant‐rated QoL showed weak evidence for a difference (BF10 = 1.81), and self‐rated QoL showed no change (BF10 = 0.67). QbCheck showed moderate to extreme evidence for most changes, with weak evidence for reaction time (BF10 = 1.38), while CPT‐II showed strong evidence for commission errors, weak evidence for response time variability, and no evidence for omission errors or reaction time. Weak evidence suggested moderate associations between QbCheck MicroEvent X and informant‐rated ADHD symptom severity (BF10 = 2.40, r = 0.47) and CPT‐II commission errors and self‐rated ADHD symptom severity (BF10 = 2.44, r = 0.39).
Conclusion
QbCheck is a valid tool for assessing neurocognitive changes in ADHD treatment but should not replace clinical outcome measures or be used as a proxy for behavioural assessments. Caution is needed when relying on a single outcome measure, emphasizing the need for multi‐source assessments to capture the full impact of treatment
Establishing Research Priorities for Children Living With Chronic Health Conditions: A Value-Weighting Study by Australian Caregivers
No full textAIM: Improving the wellbeing of children with chronic health conditions and their caregivers can be maximised through research that addresses the priorities of this population. This study aimed to investigate the research topics and areas of care deemed most important to caregivers of children living with chronic health conditions in Australia. METHODS: A list of 25 research topics were presented in two rounds of a classic Delphi consensus survey to caregivers of children with chronic health conditions. Caregivers ranked these topics according to their perceived importance. High ranking topics were taken forward into a value-weighting exercise which was presented to a national sample of caregivers. In this exercise caregivers were asked to allocate hypothetical research funding units (FU) across research topics as well to different areas of care (Prevention, Screening and Early Detection; Newly Diagnosed; Receiving treatment; Finished treatment; Relapsed, receiving Palliative care; Significant Others [e.g., family members, friends, caregivers]). RESULTS: Seventy five caregivers completed Delphi Survey 1, 45 completed Delphi Survey 2 and 252 completed the value-weighting exercise. In the value-weighting exercise, the research topic 'Improve Access to Healthcare' received the highest mean allocation of 23.42/100 FU (SD = 19.48), followed by 'Improving Day to Day Functioning' (mean allocation 17.37 FU [SD = 16.2]). The 'Prevention, Screening and Early Detection' area of care received the highest mean allocation of 27.47 FU (SD = 19.48). CONCLUSION: This study highlights the research priorities of caregivers of children living with chronic health conditions. This information can be used to guide future research and funding decisions in paediatric chronic health conditions
A perspective by the German NRZ-Authent on information and knowledge management in governmental authorities
No full textEfforts in the filing and organisation of primary data, despite being a pillar of digital transformation, appear to be less pronounced when it comes to unstructured or text-based data. This situation is contrasted by the demand for knowledge management in organisational units operating at the interface between different stakeholders, including, for instance, governmental authorities. Supporting the specific objectives of our institution, we have developed a central platform that serves as an information management system for food. By providing a flexible infrastructure for the management of text-based information, as well as an interactive and intuitive user interface for application and integration into every-day business, we have implemented a system that facilitates building of a data pool of information relevant for food and feed fraud/authenticity. While transforming the institutional information management within the NRZ-Authent, the platform allows access to the data pool by external partners at national and, potentially, European or international level.10.1038/s41538-025-00487-
Functional Analysis of HSD17B3-Deficient Male Mice Reveals Roles for HSD17B7 and HSD17B12 in Testosterone Biosynthesis
No full textHistorically, 17β-hydroxysteroid dehydrogenase type 3 (HSD17B3) was thought to be the key enzyme responsible for testicular testosterone production. In humans, loss-of-function mutations in HSD17B3 impair testosterone production during prenatal life leading to impaired development of androgen-dependent tissues in 46,XY individuals. However, male mice with HSD17B3 deficiency exhibit normal testicular testosterone concentrations, normal development of reproductive organs and are fertile, suggesting that mice express other hydroxysteroid dehydrogenase enzymes capable of testicular testosterone synthesis. This study aimed to investigate whether 17β-hydroxysteroid dehydrogenase type 12 (HSD17B12), which can convert androstenedione to testosterone in mice but not in humans, compensates for the lack of HSD17B3 in Hsd17b3 knockout (KO) mice. We used CRISPR/Cas9 to substitute the amino acid in mouse HSD17B12 that is responsible for its ability to convert androstenedione to testosterone with the amino acid of the human enzyme that prevents androstenedione being used as a substrate. When this Hsd17b12 mutation was introduced into Hsd17b3 KO mice, males exhibited normal reproductive tracts but reduced testicular testosterone production with a consequential reduction in seminal vesicle weight. This suggests HSD17B12 contributes toward testosterone production in the absence of HSD17B3, but other enzymes must also contribute. We therefore quantified other testicular hydroxysteroid dehydrogenases, finding that HSD17B7 mRNA and protein was markedly upregulated in Hsd17b3 KO testes. We confirmed that mouse, but not human, HSD17B7 can produce testosterone in vitro. We conclude that compared to humans, mice exhibit increased plasticity in testosterone production via hydroxysteroid dehydrogenase enzymes to support androgen action and male fertility
Against The Achilles’ Heel: A Survey on Red Teaming for Generative Models
No full textGenerative models are rapidly gaining popularity and being integrated into everyday applications, raising concerns over their safe use as various vulnerabilities are exposed. In light of this, the field of red teaming is undergoing fast-paced growth, highlighting the need for a comprehensive survey covering the entire pipeline and addressing emerging topics. Our extensive survey, which examines over 120 papers, introduces a taxonomy of fine-grained attack strategies grounded in the inherent capabilities of language models. Additionally, we have developed the “searcher” framework to unify various automatic red teaming approaches. Moreover, our survey covers novel areas including multimodal attacks and defenses, risks around LLM-based agents, overkill of harmless queries, and the balance between harmlessness and helpfulness.
Warning: This paper contains examples that may be offensive, harmful, or biased
Pitfalls of the existing positive environmental impact assessment methods: An EV case
No full textThe growing global efforts toward net zero emissions have sparked the need for stringent tracking and quantifying the decarbonisation progress. Over the last decade, a number of methods have been proposed to define and quantify the positive environmental impacts (PEIs) of products or actions. Although the current methods are all predominantly based on Life Cycle Assessment (LCA), their definitions, scopes, and approaches are distinct from each other, and they have not gained widespread acceptance in academia or industry. This paper examines the case of electric vehicles (EVs) to critically evaluate existing PEI assessment methods, aiming to uncover the inherent pitfalls. The results highlight three primary risks: (1) the potential for manipulation of results calculated by current methods, (2) insufficient consideration of potential rebound effects and the implications when accounting for product volume, and (3) ambiguity in what can be quantified as PEI. Accordingly, an alternative definition of PEI is proposed with suggested further research pathways
Primary care patients presenting with unexpected weight loss in Australian general practices: Replication of a diagnostic accuracy study
No full textOBJECTIVE: We calculate positive predictive values (PPVs) of patients presenting with unexpected weight loss (UWL) being diagnosed with cancer within 6 months, using data from a population of Australian primary care patients to replicate results from a previous UK study. DESIGN: A diagnostic accuracy study involving calculation of the PPV for any cancer using retrospective data from routinely collected electronic healthcare records. The index date is defined as the first recorded UWL presentation and the reference standard is cancer diagnosis within 6 months of the index date. SETTING: This study uses primary care data from the Patron primary care database, linked to hospital admissions data and the Victorian Cancer Registry. We include only patients who presented to their General Practitioners (GPs) at least once between 1 July 2007 and 1 February 2022. PARTICIPANT: Patients were included if they were at least 18 years of age at the index date, had no previous diagnosis of cancer or previous weight loss intervention, including being prescribed medications for weight loss. 13 306 patients out of a primary care population of 1 791 051 patients were identified that met the eligibility criteria. RESULTS: When stratified by age, sex and smoking status, we found PPVs lower than those derived in a previous UK primary care study, though still above 3% for male non-smokers over 60, female smokers over 70 and all males over 70. Patients from ages 60-79 with at least one abnormal blood test result had PPVs consistently above 3%, while overall, patients with abnormal blood test results have PPVs of up to 35%. CONCLUSION: We confirmed that many PPVs, while consistently below those derived in the UK study, are above clinically significant thresholds and increasing with age and the number of different abnormal blood test results
Rural Education for Regional and Community Development
No full textEducation in any of its forms (early years, primary, secondary, tertiary, and adult education) in rural and remote communities, plays a critical role in sustaining and developing regions. In this issue the articles describe programs and approaches that work to build the regional workforce and create socially inclusive communities. The articles include research that addresses concerns about attraction and retention of teachers, about the relationships and partnerships that improve learning outcomes, and about the importance of place consciousness in regional, rural, and remote contexts. The Rural Connections articles document good practice in providing access to tertiary education that otherwise would not be available, to grow the local workforce and provide pathways and awareness for young people considering their career options. In this editorial, we consider the findings presented using a policy and theoretical framework to help us consider the dynamics of rural education as an enabler for regional and community development