Digital Commons Network^™

Cardiovascular Disease And Fracture Risk In People With Type 2 Diabetes: A Nationwide Matched Case–Control Study, Aksayan Arunanthy Mahalingasivam, Annika Vestergaard Kvist, Joop P. Van Den Bergh, Cassandra Smith, Joshua R. Lewis, Peter Vestergaard, Nicklas Højgaard Hessellund Rasmussen

Research outputs 2022 to 2026

To examine, among people with type 2 diabetes (T2D), whether cardiovascular disease (CVD) phenotypes and cardiovascular medications are associated with any fracture as the primary outcome and major osteoporotic fracture (MOF) as a secondary outcome. Nationwide registry-based matched case–control study in Denmark (2013–2021) among people with T2D. Cases were individuals with T2D who sustained an incident fracture (n = 12,390), and controls were fracture-free individuals with T2D matched 1:3 by age, sex, T2D onset date, and weighted Charlson Comorbidity Index (n = 37,170). The exposures were overall CVD, prespecified clinical CVD phenotypes (acute myocardial infarction (AMI), stroke, heart failure, atrial …

Cxcr3 Is Associated With T-Cell-Induced Heart Damage In Acute Rheumatic Fever, Francis M. Middleton, Reuben Mcgregor, Natalie Lorenz, Sarah Kilian, Anna E.S. Brooks, Saem Mul Park, Ciara Ramiah, Judith Tresidder, Timothy C. Barnett, Michael Serralha, William J. Martin, Florina Chan Mow, Glenn Pearson, Mark Mayo, David I. Broadhurst, Julie Bennett, Johann Brink, Nigel J. Wilson, Anna P. Ralph, Rachel H. Webb, P. Rod Dunbar, Jonathan Carapetis, Nicole J. Moreland

Research outputs 2022 to 2026

The pathogenesis of acute rheumatic fever (ARF) is poorly understood, limiting the development of immune-modulating therapies to treat disease and prevent progressive heart damage. Here, participants with definite ARF were compared to other severe acute paediatric conditions and matched healthy controls by profiling circulating immune molecules and cells to inform disease mechanisms and potential druggable pathways. ARF shared immunological similarities with other inflammatory conditions, including elevated serum IL-6 and an increased frequency of circulating CD4⁺ T cells. However, elevation of the chemokine CCL5 and immunoglobulin IgG3, along with reduced expression of the chemokine receptor CXCR3 in the T cell …

Genetic Drivers Of Progression In Alzheimer’S Disease Are Distinct From Disease Risk, Celeste E. Cohen, Shane Fernandez, Umran Yaman, Ahmad R. Ehyaei, Eleftheria Kodosaki, Aydan Askarova, Tenielle Porter, Eleanor O’Brien, Paul Maruff, Alexi Nott, John A. Hardy, Simon M. Laws, Dervis A. Salih, Maryam Shoai

Research outputs 2022 to 2026

Background: Recent trials in Alzheimer’s disease (AD) demonstrate encouraging outcomes. These trials target risk mechanisms identified through genetic analysis whilst directly aiming to reduce progression rates. Evidence from other neurodegenerative diseases suggests the genetics of progression is distinct from risk of disease. To expand these initial successes and improve clinical outcomes further we need to understand genetics of progression of disease. These can be deduced through rigorous analysis of meticulously phenotyped longitudinal cohorts. In this study we first looked at known genetic drivers of risk, namely polygenic risk scores for AD and APOE‑ε4, to assess their role in progression. This …

Implementation And Effectiveness Of A Food Education Intervention To Promote Plant-Based Foods: A Partially Cluster-Randomized Controlled Trial, Henna Vepsäläinen, Satu Kinnunen, Sari Niinistö, Leena Forma, Suvi T. Itkonen, Tuuli E. Korhonen, Liisa Korkalo, Heli Kuusipalo, Jelena Meinilä, Kaija Nissinen, Susanna Raulio, Ros Sambell, Mari Åkerlund, Suvi M. Virtanen, Maijaliisa Erkkola

Research outputs 2022 to 2026

Background: Legumes can substitute for meat and are thus a particularly important food group for environmental sustainability. As the use of legumes among Finnish children is marginal, there is potential for a substantial increase in their consumption. However, food education delivered through early childhood education and care (ECEC) settings has rarely focused specifically on environmentally sustainable foods, such as legumes. This study describes the implementation and effectiveness of an ECEC-delivered food education intervention within the FoodStep study. Methods: The partially cluster-randomized FoodStep intervention aimed to increase the supply of vegetables, legumes, fruits, berries, and sustainable fish while reducing the provision …

Living Next Door To Mcdonald’S: A Qualitative Study Of Community Submissions And Resident Realities Pre- And Post Development, Roslyn Giglia, Jacinta Francis, Jana Buckle, Clare Whitton, Ros Sambell, Frith Klug, Lukar Thornton, Siobhan Hickling, Katherine Kent, Gina Trapp

Research outputs 2022 to 2026

Background: The proliferation of fast-food outlets (FFOs) in residential areas has raised growing concerns about their impact on community health, safety, and wellbeing. This qualitative study examined both pre-development community consultation submissions and post-development resident experiences surrounding the development of a McDonald’s outlet in a newly established suburb on the urban fringe of Perth, Western Australia (WA). Methods: Using a qualitative descriptive design, the study analyzed 183 community submissions lodged with the local council prior to development and conducted semi-structured interviews with 11 residents living within 300 m of the outlet after construction. Results: Content analysis revealed strong opposition, with …

Bone, Muscle, And Physical Function Measures In Older Adults According To Levels Of Social Disadvantage: A Cross-Sectional Study, Jason Talevski, Sharon Brennan-Olsen, Stefanie Bird, Sara Vogrin, Alison Beauchamp, Mizhgan Fatima, Cassandra Smith, Gustavo Duque

Research outputs 2022 to 2026

Summary: This cross-sectional study of 300 older adults (aged ≥ 50 years) found that less education, lower income, and health care card ownership are associated with reduced bone, muscle, and physical function measures. This underscores the need for targeted preventive strategies for osteoporosis and sarcopenia that address socioeconomic-related disparities. Purpose: The prevalence of chronic diseases follows a social gradient, although this is unclear in musculoskeletal conditions. This study aims to examine the association between social disadvantage and diagnostic measures of osteoporosis and sarcopenia in community-dwelling older adults. Methods: A single-centre, cross-sectional study was conducted in adults (≥ 50 years) residing …

Do Flywheel Exercises Provide Eccentric-Overload Training?, Darjan Spudić, Kazunori Nosaka

Research outputs 2022 to 2026

Interests in eccentric resistance exercises have been increasing in both research and practice. However, implementing eccentric resistance exercise training is often challenging due to the mechanical limitations of traditional training equipment. To address this, flywheel (FW) devices emerged as a practical alternative. FW devices are commonly considered to provide eccentric-overload training, in which the load is greater in eccentric than concentric phase. However, this is not always the case. In this article, we summarize the mechanical and physiological factors influencing the effectiveness of FW devices in achieving eccentric overload. Then, we discuss a significant limitation of FW resistance exercise in …

Perspective: Improving Social Connection And Inclusion Through Equitable Digital Health Solutions, Dominika Kwasnicka, Jaimon Kelly, Eleanor Quested, Loretta Baldassar, Suzanne Robinson, Richard Sinnott, Paul O’Halloran, Anne Tiedemann, Paul Flatau, Rajna Ogrin, Jane Farmer, Abby C. King

Research outputs 2022 to 2026

In this Perspective, we address the critical intersection of digital health, social connection, and health equity. Taking an interdisciplinary and complex adaptive systems perspective, we highlight evidence-based digital solutions to improve social connection and inclusion and, consequently, health outcomes. We describe actionable strategies for ensuring that digital health innovations benefit all, highlighting how user-centered design can address diverse needs, particularly for structurally disadvantaged populations.

Sarcomerogenesis: Evidence, Context And Key Stimuli—Response To The Commentary By Power Et Al., Anthony J. Blazevich, Walter Herzog, João Pedro Nunes

Research outputs 2022 to 2026

No abstract provided.

Application Of The Paediatric Medical Traumatic Stress Model To The Mental Health Experience Of Young People Living With Type 1 Diabetes: A Qualitative Study, Rigel Paciente, Sara Coombs, Karen Lombardi, Helen Milroy, Keely Bebbington, Heather Roby, Craig E. Taplin, Nicole Wickens, Stella Rose, Alix Woolard

Research outputs 2022 to 2026

Despite the various traumatic events that a young person living with type 1 diabetes (T1D) may experience, little is known about the burden and manifestation of traumatic stress in this population. Though mental health outcomes have been explored generally, medical trauma-sensitive approaches to understanding these experiences remain limited. We utilised a qualitative descriptive approach to explore the impact of T1D on young people’s mental health through the paediatric medical traumatic stress model (PMTS). Young people aged 13–30 living with T1D were interviewed. These interviews were recorded, transcribed, and analysed using Reflexive Thematic Analysis. Three main themes were generated: (1) perceived …

Body Composition And Muscle Health Changes After Providing Vascular Imaging Results In Older Adults: Secondary Analysis Of A Randomised Controlled Trial, Jack Dalla Via, Simone Radavelli-Bagatini, Marc Sim, Abadi K. Gebre, Catherine P. Bondonno, Kun Zhu, Shelby Mullin, John T. Schousboe, Richard J. Woodman, Markus P. Schlaich, Moira Sim, Pawel Szulc, Douglas P. Kiel, Wai H. Lim, Robin M. Daly, Jonathan M. Hodgson, Joshua R. Lewis

Research outputs 2022 to 2026

Background: Provision of vascular imaging results has been investigated to prompt changes towards healthy lifestyle behaviours, but effects on body composition and muscle health are unknown. Aim: This secondary analysis of a 12-week parallel-group randomised controlled trial (RCT) aims to explore body composition and muscle health effects of providing healthy lifestyle education (Ed) with and without abdominal aortic calcification (AAC) results. Methods: A total of 240 Australian community-dwelling older men and women (mean ± SD age 68 ± 5 years; 58% female; 57.1% with evidence of AAC) were randomised to AAC + Ed (n = 121) or Control + Ed …

Enhancing Independence And Social Connection: The Impact Of A Tailored Exercise Program On New Residents Transitioning Into Australian Residential Care Facilities, Stacey Scott, Annette Raynor, Julie Dare, Jennifer Grieve, Leesa Costello

Research outputs 2022 to 2026

Background: Transitioning from independent living to a residential care facility often results in a significant loss of independence, autonomy, and connectedness, leaving new residents with profound feelings of loss and grief. In light of these challenges, this study explored the potential benefits of a tailored in-house exercise program for new residents. Methods: The study took place in an Australian residential care facility and included four new residents (aged 72 to 88, 75% female), who participated in a 12-week tailored exercise program led by an exercise physiologist. A focused ethnographic approach was used to obtain a comprehensive data set, drawing on …

A Genomic Approach For Accurate Identification Of Closely Related Species With Next-Generation Sequencing Samples, Nour Al Dain Marzouka, Amira Al-Aamri, Fatima Alshamsi, Mariam Khalili, Sarah El Hajj Chehadeh, Meera S. Mohamed, Yassir Mohammed Eltahir, Rafeek Koliyan, Mohamed Moustafa Abdelhalim, Assem Attia, Mira Mousa, Guan Tay, Habiba Alsafar

Research outputs 2022 to 2026

Accurate species identification from Whole Genome Sequencing (WGS) data remains challenging, particularly for closely related species such as sheep (Ovis aries) and goats (Capra hircus). Through analysis of mapping quality metrics and Kraken2 taxonomic classification of 40 WGS sheep and goat samples, we demonstrate that conventional approaches yield ambiguous results, with overlapping alignment rates and inconclusive taxonomic assignments. We present a robust comparative genomic approach that uses species-specific genomic regions to distinguish these species in WGS samples. We define species-specific regions as those exhibiting distinctive coverage patterns: average coverage when samples are aligned to their matching reference genome but absent/low …

Eccentric Exercise: Muscle Damage To The New Normal, Kazunori Nosaka

Research outputs 2022 to 2026

No abstract provided.

The Relationship Between Dietary Sodium Intake And Cognitive Function: A Narrative Review, Samantha L. Gardener, M. Fu, L. Morini, T. Schwartzkopff, G. Savage, R. N. Martins, S. R. Rainey-Smith

Research outputs 2022 to 2026

Purpose of Review: This narrative review provides discussion on current evidence regarding the relationship between sodium intake and cognitive function in animal and human studies, as well as potential mechanisms underlying this relationship. Recent Findings: Recent evidence suggests high sodium intake is associated with development of cognitive impairment and neural dysfunction. Additionally, studies have proposed that high sodium intake is associated with increased aggregation of Aβ-amyloid and that hypertension (for which high sodium intake is a risk factor) modulates the relationship between Aβ-amyloid and development of cognitive impairment and Alzheimer’s disease. However, while animal studies demonstrate a consistent relationship between …

Association Of Glycd147 With Carotid Atherosclerosis: Evidence From Integrative Analyses, Cuihong Tian, Yang, Xingang Li, Hongxia Zhang, Jieyi He, Jinxiu Zhu, Yequn Chen, Xuerui Tan

Research outputs 2022 to 2026

Background: Atherosclerosis is an inflammatory cardiovascular disease that progresses with ageing. Glycosylation plays a significant role in inflammation and contributes to the pathogenesis of ageing-related diseases, including atherosclerosis. Cluster of differentiation 147 (CD147), a glycosylated agonist of matrix metallopeptidase 9 (MMP9), serves as an inducer of atherosclerosis and atherothrombosis. However, the effect of glycosylated CD147 (GlyCD147) on atherosclerosis remains unclear. This research aims to identify whether GlyCD147 is associated with atherosclerosis. Methods: To begin with, a clinical case-control study was designed to assess the differences of CD147 and GlyCD147 between 69 carotid atherosclerosis (CAS) cases and 69 controls. Traditional atherosclerotic …

Slushies Before School: Exploring How Nearby Food Outlets Impact The Eating Behaviours Of Secondary Students In Perth, Western Australia, Sharonna Mossenson, Klug, Joelie Mandzufas, Jacinta Francis, Siobhan Hickling, Lukar Thornton, Gina Trapp

Research outputs 2022 to 2026

The external school food environment, comprising food outlets and marketing near schools, shapes what young people eat. Yet little is known about how Australian adolescents perceive and navigate these environments. Focus groups were conducted with 31 school students (Years 7–12) from Perth, Western Australia, to explore their experiences of the external school food environment and its influence on their food-related behaviours. Transcripts were thematically analysed and six themes were identified. Accessibility emphasised proximity, transport links, opening hours and speed of service, with older students using outlets as social spaces. Availability of slushies, energy drinks, snacks and fast-food meal deals influenced …

Temptation At The School Fence: A Qualitative Exploration Of The Impact Of External Food Outlets On The School Community, Sharonna Mossenson, Klug, Jacinta Francis, Siobhan Hickling, Lukar Thornton, Gina Trapp

Research outputs 2022 to 2026

Retail food outlets are commonly located in close proximity to schools, providing students with opportunities to purchase and consume food enroute to or from school. These outlets are typically unhealthy and disproportionately clustered near schools, and this trend has been increasing over time. While quantitative studies have established associations between school food environments and adolescent dietary behaviours, little is known about how school personnel perceive and experience their impacts. This qualitative study explored perspectives of school personnel (n = 9) from a secondary school in Perth, Western Australia, located 150 m from two retail food precincts (areas with a high …

The Effect Of School-Based Educational Session On Knowledge, Attitudes, And Beliefs Of Cervical Cancer Among Adolescents In Mixed Day High Schools In Embu County: A Quasi-Experimental Study, Lucy W. Kivuti-Bitok, Mugo, Dorothy Mituki, Christine Marete, Irene Ngune, Jessica Wells

Research outputs 2022 to 2026

Background: School-based interventions have proven effective in enhancing knowledge and altering attitudes toward cervical cancer among adolescents. This study aimed to evaluate the effect of a school-based educational intervention on the attitudes, beliefs, and knowledge of cervical cancer among adolescents in mixed-day high schools in Embu County. Methods: This study used a single-group, repeated cross-sectional design to assess the effect of a structured health education session on cervical cancer among adolescent boys and girls in mixed-gender secondary schools. A self-administered anonymous questionnaire was administered before and immediately after the post-intervention. The education session lasted 30–45 min, and the study population …

Body Mass Index, Prebiotic Supplementation During Pregnancy And Gestational Diabetes Mellitus Risk: An Effect Modification Analysis From A Randomised Controlled Trial, Rachelle A. Pretorius, Thomas R. Sullivan, Summer V.M. Walker, Johan Garssen, Jeffrey A. Keelan, Desiree Silva, Susan L. Prescott, Debra J. Palmer

Research outputs 2022 to 2026

Background: Prebiotic dietary supplementation has been shown to improve glucose homeostasis in type 2 diabetes patients. The aim of this analysis was to determine whether pre-pregnancy body mass index (BMI) modifies the effect of prebiotic supplementation from mid-pregnancy on reducing the risk of gestational diabetes mellitus (GDM). Methods: In a double-blinded, randomised controlled trial, pregnant women < 21 gestational weeks were randomly assigned (1:1) to consume daily prebiotics (14.2 g galacto-oligosaccharides and fructo-oligosaccharides) or placebo (8.7 g maltodextrin) powder. An effect modification analysis was performed to assess the heterogeneity of the effect of prebiotic supplementation in relation to pre-pregnancy BMI on GDM diagnosis. Results: Between June 2016 and November 2021, 329 women were assigned to the prebiotic group (50.4%), and 323 (49.5%) were assigned to the placebo group. Overall, 288 of 652 women (44.2%) were classified as overweight/obese prior to pregnancy (BMI ≥ 25 kg/m²). The distribution was balanced, with 146/329 (44.4%) randomised to the prebiotics group and 142/323 (44.0%) in the placebo group. Pre-pregnancy BMI modified the effect of prebiotic supplementation, with the intervention reducing GDM rates in women with a BMI ≥ 25 kg/m^{2 …}

Co-Design And Feasibility Testing Of A Midwife-Led Birth Debrief: An Implementation Science Project, Kate Buchanan, Phoebe Backhouse, Leanne Graham, Amy O’Meagher, Sara Bayes

Research outputs 2022 to 2026

Background: The period spanning pregnancy, birth and postpartum is characterised by psychosocial as well as physiological changes: many women experience new or worsening mental ill-health during the perinatal period. Midwives play a critical role in supporting and promoting psychosocial health by providing mental health education, counselling and screening. Often this includes a post-birth conversation, guided reflection, or debrief. Information about the effectiveness and experiences of specific and structured midwife-led birth debrief is scant. Aim: Our study aimed to assess the perceived effectiveness, experiences and implementability of a midwife-led birth debriefing intervention in one Australian maternity unit. Methods: A Type II …

Progression Of Non-Radiographic To Radiographic Axial Spondyloarthritis: A Risk Model Based On A Chinese Cohort Study, Rui Ying Deng, Xiaojia Xu, Jian Hua Peng, Feng Cai Shen, Yao Gong, Dan Min Wang, Hong Jin Liang, Shu Xin Huang, Zhao Peng Chen, Wen Long Wu, Ze Xin Zheng, Ling Lin, Zhi Duo Hou

Research outputs 2022 to 2026

Objectives: To evaluate the progression from non-radiographic axial spondyloarthritis (nr-axSpA) to radiographic axial spondyloarthritis (r-axSpA) in a Chinese cohort, identify associated risk factors in both clinical and imaging arms, and enable risk stratification based on these factors. Methods: Overall, 572 patients with nr-axSpA were enrolled with a median follow-up of 5 years. Cox proportional hazard regression analyses were conducted to identify potential risk factors associated with the progression from nr-axSpA to r-axSpA in both clinical and imaging arms. A risk-scoring system was then developed by assigning each independent predictor a weight based on its regression coefficient. Patients were subsequently categorized …

Individual And Household Factors Associated With Tungiasis In A Marginalized Population In Karamoja, Northeastern Uganda, Lynne Elson, Abneel K. Matharu, Berrick Otieno, Hermann Feldmeier, Charles Waiswa, Amina Abubakar, Jürgen Krücken, Ulrike Fillinger, Francis Mutebi

All Peer-Reviewed Publications

Background: Tungiasis is a neglected tropical skin disease caused by adult female fleas which burrow into the skin of people and animals, causing considerable pain and itching. The distribution of the disease is heterogeneous, with Napak district, Karamoja sub-region of northeastern Uganda having the highest disease burden recorded globally. We aimed to determine the factors associated with this high prevalence to inform future intervention strategies. Methods: We conducted a cross-sectional study to identify factors associated with infection of individual children and adults, and a nested case–control study to identify factors for whole households (families). Infected children were identified through mass-screening …

In-Hospital Mortality Patterns And Readmissions In Patients With Chronic Obstructive Pulmonary Disease: An Analysis Of The Role Of Pulmonary Hypertension, Saad Afzal Khan, Trishna Parikh, Adishwar Rao, Akriti Agrawal, Aarohi Parikh, Farah Kazzaz, Sarah Shin, Harry Karmouty-Quintana, Maulin Patel, Kha Dinh, Bela Patel, Bindu Akkanti

Faculty, Staff and Student Publications

Chronic obstructive pulmonary disease (COPD) may be complicated by pulmonary hypertension (PH). We aimed to understand the impact of PH on in-hospital mortality and quantify the 30-day readmission rate among patients with COPD. For this cross-sectional study, we used the Nationwide Readmissions Database from 2017-2020 to identify adults ≥18 years with COPD. Patients were stratified according to PH diagnosis. Baseline characteristics between groups were compared using the Pearson chi-square test and two-sample t-test. Predictors of in-hospital mortality were determined using multivariate logistic regression analysis adjusted for demographics and confounders. The 30-day readmission rate and prevalence of PH subgroups by baseline …

Comparative Performance Of Physiological Vital-Sign Forecasting Under Random And Patient-Wise Splitting Using Deep Learning, Lavanya Vasavi Chittem Reddy

Theses and Dissertations

Physiological vital-sign forecasting estimates future measurements based on recent temporal patterns and can support analysis of continuously recorded monitoring data. This study comparatively evaluated deep feedforward, recurrent, bidirectional recurrent, long short-term memory, and bidirectional long short-term memory architectures for one-step-ahead forecasting of peripheral oxygen saturation, heart rate, and pulse rate. Each model received consecutive observations of peripheral oxygen saturation, heart rate, pulse rate, respiratory rate, and age, while separate single-output models predicted the next value of the selected target.

Random and patient-wise data splitting were compared using identical input definitions, preprocessing procedures, model architectures, and training hyperparameters. The strongest architecture …

Sociodemographic And Clinical Factors In Nmosd And Mogad: Disability, Psychiatric Burden, And Disparities, Neha S. Patil

Summer Research Program Abstracts

No abstract provided.

Evaluating The Role Of Perineural Invasion In The Risk Of Local Recurrence Of Cutaneous Melanoma After Adjuvant Radiation Therapy, Riya T. Patel

Summer Research Program Abstracts

No abstract provided.

Biomechanical Gait Analysis To Classify Neurological Gait Scores In A Spina Bifida Sheep Model, Shreya Pandiri

Summer Research Program Abstracts

No abstract provided.

Improving Adhd Screenings Through Quality Improvement, Workflow Optimization, And Evaluation Of A 6-Item Short Form Screening Tool, Paris A. Nix

Summer Research Program Abstracts

No abstract provided.

Environmental Or Occupational Heavy Metal Exposure In The Development And Progression Of End Stage Kidney Disease: A Systematic And Network Meta-Analysis, Lauren Nguyen

Summer Research Program Abstracts

No abstract provided.