The Australasian Society of Parenteral and Enteral Nutrition: Consensus statements on refeeding syndrome

Aims: This consensus statement document describes the recommendations of the Australasian Society of Parenteral and Enteral Nutrition regarding the identification and management of refeeding syndrome and refeeding syndrome risk. Methods: An expert working group completed a review of the literature to develop recommendations for the consensus statements. Review of the drafted consensus statements was undertaken by highly experienced clinicians. Results: The identification and management of refeeding syndrome requires a multidisciplinary approach. Actual refeeding syndrome is rare; however, all patients should be assessed for the risk of its development. Refeeding syndrome should only be diagnosed if the patient has had adequate nutrition intake (≥50% of estimated requirements), with electrolyte imbalances and clinical symptoms emerging after its commencement. Thiamin and multivitamin supplementation and regular electrolyte monitoring should be provided to all patients at risk of developing refeeding syndrome. There is no evidence that patients at risk of developing refeeding syndrome should be started at an initial lower enteral feeding rate than already recommended for checking tolerance to enteral feeds. Goal nutrition rates should be reached within 24–72 h for all routes of nutrition. Low electrolyte levels should be replaced as per local guidelines, with consideration given to the route of replacement. Conclusion: These consensus statements are expected to provide guidance at a national level to improve the identification and management of refeeding syndrome and refeeding syndrome risk.Kylie Matthews-Rensch, Kirrilee Blackwood, Deborah Lawlis, Lina Breik, Cameron McLean, Truc Nguyen, Sarah Phillips, Kimberly Small, Tim Stewart, Amber Thatcher, Leanne Venkat, Emily Brodie, Brydie Cleeve, Lauren Diamond, Mei Yuen Ng, Anna Small, Elizabeth Viner Smith, Varsha Asrani

The Association Between Early Graft Function, Donor Type and Long-Term Kidney Transplant Outcomes

Delayed graft function (DGF), is associated with inferior graft outcomes. Whether poor graft function without dialysis, termed slow graft function (SGF), affects outcomes is unclear. We investigated associations between SGF (serum creatinine dropping by less than 30% between days 1 and 2), DGF and graft outcomes by donor type in a cohort of 17,579 Australian and New Zealand kidney transplant recipients from 2001–2021. The primary outcomes were graft survival and death-censored graft survival Compared with immediate graft function, both SGF (Adjusted hazard ratio [aHR] 1.48 (95% CI 1.14–1.91) and DGF [aHR 1.97 (1.42–2.73)] were associated with reduced graft survival in living donor and donation after brain death (DBD) recipients [SGF aHR 1.13 (1.01–1.27); DGF aHR 1.37 (1.24–1.51)]. In donation after circulatory death (DCD) recipients, DGF [(aHR 1.52 (1.13–2.04)] but not SGF [(aHR 1.55 (1.13–2.13)] was associated with reduced graft survival. Findings were similar for death-censored graft survival. In secondary analyses, SGFwas associated with reduced patient survival in living donor recipients. SGF and DGF were associated with lower 12-month eGFR for all donor types. DGF increased the odds of rejection for all donor types; for SGF this association was significant only for DBD recipients. SGF is associated with adverse outcomes in live donor and DBD kidney recipients.Karthik Venkataraman, Georgina L. Irish, Michael G. Collins, Philip A. Clayto

Financial risk indicators of child sexual abuse live streaming: A proof of concept prediction model

The live streaming of child sexual abuse (CSA) is a technologically and financially enabled crime type which has proliferated in recent years. This study uses a machine learning approach to produce a proof of concept model for identifying the financial indicators associated with CSA live streaming. This model was successful at identifying those who live streamed child sexual abuse, while making few errors in identifying those who did not. Seven financial risk indicators were identified. Six risk indicators centred on the value of transactions, and one on the age of the individual making the transactions. These findings reveal an important opportunity to use financial transactions as an avenue for detecting and disrupting CSA live streaming.Timothy Cubitt, Sarah Napier, and Rick Brow

Prognostic value of cervical length for spontaneous preterm birth in asymptomatic women with twin pregnancy: meta-analysis of individual participant data

Objective: To quantify the prognostic value of mid-trimester cervical length for spontaneous preterm birth in asymptomatic women with twin pregnancy and to assess whether other factors may modify any association. Designs: A two stage meta-analysis of individual participant data in a Cox proportional hazard model was performed using cervical length as a continuous variable. Data Sources: Medline, Embase, Cochrane, and LILACS, among others, were searched to identify eligible studies; the search was from 1 January 2000 to 30 September 2020. Risk of bias was assessed with the QUIPS tool. Studies were from eight countries between 2001 and 2018. Eligibility Criteria: Individual participant data were sought for eligible studies that reported mid-trimester (defined between 16 and 26 weeks) transvaginal sonographic cervical length and also gestational age at birth in asymptomatic women with twin pregnancy. The primary outcome was spontaneous preterm birth before 37 weeks. Results: Among 29 eligible studies, authors of 17 studies provided individual participant data for 6437 women with a twin pregnancy (69.1% of individual participant data). Mean cervical length measurement was 39 mm (SD=9, range 1-74 mm). 2889 women (44.9%) delivered before 37 weeks' gestation, and 934 (14.9%) delivered before 34 weeks. Each 1 mm increase in cervical length was associated with a 4.0% reduction in the rate of spontaneous preterm birth before 37 weeks (hazard ratio 0.96 (95% confidence interval 0.95 to 0.97)), and a 6.8% reduction in the rate of spontaneous preterm birth before 34 weeks' gestation (0.93 (0.92 to 0.95)). The prognostic value remained stable in models adjusting for different sets of variables. Conclusion: The prognostic value of cervical length for spontaneous preterm birth in twin pregnancy is on a continuous scale. No specific cervical length has been identified that can reliably predict or exclude all spontaneous preterm births. Study Registration: CRD42020146987.Kelly Margaret Hughes, Mason Aberoumand, Anna Lene Seidler, Phoebe Swan, Mona Aboulghar, Maria de Lourdes Brizot, Clifton Brock, Marta Benito Vielba, Nathan Fox, Cynthia Gyamfi-Bannerman, Lindsay Kindinger, Giorgio Pagani, Alfredo Perales Marin, Viola Seravalli, Mariarosaria Di Tommaso, Omer Weitzner, Katharina Worda, Lukas Staub, Shaun Brennecke, Shakila Thangaratinam, Ben W Mol, Rui Wan

Electrolytic CO2 reduction in membrane electrode assembly: Challenges in (Bi)carbonate, crossover, and stability

Available online 28 January 2025Membrane electrode assembly (MEA) electrolyzers for carbon dioxide reduction reaction (CO2RR) present a transformative approach for reducing CO2 emissions while producing valuable chemicals. However, their commercialization is still hindered by several inherent challenges. This review outlines these critical bottlenecks and highlights recent advances aimed at enhancing the performance of CO2R MEA electrolyzers. First, the in-situ generated carbonate and bicarbonate species at the cathode can migrate to the anode or form salt precipitates, which reduces carbon efficiency (CO2-to-products) and obstructs gas diffusion channels. Second, product crossover can be diluted or even re-oxidized at the anode, resulting in increased energy consumption for product separation and electrolyte regeneration. Finally, the stability of CO2R MEA electrolyzers, particularly when producing multi-carbon (C2+) products, remains far insufficient for commercial viability, as degradation of the catalyst layer, gas diffusion electrode, and anolyte significantly impacts performance. To address these challenges, this review identifies potential solutions and future directions, including pure-water-fed strategy, hydrophobic catalyst layer designs, and membrane customization.Minqiu Lan, Wenhao Re

Bushfire Impact on Drinking Water Distribution Networks and Investigation Methods: A Review

Bushfire events can directly and indirectly impact drinking water distribution networks. Water authorities around the world have experienced compromised water supply and quality in the aftermath of recent bushfires, necessitating costly investigation and repair. Future climate models predict an escalation of bushfire weather events with a significant increase in the severity and frequency in many regions, for which water authorities must now prepare. Currently, there is no systematic review on the impact that bushfires can have on drinking water networks and how these impacts can be evaluated and investigated. The current study provides a systematic review of academic literature, agency response, water operator reports and media releases on these two emerging topics. On bushfire impacts, the review focuses on the physical impact to water assets, potential risk to water quality in the distribution network, and possible interruptions to water supply. On evaluation and investigation methods, the review summarizes available testing methods for evaluating physical damages to assets, identification of chemical or biological contaminants that may compromise water quality, and the identification of, or elective, interruption of water service. Gaps in our knowledge on how drinking water assets are physically damaged and how services are interrupted due to water quality testing or results are also identified to inform water operators, government agencies and researchers. Further research into the impact of bushfire temperature and duration on various types of pipe materials exposed is discussed.Vaughan Mitchell, Jinzhe Gong, Ellen Moon, and Wenyan W

A likelihood-free Bayesian approach for characterisation of multiple delaminations in laminated composite beams

First published online: July 26, 2024This paper presents a probabilistic model-based optimisation framework for localising and characterising multiple delaminations in laminated composite beams using ultrasonic guided waves (GW). A likelihood-free Bayesian method, approximate Bayesian computation by subset simulation (ABC-SS), is implemented to determine the number of delaminations and identify the unknown damage characteristics and their associated uncertainties. The ABC algorithm provides a practical way to approximate the posterior distributions of uncertain damage parameters and select the most plausible damage model for determining the number of delaminations through direct comparison of the experimentally measured and numerically simulated GW signals without assuming any likelihood functions. To overcome the expensive computational cost of traditional finite element simulations, a higher-order laminated model (HOLM) is employed to model the GW propagation behaviour in the delaminated composite beams with satisfactory accuracy and acceptable computational efficiency. Benefiting from the accurate simulation, the dataset comparison utilises the original time-domain GW signals, thereby preventing the loss of any key information from the signals for damage identification. A comprehensive series of numerical case studies are used to demonstrate the accuracy, robustness and feasibility of HOLM simulation and the proposed multiple-delamination identification framework. The practicability and accuracy of the proposed ABC framework are further validated using two experimental datasets.Zijie Zeng, Yuan Feng, Ching Tai Ng and Abdul Hamid Sheik

A Hybrid Theory and Data-driven Approach to Persuasion Detection with Large Language Models

Workshop: NLPSI 2025: First Workshop on Integrating NLP and Psychology to Study Social Interactions. Workshops held on June 23rd, 2025.Traditional psychological models of belief revision focus on face-to-face interactions, but with the rise of social media, more effective models are needed to capture belief revision at scale, in this rich text-based online discourse. Here, we use a hybrid approach, utilizing large language models (LLMs) to develop a model that predicts successful persuasion using features derived from psychological experiments. Our approach leverages LLM generated ratings of features previously examined in the literature to build a random forest classification model that predicts whether a message will result in belief change. Of the eight features tested, epistemic emotion and willingness to share to share were the top-ranking predictors of belief change in the model. Our findings provide insights into the characteristics of persuasive messages and demonstrate how LLMs can enhance models of successful persuasion based on psychological theory. Given these insights, this work has broader applications in fields such as online influence detection and misinformation mitigation, as well as measuring the effectiveness of online narratives.Gia Bao Hoang, Keith J. Ransom, Rachel G. Stephens, Carolyn Semmler, Nicolas Fay, Lewis Mitchel

SAL1-PAP retrograde signaling orchestrates photosynthetic and extracellular reactive oxygen species for stress responses

Cellular responses to abiotic stress involve multiple signals such as reactive oxygen species (ROS), Ca²⁺, abscisic acid (ABA), and chloroplast-to-nucleus retrograde signals such as 3′-phosphoadenosine 5′- -phosphate (PAP). The mechanism(s) by which these messengers intersect for cell regulation remain enigmatic, as do the roles of retrograde signals in specialized cells. Here we demonstrate a mechanistic link enabling ABA and PAP to coordinate chloroplast and plasma membrane ROS production. Contrary to its role in upregulating processes leading to quenching of ROS in foliar tissue, we show that in guard cells, PAP induces chloroplast ROS accumulation via photosynthetic electron transport and apoplast ROS via the RESPIRATORY BURST OXIDASE HOMOLOG (RBOH) proteins. Both subcellular ROS sources are necessary for stress hormone ABA-mediated stomatal closure, as well as PAP-mediated stomatal closure. However, PAP signaling diverges from ABA by activating RBOHD instead of RBOHF. Three calcium-dependent protein kinases (CPKs) transcriptionally induced by PAP, namely CPK13, CPK32, and CPK34, concurrently activate RBOHD and the slow anion channel SLAC1 by phosphorylating two SLAC1 serine (S) residues, including S120, which is also targeted by the ABA signaling kinase OPEN STOMATA 1 (OST1). Consequently, overexpression of the PAP-induced CPKs rescues stomatal closure in ost1. Our data identify chloroplast retrograde signals as critical nodes in cellular stress response networks of guard cells.Estee E. Tee, Stephen J. Fairweather, Hanh M. Vo, Chenchen Zhao, Andrew Breakspear, Sachie Kimura, Melanie Carmody, Michael Wrzaczek, Stefan Bröer, Christine Faulkner, Jaakko Kangasjärvi, Zhong-Hua Chen, Barry J. Pogson, and Kai Xun Cha

Ethics and orthodontics - it depends on the perspective

Background: It is essential that patients are provided with optimal orthodontic care. A requirement of the provision of optimal care is that it occurs in the presence of the highest standards of professional and ethical conduct. Clinicians are bound by codes of professional conduct to maintain registration with health practitioner regulatory bodies. In addition, clinicians require the ability to overcome ethical challenges with which they may be confronted in the delivery of care. By ensuring that relevant high standards are met, the terms of a social contract can be honoured, and patient safety is assured. The objective of the research presented in this thesis was to determine professional and ethical conduct from the perspective of several aspects of orthodontic treatment provision. Method: Nine cross-sectional studies and one scoping review were undertaken to explore aspects of professionalism and ethics from the perspective of the orthodontic patient, the dental student, the orthodontic clinician, the postgraduate orthodontic student, the regulator, commerce and the publication and reporting of orthodontic research. Results: The findings suggested that moral reasoning skills among undergraduate dentistry and postgraduate orthodontic students were lacking. The findings also indicated that the content of informed consent forms regarding clear aligner therapy and orthodontic retention were suboptimal and that practice websites representing most Australian-based orthodontists failed to comply with advertising law pertaining to the provision of a health service in Australia. The results from a further study found that the information provided in the websites of orthodontic product providers were incomplete and inaccurate, and the findings from a bibliographic investigation indicated that conflict of interest and funding information appears to be underreported in studies contained within orthodontic journals. Furthermore, dissatisfaction expressed by patients about aspects of orthodontic clinical care provision was recorded in the scoping review and one study in the present thesis. Conclusions: The findings from the studies in the present thesis indicated that there are deficiencies in the ethical and professional standards required in the provision of optimal orthodontic care. This is likely to have a deleterious impact on patient care. Educators and the profession should reflect on the findings to enable consideration of how best to ameliorate professional and ethical conduct in the provision of orthodontic care.Thesis (Ph.D.) -- University of Adelaide, Adelaide Dental School, 202