Lumpectomy Patients are at Highest Risk for Opioid Overprescription: A Comparison Between Practice Patterns and OPEN National Guidelines.

Background: Nearly 25% of opioid-related deaths are from prescribed opioids, and the exacerbation of the opioid epidemic by the coronavirus disease 2019 (COVID-19) pandemic underscores the urgent need to address superfluous prescribing. Therefore, we sought to align local opioid prescribing practices with national guidelines in postoperative non-metastatic breast cancer patients.

Methods: A single-institution analysis included non-metastatic breast surgery patients treated between April 2020 and July 2021.

Vibrio parahaemolyticus Foodborne Illness Associated with Oysters, Australia, 2021-2022.

The bacterium Vibrio parahaemolyticus is ubiquitous in tropical and temperate waters throughout the world and causes infections in humans resulting from water exposure and from ingestion of contaminated raw or undercooked seafood, such as oysters. We describe a nationwide outbreak of enteric infections caused by Vibrio parahaemolyticus in Australia during September 2021-January 2022. A total of 268 persons were linked with the outbreak, 97% of whom reported consuming Australia-grown oysters.

Antimicrobial prescribing in referral hospitals in Timor-Leste: results of the first two national point prevalence surveys, 2020-21.

Objectives: To describe antimicrobial use (AMU) in patients admitted to hospitals in Timor-Leste.

Methods: In 2020 and 2021, we undertook antimicrobial prescribing point prevalence surveys across all six hospitals in Timor-Leste (one national and five municipal) to describe AMU and appropriateness in admitted patients.

Results: In 2020, 291/394 (73.

Open-source code maps traumas for targeting interventions: Applying the model to compare penetrating traumas with "Stop the Bleed" training locations.

Background: To improve equitable access to geospatial analysis, a free open-source R package, called Rosymap, was created to map trauma incident locations.

Methods: To demonstrate the R package, penetrating trauma events for all patients who received care at a level one trauma center, and the locations of all "Stop the Bleed" training locations between 2019 and 2022 were geospatially analyzed.

Results: The level one trauma center treated 1531 patients for penetrating traumas between 2019 and 2022.

Vascular Access Team Central Line Dressing Changes to Reduce Infection Risk: A Focused Two-Person Approach in High-Risk Patients.

Due to low compliance by bedside nursing with a central line-associated bloodstream infection (CLABSI) prevention bundle and increased CLABSI rates, a mandatory re-education initiative at a 1200-bed university-affiliated hospital was undertaken. Despite this, 2 units, housing high-risk immunocompromised patients, continued to experience increased CLABSI rates. A quality improvement before-after project design in these units replaced bedside nursing staff with 2 nurses from the vascular access team (VAT) to perform central vascular access device (CVAD) dressing changes routinely every 7 days or earlier if needed.

The first confirmed human case of rabies, Timor-Leste, 2024.

In March 2024, the first ever human case of rabies, following a dog bite, was detected in Timor-Leste. This paper briefly discusses the circumstances of transmission, clinical presentation, palliative care of the case and public health measures taken. Timor-Leste was previously considered rabies-free.

Testing spatial working memory in pigs using an automated T-maze.

Pigs are an important large animal model for translational clinical research but underutilized in behavioral neuroscience. This is due, in part, to a lack of rigorous neurocognitive assessments for pigs. Here, we developed a new automated T-maze for pigs that takes advantage of their natural tendency to alternate.

The first confirmed outbreak of chikungunya reported in Timor-Leste, 2024.

Timor-Leste is a mountainous, half-island nation with a population of 1.3 million, which shares a land border with Indonesia and is 550 km from Darwin, Australia. Since independence in 2002, Timor-Leste has achieved significant development; however, high levels of poverty remain.

A brief description of the epidemiology of dengue in Dili, Timor-Leste, 2018-2022.

Dengue virus (DENV) infection causes 390 million infections per year and 40,000 deaths globally. It is endemic in many countries in Asia, Africa, the Americas, the Caribbean, and Oceania. Dengue is endemic in Timor-Leste year-round, but peak transmission occurs during the rainy season.

Familial rare EGFR-mutant lung cancer syndrome: Review of literature and description of R776H family.

Background: Interest in hereditary lung cancer is increasing, in particular germline mutations in the Epidermal Growth Factor Receptor (EGFR) gene. We review the current literature on this topic, discuss risk of developing lung cancer, treatment and screening options and describe a family of 3 sisters with lung cancer and their unaffected mother all with a rare EGFR germline mutation (EGFR p.R776H).

Impact of immunotherapy time-of-day infusion on survival and immunologic correlates in patients with metastatic renal cell carcinoma: a multicenter cohort analysis.

Background: Recent studies have demonstrated that earlier time-of-day infusion of immune checkpoint inhibitors (ICIs) is associated with longer progression-free survival (PFS) and overall survival (OS) among patients with metastatic melanoma and non-small cell lung cancer. These data are in line with growing preclinical evidence that the adaptive immune response may be more effectively stimulated earlier in the day. We sought to determine the impact of time-of-day ICI infusions on outcomes among patients with metastatic renal cell carcinoma (mRCC).

A pilot study using hospital surveillance and a birth cohort to investigate enteric pathogens and malnutrition in children, Dili, Timor-Leste.

In low-to-middle-income countries (LMICs), enteric pathogens contribute to child malnutrition, affecting nutrient absorption, inducing inflammation, and causing diarrhoea. This is a substantial problem in LMICs due to high disease burden, poor sanitation and nutritional status, and the cyclical nature of pathogen infection and malnutrition. This relationship remains understudied in Timor-Leste.

Lewis acid catalysed polymerisation of cyclopentenone.

A modest structural change of a β-diketiminate-supported aluminium complex leads to dramatic differences in the reactivity towards cyclopentenone. While the bulkier complex efficiently executes Diels Alder transformations the smaller analogue performs unique polymerisation of this substrate. This observation appears to be unprecedented in the chemistry of Lewis acids and cyclic dienophiles as it represents a unique way to polymerise a functionalised olefin.

Determining the impact of an artificial intelligence tool on the management of pulmonary nodules detected incidentally on CT (DOLCE) study protocol: a prospective, non-interventional multicentre UK study.

Introduction: In a small percentage of patients, pulmonary nodules found on CT scans are early lung cancers. Lung cancer detected at an early stage has a much better prognosis. The British Thoracic Society guideline on managing pulmonary nodules recommends using multivariable malignancy risk prediction models to assist in management.

Heterogeneity in the progression of retinal pathologies in mice harboring patient mimicking Impg2 mutations.

Biallelic mutations in interphotoreceptor matrix proteoglycan 2 (IMPG2) in humans cause retinitis pigmentosa (RP) with early macular involvement, albeit the disease progression varies widely due to genetic heterogeneity and IMPG2 mutation type. There are currently no treatments for IMPG2-RP. To aid preclinical studies toward eventual treatments, there is a need to better understand the progression of disease pathology in appropriate animal models.

A cluster of leptospirosis cases associated with crocodile workers in the Northern Territory, Australia, 2022.

Leptospirosis is a worldwide zoonotic waterborne disease endemic in tropical and subtropical climates. Outbreaks have been observed in the Northern Territory (NT) of Australia. We briefly described the epidemiology of leptospirosis in the NT between 2012 and 2022, and undertook an investigation of a cluster of three leptospirosis cases observed in crocodile workers between January and December 2022 in the Top End of the NT.

Impact of Integrated Pharmacology Instruction by Principal Faculty Pharmacists in Two Physician Assistant Programs: A Retrospective Study.

Purpose: In recent years, there has been a growing trend toward integrating pharmacology instruction into physician assistant (PA) programs by dedicated PA faculty pharmacists. Pharmacists train to become medication experts. Incorporating pharmacist instruction in a PA program during the didactic year provides PA students with an early opportunity to experience interprofessional education and interdisciplinary synergy through clinical application.

The response to COVID-19 in Timor-Leste: lessons learnt.

The response to the COVID-19 pandemic in Timor-Leste offers lessons that may be useful for incorporating into future responses to infectious disease outbreaks in similar resource-limited settings. In this paper, we identify nine key areas for learning from Timor-Leste's experience of the COVID-19 pandemic: (1) the importance of prior preparation for health emergencies, (2) the establishment of effective leadership and governance structures, (3) the protective impact of early border restrictions, (4) the rapid expansion of diagnostic laboratory capacity, (5) the impact of effective health communications in supporting the vaccine roll-out, (6) the opportunity to build capacity for clinical care, (7) the use of public health interventions that were found to have limited public health impact, (8) the broader effects of the pandemic and the public health response and (9) translation of lessons from COVID-19 to other public health priorities.

Seroprevalence and prevention of hepatitis B, measles and rubella among healthcare workers in Dili, Timor-Leste.

Introduction: The World Health Organisation recommends that healthcare workers (HCWs) are immune to measles and rubella, and those at risk of exposure are offered the hepatitis B vaccine. No formal programme for occupational assessment and provision of vaccinations to HCWs currently exists in Timor-Leste.

Methods: A cross-sectional study was undertaken to determine the seroprevalence of hepatitis B, measles and rubella among HCWs in Dili, Timor-Leste.

Vaccine Preventable Disease Seroprevalence in a Nationwide Assessment of Timor-Leste (VASINA-TL): study protocol for a population-representative cross-sectional serosurvey.

Introduction: Historic disruption in health infrastructure combined with data from a recent vaccine coverage survey suggests there are likely significant immunity gaps to vaccine preventable diseases and high risk of outbreaks in Timor-Leste. Community-based serological surveillance is an important tool to augment understanding of population-level immunity achieved through vaccine coverage and/or derived from prior infection.

Methods And Analysis: This national population-representative serosurvey will take a three-stage cluster sample and aims to include 5600 individuals above 1 year of age.

Transmission of canine transmissible venereal tumour between two dogs in the UK.

Canine transmissible venereal tumour (CTVT) is a contagious cancer spread by transfer of living cancer cells. Occasional cases are observed in the UK in dogs imported from endemic regions. Here, we report a case of imported canine transmissible venereal tumour that was transmitted to a second dog within the UK.