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Aims/Hypothesis: In diabetes haptoglobin (Hp) 2 vs Hp 1 allelic product is associated with cardiac and renal complications. Few studies report both Hp phenotype and Hp levels. In a Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) trial substudy we evaluated the Hp phenotype, Hp levels, and fenofibrate effects. Materials and Methods: In 480 adults with type 2 diabetes (T2D) the Hp phenotype was assessed and the Hp level quantified (both using ELISAs assays) in plasma from baseline, after 6 weeks of fenofibrate, and (in n = 200) at 2 years post‐randomization to fenofibrate or placebo. Results: The Hp phenotypes 1‐1, 2‐1, and 2‐2 frequencies were 15%, 49%, and 36%, respectively. Baseline Hp levels differed by phenotype (P < 0.0001) and decreased (median 21%) after 6 weeks fenofibrate in all phenotypes (adjusted mean (95% CI): −0.27 (−0.32, −0.23) mg/mL in Hp 1‐1, −0.29 (−0.31, −0.27) mg/mL in Hp 2‐1 and −0.05 (−0.07, −0.02) mg/mL in Hp 2‐2 (P = 0.005 and P = 0.055 vs Hp 1‐1 and Hp 2‐1, respectively)). At 2 years post‐randomization the Hp levels in the placebo group had returned to baseline, whilst the fenofibrate‐group levels remained similar to the 6 week levels. Conclusions: In type 2 diabetes, Hp levels differ by Hp phenotype and are decreased by fenofibrate in all phenotypes, but the effect is diminished in Hp 2‐2. [ABSTRACT FROM AUTHOR]

Background: Forty percent of individuals within the Disorders of Consciousness (DoC) spectrum are misdiagnosed as in a vegetative state/unresponsive wakefulness syndrome (VS/UWS) when in fact they are minimally conscious or emerged, underscoring a need to optimize evaluation techniques and interprofessional care management. Primary Objective: Conscious Care is a proposed care model that aims to improve interprofessional care of patients with DoC in the hospital setting. The aim of this paper is to describe this model's key ingredients and various components. Conclusions: This care model will advance clinician and caregiver preparedness to manage the complexities of this population and advocate for equal access to post-hospital medical and rehabilitative services. Evaluation and treatment of survivors of DoC should incorporate current evidence which drives continuous quality improvement and education to clinicians across the continuum of care. Immediate action must be taken to decrease the vulnerability and neglect of this marginalized population. Conscious Care is an innovative, sustainable solution that will improve interprofessional awareness of best practices and available science, strengthen care, and advocate for the right to quality of life that this population is so often denied. [ABSTRACT FROM AUTHOR]

Issues Addressed: Aboriginal and Torres Strait Islander (Aboriginal) people in South Australia are overburdened by cardiovascular disease, diabetes and cancer. The South Australian Aboriginal Chronic Disease Consortium (Consortium) was established in June 2017 as a collaborative partnership to lead the implementation of three state‐wide chronic disease plans using a strategic approach to identifying key priority areas for action. Methods: In 2017–2018, the Consortium Coordinating Centre facilitated a priority setting process, which involved extensive consultation, including a prioritisation survey and stakeholder workshops. The Consortium's Aboriginal Community Reference Group was instrumental in leading the identification of priorities for action. Results: The Consortium RoadMap for Action identified seven across‐plan priorities and six condition‐specific priorities. It acknowledged that: strengthening social and emotional well‐being is central to improving health outcomes; prevention and early detection, acute management and ongoing management are all components of the continuum of care; and improving access to services, strengthening the workforce, and monitoring and evaluation are required across the continuum of care. Conclusion: Widespread implementation failure in the past across the health system and health services implementation and research translation highlights the value of the Consortium approach and its commitment to implementing the state‐wide chronic disease plans in a collaborative manner. The Consortium relies on and fosters cross‐sectoral alignment, with all key players including all public, private and Aboriginal Community Controlled health services, to progress its priorities and aspirations to improve health outcomes for Aboriginal people using evidence‐based strategies. So What?: Rigorous and transparent priority setting processes that bring together research, clinical practice, health services operations, policy and community perspectives can foster intersectoral collaboration and partnership and support the implementation of shared priorities. [ABSTRACT FROM AUTHOR]

Slow strain rate tensile testing was conducted on electrodeposited copper, which is a candidate coating material for used nuclear fuel containers. Embrittlement was observed in electrodeposited copper containing 26.4 ± 1.0 ppm hydrogen, with a strain rate sensitivity such that the embrittlement was exacerbated at lower strain rate (5 × 10−7 s−1). Tensile tests conducted at 100° and 200 °C also intensified embrittlement when compared with tests conducted at room temperature. In contrast, electrodeposited copper containing only 5.25 ± 0.97 ppm hydrogen exhibited ductile behavior at all tested strain rates and temperatures. These findings suggest that a previously unexplained slow strain rate hydrogen embrittlement can operate in electrodeposited copper provided that the hydrogen concentration is sufficiently high. Further analyses revealed that the deformation of embrittled copper is achieved by the formation of internal microcracks which coalesce at the point of failure. [ABSTRACT FROM AUTHOR]

Objective: To investigate cardiac rehabilitation utilisation and effectiveness, factors, needs and barriers associated with non-completion. Design: We used the mixed-methods design with concurrent triangulation of a retrospective cohort and a qualitative study. Setting: Economically disadvantaged areas in rural Australia. Participants: Patients (≥18 years) referred to cardiac rehabilitation through a central referral system and living in rural areas of low socioeconomic status. Main measures: A Cox survival model balanced by inverse probability weighting was used to assess the association between cardiac rehabilitation utilization and 12-month mortality/cardiovascular readmissions. Associations with non-completion were tested by logistic regression. Barriers and needs to cardiac rehabilitation completion were investigated through a thematic analysis of semi-structured interviews and focus groups (n = 28). Results: Among 16,159 eligible separations, 44.3% were referred, and 11.2% completed cardiac rehabilitation. Completing programme (HR 0.65; 95%CI 0.57–0.74; p < 0.001) led to a lower risk of cardiovascular readmission/death. Living alone (OR 1.38; 95%CI 1.00–1.89; p = 0.048), having diabetes (OR 1.48; 95%CI 1.02–2.13; p = 0.037), or having depression (OR 1.54; 95%CI 1.14–2.08; p = 0.005), were associated with a higher risk of non-completion whereas enrolment in a telehealth programme was associated with a lower risk of non-completion (OR 0.26; 95%CI 0.18–0.38; p < 0.001). Themes related to logistic issues, social support, transition of care challenges, lack of care integration, and of person-centeredness emerged as barriers to completion. Conclusions: Cardiac rehabilitation completion was low but effective in reducing mortality/cardiovascular readmissions. Understanding and addressing barriers and needs through mixed methods can help tailor cardiac rehabilitation programmes to vulnerable populations and improve completion and outcomes. [ABSTRACT FROM AUTHOR]

The disposal of high-level radioactive waste (HLW) and spent nuclear fuel (SF) presents a unique challenge for the prediction of the long-term performance of corrodible structures since the HLW/SF canisters are expected, in some cases, to have lifetimes of one million years or longer. Various empirical and deterministic models have been developed over the past 45 years for making predictions of the long-term corrosion behaviour, including models for uniform and localized corrosion, environmentally assisted cracking and microbiologically influenced corrosion. As well as process models focused on specific corrosion mechanisms (described in Part 1 of this review), there is also a need for performance assessment models as part of the overall analysis of the safety of a deep geological repository (DGR). Performance assessment models are often based on simplified or abstracted process models. The manner in which various international waste management programs have predicted the long-term performance of HLW/SF containers with copper, steel, Ni and Ti alloy corrosion barriers is discussed. Performance assessments are repeated periodically during the development and implementation of a DGR, and the corrosion models are constantly updated in light of new mechanistic understanding and/or more information about the deep geological environment. Two examples of how the container performance assessment models evolve over time are also described. Performance assessment models cannot easily be validated, so it is important to build confidence in the long-term predictions using other methods, including natural analogues and large-scale in situ tests and the use of complementary models. [ABSTRACT FROM AUTHOR]

The disposal of high-level radioactive waste (HLW) and spent nuclear fuel (SF) presents a unique challenge for the prediction of the long-term performance of corrodible structures since HLW/SF containers are expected, in some cases, to have lifetimes of one million years or longer. Various empirical and deterministic models have been developed over the past 45 years for making predictions of long-term corrosion behaviour, including models for uniform and localised corrosion, environmentally assisted cracking, microbiologically influenced corrosion, and radiation-induced corrosion. More recently, fracture-mechanics-based approaches have been developed to account for joint mechanical–corrosion degradation modes. Regardless of whether empirical or deterministic models are used, it is essential to be able to demonstrate a thorough mechanistic understanding of the corrosion processes involved. In addition to process models focused on specific corrosion mechanisms, there is also a need for performance-assessment models as part of the overall demonstration of the safety of a deep geological repository. Performance-assessment models are discussed in Part 2 of this review. [ABSTRACT FROM AUTHOR]

University students consistently report high levels of stress, which has been associated with a range of adverse outcomes. Promoting adaptive coping behaviours, such as problem‐focused coping for managing university stress, is therefore a timely area of investigation. Current coping intervention approaches target reasoned cognitive processes; however, recent research has suggested that automatic processes are more strongly associated with problem‐focused coping behaviour. The current study examined the effect of an implementation intentions intervention, a technique that can support behaviour to be performed automatically by facilitating continued repetition of a plan, on problem‐focused coping behaviour under stress and stress‐related outcomes. Following a pilot study (N = 21), a preregistered randomized controlled trial was conducted with university students (N = 154) using an online survey. Participants completed baseline measures of problem‐focused coping behaviour, behavioural automaticity, behavioural intentions, action planning, perceived stress, procrastination, and psychological wellbeing; before receiving the intervention or control condition stimuli, and then at a 2‐week follow‐up. Behavioural intention and action planning were also measured immediately post‐intervention. The intervention had a significant medium‐sized effect on action planning for problem‐focused coping, but no other significant effects were detected. Exploratory assessment of plan quality revealed medium‐sized correlations between plan quality and changes in problem‐focused coping behaviour. Findings indicate that implementation intentions may be a promising approach for increasing planning for the use of problem‐focused coping. Indicators of plan quality found to be associated with changes in problem‐focused coping provide valuable avenues for intervention optimisation in future research. [ABSTRACT FROM AUTHOR]

Background: Substance use-related emergency department (ED) visits have increased substantially in North America. Screening for substance use in EDs is recommended; best approaches are unclear. This systematic review synthesizes evidence on diagnostic accuracy of ED screening tools to detect harmful substance use. Methods: We included derivation or validation studies, with or without comparator, that included adult (≥ 18 years) ED patients and evaluated screening tools to identify general or specific substance use disorders or harmful use. Our search strategy combined concepts Emergency Department AND Screening AND Substance Use. Trained reviewers assessed title/abstracts and full-text articles for inclusion, extracted data, and assessed risk of bias (QUADAS-2) independently and in duplicate. Reviewers resolved disagreements by discussion. Primary investigators adjudicated if necessary. Heterogeneity precluded meta-analysis. We descriptively summarized results. Results: Our search strategy yielded 2696 studies; we included 33. Twenty-one (64%) evaluated a North American population. Fourteen (42%) applied screening among general ED patients. Screening tools were administered by research staff (n = 21), self-administered by patients (n = 10), or non-research healthcare providers (n = 1). Most studies evaluated alcohol use screens (n = 26), most commonly the Alcohol Use Disorders Identification Test (AUDIT; n = 14), Cut down/Annoyed/Guilty/Eye-opener (CAGE; n = 13), and Rapid Alcohol Problems Screen (RAPS/RAPS4/RAPS4-QF; n = 12). Four studies assessing six tools and screening thresholds for alcohol abuse/dependence in North American patients (AUDIT ≥ 8; CAGE ≥ 2; Diagnostic and Statistical Manual of Mental Disorders, 4th Edition [DSM-IV-2] ≥ 1; RAPS ≥ 1; National Institute on Alcohol Abuse and Alcoholism [NIAAA]; Tolerance/Worry/Eye-opener/Amnesia/K-Cut down [TWEAK] ≥ 3) reported both sensitivities and specificities ≥ 83%. Two studies evaluating a single alcohol screening question (SASQ) (When was the last time you had more than X drinks in 1 day?, X = 4 for women; X = 5 for men) reported sensitivities 82–85% and specificities 70–77%. Five evaluated screening tools for general substance abuse/dependence (Relax/Alone/Friends/Family/Trouble [RAFFT] ≥ 3, Drug Abuse Screening Test [DAST] ≥ 4, single drug screening question, Alcohol, Smoking and Substance Involvement Screening Test [ASSIST] ≥ 42/18), reporting sensitivities 64%-90% and specificities 61%-100%. Studies' risk of bias were mostly high or uncertain. Conclusions: Six screening tools demonstrated both sensitivities and specificities ≥ 83% for detecting alcohol abuse/dependence in EDs. Tools with the highest sensitivities (AUDIT ≥ 8; RAPS ≥ 1) and that prioritize simplicity and efficiency (SASQ) should be prioritized. [ABSTRACT FROM AUTHOR]

Background: UK cardiovascular disease (CVD) incidence and mortality have declined in recent decades but socioeconomic inequalities persist. Aim: To present a new CVD model, and project health outcomes and the impact of guideline-recommended statin treatment across quintiles of socioeconomic deprivation in the UK. Design and setting: A lifetime microsimulation model was developed using 117 896 participants in 16 statin trials, 501 854 UK Biobank (UKB) participants, and quality-of-life data from national health surveys. Method: A CVD microsimulation model was developed using risk equations for myocardial infarction, stroke, coronary revascularisation, cancer, and vascular and non-vascular death, estimated using trial data. The authors calibrated and further developed this model in the UKB cohort, including further characteristics and a diabetes risk equation, and validated the model in UKB and Whitehall II cohorts. The model was used to predict CVD incidence, life expectancy, quality-adjusted life years (QALYs), and the impact of UK guideline-recommended statin treatment across socioeconomic deprivation quintiles. Results: Age, sex, socioeconomic deprivation, smoking, hypertension, diabetes, and cardiovascular events were key CVD risk determinants. Model-predicted event rates corresponded well to observed rates across participant categories. The model projected strong gradients in remaining life expectancy, with 4–5-year (5–8 QALYs) gaps between the least and most socioeconomically deprived quintiles. Guideline-recommended statin treatment was projected to increase QALYs, with larger gains in quintiles of higher deprivation. Conclusion: The study demonstrated the potential of guideline-recommended statin treatment to reduce socioeconomic inequalities. This CVD model is a novel resource for individualised long-term projections of health outcomes of CVD treatments. [ABSTRACT FROM AUTHOR]

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Copper has been proposed as a corrosion barrier for used fuel containers due to its thermodynamic stability under the anoxic conditions relevant to a deep geological repository. Laboratory simulations of anticipated repository conditions have demonstrated the production of small quantities of hydrogen gas, which have been interpreted as being indicative of an oxidation (corrosion) process. This work reports new corrosion results for repository‐relevant materials: electrodeposited copper, cold spray copper and junction material under Canadian and Swiss simulated ground waters. The attribution of the recorded hydrogen suggests corrosion is limited to the outermost atomic layers of copper cladding. However, the origins of the hydrogen have not been conclusively determined. Three thermal desorption methods have been used to investigate the outgassing of hydrogen from electrodeposited copper which may permit a more accurate interpretation of the hydrogen evolution profile from corrosion cells. [ABSTRACT FROM AUTHOR]

The corrosion of copper in chloride‐ and sulphate‐containing solutions containing sulphide (ranging from 5 × 10−5 M to 10−3 M) was studied by electrochemical impedance spectroscopy and the structure and physical properties of the copper sulphide deposits (Cu2S) were analysed by scanning electron microscopy. At low [SH−], a porous and non‐protective deposit was formed, and the low corrosion rates were limited by sulphide transport, partially within the deposit and partially in the bulk of the solution. At higher [SH−], the corrosion rates were much higher and initially more rapid in chloride‐containing than in sulphate‐containing solutions, suggesting a direct role for chloride in the interfacial corrosion process. When the copper sulphide deposit thickened, the rate became limited by CuI transport within the more compact and more crystalline deposit formed. Changes in the morphology of the deposit suggest that chloride adsorption on the surfaces of the deposit inhibited the incorporation of Cu3S3 clusters, transported from the corroding copper surface, into the growing crystals. [ABSTRACT FROM AUTHOR]

Natural and archaeological analogues can be a powerful means to build confidence in the long‐term prediction of corrosion in nuclear waste systems. Analogues are meaningful to both experts and lay audiences. Useful analogues exist to support the long‐term behaviour for both copper and steel used fuel containers (UFC) and examples are given for the corrosion processes that are, and are not, expected to occur under repository conditions for both materials. The concept of kinetic versus thermodynamic stability is used to explain the persistence of such analogues. The use of analogues to support the prediction of the long‐term corrosion performance of the UFC in the safety case is also discussed. While there have been a wide range of analogue studies in the past, it is suggested that future studies should be focussed on addressing specific aspects of the treatment of corrosion issues in the safety case. [ABSTRACT FROM AUTHOR]

Over the past decade, the Nuclear Waste Management Organization has conducted a thorough proof test plan (PTP) to evaluate their novel copper‐coated used fuel container and bentonite buffer box underground emplacement concept for use in a deep geological repository (DGR). This PTP has included the development of new technologies as well as feasibility studies related to engineered barrier production, underground emplacement, and safety assessment of the technologies within a DGR. Although the PTP was winding down in 2022, many work packages continue, particularly those associated with the evaluation of the corrosion performance of the used fuel container, the Nuclear Waste Management Organization (NWMO)'s copper corrosion allowance. This work evaluates the extent of corrosion that may result from oxic‐, radiolytic‐, anoxic‐, and sulfide‐induced corrosion which may occur in the Canadian DGR. Particular attention is paid to assessing the potential for localized corrosion phenomena across each project. This article provides an overview of these work packages which support a lifetime corrosion expectation of 270 µm and an extreme upper bound of corrosion of 1204 µm over one million years. [ABSTRACT FROM AUTHOR]

The metallurgy, mechanical properties, and corrosion of Cu, proposed as the corrosion barrier for Canadian used fuel containers (UFCs) for use in a deep geological repository (DGR), have been studied for decades. Bulk properties have been reported, and the knowledge applied to strengthen the performance of Cu produced by electrodeposition and cold spray. Despite this success, many degradation mechanisms are unclear from bulk testing, which cannot capture nanoscale phenomena driving degradation. This study provides examples using state‐of‐the‐art microscopy to understand mechanisms of Cu degradation, specifically for UFCs. Subtle changes in the electrodeposited Cu microstructure due to oxygen segregation are observed using atom probe tomography (APT). In aggressive sulfide‐containing environments, corrosion of the cold‐sprayed Cu occurs along particle–particle interfaces, likely inherent to the manufacturing process. Microscale tensile testing at particle–particle interfaces confirms brittle cracking in the cold‐sprayed Cu. Although experiments are not consistent with DGR conditions, results do warrant further study on the performance of the cold‐sprayed Cu in particular. [ABSTRACT FROM AUTHOR]

In 6002 Australian adults with type 2 diabetes and a median 5‐year follow‐up in the FIELD (Fenofibrate Intervention and Event Lowering in Diabetes) trial, baseline socioeconomic status (SES) and self‐reported education level were not related to development of on‐trial sight‐threatening diabetic retinopathy. Similarly, in a retinal photography substudy (n = 549), two‐step diabetic retinopathy progression was not related to SES or education. [ABSTRACT FROM AUTHOR]

Background: Heart failure is a major burden in Australia in terms of morbidity, mortality and healthcare expenditure. Multiple evidence‐based therapies are recommended for heart failure with reduced ejection fraction (HFrEF), but data on physician adherence to therapy guidelines are limited. Aim: To compare use of HFrEF therapies against current evidence‐based guidelines in an Australian hospital inpatient population. Methods: A retrospective review of patients admitted with a principal diagnosis of HFrEF across six metropolitan hospitals in Sydney, Australia, between January 2015 and June 2016. Use of medical and device therapies was compared with guideline recommendations using individual patient indications/contraindications. Readmission and mortality data were collected for a 1‐year period following the admission. Results: Of the 1028 HFrEF patients identified, 39 were being managed with palliative intent, leaving 989 patients for the primary analysis. Use of beta‐blockers (87.7% actual use/93.6% recommended use) and diuretics (88.4%/99.3%) was high among eligible patients. There were large evidence‐practice gaps for angiotensin‐converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARB; 66.4%/89.0%) and aldosterone antagonists (41.0%/77.1%). In absolute terms, use of these therapies each increased by over 11% from admission. Ivabradine (11.5%/21.2%), automated internal cardiac defibrillators (29.5%/66.1%) and cardiac resynchronisation therapy (13.1%/28.7%) were used in a minority of eligible patients. Over the 1‐year follow‐up period, the mortality rate was 14.8%, and 44.2% of patients were readmitted to hospital at least once. Conclusion: Hospitalisation is a key mechanism for initiation of HFrEF therapies. The large evidence‐practice gaps for ACEI/ARB and aldosterone antagonists represent potential avenues for improved HFrEF management. [ABSTRACT FROM AUTHOR]

Plastids are complex organelles that vary in size and function depending on the cell type. Accordingly, they can be referred to as amyloplasts, chloroplasts, chromoplasts, etioplasts, or proplasts, to only cite a few. Over the past decades, methods based on density gradients and differential centrifugation have been extensively used for the purification of plastids. However, these methods need large amounts of starting material, and hardly provide a tissue-specific resolution. Here, we applied our IPTACT (Isolation of Plastids TAgged in specific Cell Types) method, which involves the biotinylation of plastids in vivo using one-shot transgenic lines expressing the Translocon of the Outer Membrane 64 (TOC64) gene coupled with a biotin ligase receptor particle and the BirA biotin ligase, to isolate plastids from mesophyll and companion cells of Arabidopsis using tissue specific pCAB3 and pSUC2 promoters, respectively. Subsequently, a proteome profiling was performed, which allowed the identification of 1672 proteins, among which 1342 were predicted to be plastidial, and 705 were fully confirmed according to the SUBA5 database. Interestingly, although 92% of plastidial proteins were equally distributed between the two tissues, we observed an accumulation of proteins associated with jasmonic acid biosynthesis, plastoglobuli (e.g. NAD(P)H dehydrogenase C1, vitamin E deficient 1, plastoglobulin of 34 kDa, ABC1-like kinase 1) and cyclic electron flow in plastids originating from vascular tissue. Besides demonstrating the technical feasibility of isolating plastids in a tissue-specific manner, our work provides strong evidence that plastids from vascular tissue have a higher redox turnover to ensure optimal functioning, notably under high solute strength as encountered in vascular cells. [ABSTRACT FROM AUTHOR]

Daily average springtime air temperatures from four weather stations distributed along north–south and nearly east–west directions within or on the divide of the Sagavanirktok River watershed in Arctic Alaska were studied and compared with discharge measurements and field observations made from 2015 to 2021 during breakup. The results indicate that under widespread air temperature events, during El Niño, rapid and dynamic breakup can occur (promoting sediment transport along the stream), while during La Niña, slow and thermal breakup can be expected. Due to these climate pattern effects, open channel conditions (i.e., ice-free channels) are reached earlier (18 May 2015) during El Niño and later (7 June 2021) during La Niña. [ABSTRACT FROM AUTHOR]

Francisella tularensis subspecies tularensis is a category-A biothreat agent that can cause lethal tularemia. Ceftobiprole medocaril is being explored as a medical countermeasure for the treatment of pneumonic tularemia. The efficacy of ceftobiprole medocaril against inhalational tularemia was evaluated in the Fischer 344 rat model of infection. The dose was expected to be effective against F. tularensis isolates with ceftobiprole minimum inhibitory concentrations ≤0.5 µg/mL. Animals treated with ceftobiprole medocaril exhibited a 92% survival rate 31 days post-challenge, identical to the survival of levofloxacin-treated rats. By comparison, rats receiving placebo experienced 100% mortality. Terminally collected blood, liver, lung, and spleen samples confirmed disseminated F. tularensis infections in most animals that died prior to completing treatments (placebo animals and a rat treated with ceftobiprole medocaril), although levels of bacteria detected in the placebo samples were significantly elevated compared to the ceftobiprole-medocaril-treated group geometric mean. Furthermore, no evidence of infection was detected in any rat that completed ceftobiprole medocaril or levofloxacin treatment and survived to the end of the post-treatment observation period. Overall, survival rates, body weights, and bacterial burdens consistently demonstrated that treatment with ceftobiprole medocaril is efficacious against otherwise fatal cases of pneumonic tularemia in the rat model. [ABSTRACT FROM AUTHOR]

Developments in retinal imaging technologies have enabled the quantitative evaluation of the retinal vasculature. Changes in retinal calibre and/or geometry have been reported in systemic vascular diseases, including diabetes mellitus (DM), cardiovascular disease (CVD), and more recently in neurodegenerative diseases, such as dementia. Several retinal vessel analysis softwares exist, some being disease-specific, others for a broader context. In the research setting, retinal vasculature analysis using semi-automated software has identified associations between retinal vessel calibre and geometry and the presence of or risk of DM and its chronic complications, and of CVD and dementia, including in the general population. In this article, we review and compare the most widely used semi-automated retinal vessel analysis softwares and their associations with ocular imaging findings in common systemic diseases, including DM and its chronic complications, CVD, and dementia. We also provide original data comparing retinal calibre grading in people with Type 1 DM using two softwares, with good concordance. [ABSTRACT FROM AUTHOR]

Background: Nationally, Indigenous Australians are more likely to have diabetes and diabetic retinopathy (DR) than non‐Indigenous Australians. However, the prevalence of DR and impaired vision in regional primary care settings is unclear. Aim: To describe the prevalence and severity of DR and presenting vision level among Indigenous Australian adults with diabetes attending an indigenous primary care clinic in regional Australia. Methods: Participants underwent nurse‐led retinal imaging and DR screening with offsite retinal grading in the integrated Diabetes Education and Eye Screening (iDEES) project implemented at a regional indigenous primary healthcare setting between January 2018 and March 2020. Results: Of 172 eligible adults, 135 (79%) were recruited and screened for DR and vision level. The median age was 56 (46–67) years, 130 (96%) had type 2 diabetes of median (interquartile range) duration 6 (2–12) years and 48 (36%) were male. Images from 132 (97.8%) participants were gradable. DR was present in 38 (29%) participants: mild non‐proliferative in 33 (25%); moderate–severe in three (2.5%); and sight‐threatening two (1.5%). Subnormal presenting vision was present in 33%. Conclusions: A nurse‐led model of care integrating diabetes eye screening and education at a single visit was successful at recruiting Indigenous Australian adults with diabetes, screening their vision and acquiring a high rate of gradable images. Even for a short duration of known diabetes, DR was present in three out of 10 patients screened. [ABSTRACT FROM AUTHOR]

Issue Addressed: The Wellbeing Economy, which places human and ecological wellbeing at the centre of policy making, aligns with holistic Aboriginal and Torres Strait Islander conceptualisations of health and wellbeing. In order to address chronic diseases in South Australian Aboriginal and Torres Strait Islander populations, the South Australian Aboriginal Chronic Disease Consortium (Consortium) is fostering action in ways that align both with the Wellbeing Economy and with Health in All Policies (HiAP) approaches. Methods: In June 2017, the Consortium was established as a collaborative partnership between government and non‐government organisations, researchers, Aboriginal organisations and communities to lead the effective implementation of three state‐wide chronic disease plans. A coordinating centre was funded to support and progress the work of the Consortium. Results: During its first 5 years, the Consortium has developed a foundation for sustained system reform through partnering with stakeholders, leading projects and initiatives, advocating for key priorities, leveraging existing infrastructure and funding, supporting services, and coordinating delivery of priority actions using innovative approaches. Conclusions: Through the Consortium governance structure, Aboriginal and Torres Strait Islander community members, policy actors, service providers and researchers oversee, drive, influence and support the implementation of priority action initiatives. Sustained funding, competing priorities of partner organisations and project evaluation are constant challenges. So What?: A consortium approach provides direction and shared priorities, which foster collaboration across and between organisations, service providers and the Aboriginal community. Aligning with HiAP approaches and the Wellbeing Economy, it harnesses knowledge, networks and partnerships that support project implementation and reduce duplication. [ABSTRACT FROM AUTHOR]

Aims: Fracture risk is elevated in some type 2 diabetes patients. Bone fragility may be associated with more clinically severe type 2 diabetes, although prospective studies are lacking. It is unknown which diabetes‐related characteristics are independently associated with fracture risk. In this post‐hoc analysis of fracture data from the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) trial (ISRCTN#64783481), we hypothesised that diabetic microvascular complications are associated with bone fragility. Materials and Methods: The FIELD trial randomly assigned 9795 type 2 diabetes participants (aged 50–75 years) to receive oral co‐micronised fenofibrate 200 mg (n = 4895) or placebo (n = 4900) daily for a median of 5 years. We used Cox proportional hazards models to identify baseline sex‐specific diabetes‐related parameters independently associated with incident fractures. Results: Over 49,470 person‐years, 137/6138 men experienced 141 fractures and 143/3657 women experienced 145 fractures; incidence rates for the first fracture of 4∙4 (95% CI 3∙8–5∙2) and 7∙7 per 1000 person‐years (95% CI 6∙5–9∙1), respectively. Fenofibrate had no effect on fracture outcomes. In men, baseline macrovascular disease (HR 1∙52, 95% CI 1∙05–2∙21, p = 0∙03), insulin use (HR 1∙62, HR 1∙03–2∙55, p = 0∙03), and HDL‐cholesterol (HR 2∙20, 95% CI 1∙11–4∙36, p = 0∙02) were independently associated with fracture. In women, independent risk factors included baseline peripheral neuropathy (HR 2∙04, 95% CI 1∙16–3∙59, p = 0∙01) and insulin use (HR 1∙55, 95% CI 1∙02–2∙33, p = 0∙04). Conclusions: Insulin use and sex‐specific complications (in men, macrovascular disease; in women, neuropathy) are independently associated with fragility fractures in adults with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to develop prediction models for the individual-level impacts of cardiovascular events on UK healthcare costs. Methods: In the UK Biobank, people 40–70 years old, recruited in 2006–2010, were followed in linked primary (N = 192,983 individuals) and hospital care (N = 501,807 individuals) datasets. Regression models of annual primary and annual hospital care costs (2020 UK£) associated with individual characteristics and experiences of myocardial infarction (MI), stroke, coronary revascularization, incident diabetes mellitus and cancer, and vascular and nonvascular death are reported. Results: For both people without and with previous cardiovascular disease (CVD), primary care costs were modelled using one-part generalised linear models (GLMs) with identity link and Poisson distribution, and hospital costs with two-part models (part 1: logistic regression models the probability of incurring costs; part 2: GLM with identity link and Poisson distribution models the costs conditional on incurring any). In people without previous CVD, mean annual primary and hospital care costs were £360 and £514, respectively. The excess primary care costs were £190 and £360 following MI and stroke, respectively, whereas excess hospital costs decreased from £4340 and £5590, respectively, in the year of these events, to £190 and £410 two years later. People with previous CVD had more than twice higher annual costs, and incurred higher excess costs for cardiovascular events. Other characteristics associated with higher costs included older age, female sex, south Asian ethnicity, higher socioeconomic deprivation, smoking, lower level of physical activities, unhealthy body mass index, and comorbidities. Conclusions: These individual-level healthcare cost prediction models could inform assessments of the value of health technologies and policies to reduce cardiovascular and other disease risks and healthcare costs. An accompanying Excel calculator is available to facilitate the use of the models. [ABSTRACT FROM AUTHOR]

Summary Technologies identifying single nucleotide polymorphisms (SNPs) in DNA sequencing yield an avalanche of data requiring analysis and interpretation. Standard methods may require many weeks of processing time. The use of statistical methods requiring data sorting, matrix inversions of a high-dimension and replication in subsets of the data on multiple outcomes exacerbate these times. A method which reduces the computational time in problems with time-to-event outcomes and hundreds of thousands/millions of SNPs using Cox–Snell residuals after fitting the Cox proportional hazards model (PH) to a fixed set of concomitant variables is proposed. This yields coefficients for SNP effect from a Cox–Snell adjusted Poisson model and shows a high concordance to the adjusted PH model. The method is illustrated with a sample of 10 000 SNPs from a genome-wide association study in a diabetic population. The gain in processing efficiency using the proposed method based on Poisson modelling can be as high as 62%. This could result in saving of over three weeks processing time if 5 million SNPs require analysis. The method involves only a single predictor variable (SNP), offering a simpler, computationally more stable approach to examining and identifying SNP patterns associated with the outcome(s) allowing for a faster development of genetic signatures. Use of deviance residuals from the PH model to screen SNPs demonstrates a large discordance rate at a 0.2% threshold of concordance. This rate is 15 times larger than that based on the Cox–Snell residuals from the Cox–Snell adjusted Poisson model. Availability and implementation The method is simple to implement as the procedures are available in most statistical packges. The approach involves obtaining Cox-Snell residuals from a PH model, to a binary time-to-event outcome, for factors which need to be common when assessing each SNP. Each SNP is then fitted as a predictor to the outcome of interest using a Poisson model with the Cox-Snell as the exposure variable. [ABSTRACT FROM AUTHOR]

BACKGROUND: Moderate-intensity interval training (MIIT) may be a viable exercise format for improving body composition, aerobic fitness, and health-related variables. OBJECTIVES: This randomized trial aimed to analyze the effect of MIIT or high-intensity interval training (HIIT) on aerobic fitness, body composition variables, and resting metabolic rate (RMR) in women with overweight or obesity. METHODS: 31 sedentary adult women with overweight or obesity performed 7 weeks × 3 weekly sessions of either HIIT or MIIT. Physical and physiological tests were applied before and after training. RESULTS: In both analyses (intention-to-treat and by adherence to the training), aerobic fitness showed a time effect (p = 0.041 and p = 0.015), but without differences between groups (p > 0.05). No group (HIIT vs. MIIT), time (pre vs. post), or interaction effects (group vs. time) were found for RMR, body composition markers (fat mass, body fat percentage, lean mass), or body mass index – BMI (p > 0.05). In addition, MIIT induced a relatively high drop-out rate. CONCLUSIONS: This study suggested that the short-term (7-weeks) interval exercise training was effective for increasing aerobic fitness, and moderate-intensity intervals were as effective as high-intensity intervals. However, neither training format was effective for changing RMR, body composition variables, or BMI of women with overweight or obesity. Clinical trial ID: RBR-9jd7b7. [ABSTRACT FROM AUTHOR]

Short food supply chains (SFSCs) are associated with a range of contested, place-based attributes which contrast with the characteristics of complex, global and corporate chains. This article avoids such oppositional binaries by focusing on SFSCs serving two European cities, namely Oslo (Norway) and Bristol (UK). It reviews cities as a particular kind of market within which to secure custom, by presenting qualitative data from a study of SFSCs in these two cities to examine marketing barriers and opportunities encountered. Distinctive urban contexts, such as the density of consumers and presence of food-related infrastructures, can influence the marketing strategies and sales channels chosen by food enterprises. Difficulties are faced by both food producers and the sales channels through which they come to market, especially in relation to financial viability, price competition and efficiency. Our analysis, as well as highlighting connections and divergences between Oslo and Bristol, emphasises the role of these cities in providing diverse food market niches. Alongside global chains, functioning SFSCs help to reflect the history of Oslo and Bristol as trading cities with diverse populations and reveal enterprise adaptability and innovation as market demand shifts. [ABSTRACT FROM AUTHOR]

The German city of Bamberg offers lessons in how continuity and change interact within the context of the inner-urban land use of commercial horticulture, thereby informing sustainable urban transformations in historic cities. The case of Bamberg shows that urban food production is not just well-established, but a consistent and centuries-old cultural structure that influences the fabric of today's city. In this article, we discuss what forms of urban horticulture (and thus also food production) are evident from Bamberg's past and which may prevail in the future. Two questions structure our analysis. First, how are historical sites and spatial structures of horticulture shaped in the tension between continuity and change? Second, which practices/forms of urban horticulture are taken up and how are they updated by which actors? Both the heritage and contemporary practices of urban horticulture, it is argued, can be conceived of as a resource to create sustainable places and ways of life for citizens. Two new contributions result from this work. First, the article highlights the ongoing cultural heritage dimensions of urban horticulture in a field still dominated by eco-technical contributions associated with post-industrial innovation in urban planning; in this respect, heritage should be recognised as a dynamic that shapes urban change. In addition, secondly, the application of Luhmannian concepts of evolution in social systems reinforces the interdependence of continuity and change in urban settings. [ABSTRACT FROM AUTHOR]

Physical activity can have a transformational positive impact on both individual and public health outcomes. It can be used to positively and proactively manage many common chronic conditions, as well as reducing the risk of developing them. However, in the UK, over one-in-four adults is physically inactive, and one-in-three children do less than half the physical activity recommended for their age. This article looks at the benefits of physical activity, UK government recommendations for physical activity in different age groups, and how to support patients in primary care to become more active. [ABSTRACT FROM AUTHOR]

Objective: We applied an integrated social cognition model to predict physical distancing behavior, a key COVID-19 preventive behavior, over a four-month period. Design: A three-wave longitudinal survey design. Methods: Australian and US residents (N = 601) completed self-report measures of social cognition constructs (attitude, subjective norm, moral norm, perceived behavioral control [PBC]), intention, habit, and physical distancing behavior on an initial occasion (T1) and on two further occasions one week (T2) and four months (T3) later. Results: A structural equation model revealed that subjective norm, moral norm, and PBC, were consistent predictors of physical distancing intention on all three occasions. Intention and habit at T1 and T2 predicted physical distancing behavior at T2 and T3, respectively. Intention at T2 mediated effects of subjective norm, moral norm, and PBC at T2 on physical distancing behavior at T3, and habit at T1 and T2 mediated effects of behavior at T1 and T2 on follow-up behavior at T2 and T3, respectively. Conclusion: Normative (subjective and moral norms) and capacity (PBC) constructs were consistent predictors of physical distancing intention, and intention and habit were consistent predictors of physical distancing behavior. Interventions promoting physical distancing should target change in normative and personal capacity beliefs, and habit. Supplemental data for this article is available online at https://doi.org/10.1080/08870446.2021.1968397. [ABSTRACT FROM AUTHOR]

Copyright of African Archaeological Review is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of African Archaeological Review is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Advantages of high-refractive index (HRI) glass wafers for augmented reality wearables (ARWs) include high transparency, low birefringence and total thickness variation, high durability and optical quality, high mechanical stability, stiffness, and geometrical stability. ARWs enable users to see computer-generated images overlaid on top of normal view. ARWs give the user an enhanced experience and are hands-free. Waveguide technology uses a combination of diffractive or reflective gratings and HRI glass wafers to transfer or project images from the light source (projector) to the user's eye through total internal reflection (TIR). With all these advantages, glass is truly one of the world's most transformative materials. To make the waveguide-based devices a reality, Corning has developed a series of HRI glass wafers with a diameter of up to Φ300 mm. Corning augmented reality solution (ARS) provides high-throughput metrology expertise, fully automated laser cutting technology, and the capability to capture the total thickness variation over the entire glass wafers using a frequency stepping interferometer. In this paper, we first conducted optical characterization of uncoated high-refractive index glass wafers. Corning® Tropel® Flatmaster® MSP-300 was used to characterize the wafer profile properties of manufactured high-refractive index glass wafers. A variable angle spectroscopic ellipsometer (VASE) J.A. Woollam M-2000 was applied to evaluate the refractive index homogeneity of the high-refractive index glass wafers. A Metricon 2010/M system was used to measure the losses of optical waveguide at a wavelength of 409 nm, 448 nm, and 519 nm, respectively. A refractive index homogeneity of 99.976% and an optical thickness homogeneity of 99.979% were realized. Finally, an anti-reflective coating over a broad visible spectral range was added on top of a glass wafer for surface reflectance suppression. SiO2 and Nb2O5 were selected as low- and high-refractive index coating materials. The anti-reflective coating leads to a visible reflectance below 0.5% with a desired neutral aesthetic appearance. [ABSTRACT FROM AUTHOR]

Background: Empirical evidence suggests data and insights from the clinical practice guidelines and clinical quality registries are not being fully utilised, leaving health service managers, clinicians and providers without clear guidance on how best to improve healthcare delivery. This lack of uptake of existing research knowledge represents low value to the healthcare system and needs to change. Methods: Five electronic databases (MEDLINE, Embase, CINAHL, Cochrane Central and Cochrane Database of Systematic Reviews) were systematically searched. Included studies were published between 2000 and 2020 reporting on the attributes, evidence usage and impact of clinical practice guidelines and clinical quality registries on health service delivery. Results: Twenty-six articles including one randomised controlled trial, eight before-and-after studies, eight case studies/reviews, five surveys and four interview studies, covering a wide range of medical conditions and conducted in the USA, Australia and Europe, were identified. Five complementary strategies were derived to maximise the likelihood of best practice health service delivery: (1) feedback and transparency, (2) intervention sustainability, (3) clinical practice guideline adherence, (4) productive partnerships and (5) whole-of-team approach. Conclusion: These five strategies, used in context-relevant combinations, are most likely to support the application of existing high-quality data, adding value to health service delivery. The review highlighted the limitations of study design in opportunistic registry studies that do not produce clear, usable evidence to guide changes to health service implementation practices. Recommendations include exploration of innovative methodologies, improved coordination of national registries and the use of incentives to encourage guideline adherence and wider dissemination of strategies used by successful registries. [ABSTRACT FROM AUTHOR]

Aim: The aim was to describe vascular risk factors in Australian adults with diabetes attending an Indigenous primary care nurse‐led diabetes clinic. Design: This was a cross‐sectional descriptive single‐site study. Methods: Vascular risk factor data were extracted from the electronic health records of participants in the nurse‐led integrated Diabetes Education and Eye disease Screening (iDEES) study at a regional Victorian Indigenous primary health‐care clinic between January 2018 and March 2020. Results: Of 172 eligible adults, 135 (79%) provided data. Median (IQR) age was 56 (46–67) years; 89% were Indigenous; 95% had Type 2 diabetes of median (IQR) duration of 6 (2–12) years and 48 (36%) were male. Median HbA1c, blood pressure, cholesterol (total; LDL and HDL), triglycerides, eGFR, CRP and BMI were 8.0% (64 mmol/mol), 127/78 mm Hg, 4.2; 1.9; 1.1 mmol/L, 2.3 mmol/L, 89 ml/min/1.73 m2, 7.0 mg/L and 32.4 kg/m2. Of nine clinical risk factors, the median (IQR) number of risk factors at target was 4 (3–5) for women and 3 (2–5) for men, pχ2 = 0.563. Clinical targets for BMI, HbA1c, blood pressure, triglycerides, total cholesterol, LDL cholesterol, urine albumin: creatinine ratio, HDL cholesterol and smoking were met by 14%, 34%, 38%, 39%, 44%, 52%, 54%, 62% and 64%, respectively. Conclusion: A nurse‐led model of integrated clinical risk factor assessment and diabetes education identified suboptimal levels of clinical risk factor control for avoiding diabetes chronic complications amongst Australian adults with diabetes in an Indigenous primary care setting. Impact A nurse‐led model of diabetes care integrating clinical risk factor assessment into a diabetes education service is achievable. Understanding by stakeholders, including people with diabetes, their clinicians and health services, of the importance of regular monitoring of risk factors impacting diabetes complications is important. The novel nurse‐managed iDEES primary‐care model of care can assist. Trial registration: This study was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12618001204235). [ABSTRACT FROM AUTHOR]

Background: Promoting the adoption of personal hygiene behaviors known to reduce the transmission of COVID-19, such as avoiding touching one's face with unwashed hands, is important for limiting the spread of infections.Purpose: We aimed to test the efficacy of a theory-based intervention to promote the avoidance of touching one's face with unwashed hands to reduce the spread of COVID-19.Methods: We tested effects of an intervention employing imagery, persuasive communication, and planning techniques in two pre-registered studies adopting randomized controlled designs in samples of Australian (N = 254; Study 1) and US (N = 245; Study 2) residents. Participants were randomly assigned to theory-based intervention or education-only conditions (Study 1), or to theory-based intervention, education-only, and no-intervention control conditions (Study 2). The intervention was delivered online and participants completed measures of behavior and theory-based social cognition constructs pre-intervention and one-week postintervention.Results: Mixed-model ANOVAs revealed a significant increase in avoidance of touching the face with unwashed hands from pre-intervention to follow-up irrespective of intervention condition in both studies, but no significant condition effects. Exploratory analyses revealed significant effects of the theory-based intervention on behavior at follow-up in individuals with low pre-intervention risk perceptions in Study 2.Conclusions: Results indicate high adoption of avoiding touching one's face with unwashed hands, with behavior increasing over time independent of the intervention. Future research should confirm risk perceptions as a moderator of the effect theory-based interventions on infection-prevention behaviors. [ABSTRACT FROM AUTHOR]

The 26S proteasome is a conserved multi-subunit machinery in eukaryotes. It selectively degrades ubiquitinated proteins, which in turn provides an efficient molecular mechanism to regulate numerous cellular functions and developmental processes. Here, we studied a new loss-of-function allele of RPN12a, a plant ortholog of the yeast and human structural component of the 19S proteasome RPN12. Combining a set of biochemical and molecular approaches, we confirmed that a rpn12a knock-out had exacerbated 20S and impaired 26S activities. The altered proteasomal activity led to a pleiotropic phenotype affecting both the vegetative growth and reproductive phase of the plant, including a striking repression of leaf senescence associate cell-death. Further investigation demonstrated that RPN12a is involved in the regulation of several conjugates associated with the auxin, cytokinin, ethylene and jasmonic acid homeostasis. Such enhanced aptitude of plant cells for survival in rpn12a contrasts with reports on animals, where 26S proteasome mutants generally show an accelerated cell death phenotype. A loss-of-function mutation in the RPN12a proteasome subunit in Arabidopsis thaliana shows that this protein is essential for hormonal homeostasis, thereby modulating plant's development and the progression of leaf senescence. [ABSTRACT FROM AUTHOR]