Paediatrics (RCH) - Research Publications

Permanent URI for this collection

Search Results

Now showing 1 - 10 of 5427
  • Item
    No Preview Available
    Effect of systematic tuberculosis detection on mortality in young children with severe pneumonia in countries with high incidence of tuberculosis: a stepped-wedge cluster-randomised trial
    Marcy, O ; Wobudeya, E ; Font, H ; Vessière, A ; Chabala, C ; Khosa, C ; Taguebue, J-V ; Moh, R ; Mwanga-Amumpaire, J ; Lounnas, M ; Mulenga, V ; Mavale, S ; Chilundo, J ; Rego, D ; Nduna, B ; Shankalala, P ; Chirwa, U ; De Lauzanne, A ; Dim, B ; Tiogouo Ngouana, E ; Folquet Amorrissani, M ; Cisse, L ; Amon Tanoh Dick, F ; Komena, EA ; Kwedi Nolna, S ; Businge, G ; Natukunda, N ; Cumbe, S ; Mbekeka, P ; Kim, A ; Kheang, C ; Pol, S ; Maleche-Obimbo, E ; Seddon, JA ; Mao, TE ; Graham, SM ; Delacourt, C ; Borand, L ; Bonnet, M ; Marcy, O ; Serre, A ; Badrichani, A ; Razafimanantsoa, M ; Poublan, J ; Vessière, A ; Roucher, C ; Occelli, E ; Beuscart, A ; Charpin, A ; Habiyambere, G ; Mesnier, S ; Balestre, E ; Bhatta, B ; Maillard, A-L ; Orne-Gliemann, J ; Baillet, E ; Koskas, N ; D'Elbée, M ; Gabillard, D ; Font, H ; Huyen, M ; Bonnet, M ; Lounnas, M ; Espérou, H ; Couffin-Cadiergues, S ; Kuppers, A ; Hamze, B ; BORAND, L ; de LAUZANNE, A ; DIM, B ; Keang, C ; PRING, L ; YIN, S ; SARITH, C ; PHAN, C ; NHEUONG, S ; LY, S ; KAING, S ; SRENG, V ; LUN, E ; SAY, L ; SUOM, S ; FERHY, R ; SO, D ; BORN, S ; PAL, S ; NANG, B ; MAO, TE ; KIM, A ; Srey, V ; Kan, P ; Hout, L ; Ith, S ; Oum, S ; Sau, S ; Ho, KH ; Kith, D ; Nuch, N ; Horm, CL ; Sophon, C ; Roeungdeth, B ; MENG, C ; RITH, R ; PHY, S ; SOR, C ; SAO, V ; KHAT, S ; MAK, B ; UY, A ; KHAY, S ; SOM, K ; HACH, R ; SOK, H ; KUON, S ; HENG, S ; SENG, A ; NIM, S ; PAN, R ; KIM, S ; SREY LEAP, K ; NET, B ; NOUN, V ; LAY, D ; MANY, C ; Seng, S ; Ly, V ; So, S ; Oun, S ; CHEY, S ; CHHEA, R ; BAONG, L ; THOUNG, V ; KHEANG, C ; BY, B ; Nguon, V ; MEACH, E ; Tek, S ; Ngeav, S ; Lun, T ; HEM, D ; CHUT, N ; SARIK, S ; NANG, H ; MEACH, M ; SRENG, S ; SAR, D ; KIN, R ; ROS, P ; DORN, C ; KAK, C ; Sambath, SL ; Son, L ; Bin, L ; Pengong, E ; Pol, S ; Khutsorn, S ; Seang, S ; Soun, V ; Vong, V ; Khoeung, C ; Um, P ; Bou, S ; Song Pich, S ; Nim, P ; Khat, S ; Ban Si, N ; Ream, S ; Ing, S ; Chann, P ; Ngeth, S ; Sun, M ; Chhoeung, S ; Sean, S ; Prak, R ; Taguebue, J-V ; Kwedi Nolna, S ; Amboua Schouame Onambele, A ; Hycenth, N ; Melingui, B ; Nkembe Medounmga, A ; Hougnang Tatmi, L ; Etemgoua, N ; Kouesso, V ; Bugin, J ; Nzedjom, C ; Ngoya, R ; Eyike, J ; Loudjom, E ; Lonsti, R ; Dang, L ; Bintar, E ; Njayong, C ; Ngonsoa O, C ; Ndzeukap, I ; Dzoyem, P ; Dzokou, C ; Dindo, B ; Moh, R ; Komena, EA ; Aka Bony, R ; Kouadio, C ; Danho, S ; Goli, M ; Folquet, M ; Itchy, MV ; Sidibé, A ; Cissé, L ; Ouattara, J ; Konaté, M ; Amon-Tanoh Dick, F ; Cardena, M ; Adonis-Koffi, L ; Eugenie, D ; Kouamé, F ; Menan, H ; Inwoley, A ; Ouassa, T ; Nguessan, MS ; Khosa, C ; Cumbe, S ; Manhiça, E ; Zitha, A ; Chiúle, V ; Muxanga, E ; Gune, I ; Lima, Y ; Ribeiro, J ; Mavale, S ; Chilundo, J ; Maxanguana, F ; Morais, N ; Manhiça, J ; Give, J ; Atumane, J ; Lucas, G ; Thai, A ; Chave, A ; Rego, D ; Guambe, L ; Issa, F ; Carneiro, R ; Pene, N ; Florindo, N ; Machel, D ; Cumbane, C ; Mendes, H ; Kitungwa, M ; Muianga, V ; Tamele, H ; Sulude, A ; Mabota, R ; Comandante, H ; Massangaie, A ; Wobudeya, E ; Businge, GB ; Namulinda, F ; Sserunjogi, R ; Nassozi, R ; Barungi, C ; Aanyu, H ; Muwonge, D ; Kagoya, E ; Aciparu, S ; Chemutai, S ; Ntambi, S ; Wasswa, A ; Nangozi, J ; Tagoola, A ; Mbekeka, P ; Kenneth, S ; Lubega, JP ; Nassali, A ; Tagobera, J ; Agwang, C ; Kalembe, F ; Ajambo, A ; Aguti, E ; Kasibante, S ; Matende, H ; Odongo, IO ; Mwanga Amumpaire, J ; Natukunda, N ; Ngabirano, G ; Kakwenza, P ; Nuwamanya, S ; Nyangoma, M ; Nabbuto, J ; Abok, F ; Arinaitwe, R ; Birungi, D ; Mwesigwa, E ; Atwine, D ; Mbega, H ; Orikiriza, P ; Taremwa, I ; Turyashemererwa, E ; Derrick, H ; Nyehangane, D ; Kaitano, R ; Logoose, S ; Businge, S ; Ntambi, C ; Mugabi, J ; Mzee, J ; Besigye, J ; Kanzira, S ; Turyatemba, P ; Twebaze, F ; Chabala, C ; Mulenga, V ; Shankalala, P ; Hambulo, C ; Kapotwe, V ; Ngambi, M ; Kasakwa, K ; Chirwa, U ; Kapula, C ; Zulu, S ; Nawakwi, G ; Siasulingana, T ; Chilonga, J ; Chimbini, M ; Chilanga, M ; Nduna, B ; Inambao, M ; Mwambazi, M ; Halende, B ; Mumba, W ; Mankunshe, E ; Silavwe, M ; Chakopo, M ; Moono, R (Elsevier BV, 2022-11)
    Background: Tuberculosis diagnosis might be delayed or missed in children with severe pneumonia because this diagnosis is usually only considered in cases of prolonged symptoms or antibiotic failure. Systematic tuberculosis detection at hospital admission could increase case detection and reduce mortality. Methods: We did a stepped-wedge cluster-randomised trial in 16 hospitals from six countries (Cambodia, Cameroon, Côte d'Ivoire, Mozambique, Uganda, and Zambia) with high incidence of tuberculosis. Children younger than 5 years with WHO-defined severe pneumonia received either the standard of care (control group) or standard of care plus Xpert MTB/RIF Ultra (Xpert Ultra; Cepheid, Sunnyvale, CA, USA) on nasopharyngeal aspirate and stool samples (intervention group). Clusters (hospitals) were progressively switched from control to intervention at 5-week intervals, using a computer-generated random sequence, stratified on incidence rate of tuberculosis at country level, and masked to teams until 5 weeks before switch. We assessed the effect of the intervention on primary (12-week all-cause mortality) and secondary (including tuberculosis diagnosis) outcomes, using generalised linear mixed models. The primary analysis was by intention to treat. We described outcomes in children with severe acute malnutrition in a post hoc analysis. This study is registered with ClinicalTrials.gov (NCT03831906) and the Pan African Clinical Trial Registry (PACTR202101615120643). Findings: From March 21, 2019, to March 30, 2021, we enrolled 1401 children in the control group and 1169 children in the intervention group. In the intervention group, 1140 (97·5%) children had nasopharyngeal aspirates and 942 (80·6%) had their stool collected; 24 (2·1%) had positive Xpert Ultra. At 12 weeks, 110 (7·9%) children in the control group and 91 (7·8%) children in the intervention group had died (adjusted odds ratio [OR] 0·986, 95% CI 0·597–1·630, p=0·957), and 74 (5·3%) children in the control group and 88 (7·5%) children in the intervention group had tuberculosis diagnosed (adjusted OR 1·238, 95% CI 0·696–2·202, p=0·467). In children with severe acute malnutrition, 57 (23·8%) of 240 children in the control group and 53 (17·8%) of 297 children in the intervention group died, and 36 (15·0%) of 240 children in the control group and 56 (18·9%) of 297 children in the intervention group were diagnosed with tuberculosis. The main adverse events associated with nasopharyngeal aspirates were samples with blood in 312 (27·3%) of 1147 children with nasopharyngeal aspirates attempted, dyspnoea or SpO2 less than 95% in 134 (11·4%) of children, and transient respiratory distress or SpO2 less than 90% in 59 (5·2%) children. There was no serious adverse event related to nasopharyngeal aspirates reported during the trial. Interpretation: Systematic molecular tuberculosis detection at hospital admission did not reduce mortality in children with severe pneumonia. High treatment and microbiological confirmation rates support more systematic use of Xpert Ultra in this group, notably in children with severe acute malnutrition.
  • Item
    Thumbnail Image
    Vaccine Adverse Event Mining of Twitter Conversations: 2-Phase Classification Study
    Habibabadi, SK ; Haghighi, PD ; Burstein, F ; Buttery, J (JMIR PUBLICATIONS, INC, 2022-06-01)
    BACKGROUND: Traditional monitoring for adverse events following immunization (AEFI) relies on various established reporting systems, where there is inevitable lag between an AEFI occurring and its potential reporting and subsequent processing of reports. AEFI safety signal detection strives to detect AEFI as early as possible, ideally close to real time. Monitoring social media data holds promise as a resource for this. OBJECTIVE: The primary aim of this study is to investigate the utility of monitoring social media for gaining early insights into vaccine safety issues, by extracting vaccine adverse event mentions (VAEMs) from Twitter, using natural language processing techniques. The secondary aims are to document the natural language processing techniques used and identify the most effective of them for identifying tweets that contain VAEM, with a view to define an approach that might be applicable to other similar social media surveillance tasks. METHODS: A VAEM-Mine method was developed that combines topic modeling with classification techniques to extract maximal VAEM posts from a vaccine-related Twitter stream, with high degree of confidence. The approach does not require a targeted search for specific vaccine reaction-indicative words, but instead, identifies VAEM posts according to their language structure. RESULTS: The VAEM-Mine method isolated 8992 VAEMs from 811,010 vaccine-related Twitter posts and achieved an F1 score of 0.91 in the classification phase. CONCLUSIONS: Social media can assist with the detection of vaccine safety signals as a valuable complementary source for monitoring mentions of vaccine adverse events. A social media-based VAEM data stream can be assessed for changes to detect possible emerging vaccine safety signals, helping to address the well-recognized limitations of passive reporting systems, including lack of timeliness and underreporting.
  • Item
    Thumbnail Image
    Association of Dual Decline in Cognition and Gait Speed With Risk of Dementia in Older Adults.
    Collyer, TA ; Murray, AM ; Woods, RL ; Storey, E ; Chong, TT-J ; Ryan, J ; Orchard, SG ; Brodtmann, A ; Srikanth, VK ; Shah, RC ; Callisaya, ML (American Medical Association (AMA), 2022-05-02)
    Importance: Dual decline in gait speed and cognition has been found to be associated with increased dementia risk in previous studies. However, it is unclear if risks are conferred by a decline in domain-specific cognition and gait. Objective: To examine associations between dual decline in gait speed and cognition (ie, global, memory, processing speed, and verbal fluency) with risk of dementia. Design, Setting, and Participants: This cohort study used data from older adults in Australia and the US who participated in a randomized clinical trial testing low-dose aspirin between 2010 and 2017. Eligible participants in the original trial were aged 70 years or older, or 65 years or older for US participants identifying as African American or Hispanic. Data analysis was performed between October 2020 and November 2021. Exposures: Gait speed, measured at 0, 2, 4, and 6 years and trial close-out in 2017. Cognitive measures included Modified Mini-Mental State examination (3MS) for global cognition, Hopkins Verbal Learning Test-Revised (HVLT-R) for memory, Symbol Digit Modalities (SDMT) for processing speed, and Controlled Oral Word Association Test (COWAT-F) for verbal fluency, assessed at years 0, 1, 3, 5, and close-out. Participants were classified into 4 groups: dual decline in gait and cognition, gait decline only, cognitive decline only, and nondecliners. Cognitive decline was defined as membership of the lowest tertile of annual change. Gait decline was defined as a decline in gait speed of 0.05 m/s or greater per year across the study. Main Outcomes and Measures: Dementia (using Diagnostic and Statistical Manual of Mental Disorders [Fourth Edition] criteria) was adjudicated by an expert panel using cognitive tests, functional status, and clinical records. Cox proportional hazard models were used to estimate risk of dementia adjusting for covariates, with death as competing risk. Results: Of 19 114 randomized participants, 16 855 (88.2%) had longitudinal gait and cognitive data for inclusion in this study (mean [SD] age, 75.0 [4.4] years; 9435 women [56.0%], 7558 participants [44.8%] with 12 or more years of education). Compared with nondecliners, risk of dementia was highest in the gait plus HVLT-R decliners (hazard ratio [HR], 24.7; 95% CI, 16.3-37.3), followed by the gait plus 3MS (HR, 22.2; 95% CI, 15.0-32.9), gait plus COWAT-F (HR, 4.7; 95% CI, 3.5-6.3), and gait plus SDMT (HR, 4.3; 95% CI, 3.2-5.8) groups. Dual decliners had a higher risk of dementia than those with either gait or cognitive decline alone for 3MS and HVLT-R. Conclusions and Relevance: Of domains examined, the combination of decline in gait speed with memory had the strongest association with dementia risk. These findings support the inclusion of gait speed in dementia risk screening assessments.
  • Item
    Thumbnail Image
    Examining a rural Victorian community's knowledge and help seeking behaviour for family violence and the role of the local public health service
    Kelly, P ; Field, M ; Payne, R ; Giallo, R (WILEY, 2022-06-17)
    OBJECTIVE: The rates of family violence within some rural communities are higher than that of metropolitan areas. The extent to which these rural communities know about and access family violence support services is not well understood. Local health services often play a role in providing information and support for community members at risk of, or experiencing family violence. For a rural community in Victoria, the study aimed to: (a) determine community members' knowledge of family violence services, (b) explore community members' help seeking behaviour for family violence, (c) identify perceived barriers and enabling factors to accessing family violence services and (d) explore community members' expectations of, and preferences for, family violence support provided by local health services. DESIGN: A cross-sectional, anonymous, mixed-methods online survey. SETTING: A rural community in Victoria's Western District, Australia. PARTICIPANTS: Ninety-nine residents, over 18 years of age. RESULTS: The majority of respondents had been exposed to family violence. There were varying knowledge levels of family violence support services as well as a number of barriers identified that directly impacted community members seeking help. There were clear expectations about the role of the local health service in family violence identification and response. CONCLUSION: There are particular challenges for rural communities in providing support for family violence. Valuable insights can be gained from local communities about their knowledge of services and help seeking behaviours. Evidence generated by this study will inform future strategic planning for family violence services and the local health service.
  • Item
    Thumbnail Image
    Use of Whole-Genome Sequencing for Mitochondrial Disease Diagnosis
    Davis, RL ; Kumar, KR ; Puttick, C ; Liang, C ; Ahmad, KE ; Edema-Hildebrand, F ; Park, J-S ; Minoche, AE ; Gayevskiy, V ; Mallawaarachchi, AC ; Christodoulou, J ; Schofield, D ; Dinger, ME ; Cowley, MJ ; Sue, CM (LIPPINCOTT WILLIAMS & WILKINS, 2022-08-16)
    BACKGROUND AND OBJECTIVES: Mitochondrial diseases (MDs) are the commonest group of heritable metabolic disorders. Phenotypic diversity can make molecular diagnosis challenging, and causative genetic variants may reside in either mitochondrial or nuclear DNA. A single comprehensive genetic diagnostic test would be highly useful and transform the field. We applied whole-genome sequencing (WGS) to evaluate the variant detection rate and diagnostic capacity of this technology with a view to simplifying and improving the MD diagnostic pathway. METHODS: Adult patients presenting to a specialist MD clinic in Sydney, Australia, were recruited to the study if they satisfied clinical MD (Nijmegen) criteria. WGS was performed on blood DNA, followed by clinical genetic analysis for known pathogenic MD-associated variants and MD mimics. RESULTS: Of the 242 consecutive patients recruited, 62 participants had "definite," 108 had "probable," and 72 had "possible" MD classification by the Nijmegen criteria. Disease-causing variants were identified for 130 participants, regardless of the location of the causative genetic variants, giving an overall diagnostic rate of 53.7% (130 of 242). Identification of causative genetic variants informed precise treatment, restored reproductive confidence, and optimized clinical management of MD. DISCUSSION: Comprehensive bigenomic sequencing accurately detects causative genetic variants in affected MD patients, simplifying diagnosis, enabling early treatment, and informing the risk of genetic transmission.
  • Item
    Thumbnail Image
    Longitudinal Maturation of Resting State Networks: Relevance to Sustained Attention and Attention Deficit/Hyperactivity Disorder
    Thomson, P ; Malpas, CB ; Vijayakumar, N ; Johnson, KA ; Anderson, V ; Efron, D ; Hazell, P ; Silk, TJ (SPRINGER, 2022-06-08)
    The transition from childhood to adolescence involves important neural function, cognition, and behavior changes. However, the links between maturing brain function and sustained attention over this period could be better understood. This study examined typical changes in network functional connectivity over childhood to adolescence, developmental differences in attention deficit/hyperactivity disorder (ADHD), and how functional connectivity might underpin variability in sustained attention development in a longitudinal sample. A total of 398 resting state scans were collected from 173 children and adolescents (88 ADHD, 85 control) at up to three timepoints across ages 9-14 years. The effects of age, sex, and diagnostic group on changes in network functional connectivity were assessed, followed by relationships between functional connectivity and sustained attention development using linear mixed effects modelling. The ADHD group displayed greater decreases in functional connectivity between salience and visual networks compared with controls. Lower childhood functional connectivity between the frontoparietal and several brain networks was associated with more rapid sustained attention development, whereas frontoparietal to dorsal attention network connectivity related to attention trajectories in children with ADHD alone. Brain network segregation may increase into adolescence as predicted by key developmental theories; however, participants with ADHD demonstrated altered developmental trajectories between salience and visual networks. The segregation of the frontoparietal network from other brain networks may be a mechanism supporting sustained attention development. Frontoparietal to dorsal attention connectivity can be a focus for further work in ADHD.
  • Item
    Thumbnail Image
    Data Resource Profile: Melbourne Children's LifeCourse initiative (LifeCourse)
    O'Connor, M ; Moreno-Betancur, M ; Goldfeld, S ; Wake, M ; Patton, G ; Dwyer, T ; Tang, MLK ; Saffery, R ; Craig, JM ; Loke, J ; Burgner, D ; Olsson, CA ; Investigators, LC (OXFORD UNIV PRESS, 2022-05-10)
  • Item
    Thumbnail Image
    Response to Lehrer and Rheinstein.
    Tuesley, KM ; Webb, PM ; Protani, MM ; Spilsbury, K ; Pearson, S-A ; Coory, MD ; Donovan, P ; Steer, C ; Stewart, LM ; Pandeya, N ; Jordan, SJ (Oxford University Press (OUP), 2022-10-06)
  • Item
  • Item
    Thumbnail Image
    Karawun: a software package for assisting evaluation of advances in multimodal imaging for neurosurgical planning and intraoperative neuronavigation.
    Beare, R ; Alexander, B ; Warren, A ; Kean, M ; Seal, M ; Wray, A ; Maixner, W ; Yang, JY-M (Springer Science and Business Media LLC, 2022-09-07)
    PURPOSE: The neuroimaging research community-which includes a broad range of scientific, medical, statistical, and engineering disciplines-has developed many tools to advance our knowledge of brain structure, function, development, aging, and disease. Past research efforts have clearly shaped clinical practice. However, translation of new methodologies into clinical practice is challenging. Anything that can reduce these barriers has the potential to improve the rate at which research outcomes can contribute to clinical practice. In this article, we introduce Karawun, a file format conversion tool, that has become a key part of our work in translating advances in diffusion imaging acquisition and analysis into neurosurgical practice at our institution. METHODS: Karawun links analysis workflows created using open-source neuroimaging software, to Brainlab (Brainlab AG, Munich, Germany), a commercially available surgical planning and navigation suite. Karawun achieves this using DICOM standards supporting representation of 3D structures, including tractography streamlines, and thus offers far more than traditional screenshot or color overlay approaches. RESULTS: We show that neurosurgical planning data, created from multimodal imaging data using analysis methods implemented in open-source research software, can be imported into Brainlab. The datasets can be manipulated as if they were created by Brainlab, including 3D visualizations of white matter tracts and other objects. CONCLUSION: Clinicians can explore and interact with the results of research neuroimaging pipelines using familiar tools within their standard clinical workflow, understand the impact of the new methods on their practice and provide feedback to methods developers. This capability has been important to the translation of advanced analysis techniques into practice at our institution.