IntroductionRheumatic heart disease (RHD) is underdiagnosed globally resulting in missed treatment opportunities and adverse clinical outcomes. We describe the protocol for a study which aims to co-design, implement and conduct an evaluation of a task-sharing approach to echocardiographic active case finding for early detection and management of RHD in high-risk settings in Australia and Timor-Leste.Methods and analysisEchocardiograms will be obtained by trained local staff using hand-held echocardiographic devices employing the ‘Single Parasternal Long Axis view with a Sweep of the Heart’ (SPLASH) technique and interpreted by experts remote from the site of acquisition. Approximately 1500 children and pregnant women will be screened across high-risk communities in Australia and Timor-Leste over an 18-month period. The study will use a type II effectiveness-implementation hybrid design. A tailored package of implementation strategies will be co-designed with communities and health services and mapped onto a Theory of Change framework. The clinical effectiveness will be assessed as the change in the proportion of the target population that are prescribed secondary prophylaxis for RHD by the end of the study compared with baseline. The implementation will be assessed as the adoption, penetration, sustainability, fidelity and cost of the programme with a mixed-methods theory-based and economic evaluation. Data will include numbers of normal, abnormal and uninterpretable SPLASH echocardiograms obtained, numbers of participants progressing through the cascade of care, interviews with staff and programme costs.Ethics and disseminationEthical approval has been obtained from the Human Research Ethics Committee of the NT Department of Health and Menzies School of Health Research, Darwin (HREC-2022-4479), the Western Australian Aboriginal Health Ethics Committee (HREC-1237) and the Instituto Nasional Saude Publika Timor-Leste Ethics and Technical Committee (03-UEPD/INSP-TL/V/2023). Informed consent is required to be enrolled. Study findings will be disseminated in the communities involved and submitted for publication.Trial registration numberNCT06002243.
Data set for the paper "Designing a Boron Nitride Polyethylene Composite for Shielding Neutrons" published in Applied Physics Letters Materials (https://doi.org/10.1063/5.0163377). In this paper, we explore the three different ways to distribute boron-10 within HDPE. These three configurations are called: (1) blended, (2) ideal layered, and (3) manufacturable. Refer to the manuscript for details of these configurations. For the blended configuration, we have uploaded the feather files, which contain all the information that was tracked in Geant4. We have processed the ROOT files, outputted directly from Geant4, into feather files, which include the energy of each particle at the entry and exit surface of the shielding composite along with the particle type and interaction type. The feather files can be easily read into Python using pandas:pd.read_feather(filename)The feather files are labeled as "blended_B10enrich_seed1_processed_*.ftr". Each feather file contains information from ~10 ROOT files. The key information from these feather files, such as the number of neutrons and gammas exiting the shielding composite and effective dose ratio, is saved in a pickle file, called "blended_B10enrich_binned_seed1_compressed.pickle". The pickle files can be read into Python using:with open(filename, 'rb') as pickle_file: dictionary = pickle.load(pickle_file)For the ideal layered configuration, there are ~100 feather files that are available upon request. The corresponding pickle files for the ideal layered configuration are uploaded, see "layered_B10enrich_binned_compressed.pickle", which can be read into Python using the code provided above. For the manufacturable configuration, there are ~236 feather files that are ~2 GB each. To reduce the number of files uploaded to this repository, we have only uploaded the pickle files for this configuration (see "manufacturable_B10enrich_binned_compressed_*.pickle"). Please contact the authors if you have additional questions (Alisha Vira, avira@gatech.edu, or Phillip First, first@gatech.edu).
•Aboriginal People living with MJD in Australia experience numerous sleep disorders.•Majority of sleep was spent in non-rapid eye movement sleep.•Overcrowding and overnight care needs interrupt sleep.•MJD participants and caregivers reported high psychological distress.
