University of Queensland

During epidemics, emergency department (ED) syndromic surveillance of patient arrivals provides timely but nonvirus-specific assessment of epidemic intensity. Surveillance of severe infection outcomes (intensive care admission or death) is less timely because outcomes can take weeks to occur. Time series models can be used to estimate the frequency of severe infection outcomes due to viruses. We developed and evaluated daily time series modeling applied to linked ED, infection, and outcomes data from Australia to better predict population and health system burden during acute respiratory virus epidemics. In retrospective daily surveillance emulation, generalized additive models nowcasted (short-term forecast) the frequency of ED arrivals attributable to each of influenza and COVID-19 that will have a severe infection outcome within 28days. Daily nowcasts spanned days -29 to -4 from each date for which surveillance was emulated. To validate the method, nowcasts were compared with subsequently observed severe infection outcome frequencies for December 2021 through February 2023. During this period, the mean daily day-4 nowcast error was 2.7 (34.2%), compared with 3.5 (43.8%) if outcomes known at day-1 were used. With increasing real-world data availability, this method could improve rapid, automated epidemic assessment for timely public health action.

Are people a different version of themselves when they leave home to go on vacation? If so, what are the differences, and do they offer an opportunity to make tourists behave in more environmentally sustainable ways? We test whether home and vacation place identity activate different environmental self-perceptions. Across three studies, we show that home and vacation place identity differ significantly in self-descriptive attributes and reported environmental responsibility. Results suggest that tourists do not abandon environmental values but temporarily perceive themselves differently. Leveraging home place identity for altering pre-vacation booking decisions or activating home place identity during the vacation, therefore, offers promising new approaches supporting environmental responsibility. With tourism generating 8.8 % of all carbon emissions, the positive environmental impact of any behaviour change would be substantial.

Electronic Medical Records (EMRs) aim to improve efficiency, safety, and quality of care. However, the impact of EMR implementation, particularly in outpatient diabetes care, remains underexplored. This study explored clinicians' perspectives on EMR use in diabetes outpatient care. This qualitative study, conducted in line with COREQ guidelines, involved four focus groups with 22 clinicians (doctors, nurses, and allied health) at a metropolitan diabetes service in Queensland, Australia. Data were analysed using deductive content analysis, guided by the Quintuple Aim and Technology Acceptance Model/Unified Theory of Acceptance and Use of Technology frameworks. Clinicians reported mixed outcomes across the Quintuple Aim domains, shaped by technology adoption constructs. Facilitators such as improved efficiency, access to patient information, and prescribing safety reflected perceived usefulness and positive attitudes, contributing to favourable outcomes across multiple Quintuple Aim. Barriers such as navigation complexity, technical issues, alert fatigue, and overwhelming training led to negative outcomes in EMR use. Tensions around documentation practices and patient expectations of system use, resulted in mixed outcomes. Overall, clinicians viewed EMRs as essential, but sustained adoption required improved usability, tailored training, and better system integration. This study concludes that while the EMRs improved safety, efficiency, and access to information, their design and implementation also introduced burdens that negatively affected clinician experience. EMRs significantly shape the healthcare workforce, influencing workflow, wellbeing, and professional engagement. In outpatient diabetes care, specific workflow challenges such as glycaemic data integration highlight that existing EMR designs may not fully support the complexity of chronic disease management. To maximise benefits, EMR initiatives should be approached as quality improvement activities, with role-specific training, reliable infrastructure, and clinician involvement in system optimisation. Future research should address usability challenges, enhance integration, and ensure that both clinician and patient perspectives guide digital health transformation.

• TETA competes with xanthate on gold, lowering recovery via surface disruption. • Higher SIBX dosage boosts gold and pyrrhotite recovery, reducing selectivity. • Split SIBX dosing enhances gold recovery while maintaining pyrrhotite depression. • Stepwise SIBX addition forms stable films that resist TETA interference. • DFT shows xanthate films block TETA via steric and electrostatic effects. The sodium metabisulfite (SMBS)–triethylenetetramine (TETA) system is widely used in copper–gold flotation to depress pyrrhotite, but often reduces gold recovery due to competitive TETA adsorption on gold surfaces. This study presents a practical, flowsheet-compatible strategy to counter this effect by optimising the dosage and addition sequence of sodium isobutyl xanthate (SIBX), the primary gold collector. Increasing the SIBX dosage from 2.5 to 5 g/t (added entirely in the flotation cell) improved gold recovery from 53% to 59%, but also raised pyrrhotite recovery. In contrast, splitting the same total SIBX dose between milling and flotation significantly improved gold recovery to 73% while maintaining pyrrhotite depression, highlighting the importance of extended interaction time and surface pre-conditioning. Electrochemical measurements showed that stepwise addition promotes a more stable and coherent xanthate/dixanthogen layer with enhanced surface passivation, interfacial resistance, and resistance to TETA disruption. Density functional theory calculations further revealed that TETA adsorbs preferentially at unprotected gold sites via electrostatic stabilisation and Au–N dative bonding. However, a well-organised xanthate layer sterically and electrostatically blocks TETA adsorption. These findings offer mechanistic insights into collector–depressant competition and demonstrate a simple, effective strategy to enhance gold recovery without compromising pyrrhotite selectivity.

Immunotherapy efficacy is hindered by the immunosuppressive metabolism of cancer cells and tumor-associated macrophages (TAMs), yet their opposite metabolic programs complicate synchronized modulation of tumor microenvironment. Here, we report an acid-activated Fe-Zn nanocomplex (FZNC) that transforms into spiky FeOOH nanoparticles within the tumor microenvironment. This transformation enhances cellular uptake and enables selective scavenging of hydrogen sulfide (H2S)-a metabolite that promotes glycolysis in cancer cells and oxidative phosphorylation (OXPHOS) in TAMs. Local H2S depletion by FZNCs induces a bidirectional metabolic shift: cancer cells are redirected from glycolysis to OXPHOS, while TAMs switch from OXPHOS to glycolysis. This dual reprogramming enhances tumor immunogenicity with increased dendritic cell maturation and M1 polarization in vitro, and enhanced cytotoxic T-cell infiltration in vivo. FZNCs treatment suppresses tumor growth and metastasis, with synergistic effects when combined with PD-L1 blockade. This work introduces a materials-based strategy to spatially coordinate opposing metabolic programs for improved antitumor immunity.

Intact legume cells, a natural source of type 1 resistant starch (RS1), modulate the gut microbiota composition and enhance short-chain fatty acids (SCFAs) production in vitro . This study aimed to investigate the effects of intact legume cells on intestinal health and their potential blood pressure-lowering properties. A diet containing 30% intact chickpea cells or a matched control diet (containing pea protein isolate, pre-gelled starch, and cellulose to replace the protein, starch, and fibre of the chickpea diet) was fed to C57BL/6 male mice, which were randomised into saline (control) and angiotensin II (hypertensive) groups (n=7-8/group, total n=30). Gut morphology and histology and microbiota (16S rRNA), SCFA levels ( 1 H NMR), and blood pressure (tail-cuff) were studied. Confocal microscopy confirmed that intact chickpea cells retained their structure through the gastrointestinal tract, delivering RS1 to the colon. The chickpea diet significantly elevated SCFA levels, particularly butyrate, and enriched SCFA-producing bacteria, including Roseburia and Faecalibaculum, regardless of Ang II treatment. These microbiota changes were accompanied by improvements in intestinal morphology, such as increased colon length and reduced cecum collagen deposition. Despite these intestinal-related benefits, no significant effects were observed on blood pressure. This study highlights the potential of RS1 and intact legume cells to enhance gut health through microbial fermentation and SCFAs production, while emphasising the need for further research into their systemic physiological effects. • In vivo mouse model confirmed that intact chickpea cells deliver RS1 to the colon. • Intestinal morphology improved by chickpea diet with reduced collagen deposition in the cecum and longer colon length. • The chickpea diet increased SCFA levels in the colon, especially butyrate. • SCFA-producing bacteria such as Roseburia and Faecalibaculum were enriched by the chickpea diet.

Exposure to respirable and inhalable dust from engineered stone is linked to lung diseases such as silicosis and COPD, yet the physicochemical properties affecting epithelial-to-mesenchymal transition (EMT) remain unclear. Here, 41 physicochemical properties were characterized across 30 dust samples and evaluated for associations with EMT progression in A549 lung epithelial cells after 24-h exposure. EMT was assessed using three hallmarks: E-cadherin downregulation, vimentin upregulation, and α-SMA upregulation. A hybrid feature selection strategy combining correlation filtering with LassoLarsCV reduced feature redundancy and improved model robustness. The selected features were modeled using optimized regressors (Extreme Gradient Boosting regressor for E-cadherin and Vimentin; Support Vector Machine for α-SMA), and SHAP analysis quantified each property's contribution. Crystalline silica emerged as the most influential factor, showing negative associations with E-cadherin and positive associations with Vimentin and α-SMA. In contrast, sodium-, aluminum-, and rutile-bearing components were associated with lower EMT progression, likely reflecting their occurrence within less reactive mineral phases than crystalline silica. Specific surface area and absolute ζ potential were positively associated with the EMT, indicating enhanced particle-cell interactions and surface-related signaling. These findings establish a framework for linking dust physicochemical characteristics to marker-specific EMT responses and demonstrate the effectiveness of interpretable machine learning for particulate toxicity assessment.

Background:Mendelian randomization (MR) is increasingly used for causal inference in nutritional epidemiology; however, dietary MR studies often rely on instruments statistically selected from genome-wide association studies of self-reported intake, which are vulnerable to pleiotropy and reverse causation and may violate core MR assumptions. We aimed to develop and evaluate a biologically informed framework for selecting valid genetic instruments for dietary exposures, based on genes encoding taste and olfactory receptors that mediate chemosensory inputs and shape food preferences and dietary behaviour.Methods:We prioritised 1,214 nonsynonymous variants in 30 taste and 295 olfactory receptor genes with minor allele frequency ≥1%. Associations with 140 food-liking traits were tested in UK Biobank participants aged 37 to 73 years. Candidate variants were evaluated using a multi-stage filtering pipeline designed to improve instrument validity. This included replication in an independent younger cohort (Avon Longitudinal Study of Parents and Children, age 25), concordance between food liking and intake, exclusion of associations with socioeconomic status, assessment of food specificity accounting for linkage disequilibrium and co-consumption patterns, and directionality testing to reduce reverse causation. Retained variants were applied as instruments in MR analyses to assess cardiometabolic outcomes.Results:We identified 268 nonsynonymous variants within 101 olfactory and 16 taste receptor genes associated with 96 food-liking traits. The filtering process yielded 28 candidate instruments for 24 foods. Among these, the instrument for onion liking uniquely satisfied all criteria for classification as high confidence. To demonstrate clinical relevance, genetically proxied onion liking was associated with lower blood pressure and a reduced risk of type 2 diabetes in MR analyses, with no evidence of effects on body mass index, glycaemic traits, or serum lipid levels.Conclusions:Guiding genetic instrument selection using chemosensory receptor genes provides a biologically informed strategy for dietary Mendelian randomization that reduces susceptibility to pleiotropy and reverse causation. This framework enables more robust causal evaluation of diet–disease relationships and strengthens inference in nutritional epidemiology and public health research.

The nominal group technique has been shown to be an effective method for reaching consensus among a group of healthcare experts when selecting clinical indicators for application in primary care research, especially where there are competing prioritisation criteria being considered. In the context of manifest barriers to traditional face-to-face meetings, and with the advent of evolving and improved digital tools, alternative approaches are being more commonly utilised to overcome these challenges. In this study, we sought to prioritise a set of existing, validated clinical indicators proposed for inclusion in ACTMed (ACTivating primary care for MEDicine safety), a clinical trial aiming to reduce medicine-related harm in primary care. A modified nominal group technique, using a fully online approach, was employed to facilitate consensus among a group of pharmacists and general practitioners. Quantitative data were obtained using an online survey platform both prior to the structured virtual forum and again following group discussion. Qualitative material was gathered from written feedback included in the pre-forum questionnaire and through verbal contributions made during the online forum. The highest priority indicators determined by the two-staged survey process were for myocardial ischaemia, cerebrovascular ischaemia related to atrial fibrillation, heart failure, asthma/chronic obstructive pulmonary disease and falls with fracture. Qualitative reasoning behind the participants' evaluation of the clinical indicators included value for money, impact of the intervention, consequences of clinical outcomes and ability to implement the intervention in practice. In this study, the interactive component of the nominal group technique process had little impact on the final prioritisation of the clinical indicators. Potential explanations for this might include previously established strong participant views and preferences or relative group homogeneity based on similar learning, research or clinical experience.