Exploring the acceptability of a risk prediction tool for cardiometabolic risk (gestational diabetes and hypertensive disorders of pregnancy) for use in early pregnancy: A qualitative study.

Problem/ Background: The acceptability of providing women with personalised cardiometabolic risk information using risk prediction tools early in pregnancy is not well understood.

Aim: To explore women's and healthcare professionals' perspectives of the acceptability of a prognostic, composite risk prediction tool for cardiometabolic risk (gestational diabetes and/or hypertensive disorders of pregnancy) for use in early pregnancy.

Methods: Semi-structured interviews were conducted to explore the acceptability of cardiometabolic risk prediction tools, preferences for risk communication and considerations for implementation into antenatal care.

Polygenic score distribution differences across European ancestry populations: implications for breast cancer risk prediction.

Background: The 313-variant polygenic risk score (PRS) provides a promising tool for clinical breast cancer risk prediction. However, evaluation of the PRS across different European populations which could influence risk estimation has not been performed.

Methods: We explored the distribution of PRS across European populations using genotype data from 94,072 females without breast cancer diagnosis, of European-ancestry from 21 countries participating in the Breast Cancer Association Consortium (BCAC) and 223,316 females without breast cancer diagnosis from the UK Biobank.

Factors associated with not smoking among Aboriginal and Torres Strait Islander adolescents and young people: Analysis of data from the 2014 to 15 National Aboriginal and Torres Strait Islander Social Survey.

Issue Addressed: Smoking rates have been steadily declining among Aboriginal and Torres Strait Islander people. Examining the factors associated with not smoking in young people is crucial for understanding the motivations and influences that lead individuals to adopt healthy behaviours.

Methods: Secondary analysis was undertaken of data collected as part of the National Aboriginal and Torres Strait Islander Social Survey (NATSISS) 2014-15 (n = 1456).

Association of clinical phenotypes of depression with comorbid conditions, treatment patterns and outcomes: a 10-year region-based cohort study.

Depression is a heterogeneous and complex psychological syndrome with highly variable manifestations, which poses difficulties for treatment and prognosis. Depression patients are prone to developing various comorbidities, which stem from different pathophysiological mechanisms, remaining largely understudied. The current study focused on identifying comorbidity-specific phenotypes, and whether these clustered phenotypes are associated with different treatment patterns, clinical manifestations, physiological characteristics, and prognosis.

Evaluation of agreement between common clustering strategies for DNA methylation-based subtyping of breast tumours.

Aims: Clustering algorithms have been widely applied to tumor DNA methylation datasets to define methylation-based cancer subtypes. This study aimed to evaluate the agreement between subtypes obtained from common clustering strategies.

Materials & Methods: We used tumor DNA methylation data from 409 women with breast cancer from the Melbourne Collaborative Cohort Study (MCCS) and 781 breast tumors from The Cancer Genome Atlas (TCGA).

Rationale and design of a large trial of perioperative ketamine for prevention of chronic post-surgical pain.

Background: Chronic post-surgical pain (CPSP) is recognised as one of the most common and debilitating complications of major surgery. Progression from acute to chronic pain after surgery involves sensitisation of central nervous system pathways with the N-methyl-D-aspartate (NMDA) receptor having a central role. Ketamine is a potent, non-selective NMDA antagonist commonly used for management of acute postoperative pain.

Accuracy of symptom checker for the diagnosis of sexually transmitted infections using machine learning and Bayesian network algorithms.

Background: A significant proportion of individuals with symptoms of sexually transmitted infection (STI) delay or avoid seeking healthcare, and digital diagnostic tools may prompt them to seek healthcare earlier. Unfortunately, none of the currently available tools fully mimic clinical assessment or cover a wide range of STIs.

Methods: We prospectively invited attendees presenting with STI-related symptoms at Melbourne Sexual Health Centre to answer gender-specific questionnaires covering the symptoms of 12 common STIs using a computer-assisted self-interviewing system between 2015 and 2018.

Content and face validity of preference-based quality of life instruments in indigenous youth experiencing mental health problems: a qualitative study.

Background: Mainstream preference-based quality of life (QoL) measures have been traditionally based on Western principles of health. It is critical to examine whether existing preference-based QoL measures capture what is important to Indigenous people while being comprehensive and culturally acceptable. This study aims to assess the content and face validity of the EuroQol-5 dimensions 5-levels (EQ-5D-5 L), 12-item short form survey (SF-12), assessment of quality of life-6 dimensions (AQoL-6D), and recovering quality of life 10-item (ReQoL-10) within the context of indigenous youth mental health.

Menopausal hormone therapy: assessing associations with breast and colorectal cancers by familial risk.

Menopausal users of hormone replacement therapy (HRT) are at increased breast cancer risk and decreased colorectal cancer (CRC) risk compared with individuals who have never used HRT, but these opposing associations may differ by familial risk of breast cancer and CRC. We harmonized data from 3 cohorts and generated separate breast cancer and CRC familial risk scores based on cancer family history. We defined moderate or strong family history as a risk score of 0.

Psilocybin and Motor Function: A Triple-Blind, Dose-Finding Study in Healthy Participants.

Background: There has been a resurgence of research into the potential therapeutic benefits of psychedelics for neuropsychiatric disorders. Classic psychedelics, such as psilocybin, exert complex effects on higher cognitive functions such as perception and awareness, but their impact on motor function remains unexplored. Moreover, there is a theoretical rationale for using psychedelics to promote motor retraining in certain neuropsychiatric conditions associated with motor dysfunction.

Linkage to care and prevention after HIV self-testing: a systematic review and meta-analysis.

Introduction: Effective linkage to prevention and care is a crucial step following HIV testing services. This systematic review aimed to determine the proportion of individuals linked to prevention and care after HIV self-testing (HIVST) and describe factors associated with linkage.

Methods: Following PRISMA guidelines, a comprehensive search across eight databases (2010-October 2023) identified studies on linkage to care after HIVST, defined as receiving a confirmatory test or initiating antiretroviral therapy (ART) if the self-test was reactive, and/or pre-exposure prophylaxis (PrEP) if the self-test was non-reactive.

Outcomes for older patients with subarachnoid haemorrhage who require admission to an Australian intensive care unit.

Background: Advanced age is an independent risk factor for poor outcomes following aneurysmal subarachnoid haemorrhage (SAH). However, Australian data are lacking. Our aim was to evaluate outcomes for older patients admitted to an Australian intensive care unit for management of aneurysmal SAH.

Home-Based Exercise and Self-Management After Lung Cancer Resection: A Randomized Clinical Trial.

Importance: Patients with lung cancer have poor physical functioning and quality of life. Despite promising outcomes for those who undertake exercise programs, implementation into practice of previously tested hospital-based programs is rare.

Objective: To evaluate a home-based exercise and self-management program for patients after lung resection.

Biases in Routine Influenza Surveillance Indicators Used to Monitor Infection Incidence and Recommendations for Improvement.

Background: Monitoring how the incidence of influenza infections changes over time is important for quantifying the transmission dynamics and clinical severity of influenza. Infection incidence is difficult to measure directly, and hence, other quantities which are more amenable to surveillance are used to monitor trends in infection levels, with the implicit assumption that they correlate with infection incidence.

Methods: Here, we demonstrate, through mathematical reasoning using fundamental mathematical principles, the relationship between the incidence of influenza infections and three commonly reported surveillance indicators: (1) the rate per unit time of influenza-like illness reported through sentinel healthcare sites, (2) the rate per unit time of laboratory-confirmed influenza infections and (3) the proportion of laboratory tests positive for influenza ('test-positive proportion').

Associations between life-course FEV/FVC trajectories and respiratory symptoms up to middle age: analysis of data from two prospective cohort studies.

Background: Life-course lung function trajectories leading to airflow obstruction, as measured by impaired FEV/FVC (forced vital capacity), precede the onset of chronic obstructive pulmonary disease (COPD). We aimed to investigate whether individuals on impaired FEV/FVC trajectories have an increased burden of respiratory symptoms, including those who do not meet the spirometric criteria for COPD.

Methods: We analysed serial life-course data from two population-based cohort studies separately, which included respiratory symptoms and spirometry: the Tasmanian Longitudinal Health Study (TAHS, Australia) cohort was recruited at age 6-7 years and followed up until middle age (mean age 53 years; range 51-55); and the Coronary Artery Risk Development in Young Adults (CARDIA, USA) cohort was recruited at a mean age of 25 years (range 18-30) and followed up to a mean age of 55 years (range 47-64).

Perceptions of Illness Control, Coherence, and Self-Efficacy Following a Web-Based Lifestyle Program for Multiple Sclerosis: A Qualitative Analysis of Semistructured Interviews.

Background: Evidence suggests that illness perceptions held by people living with multiple sclerosis (MS) impact affective distress and physical health outcomes. In a randomized controlled trial, we developed 2 MS Online Courses-the standard care course and the intervention course (IC). The IC was adapted from an evidence-based lifestyle program.

Plasma prolactin and postmenopausal breast cancer risk: a pooled analysis of four prospective cohort studies.

Background: Prolactin, a hormone produced by the pituitary gland, regulates breast development and may contribute to breast cancer etiology. However, most epidemiologic studies of prolactin and breast cancer have been restricted to single, often small, study samples with limited exploration of effect modification.

Methods: The Biomarkers in Breast Cancer Risk Prediction consortium includes 8,279 postmenopausal women sampled from four prospective cohort studies, of whom 3,441 were diagnosed with invasive breast cancer after enrollment.

Parkinson's Disease Polygenic Risk Score and Neurological Involvement in Carriers of the FMR1 Premutation Allele: A Case for Genetic Modifier.

Background: Premutation alleles of the FMR1 X-linked gene containing CGG repeat expansions ranging from 55 to 200 are associated with diverse late-onset neurological involvements, including most severe disorder termed Fragile X-associated Tremor/Ataxia Syndrome (FXTAS). It is intriguing that at least one-third of male, and a much lower than predicted from the X-linkage proportion of female carriers are free of this syndrome. This suggests the existence of secondary genetic factors modifying the risk of neurological involvements in these carriers.

Associations of blood lipids and LDL cholesterol lowering drug-targets with colorectal cancer risk: a Mendelian randomisation study.

Background: Whether blood lipids are causally associated with colorectal cancer (CRC) risk remains unclear.

Methods: Using two-sample Mendelian randomisation (MR), our study examined the associations of genetically-predicted blood concentrations of lipids and lipoproteins (primary: LDL-C, HDL-C, triglycerides, and total cholesterol), and genetically-proxied inhibition of HMGCR, NPC1L1, and PCSK9 (which mimic therapeutic effects of LDL-lowering drugs), with risks of CRC and its subsites. Genetic associations with lipids were obtained from the Global Lipids Genetics Consortium (n = 1,320,016), while genetic associations with CRC were obtained from the largest existing CRC consortium (n = 58,221 cases and 67,694 controls).

Causal debiasing for unknown bias in histopathology-A colon cancer use case.

Advancement of AI has opened new possibility for accurate diagnosis and prognosis using digital histopathology slides which not only saves hours of expert effort but also makes the estimation more standardized and accurate. However, preserving the AI model performance on the external sites is an extremely challenging problem in the histopathology domain which is primarily due to the difference in data acquisition and/or sampling bias. Although, AI models can also learn spurious correlation, they provide unequal performance across validation population.

Preferences for attributes of an artificial intelligence-based risk assessment tool for HIV and sexually transmitted infections: a discrete choice experiment.

Introduction: Early detection and treatment of HIV and sexually transmitted infections (STIs) are crucial for effective control. We previously developed MySTIRisk, an artificial intelligence-based risk tool that predicts the risk of HIV and STIs. We examined the attributes that encourage potential users to use it.

System Dynamics Modeling of Caries Severity States in Long-Term Care.

Dental caries among long-term care (LTC) residents is a persistent and complex problem driven by social and structural factors. Systems thinking may be useful in considering novel approaches to reducing disease. This study aimed to develop a system dynamics model to simulate the progression of dentate older adults in LTC through caries severity states and estimate the effects of 3 intervention scenarios on the progression of caries: preventive topical fluoride (TF), arrest of caries with silver diamine fluoride (SDF), and a combination of TF and SDF.