Multiple health-related behaviours among Fly-In Fly-Out workers in the mining industry in Australia : A cross-sectional survey during the COVID-19 pandemic

Funding: The study received funding from Mineral Resources Limited (Australia). Mineral ResourcesLimited provided AUS$ 200 shopping voucher to the winner of a raffle draw as reimbursement for study participation. Mineral Resources Limited (Australia) provided support for this study in the form of salaries to authors MS and CH. The specific roles of these authors are articulated in the ‘author contributions’ section. Employees of Mineral Resources Limited played role in the datacollection, interpretation of study findings, preparation and decision to submit this manuscript for publication but not in the design of the study and data analysis. The preparation of this manuscript was supported by the Aberdeen-Curtin Alliance International Postgraduate Research Scholarship scheme awarded to BY-AA.Peer reviewedPublisher PD

Exploring the Experiences of the Consent Process for Aboriginal and Torres Strait Islander People Having Cardiac Surgery and Participating in Medical Research: A Study Protocol

Background: Gaining informed consent is a critical step before any medical procedure, and before taking part in medical research. Cultural differences in concepts of health and healing, communication, language, and racism, can play a part in forming barriers to gaining informed consent for Aboriginal and Torres Strait Islander people. For Aboriginal and Torres Strait Islander people, a lack of informed consent can worsen distrust and contribute to continuing health disparities. This protocol describes a study aimed at providing a better understanding of informed consent experiences of Aboriginal and Torres Strait Islander people undergoing heart surgery and participating in research. This will be complemented by comparing those experiences to the ones of the clinicians and researchers who obtain informed consent from Aboriginal and Torres Strait Islander people. Methods: The study will be conducted at the Fiona Stanley Hospital in Western Australia and Townsville University Hospital in Queensland. Participants will include Aboriginal and Torres Strait Islander patients undergoing cardiac surgery, clinicians of the cardiothoracic surgery team and medical researchers at both hospitals. Yarning will be used as an Indigenous research method to collect meaningful data from Aboriginal and Torres Strait Islander people undergoing cardiac surgery whilst semi-structured interviews will be conducted to explore Clinician’s and researchers’ experiences. Data from Aboriginal and Torres Strait Islander participant will be analysed following a cyclical approach to ensure Aboriginal and Torres Strait Islander voices are not lost during data interpretation. Inductive thematic analysis of data will be conducted to yield practical recommendations. Conclusions: We present the protocol of a study that will inform the development of strategies to ensure that informed consent processes are culturally appropriate and guarantee Aboriginal and Torres Strait Islander people’s right to self-determination. This will contribute to the provision of culturally safe healthcare services and promote the conduct of medical research that is ethical, safe and benefits Aboriginal and Torres Strait Islander people

Mental Well-Being during COVID-19 : A Cross-Sectional Study of Fly-In Fly-Out Workers in the Mining Industry in Australia

Funding: This study was funded by the Mineral Resources Limited (Australia). Mineral Resources Limited provided AUD 200 shopping voucher to the winner of a raffle draw as reimbursement for study participation. Mineral Resources Limited played role in the data collection, interpretation of study findings, preparation and decision to submit this manuscript for publication but not in the design of the study and data analysis. The study was supported by Aberdeen-Curtin Alliance Curtin International Postgraduate Research Scholarship (CIPRS) in the writing of the manuscript. B.Y.-A.A. is a recipient of Aberdeen-Curtin Alliance PhD Curtin International Postgraduate Research Scholarship (CIPRS) and Research Stipend Scholarship. Acknowledgments: We express our profound gratitude to the Mineral Resources Limited, Australia for their support in advertising the study and allowing for us undertake this study among their workers. We also extend our appreciation to all the FIFO workers who took time to participate in this study.Peer reviewedPublisher PD

HIV patients stable on ART retain evidence of a high CMV load but changes to Natural Killer cell phenotypes reflect both HIV and CMV

Background: Whilst ART corrects many effects of HIV disease, T cell populations retain features of accelerated immunological aging. Methods: Here we analyse phenotypic changes to natural killer (NK) cells in HIV patients who began ART with <200 CD4 T-cells/µl and maintained virological control for 12-17 years, compared with CMV seropositive and seronegative healthy control donors. Results: Humoral responses to CMV antigens (lysate, gB, IE-1) remain elevated in the patients (P <0.0001) despite the long duration of ART. Patient's NK cells responded poorly to K562 cells when assessed by CD107a and IFNγ, but this could not be attributed to CMV as responses were low in CMV-seronegative controls. Moreover HIV (and not CMV) increased expression of CD57 on CD56lo cells. Conclusions: Comparisons with published studies suggest that CMV accelerates age-related increases in CD57 expression but levels plateau by 60-70 years of age, so the effect of CMV disappears. In HIV patients the plateau is higher and perhaps reached sooner

Functional and clinical consequences of changes to natural killer cell phenotypes driven by chronic cytomegalovirus infections

Cytomegalovirus (CMV) infections may affect natural killer (NK) cells and are implicated in age-related disorders—notably poor vascular endothelial function. Changes may be greater in renal transplant recipients (RTR) as they have a high burden of CMV and may influence antibody-dependent cellular cytotoxicity (ADCC) responses to viral antigen. We obtained blood mononuclear cells from RTR stable after transplantation (n = 27) and age- and sex-matched controls (n = 28). Natural killer (NK) cells were assessed for expression of CD107a or TNF-a, after stimulation with autologous antibodies bound to CMV glycoprotein B (measuring ADCC) or anti-CD16 (measuring NK cell activation). Alleles of FCRG3A (encoding CD16; rs396991) were determined by the Taqman assay. The vascular endothelial function was assessed using flow-mediated dilatation (FMD) of the brachial artery. Proportions of NK cells expressing CD16 ex vivo were lower in RTR. Frequencies of NK cells expressing NKG2C or LIR-1 or lacking FcR? were highest in CMV-seropositive RTR. ADCC was affected by rs396991 genotype and CMV gB antibody levels, but not by RTR status or detection of CMV DNA in plasma. Responses of FcR?-NK cells to anti-CD16 were lower compared to FcR?+ NK cells. Increased percentages of LIR-1 + and FcR?- NK cells correlated with lower FMD. In summary, CMV evokes substantial and similar ADCC responses in CMV seropositive RTR and controls. The equivalence may reflect higher titers of CMV reactive antibody in RTR, as NK responses stimulated by ligation of CD16 were lower. NK cells that were LIR-1 + and/or FcR?- were induced by CMV and correlated inversely with vascular endothelial function

Cytomegalovirus burden improves a predictive model identifying measures of vascular risk in renal transplant recipients and healthy adults

Cytomegalovirus (CMV) has been implicated in vascular pathologies and may warrant inclusion in cardiovascular predictive algorithms. We addressed this in healthy older adults and renal transplant recipients (RTR) as they retain a high burden of CMV. RTR (n = 45) stable more than 2 years after transplantation and 58 age-matched healthy adults were assessed. Plasma inflammatory biomarkers (soluble isoform of the interferon-β receptor [sIFNAR2], soluble tumour necrosis factorreceptor-1 [sTNFR1], soluble cluster of differentiation 14 [sCD14], C reactive protein, P-selectin, intracellular cell adhesion molecule-1, vascular cell adhesion molecule-1), and measures of CMV burden (antibodies, saliva CMV DNA, and interferon γ responses to CMV) were assessed in 2014 and evaluated in 2017 as predictors of vascular health—defined using flow-mediated dilatation (FMD), pulse wave velocity (PWV), and augmentation indices (Aix@ 75). Linear regression models adjusted for age, sex, and body mass index (BMI) were optimized to identify risk factors. In 2017, RTR had inferior vascular health marked by impaired FMD and PWV. Detectable CMV DNA (P =.02) was associated with impaired FMD, whilst CMV glycoprotein B (gB) antibody attenuated this effect (P =.03) (adjusted R2 =.42). In healthy adults, the optimal model for predicting FMD (R2 =.22) incorporated high P-selectin (P =.03) and low ICAM-1 (P =.03) levels with no significant impact of CMV. Elevated sIFNAR2 (P =.04) and gB antibody (P =.06) levels predicted increasing Aix@ 75 (poor vascular health) in healthy adults (R2 =.4), whilst optimal models for RTR (R2 =.37) linked low sIFNAR2 and CMV IE-1 antibody levels with lower Aix@ 75 (better vascular health). CMV IE-1 antibody was also protective in relation to PWV in healthy adults (R2 =.55). Overall, measures of active CMV replication were more predictive of impaired FMD in RTR than standard biomarkers, but increased CMV gB antibodies may be protective

Coronary artery disease in patients with human immunodeficiency virus infection

The life expectancy of people infected with human immunodeficiency virus (HIV) is rising due to better access to combination anti-retroviral therapy (ART). Although ART has reduced acquired immune deficiency syndrome (AIDS) related mortality and morbidity, there has been an increase in non-AIDS defining illnesses such as diabetes mellitus, hypercholesterolemia and coronary artery disease (CAD). HIV is a disease marked by inflammation which has been associated with specific biological vascular processes increasing the risk of premature atherosclerosis. The combination of pre-existing risk factors, atherosclerosis, ART, opportunistic infections and coagulopathy contributes to rising CAD incidence. The prevalence of CAD has emerged as a major contributor of morbidity in these patients due to longer life expectancy. However, ART has been associated with lipodystrophy, dyslipidemia, insulin resistance, diabetes mellitus and CAD. These adverse effects, along with drug-drug interactions when ART is combined with cardiovascular drugs, result in significant challenges in the care of this group of patients. Exercise tolerance testing, echocardiography, myocardial perfusion imaging, coronary computed tomography angiography and magnetic resonance imaging help in the diagnosis of CAD and heart failure and help predict cardiovascular outcomes in a manner similar to non-infected individuals. This review will highlight the pathogenesis and factors that link HIV to CAD, presentation and treatment of HIV-patients presenting with CAD and review briefly the cardiac imaging modalities used to identify this entity and help prognosticate future outcomes

Can immunogenetics illuminate the diverse manifestations of respiratory infections?

Improved technologies for high-throughput genotyping and the establishment of well-defined cohorts prompted hope that polymorphisms would be discovered that define a patients' risk of respiratory disease or aid in diagnosis. Genetic pitfalls encountered in this quest include genotyping errors, ethnic differences and linkage dysequilibrium. Differences in the definition of the disease phenotype also create discrepancies, so immunogenetic testing has not yet reached the clinic. However, associations between a polymorphism and a disease phenotype place the gene or one in linkage dysequilibrium on the path to the disease. Here we review studies of immune-related genes that are illuminating the immunopathogenesis of community-acquired pneumonia and mycobacterial infections. © 2010 The Author(s)

Prevalence of and risk factors for HIV-associated neuropathy in Melbourne, Australia 1993-2006

Objectives: The aim of the study was to describe the prevalence of and risk factors for HIV-associated sensory neuropathy (HIV-SN) in 2006 [the era of stavudine, didanosine and zalcitabine (dNRTI)-sparing highly active antiretroviral therapy (HAART)] an

The immunological footprint of CMV in HIV-1 patients stable on long-term ART

BACKGROUND:Most HIV-infected persons are cytomegalovirus (CMV) seropositive and retain latent virus that can be reactivated by immune activation. Their T cell populations express markers reflecting a late stage of differentiation, but the contributions of HIV and CMV to this profile are unclear. We investigated the immunological "footprint" of CMV in HIV patients who had a history of extreme immunodeficiency but were now stable on antiretroviral therapy (ART).RESULTS:Twenty CMV seropositive HIV patients &gt;50years old with nadir CD4 T-cell counts &lt;200 cells/mul were studied after &gt;12years on ART. 16 CMV seropositive and 9 CMV seronegative healthy controls were included. CMV antibody titres were higher in HIV patients than controls (P&lt;0.001-0.003). Levels of soluble B-cell activating factor (sBAFF) were elevated in patients (P=0.002) and correlated with levels of CMV antibodies (P=0.03-0.002), with no clear relationship in controls. CD8 T-cell IFNgamma responses to the IE1 peptide (VLE) remained elevated in HIV patients (P=0.005). The CD57 + CD45RA + CD27 phenotype of CD8 T-cells correlated with age (r=0.60, P=0.006), antibodies against CMV IE1 protein (r=0.44, P=0.06) and CD4 T-cell IFNgamma response to CMV lysate (r=0.45, P=0.05).CONCLUSIONS:Humoral and T-cell responses to CMV remained elevated in HIV patients after &gt;12years on ART. Age and presence of CMV disease influenced CD8 T-cell phenotypes. Elevated levels of sBAFF may be a consequence of HIV disease and contribute to high titres of CMV antibody