Gender Equity in Transplantation: A Report From the Women in Transplantation Workshop of The Transplantation Society of Australia and New Zealand

The exponential growth of young talented women choosing science and medicine as their professional career over the past decade is substantial. Currently, more than half of the Australian medical doctoral graduates and early career researchers are comprised of women, but less than 20% of all academic professorial staff are women. The loss of female talent in the hierarchical ladder of Australian academia is a considerable waste of government investment, productivity, and scientific innovation. Gender disparity in the professional workforce composition is even more striking within the field of transplantation. Women are grossly underrepresented in leadership roles, with currently no female heads of unit in any of the Australian and New Zealand transplanting centers. At the same time, there is also gender segregation with a greater concentration of women in lower-status academic position compared with their male counterparts. Given the extent and magnitude of the disparity, the Women in Transplantation Committee, a subcommittee of The Transplantation Society of Australia and New Zealand established a workshop comprising 8 female clinicians/scientists in transplantation. The key objectives were to (i) identify potential gender equity issues within the transplantation workforce; (ii) devise and implement potential strategies and interventions to address some of these challenges at a societal level; (iii) set realistic and achievable goals to enhance and facility gender equality, equity, and diversity in transplantation

Implementation and Operational Research: A Randomized Noninferiority Trial of AccuCirc Device Versus Mogen Clamp for Early Infant Male Circumcision in Zimbabwe.

BACKGROUND: Early infant male circumcision (EIMC) is a potential key HIV prevention intervention, providing it can be safely and efficiently implemented in sub-Saharan Africa. Here, we present results of a randomized noninferiority trial of EIMC comparing the AccuCirc device with Mogen clamp in Zimbabwe. METHODS: Between January and June 2013, eligible infants were randomized to EIMC through either AccuCirc or Mogen clamp conducted by a doctor, using a 2:1 allocation ratio. Participants were followed for 14 days post-EIMC. Primary outcomes for the trial were EIMC safety and acceptability. RESULTS: One hundred fifty male infants were enrolled in the trial and circumcised between 6 and 54 days postpartum (n = 100 AccuCirc; n = 50 Mogen clamp). Twenty-six infants (17%) were born to HIV-infected mothers. We observed 2 moderate adverse events (AEs) [2%, 95% confidence interval (CI): 0.2 to 7.0] in the AccuCirc arm and none (95% CI: 0.0 to 7.1) in the Mogen clamp arm. The cumulative incident risk of AEs was 2.0% higher in the AccuCirc arm compared with the Mogen Clamp arm (95% CI: -0.7 to 4.7). As the 95% CI excludes the predefined noninferiority margin of 6%, the result provides evidence of noninferiority of AccuCirc compared with the Mogen clamp. Nearly all mothers (99.5%) reported great satisfaction with the outcome. All mothers, regardless of arm said they would recommend EIMC to other parents, and would circumcise their next son. CONCLUSIONS: This first randomized trial of AccuCirc versus Mogen clamp for EIMC demonstrated that EIMC using these devices is safe and acceptable to parents. There was no difference in the rate of AEs by device

Safety, Acceptability, and Feasibility of Early Infant Male Circumcision Conducted by Nurse-Midwives Using the AccuCirc Device: Results of a Field Study in Zimbabwe.

BACKGROUND: For prevention of HIV, early infant male circumcision (EIMC) needs to be scaled up in countries with high HIV prevalence. Routine EIMC will maintain the HIV prevention gains anticipated from current adult male circumcision initiatives. We present here the results of a field study of EIMC conducted in Zimbabwe. METHODS: The study was observational and based on the World Health Organization (WHO) framework for clinical evaluation of male circumcision devices. We recruited parents of newborn male infants between August 2013 and July 2014 from 2 clinics. Nurse-midwives used the AccuCirc device to circumcise eligible infants. We followed participants for 14 days after EIMC. Outcome measures were EIMC safety, acceptability, and feasibility. RESULTS: We enrolled 500 male infants in the field study (uptake 11%). The infants were circumcised between 6 and 60 days postpartum. The procedure took a median of 17 minutes (interquartile range of 5 to 18 minutes). Mothers' knowledge of male circumcision was extensive. Of the 498 mothers who completed the study questionnaire, 91% knew that male circumcision decreases the risk of HIV acquisition, and 83% correctly stated that this prevention is partial. Asked about their community's perception of EIMC, 40% felt that EIMC will likely be viewed positively in their community; 13% said negatively; and 47% said the perception could be both ways. We observed 7 moderate or severe adverse events (1.4%; 95% confidence interval, 0.4% to 2.4%). All resolved without lasting effects. Nearly all mothers (99%) reported great satisfaction with the outcome, would recommend EIMC to other parents, and would circumcise their next sons. CONCLUSION: This first field study in sub-Saharan Africa of the AccuCirc device for EIMC demonstrated that EIMC conducted by nurse-midwives with this device is safe, feasible, and acceptable to parents

Global dataset on seagrass meadow structure, biomass and production

Seagrass meadows provide valuable socio-ecological ecosystem services, including a key role in climate change mitigation and adaption. Understanding the natural history of seagrass meadows across environmental gradients is crucial to deciphering the role of seagrasses in the global ocean. In this data collation, spatial and temporal patterns in seagrass meadow structure, biomass and production data are presented as a function of biotic and abiotic habitat characteristics. The biological traits compiled include measures of meadow structure (e.g. percent cover and shoot density), biomass (e.g. above-ground biomass) and production (e.g. shoot production). Categorical factors include bioregion, geotype (coastal or estuarine), genera and year of sampling. This dataset contains data extracted from peer-reviewed publications published between 1975 and 2020 based on a Web of Science search and includes 11 data variables across 12 seagrass genera. The dataset excludes data from mesocosm and field experiments, contains 14271 data points extracted from 390 publications and is publicly available on the PANGAEA® data repository (10.1594/PANGAEA.929968; Strydom et al., 2021). The top five most studied genera are Zostera, Thalassia, Cymodocea, Halodule and Halophila (84 % of data), and the least studied genera are Phyllospadix, Amphibolis and Thalassodendron (2.3 % of data). The data hotspot bioregion is the Tropical Indo-Pacific (25 % of data) followed by the Tropical Atlantic (21 %), whereas data for the other four bioregions are evenly spread (ranging between 13 and 15 % of total data within each bioregion). From the data compiled, 57 % related to seagrass biomass and 33 % to seagrass structure, while the least number of data were related to seagrass production (11 % of data). This data collation can inform several research fields beyond seagrass ecology, such as the development of nature-based solutions for climate change mitigation, which include readership interested in blue carbon, engineering, fisheries, global change, conservation and policy

Healthcare expenditure on Indigenous and non-Indigenous Australians at high risk of cardiovascular disease

Background: In spite of bearing a heavier burden of death, disease and disability, there is mixed evidence as to whether Indigenous Australians utilise more or less healthcare services than other Australians given their elevated risk level. This study analyses the Medicare expenditure and its predictors in a cohort of Indigenous and non-Indigenous Australians at high risk of cardiovascular disease. Methods: The healthcare expenditure of participants of the Kanyini Guidelines Adherence with the Polypill (GAP) pragmatic randomised controlled trial was modelled using linear regression methods. 535 adult (48% Indigenous) participants at high risk of cardiovascular disease (CVD) were recruited through 33 primary healthcare services (including 12 Aboriginal Medical Services) across Australia. Results: There was no significant difference in the expenditure of Indigenous and non-Indigenous participants in non-remote areas following adjustment for individual characteristics. Indigenous individuals living in remote areas had lower MBS expenditure ($932 per year P< 0.001) than other individuals. MBS expenditure was found to increase with being aged over 65 years ($128, p=0.013), being female ($472, p=0.003), lower baseline reported quality of life ($102 per 0.1 decrement of utility p=0.004) and a history of diabetes ($324, p=0.001), gout ($631, p=0.022), chronic obstructive pulmonary disease ($469, p=0.019) and established CVD whether receiving guideline-recommended treatment prior to the trial ($452, p=0.005) or not ($483, p=0.04). When controlling for all other characteristics, morbidly obese patients had lower MBS expenditure than other individuals (-$887, p=0.002). Conclusion: The findings suggest that for the majority of participants, once individuals are engaged with a primary care provider, factors other than whether they are Indigenous determine the level of Medicare expenditure for each person. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN 126080005833347

Murchison widefield array observations of anomalous variability: A serendipitous night-time detection of interplanetary scintillation

We present observations of high-amplitude rapid (2 s) variability toward two bright, compact extragalactic radio sources out of several hundred of the brightest radio sources in one of the Murchison Widefield Array (MWA) Epoch of Reionization fields using the MWA at 155 MHz. After rejecting intrinsic, instrumental, and ionospheric origins we consider the most likely explanation for this variability to be interplanetary scintillation (IPS), likely the result of a large coronal mass ejection propagating from the Sun. This is confirmed by roughly contemporaneous observations with the Ooty Radio Telescope. We see evidence for structure on spatial scales ranging from 10 6 km. The serendipitous night-time nature of these detections illustrates the new regime that the MWA has opened for IPS studies with sensitive night-time, wide-field, low-frequency observations. This regime complements traditional dedicated strategies for observing IPS and can be utilized in real-time to facilitate dedicated follow-up observations. At the same time, it allows large-scale surveys for compact (arcsec) structures in low-frequency radio sources despite the resolution of the array

The Murchison Widefield Array Commissioning Survey : A Low-Frequency Catalogue of 14,110 Compact Radio Sources over 6,100 Square Degrees

22 pages, 18 figures, accepted to PASAWe present the results of an approximately 6,100 square degree 104--196MHz radio sky survey performed with the Murchison Widefield Array during instrument commissioning between 2012 September and 2012 December: the Murchison Widefield Array Commissioning Survey (MWACS). The data were taken as meridian drift scans with two different 32-antenna sub-arrays that were available during the commissioning period. The survey covers approximately 20.5 hPeer reviewedFinal Accepted Versio

The First Murchison Widefield Array low-frequency radio observations of cluster scale non-thermal emission: the case of Abell 3667

We present the first Murchison Widefield Array observations of the well-known cluster of galaxies Abell 3667 (A3667) between 105 and 241 MHz. A3667 is one of the best known examples of a galaxy cluster hosting a double radio relic and has been reported to contain a faint radio halo and bridge. The origin of radio haloes, relics and bridges is still unclear, however galaxy cluster merger seems to be an important factor. We clearly detect the north-west (NW) and south-east radio relics in A3667 and find an integrated flux density at 149 MHz of 28.1 ± 1.7 and 2.4 ± 0.1 Jy, respectively, with an average spectral index, between 120 and 1400 MHz, of −0.9 ± 0.1 for both relics. We find evidence of a spatial variation in the spectral index across the NW relic steepening towards the centre of the cluster, which indicates an ageing electron population. These properties are consistent with higher frequency observations. We detect emission that could be associated with a radio halo and bridge. However, due to the presence of poorly sampled large-scale Galactic emission and blended point sources we are unable to verify the exact nature of these features

Malaria control under the Taliban regime: insecticide-treated net purchasing, coverage, and usage among men and women in eastern Afghanistan

BACKGROUND: Scaling up insecticide-treated mosquito net (ITN) coverage is a key malaria control strategy even in conflict-affected countries 12. Socio-economic factors influence access to ITNs whether subsidized or provided free to users. This study examines reported ITN purchasing, coverage, and usage in eastern Afghanistan and explores women's access to health information during the Taliban regime (1996-2001). This strengthens the knowledge base on household-level health choices in complex-emergency settings. METHODS: Fifteen focus group discussions (FGDs) and thirty in-depth interviews were conducted with men and women from ITN-owning and non-owning households. FGDs included rank ordering, pile sorting and focused discussion of malaria knowledge and ITN purchasing. Interviews explored general health issues, prevention and treatment practices, and women's malaria knowledge and concerns. Seven key informant interviews with health-related workers and a concurrent survey of 200 ITN-owning and 214 non-owning households were used to clarify or quantify findings. RESULTS: Malaria knowledge was similar among men and women and ITN owners and non-owners. Women reported obtaining health information through a variety of sources including clinic staff, their husbands who had easier access to information, and particularly female peers. Most participants considered ITNs very desirable, though not usually household necessities. ITN owners reported more household assets than non-owners. Male ITN owners and non-owners ranked rugs and ITNs as most desired, while women ranked personal assets such as jewellery highest. While men were primarily responsible for household decision-making and purchasing, older women exerted considerable influence. Widow-led and landless households reported most difficulties purchasing ITNs. Most participants wanted to buy ITNs only if they could cover all household members. When not possible, preferential usage was given to women and children. CONCLUSIONS: Despite restricted access to health facilities and formal education, Afghan women were surprisingly knowledgeable about the causes of malaria and the value of ITNs in prevention. Inequities in ITN usage were noted between rather than within households, with some unable to afford even one ITN and others not wanting ITNs unless all household members could be protected. Malaria knowledge thus appears a lesser barrier to ITN purchasing and coverage in eastern Afghanistan than are pricing and distribution strategies