Outcomes Model For Assessing Strategies Improving In Vitro Fertilization Birth Rates

Introduction: Infertility affects one-sixth of women worldwide, with over seven million assisted reproductive cycles performed annually. Oral dydrogesterone is recommended alternatively for luteal phase support in in vitro fertilization (IVF), preventing miscarriages and improving live birth rates. This study aims to develop an outcomes model comparing oral dydrogesterone treatment with the standard of care in the IVF cycle over a 10-year period. Methods: A two-level Markov cohort model in Microsoft Excel includes six health states: IVF, pregnancy, miscarriage, live birth, perinatal death, and maternal death. Miscarriage, live birth, and perinatal death are sub-states of pregnancy. Transition probabilities are based on published rates with medical intervention limited to the first 12 weeks of gestation. A sensitivity analysis of treatment was performed. Data from a published meta-analysis of nine dydrogesterone studies for IVF luteal phase support were used. The baseline cohort is 10,000 Australian females undergoing IVF annually over a 10-year period. Results: Over the 10-year time horizon, compared to standard care, the group treated with dydrogesterone was estimated to increase the number of live births by 3.5 percent (range: 3.4 to 3.7%), reduce the number of miscarriages by 69.4 percent (range: 66.2 to 72.7%), reduce the perinatal death by 10.9 percent (range: 10.4 to 11.4%), reduce the IVF cycles by 11.56 percent (range: 11.0 to 12.11%), and reduce the death of the mothers by 10.9 percent (range: 10.4 to 11.4%). Conclusions: The outcomes model projected that treatment with oral dydrogesterone significantly reduced the number of miscarriages and improved the number of live births compared to the standard of care used for IVF patients in Australia

Machine learning and multi-omics in precision medicine for ME/CFS

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex and multifaceted disorder that defies simplistic characterisation. Traditional approaches to diagnosing and treating ME/CFS have often fallen short due to the condition’s heterogeneity and the lack of validated biomarkers. The growing field of precision medicine offers a promising approach which focuses on the genetic and molecular underpinnings of individual patients. In this review, we explore how machine learning and multi-omics (genomics, transcriptomics, proteomics, and metabolomics) can transform precision medicine in ME/CFS research and healthcare. We provide an overview on machine learning concepts for analysing large-scale biological data, highlight key advancements in multi-omics biomarker discovery, data quality and integration strategies, while reflecting on ME/CFS case study examples. We also highlight several priorities, including the critical need for applying robust computational tools and collaborative data-sharing initiatives in the endeavour to unravel the biological intricacies of ME/CFS

Rapid increase in continuous glucose monitoring use among adults with type 1 diabetes admitted to hospital: a Melbourne multicentre observational study

Continuous glucose monitoring (CGM) technology is transforming community diabetes management. Interest in the utility of CGM during hospitalisation is increasing. This multicentre retrospective observational study found that, among adult inpatients with type 1 diabetes, the proportion with inpatient CGM glucose data in hospital-linked CGM software accounts increased from 3.2% in 2021 to 20.5% in 2023. This study highlights the need for hospital-based clinicians to familiarise themselves with CGM technology

Toward open science in marketing research

The open science paradigm has gained prominence in marketing as researchers seek to enhance the validity, reliability, and transparency of research methods and findings. Journals and institutions increasingly encourage or require open science practices, and many authors have started to adapt to and meet these new research and publishing expectations. We provide guidance for effectively implementing open science practices in empirical marketing research. Our recommendations, are tailored to the unique methodological approaches and challenges of each subdiscipline and their specific research contexts. Successful integration of these practices into academic marketing research will require concerted and collaborative efforts among authors, journals, institutions, and funding agencies. We argue that the gradual, thoughtful adoption of these principles and practices will improve the quality and efficiency of scientific discovery

Using an SMS to improve bowel cancer screening: the acceptability and feasibility of a multifaceted intervention

BACKGROUND: The Australian National Bowel Cancer Screening Program sends an immunochemical faecal occult blood test to Australians aged 50-74 years to screen for bowel cancer, but uptake is low (40.9%). The SMARTscreen trial demonstrated that sending a short messaging services (SMS) prompt from the participant's general practitioner (GP) increased the proportion of kit returns by 16.5%. This research aimed to determine the acceptability and feasibility of implementing SMARTscreen. METHOD: SMARTscreen was a cluster randomized controlled trial set in 21 Australian general practices in regional Australia. Participants and general practice staff involved in the trial were included in this study. Acceptability and feasibility were measured quantitatively by calculating proportions of the SMS received, viewed, or opted out of, and qualitatively by interviewing people who sent and received the SMS. RESULTS: Of 2914 SMS sent, 2645 SMS (91%) were received by participants, 1128 (43%) people opened the weblink, and 59 (2%) people opted out of receiving future SMS. Interviews with general practice staff (n = 17) and participants (n = 18) found that sending and receiving the SMS was acceptable and feasible. The SMS was considered a low-burden activity that easily integrated into the clinic's workflow without impacting clinicians' time. Participants reported an increased intention to participate in screening, but some people worried the weblink was spam, and some suggested sending it out of working hours. CONCLUSION: The SMS-based intervention was widely accepted by GP staff and participants. Future research should test the SMS with and without the weblink, and send the SMS at a more convenient time of the day/week

Impact of employment support in different work environments on individuals with intellectual disability and their families from their own perspectives: Protocol for a systematic review of qualitative evidence

Introduction People with intellectual disability experience lower levels of employment than those with other disabilities and those without disability, and typically require support services to access and maintain employment. Reviews on employment support often focus on the perspectives of providers and employers, meaning that, thus far, the perspectives of people with intellectual disability and their family members have not been collated and synthesised. This review will address this evidence gap. Methods and analysis Six databases (CINAHL, EconLit, EMBASE, Medline Complete, PsychINFO, Web of Science) will be comprehensively searched for the last 20 years to identify English-language, peer-reviewed publications including primary qualitative data. Search results will be independently screened by three reviewers (CP, NM, SF). Backwards and forwards citation tracing will be used to identify any additional literature not found by the searches. A narrative summary of the included studies will be provided. Study characteristics such as research focus, design, setting and findings will be independently extracted by one reviewer, checked by a second. Methodological quality will be independently evaluated by two reviewers using the Critical Appraisal Skills Programme Qualitative Studies Checklist. Findings from the studies will be collated using thematic synthesis and a realist approach. Any disagreement during the review process will be resolved by a third reviewer. Ethics and dissemination Ethics approval is not required to conduct the planned systematic review of peer-reviewed, published articles because the research does not involve human participants. Findings will be published in a peer-reviewed journal, presented at leading disability conferences and disseminated via website postings and social media channels. PROSPERO registration number CRD42024615393

Scanimalia: Towards Scanning for Oceanic Care Gallery Catalogue

What happens when marine animals are animated using a desktop flatbed scanner, and why would you? This clunky technology seems impractical for underwater photographic reproduction of three-dimensional ocean animals. What results is consideration of the multifaceted qualities of marine animals and the differences between the aesthetic phenomenon of lens-based photography and emergent digital image culture. Scanimalia looks towards the flatbed scanner as an intentionally inappropriate stage to animate ocean “naturecultures” 4 with a vision of tangible recuperation in a time of ecocide. This is likened to complex fluid entanglements between humanimals and the force and pressure applied through scanning techniques. This new ecofeminist and animal studies direction for the flatbed are marine imaging and processes explored with reference to affects of proximity, compression, refraction, mutability, hallucination, and performance. The exhibition proposes vibrant ecologies led by my underwater handlings of what it is to be a human animal and the more-than-human aquatic beings with their lively and touchy-feely senses. The exhibition has six themes: scanning, curiosity, listening, humour, collaboration, and intimacy, which are translated into the specific imaging categories that arise from holding the marine animals and interacting with the flatbed. These categories form the basis of enhancing this pressing oceanic care analysis and are vessels for later discussion. The tactile reach that informs the dissertation’s six chapters is the cephalopod’s independently operating sensory arms, tentacles within tentacles, in an endlessly recursive entanglement with its two hidden legs introduction and conclusion. A malleable and invertebrate structure that extends marine animal encounters defines the desktop flatbed scanner as a tentacular stage to dive back into staying with the human trouble. 5 Informed by significant multi-species debate concerning climate and marine biology philosophies, this unlikely form of oceanic imaging reveals new readings from the physical act of pressing down onto the flatbed and seabed. Through fluid entanglements and intersections of animals and humans, the flatbed serves to demonstrate how this category of looking at critical elements of oceanic care can animate the ongoing challenges of aquatic conditions for marine environments on Millowl (Boonwurrung) Phillip Island and Nerm (Boonwurrung) Port Phillip Bay, Melbourne. With the flatbed’s sweeping and sensory collisions between humans and marine animals, Scanimalia looks towards the flatbed as an arena to inspire and animate conversations, concerns and collaborations with the sea on sustaining multi-species stories, relations and materials for others to swim upstream with. This enlivened sense of caring for the ocean is where collaboration on the flatbed occurs person to person in Australia and takes its cue from Scanimalia’s human sea custodians and animal critters as Donna J. Haraway’s furry families woofed: It matters what stories tell stories as a practice of caring and thinking.

Indirect Effects of Universal Infant Rotavirus Vaccination: A Narrative Systematic Review

Background/Objective: Rotavirus is a major cause of acute gastroenteritis (AGE) in children 18 years). Results: From an initial 757 articles, 44 studies including 9,327,974 participants were included. In unvaccinated children 18 years. Indirect effects appeared to be greater in higher income and lower under-five mortality settings. Conclusions: Understanding these indirect benefits is crucial for evaluating the broader impact and cost-effectiveness of rotavirus immunisation programs

The impact of a tailored nutrition intervention delivered for the duration of hospitalisation on daily energy delivery for patients with critical illness (INTENT): a phase II randomised controlled trial

Background: Nutrition interventions commenced in ICU and continued through to hospital discharge have not been definitively tested in critical care to date. To commence a program of research, we aimed to determine if a tailored nutrition intervention delivered for the duration of hospitalisation delivers more energy than usual care to patients initially admitted to the Intensive Care Unit (ICU). Methods: A multicentre, unblinded, parallel-group, phase II trial was conducted in twenty-two hospitals in Australia and New Zealand. Adult patients, requiring invasive mechanical ventilation (MV) for 72–120 h within ICU, and receiving < 80% estimated energy requirements from enteral nutrition (EN) were included. The intervention (tailored nutrition) commenced in ICU and included EN and supplemental parenteral nutrition (PN), and EN, PN, and/or oral nutrition after liberation from MV, and was continued until hospital discharge or study day 28. The primary outcome was daily energy delivery from nutrition (kcal). Secondary outcomes included duration of hospital stay, ventilator free days at day 28 and total blood stream infection rate. Main results: The modified intention to treat analysis included 237 patients (n = 119 intervention and n = 118 usual care). Baseline characteristics were balanced; the median [interquartile range] intervention period was 19 [14–35] and 19 [13–32] days in the tailored nutrition and usual care groups respectively. Energy delivery was 1796 ± 31 kcal/day (tailored nutrition) versus 1482 ± 32 kcal/day (usual care)—adjusted mean difference 271 kcal/day, 95% CI 189–354 kcal. No differences were observed in any secondary outcomes. Conclusions: A tailored nutrition intervention commenced in the ICU and continued until hospital discharge achieved a significant increase in energy delivery over the duration of hospitalisation for patients initially admitted to the ICU. Trial registration ClinicalTrials.gov Identifier NCT03292237. First registered 25th September 2017. Last updated 10th Feb 2023

A Nonrandomized Pilot Study to Investigate the Acceptability and Feasibility of LivR Well: A Multifaceted 28-Day Home-Based Liver Optimization Program for Acute-on-Chronic Liver Failure.

BACKGROUND AND AIMS: Acute-on-chronic liver failure (ACLF) has a 22%-74% 28-day mortality rate and 30%-40% 30-day readmission rate. We investigated the acceptability and feasibility of a multimodal community intervention for ACLF. METHODS: A single-arm nonrandomized pilot study of consecutive participants with ACLF was conducted in a tertiary health service. Participants received weekly medical and nursing reviews, dietetics, physiotherapy, pharmacy, social work, addiction medicine, and neuropsychiatry, where indicated. A digital platform included remote weight monitoring and online surveys. The primary outcome was acceptability/feasibility. Secondary outcomes included safety, mortality, readmission, liver disease severity, and costs. RESULTS: Fifty-nine patients were enrolled with median age 51 years (interquartile range (IQR): 45-59); majority alcohol etiology (74%),and median Model for End-Stage Liver Disease Sodium score 16 (IQR: 12-21). LivR Well was acceptable with low attrition (8 of 59), adherence to the program including home visits (mean 8.4 ± 4.2) and consultations (mean 2.4 ± 1.5) per patient. This was supported by positive feedback and themes identified through a qualitative subanalysis. Feasibility was demonstrated by recruitment rate of 4.94 patients/month and 86% completion. Mortality was lower than expected at 3%, 30-day readmission rate was 15%, and median Model for End-Stage Liver Disease Sodium score reduced to 15 (P = .01). Median 6-month costs reduced from $30,454 (IQR:$21,953-$65,657) to$17,657 ($4249-$42,876) (P = .009). The total 6-month health-care cost was $1,868,859 (95$2,518,227 (95% confidence interval 1,959,610-3,076,844). CONCLUSION: LivR Well was acceptable, feasible, and safe with low short-term mortality and readmission rates. Health-care costs were reduced by 26% driven by a 40% reduction in 30-day readmission. Further evaluation includes a randomized controlled trial of LivR Well compared to standard care