Assessing spatial sequencing and imaging approaches to capture the molecular and pathological heterogeneity of archived cancer tissues.

Spatial transcriptomics (ST) offers enormous potential to decipher the biological and pathological heterogeneity in precious archival cancer tissues. Traditionally, these tissues have rarely been used and only examined at a low throughput, most commonly by histopathological staining. ST adds thousands of times as many molecular features to histopathological images, but critical technical issues and limitations require more assessment of how ST performs on fixed archival tissues.

Advanced electrocardiography heart age: a prognostic, explainable machine learning approach applicable to sinus and non-sinus rhythms.

Aims: An explainable advanced electrocardiography (A-ECG) Heart Age gap is the difference between A-ECG Heart Age and chronological age. This gap is an estimate of accelerated cardiovascular aging expressed in years of healthy human aging, and can intuitively communicate cardiovascular risk to the general population. However, existing A-ECG Heart Age requires sinus rhythm.

Reinventing the evaluation wheel: COGwheel's co-designed digital innovation using the Qualtrics heat map.

The involvement of service-users, clinicians, and other health service end-users is recognised as an essential part of health and medical research. This collaborative approach can significantly contribute to methodological advancements including the development of research instruments and measures that ensure their suitability for research participants. The current paper details the co-design, development and implementation of the novel, digitised COGwheel (Co-designed Outcomes for Guests Evaluation Wheel).

Changes in platelet maturity and reactivity following acute ST-segment elevation myocardial infarction.

Background: Reduced effect of antiplatelet therapy has been reported in patients with ST-segment elevation myocardial infarction (STEMI). This could partly be explained by an increase of highly reactive immature platelets.

Objectives: To investigate changes in platelet maturity and reactivity after acute STEMI.

Delayed return of bowel function after general surgery in South Australia.

Introduction: Reference ranges for determining pathological versus normal postoperative return of bowel function are not well characterised for general surgery patients. This study aimed to characterise time to first postoperative passage of stool after general surgery; determine associations between clinical factors and delayed time to first postoperative stool; and evaluate the association between delay to first postoperative stool and prolonged length of hospital stay.

Methods: This study included consecutive admissions at two tertiary hospitals across a two-year period whom underwent a range of general surgery operations.

Arcuate fasciculus cortico-cortical evoked potentials and direct cortico-subcortical stimulation during awake craniotomy for debulking of left dominant temporal oligodendroglioma.

Electrophysiological mapping and monitoring techniques permit the objective measurement of eloquent cortical regions and accompanying white matter tracts to reduce the incidence of iatrogenic injury in glioma surgery. Recently, there has been increased interest in mapping and monitoring of the human arcuate fasciculus via cortico-cortical evoked potentials (CCEPs) during awake and asleep craniotomy. The authors present the case of a 27-year-old female who underwent a hypnosis-assisted awake craniotomy with cortico-subcortical language mapping and arcuate fasciculus CCEPs.

Bile Duct Injury During Laparoscopic Cholecystectomy: Has Anything Changed in 32 Years of Queensland Experience?

Background Bile duct injury (BDI) is a serious complication of laparoscopic cholecystectomy (LC). Large studies report an incidence of 0.08%-0.

Bladder injury during laparoscopic appendectomy: Detection, management, and learning point for surgical trainees.

Background: Laparoscopic appendectomy is one of the most common emergency surgeries. There is a paucity in the literature regarding the incidence and management of iatrogenic bladder injuries. We reviewed a series of iatrogenic bladder injuries during laparoscopic appendectomy to determine incidence, preventable risk factors and management.

Clinical efficacy of electrosurgery and steel scalpel surgery for umbilical herniorrhaphy in bovine calves: A comparative analysis.

Electrosurgery (ES) offers a promising alternative to conventional steel scalpel surgery (SSS), providing superior hemorrhage control and efficient tissue dissection with minimal invasiveness. Given the limited literature, this study aims to compare the clinical efficacy of ES with that of SSS in bovine umbilical herniorrhaphy. Fourteen crossbred male calves with reducible umbilical hernias, aged less than one month and weighing 25-47 kg, were randomly assigned to two experimental groups: group A (ES) and group B (SSS), each containing seven calves.

A novel sensitizer reduces EGFR-TKI resistance by regulating the PI3K/Akt/mTOR pathway and autophagy.

Background: The incidence and mortality of lung cancer are high, and treatment with epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) is the preferred first-line treatment for patients suffering from non-small cell lung cancer (NSCLC) with EGFR mutations. However, EGFR-TKI resistance leads to treatment failure. Yifei-Sanjie pill (YFSJ) is a novel type of Chinese patent medicine for lung cancer.

Emergency laparotomy preoperative risk assessment tool performance: A systematic review.

Background: Preoperative assessment of risk for emergency laparotomy may enhance decision making with regards to urgency or perioperative critical care admission and promote a more informed consent process for patients. Accordingly, we aimed to assess the performance of risk assessment tools in predicting mortality after emergency laparotomy.

Methods: PubMed, Embase, the Cochrane Library and CINAHL were searched to 12 February 2022 for observational studies reporting expected mortality based on a preoperative risk assessment and actual mortality after emergency laparotomy.

Primary medullary adenocarcinoma of the colon: Literature review and case series.

Aims: Medullary carcinoma of the colon is a rare subtype of adenocarcinoma, first described in 1999. Clinically known to have a favourable prognosis in comparison to poorly differentiated cancers, it is associated with deficient mismatch repair. This is an observational single center study of patients with medullary cancer, and comparison with the current literature.

Impact of work hour restrictions on the operative experience of general surgical residents: A systematic review.

Introduction: Work hour restrictions (WHR) have been implemented globally to improve resident safety and welfare, but many in the surgical community have raised concerns regarding the impact on resident education and operative experience. This systematic review aims to investigate the impact of WHR on general surgical resident operative caseload.

Materials And Methods: Medline and Embase databases were systematically searched according to PRISMA guidelines to identify articles published between 2003 and 2022 assessing the impact of WHR on the operative experience of general surgical residents.

Efficacy of frozen section in sentinel lymph node biopsy in early breast cancer - An Australian single-centre experience.

Introduction: Sentinel lymph node biopsy (SLNB) is the standard of care for axillary staging in patients with clinically lymph node negative early breast cancer, reducing the need for axillary lymph node dissection (ALND) and its associated risks. Intra-operative frozen section is a method of rapid pathological assessment of the sentinel node to identify the presence of metastatic disease and potentially avoid the need for a second operation in patient who will require an axillary lymph node dissection.

Methods: A retrospective review of a prospectively collected breast cancer database was performed.

Association between direct oral anticoagulant concentrations and clinical outcomes: A systematic review and meta-analysis.

Introduction: Current guidelines suggest preoperative direct oral anticoagulant levels of < 30-50 ng/ml. However, there is limited evidence to guide this expert consensus. Reviewing assay titres and clinical outcomes may be able to inform perioperative care of the anticoagulated patient.

Emergency laparotomy risk assessment: An audit of South Australian hospitals.

Background: Emergency laparotomy (EL) is associated with high mortality rates and is performed on a heterogenous patient population. Pre-operative risk assessment is one tool which can assist with EL patient care. We aimed to characterise rates of pre-operative risk assessment for EL patients in South Australia.

State of precision medicine for heart failure with preserved ejection fraction in a new therapeutic age.

Heart failure with preserved ejection fraction (HFpEF) is defined by heart failure (HF) with a left ventricular ejection fraction (LVEF) of at least 50%. HFpEF has a complex and heterogeneous pathophysiology with multiple co-morbidities contributing to its presentation. Establishing the diagnosis of HFpEF can be challenging.

Canagliflozin reduces oral loop diuretic intensification in patients with type 2 diabetes: A participant-level pooled analysis of the CANVAS and CREDENCE trials.

Aims: The sodium-glucose cotransporter 2 inhibitor canagliflozin reduces the risk of heart failure (HF) hospitalization or cardiovascular death and chronic kidney disease (CKD) progression among patients with type 2 diabetes at high cardiovascular risk or with CKD. Patients with type 2 diabetes commonly have coexisting HF or CKD that require treatment with loop diuretics; however, the prognostic implications of oral loop diuretic intensification are not well characterized.

Methods And Results: In this participant-level pooled analysis of the CREDENCE and CANVAS trials (not including CANVAS-R), 1454/8731 (16.

The determinants for death in hospital following moderate to severe traumatic brain injury in Australia.

Objectives: To establish the determinants of death in hospital for patients with moderate to severe traumatic brain injury (TBI) in Australia.

Design, Setting, Participants: Retrospective analysis of Australia New Zealand Trauma Registry (ANZTR) data. Cases were included if they presented to a participating hospital between 1 July 2015 and 30 June 2020 and had an Abbreviated Injury Severity (AIS) score - head greater than 2.

Family and carer experiences of advanced care planning processes and outcomes.

Objectives: Despite practice development in the area of advanced care planning (ACP) and systems wide changes implemented to support ACP processes, there has been a paucity of research which has addressed the experiences of a key stakeholder group - family and carers - as they navigate their way through these often very challenging processes. The study described in this article focussed on this key group.

Methods: In-depth qualitative interviews were undertaken with family members and carers in a regional area of Australia in order to illuminate their lived experiences of ACP processes.

Continental Preferences in Reconstruction of Pharyngolaryngectomy Defects: A Multi-National Survey.

Objectives: Reconstruction of total pharyngolaryngectomy defects may restore pharyngeal function and enable tracheoesophageal speech after resection of locoregionally advanced malignancy. Little remains known about variations in the practices and preferences of surgeons across differing global regions.

Methods: A survey was sent to reconstructive head and neck surgeons across three continents with responses analyzed to evaluate trends.

An Acceptability and Feasibility Study of a Nurse-Led Model of Contraception and Abortion Care in Rural General Practice.

Aim: To assess the acceptability and perceived feasibility of integrating a co-designed nurse-led model of contraception and medication abortion care within rural and regional general practices.

Design: Qualitative exploratory design utilising Sidani and Braden's indicators of acceptability and feasibility.

Methods: We conducted semi-structured interviews with 12 practice nurses, 8 general practitioners and 3 practice managers who currently or previously worked in rural, regional or remote general practice.

Decision Regret About Treatment Amongst Women With Early Breast Cancer: An Integrative Review.

Aims: To synthesise evidence on decision regret about treatment amongst women with early breast cancer, including (1) the type of treatment related to decision regret, (2) the level of decision regret, and (3) factors associated with decision regret.

Design: Integrative review.

Methods: Studies published between January 2000 and December 2023 were searched from five online databases to provide up-to-date evidence.

Prevalence and characteristics of adults with preserved ratio impaired spirometry (PRISm): Data from the BOLD Australia study.

Individuals with Preserved Ratio Impaired Spirometry (PRISm), defined as FEV/FVC ≥0.7 and FEV1 <80% predicted, are at higher risk of developing COPD. However, data for Australian adults are limited.