Cardiac surgery-associated acute kidney injury (CS-AKI) and fluid overload (FO) are common among neonates who undergo cardiopulmonary bypass, and increase mortality risk. Current diagnostic criteria may delay diagnosis. Thus, there is a need to identify urine biomarkers that permit earlier and more accurate diagnosis.

This single-centre ancillary prospective cohort study describes age- and disease-specific ranges of 14 urine biomarkers at perioperative time points and explores associations with CS-AKI and FO. Neonates (≤28 days) undergoing cardiac surgery were included. Preterm neonates or those who had pre-operative acute kidney injury were excluded. Urine biomarkers were measured pre-operatively, at 0 to < 8 hours after surgery, and at 8 to 24 hours after surgery. Exploratory outcomes included CS-AKI, defined by the modified Kidney Disease Improving Global Outcomes criteria, and>10% FO, both measured at 48 hours after surgery.

Overall, α-glutathione S-transferase, β-2 microglobulin, albumin, cystatin C, neutrophil gelatinase-associated lipocalin, osteopontin, uromodulin, clusterin, and vascular endothelial growth factor concentrations peaked in the early post-operative period; over the sampling period, kidney injury molecule-1 increased and trefoil factor-3 decreased. In the early post-operative period, β-2 microglobulin and α-glutathione S-transferase were higher in neonates who developed CS-AKI; and clusterin, cystatin C, neutrophil gelatinase-associated lipocalin, osteopontin, and α-glutathione S-transferase were higher in neonates who developed FO.

In a small, single-centre cohort, age- and disease-specific urine biomarker concentrations are described. These data identify typical trends and will inform future studies.

The rising number of dementia diagnoses and imminent adoption of disease-modifying treatments necessitate innovative approaches to identify individuals at risk, monitor disease course and intervene non-pharmacologically earlier in the disease course. Digital assessments of dementia risk and cognitive function have the potential to outperform traditional in-person assessments in terms of their affordability, accuracy and longitudinal tracking abilities. However, their accessibility and reliability in older adults is unclear.

To evaluate the usability and reliability of a smartphone assessment of lifestyle and cognitive factors relevant to dementia risk in a group of UK-based older adults.

Cognitively healthy adults (n = 756) recruited through the Dementias Platform UK Great Minds volunteer register completed three assessments of cognitive function and dementia risk over a 3-month period and provided usability feedback on the Five Lives smartphone application (app). We evaluated cognitive test scores for age, gender and higher education effects, normality distributions, test–retest reliability and their relationship with participants’ lifestyle dementia risk factors.

Participants found the app ‘easy to use’, ‘quick to complete’ and ‘enjoyable’. The cognitive tests showed normal or near-to-normal distributions, variable test–retest reliabilities and age-related effects. Only tests of verbal ability showed gender and education effects. The cognitive tests did not correlate with lifestyle dementia risk scores.

The Five Lives assessment demonstrates high usability and reliability among older adults. These findings highlight the potential of digital assessments in dementia research and clinical practice, enabling improved accessibility and better monitoring of cognitive health on a larger scale than traditional in-person assessments.

Caregivers of patients with primary brain tumor (PBT) describe feeling preoccupied with the inevitability of their loved one's death. However, there are currently no validated instruments to assess death anxiety in caregivers. This study sought to examine (1) the psychometric properties of the Death and Dying Distress Scale (DADDS), adapted for caregivers (DADDS-CG), and (2) the prevalence and correlates of death anxiety in caregivers of patients with PBT.

Caregivers (N = 67) of patients with PBT completed the DADDS-CG, Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7), Fear of Cancer Recurrence (FCR-7), and God Locus of Health Control (GLHC). Caregivers’ sociodemographic information and patients’ medical characteristics were also collected. Preliminary examination of the psychometric properties of the DADDS-CG was conducted using exploratory factor analysis, Cronbach's alpha, and correlations. The prevalence and risk factors of death anxiety were assessed using frequencies, pair-wise comparisons, and correlations.

Factor analysis of the DADDS-CG revealed a two-factor structure consistent with the original DADDS. The DADDS-CG demonstrated excellent internal consistency, convergent validity with the PHQ-9, GAD-7, and FCR-7, and discriminant validity with the GLHC. Over two-thirds of caregivers reported moderate-to-severe symptoms of death anxiety. Death anxiety was highest in women and caregivers of patients with high-grade PBT.

The DADDS-CG demonstrates sound psychometric properties in caregivers of patients with PBT, who report high levels of death anxiety. Further research is needed to support the measure's value in clinical care and research — both in this population and other caregivers — in order to address this unmet, psychosocial need.

American Indian and Alaska Native peoples (AI/AN) have a disproportionately high rate of obesity, but little is known about the social determinants of obesity among older AI/AN. Thus, our study assessed social determinants of obesity in AI/AN aged ≥ 50 years.

We conducted a cross-sectional analysis using multivariate generalised linear mixed models to identify social determinants associated with the risk of being classified as obese (BMI ≥ 30·0 kg/m2). Analyses were conducted for the total study population and stratified by median county poverty level.

Indian Health Service (IHS) data for AI/AN who used IHS services in FY2013.

Totally, 27 696 AI/AN aged ≥ 50 years without diabetes.

Mean BMI was 29·8 ± 6·6 with 43 % classified as obese. Women were more likely to be obese than men, and younger ages were associated with higher obesity risk. While having Medicaid coverage was associated with lower odds of obesity, private health insurance was associated with higher odds. Living in areas with lower rates of educational attainment and longer drive times to primary care services were associated with higher odds of obesity. Those who lived in a county where a larger percentage of people had low access to a grocery store were significantly less likely to be obese.

Our findings contribute to the understanding of social determinants of obesity among older AI/AN and highlight the need to investigate AI/AN obesity, including longitudinal studies with a life course perspective to further examine social determinants of obesity in older AI/AN.

To investigate the touch-contact antimicrobial efficacy of novel cold spray surface coatings composed of copper and silver metals, regard to their rate of microbial elimination.

Antimicrobial time-kill assay.

Laboratory-based study.

An adapted time-kill assay was conducted to characterize the antimicrobial efficacy of the developed coatings. A simulated touch-contact pathogenic exposure to Gram-positive Staphylococcus aureus (ATCC 25923), Gram-negative Pseudomonas aeruginosa (ATCC 27853), and the yeast Candida albicans (ATCC 10231), as well as corresponding resistant strains of gentamicin-methicillin–resistant S. aureus (ATCC 33592), azlocillin-carbenicillin–resistant P. aeruginosa (DSM 46316), and a fluconazole-resistant C. albicans strain was undertaken. Linear regression modeling was used to deduce microbial reduction rates.

A >7 log reduction in microbial colony forming units was achieved within minutes on surfaces with cold spray coatings compared to a single log bacterial reduction on copper metal sheets within a 3 hour contact period. Copper-coated 3-dimensional (3D) printed acrylonitrile butadiene styrene (ABS) achieved complete microbial elimination against all tested pathogens within a 15 minute exposure period. Similarly, a copper-on-copper coating achieved microbial elimination within 10 minutes and within 5 minutes with the addition of silver powder as a 5 wt% coating constituent.

In response to the global need for alternative solutions for infection control and prevention, these effective antimicrobial surface coatings were proposed. A longitudinal study is the next step toward technology integration.

Behavioural therapy often involves self-monitoring techniques to increase awareness about mood and stressful events. In turn, emotional self-awareness is likely to decrease symptoms of depression. Self monitoring also has potential as an early intervention tool for young people, particularly when mobile phones are used as a medium. Previous qualitative research indicates that self-monitoring via mobile phones increase emotional self-awareness with five categories proposed: awareness, identification, communication, contextualisation and decision-making.

This RCT investigates the relationships between self-monitoring, emotional self-awareness and depression using an early intervention mobile phone self-monitoring tool with young people at risk of developing depression.

Young people (between 14 and 24 years of age) identified by their GP as being at risk of depression were recruited by GPs in rural and metropolitan Victoria and randomly assigned to either the intervention group (where they monitored their mood, stress and daily activities) or the comparison group (where the questions about mood and stress were excluded). Participants completed baseline and follow-up measures of depression as well as measures of emotional self-awareness.

Results will be presented on the effects of self-monitoring on emotional self-awareness, the effects of self-monitoring on depression, anxiety and stress and the relationship between emotional self-awareness and depression, anxiety and stress.

Emotional self-awareness as a mediator in the relationship between self-monitoring and depression will be discussed focusing on the relationships between

1. (i) self-monitoring,

2. (ii) emotional self-awareness and

3. (iii) symptoms of depression, anxiety and stress.

Possible avenues for early intervention are suggested.

118 young people identified with mild or more mental health symptoms were blindly randomly allocated at the individual level, to either the intervention group (mobiletype plus usual care) or the comparison group (abbreviated mobiletype plus usual care) according to CONSORT guidelines. Participants and doctors completed baseline and follow-up questionnaires measuring mental health, patient-doctor relationship, and pathways to care (i.e. referrals, medication, and testing). Participants were followed-up at 6 weeks and 6 months.

Results from fixed effects analyses of covariance examining the differences between the experimental and control groups on the main outcome measures, with the baseline values as the covariates will be presented. The extent to which the mobiletype program reduces mental health symptoms, enhances the patient-doctor relationship and assists patients in pathways to care will be explored in detail.

Mobile and new information and connected technologies have much to offer clinical care in terms of increased efficiencies in data collection, increased engagement of participants and overall enhanced care.