Provocation of brachial plexus and systemic symptoms during the elevated arm stress test in individuals with myalgic encephalomyelitis/chronic fatigue syndrome or idiopathic chronic fatigue.

Background: We have noted that some adolescents and young adults with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) report difficulty with arms-overhead activities, suggestive of brachial plexus dysfunction or thoracic outlet syndrome (TOS). In the TOS literature, diagnostic maneuvers focus on the provocation of upper limb symptoms (arm fatigue and heaviness, paresthesias, neck and upper back pain), but not on elicitation of systemic symptoms.

Objectives: To estimate the proportion of patients with fatiguing illness who experience local and systemic symptoms during a common maneuver used in evaluating TOS-the elevated arm stress test (EAST).

Causal Inference With Observational Data and Unobserved Confounding Variables.

Experiments have long been the gold standard for causal inference in Ecology. As Ecology tackles progressively larger problems, however, we are moving beyond the scales at which randomised controlled experiments are feasible. To answer causal questions at scale, we need to also use observational data -something Ecologists tend to view with great scepticism.

The ACTION VAD registry: A collective five-year experience.

Background: The Advanced Cardiac Therapies Improving Outcomes Network (ACTION) began in 2018 as a collaborative learning health system committed to improving outcomes in pediatric heart failure, including children and adults with congenital heart disease, supported with ventricular assist devices (VADs). This report describes patient and device characteristics, and outcomes through 1-year post-implant.

Methods: The ACTION VAD registry report was created from data submitted to the ACTION learning network from April 2018 to June 2023.

Performance Understanding and Learning System (PULSE-KEY): development of a framework for implementation and performance evaluation of healthcare delivery models of care.

Objectives: Efficient performance evaluation is essential for driving improvement, ensuring accountability and optimisation of outcomes in healthcare delivery. However, its complexity often leads to ineffective implementation. This article aims to advance the field of performance measurement within alternative healthcare delivery models of care through the development and validation of a comprehensive evaluation framework.

A Comparison of Peripherally Inserted Central Catheter Materials.

Background: New catheter materials for peripherally inserted central catheters (PICCs) may reduce the risk of device failure due to infectious, thrombotic, and catheter occlusion events. However, data from randomized trials comparing these catheters are lacking.

Methods: We conducted a randomized, controlled, superiority trial in three Australian tertiary hospitals.

Solution biophysics identifies lipid nanoparticle non-sphericity, polydispersity, and dependence on internal ordering for efficacious mRNA delivery.

Lipid nanoparticles (LNPs) are the most advanced delivery system currently available for RNA therapeutics. Their development has accelerated since the success of Patisiran, the first siRNA-LNP therapeutic, and the mRNA vaccines that emerged during the COVID-19 pandemic. Designing LNPs with specific targeting, high potency, and minimal side effects is crucial for their successful clinical use.

Transparency and Authority Concerns with Using AI to Make Ethical Recommendations in Clinical Settings.

In response to recent proposals to utilize artificial intelligence (AI) to automate ethics consultations in healthcare, we raise two main problems for the prospect of having healthcare professionals rely on AI-driven programs to provide ethical guidance in clinical matters. The first cause for concern is that, because these programs would effectively function like black boxes, this approach seems to preclude the kind of transparency that would allow clinical staff to explain and justify treatment decisions to patients, fellow caregivers, and those tasked with providing oversight. The other main problem is that the kind of authority that would need to be given to the guidance issuing from these programs in order to do the work set out for them would mean that clinical staff would not be empowered to provide meaningful safeguards against it in those cases when its recommendations are morally problematic.

Hospital-Acquired Complications in Critically Ill Children and PICU Length of Stay, Duration of Respiratory Support, and Economics: Propensity Score Matching in a Single-Center Cohort, 2015-2020.

Objectives: To identify the health and economic costs of hospital-acquired complications (HACs) in children who require PICU admission.

Design: Propensity score matched cohort study analyzing routinely collected medical and costing data collected by the health service over 6 years (2015-2020).

Setting: Tertiary referral PICU in Queensland, Australia.

Effects of Routine Catheterization on Urinary Tract Infection Rates After Minor Gynecologic Surgeries.

This pilot study describes urinary tract infection (UTI) rates after routine single catheterization during minor gynecologic surgeries at a tertiary care community hospital. Records from 762 patients from 2021 were reviewed, including procedures such as hysteroscopy, loop electrosurgical excision procedure, and dilation and curettage. Findings revealed a 42.

Small-Angle X-ray Scattering (SAXS) Combined with SAXS-Driven Molecular Dynamics for Structural Analysis of Multistranded RNA Assemblies.

Nucleic acids (RNA and DNA) play crucial roles in all living organisms and find wide utility in clinical settings. The convergence of rationally designed nucleic acid multistranded assemblies with embedded therapeutic properties has led to the development of a platform based on nucleic acid nanoparticles (NANPs). NANPs incorporate various functional moieties to deliver their combinations to diseased cells in a highly controlled manner.

Extended conformations of bifurcating electron transfer flavoprotein constitute up to half the population, possibly mediating conformational change.

Electron transfer bifurcation enables biological systems to drive unfavourable (endergonic) electron transfer by coupling it to favourable (exergonic) transfer of a second electron. In electron transfer flavoproteins (ETFs), a domain-scale conformational change is believed to sever the favourable pathway after a single electron has used it, thereby preventing the energy dissipation that would accompany exergonic transfer of the second electron. To understand the conformation change that participates in turnover, we have deployed small-angle neutron scattering (SANS) and computational techniques to characterize the bifurcating ETF from (ETF).

Patient reported outcome and experience measures among patients with central venous access devices: a systematic review.

Purpose: Patients receiving treatment for solid tumours and haematological malignancies, among other acute and chronic health conditions, are highly dependent upon central venous access devices (CVADs) for administering chemotherapy and other complex therapies; thus, CVADs can meaningfully impact their health outcomes and experiences. This systematic review aimed to identify and critique patient-reported outcome measure (PROM) and patient-reported experience measure (PREM) instruments related to CVADs.

Methods: A systematic review was undertaken, commencing with an electronic search of health databases (April 2022).

Coaching People with Cardiovascular Disease to Close Their "Treatment Gaps" Reduces Hospital Utilization, Saves Lives, and Delivers Net Cost Savings Over 10 Years.

Background: Disease management programs are an essential tool in the fight against rising prevalence and costs associated with cardiovascular disease (CVD). However, there is a lack of evidence on the long-term impact of these programs on clinical outcomes, healthcare utilization, and cost. This study presents a long-term follow up of clinical, healthcare utilization and cost, and mortality consequences of The COACH Program, a 6-month telephone delivered CVD prevention program.

Evaluating allied health primary contact models of care: A mixed methods analysis of current practice.

Rationale: Allied Health Primary Contact Clinic (AHPCC) models of care are increasingly used to manage growing demands on health service capacity. There is a critical need for new models of care to demonstrate value, however comprehensive evaluation of AHPCCs, including use of metrics frameworks like the Moretto framework, have been slow to uptake, and the reasons for this are unclear.

Aims And Objectives: To understand current evaluation practices as mapped to the Moretto framework, and explore clinician attitudes to the process of service evaluation across a variety of AHPCC models implemented within a metropolitan health service in Queensland, Australia.

Deals of a feather… Modelling latent classes in R&D collaboration data using finite mixture analysis.

This work explores if behaviour-based asymmetries are likely to impact deal valuation in the life sciences by examining positive public sentiment as a proxy for market behaviour when negotiating under asymmetric conditions to examine heterogeneity in research & development collaboration (RDC) deal data. We use public sentiment as a proxy for behaviour along with stage of development-based RDC deal data to search for latent classes in the deal data using finite mixture modelling. The analysis reveals a nuanced picture: public sentiment emerges as a significant predictor of deal value, but only for approximately 15% of the data set.

Vascular access devices for prolonged intravenous therapy regimens in people diagnosed with cancer.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the relative effectiveness and vascular access device (VAD)-related complications of VADs in people requiring prolonged systemic anti-cancer treatment.

SANS investigation of fungal loosenins reveal substrate dependent impacts of protein 1 action on inter-fibril distance and packing order of cellulosic substrates.

Background: Microbial expansin-related proteins include fungal loosenins, which have been previously shown to disrupt cellulose networks and enhance the enzymatic conversion of cellulosic substrates. Despite showing beneficial impacts to cellulose processing, detailed characterization of cellulosic materials after loosenin treatment is lacking. In this study, small-angle neutron scattering (SANS) was used to investigate the effects of three recombinantly produced loosenins that originate from Phanerochaete carnosa, PcaLOOL7, PcaLOOL9, and PcaLOOL12, on the organization of holocellulose preparations from Eucalyptus and Spruce wood samples.

Hospital staff perspectives on the cost and efficiency of peripheral intravenous catheter use: a case study from three Australian hospitals.

Peripheral intravenous catheters (PIVCs) are required by most hospitalised patients. Difficult intravenous access (DIVA) makes insertion challenging, with poor patient outcomes, treatment delays and resource waste from multiple insertion attempts, often by multiple clinicians. This exploratory qualitative case study aimed to investigate how clinical and executive hospital staff view PIVC insertions for patients with DIVA from a cost and efficiency perspective.

An engineered lactate oxidase based electrochemical sensor for continuous detection of biomarker lactic acid in human sweat and serum.

Lactate levels in humans reveal intensity and duration of exertion and provide a critical readout for the severity of life-threatening illnesses such as pediatric sepsis. Using the lactate oxidase enzyme (Lox) from , we demonstrated its functionality for lactate electrochemical sensing in physiological fluids in a lab setting. The structure and dynamics of LOx were validated by crystallography, X-ray scattering, and hydroxyl radical protein footprinting.

Conformational modulation and polymerization-induced folding of proteomimetic peptide brush polymers.

Peptide-brush polymers generated by graft-through living polymerization of peptide-modified monomers exhibit high proteolytic stability, therapeutic efficacy, and potential as functional tandem repeat protein mimetics. Prior work has focused on polymers generated from structurally disordered peptides that lack defined conformations. To obtain insight into how the structure of these polymers is influenced by the folding of their peptide sidechains, a set of polymers with varying degrees of polymerization was prepared from peptide monomers that adopt α-helical secondary structure for comparison to those having random coil structures.

Development of a Prioritization Framework to Aid Healthcare Funding Decision Making in Health Technology Assessment in Australia: Application of Multicriteria Decision Analysis.

Objectives: This study develops a prioritization framework to aid healthcare funding decision making in health technology assessment (HTA) in Australia using a multiple criteria decision analysis (MCDA) approach.

Methods: MCDA frameworks for HTAs were reviewed through literature survey to identify the initial criteria and levels within each criterion. Key stakeholders and experts were consulted to confirm these criteria and levels.