Disposable and sensitive electrochemical magneto-immunosensor for point-of-care HCV diagnostics: Targeting HCVcAg, the active viremia biomarker, in patient samples.

Early detection of hepatitis C virus (HCV) infection is crucial for eliminating this silent killer, especially in resource-limited settings. HCV core antigen (HCVcAg) represents a promising alternative to the current "gold standard" HCV RNA assays as an active viremia biomarker. Herein, a highly sensitive electrochemical magneto-immunosensor for the HCVcAg was developed.

Implant waste and associated costs in trauma and orthopaedic surgery: a systematic review.

Purpose: Trauma and orthopaedic (T&O) surgery relies on medical implants and materials, often resulting in metalwork wastage (prosthesis, screws, nails, and plates). This places an economic strain on healthcare services and the environment. Our primary outcome is to quantify the implant wastage across the literature, and secondarily investigate the associated costs in this specialty.

Associations between structural brain changes and blood neurofilament light chain protein in treatment-resistant schizophrenia.

Objective: Around 30% of people with schizophrenia are refractory to antipsychotic treatment (treatment-resistant schizophrenia). Abnormal structural neuroimaging findings, in particular volume and thickness reductions, are often described in schizophrenia. Novel biomarkers of active brain pathology such as neurofilament light chain protein are now expected to improve current understanding of psychiatric disorders, including schizophrenia.

Ethical Use of Cadaveric Images in Anatomical Textbooks, Atlases, and Journals: A Consensus Response From Authors and Editors.

Nowadays, consent to use donor bodies for medical education and research is obtained from the body donors and their families before the donation. Recently, the International Federation of Associations of Anatomists (IFAA) published guidelines that could restrict the appearance of cadaveric images in commercial anatomical resources such as textbooks and other educational products. These guidelines state that the donor must expressly consent to using such images for this purpose.

Complex cesarean section: Surgical approach to reduce the risks of intraoperative complications and postpartum hemorrhage.

The incidence of cesarean section is dramatically increasing worldwide, whereas the training opportunities for obstetrician/gynecologists to manage complex cesarean section appear to be decreasing. This may be attributed to changing working hours directives and the increasing use of laparoscopy for gynecological surgical procedures, including in gynecological oncology. Various situations can create surgical difficulties during a cesarean section; however, two of the most frequent are complications from previous cesarean (myometrial defects, with or without placental intrusion and peritoneal adhesions) and the high risk of postpartum hemorrhage (uterine overdistension, abnormal placentation, uterine fibroids).

The Adelaide Score: prospective implementation of an artificial intelligence system to improve hospital and cost efficiency.

Background: The Adelaide Score is an artificial intelligence system that integrates objective vital signs and laboratory tests to predict likelihood of hospital discharge.

Methods: A prospective implementation trial was conducted at the Lyell McEwin Hospital in South Australia. The Adelaide Score was added to existing human, artificial intelligence, and other technological infrastructure for the first 28 days of April 2024 (intervention), and outcomes were compared using parametric, non-parametric and health economic analyses, to those in the first 28 days of April 2023 (control).

Generation Victoria (GenV): protocol for a longitudinal birth cohort of Victorian children and their parents.

Background: In a world confronted with new and connected challenges, novel strategies are needed to help children and adults achieve their full potential, to predict, prevent and treat disease, and to achieve equity in services and outcomes. Australia's Generation Victoria (GenV) cohorts are designed for multi-pronged discovery (what could improve outcomes?) and intervention research (what actually works, how much and for whom?). Here, we describe the key features of its protocol.

Behind the scenes of EQA - characteristics, capabilities, benefits and assets of external quality assessment (EQA).

This is the first in a series of five papers that detail the role and substantial impact that external quality assessment (EQA) and their providers' services play in ensuring diagnostic (IVD) performance quality. The aim is to give readers and users of EQA services an insight into the processes in EQA, explain to them what happens before EQA samples are delivered and after examination results are submitted to the provider, how they are assessed, what benefits participants can expect, but also who are stakeholders other than participants and what significance do EQA data and assessment results have for them. This first paper presents the history of EQA, insights into legal, financing and ethical matters, information technology used in EQA, structure and lifecycle of EQA programs, frequency and intensity of challenges, and unique requirements of extra-examination and educational EQA programs.

Prehospital video triage of suspected stroke patients in Greater Manchester: pilot project report.

Introduction: Stroke is a leading cause of mortality and morbidity, demanding prompt and accurate identification. However, prehospital diagnosis is challenging, with up to 50% of suspected strokes having other diagnoses. A prehospital video triage (PHVT) system was piloted in Greater Manchester to improve prehospital diagnostic accuracy and appropriate conveyance decisions.

Behind the scenes of EQA - characteristics, capabilities, benefits and assets of external quality assessment (EQA).

External quality assessment (EQA) enhances patient safety through the evaluation of the quality of laboratory-based and point of care testing. Regulatory agencies and accreditation organizations utilize the results and the laboratory's response to them as part of assessing the laboratory's fitness to practice. In addition, where EQA samples are commutable and the assigned value has been determined using reference measurement procedures (RMPs), EQA data contributes to the verification of metrological traceability of assays as part of the post-market surveillance of diagnostic (IVD) medical devices (IVD-MDs).

Advanced Technology in a Real-World Rehabilitation Setting: Longitudinal Observational Study on Clinician Adoption and Implementation.

Background: Advanced technologies are becoming increasingly accessible in rehabilitation. Current research suggests technology can increase therapy dosage, provide multisensory feedback, and reduce manual handling for clinicians. While more high-quality evidence regarding the effectiveness of rehabilitation technologies is needed, understanding of how to effectively integrate technology into clinical practice is also limited.

CIROZ is dispensable in ancestral vertebrates but essential for left-right patterning in humans.

Four genes-DAND5, PKD1L1, MMP21, and CIROP-form a genetic module that has specifically evolved in vertebrate species that harbor motile cilia in their left-right organizer (LRO). We find here that CIROZ (previously known as C1orf127) is also specifically expressed in the LRO of mice, frogs, and fish, where it encodes a protein with a signal peptide followed by 3 zona pellucida N domains, consistent with extracellular localization. We report 16 individuals from 10 families with bi-allelic CIROZ inactivation variants, which cause heterotaxy with congenital heart defects.

Suboptimal care factors and stillbirths during the COVID-19 pandemic in Victoria: A state-wide linkage study of stillbirths and Consultative Council on Obstetric and Paediatric Mortality and Morbidity case reviews.

Problem: The COVID-19 pandemic affected perinatal outcomes globally, with some regions reporting an increase in stillbirths.

Background: Melbourne, Australia, experienced one of the longest and most stringent pandemic lockdowns.

Aim: To compare stillbirth rates for singleton pregnancies > 20 weeks' gestation before and during the pandemic and examine differences in suboptimal care factors.

Sex, gender identity and women's health research and equality: An urgent need for clarity of language and accurate data collection.

Background: With the rise in salience of the concept of gender identity, changes are being made to language and data collection with major implications for women's health research and equality. Specifically, language referring to women is being desexed and data collection on sex diminishing. In 2023, Australia's National Health and Medical Research Council (NHMRC) undertook public consultations on two draft guidance documents discussing use of the words 'woman'/'women' when describing the involvement of pregnant women in research, and sex and gender identity data collection.

Global, regional, and national burden of primary liver cancer attributable to metabolic risks: an analysis of the Global Burden of Disease Study 1990-2021.

Background: The global burden of metabolic diseases is increasing, but estimates of their impact on primary liver cancer are uncertain. We aimed to assess the global burden of primary liver cancer attributable to metabolic risk factors, including high body mass index (BMI) and high fasting plasma glucose (FPG) levels, between 1990 and 2021.

Methods: The total number and age-standardized rates of deaths and disability-adjusted life years (DALYs) from primary liver cancer attributable to each metabolic risk factor were extracted from the Global Burden of Disease Study 1990-2021.

Challenges and strategies for effective recruitment and retention of participants in clinical research studies.

Effective recruitment and retention of participants in clinical research studies are critical to be able to draw meaningful and valid conclusions in research studies. However, there are multiple challenges related to communication, generalizability, and logistics. Researchers must address and overcome these challenges to ensure robust research outcomes.

International multicenter validation of AI-driven ultrasound detection of ovarian cancer.

Ovarian lesions are common and often incidentally detected. A critical shortage of expert ultrasound examiners has raised concerns of unnecessary interventions and delayed cancer diagnoses. Deep learning has shown promising results in the detection of ovarian cancer in ultrasound images; however, external validation is lacking.

Not "a cute" complication: phenotypic analysis of acute kidney injury in S. aureus bacteraemia.

Objectives: In this large retrospective cohort analysis, we aimed to determine the incidence of KDIGO-defined acute kidney injury (AKI) within 14 days in patients with Staphylococcus aureus bacteraemia, and the association of AKI with 30-day mortality.

Methods: A retrospective cohort study of adults with S. aureus bacteraemia between 1998 to 2023 admitted to a large regional Australian health service.

IPEM topical report: guidance on 3D printing in radiotherapy.

There has been an increase in the availability and utilization of commercially available 3D printers in radiotherapy, with applications in phantoms, brachytherapy applicators, bolus, compensators, and immobilization devices. Additive manufacturing in the form of 3D printing has the advantage of rapid production of personalized patient specific prints or customized phantoms within a short timeframe. One of the barriers to uptake has been the lack of guidance.

Overlap of Miller-Fisher Syndrome and Pharyngeal-Cervical-Brachial Variant Secondary to COVID-19 in Recurrent Guillain-Barré Syndrome: A Case Report.

Miller-Fisher syndrome (MFS) is characterized by the three major components of ophthalmoplegia, ataxia, and areflexia. The occurrence of MFS is relatively uncommon because of its monophasic nature, while recurrent Guillain-Barré syndrome (GBS) is a well-known condition. The pharyngeal-cervical-brachial (PCB) variant is a scarce variant of GBS (3%), which presents with muscle weakness initially involving the neck, oropharynx, and upper extremities.

Wide Awake Local Anaesthesia No Tourniquet Surgery of the Foot and Ankle: A Review of Indications, Technique, Patient Satisfaction, and Complications.

Wide-awake surgery of the hand was surrounded by a lot of apprehension, mainly over concerns around using epinephrine near digits and its potential to cause digital ischemia and necrosis. With multiple reports underlining its safety and effectiveness, it is now being widely adopted in hand and wrist surgery. The British Society for Surgery of the Hand has already published guidelines on operating outside of main theatres, with an emphasis on wide awake local anaesthesia no tourniquet (WALANT).

Targeting common disease pathomechanisms to treat amyotrophic lateral sclerosis.

The motor neuron disease amyotrophic lateral sclerosis (ALS) is a devastating condition with limited treatment options. The past few years have witnessed a ramping up of translational ALS research, offering the prospect of disease-modifying therapies. Although breakthroughs using gene-targeted approaches have shown potential to treat patients with specific disease-causing mutations, the applicability of such therapies remains restricted to a minority of individuals.

Primary sclerosing cholangitis in children with inflammatory bowel disease: An ESPGHAN position paper from the Hepatology Committee and the IBD Porto group.

Objective: We aimed to provide an evidence-supported approach to diagnose, monitor, and treat children with inflammatory bowel disease (IBD) and primary sclerosing cholangitis (PSC).

Methods: The core group formulated seven PICO-structured clinical questions. A systematic literature search from inception to December 2022 was conducted by a medical librarian using MEDLINE and EMBASE.