Intelligent pigments and plastics for CO2 detection

A novel CO2 intelligent pigment is incorporated into a thermoplastic polymer to create a long-lived CO2-sensitive plastic film which is characterised and then compared to a traditional solvent-based CO2 indicator film

Interventions to Promote Cancer Awareness and Early Presentation: Systematic Review

Low cancer awareness contributes to delay in presentation for cancer symptoms and may lead to delay in cancer diagnosis. The aim of this study was to review the evidence for the effectiveness of interventions to raise cancer awareness and promote early presentation in cancer to inform policy and future research. We searched bibliographic databases and reference lists for randomised controlled trials of interventions delivered to individuals, and controlled or uncontrolled studies of interventions delivered to communities. We found some evidence that interventions delivered to individuals modestly increase cancer awareness in the short term and insufficient evidence that they promote early presentation. We found limited evidence that public education campaigns reduce stage at presentation of breast cancer, malignant melanoma and retinoblastoma

Sensitivity and specificity of Aboriginal‐developed items to supplement the adapted PHQ ‐9 screening measure for depression: results from the Getting it Right study

Objective: To determine the psychometric properties of an Aboriginal and Torres Strait Islander‐developed depressive symptom screening scale. Design: Prospective diagnostic accuracy study. Setting: Ten primary health care services or residential alcohol and other drug rehabilitation services in Australia that predominantly serve Aboriginal and Torres Strait Islander peoples. Participants: 500 adults (18 years or older) who identified as Aboriginal and/or Torres Strait Islander and were able to communicate sufficiently to respond to questionnaire and interview questions. Recruitment occurred between 25 March 2015 and 2 November 2016. Main outcome measure: Criterion validity of seven Aboriginal and Torres Strait Islander‐developed items, using the adapted Patient Health Questionnaire 9 (aPHQ‐9) and depression module of the Mini International Neuropsychiatric Interview (MINI) 6.0.0 as the criterion standards. Results: The seven‐item scale had good internal consistency (α = 0.83) and correlated highly with the aPHQ‐9 (ρ = 0.76). All items were significantly associated with diagnosis of a current major depressive episode. Discriminant function and decision tree analysis identified three items forming a summed scale that classified 85% of participants correctly. These three items showed equivalent sensitivity and specificity to the aPHQ‐9 when compared with the MINI‐identified diagnosis of a current major depressive episode. Conclusion: Three items developed by and for Aboriginal and Torres Strait Islander people may provide effective, efficient and culturally appropriate screening for depression in Aboriginal and Torres Strait Islander health care contexts

Getting it Right: validating a culturally specific screening tool for depression (aPHQ‐9) in Aboriginal and Torres Strait Islander Australians

Objectives To determine the validity, sensitivity, specificity and acceptability of the culturally adapted nine‐item Patient Health Questionnaire (aPHQ‐9) as a screening tool for depression in Aboriginal and Torres Strait Islander people. Design Prospective observational validation study, 25 March 2015 – 2 November 2016. Setting, participants 500 adults (18 years or older) who identified as Aboriginal or Torres Strait Islander people and attended one of ten primary health care services or service events in urban, rural and remote Australia that predominantly serve Indigenous Australians, and were able to communicate sufficiently to respond to questionnaire and interview questions. Main outcome measures Criterion validity of the aPHQ‐9, with the depression module of the Mini‐International Neuropsychiatric Interview (MINI) 6.0.0 as the criterion standard. Results 108 of 500 participants (22%; 95% CI, 18–25%) had a current episode of major depression according to the MINI criterion. The sensitivity of the aPHQ‐9 algorithm for diagnosing a current major depressive episode was 54% (95% CI, 40–68%), its specificity was 91% (95% CI, 88–94%), with a positive predictive value of 64%. For screening for a current major depressive episode, the area under the receiver operator characteristic curve was 0.88 (95% CI, 0.85–0.92); with a cut‐point of 10 points its sensitivity was 84% (95% CI, 74–91%) and its specificity 77% (95% CI, 71–83%). The aPHQ‐9 was deemed acceptable by more than 80% of participants. Conclusions Indigenous Australians found the aPHQ‐9 acceptable as a screening tool for depression. Applying a cut‐point of 10 points, the performance characteristics of the aPHQ were good

An interferon-inducible neutrophil-driven blood transcriptional signature in human tuberculosis

Tuberculosis (TB), caused by infection with Mycobacterium tuberculosis (M. tuberculosis), is a major cause of morbidity and mortality worldwide and efforts to control TB are hampered by difficulties with diagnosis, prevention and treatment 1,2. Most people infected with M. tuberculosis remain asymptomatic, termed latent TB, with a 10% lifetime risk of developing active TB disease, but current tests cannot identify which individuals will develop disease 3. The immune response to M. tuberculosis is complex and incompletely characterized, hindering development of new diagnostics, therapies and vaccines 4,5. We identified a whole blood 393 transcript signature for active TB in intermediate and high burden settings, correlating with radiological extent of disease and reverting to that of healthy controls following treatment. A subset of latent TB patients had signatures similar to those in active TB patients. We also identified a specific 86-transcript signature that discriminated active TB from other inflammatory and infectious diseases. Modular and pathway analysis revealed that the TB signature was dominated by a neutrophil-driven interferon (IFN)-inducible gene profile, consisting of both IFN-γ and Type I IFNαβ signalling. Comparison with transcriptional signatures in purified cells and flow cytometric analysis, suggest that this TB signature reflects both changes in cellular composition and altered gene expression. Although an IFN signature was also observed in whole blood of patients with Systemic Lupus Erythematosus (SLE), their complete modular signature differed from TB with increased abundance of plasma cell transcripts. Our studies demonstrate a hitherto under-appreciated role of Type I IFNαβ signalling in TB pathogenesis, which has implications for vaccine and therapeutic development. Our study also provides a broad range of transcriptional biomarkers with potential as diagnostic and prognostic tools to combat the TB epidemic

Evidence and morality in harm-reduction debates: can we use value-neutral arguments to achieve value-driven goals?

It is common to argue that politicians make selective use of evidence to tacitly reinforce their moral positions, but all stakeholders combine facts and values to produce and use research for policy. The drug policy debate has largely been framed in terms of an opposition between evidence and politics. Focusing on harm reduction provides useful ground to discuss a further opposition proposed by evidence advocates, that between evidence and morality. Can evidence sway individuals from their existing moral positions, so as to “neutralise” morality? And if not, then should evidence advocates change the way in which they frame their arguments? To address these questions, analysis of N=27 interviews with stakeholders involved in drug policy and harm reduction research, advocacy, lobbying, implementation and decision-making in England, UK and New South Wales, Australia, was conducted. Participants’ accounts suggest that although evidence can help focus discussions away from values and principles, exposure to evidence does not necessarily change deeply held views. Whether stakeholders decide to go with the evidence or not seems contingent on whether they embrace a view of evidence as secular faith; a view that is shaped by experience, politics, training, and role. And yet, morality, values, and emotions underpin all stakeholders’ views, motivating their commitment to drug policy and harm reduction. Evidence advocates might thus benefit from morally and emotionally engaging audiences. This paper aims to develop better tools for analysing the role of morality in decision-making, starting with moral foundations theory. Using tools from disciplines such as moral psychology is relevant to the study of the politics of evidence-based policymaking

Mechanisms of inorganic carbon-14 attenuation in contaminated groundwater: Effect of solution pH on isotopic exchange and carbonate precipitation reactions

Radioactive 14C is a significant contaminant associated with nuclear fuels and wastes that is potentially highly mobile in the environment as dissolved inorganic carbonate species. This study investigated the mechanisms by which dissolved inorganic 14C is retained in surface and groundwater environments via precipitation and isotopic exchange reactions. Precipitation of calcite in the presence and absence of nucleation sites is considered along with isotopic exchange with both atmospheric CO2 and solid carbonates. Precipitation occurs at calcite supersaturation values of SICAL > 1.5 in the absence of nucleation sites and SICAL > 0–0.5 in the presence of nucleation sites, suggesting that precipitation of 14C-bearing carbonates is much more likely in subsurface environments where nucleation sites are abundant. The maximum 14C removal in solid isotopic exchange experiments occurred after approximately 2 weeks equilibration. In these experiments the amount of 14C removed from solution was proportional to the amount of calcite surface area present, and removal from solution was equivalent to rapid equalisation of the isotope ratio in an 8–10 Å active surface layer. Although the reactivity of natural carbonates may be lower than the calcite samples used in this study, these results suggest isotopic exchange with solids will be an important 14C retardation mechanism in subsurface environments containing only modest TIC concentrations. These results suggest that if inorganic 14C is released into sub-surface environments, both precipitation and solid phase isotopic exchange can result in non-conservative 14C-DIC transport and 14C contamination may persist in groundwater for decades following accidental releases. In contrast, in experiments open to atmosphere with pH values below 9.3, complete loss of dissolved inorganic 14C was very rapid and occurred with timescales of 10's of hours. 14C loss was due to a rapid exchange of dissolved 14C species with 12CO2 (g) and the kinetics of 14C removal increased as pH values were lowered (i.e. atmospheric isotopic exchange was first order with respect to the concentration of carbonic acid present). Thus these results suggest that release of inorganic 14C to surface waters with pH values <9.3 would result in rapid exchange with 12CO2 (g) and 14C would not persist in the aqueous environment, whereas 14C-DIC released to saturated subsurface environments may persist close to the release site for decades due to precipitation and solid phase exchange reactions preventing/retarding transport with the groundwater