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Population variation in physiological and behavioural responses to artificial light at night
No full textArtificial light at night (ALAN) is a ubiquitous urban stressor that disrupts circadian and seasonal behaviour and is associated with a reduction in health and fitness in a range of species. However, little is known about population-level variation in such responses, which inhibits our understanding of the magnitude and scale of ALAN's phenotypic and evolutionary effects. We explored the life-history and behavioural responses of three populations (urban, semirural and rural) of Australian field crickets, Teleogryllus commodus, reared in common garden conditions but exposed to either chronic ALAN or dark-at-night conditions over their lifetime. We measured male and female developmental duration, body mass and condition and gonadic investment. To separate the impacts of developmental versus immediate ALAN exposure on adult behavioural responses, we tested female responses to male advertisement calls in the presence or absence of an artificial light source. ALAN negatively affected survival in both sexes and reduced body condition in males. Female mate-searching depended on the interaction of developmental ALAN exposure, immediate ALAN exposure and population origin, consistent with the context-specificity of female behavioural responses. There was considerable population variation in the majority of life-history and behavioural traits measured. These differences may be driven by variation in density, resource availability, predator-prey dynamics and, potentially, the level of historical exposure to ALAN at each site. Understanding the impact of ALAN, both within and across populations, is critical in informing conservation management strategies in response to an increasingly urbanized world
Prevalence of depressive symptoms, suicidal ideation and behaviours in young people presenting with a first episode of psychosis
No full textOBJECTIVES: Suicide accounts for a proportion of the early mortality in people affected by psychotic disorders. The early phase of illness can represent a particularly high-risk time for suicide. Therefore, in a cohort of young people presenting with first-episode psychosis, this study aimed to determine: (i) the prevalence of suicidal ideation, intent with plan and self-harm and any associated demographic or clinical factors and (ii) the prevalence of depressive symptoms and any associated demographic or clinical factors. METHODS: Young people with a first episode of psychosis attending the Early Psychosis Prevention and Intervention Centre in Melbourne were included. Suicidal behaviours were recorded using a structured risk assessment - 'Clinical Risk Assessment and Management in the Community', and depressive symptoms were measured using the PHQ-9. RESULTS: A total of 355 young people were included in the study. 57.2% were male, 95.4% were single and over one quarter were migrants. At the time of presentation, 34.6% had suicidal ideation, 6.2% had suicidal intent with a plan, and 21.4% had engaged in self-harm before their presentation. Combined, 39.7% (n = 141) presented with suicidal ideation, intent with plan or self-harm. A total of 71.5% (n = 118) had moderately severe or severe depressive symptoms, which was strongly associated with suicidal ideation or behaviours at the time of presentation (OR = 4.21, 95% C.I. 2.10-8.44). CONCLUSIONS: Depressive symptoms, self-harm and suicidal behaviours are commonly present in the early phases of a psychotic disorder, which has important clinical implications for assessment and management
Data quality and representativeness of older respondents in the HILDA Survey
No full textKeeping respondents engaged through various life stages is an important part of any longitudinal survey or panel. For older-aged respondents, two such transitions are retirement and declining health. We use the Household, Income, and Labour Dynamics in Australia (HILDA) Survey, a household panel survey collecting data since 2001, to examine the representativeness of sample members across three age groups: 55–64, 65–74, and 75 and over. We first examine the response rates, item non-response and the coverage of individuals in nursing homes. We then compare population estimates from the HILDA Survey to those from a range of official sources covering demographic, labour market, and health domains. We find that the response rates are reasonably high, with a notable drop in the two oldest cohorts during the COVID-19 pandemic. Item non-response is low and does not vary greatly by age. The coverage in nursing homes is very dependent on access and the individuals being able to provide an interview. We find overall strong alignment to official statistics for these three cohorts. A notable exception is health status, where the HILDA Survey respondents report lower levels of health, likely due to advantageous panel conditioning
Air pollution exceedance events in Melbourne and Sydney, Australia, between 2000 and 2024
No full textAir pollution events pose significant challenges to public health in Melbourne and Sydney, Australia’s most populous cities. This study evaluates publicly available data to understand the frequency of air pollution exceedance events beyond World Health Organization (WHO) guidelines, as well as national and state standards. The air quality of both cities generally complies with national standards but consistently fails to meet WHO air quality guidelines. Since 2000, Sydney recorded single-pollutant events on 43% of monitored days and multi-pollutant events on 14% of monitored days. In Melbourne, single-pollutant events were recorded on 42% of monitored days, and multi-pollutant events on 8%. In Sydney, NO2 exceeded WHO guidelines on 52% of monitored days, PM2.5 on 13%, PM10 on 4%, and O3 on 6%. In Melbourne, NO2 exceeded on 47% of monitored days, PM2.5 on 4%, PM10 on 6%, and O3 on 2%. Evaluating long-term, city-scale air quality is challenging due to significant variations in spatial and temporal data coverage, especially in Melbourne. Many monitoring stations have limited temporal coverage and do not consistently monitor all key pollutants, meaning the true extent of air pollution is likely not fully captured. Since 2017, Melbourne has had only five active monitoring stations, compared to over 15 in Sydney. This study demonstrates the urgent need for expanded air pollution monitoring networks in Australia’s largest cities and highlights the need for ongoing research into the impacts of multi- as well as single-pollutant exceedance events
Pharmacodynamics of Vancomycin Against Coagulase-Negative Staphylococci Bloodstream Infections
No full textThe recommended therapeutic target for vancomycin for serious methicillin-resistant S. aureus infections is an area under the concentration–time curve (AUC) over 24 h to a minimum inhibitory concentration (MIC) ratio of ≥ 400. Its applicability to coagulase-negative staphylococcal (CoNS) bloodstream infections is unclear. Our review aims to determine the pharmacodynamic target of vancomycin for CoNS bloodstream infections. In January 2025, MEDLINE, Embase, and PubMed were searched to identify manuscripts reporting the relationship between vancomycin drug exposure (AUC) and bactericidal activity or clinical response for CoNS. Studies of alternative drug delivery systems/formulations, combination therapy, prophylaxis, other infections, and static in vitro studies were excluded. Overall, six articles were included. One in vivo study in young infants found that an AUC0-24 ≥ 300 mg/L·h and AUC24 ≥ 424 mg/L·h were associated with a 7.8-fold and 7.3-fold increased likelihood of bacteriological cure, respectively. Two studies in adults showed that an AUC24/MIC ratio ≥ 373 resulted in improved treatment success and microbiological eradication. An in vitro model demonstrated that a vancomycin AUC24/MIC ratio ≥ 665 achieved maximal bacterial killing, while a rabbit model linked an AUC24/MIC ≥ 520 to an 80% reduction in C-reactive protein. Early treatment within 24 h was associated with the greatest chance of bacteriological cure. Two studies of biofilm-embedded CoNS demonstrated inadequate bacterial killing at AUC24/MIC ratios of 260 and 354. Overall, or CoNS bloodstream infections, an AUC24 ≥ 424 mg/L·h (median MIC 1 mg/L) or AUC24/MIC ≥ 373 improves clinical outcomes. This review highlights the need for early effective vancomycin treatment. Alternative antibiotic therapy should be considered for biofilm-embedded CoNS infections
Impact of age and comorbidity on safety outcomes in phase 1 trial participants for metastatic solid malignancies
No full textINTRODUCTION: The number of phase 1 clinical trials has been increasing globally over the past decade. However, patient recruitment remains skewed towards younger populations with older adults remaining underrepresented, limiting generalizability. Few studies have systematically examined the role of comorbidities as a determinant of safety outcomes in phase 1 trials. Thus, we aimed to investigate the impact of age and comorbidity on safety outcomes of phase 1 trial participants. MATERIALS AND METHODS: This retrospective analysis examined electronic health records of patients aged ≥18 years enrolled in phase 1 trials for metastatic solid malignancies between January 2020 and May 2023. Patients were stratified into two age groups (12. Eastern Cooperative Oncology Group (ECOG) performance status was also evaluated. Logistic regression models assessed associations between age, comorbidity, and safety outcomes: serious adverse events (SAE), dose-limiting toxicities (DLT), dose reductions/interruptions (DR/DI), cessation of treatment due to toxicity (COTT), and grade 3-5 toxicities. RESULTS: We included 229 patients, of whom 51 (22%) were aged ≥70 years. Among them, 79 (34%) experienced an SAE, 109 (48%) had DR/DI, 34 (15%) had COTT, 17 (7%) had DLT, and 99 (43%) developed grade 3-5 adverse events. Age was not significantly associated with a higher likelihood of adverse safety outcomes. However, patients with ECI ≥4 had significantly higher likelihood of SAE than those with ECI <4 (50% vs. 31%, p = 0.04, OR: 2.18, 95% CI: 1.08-4.44). Patients with ECOG ≥1 had higher likelihood of SAE than those with ECOG 0 (42% vs. 29%, p = 0.06, OR: 1.75, 95% CI: 1.01-3.05, p = 0.05). Patients with ECOG ≥1 had significantly higher likelihood of grade 3-5 adverse events than those with ECOG 0 (52% vs. 36%, p = 0.03, OR: 1.89, 95% CI: 1.11-3.23, p = 0.02). Other comorbidity indices were not significantly associated with safety outcomes. DISCUSSION: Age alone was not associated with safety outcomes in phase 1 clinical trials for metastatic solid malignancies. Instead, comorbidity burden and ECOG performance status were predictors of adverse events in our cohort of patients
ABC-based forecasting in misspecified state space models
No full textApproximate Bayesian Computation (ABC) has gained popularity as a method for conducting inference and forecasting in complex models, most notably those which are intractable in some sense. In this paper, we use ABC to produce probabilistic forecasts in state space models (SSMs). Whilst ABC-based forecasting in correctly-specified SSMs has been studied, the misspecified case has not been investigated. It is this case that we emphasize. We invoke recent principles of ‘focused’ Bayesian prediction, whereby Bayesian updates are driven by a scoring rule that rewards predictive accuracy; the aim being to produce predictives that perform well in that rule, despite misspecification. Two methods are investigated for producing the focused predictions. In a simulation setting, ‘coherent’ predictions are in evidence for both methods. That is, the predictive constructed using a particular scoring rule often predicts best according to that rule. Importantly, both focused methods typically produce more accurate forecasts than an exact but misspecified predictive, in particular when the degree of misspecification is marked. An empirical application to a truly intractable SSM completes the paper
Defining early health technology assessment: building consensus using Delphi technique
No full textAlthough early health technology assessment (HTA) is increasingly being used to guide and inform decisions on product development, a consensus definition is currently lacking. A working group under the HTA International Society was established to develop a consensus-based definition of early HTA. The working group developed a definition using an iterative process that comprised five stages of work and included a two-round Delphi survey with 133 respondents in the first and 99 respondents in the second round of the survey, with various backgrounds and levels of expertise. Following this process, the working group reached the first consensus-based definition of early HTA, which is an HTA conducted to inform decisions about subsequent development, research, and/or investment by explicitly evaluating the potential value of a conceptual or actual health technology. In total, 86 (87 percent) of the 99 panelists who participated in the second round of the Delphi survey either strongly agreed or agreed with this definition. This consensus definition represents an important milestone in early HTA. It will enhance the uniformity of terminology, increasing the visibility of research and policy in this field. We also hope that it will act as a catalyst sparkling further research and developments in this discipline
Advances in magnesium-based bioresorbable cardiovascular stents: Surface engineering and clinical prospects
No full textMagnesium (Mg)-based bioresorbable stents represent a potentially groundbreaking advancement in cardiovascular therapy; offering temporary vessel support and complete biodegradability—addressing limitations of traditional stents like in-stent restenosis and long-term complications. However, challenges such as rapid corrosion and suboptimal endothelialisation have hindered their clinical adoption. This review highlights the latest breakthroughs in surface modification, alloying, and coating strategies to enhance the mechanical integrity, corrosion resistance, and biocompatibility of Mg-based stents. Key surface engineering techniques, including polymer and bioactive coatings, are examined for their role in promoting endothelial healing and minimising inflammatory responses. Future directions are proposed, focusing on personalised stent designs to optimize efficacy and long-term outcomes, positioning Mg-based stents as a transformative solution in interventional cardiology
Prevalence and Impact of Severe Mental Illness in the Australian Indigenous Population: A Comprehensive Review
No full textAbstract
To investigate the prevalence and impact of severe mental illness (SMI) within the Australian Indigenous population. A systematic search of existing literature and data sources was conducted, using PubMed, Web of Science, EMBASE, MEDLINE, PsycINFO, and SCOPUS, to collect and analyse information on the prevalence of SMI among Indigenous Australians. Screening, data extraction and risk of bias assessments were performed independently by three co-authors. Of the 3372 studies identified by the search strategy, 16 studies met the eligibility criteria and were reviewed in detail. Results indicated that the pooled prevalence of all SMI in health centre or community settings was 2.58% (95% CI 1.37–4.85), bipolar disorder was 0.32% (95% CI 0.01–17.48), schizophrenia was 1.39% (95% CI 0.86–2.25). The pooled prevalence of SMI in incarceration is 12.26% (95% CI 4.29–35.02). Indigenous Australians reported a higher prevalence of SMI than non-Indigenous Australians. Besides, one study showed that the incidence of metabolic syndrome (MetS) in Indigenous Australians with SMI (66%), higher than in non-Indigenous Australians (55%). There is an urgent need to address mental health inequality among the Indigenous Australians and conduct further research in the areas of standardized diagnostic methods, the relationship between SMI and incarceration, and the incidence of MetS