Minerva Elements (Restricted Access: Repository Staff Only)

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Rates and causes of death after release from incarceration among 1 471 526 people in eight high-income and middle-income countries: an individual participant data meta-analysis.

Borschmann, R ; Mortality After Release from Incarceration Consortium (MARIC) collaborators, ; Kinner, SA (Elsevier BV, 2024-04-10)

BACKGROUND: Formerly incarcerated people have exceptionally poor health profiles and are at increased risk of preventable mortality when compared with their general population peers. However, not enough is known about the epidemiology of mortality in this population-specifically the rates, causes, and timing of death in specific subgroups and regions-to inform the development of targeted, evidence-based responses. We aimed to document the incidence, timing, causes, and risk factors for mortality after release from incarceration. METHODS: We analysed linked administrative data from the multi-national Mortality After Release from Incarceration Consortium (MARIC) study. We examined mortality outcomes for 1 471 526 people released from incarceration in eight countries (Australia, Brazil, Canada, New Zealand, Norway, Scotland, Sweden, and the USA) from 1980 to 2018, across 10 534 441 person-years of follow-up (range 0-24 years per person). We combined data from 18 cohort studies using two-step individual participant data meta-analyses to estimate pooled all-cause and cause-specific crude mortality rates (CMRs) per 100 000 person-years, for specific time periods (first, daily from days 1-14; second, weekly from weeks 3-12; third, weeks 13-52 combined; fourth, weeks 53 and over combined; and fifth, total follow-up) after release, overall and stratified by age, sex, and region. FINDINGS: 75 427 deaths were recorded. The all-cause CMR during the first week following release (1612 [95% CI 1048-2287]) was higher than during all other time periods (incidence rate ratio [IRR] compared with week 2: 1·5 [95% CI 1·2-1·8], I2=26·0%, weeks 3-4: 2·0 [1·5-2·6], I2=53·0%, and weeks 9-12: 2·2 [1·6-3·0], I2=70·5%). The highest cause-specific mortality rates during the first week were due to alcohol and other drug poisoning (CMR 657 [95% CI 332-1076]), suicide (135 [36-277]), and cardiovascular disease (71 [16-153]). We observed considerable variation in cause-specific CMRs over time since release and across regions. Pooled all-cause CMRs were similar between males (731 [95% CI 630-839]) and females (660 [560-767]) and were higher in older age groups. INTERPRETATION: The markedly elevated rate of death in the first week post-release underscores an urgent need for investment in evidence-based, coordinated transitional healthcare, including treatment for mental illness and substance use disorders to prevent post-release deaths due to suicide and overdose. Temporal variations in rates and causes of death highlight the need for routine monitoring of post-release mortality. FUNDING: Australia's National Health and Medical Research Council.
Caries Detection in Primary Teeth Using Intraoral Scanners Featuring Fluorescence: Protocol for a Diagnostic Agreement Study

Jones, B ; Michou, S ; Chen, T ; Moreno-Betancur, M ; Kilpatrick, N ; Burgner, D ; Vannahme, C ; Silva, M (JMIR PUBLICATIONS, INC, 2023)

BACKGROUND: Digital methods that enable early caries identification can streamline data collection in research and optimize dental examinations for young children. Intraoral scanners are devices used for creating 3D models of teeth in dentistry and are being rapidly adopted into clinical workflows. Integrating fluorescence technology into scanner hardware can support early caries detection. However, the performance of caries detection methods using 3D models featuring color and fluorescence in primary teeth is unknown. OBJECTIVE: This study aims to assess the diagnostic agreement between visual examination (VE), on-screen assessment of 3D models in approximate natural colors with and without fluorescence, and application of an automated caries scoring system to the 3D models with fluorescence for caries detection in primary teeth. METHODS: The study sample will be drawn from eligible participants in a randomized controlled trial at the Royal Children's Hospital, Melbourne, Australia, where a dental assessment was conducted, including VE using the International Caries Detection and Assessment System (ICDAS) and intraoral scan using the TRIOS 4 (3Shape TRIOS A/S). Participant clinical records will be collected, and all records meeting eligibility criteria will be subject to an on-screen assessment of 3D models by 4 dental practitioners. First, all primary tooth surfaces will be examined for caries based on 3D geometry and color, using a merged ICDAS index. Second, the on-screen assessment of 3D models will include fluorescence, where caries will be classified using a merged ICDAS index that has been modified to incorporate fluorescence criteria. After 4 weeks, all examiners will repeat the on-screen assessment for all 3D models. Finally, an automated caries scoring system will be used to classify caries on primary occlusal surfaces. The agreement in the total number of caries detected per person between methods will be assessed using a Bland-Altman analysis and intraclass correlation coefficients. At a tooth surface level, agreement between methods will be estimated using multilevel models to account for the clustering of dental data. RESULTS: Automated caries scoring of 3D models was completed as of October 2023, with the publication of results expected by July 2024. On-screen assessment has commenced, with the expected completion of scoring and data analysis by March 2024. Results will be disseminated by the end of 2024. CONCLUSIONS: The study outcomes may inform new practices that use digital models to facilitate dental assessments. Novel approaches that enable remote dental examination without compromising the accuracy of VE have wide applications in the research environment, clinical practice, and the provision of teledentistry. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12622001237774; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384632. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/51578.
Neurodevelopmental outcomes in early childhood for infants born very preterm in countries outside the UK

Doyle, LW (BMJ PUBLISHING GROUP, 2024-03)
Endothelial Response to the Combined Biomechanics of Vessel Stiffness and Shear Stress Is Regulated via Piezo1

Lai, A ; Zhou, Y ; Thurgood, P ; Chheang, C ; Sekar, NC ; Nguyen, N ; Peter, K ; Khoshmanesh, K ; Baratchi, S (AMER CHEMICAL SOC, 2023-12-11)

How endothelial cells sense and respond to dynamic changes in their biophysical surroundings as we age is not fully understood. Vascular stiffness is clearly a contributing factor not only in several cardiovascular diseases but also in physiological processes such as aging and vascular dementia. To address this gap, we utilized a microfluidic model to explore how substrate stiffness in the presence of shear stress affects endothelial morphology, senescence, proliferation, and inflammation. We also studied the role of mechanosensitive ion channel Piezo1 in endothelial responses under the combined effect of shear stress and substrate stiffness. To do so, we cultured endothelial cells inside microfluidic channels covered with fibronectin-coated elastomer with elastic moduli of 40 and 200 kPa, respectively, mimicking the stiffness of the vessel walls in young and aged arteries. The endothelial cells were exposed to atheroprotective and atherogenic shear stress levels of 10 and 2 dyn/cm2, respectively. Our findings show that substrate stiffness affects senescence under atheroprotective flow conditions and cytoskeleton remodeling, senescence, and inflammation under atherogenic flow conditions. Additionally, we found that the expression of Piezo1 plays a crucial role in endothelial adaptation to flow and regulation of inflammation under both atheroprotective and atherogenic shear stress levels. However, Piezo1 contribution to endothelial senescence was limited to the soft substrate and atheroprotective shear stress level. Overall, our study characterizes the response of endothelial cells to the combined effect of shear stress and substrate stiffness and reveals a previously unidentified role of Piezo1 in endothelial response to vessel stiffening, which potentially can be therapeutically targeted to alleviate endothelial dysfunction in aging adults.
A microfluidic model to study the effects of arrhythmic flows on endothelial cells

Lai, A ; Hawke, A ; Mohammed, M ; Thurgood, P ; Concilia, G ; Peter, K ; Khoshmanesh, K ; Baratchi, S (ROYAL SOC CHEMISTRY, 2024-04-16)

Atrial fibrillation (AF) is the most common type of cardiac arrhythmia and an important contributor to morbidity and mortality. Endothelial dysfunction has been postulated to be an important contributing factor in cardiovascular events in patients with AF. However, how vascular endothelial cells respond to arrhythmic flow is not fully understood, mainly due to the limitation of current in vitro systems to mimic arrhythmic flow conditions. To address this limitation, we developed a microfluidic system to study the effect of arrhythmic flow on the mechanobiology of human aortic endothelial cells (HAECs). The system utilises a computer-controlled piezoelectric pump for generating arrhythmic flow with a unique ability to control the variability in both the frequency and amplitude of pulse waves. The flow rate is modulated to reflect physiological or pathophysiological shear stress levels on endothelial cells. This enabled us to systematically dissect the importance of variability in the frequency and amplitude of pulses and shear stress level on endothelial cell mechanobiology. Our results indicated that arrhythmic flow at physiological shear stress level promotes endothelial cell spreading and reduces the plasma membrane-to-cytoplasmic distribution of β-catenin. In contrast, arrhythmic flow at low and atherogenic shear stress levels does not promote endothelial cell spreading or redistribution of β-catenin. Interestingly, under both shear stress levels, arrhythmic flow induces inflammation by promoting monocyte adhesion via an increase in ICAM-1 expression. Collectively, our microfluidic system provides opportunities to study the effect of arrhythmic flows on vascular endothelial mechanobiology in a systematic and reproducible manner.
REDV-Functionalized Recombinant Spider Silk for Next-Generation Coronary Artery Stent Coatings: Hemocompatible, Drug-Eluting, and Endothelial Cell-Specific Materials

Mayer, K ; Ruhoff, A ; Chan, NJ ; Waterhouse, A ; O'Connor, AJ ; Scheibel, T ; Heath, DE (AMER CHEMICAL SOC, 2024-03-27)

Coronary artery stents are life-saving devices, and millions of these devices are implanted annually to treat coronary heart disease. The current gold standard in treatment is drug-eluting stents, which are coated with a biodegradable polymer layer that elutes antiproliferative drugs to prevent restenosis due to neointimal hyperplasia. Stenting is commonly paired with systemic antiplatelet therapy to prevent stent thrombosis. Despite their clinical success, current stents have significant limitations including inducing local inflammation that drives hyperplasia; a lack of hemocompatibility that promotes thrombosis, increasing need for antiplatelet therapy; and limited endothelialization, which is a critical step in the healing process. In this research, we designed a novel material for use as a next-generation coating for drug-eluting stents that addresses the limitations described above. Specifically, we developed a recombinant spider silk material that is functionalized with an REDV cell-adhesive ligand, a peptide motif that promotes specific adhesion of endothelial cells in the cardiovascular environment. We illustrated that this REDV-modified spider silk variant [eADF4(C16)-REDV] is an endothelial-cell-specific material that can promote the formation of a near-confluent endothelium. We additionally performed hemocompatibility assays using human whole blood and demonstrated that spider silk materials exhibit excellent hemocompatibility under both static and flow conditions. Furthermore, we showed that the material displayed slow enzyme-mediated degradation. Finally, we illustrated the ability to load and release the clinically relevant drug everolimus from recombinant spider silk coatings in a quantity and at a rate similar to that of commercial devices. These results support the use of REDV-functionalized recombinant spider silk as a coating for drug-eluting stents.
Strengthening the role of innovation brokers in the livestock advisory services system of Pakistan

Warriach, HM ; Ayre, M ; Nettle, R ; Height, K ; Iqbal, H ; Aziz, A ; Hayat, K ; Afzal, A ; Majeed, S ; Kumbher, A ; McGill, DM ; Bush, R (CSIRO Publishing, )

Context This article assesses development and implementation of a non-traditional training ‘whole-family extension approach’ (WFEA) that contributes to the innovation-brokering capacity of farm advisors within the current livestock advisory services system of Pakistan. Aims The primary objectives of the research were to explore how the WFEA training leads to improved capacity and knowledge of farm advisors and then examine these through the lens of innovation brokers and the difference they can make within the extension system, including (1) articulation of problems and possibilities, (2) network building and (3) supporting negotiation and learning in networks. Methods A qualitative investigation was conducted during four facilitated discussions and three field follow-up visits following project interventions to build the capacity of 50 farm advisors from across a network of 22 organisations that are part of the Pakistani’s livestock extension system. Data were collected by using the following two qualitative approaches: (1) facilitated discussions, during each of the four separate training workshops; and (2) field follow-up visits, where farm advisors were interviewed following a set of semi-structured questions. The data were analysed to assess the changes observed across the different farm advisors during the training interventions and subsequent mentoring provided by the project team. Key results Gaps in innovation-brokering capacity from WFEA were identified and include co-designing and more institutional support of various collaborating organisations, use of visioning tools, scenario analysis to predict possible future for the farm-advisor training and training of farm advisors on analytical skills to capture the household impacts; these should be incorporated in WFEA training. Conclusions A holistic extension training intervention approach (the WFEA) can positively influence the innovation-brokering capacity of farm advisors within the current livestock advisory services system of Pakistan. Implications This article has contributed to the literature on innovation-brokering roles in the livestock advisory systems by highlighting key additional functions of innovation-brokering in a developing-country context. Furthermore, examples from Pakistan can be used to show how farm advisors can develop skills in articulating problems and possibilities, network building and supporting negotiation and learning in networks.
Designing zero-emissions containerized last-mile delivery systems: A case study for melbourne

Sina Mohri, S ; Mohammadi, M ; Van Woensel, T (Elsevier BV, 2024-02)
Sensing Coherent Nuclear Spin Dynamics with an Ensemble of Paramagnetic Nitrogen Spins

Goldblatt, RM ; Martin, AM ; Wood, AA (American Physical Society (APS), )

The unpolarized spin environment surrounding a central spin qubit is typically considered as an incoherent source of dephasing, however, precise characterization and control of the spin bath can yield a resource for storing and sensing with quantum states. In this work, we use nitrogen-vacancy (NV) centers in diamond to measure the coherence of optically dark paramagnetic nitrogen defects (P1 centers) and detect coherent interactions between the P1 centers and a local bath of 13C nuclear spins. The dipolar coupling between the P1 centers and 13C nuclear spins is identified by signature periodic collapses and revivals in the P1 spin coherence signal. We then demonstrate, using a range of dynamical decoupling protocols, that the probing NV centers and the P1 spins are coupled to independent ensembles of 13C nuclear spins. Our work illustrates how the optically dark P1 spins can be used to extract information from their local environment and offers new insight into the interactions within a many-body system. Published by the American Physical Society 2024
Identifying regions of importance in wall-bounded turbulence through explainable deep learning

Cremades, A ; Hoyas, S ; Deshpande, R ; Quintero, P ; Lellep, M ; Lee, WJ ; Monty, JP ; Hutchins, N ; Linkmann, M ; Marusic, I ; Vinuesa, R (Springer Science and Business Media LLC, )

Abstract Despite its great scientific and technological importance, wall-bounded turbulence is an unresolved problem in classical physics that requires new perspectives to be tackled. One of the key strategies has been to study interactions among the energy-containing coherent structures in the flow. Such interactions are explored in this study using an explainable deep-learning method. The instantaneous velocity field obtained from a turbulent channel flow simulation is used to predict the velocity field in time through a U-net architecture. Based on the predicted flow, we assess the importance of each structure for this prediction using the game-theoretic algorithm of SHapley Additive exPlanations (SHAP). This work provides results in agreement with previous observations in the literature and extends them by revealing that the most important structures in the flow are not necessarily the ones with the highest contribution to the Reynolds shear stress. We also apply the method to an experimental database, where we can identify structures based on their importance score. This framework has the potential to shed light on numerous fundamental phenomena of wall-bounded turbulence, including novel strategies for flow control.

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