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We present the serendipitous radio-continuum discovery of a likely Galactic supernova remnant (SNR) G305.4–2.2. This object displays a remarkable circular symmetry in shape, making it one of the most circular Galactic SNRs known. Nicknamed Teleios due to its symmetry, it was detected in the new Australian Square Kilometre Array Pathfinder (ASKAP) Evolutionary Map of the Universe (EMU) radio–continuum images with an angular size of 1 320$^{\prime\prime}$$\times$1 260$^{\prime\prime}$ and PA = 0$^\circ$. While there is a hint of possible H$\alpha$ and gamma-ray emission, Teleios is exclusively seen at radio–continuum frequencies. Interestingly, Teleios is not only almost perfectly symmetric, but it also has one of the lowest surface brightnesses discovered among Galactic SNRs and a steep spectral index of $\alpha$=–0.6$\pm$0.3. Our best estimates from Hi studies and the $\Sigma$–D relation place Teleios as a type Ia SNR at a distance of either $\sim$2.2 kpc (near-side) or $\sim$7.7 kpc (far-side). This indicates two possible scenarios, either a young (under 1 000 yr) or a somewhat older SNR (over 10 000 yr). With a corresponding diameter of 14/48 pc, our evolutionary studies place Teleios at the either early or late Sedov phase, depending on the distance/diameter estimate. However, our modelling also predicts X-ray emission, which we do not see in the present generation of eROSITA images. We also explored a type Iax explosion scenario that would point to a much closer distance of $\lt$1 kpc and Teleios size of only $\sim$3.3 pc, which would be similar to the only known type Iax remnant SN1181. Unfortunately, all examined scenarios have their challenges, and no definitive Supernova (SN) origin type can be established at this stage. Remarkably, Teleios has retained its symmetrical shape as it aged even to such a diameter, suggesting expansion into a rarefied and isotropic ambient medium. The low radio surface brightness and the lack of pronounced polarisation can be explained by a high level of ambient rotation measure (RM), with the largest RM being observed at Teleios’s centre.
A common feature of public policy in Australia in recent decades has been use of wage caps to restrain public sector wage growth. In this paper we explore the nature of the relationship between wage growth in public and private sectors, and thereby whether wage caps have also influenced private sector wage growth. Despite the differences in wage setting institutions and mechanisms, analysis presented reveals that private and public sector wage growth are closely entwined at the aggregate level for Australia, and in all states and territories. Naïve Vector Error Correction Models identify the private sector as the long run wage leader for Australia and half the states and territories. However, after controlling for a structural break occurring during the COVID-19 era, our results indicate that joint or bi-directional wage leadership between both sectors is the norm. Findings suggest that wage caps implemented after the GFC to suppress public sector wage growth likely spilled over to the private sector, contributing to widespread wage stagnation experienced throughout the 2010s. More recently, these public sector wage caps stifled the ability of public sector wages to adjust to rapid private sector wage growth. These findings have important policy implications for public sector wage policy as a key contributor to governments’ labour market and macroeconomic management.
The next-generation radio astronomy instruments are providing a massive increase in sensitivity and coverage, largely through increasing the number of stations in the array and the frequency span sampled. The two primary problems encountered when processing the resultant avalanche of data are the need for abundant storage and the constraints imposed by I/O, as I/O bandwidths drop significantly on cold storage. An example of this is the data deluge expected from the SKA Telescopes of more than 60 PB per day, all to be stored on the buffer filesystem. While compressing the data is an obvious solution, the impacts on the final data products are hard to predict. In this paper, we chose an error-controlled compressor – MGARD – and applied it to simulated SKA-Mid and real pathfinder visibility data, in noise-free and noise-dominated regimes. As the data have an implicit error level in the system temperature, using an error bound in compression provides a natural metric for compression. MGARD ensures the compression incurred errors adhere to the user-prescribed tolerance. To measure the degradation of images reconstructed using the lossy compressed data, we proposed a list of diagnostic measures, exploring the trade-off between these error bounds and the corresponding compression ratios, as well as the impact on science quality derived from the lossy compressed data products through a series of experiments. We studied the global and local impacts on the output images for continuum and spectral line examples. We found relative error bounds of as much as 10%, which provide compression ratios of about 20, have a limited impact on the continuum imaging as the increased noise is less than the image RMS, whereas a 1% error bound (compression ratio of 8) introduces an increase in noise of about an order of magnitude less than the image RMS. For extremely sensitive observations and for very precious data, we would recommend a $0.1\%$ error bound with compression ratios of about 4. These have noise impacts two orders of magnitude less than the image RMS levels. At these levels, the limits are due to instabilities in the deconvolution methods. We compared the results to the alternative compression tool DYSCO, in both the impacts on the images and in the relative flexibility. MGARD provides better compression for similar error bounds and has a host of potentially powerful additional features.
Targeting the glutamatergic system is posited as a potentially novel therapeutic strategy for psychotic disorders. While studies in subjects indicate that antipsychotic medication reduces brain glutamatergic measures, they were unable to disambiguate clinical changes from drug effects.
Aims
To address this, we investigated the effects of a dopamine D2 receptor partial agonist (aripiprazole) and a dopamine D2 receptor antagonist (amisulpride) on glutamatergic metabolites in the anterior cingulate cortex (ACC), striatum and thalamus in healthy controls.
Method
A double-blind, within-subject, cross-over, placebo-controlled study design with two arms (n = 25 per arm) was conducted. Healthy volunteers received either aripiprazole (up to 10 mg/day) for 7 days or amisulpride (up to 400 mg/day) and a corresponding period of placebo treatment in a pseudo-randomised order. Magnetic resonance spectroscopy (1H-MRS) was used to measure glutamatergic metabolite levels and was carried out at three different time points: baseline, after 1 week of drug and after 1 week of placebo. Values were analysed as a combined measure across the ACC, striatum and thalamus.
Results
Aripiprazole significantly increased glutamate + glutamine (Glx) levels compared with placebo (β = 0.55, 95% CI [0.15, 0.95], P = 0.007). At baseline, the mean Glx level was 8.14 institutional units (s.d. = 2.15); following aripiprazole treatment, the mean Glx level was 8.16 institutional units (s.d. = 2.40) compared with 7.61 institutional units (s.d. = 2.36) for placebo. This effect remained significant after adjusting for plasma parent and active metabolite drug levels. There was an observed increase with amisulpride that did not reach statistical significance.
Conclusions
One week of aripiprazole administration in healthy participants altered brain Glx levels as compared with placebo administration. These findings provide novel insights into the relationship between antipsychotic treatment and brain metabolites in a healthy participant cohort.
Governments are increasingly implementing policies to improve population diets, despite food industry resistance to regulation that may reduce their profits from sales of unhealthy foods. However, retail food environments remain an important target for policy action. This study analysed publicly available responses of industry actors to two public consultations on regulatory options for restricting unhealthy food price and placement promotions in retail outlets in Scotland.
Design:
We conducted a qualitative content analysis guided by the Policy Dystopia Model to identify the discursive (argument-based) and instrumental (tactic-based) strategies used by industry actors to counter the proposed food retail policies.
Setting:
Scotland, UK, 2017-2019.
Participants:
N/A
Results:
Most food and retail industry responses opposed the policy proposals. Discursive strategies employed by these actors commonly highlighted the potential costs to the economy, their industries and the public in the context of a financial crisis, and disputed the potential health benefits of the proposals. They claimed that existing efforts to improve population diets, such as nutritional reformulation, would be undermined. Instrumental strategies included using unsubstantiated and misleading claims, building a coordinated narrative focused on key opposing arguments and seeking further involvement in policy decision-making.
Conclusions:
These findings can be used by public health actors to anticipate and prepare for industry opposition when developing policies targeted at reducing the promotion of unhealthy food in retail settings. Government action should ensure robust management of conflicts of interest and establishment of guidance for the use of supporting evidence as part of the public health policy process.
Cognitive impairments are a core feature of psychotic disorders, but their long-term trajectory remains contentious. Previous meta-analyses focused on the first 5 years following psychosis onset. Here, we evaluated the change in cognitive impairments in psychotic disorders with a meta-analysis of studies with follow-ups of 5+ years. Following preregistration, databases were searched for relevant articles until July 2024. Two authors screened the reports for studies reporting on the change in cognitive impairments in global cognition, verbal learning and memory, visual learning and memory, working memory, attention, speed of processing, reasoning and problem-solving, and verbal fluency in individuals with psychotic disorders, with a minimum follow-up of 5 years. Three authors extracted data, and the PRISMA guidelines were followed. Random-effects meta-analyses and moderator analyses were conducted. Twenty-four studies comprising 2,633 patients and 1,019 controls were included in the study. Over an average of 8.46 years, cognitive impairments remained stable in all eight measures: global cognition (g = 0.09; 95% CI = 0.03–0.20), verbal memory (g = 0.05; 95% CI = −0.11, 0.21), visual memory (g = −0.16; 95% CI = −0.35, 0.03), working memory (g = 0.03; 95% CI = −0.09, 0.14), attention (g = 0.22; 95% CI = −0.36, 0.80), speed of processing (g = 0.10; 95% CI = −0.14, 0.35), reasoning and problem-solving (g = 0.16; 95% CI = −0.03, 0.35), and verbal fluency (g = 0.08; 95% CI = −0.03, 0.19). We conclude that cognitive impairments remain stable over time, consistent with the neurodevelopmental view of psychotic disorders.
The chapter starts by presenting a sketch of the phonology of Irish. This covers first the segmental phonology dealing with consonants and then vowels. The importance of the palatalised–non-palatalised distinction in the consonant system is stressed. The phonotactics of Irish are described and the range of possible consonant clusters outlined. Attention is then turned to prosodic aspects of Irish phonology, with a description of both stress and intonation.
Phonological processes such as allophonic variation and sandhi phenomena are also included, and a description of the initial consonant mutation system is given in phonological terms. In all these sections of the chapter, important dialect differences are noted. Following the description of Irish phonology, a review is presented of studies of the acquisition of Irish as a first (or joint first) language. Two diary studies provided some information on order of acquisition of segments and on patterns of simplification. A longitudinal, group study is also reviewed and the results of this add much more to our knowledge of phonological acquisition in Irish. The chapter concludes with a look at the development of new, urban, forms of Irish, and at the need for more research into phonological acquisition norms in Irish.
Current evidence underscores a need to transform how we do clinical research, shifting from academic-driven priorities to co-led community partnership focused programs, accessible and relevant career pathway programs that expand opportunities for career development, and design of trainings and practices to develop cultural competence among research teams. Failures of equitable research translation contribute to health disparities. Drivers of this failed translation include lack of diversity in both researchers and participants, lack of alignment between research institutions and the communities they serve, and lack of attention to structural sources of inequity and drivers of mistrust for science and research. The Duke University Research Equity and Diversity Initiative (READI) is a program designed to better align clinical research programs with community health priorities through community engagement. Organized around three specific aims, READI-supported programs targeting increased workforce diversity, workforce training in community engagement and cultural competence, inclusive research engagement principles, and development of trustworthy partnerships.
Time parallelization, also known as PinT (parallel-in-time), is a new research direction for the development of algorithms used for solving very large-scale evolution problems on highly parallel computing architectures. Despite the fact that interesting theoretical work on PinT appeared as early as 1964, it was not until 2004, when processor clock speeds reached their physical limit, that research in PinT took off. A distinctive characteristic of parallelization in time is that information flow only goes forward in time, meaning that time evolution processes seem necessarily to be sequential. Nevertheless, many algorithms have been developed for PinT computations over the past two decades, and they are often grouped into four basic classes according to how the techniques work and are used: shooting-type methods; waveform relaxation methods based on domain decomposition; multigrid methods in space–time; and direct time parallel methods. However, over the past few years, it has been recognized that highly successful PinT algorithms for parabolic problems struggle when applied to hyperbolic problems. We will therefore focus on this important aspect, first by providing a summary of the fundamental differences between parabolic and hyperbolic problems for time parallelization. We then group PinT algorithms into two basic groups. The first group contains four effective PinT techniques for hyperbolic problems: Schwarz waveform relaxation (SWR) with its relation to tent pitching; parallel integral deferred correction; ParaExp; and ParaDiag. While the methods in the first group also work well for parabolic problems, we then present PinT methods specifically designed for parabolic problems in the second group: Parareal; the parallel full approximation scheme in space–time (PFASST); multigrid reduction in time (MGRiT); and space–time multigrid (STMG). We complement our analysis with numerical illustrations using four time-dependent PDEs: the heat equation; the advection–diffusion equation; Burgers’ equation; and the second-order wave equation.
The antibiotic spectrum index (ASI) outcome quantifies antibiotic exposure based on spectrum of activity. Our objective was to examine ASI as an exploratory outcome in the context of a recent stewardship-focused, clinical trial in childhood pneumonia that originally used a binary guideline-concordant outcome.
Design:
Secondary analysis of a randomized clinical trial.
Setting:
Two tertiary pediatric hospitals.
Methods:
Encounters were randomly assigned to clinical decision support (CDS) or usual care treatment arm. The ASI was calculated by summing daily ASI scores for each unique antibiotic administered. It was evaluated as a continuous and ordinal measure: No Antibiotics (ASI = 0), Narrow (1-2), Intermediate (3-4), Broad (5-7), and Very Broad (≥8). Proportional odds regression modeled the ordinal ASI outcome in the first 24 hours by treatment arm and compared to the guideline-concordance outcome. Results were stratified by emergency department (ED) disposition. We also conducted a longitudinal, descriptive analysis of day-to-day ASI for those with in-hospital dispositions.
Results:
We included 1027 encounters, 549 (53%) were randomized to CDS and 478 (47%) usual care respectively. ASI Category did not differ by treatment arm overall (Odds Ratio: 0.88[95% Confidence Interval: 0.70,1.09]), which mirrored binary guideline-concordance. Mean ASI was lower for concordant encounters (2.1 vs 8.4, P < 0.001) and across all ED dispositions. In the longitudinal analysis, there were 1137 day-to-day ASI comparisons, with only 7% representing spectrum escalations.
Conclusions:
The ASI outcome yielded similar results to a dichotomous concordance outcome. However, ASI provided more granular insights into antibiotic prescribing, suggesting ASI may be a useful outcome measure in future stewardship-focused trials.
The First Large Absorption Survey in H i (FLASH) is a large-area radio survey for neutral hydrogen in and around galaxies in the intermediate redshift range $0.4\lt z\lt1.0$, using the 21-cm H i absorption line as a probe of cold neutral gas. The survey uses the ASKAP radio telescope and will cover 24,000 deg$^2$ of sky over the next five years. FLASH breaks new ground in two ways – it is the first large H i absorption survey to be carried out without any optical preselection of targets, and we use an automated Bayesian line-finding tool to search through large datasets and assign a statistical significance to potential line detections. Two Pilot Surveys, covering around 3000 deg$^2$ of sky, were carried out in 2019-22 to test and verify the strategy for the full FLASH survey. The processed data products from these Pilot Surveys (spectral-line cubes, continuum images, and catalogues) are public and available online. In this paper, we describe the FLASH spectral-line and continuum data products and discuss the quality of the H i spectra and the completeness of our automated line search. Finally, we present a set of 30 new H i absorption lines that were robustly detected in the Pilot Surveys, almost doubling the number of known H i absorption systems at $0.4\lt z\lt1$. The detected lines span a wide range in H i optical depth, including three lines with a peak optical depth $\tau\gt1$, and appear to be a mixture of intervening and associated systems. Interestingly, around two-thirds of the lines found in this untargeted sample are detected against sources with a peaked-spectrum radio continuum, which are only a minor (5–20%) fraction of the overall radio-source population. The detection rate for H i absorption lines in the Pilot Surveys (0.3 to 0.5 lines per 40 deg$^2$ ASKAP field) is a factor of two below the expected value. One possible reason for this is the presence of a range of spectral-line artefacts in the Pilot Survey data that have now been mitigated and are not expected to recur in the full FLASH survey. A future paper in this series will discuss the host galaxies of the H i absorption systems identified here.
Edited by
David Mabey, London School of Hygiene and Tropical Medicine,Martin W. Weber, World Health Organization,Moffat Nyirenda, London School of Hygiene and Tropical Medicine,Dorothy Yeboah-Manu, Noguchi Memorial Institute for Medical Research, University of Ghana,Jackson Orem, Uganda Cancer Institute, Kampala,Laura Benjamin, University College London,Michael Marks, London School of Hygiene and Tropical Medicine,Nicholas A. Feasey, Liverpool School of Tropical Medicine
The mortality rate of children less than 5 years of age has decreased by 60% since 1990, with the Millennium Development Goals having been a powerful drive for improvement. However, the reduction has not been evenly distributed throughout the world (UN IGME 2020). Sub-Saharan Africa remains the region with the highest under-5 mortality rate in the world, where 1 child in every 13 dies before celebrating their 5th birthday (UN IGME 2020).
We present the Evolutionary Map of the Universe (EMU) survey conducted with the Australian Square Kilometre Array Pathfinder (ASKAP). EMU aims to deliver the touchstone radio atlas of the southern hemisphere. We introduce EMU and review its science drivers and key science goals, updated and tailored to the current ASKAP five-year survey plan. The development of the survey strategy and planned sky coverage is presented, along with the operational aspects of the survey and associated data analysis, together with a selection of diagnostics demonstrating the imaging quality and data characteristics. We give a general description of the value-added data pipeline and data products before concluding with a discussion of links to other surveys and projects and an outline of EMU’s legacy value.
The stars of the Milky Way carry the chemical history of our Galaxy in their atmospheres as they journey through its vast expanse. Like barcodes, we can extract the chemical fingerprints of stars from high-resolution spectroscopy. The fourth data release (DR4) of the Galactic Archaeology with HERMES (GALAH) Survey, based on a decade of observations, provides the chemical abundances of up to 32 elements for 917 588 stars that also have exquisite astrometric data from the Gaia satellite. For the first time, these elements include life-essential nitrogen to complement carbon, and oxygen as well as more measurements of rare-earth elements critical to modern-life electronics, offering unparalleled insights into the chemical composition of the Milky Way. For this release, we use neural networks to simultaneously fit stellar parameters and abundances across the whole wavelength range, leveraging synthetic grids computed with Spectroscopy Made Easy. These grids account for atomic line formation in non-local thermodynamic equilibrium for 14 elements. In a two-iteration process, we first fit stellar labels to all 1 085 520 spectra, then co-add repeated observations and refine these labels using astrometric data from Gaia and 2MASS photometry, improving the accuracy and precision of stellar parameters and abundances. Our validation thoroughly assesses the reliability of spectroscopic measurements and highlights key caveats. GALAH DR4 represents yet another milestone in Galactic archaeology, combining detailed chemical compositions from multiple nucleosynthetic channels with kinematic information and age estimates. The resulting dataset, covering nearly a million stars, opens new avenues for understanding not only the chemical and dynamical history of the Milky Way but also the broader questions of the origin of elements and the evolution of planets, stars, and galaxies.
Cardiovascular diseases (CVDs) are the leading cause of death worldwide(1). As poor diet quality is a major contributor to CVD burden; dietary intervention is recommended as a first-line approach to CVD prevention and management(2). Personalised nutrition (PN) refers to individualised nutrition care based on genetic, phenotypic, medical, and/or behavioural and lifestyle characteristics(3). Medical nutrition therapy by dietitians shares many of these principles and can be categorised as PN(4). PN may be beneficial in improving CVD risk factors and diet, however, this has not previously been systematically reviewed. The aim of this systematic review was to evaluate the effectiveness of PN interventions on CVD risk factors and diet in adults at elevated CVD risk. A comprehensive search was conducted in March 2023 across Embase, Medline, CINAHL, PubMed, Scopus and Cochrane databases, focusing on randomised controlled trials (RCTs) published after 2000 in English. Included studies tested the effect of PN interventions on adults with elevated CVD risk factors (determined by anthropometric measures, clinical indicators, or high overall CVD risk). Risk of bias was assessed using the Academy of Nutrition and Dietetics Quality Criteria checklist. Random-effects meta-analysis were conducted to explore weighted mean differences (WMD) in change or final mean values for studies with comparable data (studies with dietary counselling interventions), for outcomes including blood pressure (BP), blood lipids, and anthropometric measurements. Sixteen articles reporting on 15 unique studies (n = 7676) met inclusion criteria and were extracted. Outcomes of participants (n = 40–564) with CVD risk factors including hyperlipidaemia (n = 5), high blood pressure (n = 3), BMI > 25kg/m2 (n = 1) or multiple factors (n = 7) were reported. Results found potential benefits of PN on systolic blood pressure (SBP) (WMD −1.91 [95% CI −3.51, −0.31] mmHg), diastolic blood pressure (DBP) (WMD −1.49 [95% CI −2.39, −0.58] mmHg), triglycerides (TG) (WMD −0.18 [95% CI −0.34, −0.03] mmol/L), and dietary intake in individuals at high CVD risk. Results were inconsistent for plasma lipid and anthropometric outcomes. Dietary counselling PN interventions showed promising results on CVD risk factors in individuals at-risk individuals. Further evidence for other personalisation methods and improvements to methodological quality and longer study durations are required in future PN interventions.
Nutritional metabolomics is an emerging objective dietary biomarker method to help characterise dietary intake. Our recent scoping review identified gaps and inconsistencies in both design features and level of detail of reported dietary intervention methods in human feeding studies measuring the metabolome(1) and our cross-over feeding study protocol details dietary information for identification of metabolites that characterise ‘healthy’ and ‘unhealthy’ (typical) Australian diets(2). The current study aimed to gain consensus on core diet-related item details (DID) and recommendations for reporting DIDs to inform development of a reporting checklist. The aim of this checklist is to guide researchers on reporting dietary information within human feeding studies measuring the dietary metabolome. A two-stage online Delphi was conducted encompassing 5 survey rounds (February–July 2024). This study is approved by the University of Newcastle’s Human Research Ethics Committee (HREC; H-2023-0405). Sixty-seven experts were invited across expertise in clinical trial design, feeding study intervention implementation, metabolomics, and/or human biospecimen analyses. Twenty-eight DIDs categorised across five domains underwent consensus development. Stage 1 (2 rounds) gained consensus on a core set of DIDs, including phrasing. Stage 2 (3 rounds) gained consensus on standard reporting recommendations for each DID and acceptance of the final reporting guideline. The research team convened after every round to discuss consensus-driven results. Experts resided from Australia, New Zealand, United States, United Kingdom, Sweden, Israel, Italy and Denmark. Twenty-five completed stage 1 and n = 22 completed stage 2. After stage 1, two DIDs merged and two new DIDs were identified, totalling 29 core DIDs. At the end of stage 2, round 2, based on expert feedback, all items were organised to determine differing degrees of reporting in the methods section of publications, with additional recommendations collated for other sections, including supplementary files. The reporting guideline (DID-METAB Checklist) was generated and accepted by the expert working group in round 3, with all experts agreeing that relevant journals should include the checklist as a suggested reporting tool for relevant studies or used alongside existing reporting tools. The Delphi process gained consensus on a core set of DIDs, and consolidated expert views on the level of detail required when reporting DIDs in research. The Delphi process generated the reporting guideline (DID-METAB Checklist) which can be implemented independently or as an extension to existing guidelines such as CONSORT (at item 5) or SPIRIT (at item 11) to improve reproducibility and comparability of feeding studies. Endorsement by scientific societies and journals will be key for the dissemination strategy and optimising the utility of the tool to strengthen the evidence base of nutritional metabolomics. The DID-METAB Checklist will be a key tool to advance reporting of diet-related methodologies in metabolomics for both personalised and precision nutrition interventions in clinical practice.
Interest in the consumption of food containing live microbes (LM) as a component of dietary patterns has accelerated, due to potential positive contributions to health and chronic disease risk, including cardiovascular disease (CVD)(1,2). There are different patterns of LM consumption, including through the intake of probiotics or fermented foods or via a broader spectrum of foods that may harbour microbes, such as raw, unpeeled fruits and vegetables(3). To date, no study has quantitatively assessed potential intake of LM in a sample of Australians. The aim was to quantify presence of LM for common foods and beverages consumed in Australia, using the Australian Eating Survey® (AES) and AES-Heart®(4,5 food frequency questionnaires as the dietary assessment tool. Quantification of potential live microbial content (per gram) was conducted in accordance with the methodology outlined by Marco et al.(3). Briefly, foods were assigned to categories with LM ranges defined as low (Low; < 104 CFU/g), medium (Medium; 104–107 CFU/g), or high (High; > 107 CFU/g) for level of live microbes(3). These categories were based on the expected prevalence of viable microorganisms within different food matrices. Specifically, pasteurised food products are characterised as having microbial concentrations Low < 104 CFU/g. In contrast, fresh fruits and vegetables, consumed unpeeled exhibit a microbial range considered medium (Medium; 104–107 CFU/g), while unpasteurised fermented foods and probiotic supplemented foods exhibit significantly higher microbial content (High > 107 CFU/g). Based on this methodology, the estimated quantities of live microbes in 400 foods and beverages (including individual products and mixed dishes) within the AES and AES-Heart®(4,5 FFQs were determined and summarised across 22 food groups using the 2-digit codes from the 2011–2013 AUSNUT database(6). Preliminary results indicate the Low group was the most represented, out of the 400 foods 369 belong to this category. The food groups that represent the highest percentages in the Low group were vegetable products and dishes (13.8%) followed by meat, poultry, and game products and dishes (13.6%). The Medium group was composed by 25 items, with the most representative food groups being fruit products and dishes (48%). In the High group, the representative food groups were dairy and meat substitutes (e.g., soy yoghurt; 66.7%) and milk products and dishes (33.3%). The creation of this database will facilitates new research opportunities to investigate relationships between intake of live microbes and health outcomes, including CVD. Future research into how dietary pattern rich in live microbes related to chronic disease risk factors, such as reduced BMI, blood pressure, plasma lipids and glucose, in the Australian population could offer new insights into risk factor management through LM dietary interventions.
Objective biomarkers of a healthy and typical Australian diet could enhance dietary assessment and provide insight into how adherence to, or deviations from, dietary guidelines impact health. This study aimed to identify and compare plasma and urinary metabolites in healthy Australian adults in response to a healthy and typical dietary pattern. This was an 8-week randomised, cross-over feeding trial(1). After a two-week run-in period, participants were randomly allocated to follow each diet for two weeks, with a minimum two-week washout period in between. The Healthy Australian Diet adhered to the Australian Dietary Guidelines(2), including a balanced intake of the five food groups and meeting Acceptable Macronutrient Distribution Range targets(3). The Typical Australian Diet was formulated based on apparent consumption patterns in Australia(4). During each feeding phase, all food items were provided to ensure compliance. Both diets included different key indicator foods associated with known metabolites. Comprehensive data collection occurred at four key visits: week 0 (end of run-in; baseline 1), week 2 (post-feeding phase 1), week 4 (end of washout, baseline 2), and week 8 (post-feeding phase 2). Blood samples following a ≥ 8-hour fast were collected by an accredited pathologist, and spot urine samples were self-collected by participants at the morning appointment. Metabolomics data was obtained using Ultra-high Performance Liquid Chromatography-Tandem Mass Spectrometry (UHPLC-MS/MS) through Metabolon Inc.’s (Morrisville, USA) Global Discovery Panel. Metabolite concentrations were log-transformed. Differential changes in metabolites between intervention groups were evaluated using linear mixed-effect models, adjusting for diet sequence, feeding phase, and subject ID as a random variable to account for potential autocorrelation. Post-hoc pairwise comparisons were conducted to assess the impact effects of each diet. A total of 34 healthy Australian adults (age 38.4 ± 18.1 years, 53% females) completed all study measures. After adjusting for multiple comparisons, significant differences between TAD and HAD groups were observed for 257 plasma and 91 urine metabolites. Of these, 44 known metabolites consistently differed between dietary pattern groups in both biofluid types (plasma and urine). Several associations between specific food groups and metabolites were identified, including the externally validated metabolites associated with dark chocolate (theobromine), orange juice (proline betaine), and cruciferous vegetables (S-methylcysteine sulfoxide, S-methylcysteine). Consumption of dietary patterns aligned with Australian dietary guidelines had a measurable impact on the short-term human metabolome compared to a typical Australian dietary pattern. While some metabolites are established as biomarkers of specific foods, others may represent novel biomarkers requiring validation in future clinical trials and diverse populations. Further research should explore the relationship between these metabolites, the gut microbiome, and clinical outcomes. Additionally, studies are needed to assess the feasibility of using these biomarkers to evaluate diets in real-world settings.
Emerging research has highlighted a relationship between diet and genetics, suggesting that individuals may benefit more from personalised dietary recommendations based on their genetic risk for cardiovascular disease (CVD)(1,2). This current study aims to: (1) Measure knowledge of genetics among healthcare professionals (HCPs) working in CVD, (2) Identify HCPs’ attitudes to using genetic risk to tailor dietary interventions, and (3) Identify perceived barriers and enablers to implementing genetics to tailor dietary interventions. In a mixed-methods study, Australian HCPs (dietitians and AHPRA registered healthcare professionals) working with people with CVD were invited to complete an anonymous online survey (REDCap) and an optional interview. Recruitment occurred through social media and relevant professional organisations. Survey questions were underpinned by the theoretical domains framework(3) and data was synthesised descriptively. Semi-structured interviews were undertaken via Zoom. Interview responses were analysed using a thematic analysis approach using Braun & Clarke methodology(4). Survey responders (n = 63, 89% female, mean age 42 ± 14 years) were primarily dietitians (83%), with ≥ 10 years of experience (56%) and spent at least 20% of their time working with people with CVD (n = 55, 87%). Approximately half of respondents were aware that genetic testing for CVD exists (n = 36) and always assess family history of CVD (n = 31). Few respondents reported using genetic testing (n = 5, 8%) or felt confident interpreting and using genetic testing (n = 7, 11%) in practice. Respondents were interested in incorporating genetics into their practice to tailor dietary advice (n = 44, 70%). Primary barriers to using genetic testing included financial costs to patients and negative implications for some patients. Almost all respondents agreed genetic testing will allow for more targeted and personalised approaches for prevention and management of CVD (94%). From the interviews (n = 15, 87% female, 43 ± 17 years, 87% dietitian), three themes were identified: (1) ‘On the periphery of care’—HCPs are aware of the role of genetics in health and are interested in knowing more, but it is not yet part of usual practice; (2) ‘A piece of the puzzle’—using genetic testing could be a tool to help personalise, prioritise and motivate participants; and (3) ‘Whose role is it?’—There is uncertainty regarding HCP roles and knowing exactly whose role it is to educate patients. Healthcare professionals are interested in using genetics to tailor dietary advice for CVD, but potential implications for patients need to be considered. Upskilling is required to increase their knowledge and confidence in this area. Further clarity regarding HCP roles in patient education is needed before this can be implemented in practice.