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Perioperative pediatric tonsillectomy analgesia: A single-center review of practice and cost-effectiveness analysis

Tonsillectomy is one of the most common pediatric surgeries and results in considerable postoperative pain. Insufficiently managed pain is costly, risks physiological and psychological consequences with multi-modal analgesia widely recommended to minimize opioid-based agents. We determined adherence to multi-modal analgesia guidelines and assessed cost-effectiveness. We undertook a cross-sectional cohort study at a tertiary pediatric institution in Perth, Western Australia, retrospectively identifying selected patients undergoing tonsillectomy over two discrete periods of 6-week duration.

Adiposity associated DNA methylation signatures in adolescents are related to leptin and perinatal factors

Epigenetics links perinatal influences with later obesity. We identifed differentially methylated CpG (dmCpG) loci measured at 17 years associated with concurrent adiposity measures and examined whether these were associated with hsCRP, adipokines, and early life environmental factors. Genome-wide DNA methylation from 1192 Raine Study participants at 17 years, identified 29 dmCpGs associated with body mass index, 10 with waist circumference and 9 with subcutaneous fat thickness.

Performance of the Autism Observation Scale for Infants with community-ascertained infants showing early signs of autism

We investigated whether a commonly used research assessment - the Autism Observation Scale for Infants (AOSI) - accurately measures autism behaviours among infants showing early signs of autism identified within the community. The AOSI is often included in studies tracking the development of infants at increased likelihood of autism, such as the infant siblings of diagnosed children. However, the suitability of this measure has not previously been tested with community-referred infants.

Experiences of Parents of Specialist Peer Mentored Autistic University Students

Parents continue to support to autistic university students, and consequently, experience considerable stress. The aim was to explore the experiences of parents of specialist peer mentored university students and to examine these using the ICF as a theoretical framework.

The Milk Metabolome of Non-secretor and Lewis Negative Mothers

The functional role of milk for the developing neonate is an area of great interest, and a significant amount of research has been done. However, a lot of work remains to fully understand the complexities of milk, and the variations imposed through genetics. It has previously been shown that both secretor (Se) and Lewis blood type (Le) status impacts the human milk oligosaccharide (HMO) content of human milk. While some studies have compared the non-HMO milk metabolome of Se+ and Se- women, none have reported on the non-HMO milk metabolome of Se- and Le- mothers.

Has COVID19 derailed Bhutan's national malaria elimination goal? A commentary

The COVID-19 pandemic has resulted in massive global disruptions with considerable impact on the delivery of health services and national health programmes. Since the detection of the first COVID-19 case on 5th March 2020, the Royal Government of Bhutan implemented a number of containment measures including border closure and national lockdowns. Against the backdrop of this global COVID-19 pandemic response, there was a sudden surge of locally-transmitted malaria cases between June to August 2020.

Gender Balance in Anesthesiology: Is a Change of Societal Mindset Needed?

With great interest, we are following the discussion on Speaker Gender Representation and Trends in Authorship. While it is indeed very popular and important to look at speaker representation, authorship, or board membership by gender, the underlying reasons for the unequal gender representation are not as easy to determine. Counting numbers on panels or boards may also not add up to real representation.

Health and climate change MJA–Lancet Countdown report: Australia gets another failing grade in 2020 but shows signs of progress

At the end of 2019 and into 2020, catastrophic fires in Australia consumed homes, lives, wildlife, and land. Just as the fires subsided, Australia, like the rest of the world, faced another emergency—the COVID-19 pandemic. It is instructive to reflect on lessons from the health disasters of the past year. Following publication of the Lancet Countdown on Health and Climate Change, the Medical Journal of Australia (MJA)–Lancet Australian Countdown was published in December, 2020. This annual report on health and climate change in Australia is in its third year and comprises the efforts of five Australian institutions, in collaboration with University College London, UK, facilitated by a partnership between The Lancet and the MJA.

Using 3D Printing to Visualize 2D Chromatograms and NMR Spectra for the Classroom

The use of three-dimensional printing in chemistry education has expanded greatly in the past 10 years. The technique has been used to demonstrate a range of concepts including molecular structure, orbitals, and point groups; to produce chemical equipment such as cuvettes and columns; and even to print out mathematical shapes and functions. Here, 3D printing is used to create physical models of two-dimensional NMR spectra and HPLC chromatograms to facilitate student understanding of these challenging concepts.

Prenatal exposure to maternal, but not paternal, tobacco smoking is associated with smoking in adolescence

Mounting epidemiological evidence suggests an association between prenatal tobacco exposure and an increased risk of tobacco smoking in offspring. However, it is uncertain whether the association is due to the intrauterine or shared environmental exposures. Study participants were from the Raine Study, a prospective birth cohort study based in Perth, Western Australia (N = 2730). Tobacco smoking in adolescents, at age 17 years, was measured using a self-reported questionnaire. Log-binomial regression was used to estimate the relative risks (RRs) of tobacco smoking in offspring exposed to maternal prenatal tobacco use during the first and third trimesters of pregnancy. We have also calculated the E-values to investigate the potential effect of unmeasured confounding. Paternal smoking during pregnancy was used as a negative control for comparison.