Dementia Care Research and Psychosocial Factors.

Background: The Promoting Independence Through quality Care at Home (PITCH) project aimed to improve outcomes for people with dementia and their carers via a co-designed training intervention for home care workers (HCWs). The results of the primary efficacy analysis of the successful stepped-wedge cluster RCT (n = 172 HCWs in 18 clusters in 7 Australian service providers) were presented at AAIC 2023.

Method: This presentation goes beyond efficacy and discusses the implementation science (process evaluation and behavioural change) and health economic analysis of the intervention.

Dementia Care Research and Psychosocial Factors.

Background: Australia has a rich migration history, with one in three older people coming from a culturally and linguistically diverse (CALD) background. Patients from CALD backgrounds tend to present at later stages of their diseases but face difficulties accessing appropriate dementia care compared to English-speaking patients. Limited literature exists on the clinical experience among CALD patients who have been historically underrepresented in dementia research.

Olanzapine versus quetiapine in critically ill patients with hyperactive delirium: Protocol for a multicentre, cluster-randomised, double-crossover, pragmatic clinical trial (CALM-ICU).

Background: Patients in the intensive care unit (ICU) frequently develop hyperactive delirium, which may be accompanied by behaviour that increases clinical risks to themselves as well as other patients and staff. There is a paucity of evidence to inform the urgent enteral administration of antipsychotic drugs to treat such hyperactive delirium and behavioural disturbances.

Objective: The aim of this study is to test the efficacy and safety of administering enteral olanzapine when compared to quetiapine in critically ill patients with hyperactive delirium.

Efficacy and safety of guanfacine in hospitalized patients with delirium: A scoping review.

Objective: To assess current evidence regarding guanfacine use in hospitalized patients with delirium.

Introduction: Delirium is a common and important complication of critical illness. Central alpha-2 agonists are often used for symptomatic management.

Provision of continuous renal replacement therapy in children in intensive care in Australia and New Zealand.

Objectives: The objective of this study was to describe current use, clinical practice, and outcomes of continuous renal replacement therapy (CRRT) in children in the intensive care unit (ICU) in Australia and New Zealand.

Design: retrospective, binational registry-based cohort study and electronic survey of clinical practice.

Setting: ICUs that contribute to the Australian and New Zealand Paediatric Intensive Care Registry and a survey conducted in November 2021 including ICUs accredited for paediatric intensive care training that provide CRRT for children were part of this study.

Hospital-level volume in extracorporeal membrane oxygenation cases and death or disability at 6 months.

Objective: Extracorporeal membrane oxygenation (ECMO) is a high-risk procedure with significant morbidity and mortality and there is an uncertain volume-outcome relationship, especially regarding long-term functional outcomes. The aim of this study was to examine the association between ECMO centre volume and long-term death and disability outcomes.

Design Setting And Participants: This is a registry-embedded observational cohort study.

Timing of adjunctive vasopressin initiation for septic shock patients and hospital mortality: A multicentre observational study.

Objective: The optimal timing of vasopressin initiation as an adjunctive vasopressor remains unclear. We aimed to study the association between the timing of vasopressin commencement, pre-specified physiological parameters, and hospital mortality.

Design: We conducted a multicentre, retrospective, observational study.

Prone positioning of nonintubated patients with COVID-19 in Australian intensive care units.

Objective: To describe the use of and outcomes from awake prone positioning (APP) in nonintubated patients with COVID-19 in Australian intensive care units (ICUs) in comparison to those who did not receive APP, and to explore the temporal relationship between publication of APP research and changes in clinical practice.

Design: Multicentre, observational cohort study.

Setting: Seventy-eight Australian ICUs participating in SPRINT-SARI Australia.

ICU-acquired hypernatremia: Prevalence, patient characteristics, trajectory, risk factors, and outcomes.

Objective: Knowledge of intensive care unit (ICU) acquired hypernatremia (ICU-AH) has been hampered by the absence of granular data and confounded by variable definitions and inclusion criteria.

Design: Multicentre retrospective cohort study.

Setting: Twelve ICUs in Queensland (QLD), Australia.

Continuous frusemide infusion versus intermittent bolus therapy in paediatric intensive care: A single centre retrospective study.

Objective: Frusemide is a common diuretic administered to critically ill children intravenously, by either continuous infusion (CI) or intermittent bolus (IB). We aim to describe the characteristics of children who receive intravenous frusemide, patterns of use, and incidence of acute kidney injury (AKI), and to investigate factors associated with commencing CI.

Design: Retrospective observational study.

Exploring the role of splicing in TP53 variant pathogenicity through predictions and minigene assays.

Background: TP53 variant classification benefits from the availability of large-scale functional data for missense variants generated using cDNA-based assays. However, absence of comprehensive splicing assay data for TP53 confounds the classification of the subset of predicted missense and synonymous variants that are also predicted to alter splicing. Our study aimed to generate and apply splicing assay data for a prioritised group of 59 TP53 predicted missense or synonymous variants that are also predicted to affect splicing by either SpliceAI or MaxEntScan.

Comparing Patient-Specific Variations in Intra-Cochlear Neural Health Estimated Using Psychophysical Thresholds and Panoramic Electrically Evoked Compound Action Potentials (PECAPs).

Purpose: Variations in neural survival along the cochlear implant electrode array leads to off-place listening, resulting in poorer speech understanding outcomes for recipients. Therefore, it is important to develop and compare clinically viable tests to identify these patient-specific intra-cochlear neural differences.

Methods: Nineteen experienced cochlear implant recipients (9 males and 10 females) were recruited for this study.

Challenges with cancer pain management: novel opioid shortages and cancer trials restrictions.

Patients with advanced cancer often experience bothersome symptoms requiring specialist palliative care input. Oncology clinical trials commonly include a list of prohibited medications while on trial, to avoid potential drug interactions with the investigational product. This case series illustrates how recent opioid shortages combined with prohibited opioids in clinical trials significantly impacted cancer pain control and quality of life.

Lack of correlation between school reopening and trends in adult COVID-19 hospitalisations and death rates during the Delta and early Omicron periods: an ecological analysis of five countries.

Objectives: In this ecological study, we describe SARS-CoV-2 case incidence for school age and adult populations, COVID-19 hospitalisation and death rates during Delta and the early Omicron periods, before and after schools reopened in five countries.

Methods: Data were extracted from government websites. Cases and COVID-19 hospitalisation and death incidence rates were calculated during the Delta and early Omicron periods in Australia, Canada, Denmark, Finland and the United Kingdom, for two weeks preceding and six weeks after schools reopened.

Measurable residual disease and posttransplantation gilteritinib maintenance for patients with FLT3-ITD-mutated AML.

BMT CTN 1506 ("MORPHO"; NCT02997202) was a randomized phase 3 study of gilteritinib compared to placebo as maintenance therapy after hematopoietic stem cell transplantation (HCT) for patients with FLT3-ITD-mutated acute myeloid leukemia (AML). A key secondary endpoint was to determine the impact on survival of pre- and/or post-HCT measurable residual disease (MRD), as determined using a highly sensitive assay for FLT3-ITD mutations. Generally, gilteritinib maintenance therapy was associated with improved relapse-free survival (RFS) for participants with detectable peri-HCT MRD, whereas no benefit was evident for those lacking detectable MRD.

Inferring effects of mutations on SARS-CoV-2 transmission from genomic surveillance data.

New and more transmissible variants of SARS-CoV-2 have arisen multiple times over the course of the pandemic. Rapidly identifying mutations that affect transmission could improve our understanding of viral biology and highlight new variants that warrant further study. Here we develop a generic, analytical epidemiological model to infer the transmission effects of mutations from genomic surveillance data.

Global Challenges in the Access of Endovascular Treatment for Acute Ischemic Stroke (Global MT Access).

Background: Mechanical thrombectomy (MT) is the standard of care for eligible acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) since 2015.

Aim: Our aim was to determine the key challenges for MT implementation and access worldwide.

Methods: We conducted an international online survey consisting of 37 questions, distributed through the World Stroke Organization network, and as invited by co-authors between December 2022 and March 2023.

Risk of Adverse Pregnancy Outcomes Associated With Antiseizure Medications and Their Indications: A Systematic Review and Meta-Analysis.

Background And Objectives: Aside from congenital malformations and impaired postnatal neurodevelopment, risks associated with antiseizure medication (ASM) use during pregnancy have been sparsely investigated, particularly outside of epilepsy. We aimed to assess these risks through a systematic literature review and meta-analysis, including ASM exposure for indication.

Methods: We searched MEDLINE, EMBASE, and Cochrane for studies including pregnant women on ASMs for any indication and untreated pregnant women, investigating obstetric complications and fetal/neonatal complications other than congenital malformations and impaired neurodevelopment.

Findings from a Project Which Established Hepatitis C Point-of-Care Testing and Linkage to Care at a Homelessness Service in Adelaide, Australia, 2021-2022.

Background: Point-of-care hepatitis C virus (HCV) testing streamlines testing and treatment pathways. In this study, we established an HCV model of care in a homelessness service by offering antibody and RNA point-of-care testing.

Methods: A nurse and peer-led HCV model of care with peer support were implemented between November 2021 and April 2022 at a homelessness service in Adelaide, Australia.

TRAPPopathies: Severe Multisystem Disorders Caused by Variants in Genes of the Transport Protein Particle (TRAPP) Complexes.

The TRAPP (TRAnsport Protein Particle) protein complex is a multi-subunit complex involved in vesicular transport between intracellular compartments. The TRAPP complex plays an important role in endoplasmic reticulum-to-Golgi and Golgi-to-plasma membrane transport, as well as autophagy. TRAPP complexes comprise a core complex, TRAPPI, and the association of peripheral protein subunits to make two complexes, known as TRAPPII and TRAPPIII, which act as Guanine Nucleotide Exchange Factors (GEFs) of Rab11 and Rab1, respectively.