A Qualitative Descriptive Study of Rural Primary Healthcare Professionals' Capacity for Disaster Health Management Before and During the COVID-19 Pandemic.

Introduction: Rural areas face additional challenges in preventing, preparing for, responding to, and recovering from disasters. This study aimed to understand how rural primary healthcare professionals (PHCPs) perceive their roles, involvement, and capacity in disaster health management.

Methods: For this qualitative descriptive research, semi-structured interviews were carried out with convenience and purposive samples of rural PHCPs before and during the COVID-19 pandemic.

In Vitro Three-Dimensional (3D) Models for Melanoma Immunotherapy.

Melanoma is responsible for the majority of skin cancer-related fatalities. Immune checkpoint inhibitor (ICI) treatments have revolutionized the management of the disease by significantly increasing patient survival rates. However, a considerable number of tumors treated with these drugs fail to respond or may develop resistance over time.

The Effect of Frontal Deformity at the Ankle Joint on Total Ankle Arthroplasty Revision Rate.

The presence of severe coronal plane deformity in the ankle joint is widely recognized as challenging to correct by total ankle joint arthroplasty alone, necessitating additional rearfoot fusion. The primary aim of this retrospective study was to investigate the potential associations between the presence or severity of coronal tibiotalar deformities and adverse outcomes after isolated total ankle arthroplasty, such as revisions and complications. The secondary aim was to analyze the potential associations between comorbidities, demographics, and implant types, and adverse outcomes.

Multicellular bioprinted skin facilitates human-like skin architecture in vivo.

Bioprinting is a promising alternative method to generate skin substitutes because it can replicate the structural organization of the skin into biomimetic layers in vitro. In this study, six primary human skin cell types were used to bioprint a trilayer skin construct consisting of epidermis, dermis, and hypodermis. Transplantation of the bioprinted skin with human cells onto full-thickness wounds of nu/nu mice promoted rapid vascularization and formation of epidermal rete ridges analogous to the native human epidermis, with a normal-looking extracellular matrix.

Medical 3D Printing: Tools and Techniques, Today and Tomorrow.

Three-dimensional printing is a still-emerging technology with high impact for the medical community, particularly in the development of tissues for the clinic. Many types of printers are under development, including extrusion, droplet, melt, and light-curing technologies. Herein we discuss the various types of 3D printers and their strengths and weaknesses concerning tissue engineering.

Potential role of general practice in reducing emergency department demand: A qualitative study.

Objective: To inform local, state and national strategies intended to reduce demand for ED care, the present study aimed to identify key factors influencing the current provision of acute care within primary healthcare (PHC) and explore the policy and system changes potentially required.

Methods: Semi-structured interviews with key stakeholders were audio-recorded, transcribed verbatim and analysed through content and thematic approaches incorporating the Walt and Gilson health policy framework.

Results: Eleven interviews were conducted.

Bioprinting Au Natural: The Biologics of Bioinks.

The development of appropriate bioinks is a complex task, dependent on the mechanical and biochemical requirements of the final construct and the type of printer used for fabrication. The two most common tissue printers are micro-extrusion and digital light projection printers. Here we briefly discuss the required characteristics of a bioink for each of these printing processes.

Night shift work undertaken by women and fertility treatment interact to increase prevalence of urogenital anomalies in children.

Objective: To investigate the role of maternal night shift work in occurrence of urogenital anomalies in offspring, considering a possible interaction with mode of conception.

Methods: A population-based cohort comprising births in South Australia (1986-2002) was produced via linkage of fertility clinic records, perinatal and birth defects data. This study concerned first births to women in paid employment (n=98 103).

Disaster Management in Rural and Remote Primary Health Care: A Scoping Review.

Objective: This scoping review aims to map the roles of rural and remote primary health care professionals (PHCPs) during disasters.

Introduction: Disasters can have catastrophic impacts on society and are broadly classified into natural events, man-made incidents, or a mixture of both. The PHCPs working in rural and remote communities face additional challenges when dealing with disasters and have significant roles during the Prevention, Preparedness, Response, and Recovery (PPRR) stages of disaster management.

Extrusion-Based Bioprinting: Current Standards and Relevancy for Human-Sized Tissue Fabrication.

The field of bioengineering has long pursued the goal of fabricating large-scale tissue constructs for use both in vitro and in vivo. Recent technological advances have indicated that bioprinting will be a key technique in manufacturing these specimens. This chapter aims to provide an overview of what has been achieved to date through the use of microextrusion bioprinters and what major challenges still impede progress.

Disaster management in rural and remote primary healthcare settings: a scoping review protocol.

Objective: This scoping review aims to systematically identify and map the roles of primary healthcare professionals in rural and remote areas during natural, man-made and pandemic disasters.

Introduction: Disasters can be caused by natural events, man-made incidents or infective agents resulting in a pandemic. Healthcare practitioners working in primary care settings have important roles during disaster prevention, preparedness, response and recovery.

Circadian mismatch and cardiovascular response to a performance challenge: Larks in morning and evening work sessions.

We presented morning chronotype ("Lark") university undergraduate volunteers a more or less difficult Sternberg-type recognition memory task either in the morning (8-11 am) or in the evening (5-8 pm) with instructions that they could win a prize if they were 85% successful. We established morning chronotype using the Composite Scale for Morningness (Smith et al., 1989), employing a tertile split on a pool of scale scores that ranged from 13 (extreme eveningness) to 55 (extreme morningness).

Improving haemodynamic optimization of cardiac resynchronization therapy for heart failure.

Objective: Optimization of cardiac resynchronization therapy using non-invasive haemodynamic parameters produces reliable optima when performed at high atrial paced heart rates. Here we investigate whether this is a result of increased heart rate or atrial pacing itself.

Approach: Forty-three patients with cardiac resynchronization therapy underwent haemodynamic optimization of atrioventricular (AV) delay using non-invasive beat-to-beat systolic blood pressure in three states: rest (atrial-sensing, 66  ±  11 bpm), slow atrial pacing (73  ±  12 bpm), and fast atrial pacing (94  ±  10 bpm).

Strategy for peptide quantification using LC-MS in regulated bioanalysis: case study with a glucose-responsive insulin.

Advances in technology have led to a shift for peptide quantification from traditional ligand-binding assays to LC-MS/MS-based analysis, which presents challenges, in other assay sensitivity, specificity and ruggedness, in addition to lacking of regulatory guidance, especially for the hybrid assay format. Methodology & results: This report communicates a strategy that has been employed in our laboratories for method development and assay validation, and exemplified in a case study of MK-2640, a glucose-responsive insulin, in multiple matrices. Intact MK-2640 was monitored, while immunoaffinity purification and SPE were used to support the rat/dog GLP and clinical studies, respectively.

Distinct impacts of heart rate and right atrial-pacing on left atrial mechanical activation and optimal AV delay in CRT.

Background: Controversy exists regarding how atrial activation mode and heart rate affect optimal atrioventricular (AV) delay in cardiac resynchronization therapy. We studied these questions using high-reproducibility hemodynamic and echocardiographic measurements.

Methods: Twenty patients were hemodynamically optimized using noninvasive beat-to-beat blood pressure at rest (62 ± 11 beats/min), during exercise (80 ± 6 beats/min), and at three atrially paced rates: 5, 25, and 45 beats/min above rest, denoted as A , A , and A , respectively.

Managing antibiotics wisely: a quality improvement programme in a tertiary neonatal unit in the UK.

Microbial resistance to antibiotics is a serious global health problem compounded by antibiotic overuse and limited investment in new antibiotic research. Inappropriate perinatal antibiotic exposure is increasingly linked to lifelong adverse outcomes through its impact on the developing microbiome. Antibiotic stewardship may be the only effective preventative strategy currently available.

Risk of febrile neutropenia and early treatment cessation in men receiving standard and dose-reduced 3-weekly docetaxel for metastatic castration-resistant prostate cancer.

Background: Docetaxel is an effective therapy for metastatic castration-resistant prostate cancer (mCRPC); however, many patients experience febrile neutropenia (FN) and cease treatment early due to toxicity. It is not known whether lower dose (LD) q3-weekly docetaxel impacts toxicity or efficacy.

Methods: Multicenter retrospective study included 166 patients with mCRPC who received q3-weekly docetaxel between 2010 and 2015.

Effects of fish oils on ex vivo B-cell responses of obese subjects upon BCR/TLR stimulation: a pilot study.

The long-chain n-3 polyunsaturated fatty acids (LC-PUFAs) eicosapentaenoic (EPA) and docosahexaenoic acid (DHA) in fish oil have immunomodulatory properties. B cells are a poorly studied target of EPA/DHA in humans. Therefore, in this pilot study, we tested how n-3 LC-PUFAs influence B-cell responses of obese humans.

Sperm donation perinatal outcomes in an Australian population cohort.

Aim: To compare perinatal outcomes for neonates conceived with donated sperm with those for neonates conceived spontaneously in an Australian population cohort.

Methods: Perinatal outcomes for all births in South Australia for the period January 1986-December 2002 were linked with assisted reproductive treatment records to determine those conceived from donated sperm. Birth outcome measures were analyzed using Student's t-test and logistic regression using generalized estimating equations to determine statistical significance.

Maternal factors and the risk of birth defects after IVF and ICSI: a whole of population cohort study.

Objective: To assess the contribution of maternal factors to major birth defects after in vitro fertilisation (IVF), intracytoplasmic sperm injection (ICSI), and natural conception.

Design: Retrospective cohort study in South Australia for the period January 1986 to December 2002.

Setting: A whole of population study.

Resonance as the Mechanism of Daytime Periodic Breathing in Patients with Heart Failure.

Rationale: In patients with chronic heart failure, daytime oscillatory breathing at rest is associated with a high risk of mortality. Experimental evidence, including exaggerated ventilatory responses to CO and prolonged circulation time, implicates the ventilatory control system and suggests feedback instability (loop gain > 1) is responsible. However, daytime oscillatory patterns often appear remarkably irregular versus classic instability (Cheyne-Stokes respiration), suggesting our mechanistic understanding is limited.

Spontaneous loss of a co-twin and the risk of birth defects after assisted conception.

The study of very early pregnancy loss is impractical in the general population, but possible amongst infertility patients receiving carefully monitored treatments. We examined the association between fetal loss and the risk of birth defects in the surviving co-twin in a retrospective cohort study of infertility patients within an infertility clinic in South Australia from January 1986 to December 2002, linked to population registries for births, terminations and birth defects. The study population consisted of a total of 5683 births.

A long-term follow-up of patients with prolonged asystole of greater than 15s on head-up tilt testing.

Background: Head-up tilt (HUT) is used for diagnosis of vasovagal syncope (VVS), and can provoke cardioinhibition. VVS is usually considered benign, however pacemaker insertion may be indicated in some patients. We sought to characterize the long-term outcomes of patients with prolonged asystole (>15s) on HUT.

Automated speckle tracking algorithm to aid on-axis imaging in echocardiography.

Obtaining a "correct" view in echocardiography is a subjective process in which an operator attempts to obtain images conforming to consensus standard views. Real-time objective quantification of image alignment may assist less experienced operators, but no reliable index yet exists. We present a fully automated algorithm for detecting incorrect medial/lateral translation of an ultrasound probe by image analysis.

Defining the real-world reproducibility of visual grading of left ventricular function and visual estimation of left ventricular ejection fraction: impact of image quality, experience and accreditation.

Left ventricular function can be evaluated by qualitative grading and by eyeball estimation of ejection fraction (EF). We sought to define the reproducibility of these techniques, and how they are affected by image quality, experience and accreditation. Twenty apical four-chamber echocardiographic cine loops (Online Resource 1-20) of varying image quality and left ventricular function were anonymized and presented to 35 operators.