Manukau Institute of Technology

Eczema is a chronic skin condition, characterised by inflammation, erythema, and pruritus. Usage of topical therapies containing botanical extracts is common, however evidence of efficacy is often lacking. This trial investigated the safety and efficacy of a mānuka-oil based cream, 2% ECMT-154, versus vehicle control (VC) for the topical treatment of eczema. This single-blind, parallel group randomised controlled trial was undertaken in 11 community pharmacies across New Zealand. Adults with moderate-to-severe eczema (Patient Oriented Eczema Measure [POEM] ≥ 8 to ≤ 24) were randomised 1:1 to topical 2% ECMT-154 or VC cream, applied twice daily for six weeks. The primary outcome was POEM at week six. 118 participants were recruited between 20th January 2022 and 22nd May 2023. Between baseline and week six mean POEM score (standard deviation) improved from 16.3 (4.2) to 8.8 (5.7) in the ECMT-154 group, and from 16.9 (3.8) to 8.8 (5.7) in the VC group, a between group difference of -0.38 (95% CI: -2.58 to 1.82, p = 0.74). No statistically significant differences were observed across all secondary outcome measures, and no serious adverse events were reported. Whilst symptoms of eczema improved in both treatment groups, there was no evidence of a difference in efficacy between ECMT-154 and VC cream in the treatment of eczema. Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12621001096842, the study was registered on 18th of August 2021.

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Abstract A computational simulation approach is used to investigate the dynamic behaviour of a humidifier unit under heated water vapour and high-intensity turbulent airflow. The study is carried out using the hybrid numerical simulation approach combined with Thermodynamic Computational Fluid Dynamics (TCFD) and Aeroacoustics (AA) Modelling. Highly turbulent, pressurised, and velocity flow is applied with the thermodynamic model of the heated water to present the actual conditions considered in this investigation. The simulated results show that the turbulent behaviour of the flow has increased under the new airflow conditions, such as water vapour in a confined environment, for a short period. These behaviours are further investigated in terms of noise generation using the Aeroacoustics modelling approaches. The predicted Sound Pressure Level (SPL) results are compared well with the experimental results. Furthermore, the simulated results are used to predict the locations of the possible noise sources. It shows the loudness of the noise level that occurred within the humidifier unit. These findings are being used as guidelines to contribute to the optimisation and development of CPAP device products.

ObjectivesUltrasound competency is critical in modern healthcare, yet no standardized framework currently supports ultrasound skill monitoring across diverse clinical settings and user types. Existing frameworks often lack generalizability, overemphasize exam counts, and fail to assess key skills such as interpretation, limiting ultrasound's safe and effective integration into clinical practice. The objective of this study is to develop a consensus‐based, universal framework for monitoring ultrasound competency across clinical applications and disciplines.MethodsA modified Delphi process was conducted with an international panel of Point‐of‐Care ultrasound experts. Panelists independently evaluated framework elements categorized by competency domains (experience, skills, autonomy), skill domains (indication, acquisition, interpretation, clinical integration), metrics (eg, exam counts, entrustability, interpretation accuracy, etc.), answer sets (score‐based inputs used by assessors), and score criteria (requirements for each score). Consensus thresholds were defined as strong consensus at >84%, and weak consensus at 68–84%. Two Delphi rounds were completed.ResultsNineteen experts participated across 2 Delphi rounds. Strong consensus was reached to include 3 competency domains (experience, skills, autonomy) and 4 skill domains (indication, acquisition, interpretation, and clinical integration). Optional components, including the use of acquisition skill trees and varied answer set granularity, were favored by some participants to allow ultrasound programs to tailor the framework to specific examinations, assessment scenarios, and job roles.ConclusionThe resulting modular framework provides a flexible, consensus‐based approach to ultrasound competency assessment, enabling cross‐program comparisons and evaluation of training methods. Validation across diverse settings is needed to support its use in global competency standards and ultrasound education expansion.

Background/Objectives: Pacific peoples in Aotearoa, New Zealand experience the highest burden of gout globally, yet there is still a lack of awareness and understanding of the disease. A Pacific community group and Pacific health professional network co-designed Pacific gout resources to improve understanding. The aim of this study is to identify and discuss the current state and perceptions of Pacific gout education, and explore health professionals’ views on Pacific co-designed resources and their usefulness in clinical settings. Methods: The Fa’afaletui model was utilised to conduct semi-structured Talanga interviews with 14 health professionals in Auckland, New Zealand who work in primary care clinics. The interview explored their views on providing gout education and on the feasibility of the Pacific co-designed gout resources. Talanga interviews were audio recorded and thematically analysed. Results: Overall, health professionals responded positively to the co-designed resources, identifying the benefits of supporting primary care consultations and improving Pacific patients’ understanding of gout. The key findings were summarised in five main themes: (1) health system barriers to gout education, (2) misleading information, (3) health professionals’ experiences of providing health education, (4) general impressions of Pacific co-designed resources, and (5) the feasibility of Pacific co-designed educational resources in a clinical setting. Conclusions: This study presents the views of health professionals in providing health education related to gout and on the feasibility of Pacific co-designed educational resources. It reinforces the significance of involving communities in the design and implementation of interventions to ensure they are culturally safe, relevant, and have long-term impacts on gout management.

ABSTRACT Solastalgia is the emotional response elicited by ecological degradation, originating from the concepts of solace, desolation, and pain. Climate change has profound societal and health impacts especially for marginalised communities who face food shortages, poverty and forced displacement. Indigenous peoples have deep relational ancestral connections with the land that are beyond connection to place, and experience unique intensified forms of distress resulting from environmental degradation. For Indigenous peoples, connections with land are disrupted through extractive politics such as colonisation and now climate emergency, legacies that leave deleterious effects on wellbeing. In collective Indigenous cultures, distress is embedded within wider contexts of community, history, and the earth itself. This paper critically reviews solastalgia from Māori and care ethics perspectives to demonstrate the power of adding relational, contextual, and embodied elements to the concept. This paper argues for the incorporation of Indigenous knowledge in the conceptualisation of climate-related distress. Māori notions of voice and place inform research approaches that are in solidarity with Indigenous voice to examine the impacts of climate degradation.

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This study presents a decision tree (DT) based machine learning approach to detect early anomalies and faults in solar maximum power point ‎tracking (MPPT) integrated photovoltaic (PV) module circuits. A four-panel array, built using a single diode model, is simulated to generate ‎a synthetic, balanced dataset for training and evaluation. Among the different models tested, including neural networks (NN) and support ‎vector classifiers (SVC), the DT model showed the best performance in precision and recall across all anomaly labels while maintaining ‎simplicity and low computational cost. Currently, the model is limited to four module configurations, and the use of synthetic data may lead ‎to overfitting when applied to real-world scenarios. Nevertheless, the methodology can be adapted to grid configurations with other known ‎parameters. This work provides a practical basis for integrating early anomaly detection systems into PV installations, increasing operational ‎efficiency and reducing maintenance costs.

Fiji currently uses a seven-day Clarithromycin based triple therapy regimen for Heliobacter pylori (H. pylori) eradication, and the local eradication rate is unknown. H. pylori testing is performed using a rapid urease test (RUT) during gastroscopy in Fiji. A year-long prospective observational study was undertaken at the Colonial War Memorial Hospital in Fiji. Eligible participants included patients who had peptic ulcer disease (PUD) on gastroscopy and a positive RUT. Consenting participants were prescribed Clarithromycin based triple therapy for 7 days, and underwent a second gastroscopy with RUT after 6 to 8 weeks. Participants who tested positive on a repeat RUT received Clarithromycin based triple therapy for 14 days, and underwent a third gastroscopy and RUT. Participants who remained positive for H. pylori were prescribed quadruple therapy for 14 days. Forty-nine patients were enrolled in the study. Thirty-six (73.5%) had a negative RUT after a seven-day Clarithromycin-based regimen. Eleven of the 13 participants who remained positive eradicated H. pylori after being given another course of the same regimen for 14 days, resulting in a final eradication rate of 95.9%. The remaining two participants received quadruple therapy for 14 days. This study demonstrates an eradication rate of 73.5% using a seven-day Clarithromycin-based regimen in Fiji among H. pylori positive patients with PUD on gastroscopy. This was significantly improved using a 14-day regimen. H. pylori has reduced susceptibility to the current seven-day Clarithromycin based regimen. Future local guidelines should extend to 14 days to achieve a greater eradication rate.

This randomized positively controlled intervention study assessed the superiority of presynchrony by a single i.m. injection of PGF2α given 3 or 4 d before commencement of an Ovsynch and progesterone program, compared with no presynchrony, in anestrous cows. Additionally, noninferiority of a novel intravaginal progesterone-releasing device (Ulti-mate) compared with a commercially available device (CIDR) was assessed. Cows (n = 1,557) not detected in estrus by 12 or 13 d before the start of the seasonal breeding program (d 0) and calved >13 d, were blocked within herd by lactation (i.e., primiparous vs. multiparous) and randomly assigned to treatment with Ulti-mate or CIDR devices, and presynchrony or not, in a 2 × 2 factorial design. At d -12 or -13 cows assigned to presynchrony received an i.m. injection of PGF2α. On d -9 all cows received GnRH and the assigned device. On d -2 the devices were removed, and all cows received PGF2α at device removal and again 24 h later. Cows not observed in estrus by ∼56 h after device removal were injected with GnRH and bred ∼16 h later. Those cows that had been detected in estrus by the time of the final GnRH were not injected. A subset of 128 cows from 2 herds underwent ovarian ultrasonography on d -12, -9, -7, -1 and +2, and blood samples were drawn from the tail vessels on d -12, -9, and -7 for serum progesterone analyses. Pregnancy status was determined by transrectal ultrasonography at ∼5 wk after first insemination, and again ∼6 wk after the end of the seasonal breeding program. Pregnancy per artificial insemination (AI) was greater in presynchronized (54.3%, 95% CI: 50.4%-58.2%) than non-presynchronized (49.2%, 95% CI: 45.2%-53.1%) cows. Presynchrony also resulted in greater proportions of cows pregnant by 3 and 6 wk into the breeding program. There were 71/128 cows with corpora lutea detected by ultrasonography at d -12. Presynchrony increased the proportion of these cows undergoing luteolysis between d -12 and d -9 compared with no presynchrony (23/28 [82.1%] vs. 11/29 [37.0%]). Neither device type nor presynchrony altered the proportion of cows ovulating following device removal by d +2. There was no difference in pregnancy per AI or the proportion of cows pregnant by 3 or 6 wk between cows treated with Ulti-mate or CIDR devices The Ulti-mate device was declared noninferior to the CIDR device in terms of pregnancy per AI because the lower 95% CI of the difference was less than -7 percentage points. We conclude that presynchrony with PGF2α, 3 or 4 d before progesterone-releasing device insertion, resulted in greater pregnancy per AI and greater pregnancy proportion by 3 and 6 wk into the breeding program.