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IntroductionPeritoneal dialysis (PD)-related peritonitis is one of the leading causes of discontinuation of PD and is considered a critically important outcome for patients on PD. However, there is no universally accepted method of measuring this outcome in clinical trials.MethodsWe convened an online consensus workshop to establish a core outcome measure for PD-related peritonitis in clinical trials.ResultsA total of 53 participants, including 18 patients and caregivers, from 12 countries engaged in breakout discussions in this workshop. Transcripts were analyzed thematically. We identified the following 3 themes: (i) feasibility and applicability across diverse settings, which reflected the difficulty with implementing laboratory-based measures in resource-limited environments; (ii) ensuring validity, which included minimizing false positives and considering the specificity of symptoms; and (iii) being meaningful and tangible to patients, which meant that the measure should be easy to interpret, reflect the impact that symptoms have on patients, and promote transparency by standardizing the reporting of peritonitis among dialysis units.ConclusionA core outcome measure for PD-related peritonitis should include both symptom-based and laboratory-based criteria. Thus, the International Society for Peritoneal Dialysis (ISPD) definition of peritonitis is acceptable. However, there should be consideration of reporting suspected peritonitis in cases where laboratory confirmation is not possible. The measure should include all infections from the time of catheter insertion and capture both the rate of infection and the number of patients who remain peritonitis free. A core outcome measure with these features would increase the impact of clinical trials on the care and decision-making of patients receiving PD.

IntroductionPatients with glomerular disease experience symptoms that impair their physical and mental health while managing their treatments, diet, appointments and monitoring general and specific indicators of health and their illness. We sought to describe the perspectives of patients and their care partners on self-management in glomerular disease.MethodsWe conducted 16 focus groups involving adult patients with glomerular disease (n = 101) and their care partners (n = 34) in Australia, Hong Kong, the United Kingdom, and United States. Transcripts were analyzed thematically.ResultsWe identified the following 4 themes: empowered in autonomy (gaining confidence through understanding, taking ownership of disease and treatment, learning a positive health approach); overwhelmed by compounding treatment burdens (financially undermined and depleted, demoralized by side effects and harms, frustrated by fragmented and inflexible care, fear of possible drug harms); striving for stability and normalcy (making personal sacrifices, maximizing life participation, attentiveness to bodily signs, avoiding precarious health states, integrating medicines into routines); and necessity of health-sustaining relationships (buoyed by social support, fulfilling meaningful responsibilities, sharing and normalizing experiences, seeking a trusting and respectful alliance).ConclusionPatients with glomerular disease and their care partners value their capacity for autonomy and disease ownership, stability of their health, and relationships that support self-management. Strategies directed at strengthening these factors may increase self-efficacy and improve the care and outcomes for patients with glomerular disease.

Author(s): Rachael Kermond [sup.1] , Simon Carter [sup.2] [sup.3] , Catherine Quinlan [sup.2] [sup.4] [sup.5] Author Affiliations: (1) grid.413973.b, 0000 0000 9690 854X, Nephrology Department, Children's Hospital Westmead, Sydney Children's [...]

Geophysical methods depend on a range of physical and chemical mechanisms, and each method has different sensitivities and resolution of Earth parameters, and over different scale lengths. Additionally, such geophysical methods will also have their own statistical characteristics. Thus, it is a significant challenge to combine different methods through a single inversion framework. Rather than attempting to find an optimal and single model for different geophysical responses, an alternative approach is to use FCM clustering to identify clusters of parameters from two or more different geophysical data sets or models that have similar statistical properties. In this paper, we apply the FCM approach to integrate data and model sets for an array of 100 broadband magnetotelluric (MT) and 100 passive seismic receivers spaced 1 km apart on a 10 by 10 grid above the Vulcan IOCG prospect in the Olympic Cu–Au Province, southern Australia. The challenge for exploration of the Vulcan prospect is that it lies beneath 750 m of regolith sedimentary cover, no single geophysical method provides a unique characterization of the deposit geometry, and drilling is very expensive. Fuzzy c-mean cluster analyses are undertaken in 2D for gravity data and shear-wave velocity model data for basement depths beneath cover and in 3D for shear-wave velocity and electrical resistivity model data. Fuzzy c-mean clustering is shown to provide a simple and efficient method of integrating different geophysical measurements to produce a geological framework that can be verified with drilling information. [ABSTRACT FROM AUTHOR]

As most outcropping and shallow mineral deposits have been found, new technology is imperative to finding the hidden critical mineral deposits required for the renewable energy transition. One such seismic technique, called ambient noise tomography (ANT), has shown promise in recent years as a low cost and low environmental impact passive method of three-dimensional (3D) imaging of shear-wave velocity structure of the Earth. Over the last twenty years the method has been well-established in academia to image crustal and regional scale geological features but has seldom been used at the mineral exploration deposit-scale. In this paper we show the application of seismic ANT at an IOCG deposit in South Australia under more than 750 m of sedimentary cover. A 100-site survey in a 10 by 10 grid with site spacing of 1 km, using 3-component nodal seismometers with a natural-frequency of 5 Hz, was conducted over a two-week period. Data were inverted to generate a 3D velocity model to a depth of 2 km. When compared to drillholes in the survey area, the tomographic model delineates cover sequence lithologies and the depth of crystalline basement. A velocity anomaly in the basement has characteristics of a potential IOCG deposit and is aligned with a gravity anomaly due to brecciated haematite. The results of the paper indicate that ANT is a useful tool for deep cover mineral exploration that can potentially expedite the discovery of new deposits. [ABSTRACT FROM AUTHOR]

The presence of thick (>100 m) and electrically conductive (< 10 Ω.m) ground cover is a major impediment in mineral exploration of deep resources. Iron-oxide copper gold (IOCG) systems in Australia are often associated with a pronounced potential field anomaly, depending on the oxidation state of iron, but the gravity and magnetic field signatures have little vertical resolution unless constrained by drill hole petrophysics. Additionally, IOCG systems have deep magmatic sources, with their conductivity anomalies extending at least to the lithospheric mantle. The Vulcan IOCG prospect lies about 30 km northeast of the Olympic Dam IOCG mine and is defined by a significant gravity anomaly associated with brecciated haematite beneath 850 m of sedimentary cover sequences. To image the physical properties and structural geometry of the Vulcan IOCG prospect, a 100-site broadband MT and passive seismic array was deployed in a 1 km grid over a 9 by 9 km area. Three-dimensional inversion of MT responses resolve structure in three distinct domains. Firstly, broad limestone-quartzite-shale stratigraphy (1–30 Ω.m) in the 850 m cover is delineated in resistivity and corresponds well with changes in shear-wave velocity. Secondly, the region of brecciated haematite below the cover sequences is shown to have lower resistivity (< 60 Ω.m) than surrounding country rock (> 100 Ω.m). Thirdly, a more electrically conductive (< 30 Ω.m) vertical zone that extends > 5 km is imaged a few kilometers to the northeast of the Vulcan haematite breccia, and appears to be linked by a region of low shear-wave velocity in the depth range 1–2 km. Two-dimensional inversion of more regional MT responses along a 200-km line passing through the Vulcan prospect suggest this vertical region of low resistivity links to the lower-crust with anomalous resistivity of < 60 Ω.m in a similar way as imaged beneath the Olympic Dam mine. It is suggested that this conductive region is associated with graphite precipitated from magmatically derived CO2-rich fluids cooling in a reducing environment. [ABSTRACT FROM AUTHOR]

Induced polarisation (IP) is a common geophysical method of exploration for disseminated sulphides. However, in areas with deep (>200 m) and conductive (10 Ωm or less) cover, the technique is less successful as it requires a significant transmitter source and large-offset dipoles. An alternative approach is to use natural-variations in Earth's external magnetic field as the polarising source of the signal, known as natural-field IP. This paper presents a study of extracting IP information from electrical dipole observations during a broadband magnetotelluric (MT) program with a 9 km by 9 km grid of 100 sites above the Vulcan IOCG deposit beneath 750 m of cover, ∼40 km north of the Olympic Dam IOCG mine in South Australia. Inter-site transfer functions between 95 sites and five reference sites at the southeast and southwest corners of the grid were computed to determine a phase shift between horizontal electric fields in the bandwidth of 1–100 s period. Phase shifts of up to – 5 degrees were centred on a region of brecciated hematite where drill holes intersected pyrite, and an inferred fault-zone from passive seismics that marks the boundary between upper crust that is resistive (>100 Ω.m) with high magnetic susceptibility to the south of the fault, and a region of conductive crust (<10 Ω.m) which is low magnetic susceptibility. Our study suggests that the natural-field IP method can identify regions of polarizable minerals beneath deep cover where artificial power sources cannot be feasibly deployed. Such surveys are cheaper, safer, and easier to deploy as only receivers are required, and 3D coverage can be obtained as the source-field is of much larger dimension than the survey array. In addition, the natural-field IP signals are observed as part of the MT program so that both electrical resistivity and polarisation parameters can be determined. [ABSTRACT FROM AUTHOR]

Population pharmacokinetic (PK) models are widely used to inform drug development by pharmaceutical companies and facilitate drug evaluation by regulatory agencies. Developing a population PK model is a multi‐step, challenging, and time‐consuming process involving iterative manual model fitting and evaluation. A tool for fully automatic model development (AMD) of common population PK models is presented here. The AMD tool is implemented in Pharmpy, a versatile open‐source library for pharmacometrics. It consists of different modules responsible for developing the different components of population PK models, including the structural model, the inter‐individual variability (IIV) model, the inter‐occasional variability (IOV) model, the residual unexplained variability (RUV) model, the covariate model, and the allometry model. The AMD tool was evaluated using 10 real PK datasets involving the structural, IIV, and RUV modules in three sequences. The different sequences yielded generally consistent structural models; however, there were variations in the results of the IIV and RUV models. The final models of the AMD tool showed lower Bayesian Information Criterion (BIC) values and similar visual predictive check plots compared with the available published models, indicating reasonable quality, in addition to reasonable run time. A similar conclusion was also drawn in a simulation study. The developed AMD tool serves as a promising tool for fast and fully automatic population PK model building with the potential to facilitate the use of modeling and simulation in drug development. [ABSTRACT FROM AUTHOR]

Background Despite peritoneal dialysis being the preferred mode of renal replacement therapy in neonates and infants, long-term haemodialysis may be necessary in a minority of patients with its attendant risks. Case Diagnosis/Treatment This case identifies plastic bronchitis as a rare yet serious complication of long-term large bore vascular access when a vessel-sparing approach is not possible. Conclusions An appropriately sized catheter should be used for the dialytic therapy required and to optimize access survival., Author(s): Simon Carter [sup.1] , Dayna van de Hoef [sup.2] , Michael Temple [sup.3] , Elizabeth Harvey [sup.1] , Suhail Al-Saleh [sup.4] , Christoph Licht [sup.1] , Damien Noone [sup.1] [...]