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Online learning dexterity, or the ability to effortlessly adapt to online learning situations, has become critical since the COVID-19 pandemic, but its processes are not well-understood. Using grounded theory, this study develops a paradigm model of online learning dexterity from semi-structured interviews with 32 undergraduate and postgraduate students from a university in New Zealand. Through students' online learning experiences during the pandemic from 2020 to 2021, online learning dexterity is found to be how students make online learning 'just as good' as face-to-face learning by creating and adjusting five learning manoeuvres according to developing online learning circumstances. Undergraduates and postgraduates re-use familiar study strategies as "deep learning manoeuvres," but undergraduates restrict "support-seeking manoeuvres" to lecturers. Technical problems with online systems and poor course organisation by lecturers affected learning productivity, resulting in the need for more "time optimisation manoeuvres." Social support helped students activate "persistence manoeuvres" to sustain online class attendance. However, undergraduates had more problems sustaining interest and engagement during class as they were not as proficient with using "learning presence manoeuvres" as postgraduates enrolled in distance learning programmes. The theoretical and practical significance of online learning dexterity for post-pandemic higher education is discussed.

Background: Malignant pleural effusions (MPEs) are common, and a third of them have underlying trapped lung (TL). Management of MPE and TL is suspected to be heterogeneous. Understanding current practices in Australasia is important in guiding policies and future research. Aims: Electronic survey of Australia‐New Zealand respiratory physicians, thoracic surgeons and their respective trainees to determine practice of MPE and TL management. Results: Of the 132 respondents, 56% were respiratory physicians, 23% were surgeons and 20% were trainees. Many respondents defined TL as >25% or any level of incomplete lung expansion; 75% would use large‐volume thoracentesis to determine whether TL was present. For patients with TL, indwelling pleural catheters (IPCs) were the preferred treatment irrespective of prognosis. In those without TL, surgical pleurodesis was the most common choice if prognosis was >6 months, whereas IPC was the preferred option if survival was <3 months. Only 5% of respondents considered decortication having a definite role in TL, but 55% would consider it in select cases. Forty‐nine per cent of surgeons would not perform decortication when the lung does not fully expand intra‐operatively. Perceived advantages of IPCs were minimisation of hospital time, effusion re‐intervention and usefulness irrespective of TL status. Perceived disadvantages of IPCs were lack of suitable drainage care, potentially indefinite duration of catheter‐in‐situ and catheter complications. Conclusion: This survey highlights the lack of definition of TL and heterogeneity of MPE management in Australasia, especially for patients with expandable lungs. This survey also identified the main hurdles of IPC use that should be targeted. [ABSTRACT FROM AUTHOR]

Deforestation, increasing urban development and associated infrastructure have resulted in widespread loss of roosting habitat for New Zealand's long-tailed bat (Chalinolobus tuberculatus, pekapeka-tou-roa). As a result, artificial roosts are increasingly proposed as a short to medium-term mitigation measure, despite the absence of specific protocols for the installation, maintenance, and suitability for New Zealand bats. As of 2021, more than 110 artificial roosts had been installed in urban parks within Hamilton City, New Zealand. To determine their uptake and suitability for long-tailed bats, 74 Kent style roosts of varying ages were monitored for 1 year, with 24 (32%) roosts observed occupied by long-tailed bats. Occupation was generally infrequent, with no clear seasonal pattern or specific areas of occupation. However, two older roosts were consistently occupied, with numbers notably increasing during the summer maternity season. Distance to stand edge was the only factor that could be used to predict occupation, with logistic regression indicating that long-tailed bats may prefer roosts in less exposed areas with stable microclimates, within tree stands or sheltered landscape features. Future artificial roost installations should site roosts away from the stand edge in sheltered locations, ideally near natural or already occupied roosts to facilitate discovery and uptake. [ABSTRACT FROM AUTHOR]

Artificial light at night (ALAN) is considered a growing threat to bat species due to its potential impacts on circadian cycles, increased predation risk, and avoidance behaviour. Urban expansion and associated increases in ALAN may impact the behaviour of New Zealand's critically threatened long-tailed bat (Chalinolobus tuberculatus). To determine whether long-tailed bat behaviour was affected by ALAN, a small-scale study was conducted on the fringe of Hamilton City, New Zealand, using LED floodlights. Changes in the number of nightly detections in response to periodic illumination were measured using acoustic monitoring and compared to a nearby unlit control site. Bat detection rates were significantly lower on lit nights compared to unlit nights at the treatment site, while there was no significant difference at the control site for the same period. In addition, the median time of the first recorded bat detection was c. 2 h later during lit nights compared to unlit nights at the treatment site. These results indicate that ALAN may have a negative effect on the behaviour of long-tailed bats, potentially delaying the use of areas and excluding them from foraging habitat. Further research into the effects and potential mitigation of ALAN for long-tailed bats is required. [ABSTRACT FROM AUTHOR]

Background and aim: Social practices such as smoking–drinking co‐use often go 'hand‐in‐hand', linked by the coordination of materials, skills and meanings. However, the experience of using e‐cigarettes while drinking among people who smoke (and drink) remains underexplored. We used social practice theory to show how smoking, vaping and drinking intersect and to explain how vaping created two new social practices among people who tried e‐cigarettes to stop smoking: 'vaping–drinking' co‐use and 'smoking–vaping–drinking' poly‐use. Methods: We conducted five in‐depth interviews over 18–24 weeks during 2018–19, with each of nine Aotearoa New Zealand young adults aged 20–29 years. Participants smoked daily, did not regularly use e‐cigarettes at entry and wished to try vaping to stop smoking. We analysed participants' reports of smoking or vaping while drinking using thematic analysis. Results: Individual participants reported both co‐use and poly‐use occasions throughout the study. Vaping–drinking co‐use arose from practice 'replacement' processes, where vaping fully substituted smoking. Smoking–vaping–drinking poly‐use arose from 'adjacency' processes where vaping complemented smoking. Participants used both processes flexibly over time, which required new skills in material, temporal, pleasure and social coordination to try to recreate valued meanings of comfort, security and communality associated with well‐established smoking–drinking practices. Unsuccessful coordination attempts maintained smoking–drinking co‐use. Conclusion: Among Aotearoa New Zealand young adult smokers who want to use vaping to stop smoking, drinking occasions may help to maintain existing smoking–drinking practices and facilitate the development of vaping–drinking co‐use and smoking–vaping–drinking poly‐use practices, potentially prolonging individuals' exposure to smoking. [ABSTRACT FROM AUTHOR]

Background Emergency department (ED) clinicians are more frequently providing care, including end-of-life care, to older people. Objectives To estimate the need for ED end-of-life care for people aged ≥65 years, describe characteristics of those dying within 48 hours of ED presentation and compare those dying in ED with those dying elsewhere. Methods We conducted a retrospective cohort study analysing data from 177 hospitals in Australia and New Zealand. Data on older people presenting to ED from January to December 2018, and those who died within 48 hours of ED presentation, were analysed using simple descriptive statistics and univariate logistic regression. Results From participating hospitals in Australia or New Zealand, 10,921 deaths in older people occurred. The 48-hour mortality rate was 6.43 per 1,000 ED presentations (95% confidence interval: 6.31–6.56). Just over a quarter (n = 3,067, 28.1%) died in ED. About one-quarter of the cohort (n = 2,887, 26.4%) was triaged into less urgent triage categories. Factors with an increased risk of dying in ED included age 65–74 years, ambulance arrival, most urgent triage categories, principal diagnosis of circulatory system disorder, and not identifying as an Aboriginal or Torres Strait Islander person. Of the 7,677 older people admitted, half (n = 3,836, 50.0%) had an encounter for palliative care prior to, or during, this presentation. Conclusions Our findings provide insight into the challenges of recognising the dying older patient and differentiating those appropriate for end-of-life care. We support recommendations for national advanced care planning registers and suggest a review of triage systems with an older person-focused lens. [ABSTRACT FROM AUTHOR]

This study proposed a composite tibia defect scaffold with radial gradient porosity, utilizing finite element analysis to assess stress in the tibial region with significant critical-sized defects. Simulations for scaffolds with different porosities were conducted, designing an optimal tibia defect scaffold with radial gradient porosity for repairing and replacing critical bone defects. Radial gradient porosity scaffolds resulted in a more uniform stress distribution, reducing titanium alloy stiffness and alleviating stress shielding effects. The scaffold was manufactured using selective laser melting (SLM) technology with stress relief annealing to simplify porous structure fabrication. The study used New Zealand white rabbits' tibia defect sites as simulation parameters, reconstructing the 3D model and implanting the composite scaffold. Finite element analysis in ANSYS-Workbench simulated forces under high-activity conditions, analyzing stress distribution and strain. In the simulation, the titanium alloy scaffold bore a maximum stress of 122.8626 MPa, while the centrally encapsulated HAp material delivered 27.92 MPa. The design demonstrated superior structural strength, thereby reducing stress concentration. The scaffold was manufactured using SLM, and the uniform design method was used to determine a collection of optimum annealing parameters. Nanoindentation and compression tests were used to determine the influence of annealing on the elastic modulus, hardness, and strain energy of the scaffold. [ABSTRACT FROM AUTHOR]

Terrestrial glacial records from the Patagonian Andes and New Zealand Alps document quasi-synchronous Southern Hemisphere-wide glacier advances during the late Quaternary. However, these records are inherently incomplete. Here, we provide a continuous marine record of western-central Patagonian ice sheet (PIS) extent over a complete glacial-interglacial cycle back into the penultimate glacial (~140 ka). Sediment core MR16-09 PC03, located at 46°S and ~150 km offshore Chile, received high terrestrial sediment and meltwater input when the central PIS extended westward. We use biomarkers, foraminiferal oxygen isotopes, and major elemental data to reconstruct terrestrial sediment and freshwater input related to PIS variations. Our sediment record documents three intervals of general PIS marginal fluctuations, during Marine Isotope Stage (MIS) 6 (140 to 135 ka), MIS 4 (~70 to 60 ka), and late MIS 3 to MIS 2 (~40 to 18 ka). These higher terrigenous input intervals occurred during sea-level low stands, when the western PIS covered most of the Chilean fjords, which today retain glaciofluvial sediments. During these intervals, high-amplitude phases of enhanced sediment supply occur at millennial timescales, reflecting increased ice discharge most likely due to a growing PIS. We assign the late MIS 3 to MIS 2 phases and, by inference, older advances to Antarctic cold stages. We conclude that the increased sediment/meltwater release during Southern Hemisphere millennial-scale cold phases was likely related to higher precipitation caused by enhanced westerly winds at the northwestern margin of the PIS. Our records complement terrestrial archives and provide evidence for PIS climate sensitivity. [ABSTRACT FROM AUTHOR]

E-liquid flavours are perhaps the most materially disruptive aspect of vaping compared with smoking, especially for people who smoke tobacco and who wish to quit. A better understanding of whether and how e-liquid flavours create personal and social value for people who smoke may offer insights into how vaping has become a social practice among this group. These insights may be useful for countries such as New Zealand, where health authorities have endorsed e-cigarettes to help achieve the Government's Smokefree 2025 goal. We drew on longitudinal in-depth interviews with 11 New Zealand young adults (19–29 years old) who smoked tobacco and who were willing to try an e-cigarette to stop smoking. Each participant was interviewed five times over 18–24 weeks during 2018–2019 and at every interview asked about their e-liquid flavour use and perceptions and experiences of these flavours compared to smoking. We thematically analysed the transcripts with an emphasis on exploring tensions between old and new skills, meanings, and emotions associated with smoking, vaping, and e-liquid flavours. We found that flavours could disrupt tobacco's value proposition by provoking emotional responses that had a crucial impact on participants' feelings of emotional security when vaping. Competence to deal with initially unsettling feelings when vaping was key to helping participants reorient meanings and emotions and embed vaping in their lives. As e-liquids are purchased regularly, and flavours ideally sampled in-person, countries could optimise vaping regulations by limiting online sales and mandating cessation advice and support at all point-of-sale interactions. [ABSTRACT FROM AUTHOR]

Several vascular embolization materials are commonly used in clinical practice, however, having application defects of varying degrees, such as poor intraoperative imaging and easy recanalization of embolized blood vessels, they are challenging for application during Transcatheter arterial embolization (TAE). Thus, an intraoperative visible vascular embolization material with good embolization effect and biocompatibility can improve transcatheter arterial embolization clinical efficacy to some extent. Our study aimed to synthesize a novel vascular embolization material that can achieve complete embolization of arterial trunks and peripheral vessels, namely poly (N-isopropyl acrylamide)-co-acrylic acid nanogel (NIPAM-co-AA). Iohexol 200 mg/mL was co-assembled with 7 wt% NIPAM-co-AA nanogel to create an intelligent thermosensitive radiopaque nanogel (INCA), which achieves a good intraoperative imaging effect and is convenient for transcatheter arterial bolus injection due to its good fluidity and temperature-sensitive sol-gel phase transition. The normal rabbit kidney embolism model further confirmed that INCA could effectively use Digital subtraction angiography (DSA) to achieve intraoperative imaging, and real-time monitoring of the embolization process could avoid mis-embolization and leakage. Meanwhile, in a 42-day study, INCA demonstrated an excellent embolization effect on the right renal artery of New Zealand white rabbits, with no vascular recanalization and ischemic necrosis and calcification remaining. As a result, this radiopaque thermosensitive nanogel has the potential to be an intelligent thermosensitive medical vascular embolization material, providing dual benefits in TAE intraoperative imaging and long-term postoperative embolization while effectively addressing the shortcomings and challenges of commonly used clinical vascular embolization agents. [ABSTRACT FROM AUTHOR]

Background: Emergency department (ED) utilization is a significant concern in many countries, but few population‐based studies have compared ED use. Our objective was to compare ED utilization in New York (United States), Ontario (Canada), and New Zealand (NZ). Methods: A retrospective cross‐sectional analysis of all ED visits between January 1, 2016, and September 30, 2017, for adults ≥18 years using data from the State Emergency Department and Inpatient Databases (New York), the National Ambulatory Care Reporting System and Discharge Abstract Data (Ontario), and the National Non‐Admitted Patient Collection and the National Minimum Data Set (New Zealand). Outcomes included age‐ and sex‐standardized per‐capita ED utilization (overall and stratified by neighborhood income), ED disposition, and ED revisit and hospitalization within 30 days of ED discharge. Results: There were 10,998,371 ED visits in New York, 8,754,751 in Ontario, and 1,547,801 in New Zealand. Patients were older in Ontario (mean age 51.1 years) compared to New Zealand (50.3) and New York (48.7). Annual sex‐ and age‐standardized per‐capita ED utilization was higher in Ontario than New York or New Zealand (443.2 vs. 404.0 or 248.4 visits per 1000 population/year, respectively). In all countries, ED utilization was highest for residents of the lowest income quintile neighborhoods. The proportion of ED visits resulting in hospitalization was higher in New Zealand (34.5%) compared to New York (20.8%) and Ontario (12.8%). Thirty‐day ED revisits were higher in Ontario (27.0%) than New Zealand (18.6%) or New York (21.4%). Conclusions: Patterns of ED utilization differed widely across three high‐income countries. These differences highlight the varying approaches that our countries take with respect to urgent visits, suggest opportunities for shared learning through international comparisons, and raise important questions about optimal approaches for all countries. [ABSTRACT FROM AUTHOR]

Aims and objectives: This review aimed to demonstrate the self‐care behaviours of first‐generation Chinese immigrants with cardiovascular disease in western countries and identify related cultural factors. Background: Self‐care is the cornerstone to mitigate disease symptoms and maintain health status. Chinese immigrants to western countries, operating within a cross‐cultural context, may find self‐care to manage their cardiovascular disease challenging. Design: An integrative review was conducted. Methods: Seven databases were searched Scopus, ProQuest Health & Medicine, Medline (Ovid), Embase (Ovid), AMED (Ovid), PsycINFO and CINAHL, with output limited to peer‐reviewed studies published from 2000 to 2020 in English or Chinese. Initially, 2037 papers were screened. Six papers were retained and critiqued using the Joanna Briggs Institute critical appraisal tools. Deductive and inductive approaches were utilised to analyse the findings. The PRISMA 2020 checklist informed review reportage. Result: In general, Chinese immigrants with cardiovascular disease took an active role in management of their cardiovascular disease, including through diet and activity adaptation and adherence to western medication. Families also played a significant role in disease decision‐making and management. However, language and cultural barriers impeded their access to health information and resources in host countries. Relevance to clinical practice: Understanding self‐care behaviours and associated cultural factors among Chinese immigrants with cardiovascular disease is important to improve nurses' culturally sensitive practices and provide tailored health education interventions to promote self‐care behaviours among immigrant populations. The scarcity of literature on self‐care behaviours among Chinese first‐generation immigrants with cardiovascular disease indicates the need for further research in this area. Development of culturally and linguistically sensitive health resources and education programs is urgently needed. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to explore the aetiology of severe duodenal mucosal abnormality in consecutive patients who underwent gastroscopy and duodenal biopsy over the past 10 years. Background: A range of differential diagnoses have been reported for severe duodenal architectural distortion. Methods: Clinical and laboratory data of all the patients with severe duodenal architectural distortion diagnosed at MidCentral District Health Board (DHB), New Zealand were collected and statistically analysed. Ninety-five percent confidence intervals (CI) are shown. Results: Between September 2009 and April 2019, 229 patients were diagnosed with severe enteropathy. The median patient age was 41 years (range 6-83 years). Two hundred and twenty-four of these patients (97.8%, 95.0-99.3%) were diagnosed with coeliac disease (CeD), with one of these patients having gluten induced T-cell lymphoma. From the remaining five patients, one had a diagnosis of tropical sprue and four did not have a clear aetiology. There were 180 patients from 191 (94.2%, 89.9-97.1%) with at least one positive coeliac marker, all with a diagnosis of CeD. Eleven patients (5.8% of 191, 2.9-10.1%) had negative markers for both tissue transglutaminase IgA (tTG-IgA) and IgA-endomysial antibodies (EMA-IgA) with six having a diagnosis of seronegative CeD. Conclusion: Although the spectrum of histological changes in CeD may range from normal to a flat mucosa, severe duodenal architectural distortion seems to occur mainly in CeD. Idiopathic enteropathy was recorded as the second but by far less frequent presentation of severe enteropathy. This study highlights that infection and other aetiologies are rarely implicated in severe enteropathy, with one case (0.4%) of refractory CeD/T-cell lymphoma. [ABSTRACT FROM AUTHOR]

Many ophthalmologists preform clinical refactions, although little is known of the perceptions and practise of refraction by ophthalmologists and key barriers preventing this aspect of ophthalmic practice. Although there are numerous studies on visual acuity in ophthalmology, there is no study to date on the practice of refraction by ophthalmologists. This study evaluates the practice patterns of ophthalmologists in current practice. It specifically addresses perceptions of ophthalmologists about (a) the importance of refraction in clinical practice, and (b) barriers to performing refraction. The methodology and frequency of performing refraction by ophthalmologists is also assessed. This cross-sectional study was conducted at the Annual Scientific Congress of the Royal Australian and New Zealand College of ophthalmologists in 2017, held in Perth, Australia. All attending ophthalmologists and ophthalmology trainees were invited to participate. Participants completed a 17-variable questionnaire on the perceptions of practitioners about refraction and their practice of it. Data were analysed using Microsoft Excel and IBM SPSS Version 24. At this Congress, 213 attendees completed the survey, with most being consultant general ophthalmologists (85%). Twenty-six percent of participants either 'really loved' or 'liked' refracting patients. Those who reported feeling competent with refraction were more likely to perform it themselves (p = 0.001). Individuals most commonly reported taking 3-5 minutes to refract a patient (38%). Participants under the age of 65, and participants practising paediatric ophthalmology, were more likely to perform a refraction. The literature indicates that this is the first study to describe the practice patterns of refraction by ophthalmologists. Although ophthalmologists found refraction important, the majority preferred patients to be refracted by others. Key barriers to ophthalmologists performing refraction included the time required to perform the refraction, a busy clinic, and the availability of alternative providers. [ABSTRACT FROM AUTHOR]

Aims: We investigated titration patterns of angiotensin‐converting enzyme inhibitors (ACEis)/angiotensin receptor blockers (ARBs) and beta‐blockers, quality of life (QoL) over 6 months, and associated 1 year outcome [all‐cause mortality/heart failure (HF) hospitalization] in a real‐world population with HF with reduced ejection fraction (HFrEF). Methods and results: Participants with HFrEF (left ventricular ejection fraction <40%) from a prospective multi‐centre study were examined for use and dose [relative to guideline‐recommended maintenance dose (GRD)] of ACEis/ARBs and beta‐blockers at baseline and 6 months. 'Stay low' was defined as <50% GRD at both time points, 'stay high' as ≥50% GRD, and 'up‐titrate' and 'down‐titrate' as dose trajectories. Among 1110 patients (mean age 63 ± 13 years, 16% women, 26% New York Heart Association Class III/IV), 714 (64%) were multi‐ethnic Asians from Singapore and 396 were from New Zealand (mainly European ethnicity). Baseline use of either ACEis/ARBs or beta‐blockers was high (87%). Loop diuretic was prescribed in >80% of patients, mineralocorticoid receptor antagonist in about half of patients, and statins in >90% of patients. At baseline, only 11% and 9% received 100% GRD for each drug class, respectively, with about half (47%) achieving ≥50% GRD for ACEis/ARBs or beta‐blockers. At 6 months, a large majority remained in the 'stay low' category, one third remained in 'stay high', whereas 10–16% up‐titrated and 4–6% down‐titrated. Patients with lower (vs. higher) N‐terminal pro‐beta‐type natriuretic peptide levels were more likely to be up‐titrated or be in 'stay high' for ACEis/ARBs and beta‐blockers (P = 0.002). Ischaemic aetiology, prior HF hospitalization, and enrolment in Singapore (vs. New Zealand) were independently associated with higher odds of 'staying low' (all P < 0.005) for prescribed doses of ACEis/ARBs and beta‐blockers. Adjusted for inverse probability weighting, ≥100% GRD for ACEis/ARBs [hazard ratio (HR) = 0.42; 95% confidence interval (CI) 0.24–0.73] and ≥50% GRD for beta‐blockers (HR = 0.58; 95% CI 0.37–0.90) (vs. Nil) were associated with lower hazards for 1 year composite outcome. Country of enrolment did not modify the associations of dose categories with 1 year composite outcome. Higher medication doses were associated with greater improvements in QoL. Conclusions: Although HF medication use at baseline was high, most patients did not have these medications up‐titrated over 6 months. Multiple clinical factors were associated with changes in medication dosages. Further research is urgently needed to investigate the causes of lack of up‐titration of HF therapy (and its frequency), which could inform strategies for timely up‐titration of HF therapy based on clinical and biochemical parameters. [ABSTRACT FROM AUTHOR]

This research study sought to identify prominent features of the nature of science (NOS) embedded in authentic scientific inquiry. Fourteen well-established scientists from different parts of the world, working in experimental or theoretical research, in both traditional fields such as astrophysics and rapidly growing research fields such as molecular biology, participated as the informants of the study. The descriptions of their practices revealed eight prominent categories of NOS features. In an earlier paper of ours, we have reported four categories under the two themes: (1) the methods of scientific investigation and (2) the role and status of scientific knowledge. In this paper, we focus on the remaining four categories under the theme: social dimensions of science. Scientists' descriptions of their practices have "put some flesh on the bones" of the assertion that science is socially and culturally embedded. These descriptions also have considerable potential for development into interesting case studies as teaching resources to enhance and enrich students' understanding of NOS. (Contains 1 table and 7 notes.)

Background: Thyroidectomy is traditionally an open procedure. The potential for and unpredictability of patients developing an unsightly anterior neck scar has led many investigators to develop various 'scarless' thyroidectomy techniques. Here we report on our initial experience, and to our knowledge, the first and largest series of this technique in Australia and New Zealand. Methods: Across two centres in Western Australia, three Endocrine surgeons utilized the Transoral Endoscopic Thyroidectomy vestibular approach (TOETVA). Key endpoints such as operating time, blood loss, pain scores, recurrent laryngeal nerve injury and hypoparathyroidism was collected. Data was analysed using R statistical program. Results: One hundred and two TOETVAs were performed between March 2018 and May 2021. There were 66 hemithyroidectomies, 34 total thyroidectomies (four converted to open), and two isthmusectomies. We noted a trend in median operating time decreasing over the study period. There were no cases of permanent recurrent laryngeal nerve palsy, wound infection, seroma or haematoma. We had four instances of open conversion; one temporary RLN palsy, and 12 cases of temporary hypoparathyroidism. Conclusion: This is the first series of TOETVA reported in Australia and New Zealand. Our results demonstrate that with appropriate surgeon experience, training, collaboration, and in well selected patients, this is a feasible and safe thyroidectomy technique. We hope that our work will build confidence in Endocrine Surgical units seeking to develop this technique in Australia. [ABSTRACT FROM AUTHOR]

The objective of this study as to evaluate the biomechanical and osteointegration properties of 3D printed porous polyetheretherketone (PEEK) with hydroxyapatite (HA) coating by simulated body fluid (SBF) method. Cylindrical scaffolds were designed and fabricated by using PEEK material through fused deposition molding (FDM). The scaffolds were divided into solid group, porous group and porous-HA group (decorated by hydroxyapatite). The mechanical properties of each group of scaffolds were tested. Then, a total of 12 New Zealand rabbits were implemented for implantation of scaffolds at femoral condyle. Finally, the osteointegration ability of scaffolds were evaluated by Micro computed tomography (Micro-CT), histology and fluorescence staining. The HA was successfully decorated on the surface of the PEEK scaffold. The modulus of solid, porous and porous-HA group was 1289.43 ± 71.44 MPa, 196.36 ± 9.89 MPa and 183.29 ± 7.71 MPa, and the compressive strength was 107.24 ± 5.15 MPa, 33.12 ± 3.86 MPa and 29.99 ± 4.16 MPa, respectively. The micro-CT results showed that the bone volume/total volume ratio (BV/TV) in the porous-HA group was significantly greater than that in solid and porous group. Compared with porous group, the trabecular number (Tb. N) and trabecular thickness (Tb. Th) of porous-HA group was higher, and the trabecular spacing (Tb. Sp) was lower. The histology and fluorescence staining showed that more new bone tissue was formed in the porous-HA at different periods compared with the porous and solid groups. In addition, according to the results of the biomechanical test and osteointegration assessment, the biomechanical properties of 3D-printed porous PEEK scaffolds are close to human trabecular bone tissue, and the hydroxyapatite coating does not degrade its biomechanical performance. The porous structure can facilitate the integration of bone tissue, and the HA coating can markedly improve this process. [ABSTRACT FROM AUTHOR]

Introduction: Social interactions help smoking and vaping practices evolve, and are essential when constructing social identities. Among people who smoke, vaping offers an alternative practice to 'smoking' and 'non‐smoking', and using e‐cigarettes blurs the boundaries between 'smoker' and 'non‐smoker' social identities. In this study, we explored the development of vaping and smoking social identities over time among young adults who smoked and used e‐cigarettes. Methods: Over 18–24 weeks during 2018–2019, we conducted five interviews with each of 11 New Zealand young adults aged 19–29 years who tried vaping to stop smoking. We analysed participants' interview transcripts for social interactions involving smoking or vaping and used social identity theory to explore their construction of vaping social identities. Results: Participants entered the study with smoke‐free goals, and constructed social identities explicitly in relation to a smoke‐free transition. Two key identity processes, 'adopting legitimacy' and 'transferring considerateness', informed participants' social identity construction as they attempted to reconcile their e‐cigarette use with their pre‐study characterisations of vaping as 'illegitimate' and 'obnoxious'. Our findings suggest that adopting a 'legitimate' vaper identity focussed on smoking cessation, and being perceived and accepted by others as a 'legitimate vaper', were essential in participants' identification as 'vapers'. Identifying as a 'legitimate' vaper was a pre‐requisite to transferring a 'considerate' identity from smoking to vaping. Discussion and Conclusion: Participants' construction of vaping social identities suggests that negotiating and reconciling valued aspects of a smoking social identity with nascent vaping practices may be important during smoking‐to‐vaping transition attempts. [ABSTRACT FROM AUTHOR]

The liver is the most complex vascular anatomy of all human organs, with extremely rich blood flow and fragile texture. Massive liver bleeding usually occurs after traumatic liver injury, causing severe systematic issues. Thus, bleeding control is critical in hindering mortality rates and complications in patients. In this study, non-compression hemostasis materials based on chitosan lactate particles (CLP) were developed for handling liver bleeding after injuries. CLP showed good blood biocompatibility and antibacterial performance against S. aureus. Taking advantage of the vital capacity of CLP to promote red blood cell and platelet adhesion, CLP exhibited in vivo homeostasis properties as non-compression hemostasis materials for traumatic liver injury, both in SD rats, New Zealand rabbits, or in beagles. Whereas CLP has better hemostasis than the commercial hemostatic agent Celox™. [ABSTRACT FROM AUTHOR]

The wedge-tailed green pigeon (Treron sphenurus) has a protective value in the evolution of the family Columbidae. In this study, the complete mitogenome of T. sphenurus from Baise City, China, which represents the first sequenced species of the genus Treron in Tribe Treronini, is reported. This was accomplished using PCR-based methods and a primer-walking sequencing strategy with genus-specific primers. The mitogenome was found to be 18,919 bp in length comprising 37 genes, including 13 protein-coding genes, two rRNA genes, 22 tRNA genes, and one control region. In terms of structure and composition, many similarities were found between the T. sphenurus and Hemiphaga novaeseelandiae (New Zealand pigeon) mitogenomes. This was further supported by phylogenetic analysis showing that T. sphenurus has a close evolutionary relationship with H. novaeseelandiae. The complete mitogenome of T. sphenurus reported here is expected to provide valuable molecular information for further studies on the phylogeny of the genus Treron and for analyses of the taxonomic status of the family Columbidae. [ABSTRACT FROM AUTHOR]

Fracture nonunion is a common and challenging complication. Although direct current stimulation has been suggested to promote fracture healing, differences in cell density near the positive and negative electrodes have been reported during direct current stimulation. This study aimed to explore the effects of these differences on osteoblast proliferation and fracture healing. MC3T3-E1 cells were stimulated by positive and negative charges to observe cell proliferation, apoptosis, and osteogenic factor expression in vitro, while positive and negative charges were connected to the Kirschner wires of the fractures in an in vivo double-toe fracture model in New Zealand white rabbits and fracture healing was assessed in digital radiography (DR) examinations performed on days 1, 15, 30. Bone tissue samples of all rabbits were analysed histologically after the last examination. The results showed that in comparison with the control group, after DC stimulation, the number of cells near the positive electrode decreased significantly (P < 0.05), apoptosis increased (P < 0.05), the expression of osteocalcin, osteoblast-specific genes, and osteonectin decreased significantly near the positive electrode (P < 0.05) and increased significantly at the negative electrode (P < 0.05). The fracture at the positive electrode junction of New Zealand white rabbits did not heal. Histomorphological analysis showed more bone trabeculae and calcified bone in the bone tissue sections of the control group and the negative electrode group than in the positive electrode group. The bone trabeculae were thick and showed good connections. However, positive charge inhibited osteoblast proliferation and a positive charge at fracture sites did not favour fracture healing. Thus, a positive charge near the fracture site may be a reason for fracture nonunion. [ABSTRACT FROM AUTHOR]

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Over the last two decades, task-based language teaching (TBLT) has been promoted as more effective for language acquisition than conventional communicative pedagogic practices in a variety of literature. However, it is unclear whether TBLT principles are integrated into English as additional language (EAL) teachers' beliefs and how they made use of ideas announced in the TBLT literature at tertiary level in New Zealand. This exploratory study investigated whether TBLT is evident in three tertiary EAL teachers' classes and how these teachers used tasks in language classes in New Zealand. Repeated semi-structured interviews and classroom observations were employed in this case study research. A key finding is that teachers were using a Communicative Language Teaching model rather than what they claimed to be TBLT. Furthermore, teachers did not prioritize a particular task feature, which was to have a non-linguistic outcome at the end of the task. This study contributes to our understanding of teachers' beliefs and practices with regard to TBLT in New Zealand. [ABSTRACT FROM AUTHOR]

Introduction: Electronic nicotine delivery systems (ENDS) likely pose fewer health risks than smoking. Yet ENDS uptake has increased among never-smoking young adults, who likely face greater health risks relative to non-users of ENDS. To date, few qualitative studies have explored ENDS uptake and use by never-smokers. Methods: We conducted in-depth, semi-structured interviews with 16 current ENDS users from New Zealand aged 18 to 24 years old who reported never having smoked cigarettes regularly. We explored participants' experimentation with conventional tobacco products, trial, uptake and patterns of ENDS use, and their future intentions regarding both ENDS and conventional tobacco products. We managed the data using NVivo12 and used thematic analysis to interpret the transcripts. Results: ENDS use enhanced connection and belonging by providing communal experiences and facilitating social interactions. Participants' mastery of tricks generated social cachet within friendship groups and counteracted the ENDS-related stigma they experienced. Flavours, clouds and devices' physical attributes provided stimulation and engagement, and some used ENDS for stress or appetite management. Lastly, participants rationalised ENDS uptake by referencing the far greater risks smoking posed. Conclusions: ENDS uptake by young adult never-smokers is driven by both psycho-social and functional factors. ENDS provided shared hedonic experiences and physical pleasures, and generated both bonding and bridging social capital, although many participants had also experienced judgement from others for using ENDS. Policies that denormalise ENDS as recreational devices could discourage uptake by never-smokers, though measures will require careful nuancing to avoid deterring smokers from switching to ENDS. [ABSTRACT FROM AUTHOR]

A thin oxide film on NZ alloy (Zr-1Sn-0.3Nb-0.3Fe-0.1Cr) was formed to investigate the correlation of microstructure and corrosion behavior at the initial stage by directly identifying defect-enriched sites. The sites of high conductivity are revealed and labelled by silver deposition, and in the further investigation of microstructure secondary phase precipitates (SPPs) interconnected with micro cracks are found below. Enrichment of oxygen-18 and deuterium in SPPs after isotopic tracing by secondary corrosion highlights their influence on carrier diffusion. Thus, the percolation for corrosion media transportation is reached locally by SPPs interconnected with micro cracks. • New method of silver deposition to pinpoint the permeable sites of the oxide film for carrier diffusion. • Discovery of oxygen and hydrogen enriched in SPPs after isotope tracing. • SPPs bridge micro cracks as the preferential pathways of corrosion. [ABSTRACT FROM AUTHOR]

The common bully (Gobiomorphus cotidianus) was used as a bioindicator to assess the impacts of geothermal, bleached kraft mill effluent (BKME), sewage, and thermal discharges in the Waikato River, Northern New Zealand. A range of morphological and physiological parameters were measured to assess fitness in fish sampled upstream and downstream from these point sources. Isotopic signatures gave evidence that fish were resident at sites and showed a gradient corresponding to site-specific sources of carbon and nitrogen along the river. There were changes in the size range and age structure of the populations but, no physiological responses were detected. Limited impacts were observed on common bully health at individual discharge sites, or downstream where the river showed gradual deterioration in water quality, particularly nutrient enrichment, and increased turbidity. Despite the gradual deterioration in water quality no concomitant cumulative impacts were observed in common bully. Responses were largely local in nature, responding to point-source discharges. Population responses at the geothermal and BKME discharge sites warrant further study to investigate possible effects on fish recruitment. [ABSTRACT FROM AUTHOR]

Aim: To review the expected increasing demand for cancer services among low and middle‐income countries (LMICs) in the Asia‐Pacific (APAC), and to describe ways in which Australia and New Zealand (ANZ) can provide support to improve cancer outcomes in our region. Methods: We first review the current and projected incidence of cancer within the APAC between 2018 and 2040, and the estimated demand for chemotherapy, radiotherapy and surgery. We then explore potential ways in which ANZ can increase regional collaborations to improve cancer outcomes. Results: We identify 6 ways that ANZ can collaborate with LMICs to improve cancer care in the APAC through the ANZ Regional Oncology Collaboration Strategy: Increasing education and institutional collaborations in the APAC region through in‐country training, twinning partnerships, observerships and formalised training programs in order to increase cancer care quality and capacity.Promoting and assisting in the establishment and maintenance of population‐based cancer registries in LMICs.Increasing research capacity in LMICs through collaboration and promoting high quality global oncology research within ANZ.Engaging and training Australian and New Zealand clinicians in global oncology, increasing awareness of this important career path, and increasing health policy engagement.Increasing web‐based endeavours through virtual tumour boards, web‐based advocacy platforms and web‐based teaching programs.Continuing to leverage for funding through professional bodies, government, industry, not‐for‐profit organisations and local hospital funds. Conclusion: We propose the creation of an Australian and New Zealand Interest Group to provide formalised and sustained collaboration between researchers, clinicians and stakeholders. [ABSTRACT FROM AUTHOR]

Public opinion regarding scientific developments such as genetically modified food can be mixed. We suggest such science-based technological innovations are rejected by some because they are perceived to be advanced as part of a conspiracy. In nationally representative samples (Australia n = 1011; New Zealand n = 754), we report the associations between five conspiracism facets and anti-science attitudes. Results indicate broad public opposition to genetically modified food and use of nuclear power, but more acceptance of renewable power, potable recycled water, 5G networks, and childhood vaccinations. There were small to moderate associations between the rejection of scientific innovations and conspiracism. Multivariate models estimating unique associations of conspiracism facets with anti-science attitudes suggested several novel and important relationships, particularly for childhood vaccination, genetically modified food, and 5G networks. We discuss the importance of examining factors such as conspiracism in understanding what may motivate and sustain rejection of scientific evidence-based claims about socially contentious technological innovations. [ABSTRACT FROM AUTHOR]

Introduction: Although roll‐your‐own (RYO) loose tobacco is increasingly popular among smokers, no jurisdictions have used RYO‐specific pictorial warning labels (PWL) on tobacco packaging. We explored how New Zealand RYO smokers, a population with over 10 years of exposure to PWLs, reacted to RYO‐specific warnings featuring novel themes. Methods: We conducted an online survey of 785 RYO smokers in March 2019. Eligible participants were smokers aged 18–70 years who smoked predominantly RYO cigarettes. Participants randomly viewed two of eight RYO‐specific PWLs featuring themes of health information (mouth and throat cancer), suffering (male and female), toxins, material hardship, cost, family transmission of smoking and harm to pets and answered items assessing negative emotions and perceived effectiveness. Results: Compared to a reference health information PWL (most similar in content and tone to New Zealand's existing PWLs), only a male suffering PWL elicited both significantly stronger negative emotion and higher perceived effectiveness. No themes performed significantly worse than the health information PWL, suggesting any of the themes could be at least as effective as existing health warnings among New Zealand RYO smokers. The individual‐level factors consistently associated with negative emotion and perceived effectiveness were age, desire to quit smoking, believing quitting could reduce risk of serious disease, a quit attempt within the previous 6 months and ever‐planning to quit. Conclusion: Our findings suggest that, in the New Zealand context, a PWL emphasising male suffering could be a useful starting point for assessing RYO‐specific PWLs compared to general smoking warnings. [ABSTRACT FROM AUTHOR]

Donor characteristics help guide donor pancreas acceptance for solid pancreas-kidney transplantation; however, these criteria vary worldwide. Such variation could result in nonuse of potentially transplantable organs. Using a registry cohort, we identified donor characteristics associated with donor pancreas retrieval and subsequent solid pancreas transplantation in Australia and New Zealand. Australia and New Zealand Organ Donor registry donor data from 2007 to 2016 were used to define cohort 1 (all donors authorized for pancreas retrieval) and cohort 2 (all retrieved donor pancreata considered for solid pancreas transplantation). Donor factors significantly associated with donor pancreas retrieval (cohort 1) and solid pancreas transplantation of retrieved donor pancreata (cohort 2) were determined via multivariable logistic regression. Nonretrieval and nonuse of solid organ donor pancreas increased throughout the study period, and nonauthorization for pancreas donation remained stable. Donor body mass index, sex, and viral serology were associated with donor pancreas retrieval but not transplantation. Donor age, cause of death, donation after brain death status, terminal serum creatinine, and donor region were associated with both donor pancreas retrieval and acceptance for solid pancreas transplantation with donation after brain death status being the strongest predictor for both outcomes. Donor age, cause of death, donation after brain death status, terminal serum creatinine, and donor region were associated with both donor pancreas retrieval and subsequent transplantation in Australia and New Zealand. Subsequent correlation of these factors with post-pancreas transplant outcomes would help guide pancreas transplant decisions and minimize nonuse of potentially usable donor pancreata. [ABSTRACT FROM AUTHOR]

Background: Urinary catheters are useful among hospital patients for allowing urinary flows and preparing patients for surgery. However, urinary infections associated with catheters cause significant patient discomfort and burden hospital resources. A nurse led intervention aiming to reduce inpatient catheterisation rates was recently trialled among adult overnight patients in four New South Wales hospitals. It included: 'train-the trainer' workshops, site champions, compliance audits and promotional materials. This study is the 'in-trial' cost-effectiveness analysis, conducted from the perspective of the New South Wales Ministry of Health.Methods: The primary outcome variable was catheterisation rates. Catheterisation and procedure/treatment data were collected in three point prevalence patient surveys: pre-intervention (n = 1630), 4-months (n = 1677), and 9-months post-intervention (n = 1551). Intervention costs were based on trial records while labour costs were gathered from wage awards. Incremental cost effectiveness ratios were calculated for 4- and 9-months post-intervention and tested with non-parametric bootstrapping. Sensitivity scenarios recalculated results after adjusting costs and parameters.Results: The trial found reductions in catheterisations across the four hospitals between preintervention (12.0 % (10.4 - 13.5 %), n = 195) and the 4- (9.9 % (8.5 - 11.3 %), n = 166 ) and 9- months (10.2 % (8.7 - 11.7 %) n = 158) post-intervention points. The trend was statistically non-significant (p = 0.1). Only one diagnosed CAUTI case was observed across the surveys. However, statistically and clinically significant decreases in catheterisation rates occurred for medical and critical care wards, and among female patients and short-term catheterisations. Incremental cost effectiveness ratios at 4-months and 9-months post-intervention were $188 and $264. Bootstrapping found reductions in catheterisations at positive costs over at least 72 % of iterations. Sensitivity scenarios showed that cost effectiveness was most responsive to changes in catheterisation rates.Conclusions: Analysis showed that the association between the intervention and changes in catheterisation rates was not statistically significant. However, the intervention resulted in statistically significant reductions for subgroups including among short-term catheterisations and female patients. Cost-effectiveness analysis showed that reductions in catheterisations were most likely achieved at positive cost.Trial Registration: Registered with the Australian New Zealand Clinical Trials Registry (ACTRN12617000090314). First hospital enrolment, 15/11/2016; last hospital enrolment, 8/12/2016. [ABSTRACT FROM AUTHOR]

Background: miRNA is one of the crucial roles in the complex and dynamic network that regulates the development of skeletal muscle. The landscape of skeletal muscle miRNAs from fetus to adult in New Zealand rabbits has not been revealed yet. Results: In this study, nine RNA-seq libraries of fetus, child and adult rabbits' leg muscles were constructed. A total of 278 differentially expressed miRNAs (DEmiRNAs) were identified. In the fetus vs. child group, the main functional enrichments were involved in membrane and transport. Pathway enriched terms of up-regulated DEmiRNAs were connected with the differentiation and hypertrophy of skeletal muscle, and down-regulated ones were related to muscle structure and metabolic capacity. In the child vs. adult group, functions were associated to positioning and transportation, and pathways were relevant to ECM, muscle structure and hypertrophy. Finally, ocu-miR-185-3p and ocu-miR-370-3p, which had the most target genes, were identified as hub-miRNAs in these two groups. Conclusions: In short, we summarized the highly expressed and uniquely expressed DEmiRNAs of fetus, child and adult rabbits' leg muscles. Besides, the potential functional changes of miRNAs in two consecutive stages have been explored. Among them, the ocu-miR-185-3p and ocu-miR-370-3p with the most target genes were selected as hub-miRNAs. These data improved the understanding of the regulatory molecules of meat rabbit development, and provided a novel perspective for molecular breeding of meat rabbits. [ABSTRACT FROM AUTHOR]

Background: The temporal expression pattern of circular RNAs (circRNAs) across developmental stages is essential for skeletal muscle growth and functional analysis. However, there are few analyses on the potential functions of circRNAs in rabbit skeletal muscle development. Results: Initially, the paraffin sections showed extremely significant differences in the diameter, number, area and density of skeletal muscle fibers of the fetus, child, adult rabbit hind legs (P < 0.01). Then, RNA-seq libraries of these three stages were constructed. A total of 481 differentially expressed circRNAs (DE-circRNAs) and 5,658 differentially expressed genes (DEGs) were identified. Subsequently, DE-circRNAs, whose host genes were DEGs or non-DEGs, were analyzed by GO respectively. In the fetus vs. child group, up-regulated DE-circRNAs (whose host genes were DEGs) were related to muscle fiber structure, and down-regulated ones were related to mitosis. The up-regulated DE-circRNAs (whose host genes were non-DEGs) were involved in enzyme activity, methylation and glycosylation, and the down-regulated ones were involved in mitosis and catabolism. In the fetus vs. adult group, the up-regulated DE-circRNAs (whose host genes were DEGs) were related to skeletal muscle basic structure, and the down-regulated ones were also associated with cell proliferation. But the up-regulated DE-circRNAs (whose host genes were non-DEGs) were connected with regulation of histone ubiquitination, chromatin and organelles. The down-regulated DE-circRNAs were connected with the catabolism processes. In addition, novel_circ_0022663 and novel_circ_0005489, which might have coding potential, and novel_circ_0004210 and novel_circ_0001669, which might have miRNA sponge capability, were screened out. Conclusions: In this study, hind leg muscles of fetus, child and adult rabbits were collected for paraffin section and RNA-seq to observe the structural changes of skeletal muscle and obtain circRNA expression profiles at different stages. These data provided a catalog of circRNAs related to muscle development in New Zealand rabbits, allowing us to better understand the functional transitions in mammalian muscle development. [ABSTRACT FROM AUTHOR]

Purpose: To establish an animal model of adjacent intervertebral disc degeneration by performing spinal fixation and fusion after percutaneous needle puncture and removal of the intervertebral disc or percutaneous needling of the vertebral body without removal of the intervertebral disc. Methods: We established a model of adjacent intervertebral disc degeneration after spinal fixation and fusion of rabbits maintained in upright feeding cages. Twenty-five healthy New Zealand rabbits were used. In the experimental group, the L3-4 intervertebral disc was percutaneously punctured with an 18-G needle under fluoroscopic guidance. Once degeneration occurred, the L3-4 disc was excised, and interbody fusion was performed. The changes in the adjacent intervertebral discs were observed periodically via X-ray and MRI. In the control group, the L3 vertebral body was percutaneously needled with an 18-G needle under fluoroscopic guidance. The changes in the adjacent intervertebral discs were observed on X-ray and MRI at 4, 8, and 12 weeks after puncture in both groups. At 12 weeks postoperatively, the animals were euthanized, and the histopathologic changes of the adjacent intervertebral discs were assessed using hematoxylin-eosin and TdT-mediated dUTP nick end labeling (TUNEL) staining. The mRNA and protein expressions of aggrecanase-1 were measured by real-time quantitative PCR and Western blot analysis. The product of aggrecan degradation, Aggrecan ARGxx, was measured by Western blot analysis. Results: The degeneration of the intervertebral discs in the adjacent segments in the experimental group increased over time. The mRNA and protein expressions of aggrecanase-1 and the expression of Aggrecan ARGxx in the experimental group were significantly increased after puncture, fixation, and fusion (P<0.05). The adjacent intervertebral disc sections had a significantly lower cell density and significantly higher TUNEL-positive cell rate in the experimental group than the control group (P<0.05). Conclusion: The results suggest that the occurrence of intervertebral disc degeneration in adjacent segments may begin with the degeneration of the punctured intervertebral disc. [ABSTRACT FROM AUTHOR]

Introduction: While coformulated ledipasvir (90 mg)/sofosbuvir (400 mg) (LDV/SOF) is approved for the treatment of hepatitis C virus (HCV) genotype 2 (GT2) infection in Taiwan, Japan, and New Zealand, data regarding its use for HIV (Human Immunodeficiency Virus)-positive patients infected with HCV GT2 are sparse. We aimed to assess the effectiveness and tolerability of LDV/SOF for HIV-positive patients with HCV GT2 coinfection. Methods: From January 2019 to July 2020, consecutive HIV-positive Taiwanese patients infected with HCV GT2 who received LDV/SOF were retrospectively included for analysis. The effectiveness was determined by sustained virologic response 12 weeks off-therapy (SVR12). Results: Of the 114 patients (mean age, 38.6 years) initiating LDV/SOF during the study period, 0.9% had liver cirrhosis and 4.4% were HCV treatment-experienced. All patients had estimated glomerular filtration rate (eGFR) > 30 ml/min/1.73 m2 and were receiving antiretroviral therapy with 98.2% having CD4 counts ≥ 200 cells/mm3 and 93.9% plasma HIV RNA load < 50 copies/ml. Antiretrovirals prescribed included tenofovir alafenamide/emtricitabine in 42.1%, tenofovir disoproxil fumarate (TDF)/emtricitabine 18.4%, other nucleoside reverse transcriptase inhibitors (NRTIs) 39.5%, non-NRTIs 12.3%, protease inhibitors 13.2%, and integrase inhibitors 74.6%. All patients had undetectable plasma HCV RNA load at the end of treatment, and 96.5% achieved SVR12 in intention-to-treat analysis. The on-treatment eGFR decline was more pronounced in those receiving TDF-containing antiretroviral therapy (mean change, − 8.33 ml/min/1.73 m2), which was reversible after discontinuation of LDV/SOF. None of the patients interrupted LDV/SOF during the 12-week treatment course. Conclusion: Similar to the response observed among HIV-negative patients, LDV/SOF is effective for HIV-positive patients coinfected with HCV GT2. [ABSTRACT FROM AUTHOR]

Background: Little is currently known about how e-liquid flavor use evolves among electronic cigarette users. We describe patterns of e-liquid and flavor category use, and variety-seeking, among New Zealand adult smokers attempting to transition from smoking to e-cigarettes.Methods: Data were collected in 2018-19, using a longitudinal design comprising up to five in-depth interviews over a 12-20 week period. Participants (n = 32) were current smokers aged ≥18 years, who were not currently using an e-cigarette once a week or more often, and were willing to use an e-cigarette in an attempt to stop smoking. We purchased participants a starter e-cigarette of their choice; they supplied their own e-liquids throughout the study. We extracted e-liquid use data from the verbatim interview transcripts, categorized these into flavor categories, and then explored these data for the whole sample, and by flavor category purchased at intake.Results: Most participants (n = 12) selected a tobacco flavored e-liquid at intake; fruit (n = 7), mint/menthol (n = 6), and dessert/sweets and non-alcoholic beverage (both n = 5) were also popular. Most participants were still using their initially chosen flavor category at study exit, however, many described variety-seeking behaviors, which typically occurred during the first 12 weeks of enrolment.Conclusion: Most participants did not follow a straightforward e-liquid or flavor category pathway. Evidence of a variety-seeking continuum, typically occurring within the first 12 weeks, suggests possible opportunities at specialist e-cigarette stores to couple e-liquid purchasing occasions with cessation advice.Implications: Variety-seeking behavior was common and typically reported within the first 12 weeks of participants' e-cigarette-assisted attempt to transition away from smoking. Policies allowing diverse e-liquid flavors at specialist stores only could support users' variety-seeking and potentially create opportunities to couple e-liquid purchasing occasions with cessation advice during the first months of a transition attempt. [ABSTRACT FROM AUTHOR]

Spirituality permeates our land, our waters, and our people; it is inherent in Māori culture, often explicit for new migrants, but frequently ignored or tokenistically acknowledged in mainstream culture. Older New Zealanders are a pluralistic population, often fiercely secular, with a small but active religious population. How we now treat our elders requires work, needs careful consideration, and vision. As a country, New Zealand has embraced the notion of 'well-being', with the first 'well-being budget' announced in 2019. But well-being, or hauora as it is known for Māori, is incomplete without spirituality. This paper examines the place of spirituality, based on understandings and observations grounded in the New Zealand context, which comprises four interrelated areas: zeitgeist, scope and definitions, models, and evidence. We suggest this framework is a useful approach to examining what can be an ineffable personal experience and challenge to society's provision of aged care and healthy ageing. [ABSTRACT FROM AUTHOR]

Introduction: If electronic nicotine delivery systems (ENDS) are to bring public health benefits, members of population groups most affected by smoking must find them an easily adopted and satisfying replacement for smoking. We explored experiences of ENDS uptake and use among Māori and Pacific peoples living in New Zealand and probed factors that assisted transitions from smoking to vaping.Methods: We recruited 16 participants using whānaungatanga and community advertising. All were aged 18 or over, identified as Māori or Pacific (or both), had smoked at least 100 cigarettes, and were current ENDS users. We undertook in-depth interviews and analyzed the data using a thematic analysis approach.Results: We identified two key challenges that participants reported facing: their search for a satisfying ENDS experience and resisting social cues that could trigger relapse. Two supportive factors facilitated and reinforced smoking to vaping transitions: improved financial and physical well-being, and feeling connected to vaping communities.Conclusion: Learning about ENDS devices from those who had successfully switched from smoking to vaping provided much-needed information, reinforced the financial benefits of switching, and could inspire those making this transition to persist until they too become smoke free.Implications: Measures to support transitions from smoking to ENDS use could reduce inequities in smoking prevalence that indigenous people experience. Collective cessation interventions that draw on communities' knowledge and connections may enable smokers to access support that helps them navigate the potentially complex pathway from smoking to vaping. [ABSTRACT FROM AUTHOR]

Background. Vascular adventitia contains progenitor cells and is shown to participate in vascular remolding. Progenitor cells are recruited into the venous thrombi in mice to promote neovascularization. We hypothesized that the adventitial progenitor cells of human great saphenous vein (HGSV-AdPC) enhance the resolution of venous thrombosis via neovascularization. Methods. Human great saphenous vein (HGSV) was harvested from the patients with great saphenous vein varicose and sectioned for immunohistochemistry, or minced for progenitor cell primary culture, or placed in sodium dodecyl sulfate solution for decellularization. Human venous thrombi were collected from patients with great saphenous vein varicose and superficial thrombophlebitis. Infrarenal abdominal aorta of New Zealand white rabbits was replaced with interposing decellularized vessel, and the patency of the grafts was confirmed by ultrasonic examination. Animal venous thrombi in the left infrarenal vena cava of mice were produced with Prolene suture ligation and ophthalmic force clipping of this portion. After HGSVs were digested by collagenase, the CD34+CD117+ HGSV-AdPC were isolated on FACS system, labelled with CM-Dil, and transplanted into the adventitia of infrarenal vena cava of nude mice. The percentage of thrombus organization area to the thrombus area was calculated as the organization rate. The thrombus cell, endothelial cells, and macrophages in the thrombi were counted in sections. Cell smears and frozen sections of human saphenous veins and venous thrombi were labeled with Sca1, CD34, CD117, Flk1, CD31, and F4/80 antibodies. The CD34+CD117+ HGSV-AdPC were cultured in endothelial growth medium with vascular endothelial growth factor (VEGF) to induce endothelial cell differentiation and analyzed with real time-PCR, Western blotting, and tube formation assays. Results. Immunohistochemical staining showed that the CD34+CD117+ cells were located within the adventitia of HGSVs, and many CD34+ and CD117+ cells have emerged in the human venous thrombi. The number of progenitor cells within the marginal area of 7 days mice thrombi was shown to be Sca1+ ≈21%, CD34+ ≈12%, CD117+ ≈9%, and Flk1+ ≈5%. Many CD34+adventitial progenitor cells have migrated into the decellularized vessels. FACS showed that the number of CD34+CD117+ HGSV-AdPC in primary cultured cells as 1.2 ± 0.07 %. After CD34+CD117+HGSV-AdPC were transplanted into the adventitia of nude mice vena cava with venous thrombi, the organization rate, nucleate cell count, endothelial cells, and macrophage cells of thrombi were shown to be significantly increased. The transplanted CD34+CD117+ HGSV-AdPC at the adventitia have crossed the vein wall, entered the venous thrombi, and differentiated into endothelial cells. The CD34+CD117+ HGSV-AdPC in the culture medium in the presence of VEGF-promoted gene and protein expression of endothelial cell markers in vitro and induced tube formation. Conclusions. HGSV-AdPC could cross the vein wall and migrate from the adventitia into the venous thrombi. Increased HGSV-AdPC in the adventitia has enhanced the resolution of venous thrombi via differentiating into endothelial cells of neovascularization. [ABSTRACT FROM AUTHOR]

Background: Psoriasis is a chronic inflammatory disease affecting ~2–3% of the Australasian population. Therapeutic options include topical agents, phototherapy, systemic immunomodulators and biologic agents. Biologics present an acceptable short‐ and medium‐term safety profile, derived mainly from randomised controlled trials (RCTs) and, however, may not represent real‐world rates of adverse events (AEs). Methods: A retrospective, observational study of patients enrolled in The Australasian Psoriasis Registry from April 2008 to October 2018 was conducted. Data were collected from 104 sites in Australia and New Zealand. Patient characteristics, treatments and AE data were collected. AEs were classified by MedDRA System events. Results: 2094 patients were included (3765 patient‐treatments), comprising; 1110 phototherapy, 1280 systemic and 1375 biologic therapy patient‐treatments. Treatment arms were not mutually exclusive. The mean ± SD from date of diagnosis of psoriasis to commencement of biologic therapy was 8.9 ± 12.3 years. Methotrexate had the longest exposure time (3740.3 patient‐years), and ustekinumab had the longest median (95% CI) time on treatment, 4.3 years (2.2, 6.6). AE differences on biologic treatment were present between patients who would have been eligible or ineligible for RCTs. Approximately 29% of registry patients would have been excluded from clinical trials enrolment. Patients ineligible for RCTs had increased adjusted hazard ratios (95% CI) of: infections and infestations (2.3, 1.7–3.1; P < 0.001), cardiac (8.2, 3.5–25.6; P < 0.001), gastrointestinal (3.5, 1.52–8.0; P < 0.001), hepatobiliary (5.6 1.7–19.1; P < 0.001), psychiatric (4.7, 1.5–14.1; P = 0.006) and eye disorders (4.8 1.5–15.6; P = 0.008), compared to those eligible for RCTs. Incidence rates in the trial eligible patients were similar to those reported from RCT rates. Conclusions: This study establishes treatment modalities in use for severe psoriasis and the clinical rates of AEs associated with biologic therapy. [ABSTRACT FROM AUTHOR]

Problem: In a Master of Dietetics program, cultural competence was originally taught with lectures of cultural food practices. Course evaluations reflected that students wanted more opportunities to practice multicultural communication skills whereas lecturers felt that students' personal inquiry of cultural competence could be strengthened. This study explores whether the combination of self-directed pre-class learning and in-class activities through flipped learning could address these instructional issues. Three research questions were examined: (1) How did dietetic students' perceived confidence in multicultural communication change before and after undergoing flipped learning? (2) Which aspects of cultural competence influenced students' confidence in multicultural communication before and after flipped learning? (3) Which aspects of cultural competence were students' cultural learning goals based upon after flipped learning? Intervention: The intervention began with an introductory lesson in which students attended a lecture on New Zealand's cultural landscape, self-assessed their cultural influences, and completed self-directed learning of cultural competence concepts. After this, students participated in two flipped learning lessons; the first lesson focused on cultural knowledge and the second on multicultural communication skills. For both lessons, students completed preparatory activities before engaging in small-group activities during the class sessions. Before and after the flipped learning lessons, students wrote online reflections about the reasons underlying their confidence in multicultural communication. Context: The intervention was carried out with 32 early dietetic students who were in their first semester of postgraduate studies and 31 students consented to study participation. The majority of study participants were female (n = 30, 97%), European or Asian (n = 28, 91%), and between 21–30 years old (n = 27, 87%). Impact: Pre and post module surveys submitted by 31 students showed that more of them reported being confident or very confident in multicultural communication after flipped learning. Reflections submitted by 31 students before flipped learning showed that their confidence in multicultural communication was based upon their cultural knowledge and cultural interaction experiences. Reflections submitted by 19 students after flipped learning indicated that they developed cultural skill which helped them become confident in multicultural communication. These students set goals to continue developing their cultural knowledge, engaging in cultural interaction, and optimizing opportunities for applying cultural skill during clinical practice. Lessons learned: The study results showed that flipped learning can be used for cultural learning. As compared to lectures, flipped learning can provide students with more authentic contexts to practice multicultural communication. These learning experiences model how students might continue to self-direct their cultural competence development throughout their professional practice. [ABSTRACT FROM AUTHOR]