Socio-demographic and health service factors associated with antibiotic dispensing in older Australian adults

© 2019 Chen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background Widespread use of antibiotics has led to the development of antibiotic resistance. However, there are limited data describing antibiotic use in the community setting, and examining factors associated with greater use. Our study aimed to quantify antibiotic dispensing in older adults in the community according to socio-demographics and health services use. Methods Prospective analysis of a population-based cohort study of 239,981 adults aged 45 years in Australia (the Sax Institute’s 45 and Up Study). Data on socio-demographics and health from a questionnaire, were linked to 2015 antibiotic dispensing data from the Pharmaceutical Benefits Scheme (PBS), as well as other administrative health databases. We estimated the Defined Daily Dose (DDD) of systemic antibiotics dispensed, defined by an Anatomic Therapeutic Classification code beginning with J01, in 2015. We also conducted Poisson regression with robust standard errors to identify factors associated with antibiotic dispensing. Results Overall, 49.3% of 45 and Up Study participants had at least one systemic antibiotic dispensed in 2015 with a total of 392,856 prescriptions dispensed and an average of 36.5 DDDs/1000-persons/day in the study population. The quantity of antibiotics dispensed increased with increasing age (25.6 DDDs/1000/day in 15 general practitioner consultations in the last year (80.5 and 88.3 DDDs/1000/day, respectively). These factors remained strongly associated with greater antibiotic dispensing after adjusting for age, sex, education, income, area of residence and co-morbidities. Conclusions Residence in aged care facilities and high GP visits are associated with greater antibiotic dispensing. This study provides important evidence regarding high use groups for antimicrobial stewardship

A review of camera trapping for conservation behaviour research

An understanding of animal behaviour is important if conservation initiatives are to be effective. However, quantifying the behaviour of wild animals presents significant challenges. Remote-sensing camera traps are becoming increasingly popular survey instruments that have been used to non-invasively study a variety of animal behaviours, yielding key insights into behavioural repertoires. They are well suited to ethological studies and provide considerable opportunities for generating conservation-relevant behavioural data if novel and robust methodological and analytical solutions can be developed. This paper reviews the current state of camera-trap-based ethological studies, describes new and emerging directions in camera-based conservation behaviour, and highlights a number of limitations and considerations of particular relevance for camera-based studies. Three promising areas of study are discussed: (1) documenting anthropogenic impacts on behaviour; (2) incorporating behavioural responses into management planning and (3) using behavioural indicators such as giving up densities and daily activity patterns. We emphasize the importance of reporting methodological details, utilizing emerging camera trap metadata standards and central data repositories for facilitating reproducibility, comparison and synthesis across studies. Behavioural studies using camera traps are in their infancy; the full potential of the technology is as yet unrealized. Researchers are encouraged to embrace conservation-driven hypotheses in order to meet future challenges and improve the efficacy of conservation and management processes

Tailoring the electrochemical properties of 2D-hBN via physical linear defects: physicochemical, computational and electrochemical characterisation

Monolayer hexagonal-boron nitride films (2D-hBN) are typically reported within the literature to be electrochemically inactive due to their considerable band gap (ca. 5.2–5.8 eV). It is demonstrated herein that introducing physical linear defects (PLDs) upon the basal plane surface of 2D-hBN gives rise to electrochemically useful signatures. The reason for this transformation from insulator to semiconductor (inferred from physicochemical and computational characterisation) is likely due to full hydrogenation and oxygen passivation of the boron and/or nitrogen at edge sites. This results in a decrease in the band gap (from ca. 6.11 to 2.36/2.84 eV; theoretical calculated values, for the fully hydrogenated oxygen passivation at the N or B respectively). The 2D-hBN films are shown to be tailored through the introduction of PLDs, with the electrochemical behaviour dependent upon the surface coverage of edge plane-sites/defects, which is correlated with electrochemical performance towards redox probes (hexaammineruthenium(III) chloride and Fe2+/3+) and the hydrogen evolution reaction. This manuscript de-convolutes, for the first time, the fundamental electron transfer properties of 2D-hBN, demonstrating that through implementation of PLDs, one can beneficially tailor the electrochemical properties of this nanomateria

Fiducial Reference Measurements for Satellite Ocean Colour (FRM4SOC)

Earth observation data can help us understand and address some of the grand challenges and threats facing us today as a species and as a planet, for example climate change and its impacts and sustainable use of the Earth’s resources. However, in order to have confidence in earth observation data, measurements made at the surface of the Earth, with the intention of providing verification or validation of satellite-mounted sensor measurements, should be trustworthy and at least of the same high quality as those taken with the satellite sensors themselves. Metrology tells us that in order to be trustworthy, measurements should include an unbroken chain of SI-traceable calibrations and comparisons and full uncertainty budgets for each of the in situ sensors. Until now, this has not been the case for most satellite validation measurements. Therefore, within this context, the European Space Agency (ESA) funded a series of Fiducial Reference Measurements (FRM) projects targeting the validation of satellite data products of the atmosphere, land, and ocean, and setting the framework, standards, and protocols for future satellite validation efforts. The FRM4SOC project was structured to provide this support for evaluating and improving the state of the art in ocean colour radiometry (OCR) and satellite ocean colour validation through a series of comparisons under the auspices of the Committee on Earth Observation Satellites (CEOS). This followed the recommendations from the International Ocean Colour Coordinating Group’s white paper and supports the CEOS ocean colour virtual constellation. The main objective was to establish and maintain SI traceable ground-based FRM for satellite ocean colour and thus make a fundamental contribution to the European system for monitoring the Earth (Copernicus). This paper outlines the FRM4SOC project structure, objectives and methodology and highlights the main results and achievements of the project: (1) An international SI-traceable comparison of irradiance and radiance sources used for OCR calibration that set measurement, calibration and uncertainty estimation protocols and indicated good agreement between the participating calibration laboratories from around the world; (2) An international SI-traceable laboratory and outdoor comparison of radiometers used for satellite ocean colour validation that set OCR calibration and comparison protocols; (3) A major review and update to the protocols for taking irradiance and radiance field measurements for satellite ocean colour validation, with particular focus on aspects of data acquisition and processing that must be considered in the estimation of measurement uncertainty and guidelines for good practice; (4) A technical comparison of the main radiometers used globally for satellite ocean colour validation bringing radiometer manufacturers together around the same table for the first time to discuss instrument characterisation and its documentation, as needed for measurement uncertainty estimation; (5) Two major international side-by-side field intercomparisons of multiple ocean colour radiometers, one on the Atlantic Meridional Transect (AMT) oceanographic cruise, and the other on the Acqua Alta oceanographic tower in the Gulf of Venice; (6) Impact and promotion of FRM within the ocean colour community, including a scientific road map for the FRM-based future of satellite ocean colour validation and vicarious calibration (based on the findings of the FRM4SOC project, the consensus from two major international FRM4SOC workshops and previous literature, including the IOCCG white paper on in situ ocean colour radiometry)

Graphene Oxide Bulk-Modified Screen-Printed Electrodes Provide Beneficial Electroanalytical Sensing Capabilities

We demonstrate a facile methodology for the mass production of graphene oxide (GO) bulk-modified screen-printed electrodes (GO-SPEs) that are economical, highly reproducible and provide analytically useful outputs. Through fabricating GO-SPEs with varying percentage mass incorporations (2.5%, 5%, 7.5% and 10%) of GO, an electrocatalytic effect towards the chosen electroanalytical probes is observed, which increases with greater GO incorporated compared to bare/graphite SPEs. The optimum mass ratio of 10% GO to 90% carbon ink produces an electroanalytical signal towards dopamine (DA) and uric acid (UA) which is ca. ×10 greater in magnitude than that achievable at a bare/unmodified graphite SPE. Furthermore, 10% GO-SPEs exhibit a competitively low limit of detection (3σ) towards DA at ca. 81 nM, which is superior to that of a bare/unmodified graphite SPE at ca. 780 nM. The improved analytical response is attributed to the large number of oxygenated species inhabiting the edge and defect sites of the GO nanosheets, which are able to exhibit electrocatalytic responses towards inner-sphere electrochemical analytes. Our reported methodology is simple, scalable, and cost effective for the fabrication of GO-SPEs that display highly competitive LODs and are of significant interest for use in commercial and medicinal applications

Electrochemical properties of vertically aligned graphenes: tailoring heterogeneous electron transfer through manipulation of the carbon microstructure

The structure of vertically aligned graphene electrodes is shown to directly affect heterogeneous electron transfer kinetics in terms of the density of active edge plane sites of the microstructure, where greater edge content results in favourable electrochemical behaviour

Higher Spin Gravity with Matter in AdS_3 and Its CFT Dual

We study Vasiliev's system of higher spin gauge fields coupled to massive scalars in AdS_3, and compute the tree level two and three point functions. These are compared to the large N limit of the W_N minimal model, and nontrivial agreements are found. We propose a modified version of the conjecture of Gaberdiel and Gopakumar, under which the bulk theory is perturbatively dual to a subsector of the CFT that closes on the sphere.Comment: 58 pages; typos corrected, references adde

Accuracy of magnetic resonance studies in the detection of chondral and labral lesions in femoroacetabular impingement : systematic review and meta-analysis

Background: Several types of Magnetic resonance imaging (MRI) are commonly used in imaging of femoroacetabular impingement (FAI), however till now there are no clear protocols and recommendations for each type. The aim of this meta-analysis is to detect the accuracy of conventional magnetic resonance imaging (cMRI), direct magnetic resonance arthrography (dMRA) and indirect magnetic resonance arthrography (iMRA) in the diagnosis of chondral and labral lesions in femoroacetabular impingement (FAI). Methods: A literature search was finalized on the 17th of May 2016 to collect all studies identifying the accuracy of cMRI, dMRA and iMRA in diagnosing chondral and labral lesions associated with FAI using surgical results (arthroscopic or open) as a reference test. Pooled sensitivity and specificity with 95% confidence intervals using a random-effects meta-analysis for MRI, dMRA and iMRA were calculated also area under receiver operating characteristic (ROC) curve (AUC) was retrieved whenever possible where AUC is equivocal to diagnostic accuracy. Results: The search yielded 192 publications which were reviewed according inclusion and exclusion criteria then 21 studies fulfilled the eligibility criteria for the qualitative analysis with a total number of 828 cases, lastly 12 studies were included in the quantitative meta-analysis. Meta-analysis showed that as regard labral lesions the pooled sensitivity, specificity and AUC for cMRI were 0.864, 0.833 and 0.88 and for dMRA were 0.91, 0.58 and 0.92. While in chondral lesions the pooled sensitivity, specificity and AUC for cMRI were 0.76, 0.72 and 0.75 and for dMRA were 0.75, 0.79 and 0.83, while for iMRA were sensitivity of 0.722 and specificity of 0.917. Conclusions: The present meta-analysis showed that the diagnostic test accuracy was superior for dMRA when compared with cMRI for detection of labral and chondral lesions. The diagnostic test accuracy was superior for labral lesions when compared with chondral lesions in both cMRI and dMRA. Promising results are obtained concerning iMRA but further studies still needed to fully assess its diagnostic accuracy

Multi-centre reproducibility of diffusion MRI parameters for clinical sequences in the brain.

The purpose of this work was to assess the reproducibility of diffusion imaging, and in particular the apparent diffusion coefficient (ADC), intra-voxel incoherent motion (IVIM) parameters and diffusion tensor imaging (DTI) parameters, across multiple centres using clinically available protocols with limited harmonization between sequences. An ice-water phantom and nine healthy volunteers were scanned across fives centres on eight scanners (four Siemens 1.5T, four Philips 3T). The mean ADC, IVIM parameters (diffusion coefficient D and perfusion fraction f) and DTI parameters (mean diffusivity MD and fractional anisotropy FA), were measured in grey matter, white matter and specific brain sub-regions. A mixed effect model was used to measure the intra- and inter-scanner coefficient of variation (CV) for each of the five parameters. ADC, D, MD and FA had a good intra- and inter-scanner reproducibility in both grey and white matter, with a CV ranging between 1% and 7.4%; mean 2.6%. Other brain regions also showed high levels of reproducibility except for small structures such as the choroid plexus. The IVIM parameter f had a higher intra-scanner CV of 8.4% and inter-scanner CV of 24.8%. No major difference in the inter-scanner CV for ADC, D, MD and FA was observed when analysing the 1.5T and 3T scanners separately. ADC, D, MD and FA all showed good intra-scanner reproducibility, with the inter-scanner reproducibility being comparable or faring slightly worse, suggesting that using data from multiple scanners does not have an adverse effect compared with using data from the same scanner. The IVIM parameter f had a poorer inter-scanner CV when scanners of different field strengths were combined, and the parameter was also affected by the scan acquisition resolution. This study shows that the majority of diffusion MRI derived parameters are robust across 1.5T and 3T scanners and suitable for use in multi-centre clinical studies and trials

A mathematical model for breath gas analysis of volatile organic compounds with special emphasis on acetone

Recommended standardized procedures for determining exhaled lower respiratory nitric oxide and nasal nitric oxide have been developed by task forces of the European Respiratory Society and the American Thoracic Society. These recommendations have paved the way for the measurement of nitric oxide to become a diagnostic tool for specific clinical applications. It would be desirable to develop similar guidelines for the sampling of other trace gases in exhaled breath, especially volatile organic compounds (VOCs) which reflect ongoing metabolism. The concentrations of water-soluble, blood-borne substances in exhaled breath are influenced by: (i) breathing patterns affecting gas exchange in the conducting airways; (ii) the concentrations in the tracheo-bronchial lining fluid; (iii) the alveolar and systemic concentrations of the compound. The classical Farhi equation takes only the alveolar concentrations into account. Real-time measurements of acetone in end-tidal breath under an ergometer challenge show characteristics which cannot be explained within the Farhi setting. Here we develop a compartment model that reliably captures these profiles and is capable of relating breath to the systemic concentrations of acetone. By comparison with experimental data it is inferred that the major part of variability in breath acetone concentrations (e.g., in response to moderate exercise or altered breathing patterns) can be attributed to airway gas exchange, with minimal changes of the underlying blood and tissue concentrations. Moreover, it is deduced that measured end-tidal breath concentrations of acetone determined during resting conditions and free breathing will be rather poor indicators for endogenous levels. Particularly, the current formulation includes the classical Farhi and the Scheid series inhomogeneity model as special limiting cases.Comment: 38 page