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Purpose: To compare local sweating rate (LSR) and local sweat sodium ([Na+]), chloride ([Cl−]), and potassium ([K+]) concentrations of tattooed skin and contralateral non-tattooed skin during exercise. Methods: Thirty-three recreational exercisers (17 men, 16 women) with ≥ 1 unilateral permanent tattoo on the torso/arms were tested during cycling, running, or fitness sessions (26 ± 4 °C and 54 ± 13% relative humidity). Forty-eight tattoos with a range of ink colors, ages (3 weeks to 20 years), and densities (10–100%) were included. Before exercise, the skin was cleaned with alcohol and patches (3 M Tegaderm + Pad) were placed on the tattooed and contralateral non-tattooed skin. LSR was calculated from sweat mass (0.80 ± 0.31 g), patch surface area (11.9 cm2), and duration (62 ± 14 min). Sweat [Na+], [Cl−], and [K+] were measured via ion chromatography. Results: Based on the analysis of variance results, there were no differences between tattooed and non-tattooed skin for LSR (1.16 ± 0.52 vs. 1.12 ± 0.53 mg/cm2/min; p = 0.51), sweat [Na+] (60.2 ± 23.5 vs. 58.5 ± 22.7 mmol/L; p = 0.27), sweat [Cl−] (52.1 ± 22.4 vs. 50.6 ± 22.0 mmol/L; p = 0.31), or sweat [K+] (5.8 ± 1.6 vs. 5.9 ± 1.4 mmol/L; p = 0.31). Multiple regression analyses suggested that younger tattoos were associated with higher sweat [Na+] (p = 0.045) and colorful tattoos were associated with higher sweat [Cl−] (p = 0.04) compared with contralateral non-tattooed skin. Otherwise, there were no effects of LSR or tattoo characteristics on regression models for LSR or sweat electrolyte concentrations. Conclusion: There were no effects of tattoos on LSR and sweat [K+] during exercise-induced sweating, but tattoo age and color had small effects on sweat [Na+] and sweat [Cl−], respectively. Clinical trial identifiers: NCT04240951 was registered on January 27, 2020 and NCT04920266 was registered on June 9, 2021. [ABSTRACT FROM AUTHOR]

L5446 --> Recently, there has been significant interest in the use of sweat as a non‐invasive diagnostic biofluid. Research to date has focused primarily on electrolytes, micronutrients, or metabolites as markers of hydration status or metabolic stress, while fewer studies have measured messenger molecules like cytokines and chemokines. The purpose of this study was to determine time course and regional differences in sweat EGF, IFN‐γ, IL‐1β, IL‐1α, IL‐1RA, TNF‐α, IL‐8, IL‐10, and IL‐6 concentrations during steady state exercise. Eight moderately trained subjects (34±7 y, 80.2±10.2 kg, 52.2±6.4 ml/kg/min VO2max) completed 90 min of cycling at 82±6 %HRmax in the heat (32°C, 50% RH). Preceding exercise, right dorsal forearm (RDF), right triceps (RT), right scapula (RS) and forehead (FH) were cleaned with alcohol and deionized water. Absorbent patches (10 cm2 absorbent pad, 3M Tegaderm™ + Pad) were applied at 0, 30, and 60 minutes into exercise. The patches were removed at 25, 55, and 85 minutes into exercise. Sweat cytokines were measured using Multiplex (EMD Millipore, MagPix) customized kits. Kruskal‐Wallis was used to test differences among groups. Dunn's test for multiple comparisons was used for post‐hoc analysis. Cytokine measurements are shown as median ± IQR. There were no differences in IL‐1β or IL‐10 across sites or across time. The majority of samples (62%) were below detection for IFNγ and TNFα. IL‐1α (3413±4564 pg/mL; p<0.0001), IL‐1RA (343.4±717.2 pg/mL; p=0.0001), IL‐6 (0.12±0.03 pg/mL; p=0015), and IL‐8 (0.21±2.1 pg/mL; p<0.001) varied across sites. There were specific differences between IL‐1α FH (1007±1465 pg/mL) compared to RDF (3785±2354 pg/mL; p=0.0001), RS (5860±9491 pg/mL; p<0.0001), and RT (4236±9877 pg/mL; p<0.0001). There were also specific differences when FH IL‐1RA (876.6±1146.6 pg/mL) was compared to RDF (182.1±257.3 pg/mL; p=0.0013) and RS (91.6±385.6 pg/mL; p=0.0004). FH IL‐6 (0.11±0.03 pg/mL) showed significant differences when compared to RDF (p=0.03), RS (p=0.02), and RT (p=0.002). FH IL‐8 (4.9±9.9 pg/mL) also showed significant differences when compared to RDF (p<0.0001), RS (p=0.0001), and RT (p=0.0001). FH IL‐1α varied across time (2274±2191, 864.9±1418, 589.5±1014 pg/mL at 25, 55, and 85 min respectively; p=0.046), with specific differences between 25 and 85 min (p=0.049). EGF varied across time for all skin regions (FH p=0.0001; RDF p=0.01; RS=0.003; RT p=0.009) with significant differences between 25 and 85 min for all sites (FH p<0.0001; RDF p=0.009; RS p=0.003; RT p=0.01). RS EGF also showed significant differences between 25 and 55 min (p=0.04). In conclusion, EGF decreased significantly from 25 to 85 min for all sites. There was significant regional variation in IL‐1α, IL‐1 RA, IL‐6, and IL‐8, especially when FH was compared to RDF, RS, and RT. This study suggests that cytokine concentrations vary across skin regions and sample collection timing which could impact the usage of sweat as a diagnostic tool. Disclosure Statement: All authors are employed by the Gatorade Sports Science Institute, a division of PepsiCo, Inc. The views expressed in this abstract are those of the authors and do not necessarily reflect the position or policy of PepsiCo, Inc. [ABSTRACT FROM AUTHOR]

L4984 --> The ability to use sweat as a biofluid for noninvasive sampling and diagnostics is a popular area of innovation. However, body mapping for local sweat metabolites is lacking and collection methods are inconsistent. To determine regional and time course differences in sweat cortisol and glucose concentrations we collected sweat with absorbent patches (3MTMTegaderm+PAD) from eight, non‐acclimatized, euhydrated (USG 1.012±0.008) subjects (24‐44 y; 80.2±10.2 kg; V̇O2 max 52.2 ±6.4 mL/kg/min) at the following sites: right dorsal forearm (RDF), right triceps (RT), right scapula (RS) and forehead (FH) at 0‐25 (25), 30‐55 (55), and 60‐85 (85) min during 90 min of cycling (82% HR max) in a heated chamber (32°C, 50% RH). ELISA was used for the detection of cortisol (Invitrogen, ThermoFisher Scientific) and glucose (Caymen Chemical Co.) concentrations. Data are presented as mean±SD or median±IQR for data that were not normally distributed. One‐way ANOVA or Kruskal‐Wallis were used to test differences among groups. Dunn's test for multiple comparisons was used for post‐hoc analysis. Excretion rates (ER) were calculated as the product of concentration and local sweat rate (LSR). Whole body sweat rate was 0.85±0.09 mg/cm2/min. LSR was significantly different among sites (FH 4.1±2.3 > RS 1.6±0.6, RDF 1.4±0.9 > RT 0.8±0.5 mg/cm2/min; p<0.0001). LSR was the same across time for FH, whereas RDF (p=0.04), RS (p=0.01), and RT (p=0.01) varied. RS LSR at 55 (p=0.02) and 85 (p=0.02) were greater than 25 min. RT LSR at 55 was higher than 25 min (p=0.01). RDF LSR had no specific differences. Cortisol concentrations were similar across sites (FH 2.7±3.1, RDF 2.2±2.1, RS 2.2±2.2, RT 1.9±1.5 ng/mL). FH cortisol concentrations varied across time (1.8±1.6, 2.9±2.2, 4.9±9.6 ng/mL at 25, 55, and 85 min, respectively; p=0.02), with specific differences between 25 and 85 min (p=0.02). RDF cortisol concentrations also varied across time (1.3±1.6, 2.9±1.7, 3.5±6.3 ng/mL at 25, 55, and 85 min, respectively; p=0.01), with specific differences between RDF 25 and 85 min (p=0.01). RT and RS cortisol concentrations were similar across time. Cortisol ER was 4.3±6.2 pg/cm2/min and varied across sites (FH 9.8±14.8, RDF 3.7±4.9, RS 4.0±3.1, RT 2.2±2.2 pg/cm2/min (p<0.0001)). FH cortisol ER was greater than all other sites (RDF p=0.004, RS p=0.006, RT p<0.0001). FH (p=0.02) and RDF (p=0.01) cortisol ERs varied across time points, where 85 was greater than 25 min (FH p=0.02, RDF p=0.01). RT and RS cortisol ERs were similar across time. Glucose concentrations (0.2±0.5 mg/dL) were similar across sites and between time points within the same site. Glucose ER across all sites was 5.2±9.1 ng/cm2/min and differed across sites (FH 5.4±22.4, RDF 6.2±9.9, RS 7.0±8.6, RT 2.8±4.1 ng/cm2/min; p=0.04), where FH was greater than RT (p=0.03). Glucose ER did not differ between time points within each location. In summary, cortisol concentration and ER increase as exercise time progresses on the FH and RDF, but not the RS or RT. This study demonstrates that the site and time point selection for sweat sampling is a necessary consideration for future research. [ABSTRACT FROM AUTHOR]

Background: As part of an evaluation of an oral healthcare practice-based model that identifies patients with prediabetes or type-2 diabetes, this study reports on the proportion of patients identified with clinically confirmed type-2 diabetes (T2D)/prediabetes and barriers of implementation of the model. Methodology: Urban and rural oral healthcare practices were invited to participate. Participating practices invited eligible patients to participate in the screening program using the Australian Type-2 Diabetes Risk Assessment Tool (AUSDRISK). Participants were categorised as low, intermediate, or high-risk for prediabetes/T2D. Patients in the intermediate or high-risk category were referred to their General Medical Practitioner (GP) for further investigation. Results: Fifty-one oral healthcare practices and 76 Oral Health Professionals (OHP) participated (60 Dentists, 8 Dental Hygienists, 8 Oral Health Therapists). 797 patients were screened; 102 were low-risk; 331 intermediate-risk; and 364 high-risk for T2D. Of the 695 participants in the intermediate or high-risk groups, 386 (55.5%) were referred to their GP for T2D assessment. Of them, 96 (25.0%) results were returned to OHPs. Of the returned results, six were (6.3%) diagnosed with pre-T2D. Conclusion: Patients found to have undiagnosed T2D/prediabetes (6.3%) were within the expected range reported in the literature. Findings indicate that identifying individuals at an elevated risk of having or developing T2D is effective, feasible and could be incorporated into oral healthcare settings. However, this integration may require additional OHPs training and education to ensure that patients at elevated risk of T2D are referred for further assessment. [ABSTRACT FROM AUTHOR]

Competent individuals can provide incompetent care if they are not able to function as a team. The current column provides highlights from a presentation given by the authors at this year's Association for Nursing Professional Development annual convention, expanding on the concept of collective competence with real-life situations. [ABSTRACT FROM AUTHOR]

Background: As part of a larger study on the identification of undiagnosed Type 2 diabetes (T2D), and prediabetes patients in dental settings, this study explored oral healthcare professionals' (OHP) attitudes with respect to the relevance and appropriateness of screening for prediabetes/T2D in general oral healthcare settings. It also aims to gain a deeper understanding of OHPs' concerns and perceived barriers to screening for T2D.Methods: Semi-structured interviews were conducted with 11 OHPs: eight dentists, two dental hygienists and one oral health therapist. Interviews were audio recorded, transcribed verbatim and analysed using thematic analysis.Results: Themes that emerged from the interviews were organised under three major categories: 1) Implementation: OHPs willingness to screen for prediabetes/T2D; 2) Barriers to implementation of screenings; subdivided into: a) lack of knowledge and formal training about T2D screening methodology; b) concerns about patients' awareness and acceptance of T2D screening in oral healthcare settings; c) costs and reimbursement for the time and resources required to screen patients; and d) legal and scope of practice; and 3) Collaboration and communication between OHPs and General practitioners (GP).Conclusions: The oral healthcare setting was considered as appropriate for medical screening, and OHPs were willing to participate in screening for prediabetes/T2D. Nonetheless, for the successful implementation of a screening programme, several barriers need to be addressed, and effective medical screening would require collaboration between oral health and medical and other health professionals, as well as clarification of legal and reimbursement issues. [ABSTRACT FROM AUTHOR]

Background: While community pharmacies have been successful in providing harm reduction support for illicit substance consumers, little research has explored their role in addressing the needs of anabolic–androgenic steroid (AAS) consumers. Objective: This study aimed to triangulate the attitudes and experiences of AAS consumers and community pharmacist's regarding AAS harm reduction. Methods: Semi-structured interviews were conducted with AAS consumers (n = 8) and community pharmacists (n = 15) between December 2022 and August 2023 in Australia. Interview data were analysed using reflexive thematic analysis. Results: While consumers emphasised easy access to pharmacies, particularly in urban areas, challenges were noted in rural regions. AAS consumers expressed a preference for community pharmacies, perceiving them as less confronting and a feasible avenue for accessing professional advice, highlighting the potential role of pharmacists in nurturing therapeutic alliances with AAS consumers. Similarly, pharmacists expressed receptivity to providing harm reduction information but acknowledged knowledge gaps, suggesting a need for tailored education programs to support AAS consumers effectively. Conclusions: Community pharmacies can be an important environment for AAS harm reduction. Strategies include utilising private spaces for open discussions with AAS consumers and enhancing pharmacists' understanding of AAS to foster trust and support. Further research is needed to address knowledge gaps and training needs for pharmacy staff, with the aim of creating a safer environment for AAS consumers. [ABSTRACT FROM AUTHOR]

The article discusses the Australia and New Zealand Prostate Cancer Outcomes Registry (PCOR-ANZ) and its findings and plans for the future. The registry has been in operation since 2015 and has collected data on over 92,000 people with new prostate cancer diagnoses. The report highlights changes in the proportion of people diagnosed with different risk groups and the shift towards transperineal prostate biopsy. It also discusses the management of prostate cancer based on risk groups and the collection of patient-reported outcomes measures (PROMs). The authors identify opportunities for improvement and the need to expand the use of PCOR-ANZ data to improve outcomes for people with prostate cancer in Australia and New Zealand. [Extracted from the article]

A letter to the editor is presented in response to the article "State-Based Legal Requirement for Schedule 8 Prescriptions: Why so Complicated?" by Andy C. Hua and colleagues in a 2015 issue.

Background: Consumer awareness of emergency contraception is generally poor. School leavers (schoolies) engage in risky behaviours, including casual sex and alcohol and drug consumption. Aim: The aim of this study was to explore the awareness of an at‐risk population of schoolies regarding the use and availability of emergency contraception. Methods: An electronic survey was self‐administered by participants using Wi‐Fi‐connected iPads at the Schoolies Wristband Distribution Centre, Surfers Paradise, on the first day of Queensland Schoolies Week, November 2017. Outcomes measured were awareness of the availability of emergency contraception from a pharmacy, maximum time for effective use following unprotected intercourse and whether emergency contraception is harmful to the health of the user. Results: Schoolies completed 498 valid surveys. Most (83.5%) were aged 17 years and 50.8% were aware that emergency contraception is available from community pharmacies with prescription and 36.7% were aware that it is available without prescription; 18.5% were aware of the 72‐ or 120‐h effectiveness window and 38.0% agreed that it is not harmful. All questions were associated with considerable uncertainty. Females were 1.8‐ to 3.2‐fold more likely than males to provide an appropriate response to any emergency contraception statement. Conclusion: Schoolies' awareness of emergency contraception availability, effectiveness window and safety was low. At‐risk schoolies may not access emergency contraception when indicated due to fear of harm, uncertainty about its effectiveness window or a lack of knowledge about timely non‐prescription access from community pharmacies. Targeted education may improve current knowledge gaps. The misnomer 'morning‐after pill' should be abandoned for the clinically appropriate term 'emergency contraception'. [ABSTRACT FROM AUTHOR]

Exercise or work in hot environments increases susceptibility to exertional heat illnesses such as exertional heat stroke (EHS). EHS occurs when body heat gain exceeds body heat dissipation, resulting in rapid body heat storage and potentially life-threatening consequences. EHS poses a dangerous threat for athletes, agriculture workers, and military personnel, as they are often exposed to hot environmental conditions that restrict body heat loss or contribute to body heat gain. Currently, there is limited guidance on return to activity (RTA) after an episode of EHS. While examining biomarkers in the blood is thought to be beneficial for determining RTA, they are not sensitive or specific enough to be a final determining factor as organ damage may persist despite blood biomarkers returning to baseline levels. As such, additional assessment tests to more accurately determine RTA are desired. One method used for determining RTA is the heat tolerance test (HTT, 120 minutes treadmill walking; 40°C, 40% relative humidity). Unfortunately, the HTT provides even less information about EHS recovery since it offers no test sensitivity or specificity even after years of implementation. We provide an overview of the HTT and the controversy of this test with respect to assessment criteria, applicability to tasks involving high metabolic workloads, and the lack of follow-up analyses to determine its accuracy for determining recovery in order to diminish the likelihood of a second EHS occurrence. [ABSTRACT FROM AUTHOR]

Objective To measure the impact of the multidisciplinary Turning Pain Into Gain program in people experiencing chronic pain of any etiology. Methods A mixed-methods observational study of 252 participants was used to explore the impact of Turning Pain Into Gain on medication use; quality of life and functioning, as measured by the Pain Self-Efficacy Questionnaire; and self-reported hospitalizations between 2015 and 2016. Results Responses from 178 participants showed an increased alignment with Australian pain medication guidelines (e.g. a 7.3% reduction in paracetamol duplication was reported with a concurrent 5.1% rise in the administration of sustained-release paracetamol formulations); improved Pain Self-Efficacy Questionnaire scores from 23.1 (out of a possible score of 60) preprogram to 35.3 postprogram; and a reduction in self-reported hospitalizations from 50 cases in the 12 months preprogram to 11 cases in the 12 months postprogram. Conclusions Positive medication, Pain Self-Efficacy Questionnaire, and hospitalization changes provide evidence for the broader implementation of similar patient-centered programs to promote more holistic management of diverse types of chronic pain in primary care. Reduced hospitalization reflects potential for this intervention to be cost-effective, which could be investigated further. [ABSTRACT FROM AUTHOR]

Provides information on a study that examined the nature of shared medications among community-dwelling, elderly, Australian war veterans and widow(er)s. Methodology of the study; Results of the study.

1. Phenotypic plasticity is essential for the persistence of organisms under changing environmental conditions but the control of the relevant cellular mechanisms including which genes are involved and the regulation of those genes remains unclear. One way to address this issue is to evaluate links between gene expression, methylation and phenotype using transplantation and common garden experiments within genetically homogeneous populations. 2. This approach was taken using the Antarctic limpet Nacella concinna. In this species, two distinct phenotypes are associated with the intertidal and subtidal zones. The in situ gene expression and methylation profiles of intertidal and subtidal cohorts were directly compared before and after reciprocal transplantation as well as after a common garden acclimation to aquarium conditions for 9 months. 3. Expression profiles showed significant modulation of cellular metabolism to habitat zone with the intertidal profile characterised by transcription modules for antioxidant production, DNA repair and the cytoskeleton reflecting the need to cope with continually fluctuating and stressful conditions including wave action, UV irradiation and desiccation. 4. Transplantation had an effect on gene expression. The subtidal animals transplanted to the intertidal zone modified their gene expression patterns towards that of an intertidal profile. In contrast, many of the antioxidant genes were still differentially expressed in the intertidal animals several weeks after transplantation into the relatively benign subtidal zone. 5. Furthermore, a core of genes involved in antioxidation was still preferentially expressed in intertidal animals at the end of the common garden experiment. Thus, acclimation in an aquarium tank for 9 months did not completely erase the intertidal gene expression profile. 6. Significant methylation differences were measured between intertidal and subtidal animals from the wild and after transplantation, which were reduced on common garden acclimation. This suggests that epigenetic factors play an important role in physiological flexibility associated with environmental niche. [ABSTRACT FROM AUTHOR]

Multicellular spheroids generated through cellular self-assembly provide cytoarchitectural complexities of native tissue including three-dimensionality, extensive cell-cell contacts, and appropriate cell-extracellular matrix interactions. They are increasingly suggested as building blocks for larger engineered tissues to achieve shapes, organization, heterogeneity, and other biomimetic complexities. Application of these tissue culture platforms is of particular importance in cardiac research as the myocardium is comprised of distinct but intermingled cell types. Here, we generated scaffold-free 3D cardiac microtissue spheroids comprised of cardiac myocytes (CMs) and/or cardiac fibroblasts (CFs) and used them as building blocks to form larger microtissues with different spatial distributions of CMs and CFs. Characterization of fusing homotypic and heterotypic spheroid pairs revealed an important influence of CFs on fusion kinetics, but most strikingly showed rapid fusion kinetics between heterotypic pairs consisting of one CF and one CM spheroid, indicating that CMs and CFs self-sort in vitro into the intermixed morphology found in the healthy myocardium. We then examined electrophysiological integration of fused homotypic and heterotypic microtissues by mapping action potential propagation. Heterocellular elongated microtissues which recapitulate the disproportionate CF spatial distribution seen in the infarcted myocardium showed that action potentials propagate through CF volumes albeit with significant delay. Complementary computational modeling revealed an important role of CF sodium currents and the spatial distribution of the CM-CF boundary in action potential conduction through CF volumes. Taken together, this study provides useful insights for the development of complex, heterocellular engineered 3D tissue constructs and their engraftment via tissue fusion and has implications for arrhythmogenesis in cardiac disease and repair. [ABSTRACT FROM AUTHOR]

Background: The evidence for the clinical utility of pharmacogenomic (PGx) testing is growing, and guidelines exist for the use of PGx testing to inform prescribing of 13 antidepressants. Although previous randomised controlled trials of PGx testing for antidepressant prescribing have shown an association with remission of depression in clinical psychiatric settings, few trials have focused on the primary care setting, where most antidepressant prescribing occurs. Methods: The PRESIDE Trial is a stratified double-blinded randomised controlled superiority trial that aims to evaluate the impact of a PGx-informed antidepressant prescribing report (compared with standard prescribing using the Australian Therapeutic Guidelines) on depressive symptoms after 12 weeks, when delivered in primary care. Six hundred seventy-two patients aged 18–65 years of general practitioners (GPs) in Victoria with moderate to severe depressive symptoms, measured using the Patient Health Questionnaire-9 (PHQ-9), will be randomly allocated 1:1 to each arm using a computer-generated sequence. Participants and GPs will be blinded to the study arm. The primary outcome is a difference between arms in the change of depressive symptoms, measured using the PHQ-9 after 12 weeks. Secondary outcomes include a difference between the arms in change in PHQ-9 score at 4, 8 and 26 weeks, proportion in remission at 12 weeks, a change in side effect profile of antidepressant medications, adherence to antidepressant medications, change in quality of life and cost-effectiveness of the intervention. Discussion: This trial will provide evidence as to whether PGx-informed antidepressant prescribing is clinically efficacious and cost-effective. It will inform national and international policy and guidelines about the use of PGx to select antidepressants for people with moderate to severe depressive symptoms presenting in primary care. Trial registration: Australian and New Zealand Clinical Trial Registry ACTRN12621000181808. Registered on 22 February 2021. [ABSTRACT FROM AUTHOR]

Examines the outcomes of a randomized controlled trial of a clinical pharmacy intervention in nursing homes. Reduction of drug use with no change in morbidity indices; Improvement of nursing home resident outcomes related to changes in drug use and drug-related expenditure; Measurement on the outcomes related to drug use.