Griffith Research Online

This opinion paper provides an overview of musculoskeletal modeling, revealing insights into muscle-tendon kinematics, forces, and joint contact forces during dynamic movements, thereby advancing our understanding of biomechanics. While subject-specific modeling poses challenges, emerging software tools enable rapid personalization of musculoskeletal geometry and motor control, enhancing physiological accuracy. Advanced predictive simulations and multi-scale modeling expand clinical applications, facilitating surgery outcomes prediction and movement modification for joint diseases. Collaborative interdisciplinary efforts are essential for overcoming challenges, refining workflows, and ultimately enhancing clinical treatment outcomes.

Objective Despite recommendations in international guidelines, implementation of psychological therapy for psychosis is limited. Clinician level factors (i.e. attitudes, confidence, and training) are significant barriers to implementation, but have not been investigated within the context of Australian professional psychology graduates. The current study aimed to examine predictors of interest and confidence in working therapeutically with people with psychosis in recent graduates of Australian psychology postgraduate training courses.

Method An online survey was completed by 108 recent graduates from Australian postgraduate psychology courses. Participants provided data on hours of training, practicum experience, stigma, therapeutic optimism and levels of interest and confidence in working therapeutically with people with psychosis.

Results Participants reported low levels of training and practical experience in psychological therapy for psychosis. Participants with higher training hours and who had delivered an intervention to someone with psychosis during training reported significantly more confidence in their ability to work with people experiencing psychosis. However, stigma was the only significant predictor of interest; psychologists with higher stigmatised attitudes were less interested in working with psychosis.

Conclusions Increased opportunities for practicum experience with people with psychosis and interventions that address stigma in professional psychology training may support increased interest and confidence in providing psychological interventions for psychosis.

Background While left ventricular ejection fraction (LVEF) is the primary variable utilized for prognosis following myocardial infarction (MI), it is relatively indiscriminate for survival in patients with mildly reduced (> 40%) or preserved LVEF (> 50%). Improving risk stratification in patients with mildly reduced or preserved LVEF remains an unmet need, and could be achieved by using a combination approach using prognostically validated measures of left-ventricular (LV) size, geometry, and function.

Aims The aim of this study was to compare the prognostic utility of a Combined Echo-Score for predicting all-cause (ACM) and cardiac mortality (CM) following MI to LVEF alone, including the sub-groups with LVEF > 40% and LVEF > 50%.

Methods Retrospective data on 3094 consecutive patients with MI from 2013 to 2021 who had inpatient echocardiography were included, including both patients with ST-elevation MI (n = 869 [28.1%]) and non-ST-elevation MI (n = 2225 [71.9%]). Echo-Score consisted of LVEF < 40% (2 points) or LVEF < 50% (1 point), and 1 point each for left atrial volume index > 34 mL/m2, septal E/eʹ > 15, abnormal LV mass-index, tricuspid regurgitation velocity > 2.8 m/s, and abnormal LV end-systolic volume-index. Simple addition was used to derive a score out of 7.

Results At a median follow-up of 4.5 years there were 445 deaths (130 cardiac deaths). On Cox proportional-hazards multivariable analysis incorporating significant clinical and echocardiographic predictors, Echo-Score was an independent predictor of both ACM (HR 1.34, p < .001) and CM (HR 1.59, p < .001). Inter-model comparisons of model 𝛘2, Harrel's C and Somer's D, and Receiver operating curves confirmed the superior prognostic value of Echo-Score for both endpoints compared to LVEF. In the subgroups with LVEF > 40% and LVEF > 50%, Echo-Score was similarly superior to LVEF for predicting ACM and CM.

Conclusions An Echo-Score composed of prognostically validated LV parameters is superior to LVEF alone for predicting survival in patients with MI, including the subgroups with mildly reduced and preserved LVEF. This could lead to improved patient risk stratification, better-targeted therapies, and potentially more efficient use of device therapies. Further studies should be considered to define the benefit of further investigation and treatment in high-risk subgroups.

Management programs that successfully recovered wild saltwater crocodile (Crocodylus porosus) populations in the Northern Territory of Australia did so with an expanding commitment to maintaining public safety. One aspect of the program is the ongoing removal of resident and immigrant crocodiles within Darwin Harbor (since 1979), the main urban center. We determined the likely sources of crocodiles caught as problem animals between 2015–2017 by comparing recently developed methods for population assignment. Depending on the assignment model used, we estimated that between 30% and 50% of crocodiles in Darwin Harbor originated from the Adelaide and Mary rivers, and the Kakadu region east of Darwin, and between 20% and 30% of crocodiles originated from the Finniss, Reynolds, and Daly rivers southwest of Darwin. Saltwater crocodiles occur at particularly high densities in these catchments. The remainder came from a mixture of different sources across the Northern Territory. The most common animals captured were immature (150–180 cm) males that have traveled 100–200 km. We did not identify any relationships between the distance from the inferred origin to Darwin Harbor and the size and sex of the crocodiles, or the year of capture. The targeted removal of crocodiles from specific sites such as Darwin Harbor, near where most people live, improves public safety in the highest risk areas, without compromising abundant source populations in most areas.