Advances and challenges in precision imaging.

Technological innovations in genomics and related fields have facilitated large sequencing efforts, supported new biological discoveries in cancer, and spawned an era of liquid biopsy biomarkers. Despite these advances, precision oncology has practical constraints, partly related to cancer's biological diversity and spatial and temporal complexity. Advanced imaging technologies are being developed to address some of the current limitations in early detection, treatment selection and planning, drug delivery, and therapeutic response, as well as difficulties posed by drug resistance, drug toxicity, disease monitoring, and metastatic evolution.

Vanzacaftor-tezacaftor-deutivacaftor for children aged 6-11 years with cystic fibrosis (RIDGELINE Trial VX21-121-105): an analysis from a single-arm, phase 3 trial.

Background: In phase 2 trials in people with cystic fibrosis aged 18 years and older, vanzacaftor-tezacaftor-deutivacaftor has been shown to be a safe and effective, once-daily cystic fibrosis transmembrane conductance regulator (CFTR) modulator. Restoring normal CFTR function early in life has the potential to prevent manifestations of cystic fibrosis. We aimed to evaluate the safety, tolerability, efficacy, and pharmacokinetics of vanzacaftor-tezacaftor-deutivacaftor in children with cystic fibrosis aged 6-11 years.

Vanzacaftor-tezacaftor-deutivacaftor versus elexacaftor-tezacaftor-ivacaftor in individuals with cystic fibrosis aged 12 years and older (SKYLINE Trials VX20-121-102 and VX20-121-103): results from two randomised, active-controlled, phase 3 trials.

Background: The goal of cystic fibrosis transmembrane conductance regulator (CFTR) modulators is to reach normal CFTR function in people with cystic fibrosis. Vanzacaftor-tezacaftor-deutivacaftor restored CFTR function in vitro and in phase 2 trials in participants aged 18 years and older resulting in improvements in CFTR function, as measured by sweat chloride concentrations and lung function as measured by spirometry. We aimed to evaluate the efficacy and safety of vanzacaftor-tezacaftor-deutivacaftor compared with standard of care elexacaftor-tezacaftor-ivacaftor in individuals with cystic fibrosis aged 12 years and older.

A new protocolised treatment strategy optimising medical and surgical care leads to improved healing of Crohn's perianal fistulas.

Background & Aims: Crohn's perianal fistula healing rates remain low. We evaluated the efficacy of a protocolised multidisciplinary treatment strategy optimising care in adults with Crohn's perianal fistulas.

Methods: A new treatment strategy was established at a single tertiary centre.

Prevalence of alcohol exposure in burns related injuries.

The aim of this registry-based cohort study was to quantify the prevalence, injury characteristics, and outcomes of alcohol exposure in burn-related injuries. All patients ≥ 18 years presenting to The Alfred Emergency & Trauma Centre, a major trauma centre in Victoria, Australia between January 1, 2019 and December 31, 2022 and included in the Victorian Adult Burns Service registry were included. An explicit chart review was performed to verify retrieved data with alcohol exposure coded when documented in medical records, laboratory evidence of a blood alcohol concentration > 2mmol/L, or recorded in discharge ICD-10-AM codes.

Surgical simulation educational research.

Surgical simulation is increasingly embedded in training programs. Diverse simulation modalities offer opportunities to support learning in wide-ranging competencies. Examples of approaches to classifying research have been applied to surgical simulation educational research.

Multigenerational effects of individual and binary mixtures of two commonly used NSAIDs on Daphnia carinata.

Pharmaceuticals, including non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (IBU) and naproxen (NPX), are widely used for medical purposes but have also become prevalent environmental contaminants. However, there is limited understanding of their effects on aquatic organisms, especially regarding multigenerational and mixture exposures. This study aimed to evaluate the toxicological impacts of ibuprofen and naproxen, individually and in combination, on three generations of Daphnia carinata, a freshwater organism.

Experiences of perinatal genetic screening for people from migrant and refugee backgrounds: a scoping review.

People from refugee and migrant backgrounds often face poor experiences and outcomes in healthcare, and genetic healthcare is no exception. Understanding whether and how these health inequities manifest is an important step towards equitable perinatal genetic screening for genetic or chromosomal conditions (offered preconception, prenatally, or during the newborn period). A scoping review was conducted to review international evidence of perceptions and experiences of perinatal genetic screening for people from migrant and refugee backgrounds.

Wellbeing and the Lived Experience of Injured Workers Following Finalisation of a Workers' Compensation Claim.

Purpose: Workers' compensation claims can negatively affect the wellbeing of injured workers. For some, these negative effects continue beyond finalisation of the workers' compensation claim. It is unclear what factors influence wellbeing following finalisation of a workers' compensation claim.

Cerebral venous sinus thrombosis after intrathecal administration of nusinersen.

Cerebral venous sinus thrombosis is an uncommon sequela of low intracranial pressure, which may result from a lumbar puncture (LP). We describe a case of a patient in their 40s presenting with 48 hours of persistent headache following intrathecal administration of nusinersen for spinal muscular atrophy (SMA) type 3. There were no focal neurological signs or symptoms apart from baseline symmetrical proximal limb weakness attributed to SMA.

Alternative healthcare delivery arrangements in Nepal: a systematic review of comparative effectiveness, safety and cost-effectiveness studies.

Background: The way that healthcare services are organised and delivered (termed 'healthcare delivery arrangements') is a key aspect of a health system. Changing the way health care is delivered, for example, task shifting that delivers the same care at lower cost, may be one way of improving healthcare system sustainability. We synthesised the existing randomised trial evidence to compare the effects of alternative healthcare delivery arrangements versus usual care in Nepal.

Malaria monoclonals block brain binding.

In Plasmodium falciparum malaria, infected cells accumulate in blood vessels of organs, including the brain. Recently, Reyes et al. identified monoclonal antibodies that stop infected cells from binding to the endothelial protein C receptor (EPCR) in a model of brain blood vessels.

The growing range of complications of diabetes mellitus.

With the rising prevalence of type 2 diabetes mellitus (T2DM) and obesity, several previously under-recognised complications associated with T2DM are becoming more evident. The most common of these emerging complications are metabolic dysfunction-associated steatotic liver disease (MASLD), cancer, dementia, sarcopenia, and frailty, as well as other conditions involving the lung, heart, and intestinal tract. Likely causative factors are chronic inflammation and insulin resistance, whereas blood glucose levels appear to play a lesser role.

Osteoarthritis.

Osteoarthritis is a heterogeneous disorder that is increasingly prevalent largely due to aging and obesity, resulting in a major disease burden worldwide. Knowledge about the underlying aetiology has improved, with increased understanding of the role of genetic factors, the microbiome, and existence of different pain mechanisms. However, this knowledge has not yet been translated into new treatment options.

Metabolic reprogramming, malignant transformation and metastasis: lessons from chronic lymphocytic leukaemia and prostate cancer.

Metabolic reprogramming is a hallmark of cancer, crucial for malignant transformation and metastasis. Chronic lymphocytic leukaemia (CLL) and prostate cancer exhibit similar metabolic adaptations, particularly in glucose and lipid metabolism. Understanding this metabolic plasticity is crucial for identifying mechanisms contributing to metastasis.

Exploring the acceptability of a risk prediction tool for cardiometabolic risk (gestational diabetes and hypertensive disorders of pregnancy) for use in early pregnancy: A qualitative study.

Problem/ Background: The acceptability of providing women with personalised cardiometabolic risk information using risk prediction tools early in pregnancy is not well understood.

Aim: To explore women's and healthcare professionals' perspectives of the acceptability of a prognostic, composite risk prediction tool for cardiometabolic risk (gestational diabetes and/or hypertensive disorders of pregnancy) for use in early pregnancy.

Methods: Semi-structured interviews were conducted to explore the acceptability of cardiometabolic risk prediction tools, preferences for risk communication and considerations for implementation into antenatal care.

"I'm still a me:" challenges and changes to the relational-self following the onset of aphasia, a grounded theory study.

Purpose: People with post-stroke aphasia experience relationship changes which can lead to an altered relational self. The aim of this research was to explore the experiences of a group of people with post-stroke aphasia regarding changes to the relational self.

Method: A constructivist grounded theory approach was used.

Appropriateness of lumbar spine imaging in patients presenting to the emergency department with low back pain in a Western Australian tertiary hospital.

Background: The Australian Rheumatology Association identified the use of imaging in patients with low back pain without indication of serious pathology as a low-value practice.

Aims: To determine the appropriateness of diagnostic lumbar spine imaging requests in patients with low back pain presenting to a Western Australian hospital's emergency department.

Methods: We conducted a retrospective review of all adult patients (18 years and older) who presented with low back pain to the Fiona Stanley Hospital emergency department from 1 July 2020 to 31 December 2020.

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.

Land Use Change Consistently Reduces α- But Not β- and γ-Diversity of Bees.

Land use change threatens global biodiversity and compromises ecosystem functions, including pollination and food production. Reduced taxonomic α-diversity is often reported under land use change, yet the impacts could be different at larger spatial scales (i.e.

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).

Imaging abnormalities of the acromioclavicular joint and subacromial space are common in asymptomatic shoulders: a systematic review.

Objectives: To determine the prevalence of acromioclavicular (AC) joint and subacromial space imaging abnormalities in asymptomatic adults, with a secondary objective of comparing findings between asymptomatic and symptomatic shoulders within the same study populations.

Methods: We conducted a systematic review of studies examining shoulder imaging abnormalities detected by X-ray, ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) in asymptomatic adults (PROSPERO registration CRD42018090041). This report focuses on AC joint and subacromial space abnormalities.