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Papers by Johnny Lo

Research paper thumbnail of Food Supply Impacts and Solutions Associated with the COVID-19 Pandemic: A Regional Australian Case Study

International Journal of Environmental Research and Public Health

This study aimed to explore how food supply chains were impacted by COVID-19 and identify how the... more This study aimed to explore how food supply chains were impacted by COVID-19 and identify how the region could be better prepared for future crises. An online survey was completed by 107 consumers. In-depth interviews were conducted with 27 food supply stakeholders working in food production, distribution, retail, hospitality, institutions (i.e., childcare), logistics/freight and local government. Pre-COVID-19, farmer-direct distribution options and hospitality businesses comprised a substantial proportion of local food producer businesses. During the COVID-19 pandemic, consumers favoured local food supply options, farmers collaborated, and produce usually destined for export was redirected into local markets. Critical food supply actions included keeping borders open to food freight, enhancing social capital through real-time business communication, and business flexibility. Solutions included business adaptation, for example, farmers selling produce boxes and hospitality businesse...

Research paper thumbnail of Predictors of nutrition care process knowledge and use among dietitians internationally

Journal of Human Nutrition and Dietetics, 2021

BACKGROUND The nutrition care process (NCP) and its associated standardised terminology (NCPT, re... more BACKGROUND The nutrition care process (NCP) and its associated standardised terminology (NCPT, referred to collectively as NCP/T) forms a problem-solving framework fundamental to dietetic practice. Global implementation would assist in confirming outcomes from dietetic care, but implementation rates have varied between countries. We investigated which factors predict NCP/T knowledge and use among dietetic professionals in an international cohort, aiming to understand how implementation can be strengthened. METHODS The validated International NCP Implementation Survey was disseminated to dietitians in 10 countries via professional networks. Implementation, attitudes and knowledge of the NCP/T along with workplace and educational data were assessed. Independent predictive factors associated with higher NCP/T knowledge and use were identified using backward stepwise logistic regression. RESULTS Data from 6149 respondents was used for this analysis. Enablers that were independent predictors of both high knowledge and frequent use of NCP/T were peer support, recommendation from national dietetic association and workplace requirements (all p < 0.001). Country of residence and working in clinical settings (p < 0.001) were demographic characteristics that were independent predictors of high knowledge and frequent use of NCP/T. A high knowledge score was an independent predictor of frequent NCP/T use (p = 0.002). CONCLUSIONS Important modifiable enablers for NCP knowledge and use rely on organisational management. National dietetic organisations and key stakeholders such as employers are encouraged to integrate active NCP/T support in their leadership initiatives. This could take the form of policies, formalised and structured training strategies, and informatics initiatives for the integration in electronic health records.

Research paper thumbnail of Author response for "The relationship between lifestyle and serum neurofilament light protein in Huntington’s disease

Research paper thumbnail of Estimation of tropospheric wet delay from GNSS measurements

and support throughout the course of my study. Special mention also for my cosupervisors Prof. Wi... more and support throughout the course of my study. Special mention also for my cosupervisors Prof. Will Featherstone and Dr. Joseph Awange. This would not be possible without their advice and support. I would also like to extend my appreciation to Dr. Nigel Penna for his supervision early on in my study. Furthermore, I would like to express my appreciation to Dr. Congwei Hu for providing the PPP program needed to perform the analysis of the dynamic models. Special thanks also go to the Head of the Department of Spatial Sciences, Prof. Bert Veenendaal, Associate Prof. Jon Kirby and the rest of the staff members for the encouragement and help during my study. I am grateful to my colleagues and friends, Dr. Kwang-Ho Bae and Dr. David Belton for their continuing support. I am also thankful to Dr. Ritu Gupta at the Department of Mathematics and Statistics for her mentoring and support, and for providing me with employment opportunities during my time at the Curtin University of Technology. I would also like to thank Prof. Gunnar Elgered (Onsala Space Observatory), Mr. Walter Schwarz (Fundamentalstation Wettzell), and the Bureau of Meteorology for providing all the radiosonde and water vapour radiometer data that were necessary to complete my analysis. I would like to acknowledge Curtin University and the Bureau of Meteorology for awarding me with the Australian Postgraduate Award Industry (APAI) scholarship. I would like to sincerely thank my brother Jeff, my sisters Karen and Susan, and in particular, my parents for their encouragement and patience. Finally, I am eternally grateful to my wife, Wendy, for all her love and support during these past few years. v

Research paper thumbnail of Increasing Food Expenditure in Long Day-Care by an Extra $0.50 Per Child/Day Would Improve Core Food Group Provision

Nutrients, 2020

Early childhood education and care services are a significant feature of Australian family life, ... more Early childhood education and care services are a significant feature of Australian family life, where nearly 1.4 million children attended a service in 2019. This paper reports on the cost of food provided to children in long day-care (LDC) services and extrapolates expenditure recommendations to support food provision compliance. A cross-sectional audit of LDC services in metropolitan Perth was conducted to determine food group provision by weighing raw ingredients of meal preparation—morning tea, lunch, and afternoon tea (MT, L, AT). Ingredients were costed at 2017 online metropolitan pricing from a large supermarket chain. Across participating services, 2 days of food expenditure per child/day ranged between 1.17and1.17 and 1.17and4.03 across MT, L, AT, and averaged 2.00perchild/day.Multivariableanalysissuggeststhatanincreaseof2.00 per child/day. Multivariable analysis suggests that an increase of 2.00perchild/day.Multivariableanalysissuggeststhatanincreaseof0.50 per child/day increases the odds of a LDC service meeting >50% of Australian Dietary Guideline (ADG) recommendations across ≥4 core food groups by...

Research paper thumbnail of Definitions, Sources and Self-Reported Consumption of Regionally Grown Fruits and Vegetables in Two Regions of Australia

Nutrients, 2020

Regional food systems are complex networks, with numerous retail sources that underpin a local ec... more Regional food systems are complex networks, with numerous retail sources that underpin a local economy. However, evidence is limited regarding how consumers define, identify, and source regionally grown fresh fruits and vegetables (RGFFV). A cross-sectional study was conducted in Tasmania (TAS) and South Western Australia (SWA) to compare how RGFFV are defined, identified and sourced by consumers, including self-reported consumption of selected RGFFV. Survey data were analyzed using the Chi-square test and t-tests. Results (TAS n = 120, SWA n = 123) identified that consumers had mixed perceptions of how RGFFV are defined, including produce sold at farmers markets, or grown within their region (TAS/SWA). RGFFV were commonly identified using product labelling (55% TAS, 69% SWA; p > 0.05). Respondents reported frequently shopping for RGFFV at major supermarkets, with more TAS respondents shopping weekly in comparison to SWA respondents (67% vs. 38%; p < 0.001). Supermarkets offer...

Research paper thumbnail of FP12.07 Prognostic Value of HLA-I Homozygosity in Non-Small Cell Lung Cancer Patients Treated with Single Agent Immunotherapy

Journal of Thoracic Oncology, 2021

results indicate that low TMB or presence of HLA B27 and HLA B*15:02 were associated with primary... more results indicate that low TMB or presence of HLA B27 and HLA B*15:02 were associated with primary resistance to ICIs. For acquired resistance to ICIs, known mutations were found when disease progressed on ICIs (3/25), including B2M p.W80*, B2M p.L15Ffs*41 and JAK1 p.L235I (Figure 1G). One patient had PFS of 11.2 months with acquired B2M mutation p.L15Ffs*41 detected only in post-progression sample (Figure 1H). Conclusion: In Chinese advanced NSCLC, low TNB and presence of HLA B*15:02 and supertype B27 are biomarkers of primary resistance to ICIs, implying TNB and HLA genotypes can help screen patients with greater clinical benefit from immunotherapy in addition to PD-L1. Known mutations of acquired resistance to ICIs are found in few samples, other molecular mechanisms need to be explored to understand acquired resistance to ICIs.

Research paper thumbnail of Dual tasking impairments are associated with striatal pathology in Huntington’s disease

Annals of Clinical and Translational Neurology, 2020

Background: Recent findings suggest that individuals with Huntington's disease (HD) have an impai... more Background: Recent findings suggest that individuals with Huntington's disease (HD) have an impaired capacity to execute cognitive and motor tasks simultaneously, or dual task, which gradually worsens as the disease advances. The onset and neuropathological changes mediating impairments in dual tasking in individuals with HD are unclear. The reliability of dual tasking assessments for individuals with HD is also unclear. Objectives: To evaluate differences in dual tasking performance between individuals with HD (presymptomatic and prodromal) and matched controls, to investigate associations between striatal volume and dual tasking performance, and to determine the reliability of dual tasking assessments. Methods: Twenty individuals with HD (10 presymptomatic and 10 prodromal) and 20 healthy controls were recruited for the study. Individuals undertook four single and dual task assessments, comprising motor (postural stability or force steadiness) and cognitive (simple or complex mental arithmetic) components, with single and dual tasks performed three times each. Participants also undertook a magnetic resonance imaging assessment. Results: Compared to healthy controls, individuals with presymptomatic and prodromal HD displayed significant deficits in dual tasking, particularly cognitive task performance when concurrently undertaking motor tasks (P < 0.05). The observed deficits in dual tasking were associated with reduced volume in caudate and putamen structures (P < 0.05),however, not with clinical measures of disease burden. An analysis of the reliability of dual tasking assessments revealed moderate to high test-retest reliability [ICC: 0.61-0.99] for individuals with presymptomatic and prodromal HD and healthy controls. Conclusions: Individuals with presymptomatic and prodromal HD have significant deficits in dual tasking that are associated with striatal degeneration. Findings also indicate that dual tasking assessments are reliable in individuals presymptomatic and prodromal HD and healthy controls.

Research paper thumbnail of Prognostic value of HLA-I homozygosity in patients with non-small cell lung cancer treated with single agent immunotherapy

Journal for ImmunoTherapy of Cancer, 2020

BackgroundWe aimed to assess the impact of genomic human leukocyte antigen (HLA)-I/II homozygosit... more BackgroundWe aimed to assess the impact of genomic human leukocyte antigen (HLA)-I/II homozygosity on the survival benefit of patients with unresectable locally advanced, metastatic non-small lung cancer treated by single-agent programmed cell death protein-1/programmed death ligand 1 (PD1/PDL1) inhibitors.MethodsWe collected blood from 170 patients with advanced lung cancer treated with immunotherapy at two major oncology centers in Western Australia. Genomic DNA was extracted from white blood cells and used for HLA-I/II high-resolution typing. HLA-I/II homozygosity was tested for association with survival outcomes. Univariable and multivariable Cox regression models were constructed to determine whether HLA homozygosity was an independent prognostic factor affecting Overall Survival (OS) and Progression Free Survival (PFS). We also investigated the association between individual HLA-A and -B supertypes with OS.ResultsHomozygosity at HLA-I loci, but not HLA-II, was significantly as...

Research paper thumbnail of To dine in or not to dine in: A comparison of food selection and preparation behaviours in those with and without food security

Health Promotion Journal of Australia, 2020

This is an open access article under the terms of the Creative Commons Attribution License, which... more This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Research paper thumbnail of Australian Consumers Are Willing to Pay for the Health Star Rating Front-of-Pack Nutrition Label

Nutrients, 2020

The Australia and New Zealand Ministerial Forum on Food Regulation has supported the recommendati... more The Australia and New Zealand Ministerial Forum on Food Regulation has supported the recommendations set out in the 2019 Health Star Rating System Five Year Review Report. Specifically, the forum supported, in principle, Recommendation 9, to mandate the Health Star Rating if clear uptake targets were not achieved while the system is voluntary. Given that mandatory labelling is being considered, it is important to investigate how much consumers value the Health Star Rating in order to understand potential consumer uptake and inform industry. The aim of this study was to assess consumers’ valuation of the Health Star Rating system by analysing their willingness to pay for a packaged food product with the Health Star Rating label, utilising a double-bounded dichotomous choice contingent valuation approach. The results indicate that almost two-thirds of Australian household grocery shoppers were willing to pay more for a product with the Health Star Rating, on average up to an additiona...

Research paper thumbnail of The study protocol for a pseudo-randomised pre-post designed controlled intervention trial to study the effects of a 7-week cooking program on self-efficacy and biomarkers of health: the ECU lifestyle and biomarkers get connected study (ECULABJMOF) including the Jamie’s Ministry of Food WA partic...

BMC Public Health, 2020

Background Australia, like other nations, has experienced a shift in dietary patterns away from h... more Background Australia, like other nations, has experienced a shift in dietary patterns away from home cooking of nutritious foods, towards a reliance on pre-prepared convenience meals. These are typically energy-dense, nutrient-poor and contribute to the rising prevalence of obesity and chronic disease burden. The aims of this study were to evaluate whether a community-based cooking program instigated a change to participants’ skills, attitudes, knowledge, enjoyment and satisfaction of cooking and cooking confidence (self-efficacy). Methods The pseudo-random, pre-post study design consisted of an intervention and a control group. Participant recruitment and group allocation was based on their program start dates. Intervention participants were surveyed three times (baseline, 7 weeks and 6 months) and the control group were surveyed at baseline and 5 weeks. All participants were registered via an online website and were 18 years or over. Upon consent, participants were offered four le...

Research paper thumbnail of The relationship between lifestyle and serum neurofilament light protein in Huntington’s disease

Brain and Behavior, 2020

This is an open access article under the terms of the Creative Commons Attribution License, which... more This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Research paper thumbnail of Australian Consumer Perceptions of Regionally Grown Fruits and Vegetables: Importance, Enablers, and Barriers

International Journal of Environmental Research and Public Health, 2019

Fresh fruits and vegetables are a cornerstone of a balanced diet; their consumption has health, e... more Fresh fruits and vegetables are a cornerstone of a balanced diet; their consumption has health, environmental, ethical, and economic implications. This pilot study aimed to: (i) measure fruit and vegetable consumption; (ii) understand consumer perceptions of the perceived importance of regionally grown fresh fruit and vegetables (RGFFV); and (iii) identify the barriers and enablers of access and consumption of RGFFV. The study took place in Tasmania (TAS) and South Western Australia (SWA). A 54-item survey included questions relating to purchasing and consumption patterns; barriers and enablers related to access and consumption of RGFFV; and sociodemographic information. Survey data were analyzed using Chi-square test and binary logistic regression. A total of n = 120 TAS and n = 123 SWA adult respondents participated. SWA respondents had higher intakes of fruit (p < 0.001) and vegetables (p < 0.001). Almost all respondents (97%) rated purchasing of RGFFV as important. Top ena...

Research paper thumbnail of PD-L1 Expression on Circulating Tumor Cells May Be Predictive of Response to Pembrolizumab in Advanced Melanoma: Results from a Pilot Study

The Oncologist, 2019

Background PD-1 inhibitors are routinely used for the treatment of advanced melanoma. This study ... more Background PD-1 inhibitors are routinely used for the treatment of advanced melanoma. This study sought to determine whether PD-L1 expression on circulating tumor cells (CTCs) can serve as a predictive biomarker of clinical benefit and response to treatment with the PD-1 inhibitor pembrolizumab. Methods Blood samples were collected from patients with metastatic melanoma receiving pembrolizumab, prior to treatment and 6–12 weeks after initiation of therapy. Multiparametric flow cytometry was used to identify CTCs and evaluate the expression of PD-L1. Results CTCs were detected in 25 of 40 patients (63%). Patients with detectable PD-L1+ CTCs (14/25, 64%) had significantly longer progression-free survival (PFS) compared with patients with PD-L1− CTCs (26.6 months vs. 5.5 months; p = .018). The 12-month PFS rates were 76% versus 22% in the PD-L1+ versus PD-L1− CTCs groups (p = .012), respectively. A multivariate linear regression analysis confirmed that PD-L1+ CTC is an independent pred...

Research paper thumbnail of Measuring food provision in Western Australian long day care (LDC) services: a weighed food record method/protocol at a service level

Nutrition Journal, 2019

Background: There are currently 1.3 million children utilising Early Childhood Education and Care... more Background: There are currently 1.3 million children utilising Early Childhood Education and Care (ECEC) services in Australia. Long day care (LDC), family day care and out of school hours care currently provide this service in different environments. This research reports findings from a LDC perspective. Children can consume 40-67% of their food intake whilst at LDC services, this highlights the importance of monitoring food provision at a service level. There are several methods to measure food provision which typically focus on intake at an individual level. There is limited evidence of measuring food provision accurately at a service level and for young children. Accurate and consistent dietary assessment methods are required to determine compliance with dietary guidelines and to provide rigour for comparison between studies. Methods: Convenience sampling was used to recruit 30 LDC services and food provision assessed over two consecutive days. To ensure consistency, trained researchers weighed raw food ingredients used in food preparation at each service. Food and food weights were allocated to food groups to determine average serves of food group provision at morning tea, lunch and afternoon tea per child. All data were entered into Foodworks for dietary analysis and compliance with dietary guidelines was assessed using Wilcoxon signed-rank and one-sample t-tests (SPSS). Discussion: This paper outlines the process of data collection for the measurement and auditing of food provision and food waste at a service level. There is an urgent need to ensure that food provision at a service level complies with current dietary guidelines and is accurately assessed. Following a standard method of data collection will allow a more accurate comparison between studies and allow change to be monitored more accurately over time to guide decision makers. Trial registration: As this research project is conducted at a service level and not a clinical trial, registration was not required.

Research paper thumbnail of Long-term Paleolithic diet is associated with lower resistant starch intake, different gut microbiota composition and increased serum TMAO concentrations

European Journal of Nutrition, 2019

Background The Paleolithic diet is promoted worldwide for improved gut health. However, there is ... more Background The Paleolithic diet is promoted worldwide for improved gut health. However, there is little evidence available to support these claims, with existing literature examining anthropometric and cardiometabolic outcomes. Objective To determine the association between dietary intake, markers of colonic health, microbiota, and serum trimethylamine-N-oxide (TMAO), a gut-derived metabolite associated with cardiovascular disease. Design In a cross-sectional design, long-term (n = 44, > 1 year) self-reported followers of a Paleolithic diet (PD) and controls (n = 47) consuming a diet typical of national recommendations were recruited. Diets were assessed via 3-day weighed diet records; 48-h stool for short chain fatty acids using GC/MS, microbial composition via 16S rRNA sequencing of the V4 region using Illumina MiSeq. TMAO was quantified using LC–MS/MS. Results Participants were grouped according to PD adherence; namely excluding grains and dairy products. Strict Paleolithic (S...

Research paper thumbnail of Food-Insecure Household’s Self-Reported Perceptions of Food Labels, Product Attributes and Consumption Behaviours

Nutrients, 2019

Dietary compromises related to food insecurity profoundly undermine health and constitute a serio... more Dietary compromises related to food insecurity profoundly undermine health and constitute a serious public health issue, even in developed nations. The aim of this study was to explore the impact of food labelling and product attributes on the purchasing choices of food-insecure households in Australia. An online survey containing 19 food choice and 28 purchasing behaviours questions was completed by 1056 adults responsible for household grocery shopping. The short form of the US Household Food Security Survey Module was used as the food security indicator. Multinomial logistic regression modelling was employed to analyse the survey data. Respondents were classified as having either high-marginal (63.4%, n = 670), low (19.8%, n = 209) or very low (16.8%, n = 177) food security. Respondents with low or very low food security status were less likely to self-report understanding the information on the back of packaging (p < 0.001), find information on food labels useful (p = 0.002) ...

Research paper thumbnail of The impact of whey protein supplementation in older adults on nutrient intakes and satiety over an 11-week exercise intervention

Food Quality and Preference, 2018

The impact of whey protein supplementation in older adults on nutrient intakes and satiety over a... more The impact of whey protein supplementation in older adults on nutrient intakes and satiety over an 11-week exercise intervention

Research paper thumbnail of Development and validation of a simple LC-MS/MS method for the simultaneous quantitative determination of trimethylamine-N-oxide and branched chain amino acids in human serum

Analytical and Bioanalytical Chemistry, 2018

Serum branched chain amino acids and trimethylamine-N-oxide are monitored as potential indicators... more Serum branched chain amino acids and trimethylamine-N-oxide are monitored as potential indicators of diabetes and cardiovascular health respectively. A rapid method for their simultaneous determination using liquid chromatography and tandem mass spectrometry is described here. Branched chain amino acids and trimethylamine-N-oxide were quantified based on their specific MS/MS fragments using a selected reaction monitoring approach. A number of columns were tested for their ability to separate the analytes. A C18-PFP column separated the analytes in just 4 minutes, and resulted in excellent peak shape and retention time repeatability, and was therefore chosen as the optimal column. A second column, the Intrada Amino Acid column, was chosen for comparison and validation experiments as it provided an orthogonal separation mechanism. The intra-day and inter-day precision and accuracy were less than 12% for trimethylamine-N-oxide and less than 6% for the branched chain amino acids. Recoveries, where serum was spiked with three different concentrations of the analytes, ranged from 97 to 113%. The LODs and LOQs for trimethylamine-N-oxide were 1 and 6 ng/mL, for leucine and isoleucine were 4 and 8 ng/mL, and for valine were 5 and 15 ng/mL, respectively. The C18-PFP column method was validated using the Intrada Amino Acid column method and percentage agreement for all four analytes was within 10%. Sample preparation was minimal, and use of labelled internal standards accounted for matrix effects. The method was successfully applied to human plasma samples.

Research paper thumbnail of Food Supply Impacts and Solutions Associated with the COVID-19 Pandemic: A Regional Australian Case Study

International Journal of Environmental Research and Public Health

This study aimed to explore how food supply chains were impacted by COVID-19 and identify how the... more This study aimed to explore how food supply chains were impacted by COVID-19 and identify how the region could be better prepared for future crises. An online survey was completed by 107 consumers. In-depth interviews were conducted with 27 food supply stakeholders working in food production, distribution, retail, hospitality, institutions (i.e., childcare), logistics/freight and local government. Pre-COVID-19, farmer-direct distribution options and hospitality businesses comprised a substantial proportion of local food producer businesses. During the COVID-19 pandemic, consumers favoured local food supply options, farmers collaborated, and produce usually destined for export was redirected into local markets. Critical food supply actions included keeping borders open to food freight, enhancing social capital through real-time business communication, and business flexibility. Solutions included business adaptation, for example, farmers selling produce boxes and hospitality businesse...

Research paper thumbnail of Predictors of nutrition care process knowledge and use among dietitians internationally

Journal of Human Nutrition and Dietetics, 2021

BACKGROUND The nutrition care process (NCP) and its associated standardised terminology (NCPT, re... more BACKGROUND The nutrition care process (NCP) and its associated standardised terminology (NCPT, referred to collectively as NCP/T) forms a problem-solving framework fundamental to dietetic practice. Global implementation would assist in confirming outcomes from dietetic care, but implementation rates have varied between countries. We investigated which factors predict NCP/T knowledge and use among dietetic professionals in an international cohort, aiming to understand how implementation can be strengthened. METHODS The validated International NCP Implementation Survey was disseminated to dietitians in 10 countries via professional networks. Implementation, attitudes and knowledge of the NCP/T along with workplace and educational data were assessed. Independent predictive factors associated with higher NCP/T knowledge and use were identified using backward stepwise logistic regression. RESULTS Data from 6149 respondents was used for this analysis. Enablers that were independent predictors of both high knowledge and frequent use of NCP/T were peer support, recommendation from national dietetic association and workplace requirements (all p < 0.001). Country of residence and working in clinical settings (p < 0.001) were demographic characteristics that were independent predictors of high knowledge and frequent use of NCP/T. A high knowledge score was an independent predictor of frequent NCP/T use (p = 0.002). CONCLUSIONS Important modifiable enablers for NCP knowledge and use rely on organisational management. National dietetic organisations and key stakeholders such as employers are encouraged to integrate active NCP/T support in their leadership initiatives. This could take the form of policies, formalised and structured training strategies, and informatics initiatives for the integration in electronic health records.

Research paper thumbnail of Author response for "The relationship between lifestyle and serum neurofilament light protein in Huntington’s disease

Research paper thumbnail of Estimation of tropospheric wet delay from GNSS measurements

and support throughout the course of my study. Special mention also for my cosupervisors Prof. Wi... more and support throughout the course of my study. Special mention also for my cosupervisors Prof. Will Featherstone and Dr. Joseph Awange. This would not be possible without their advice and support. I would also like to extend my appreciation to Dr. Nigel Penna for his supervision early on in my study. Furthermore, I would like to express my appreciation to Dr. Congwei Hu for providing the PPP program needed to perform the analysis of the dynamic models. Special thanks also go to the Head of the Department of Spatial Sciences, Prof. Bert Veenendaal, Associate Prof. Jon Kirby and the rest of the staff members for the encouragement and help during my study. I am grateful to my colleagues and friends, Dr. Kwang-Ho Bae and Dr. David Belton for their continuing support. I am also thankful to Dr. Ritu Gupta at the Department of Mathematics and Statistics for her mentoring and support, and for providing me with employment opportunities during my time at the Curtin University of Technology. I would also like to thank Prof. Gunnar Elgered (Onsala Space Observatory), Mr. Walter Schwarz (Fundamentalstation Wettzell), and the Bureau of Meteorology for providing all the radiosonde and water vapour radiometer data that were necessary to complete my analysis. I would like to acknowledge Curtin University and the Bureau of Meteorology for awarding me with the Australian Postgraduate Award Industry (APAI) scholarship. I would like to sincerely thank my brother Jeff, my sisters Karen and Susan, and in particular, my parents for their encouragement and patience. Finally, I am eternally grateful to my wife, Wendy, for all her love and support during these past few years. v

Research paper thumbnail of Increasing Food Expenditure in Long Day-Care by an Extra $0.50 Per Child/Day Would Improve Core Food Group Provision

Nutrients, 2020

Early childhood education and care services are a significant feature of Australian family life, ... more Early childhood education and care services are a significant feature of Australian family life, where nearly 1.4 million children attended a service in 2019. This paper reports on the cost of food provided to children in long day-care (LDC) services and extrapolates expenditure recommendations to support food provision compliance. A cross-sectional audit of LDC services in metropolitan Perth was conducted to determine food group provision by weighing raw ingredients of meal preparation—morning tea, lunch, and afternoon tea (MT, L, AT). Ingredients were costed at 2017 online metropolitan pricing from a large supermarket chain. Across participating services, 2 days of food expenditure per child/day ranged between 1.17and1.17 and 1.17and4.03 across MT, L, AT, and averaged 2.00perchild/day.Multivariableanalysissuggeststhatanincreaseof2.00 per child/day. Multivariable analysis suggests that an increase of 2.00perchild/day.Multivariableanalysissuggeststhatanincreaseof0.50 per child/day increases the odds of a LDC service meeting >50% of Australian Dietary Guideline (ADG) recommendations across ≥4 core food groups by...

Research paper thumbnail of Definitions, Sources and Self-Reported Consumption of Regionally Grown Fruits and Vegetables in Two Regions of Australia

Nutrients, 2020

Regional food systems are complex networks, with numerous retail sources that underpin a local ec... more Regional food systems are complex networks, with numerous retail sources that underpin a local economy. However, evidence is limited regarding how consumers define, identify, and source regionally grown fresh fruits and vegetables (RGFFV). A cross-sectional study was conducted in Tasmania (TAS) and South Western Australia (SWA) to compare how RGFFV are defined, identified and sourced by consumers, including self-reported consumption of selected RGFFV. Survey data were analyzed using the Chi-square test and t-tests. Results (TAS n = 120, SWA n = 123) identified that consumers had mixed perceptions of how RGFFV are defined, including produce sold at farmers markets, or grown within their region (TAS/SWA). RGFFV were commonly identified using product labelling (55% TAS, 69% SWA; p > 0.05). Respondents reported frequently shopping for RGFFV at major supermarkets, with more TAS respondents shopping weekly in comparison to SWA respondents (67% vs. 38%; p < 0.001). Supermarkets offer...

Research paper thumbnail of FP12.07 Prognostic Value of HLA-I Homozygosity in Non-Small Cell Lung Cancer Patients Treated with Single Agent Immunotherapy

Journal of Thoracic Oncology, 2021

results indicate that low TMB or presence of HLA B27 and HLA B*15:02 were associated with primary... more results indicate that low TMB or presence of HLA B27 and HLA B*15:02 were associated with primary resistance to ICIs. For acquired resistance to ICIs, known mutations were found when disease progressed on ICIs (3/25), including B2M p.W80*, B2M p.L15Ffs*41 and JAK1 p.L235I (Figure 1G). One patient had PFS of 11.2 months with acquired B2M mutation p.L15Ffs*41 detected only in post-progression sample (Figure 1H). Conclusion: In Chinese advanced NSCLC, low TNB and presence of HLA B*15:02 and supertype B27 are biomarkers of primary resistance to ICIs, implying TNB and HLA genotypes can help screen patients with greater clinical benefit from immunotherapy in addition to PD-L1. Known mutations of acquired resistance to ICIs are found in few samples, other molecular mechanisms need to be explored to understand acquired resistance to ICIs.

Research paper thumbnail of Dual tasking impairments are associated with striatal pathology in Huntington’s disease

Annals of Clinical and Translational Neurology, 2020

Background: Recent findings suggest that individuals with Huntington's disease (HD) have an impai... more Background: Recent findings suggest that individuals with Huntington's disease (HD) have an impaired capacity to execute cognitive and motor tasks simultaneously, or dual task, which gradually worsens as the disease advances. The onset and neuropathological changes mediating impairments in dual tasking in individuals with HD are unclear. The reliability of dual tasking assessments for individuals with HD is also unclear. Objectives: To evaluate differences in dual tasking performance between individuals with HD (presymptomatic and prodromal) and matched controls, to investigate associations between striatal volume and dual tasking performance, and to determine the reliability of dual tasking assessments. Methods: Twenty individuals with HD (10 presymptomatic and 10 prodromal) and 20 healthy controls were recruited for the study. Individuals undertook four single and dual task assessments, comprising motor (postural stability or force steadiness) and cognitive (simple or complex mental arithmetic) components, with single and dual tasks performed three times each. Participants also undertook a magnetic resonance imaging assessment. Results: Compared to healthy controls, individuals with presymptomatic and prodromal HD displayed significant deficits in dual tasking, particularly cognitive task performance when concurrently undertaking motor tasks (P < 0.05). The observed deficits in dual tasking were associated with reduced volume in caudate and putamen structures (P < 0.05),however, not with clinical measures of disease burden. An analysis of the reliability of dual tasking assessments revealed moderate to high test-retest reliability [ICC: 0.61-0.99] for individuals with presymptomatic and prodromal HD and healthy controls. Conclusions: Individuals with presymptomatic and prodromal HD have significant deficits in dual tasking that are associated with striatal degeneration. Findings also indicate that dual tasking assessments are reliable in individuals presymptomatic and prodromal HD and healthy controls.

Research paper thumbnail of Prognostic value of HLA-I homozygosity in patients with non-small cell lung cancer treated with single agent immunotherapy

Journal for ImmunoTherapy of Cancer, 2020

BackgroundWe aimed to assess the impact of genomic human leukocyte antigen (HLA)-I/II homozygosit... more BackgroundWe aimed to assess the impact of genomic human leukocyte antigen (HLA)-I/II homozygosity on the survival benefit of patients with unresectable locally advanced, metastatic non-small lung cancer treated by single-agent programmed cell death protein-1/programmed death ligand 1 (PD1/PDL1) inhibitors.MethodsWe collected blood from 170 patients with advanced lung cancer treated with immunotherapy at two major oncology centers in Western Australia. Genomic DNA was extracted from white blood cells and used for HLA-I/II high-resolution typing. HLA-I/II homozygosity was tested for association with survival outcomes. Univariable and multivariable Cox regression models were constructed to determine whether HLA homozygosity was an independent prognostic factor affecting Overall Survival (OS) and Progression Free Survival (PFS). We also investigated the association between individual HLA-A and -B supertypes with OS.ResultsHomozygosity at HLA-I loci, but not HLA-II, was significantly as...

Research paper thumbnail of To dine in or not to dine in: A comparison of food selection and preparation behaviours in those with and without food security

Health Promotion Journal of Australia, 2020

This is an open access article under the terms of the Creative Commons Attribution License, which... more This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Research paper thumbnail of Australian Consumers Are Willing to Pay for the Health Star Rating Front-of-Pack Nutrition Label

Nutrients, 2020

The Australia and New Zealand Ministerial Forum on Food Regulation has supported the recommendati... more The Australia and New Zealand Ministerial Forum on Food Regulation has supported the recommendations set out in the 2019 Health Star Rating System Five Year Review Report. Specifically, the forum supported, in principle, Recommendation 9, to mandate the Health Star Rating if clear uptake targets were not achieved while the system is voluntary. Given that mandatory labelling is being considered, it is important to investigate how much consumers value the Health Star Rating in order to understand potential consumer uptake and inform industry. The aim of this study was to assess consumers’ valuation of the Health Star Rating system by analysing their willingness to pay for a packaged food product with the Health Star Rating label, utilising a double-bounded dichotomous choice contingent valuation approach. The results indicate that almost two-thirds of Australian household grocery shoppers were willing to pay more for a product with the Health Star Rating, on average up to an additiona...

Research paper thumbnail of The study protocol for a pseudo-randomised pre-post designed controlled intervention trial to study the effects of a 7-week cooking program on self-efficacy and biomarkers of health: the ECU lifestyle and biomarkers get connected study (ECULABJMOF) including the Jamie’s Ministry of Food WA partic...

BMC Public Health, 2020

Background Australia, like other nations, has experienced a shift in dietary patterns away from h... more Background Australia, like other nations, has experienced a shift in dietary patterns away from home cooking of nutritious foods, towards a reliance on pre-prepared convenience meals. These are typically energy-dense, nutrient-poor and contribute to the rising prevalence of obesity and chronic disease burden. The aims of this study were to evaluate whether a community-based cooking program instigated a change to participants’ skills, attitudes, knowledge, enjoyment and satisfaction of cooking and cooking confidence (self-efficacy). Methods The pseudo-random, pre-post study design consisted of an intervention and a control group. Participant recruitment and group allocation was based on their program start dates. Intervention participants were surveyed three times (baseline, 7 weeks and 6 months) and the control group were surveyed at baseline and 5 weeks. All participants were registered via an online website and were 18 years or over. Upon consent, participants were offered four le...

Research paper thumbnail of The relationship between lifestyle and serum neurofilament light protein in Huntington’s disease

Brain and Behavior, 2020

This is an open access article under the terms of the Creative Commons Attribution License, which... more This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Research paper thumbnail of Australian Consumer Perceptions of Regionally Grown Fruits and Vegetables: Importance, Enablers, and Barriers

International Journal of Environmental Research and Public Health, 2019

Fresh fruits and vegetables are a cornerstone of a balanced diet; their consumption has health, e... more Fresh fruits and vegetables are a cornerstone of a balanced diet; their consumption has health, environmental, ethical, and economic implications. This pilot study aimed to: (i) measure fruit and vegetable consumption; (ii) understand consumer perceptions of the perceived importance of regionally grown fresh fruit and vegetables (RGFFV); and (iii) identify the barriers and enablers of access and consumption of RGFFV. The study took place in Tasmania (TAS) and South Western Australia (SWA). A 54-item survey included questions relating to purchasing and consumption patterns; barriers and enablers related to access and consumption of RGFFV; and sociodemographic information. Survey data were analyzed using Chi-square test and binary logistic regression. A total of n = 120 TAS and n = 123 SWA adult respondents participated. SWA respondents had higher intakes of fruit (p < 0.001) and vegetables (p < 0.001). Almost all respondents (97%) rated purchasing of RGFFV as important. Top ena...

Research paper thumbnail of PD-L1 Expression on Circulating Tumor Cells May Be Predictive of Response to Pembrolizumab in Advanced Melanoma: Results from a Pilot Study

The Oncologist, 2019

Background PD-1 inhibitors are routinely used for the treatment of advanced melanoma. This study ... more Background PD-1 inhibitors are routinely used for the treatment of advanced melanoma. This study sought to determine whether PD-L1 expression on circulating tumor cells (CTCs) can serve as a predictive biomarker of clinical benefit and response to treatment with the PD-1 inhibitor pembrolizumab. Methods Blood samples were collected from patients with metastatic melanoma receiving pembrolizumab, prior to treatment and 6–12 weeks after initiation of therapy. Multiparametric flow cytometry was used to identify CTCs and evaluate the expression of PD-L1. Results CTCs were detected in 25 of 40 patients (63%). Patients with detectable PD-L1+ CTCs (14/25, 64%) had significantly longer progression-free survival (PFS) compared with patients with PD-L1− CTCs (26.6 months vs. 5.5 months; p = .018). The 12-month PFS rates were 76% versus 22% in the PD-L1+ versus PD-L1− CTCs groups (p = .012), respectively. A multivariate linear regression analysis confirmed that PD-L1+ CTC is an independent pred...

Research paper thumbnail of Measuring food provision in Western Australian long day care (LDC) services: a weighed food record method/protocol at a service level

Nutrition Journal, 2019

Background: There are currently 1.3 million children utilising Early Childhood Education and Care... more Background: There are currently 1.3 million children utilising Early Childhood Education and Care (ECEC) services in Australia. Long day care (LDC), family day care and out of school hours care currently provide this service in different environments. This research reports findings from a LDC perspective. Children can consume 40-67% of their food intake whilst at LDC services, this highlights the importance of monitoring food provision at a service level. There are several methods to measure food provision which typically focus on intake at an individual level. There is limited evidence of measuring food provision accurately at a service level and for young children. Accurate and consistent dietary assessment methods are required to determine compliance with dietary guidelines and to provide rigour for comparison between studies. Methods: Convenience sampling was used to recruit 30 LDC services and food provision assessed over two consecutive days. To ensure consistency, trained researchers weighed raw food ingredients used in food preparation at each service. Food and food weights were allocated to food groups to determine average serves of food group provision at morning tea, lunch and afternoon tea per child. All data were entered into Foodworks for dietary analysis and compliance with dietary guidelines was assessed using Wilcoxon signed-rank and one-sample t-tests (SPSS). Discussion: This paper outlines the process of data collection for the measurement and auditing of food provision and food waste at a service level. There is an urgent need to ensure that food provision at a service level complies with current dietary guidelines and is accurately assessed. Following a standard method of data collection will allow a more accurate comparison between studies and allow change to be monitored more accurately over time to guide decision makers. Trial registration: As this research project is conducted at a service level and not a clinical trial, registration was not required.

Research paper thumbnail of Long-term Paleolithic diet is associated with lower resistant starch intake, different gut microbiota composition and increased serum TMAO concentrations

European Journal of Nutrition, 2019

Background The Paleolithic diet is promoted worldwide for improved gut health. However, there is ... more Background The Paleolithic diet is promoted worldwide for improved gut health. However, there is little evidence available to support these claims, with existing literature examining anthropometric and cardiometabolic outcomes. Objective To determine the association between dietary intake, markers of colonic health, microbiota, and serum trimethylamine-N-oxide (TMAO), a gut-derived metabolite associated with cardiovascular disease. Design In a cross-sectional design, long-term (n = 44, > 1 year) self-reported followers of a Paleolithic diet (PD) and controls (n = 47) consuming a diet typical of national recommendations were recruited. Diets were assessed via 3-day weighed diet records; 48-h stool for short chain fatty acids using GC/MS, microbial composition via 16S rRNA sequencing of the V4 region using Illumina MiSeq. TMAO was quantified using LC–MS/MS. Results Participants were grouped according to PD adherence; namely excluding grains and dairy products. Strict Paleolithic (S...

Research paper thumbnail of Food-Insecure Household’s Self-Reported Perceptions of Food Labels, Product Attributes and Consumption Behaviours

Nutrients, 2019

Dietary compromises related to food insecurity profoundly undermine health and constitute a serio... more Dietary compromises related to food insecurity profoundly undermine health and constitute a serious public health issue, even in developed nations. The aim of this study was to explore the impact of food labelling and product attributes on the purchasing choices of food-insecure households in Australia. An online survey containing 19 food choice and 28 purchasing behaviours questions was completed by 1056 adults responsible for household grocery shopping. The short form of the US Household Food Security Survey Module was used as the food security indicator. Multinomial logistic regression modelling was employed to analyse the survey data. Respondents were classified as having either high-marginal (63.4%, n = 670), low (19.8%, n = 209) or very low (16.8%, n = 177) food security. Respondents with low or very low food security status were less likely to self-report understanding the information on the back of packaging (p < 0.001), find information on food labels useful (p = 0.002) ...

Research paper thumbnail of The impact of whey protein supplementation in older adults on nutrient intakes and satiety over an 11-week exercise intervention

Food Quality and Preference, 2018

The impact of whey protein supplementation in older adults on nutrient intakes and satiety over a... more The impact of whey protein supplementation in older adults on nutrient intakes and satiety over an 11-week exercise intervention

Research paper thumbnail of Development and validation of a simple LC-MS/MS method for the simultaneous quantitative determination of trimethylamine-N-oxide and branched chain amino acids in human serum

Analytical and Bioanalytical Chemistry, 2018

Serum branched chain amino acids and trimethylamine-N-oxide are monitored as potential indicators... more Serum branched chain amino acids and trimethylamine-N-oxide are monitored as potential indicators of diabetes and cardiovascular health respectively. A rapid method for their simultaneous determination using liquid chromatography and tandem mass spectrometry is described here. Branched chain amino acids and trimethylamine-N-oxide were quantified based on their specific MS/MS fragments using a selected reaction monitoring approach. A number of columns were tested for their ability to separate the analytes. A C18-PFP column separated the analytes in just 4 minutes, and resulted in excellent peak shape and retention time repeatability, and was therefore chosen as the optimal column. A second column, the Intrada Amino Acid column, was chosen for comparison and validation experiments as it provided an orthogonal separation mechanism. The intra-day and inter-day precision and accuracy were less than 12% for trimethylamine-N-oxide and less than 6% for the branched chain amino acids. Recoveries, where serum was spiked with three different concentrations of the analytes, ranged from 97 to 113%. The LODs and LOQs for trimethylamine-N-oxide were 1 and 6 ng/mL, for leucine and isoleucine were 4 and 8 ng/mL, and for valine were 5 and 15 ng/mL, respectively. The C18-PFP column method was validated using the Intrada Amino Acid column method and percentage agreement for all four analytes was within 10%. Sample preparation was minimal, and use of labelled internal standards accounted for matrix effects. The method was successfully applied to human plasma samples.