Stereoelectroencephalography: a review of complications and outcomes in a new Australian centre.

BACKGROUND: Surgical management of refractory focal epilepsy requires preoperative localisation of the epileptogenic zone (EZ). To augment noninvasive studies, stereoelectroencephalography (SEEG) is being increasingly adopted as a form of intracranial monitoring. AIMS: This study aimed to determine the rate of complications for patients undergoing SEEG and to report the success of SEEG with regard to EZ detection and seizure outcome following definitive surgery. METHODS: A retrospective cohort design investigated all cases of SEEG at our institution. Surgical, anaesthetic and medical complications with subsequent epilepsy surgery and seizure outcome data were extracted from medical records. Multivariate logistic regression was used to investigate the relationship between both the number of electrodes per patient and the duration of SEEG recording with the rate of complications. RESULTS: Sixty-four patients with 66 implantations were included. Headache was the most common complication (n = 54, 82%). There were no major surgical or medical complications. Two anaesthetic complications occurred. EZ localisation was successful in 63 cases (95%). Curative intent surgery was performed in 39 patients (59%) and 23 patients achieved an Engel class I outcome (59% of those undergoing surgery). The number of electrodes and duration of recording were not associated with complications. CONCLUSIONS: No patients in our series experienced major surgical or medical complications and we have highlighted the challenges associated with neuroanaesthesia in SEEG. Our complication rates and seizure outcomes are equivalent to published literature indicating that this technique can be successfully established in newer centres using careful case selection. Standardised reporting of SEEG complications should be adopted.

Reflected acoustic energy from geological layers during seismic reflection surveys.

Acoustic propagation is significantly impacted by seabed characteristics, which play a large role in propagation modeling. Shallow seabed characteristics comprise a notable area of research due to their impacts on bottom loss, but deep seabed characteristics are often ignored. At low frequencies (several hundred Hertz, particularly below 100 Hz) and at ranges less than that corresponding to the seafloor critical angle, these deep layer characteristics have non-negligible effects. Those effects are explored here using a subset of data from a marine seismic reflection survey, MGL2104, in an environment with a nearly constant ∼2.6 km bathymetry. The source is a 5700 in.3 airgun array and reflections are measured by a 1200 channel, ∼15 km streamer, with both arrays at 12 m depth. The results show that in one-third-octave bands below 100 Hz, a significant fraction of the reflected energy (sometimes >50%) at certain ranges in the water column is attributable to sub-seabed layers, and the seafloor reflections only become the dominant source at ranges where the reflection path approaches a critical angle. The analysis also considers the effects of layer depths on reflected energy, demonstrating that increased depth does not necessarily correlate with decreased energy reflected in the water column.

The Impact of Orbital Volume on Post-traumatic Enophthalmos: A Systematic Review and Meta-analysis.

PURPOSE: Orbital volume increase has been previously linked with post-traumatic enophthalmos. However, this varies and some studies show no correlation. This systematic review and meta-analysis aimed to synthesize the correlation between orbital volume and enophthalmos and to determine if surgical intervention, enophthalmos measurement method, fracture location, or timing affect this correlation. METHODS: Automation tools were used to assist in this review of 6 databases. Searches were performed across all dates. Included studies quantitatively reported orbital volume and enophthalmos following traumatic orbital wall fractures in at least 5 adult subjects. Correlational data were extracted or calculated. Random-effects meta-analysis was used with subgroup analyses for each of the secondary aims. RESULTS: Twenty-five articles describing 648 patients were included. The pooled correlation between orbital volume and enophthalmos was r =0.71 ( R2 =0.50, P <0.001). Operative status, enophthalmos measurement method, and fracture location did not affect pooled correlation. The delay between trauma or surgery and enophthalmos measurement was not shown to modulate correlation for unoperated patients ( R2 =0.05, P =0.22) but showed a negative relationship for postoperative patients ( z =-0.0281, SE=0.0128, R2 =0.63, P =0.03), but this was heavily influenced by a single article. All results had high residual heterogeneity. Studies were rated as moderate, low, or very low quality with few stating explicit hypotheses or limitations. CONCLUSIONS: Bony orbital volume expansion accounts for around 50% of post-traumatic enophthalmos. The other half is probably explained by soft tissue or geometric bony, rather than volumetric, changes.

Population genomics shows no distinction between pathogenic Candida krusei and environmental Pichia kudriavzevii: One species, four names.

We investigated genomic diversity of a yeast species that is both an opportunistic pathogen and an important industrial yeast. Under the name Candida krusei, it is responsible for about 2% of yeast infections caused by Candida species in humans. Bloodstream infections with C. krusei are problematic because most isolates are fluconazole-resistant. Under the names Pichia kudriavzevii, Issatchenkia orientalis and Candida glycerinogenes, the same yeast, including genetically modified strains, is used for industrial-scale production of glycerol and succinate. It is also used to make some fermented foods. Here, we sequenced the type strains of C. krusei (CBS573T) and P. kudriavzevii (CBS5147T), as well as 30 other clinical and environmental isolates. Our results show conclusively that they are the same species, with collinear genomes 99.6% identical in DNA sequence. Phylogenetic analysis of SNPs does not segregate clinical and environmental isolates into separate clades, suggesting that C. krusei infections are frequently acquired from the environment. Reduced resistance of strains to fluconazole correlates with the presence of one gene instead of two at the ABC11-ABC1 tandem locus. Most isolates are diploid, but one-quarter are triploid. Loss of heterozygosity is common, including at the mating-type locus. Our PacBio/Illumina assembly of the 10.8 Mb CBS573T genome is resolved into 5 complete chromosomes, and was annotated using RNAseq support. Each of the 5 centromeres is a 35 kb gene desert containing a large inverted repeat. This species is a member of the genus Pichia and family Pichiaceae (the methylotrophic yeasts clade), and so is only distantly related to other pathogenic Candida species.

Irish dairy farmers' engagement with animal health surveillance services: Factors influencing sample submission.

A high-quality animal health surveillance service is required to inform policy and decision-making in food-animal disease control, to substantiate claims regarding national animal health status and for the early detection of exotic or emerging diseases. In Ireland, the Department of Agriculture, Food and the Marine provides partially subsidized testing of farm animal samples and postmortem examinations to the Irish agriculture sector (farmers) at 6 regional veterinary laboratories (RVL) throughout the country. Diagnoses and data from these submissions are recorded and reported monthly and annually to enable animal health monitoring and disease surveillance. In a passive surveillance model, both the veterinary practitioner and the farmer play a vital role in sample submission by determining which cases are sent to the laboratory for postmortem or diagnostic testing. This paper identified factors influencing Irish dairy farmers' decisions to submit carcasses to RVL. Behavioral determinants of the submission of samples where veterinary professionals are concerned has been studied previously; however, limited work has studied determinants among farmers. This study conducted qualitative analyses of decisions of Irish dairy farmers relevant to diagnostic sample submission to an RVL and to examine the herd-level characteristics of farmers that submitted cases to an RVL. The biographical narrative interpretive method was used to interview 5 case-study farmers who were classified nonsubmitters, medium, or high submitters to the postmortem service based on the proportion of on-farm mortalities submitted to the laboratory service in 2016. The data obtained from these interviews were supplemented and triangulated through dairy farmer focus groups. The data were thematically analyzed and described qualitatively. In addition, quantitative analysis was undertaken. Data for herds within the catchment area of a central RVL were extracted, and a multivariable logistic regression model was constructed to examine the relationship between herds from which carcasses were submitted to the laboratory and those from which none were submitted. Results from the analysis show that the farmer's veterinary practitioner was the primary influence on submission of carcasses to the laboratory. Similarly, the type of incident, logistical issues with transporting carcasses to the laboratory, influence of peers, presence of alternative private laboratories, and a fear of government involvement were key factors emerging from the case-study interview and focus group data. Herd size was identified in both the qualitative and quantitative analysis as a factor determining submission. In the logistic regression model, herd size and increased levels of expansion were positively correlated with the odds of submission, whereas distance from the laboratory was negatively associated with odds of submission. These results identify the main factors influencing the use of diagnostic services for surveillance of animal health, signaling how services may be made more attractive by policy makers to a potentially wider cohort of users.

The Methylotroph Gene Order Browser (MGOB) reveals conserved synteny and ancestral centromere locations in the yeast family Pichiaceae.

The yeast family Pichiaceae, also known as the 'methylotrophs clade', is a relatively little studied group of yeasts despite its economic and clinical relevance. To explore the genome evolution and synteny relationships within this family, we developed the Methylotroph Gene Order Browser (MGOB, http://mgob.ucd.ie) similar to our previous gene order browsers for other yeast families. The dataset contains genome sequences from nine Pichiaceae species, including our recent reference sequence of Pichia kudriavzevii. As an example, we demonstrate the conservation of synteny around the MOX1 locus among species both containing and lacking the MOX1 gene for methanol assimilation. We found ancient clusters of genes that are conserved as adjacent between Pichiaceae and Saccharomycetaceae. Surprisingly, we found evidence that the locations of some centromeres have been conserved among Pichiaceae species, and between Pichiaceae and Saccharomycetaceae, even though the centromeres fall into different structural categories-point centromeres, inverted repeats and retrotransposon cluster centromeres.

Comparative genomics of biotechnologically important yeasts.

Ascomycete yeasts are metabolically diverse, with great potential for biotechnology. Here, we report the comparative genome analysis of 29 taxonomically and biotechnologically important yeasts, including 16 newly sequenced. We identify a genetic code change, CUG-Ala, in Pachysolen tannophilus in the clade sister to the known CUG-Ser clade. Our well-resolved yeast phylogeny shows that some traits, such as methylotrophy, are restricted to single clades, whereas others, such as l-rhamnose utilization, have patchy phylogenetic distributions. Gene clusters, with variable organization and distribution, encode many pathways of interest. Genomics can predict some biochemical traits precisely, but the genomic basis of others, such as xylose utilization, remains unresolved. Our data also provide insight into early evolution of ascomycetes. We document the loss of H3K9me2/3 heterochromatin, the origin of ascomycete mating-type switching, and panascomycete synteny at the MAT locus. These data and analyses will facilitate the engineering of efficient biosynthetic and degradative pathways and gateways for genomic manipulation.

Frequency-difference beamforming in the presence of strong random scattering.

Frequency-difference beamforming [Abadi, Song, and Dowling (2012). J. Acoust. Soc. Am. 132, 3018-3029] is a nonlinear, out-of-band signal processing technique used to beamform non-zero bandwidth signals at below-band frequencies. This is accomplished with the frequency-difference autoproduct AP(Δω)=P(ω2)P*(ω1), a quadratic product of complex field amplitudes that mimics a genuine field at the difference frequency, Δω=ω2-ω1. For frequency-difference beamforming, AP(Δω) replaces the in-band complex field in the conventional beamforming algorithm. Here, the near-field performance of frequency-difference beamforming is evaluated in the presence of 1 to 30 high-contrast spherical scatterers with radius a placed between, and in the plane defined by the source and a 12-element linear receiving array with element spacing d. Based on the center frequency wave number, k, of the 150-200 kHz frequency sweep source signal, the scatterers are large, ka ≈ 15; the array is sparse, kd = 37; and the average source-to-receiver distance is up to 4.3 mean-free-path lengths. Beamforming results from simulations and experiments show that in-band beamforming loses peak-to-sidelobe ratio and fails to reliably locate the source as the scatterer count increases. Using the same signals, frequency-difference beamforming with difference frequencies from 5 to 25 kHz localizes sources reliably with higher peak-to-side-lobe ratios, though with reduced resolution.

Plasmodium P-Type Cyclin CYC3 Modulates Endomitotic Growth during Oocyst Development in Mosquitoes.

Cell-cycle progression and cell division in eukaryotes are governed in part by the cyclin family and their regulation of cyclin-dependent kinases (CDKs). Cyclins are very well characterised in model systems such as yeast and human cells, but surprisingly little is known about their number and role in Plasmodium, the unicellular protozoan parasite that causes malaria. Malaria parasite cell division and proliferation differs from that of many eukaryotes. During its life cycle it undergoes two types of mitosis: endomitosis in asexual stages and an extremely rapid mitotic process during male gametogenesis. Both schizogony (producing merozoites) in host liver and red blood cells, and sporogony (producing sporozoites) in the mosquito vector, are endomitotic with repeated nuclear replication, without chromosome condensation, before cell division. The role of specific cyclins during Plasmodium cell proliferation was unknown. We show here that the Plasmodium genome contains only three cyclin genes, representing an unusual repertoire of cyclin classes. Expression and reverse genetic analyses of the single Plant (P)-type cyclin, CYC3, in the rodent malaria parasite, Plasmodium berghei, revealed a cytoplasmic and nuclear location of the GFP-tagged protein throughout the lifecycle. Deletion of cyc3 resulted in defects in size, number and growth of oocysts, with abnormalities in budding and sporozoite formation. Furthermore, global transcript analysis of the cyc3-deleted and wild type parasites at gametocyte and ookinete stages identified differentially expressed genes required for signalling, invasion and oocyst development. Collectively these data suggest that cyc3 modulates oocyst endomitotic development in Plasmodium berghei.

Performance comparisons of frequency-difference and conventional beamforming.

Frequency-difference beamforming [Abadi, Song, and Dowling (2012b). J. Acoust. Soc. Am. 132, 3018-3029] is an unconventional beamforming method for use with sparse receiver arrays. It involves beamforming a quadratic product of complex field amplitudes, P(ω2)P*(ω1), at the difference frequency, ω2-ω1, instead of beamforming the complex field amplitude P(ω) at frequencies ω within the signal bandwidth. Frequency-difference beamforming is readily implemented with ordinary transducer array recordings of non-zero bandwidth signals. Results for, and comparisons of, frequency-difference beamforming from simulations and experiments are reported herein. In particular, spherical-wave beamforming is investigated using 15 and 165 kHz pulse signals in a 1.07-m-diameter water tank with a linear array having 14 elements spaced 5.08 cm apart. Here, frequency-difference beamforming using the high-frequency pulses provides comparable results to conventional beamforming at 15 kHz. Plane-wave beamforming is investigated using 11.2-32.8 kHz frequency-sweep signals broadcast 3 km through a 106-m-deep ocean sound channel to a vertical array having 16 elements spaced 3.75 m apart. Here, frequency difference beamforming in the 1.7-2.3 kHz difference frequency band provides results comparable to conventional beamforming in this band.

Associations between a paternal healthy lifestyle score and its individual components with childhood overweight and obesity.

BACKGROUND: Maternal healthy lifestyle behaviors during pregnancy have been associated with reduced risk of offspring overweight and obesity (OWOB). However, there has been little investigation, in the context of the Paternal Origins of Health and Disease (POHaD) paradigm, of the potential influence of the paternal lifestyle on offspring OWOB. OBJECTIVES: To describe paternal healthy lifestyle factors around pregnancy and investigate their associations, individually and combined, with offspring risk of OWOB during childhood. MATERIALS AND METHODS: Participants included 295 father-child pairs from the Lifeways Cross-Generation Cohort Study. A composite paternal healthy lifestyle score (HLS) based on having a high dietary quality (top 40% of the Healthy Eating Index-2015), meeting physical activity guidelines (≥450 MET-min/week of moderate-to-vigorous physical activity), having a healthy body mass index (BMI) (18.5-24.9 kg/m2 ), being a non-smoker, and having no/moderate alcohol intake, was calculated (range 0-5). Paternal HLS (and individual components) associations with child BMI and waist-to-height ratio (WHtR) at age 5 and 9 years were assessed using linear (BMI z-scores and WHtR) and logistic (IOTF categories) regression analyses, adjusted for sociodemographic characteristics. RESULTS: At age 5 and 9 years, 23.5% and 16.9% of children were classified as living with OWOB, respectively. Of the 160 pairs with a complete HLS, 45.0% of the fathers had unfavorable lifestyle factors, determined by a low HLS between 0 and 2 points. Although a low paternal HLS was not significantly associated with a higher risk of childhood OWOB measured using either BMI z-scores and IOTF categories, it was associated with a greater child WHtR, an indicator of central adiposity, at 9 years of age (ß [95% CI] = 0.04 [0.01,0.07]). DISCUSSION AND CONCLUSION: Almost half of the fathers had unfavorable lifestyle factors around pregnancy. A low paternal HLS was associated with a greater child WHtR at 9 years but not with a higher risk of childhood OWOB when measured by BMI z-scores or IOTF categories.

Sociodemographic factor associations with maternal and placental outcomes: A cluster and partial least squares regression analysis.

INTRODUCTION: Maternal social disadvantage adversely affects maternal and offspring health, with limited research on placental outcomes. Therefore, we examined maternal sociodemographic factor associations with placental and birth outcomes in general (Lifeways Cross-Generation Cohort) and at-risk (PEARS Study of mothers with overweight or obesity) populations of pregnant women. METHODS: TwoStep cluster analysis profiled Lifeways mothers (n = 250) based on their age, parity, marital status, household income, private healthcare insurance, homeowner status, and education. Differences in placental and birth outcomes (untrimmed placental weight (PW), birthweight (BW) and BW:PW ratio) between clusters were assessed using one-way ANOVA and chi-square tests. Partial least squares regression analysed individual effects of sociodemographic factors on placental and birth outcomes in Lifeways and PEARS mothers (n = 461). RESULTS: Clusters were classified as "Married Homeowners" (n = 140, 56 %), "Highest Income" (n = 58, 23.2 %) and "Renters" (n = 52, 20.8 %) in the Lifeways Cohort. Renters were younger, more likely to smoke, have a means-tested medical card and more pro-inflammatory diets compared to other clusters (p < 0.01). Compared to Married Homeowners, renters' offspring had lower BW (-259.26 g, p < 0.01), shorter birth length (-1.31 cm, p < 0.01) and smaller head circumference (-0.59 cm, p = 0.02). PLS regression analyses identified nulliparity as having the greatest negative effect on PW (Lifeways and PEARS) while being a homeowner had the greatest positive effect on PW (Lifeways). CONCLUSION: Certain combinations of sociodemographic factors (particularly homeownership) were associated with less favourable lifestyle factors, and with birth, but not placental outcomes. When explored individually, parity contributed to the prediction of placental and birth outcomes in both cohorts of pregnant women.

Distributed acoustic sensing for detecting near surface hydroacoustic signals.

Distributed acoustic sensing (DAS) is a technology that turns a fiber-optic cable into an acoustic sensor by measuring the phase change of backscattered light caused by changes in strain from an acoustic field. In October 2022, 9 days of DAS and co-located hydrophone data were collected in the Puget Sound near Seattle, WA. Passive data were continuously recorded for the duration and a broadband source was fired from several locations and depths on the first and last days. This dataset provides comparisons between DAS and hydrophone measurements and demonstrates the ability of DAS to measure acoustics signals up to ∼700 Hz.

Predicting mortality and admission duration for burns patients in Queensland, Australia: a retrospective cohort study.

BACKGROUND: Burn outcomes can be improved by reducing mortality and hospital admission duration. This increases patient quality of life and reduces hospital-associated complications and costs. This study aimed to develop a model with which to predict burns inpatient mortality and admission duration. METHODS: Multiple logistic and linear regression were used to investigate mortality and admission duration by age, total body surface area, sex, delay to presentation, the use of surgery, discharge distance and period. RESULTS: One thousand four hundred and seventy nine patients (747 pre-COVID and 732 during COVID) were admitted between the study dates. Using multiple logistic regression, age and total body surface area predicted mortality LR X2 (5), P < 0.001, pseudo R2  = 0.57. Using multiple linear regression, age, total body surface area and the use of surgery predicted admission duration F (7, 1455) = 161.42, P < 0.001, R2  = 0.44. Sex, delay to presentation, period and discharge distance did not predict mortality or admission duration. CONCLUSIONS: In our institution, mortality was increased by 8.6% for each additional year of age and by 11.3% for each additional percentage total body surface area. Likewise, admission duration was prolonged by 1 day for every 7 years of increased age, by 1 day for each additional percentage total body surface area or by 7 days if surgery was required. These models have been incorporated into a set of prediction tables for mortality and admission duration for use in our institute that can guide patient and family discussions.

Evidence from a Smoking Management Service in a University Teaching Hospital in Dublin, Ireland monitored by repeat surveys, 1997-2022.

St Vincent's University Hospital (SVUH) has a comprehensive smoking management programme and since 1997 has conducted periodic surveys of inpatients, outpatients, staff and visitors to establish prevalence of smoking and associated attitudes towards the hospital's smoke-free campus policy pioneered in 2009. We report trends and describe also the online community stop smoking course (SSC) developed more recently in response to COVID-19. A questionnaire examining attitudes and smoking status was administered by census surveys of inpatients, quota or random sub-sample surveys of staff, and quota surveys with outpatients and visitors in the time period of 1997-2018. Chi square test for trend was used. Smoking rates declined in all groups but significantly so in outpatients (19.5% vs. 10%; p < 0.01), visitors (27.4% vs. 9.5%; p < 0.0001) and staff (30.0% vs. 10.8%; p < 0.0001). Use of E-Cigarettes was low in all cohorts. Rates of smoking were borderline higher in inpatients eligible by income for state-funded General Medical Services (33.2% vs 26.8%, p = 0.099). Support for and awareness of the ban increased over time. Demographic and quit data was compared between participants of in-person or online SSC. The online courses were successful with a maintenance of quit rates (End of Course: 54.7% vs. 55.0%, 1 Month: 50.4% vs. 54.0%, 3 Month: 19.8% vs. 22.5%). While the hospital community's smoking prevalence has decreased over time and attitudes to the smoking ban have been increasingly positive, the campus is not without difficulties in keeping it smoke-free. We continue to advocate for hospital staff support in enacting this flagship initiative.

Associations between the maternal healthy lifestyle score and its individual components during early pregnancy with placental outcomes.

INTRODUCTION: The influence of maternal lifestyle behaviours on placental growth have been investigated individually, but with conflicting results, and their combined effect is under-researched. Therefore, we examined associations between a composite maternal healthy lifestyle score (HLS), and its individual components, during early pregnancy with placental outcomes. METHODS: Participants included Lifeways Cross-Generational Cohort mother-child pairs (n = 202). A composite HLS based on a less inflammatory diet (bottom 40% of the energy-adjusted Dietary Inflammatory Index (E-DII™)), moderate-to-vigorous physical activity (MVPA), healthy pre-pregnancy BMI (18.5-24.9 kg/m2), never smoking, and non-/moderate alcohol intake was calculated. Quantile regression analysed HLS (and individual components) associations with measures of placental development (untrimmed placental weight (PW)) and function (birth weight:placental weight (BW:PW) ratio) at the 10th, 25th, 50th, 75th and 90th centiles. RESULTS: A more pro-inflammatory diet was positively, and smoking and heavy alcohol consumption were negatively, associated with PW at median centiles (B: 41.97 g, CI: 3.71, 80.22, p < 0.05; B: -58.51 g, CI: -116.24, -0.77, p < 0.05; B: -120.20 g, CI: -177.97, -62.43, p < 0.05 respectively). Low MVPA was inversely associated with BW:PW ratio at the 10th and 90th centiles (B: -0.36, CI: -0.132, -0.29, p < 0.01 and B: -0.45, CI: -0.728, -0.182, p < 0.01, respectively). Heavy alcohol intake was positively associated with BW:PW ratio at the 10th centile (B: 0.54, CI: 0.24, 0.85, p < 0.01). Results of sex-stratified analysis provide evidence of sexual dimorphism. DISCUSSION: Associations of certain lifestyle factors, but not the composite HLS, during early pregnancy with measures of placental development (PW) and function (BW:PW ratio) varied by quantiles and by sex.

Parental lifestyle patterns around pregnancy and risk of childhood obesity in four European birth cohort studies.

BACKGROUND: A high prevalence of excess weight in children younger than 5 years suggests the involvement of early-life risk factors. The preconception and pregnancy periods are crucial stages for the implementation of interventions to prevent childhood obesity. Most studies so far have evaluated the effects of early-life factors separately, with only a few investigating the combined effect of parental lifestyle factors. Our objective was to fill the literature gap regarding parental lifestyle factors in the preconception and pregnancy periods and to study their association with the risk of overweight in children after the age of 5 years. METHODS: We harmonised and interpreted data from four European mother-offspring cohorts (EDEN [comprising 1900 families], Elfe [comprising 18 000 families], Lifeways [comprising 1100 families], and Generation R [comprising 9500 families]). Written informed consent was obtained from parents of all involved children. Lifestyle factor data collected through questionnaires comprised parental smoking, BMI, gestational weight gain, diet, physical activity, and sedentary behaviour. We applied principal component analyses to identify multiple lifestyle patterns in preconception and pregnancy. Their association with child BMI z-score and risk of overweight (including obesity, overweight and obesity, as defined by the International Task Force reference) between the ages of 5 and 12 years were assessed using cohort-specific multivariable linear and logistic regression models (adjusted for confounders including parental age, education level, employment status, geographic origin, parity, and household income). FINDINGS: Among the various lifestyle patterns identified in all cohorts, the two that better explained variance were high parental smoking plus low maternal diet quality or high maternal sedentary behaviour, and high parental BMI plus low gestational weight gain. Overall, we observed that patterns characterised by high parental BMI, smoking, low-quality diet, or sedentary lifestyle before or during pregnancy were associated with higher BMI z-scores and risk of overweight and obesity in children aged 5-12 years. INTERPRETATION: Our data contribute to a better understanding of how parental lifestyle factors might be associated with the risk of childhood obesity. These findings are valuable to inform future family-based and multi-behavioural child obesity prevention strategies in early life. FUNDING: European Union's Horizon 2020 under the ERA-NET Cofund action (reference 727565) and European Joint Programming Initiative "A Healthy Diet for a Healthy Life" (JPI HDHL, EndObesity).

Outcomes of hyperbaric oxygen treatment for central and branch retinal artery occlusion at a major Australian referral hospital.

Introduction: This study analysed the treatment outcomes of patients that received hyperbaric oxygen treatment (HBOT) for retinal artery occlusion (RAO) at the Royal Brisbane and Women's Hospital in Brisbane, Australia between 2015 and 2021. Methods: Retrospective study from patient records including 22 eyes from 22 patients that received HBOT for either central RAO (17 patients) or branch RAO (five patients). Patients received the Royal Brisbane and Women's Hospital RAO protocol for their HBOT. Analysis included best corrected visual acuity pre- and post-treatment, subjective improvements, side effects and patient risk factors were also recorded. Results: Improvement in best corrected visual acuity was LogMAR -0.2 for central RAO on average with 8/17 (47%) experiencing objective improvement, 5/17 (29%) experienced no change and 4/22 (24%) experienced a reduction in best corrected visual acuity. Subjective improvement (colour perception or visual fields) was reported in an additional 4/17 patients, resulting in 12/17 (71%) reporting improvement either in visual acuity or subjectively. There was no improvement in the best corrected visual acuity of any of the five patients suffering from branch RAO. Cardiovascular risk factors present in the cohort included hypertension, hypercholesterolaemia, previous cardiovascular events, cardiac disease and smoking. Limited side effects were experienced by this patient cohort with no recorded irreversible side effects. Conclusions: Hyperbaric oxygen treatment appears a safe, beneficial treatment for central RAO. No benefit was demonstrated in branch RAO although numbers were small. Increased awareness of HBOT for RAO resulting in streamlined referrals and transfers and greater uptake of this intervention may further improve patient outcomes.

Impact of parental lifestyle patterns in the preconception and pregnancy periods on childhood obesity.

Introduction: High prevalence of overweight and obesity already observed in preschool children suggests the involvement of early-life risk factors. Preconception period and pregnancy are crucial windows for the implementation of child obesity prevention interventions with parental lifestyle factors as relevant targets. So far, most studies have evaluated their role separately, with only a few having investigated their potential synergistic effect on childhood obesity. Our objective was to investigate parental lifestyle patterns in the preconception and pregnancy periods and their association with the risk of child overweight after 5 years. Materials and methods: We harmonized and interpreted results from four European mother-offspring cohorts participating in the EndObesity Consortium [EDEN, France; Elfe, France; Lifeways, Ireland; and Generation R, Netherlands] with data available for 1,900, 18,000, 1,100, and 9,500 families, respectively. Lifestyle factors were collected using questionnaires and included parental smoking, body mass index (BMI), gestational weight gain, diet, physical activity, and sedentary behavior. We applied principal component analyses to identify parental lifestyle patterns in preconception and pregnancy. Their association with risk of overweight (including obesity; OW-OB) and BMI z-scores between 5 and 12 years were assessed using cohort-specific multivariable logistic and linear and regression models (adjusted for potential confounders including parental age, education level, employment status, geographic origin, parity, and household income). Results: Among the various lifestyle patterns derived in all cohorts, the two explaining the most variance were characterized by (1) "high parental smoking, low maternal diet quality (and high maternal sedentary behavior in some cohorts)" and, (2) "high parental BMI and low gestational weight gain." Patterns characterized by high parental BMI, smoking, low diet quality or high sedentary lifestyle before or during pregnancy were associated with higher risk of OW-OB in children, and BMI z-score at any age, with consistent strengths of associations in the main cohorts, except for lifeways. Conclusion: This project provides insight into how combined parental lifestyle factors in the preconception and pregnancy periods are associated with the future risk of child obesity. These findings are valuable to inform family-based and multi-behavioural child obesity prevention strategies in early life.

Three-dimensional (3D) printing for post-traumatic orbital reconstruction, a systematic review and meta-analysis.

The purpose of this study was to determine if three-dimensional (3D) printed orbit models and preoperative plate contouring provides benefit over traditional surgical reconstruction of orbit fractures. This systematic review and meta-analysis searched five databases to identify cases of 3D printing for orbital fracture reconstruction. Primary outcomes were resolution of diplopia and enophthalmos, orbital volume symmetry and operation duration. Meta-analyses were used to calculate log odds ratios (OR) for diplopia and enophthalmos and absolute mean difference for orbital volume. A total of 58 articles describing 906 patient cases were included. A single article for each of diplopia and enophthalmos compared 3D printing with traditional management, which prevented answering the primary research question. However, pre-post meta-analysis showed that postoperative groups were less likely to have diplopia (n = 747, log OR = -2.35, 95%CI -1.72 to -2.98, p < 0.001, I2 = 10.91%) and enophthalmos (n = 486, log OR = -2.47, 95%CI -1.95 to -2.99, p < 0.001, I2 = 11.33%) than preoperatively. Mean orbital volume did not differ between the repaired and uninjured orbits (n = 290, mean difference = -0.13 cm3, 95%CI -0.48 to 0.22, p = 0.472, I2 = 9.48%). Pooled mean operation duration for orbital reconstruction with 3D printing was 67.70 minutes (standard error [SE] = 4.24 minutes). Orbital reconstruction combined with 3D printing adequately restores orbital volume symmetry and improves diplopia and enophthalmos. Due to a lack of controlled studies, it remains unclear what contribution 3D printing alone makes to these results. Three-dimensional printing is likely a safe, accurate and effective adjunct; however, further controlled studies are required.