Impact of COVID-19 pandemic on ophthalmic presentations to an Australian outer metropolitan and rural emergency department: a retrospective comparative study.

BACKGROUND: To analyse ophthalmic presentations to an outer metropolitan and a rural emergency department (ED) during the first wave of the COVID-19 pandemic in New South Wales (NSW), Australia. METHODS: A retrospective comparative study of ophthalmic emergency presentations to Campbelltown Hospital (fifth busiest NSW metropolitan ED; population 310,000) and Bowral and District Hospital (rural ED; population 48,000) before and during COVID-19 was conducted. Patient demographics, triage category, referral source, diagnosis, length of stay, departure status, and follow-up location were assessed from coding data between March 1st to May 31st in 2019 and 2020, corresponding to the peak case numbers and restrictions during the first wave of the COVID-19 pandemic in NSW. Differences before and during COVID-19 were analysed using chi-squared tests or independent sample t-tests. RESULTS: There was no change in ophthalmic presentations at Campbelltown (n = 228 in 2019 vs. n = 232 in 2020; + 1.75%, p = 0.12) and an increase at Bowral (n = 100 in 2019 vs. n = 111 in 2020; + 11%, p < 0.01) during COVID-19. Urgent ophthalmic presentations (Triage Category 3) decreased at Bowral (p = 0.0075), while non-urgent ophthalmic presentations (Triage Category 5) increased at both hospitals (Campbelltown p < 0.05, Bowral p < 0.01). CONCLUSIONS: There was no change in the total number of ophthalmic presentations to an outer metropolitan and an increase to a rural ED during the first wave of the COVID-19 pandemic in New South Wales, Australia. A change in the type of ophthalmic presentations at these peripheral EDs suggest that a high demand for ophthalmic services remained despite the pandemic and its associated gathering and movement restrictions. A flexible healthcare delivery strategy, such as tele-ophthalmology, may optimise patient care during and after COVID-19

Surface grafting of electrospun fibers using ATRP and RAFT for the control of biointerfacial interactions

BACKGROUND The ability to present signalling molecules within a low fouling 3D environment that mimics the extracellular matrix is an important goal for a range of biomedical applications, both in vitro and in vivo. Cell responses can be triggered by non-specific protein interactions occurring on the surface of a biomaterial, which is an undesirable process when studying specific receptor-ligand interactions. It is therefore useful to present specific ligands of interest to cell surface receptors in a 3D environment that minimizes non-specific interactions with biomolecules, such as proteins. METHOD In this study, surface-initiated atom transfer radical polymerization (SI-ATRP) of poly(ethylene glycol)-based monomers was carried out from the surface of electrospun fibers composed of a styrene/vinylbenzyl chloride copolymer. Surface initiated radical addition-fragmentation chain transfer (SI-RAFT) polymerisation was also carried out to generate bottle brush copolymer coatings consisting of poly(acrylic acid) and poly(acrylamide). These were grown from surface trithiocarbonate groups generated from the chloromethyl styrene moieties existing in the original synthesised polymer. XPS was used to characterise the surface composition of the fibers after grafting and after coupling with fluorine functional XPS labels. RESULTS Bottle brush type coatings were able to be produced by ATRP which consisted of poly(ethylene glycol) methacrylate and a terminal alkyne-functionalised monomer. The ATRP coatings showed reduced non-specific protein adsorption, as a result of effective PEG incorporation and pendant alkynes groups existing as part of the brushes allowed for further conjugation of via azide-alkyne Huisgen 1,3-dipolar cycloaddition. In the case of RAFT, carboxylic acid moieties were effectively coupled to an amine label via amide bond formation. In each case XPS analysis demonstrated that covalent immobilisation had effectively taken place. CONCLUSION Overall, the studies presented an effective platform for the preparation of 3D scaffolds which contain effective conjugation sites for attachment of specific bioactive signals of interest, as well as actively reducing non-specific protein interactions.This research was supported by the Cooperative Research Centre for Polymers (CRCP)

Microbial quality of drinking water from groundtanks and tankers at source and point-of-use in eThekwini Municipality, South Africa, and its relationship to health outcomes

Drinking water quality was investigated at source and corresponding point-of-use in 2 peri-urban areas receiving drinking water either by communal water tanker or by delivery directly from the distribution system to household-based groundtanks with taps. Water quality variables measured were heterotrophic bacteria, total coliforms, E. coli, conductivity, turbidity, pH, and total and residual chlorine. Water quality data were analysed together with an existing epidemiological database to investigate links between microbial quality of drinking water, household demographics, health outcomes, socio-economic status, hygiene and sanitation practices. Groundtank households had better quality drinking water than households using storage containers filled from communal tankers. Uncovered storage containers had the poorest microbial water quality among all storage containers. All stored water did not meet drinking water standards, although mains water did. Households with children under 5 years and using open-topped containers had the poorest water quality overall. Households with groundtanks had the best water quality at point-of-use, but did not have the lowest occurrence of health effects. Although groundtanks were supplied together with urine diversion (UD) toilets and hygiene education, groundtank households showed overall poorer hygiene practices than tanker-supplied households, and some groundtank households with UD toilets preferred to continue using open defecation. Households that practised open defecation had higher levels of E. coli in their drinking water and higher rates of adverse health outcomes. Poorer socio-economic standing and lower educational standard were associated with poorer water quality, poorer hygiene practices and higher rates of diarrhoea and vomiting.Keywords: drinking water; point of use; water quality; water quantity; hygiene; sanitatio

Water security in South Africa: perceptions on public expectations and municipal obligations, governance and water re-use

South Africa is a water-scarce country with increasing pressure on its water resources. Urgent interventions are needed to protect water security within this rapidly developing country. This paper reports on an interdisciplinary Water Security Colloquium, convened by the South African Young Academy of Science in 2014. A selected group of water professionals from academia, civil society and local government was brought together to discuss water security under three focus themes: ‘public expectations and municipal obligations’, ‘water security and governance: challenges and advances’, and ‘water re-use: health and infrastructural considerations’. Participant perceptions were generated using a focus group methodology, combined with participatory data collection methods. Under each theme, inputs were categorised as ‘challenges’, ‘gaps in knowledge’, and ‘solutions/recommendations’ and these inputs were thereafter ranked in order of importance via a ‘voting’ process. Major challenges perceived included a lack of both skills and political will in government, a need to restore citizen trust in government intention and capability to deliver water-related services, and a failure to up-scale existing water re-use technology. Participants identified understanding of the process and implications of the Green and Blue Drop Programmes, knowledge transfer to the public, and the role of educators as major knowledge gaps. The top suggestions proposed included creating public awareness around and buy-in to initiatives to improve water security, accessible and user-friendly conversion of research results to implementation, and ensuring an active role for educators in creating awareness around water security. In view of the concerns identified, participants suggested as potential solutions: improving government and public understanding around water issues, incentivising water re-use and conservation, introducing rising block tariffs and improving human capacity development in the water sector. Developing the ecological infrastructure that protects both quantity and quality of water and building strong partnerships among all stakeholders were also recognised as key.Keywords: capacity development, education, governance, water security, water re-use, water conservation, local governmen

Panta rei: Tracking Semantic Change with Distributional Semantics in Ancient Greek

We present a method to explore semantic change as a function of variation in distributional semantic spaces. In this paper, we apply this approach to automatically identify the areas of semantic change in the lexicon of Ancient Greek between the pre-Christian and Christian era. Distributional Semantic Models are used to identify meaningful clusters and patterns of semantic shift within a set of target words, defined through a purely data-driven approach. The results emphasize the role played by the diffusion of Christianity and by technical languages in determining semantic change in Ancient Greek and show the potentialities of distributional models in diachronic semantics

Atypical chemokine receptor 4 shapes activated B cell fate

Activated B cells can initially differentiate into three functionally distinct fates-early plasmablasts (PBs), germinal center (GC) B cells, or early memory B cells-by mechanisms that remain poorly understood. Here, we identify atypical chemokine receptor 4 (ACKR4), a decoy receptor that binds and degrades CCR7 ligands CCL19/CCL21, as a regulator of early activated B cell differentiation. By restricting initial access to splenic interfollicular zones (IFZs), ACKR4 limits the early proliferation of activated B cells, reducing the numbers available for subsequent differentiation. Consequently, ACKR4 deficiency enhanced early PB and GC B cell responses in a CCL19/CCL21-dependent and B cell-intrinsic manner. Conversely, aberrant localization of ACKR4-deficient activated B cells to the IFZ was associated with their preferential commitment to the early PB linage. Our results reveal a regulatory mechanism of B cell trafficking via an atypical chemokine receptor that shapes activated B cell fate

Efficacy and toxicity outcomes for patients treated with focal salvage high dose rate brachytherapy for locally recurrent prostate cancer

Introduction Isolated local recurrence of prostate cancer following primary radiotherapy or brachytherapy may be treated with focal salvage high dose rate brachytherapy, although there remains an absence of high quality evidence to support this approach. Methods Men with prostate cancer treated consecutively between 2015 and 2018 using 19 Gy in a single fraction high dose rate brachytherapy (HDR) for locally recurrent prostate cancer were identified from an institutional database. Univariable analysis was performed to evaluate the relationship between patient, disease and treatment factors with biochemical progression free survival (bPFS). Results 43 patients were eligible for evaluation. Median follow up duration was 26 months (range 1–60). Median bPFS was 35 months (95% confidence interval 25.6–44.4). Kaplan-Meier estimates for bPFS at 1, 2 and 3 years post salvage were 95.2%, 70.6% and 41.8% respectively. On univariable Cox regression analysis, only nadir PSA was significantly associated with bPFS although the majority of patients were also treated with androgen deprivation therapy. Only one late grade 3 genitourinary toxicity was observed. Conclusion Focal salvage HDR brachytherapy may provide good biochemical control with a low risk of severe toxicity. Further evaluation within clinical trials are needed to establish its role in the management of locally recurrent prostate cancer