Cost savings of reducing opioid prescribing for the treatment of people with low back pain in general practice: a modelling study.

Background: Low back pain (LBP) is the leading cause of disability worldwide. Contrary to clinical guidelines, opioids are frequently prescribed early in the management of LBP in primary care, leading to potential harm and downstream healthcare costs. The objective of this study was to model the one-year impacts of strategies that reduce opioid prescribing for low back pain (LBP) in primary care on healthcare costs and overdose deaths Australia-wide and explore the potential for such strategies to be cost-neutral.

Outcomes of ophthalmic nurse conducted phone call follow-up of cataract surgery patients at an Australian Public Hospital.

Background: COVID-related clinic shutdowns mandated the use of a day 1 telephone follow-up the day after routine cataract surgery rather than clinic attendance. We investigated to see if this is a safe alternative to standard care.

Methods: Ninety-nine patients who underwent a routine cataract extraction between 22 April 2020 and 19 August 2020 at our Hospital were included in this audit.

Gendered Experiences of Intravenous Iron Infusion Reactions: A Patient Perspective.

Hypophosphatemia following iron infusion is thought to be a relatively rare complication of intravenous iron infusion, though research is beginning to demonstrate that it occurs more often than previously assumed. Still, healthcare professionals are often unaware of this potential complication. This, coupled with the medical bias women can receive in health settings-plus the over-representation of women receiving intravenous iron-means that symptoms of hypophosphatemia may be misinterpreted or worse, misdiagnosed.

A faunal inventory of methane seeps on the Pacific margin of Costa Rica.

The methane seeps on the Pacific margin of Costa Rica support extensive animal diversity and offer insights into deep-sea biogeography. During five expeditions between 2009 and 2019, we conducted intensive faunal sampling via 63 submersible dives to 11 localities at depths of 300-3600 m. Based on these expeditions and published literature, we compiled voucher specimens, images, and 274 newly published DNA sequences to present a taxonomic inventory of macrofaunal and megafaunal diversity with a focus on invertebrates.

Durvalumab, Tremelimumab, and Platinum Chemotherapy in Mutation-Positive NSCLC: An Open-Label Phase 2 Trial (ILLUMINATE).

Introduction: -mutant NSCLC is associated with low mutation burden and low levels of PD-L1 expression. We conducted a phase 2 trial to determine the efficacy of durvalumab, tremelimumab, and platinum-pemetrexed in mutant NSCLC after progression with EGFR tyrosine kinase inhibitors (TKIs).

Methods: Participants were treated with induction durvalumab, tremelimumab, and platinum-pemetrexed, followed by durvalumab-pemetrexed maintenance.

IDH-mutant gliomas in children and adolescents - from biology to clinical trials.

Gliomas account for nearly 30% of all primary central nervous system (CNS) tumors in children and adolescents and young adults (AYA), contributing to significant morbidity and mortality. The updated molecular classification of gliomas defines molecularly diverse subtypes with a spectrum of tumors associated with age-distinct incidence. In adults, gliomas are characterized by the presence or absence of mutations in isocitrate dehydrogenase (), with mutated (mIDH) gliomas providing favorable outcomes and avenues for targeted therapy with the emergence of mIDH inhibitors.

A Pilot Trial of Tongue Reconstruction Using the Chimeric Innervated Vastus Lateralis Muscle and Antero-Lateral Thigh Free Flap.

Background: Subtotal and total glossectomies for advanced tongue cancer result in significant speech- and swallow-related morbidity, impairing quality of life. This prospective pilot study compares the safety and functional outcomes associated with using a chimeric innervated muscle and fasciocutaneous flap for soft tissue reconstruction.

Materials And Methods: A prospective, non-randomized controlled pilot study evaluated a standardized technique for tongue reconstruction using a chimeric innervated vastus lateralis muscle and anterolateral thigh fasciocutaneous flap.

Use of immunoglobulin G homeostatic set point and recovery time in plasmapheresis donor safety monitoring: A retrospective observational cohort study.

Background And Objectives: Serum immunoglobulin G (IgG) and total protein are used to monitor plasmapheresis donor safety. However, there is a lack of information from large donor cohorts to determine the best use of these measurements.

Materials And Methods: We identified 230,144 plasmapheresis donors making their first donation between 1 July 2020 and 31 March 2024.

The promise of community-driven preprints in ecology and evolution.

Publishing preprints is quickly becoming commonplace in ecology and evolutionary biology. Preprints can facilitate the rapid sharing of scientific knowledge establishing precedence and enabling feedback from the research community before peer review. Yet, significant barriers to preprint use exist, including language barriers, a lack of understanding about the benefits of preprints and a lack of diversity in the types of research outputs accepted (e.

Clinical impact of the Z0011 trial on axillary surgical management in Australia and New Zealand from the BreastSurgANZ Quality Audit.

Background: The clinical management of the axilla in early breast cancer has changed since the Z0011 trial, which showed that axillary lymph node dissection (ALND) is not necessary in select patients with a positive sentinel lymph node biopsy (SLNB). Studies have shown a significant decrease in the rates of completion ALND (cALND) since Z0011. The aims of this study were to investigate the effect of the Z0011 trial on the management of positive axillary sentinel nodes and the trends in axillary surgical management since 2005 in Australia and New Zealand.

A randomised controlled implementation trial of the feasibility and effectiveness of school staff delivery of a selective substance use and mental health program during the COVID-19 pandemic.

Background: Preventure is a selective school-based personality-targeted program that has shown long-term benefits in preventing student alcohol use, internalising and externalising problems when delivered by psychologists. In this first Australian randomised controlled trial of school staff implementation of Preventure, we aimed to examine i) acceptability, feasibility, and fidelity and ii) effectiveness of Preventure on student alcohol use, internalising, and externalising symptoms.

Methods: A cluster-randomised controlled implementation trial was conducted in Sydney, Australia and was guided by the RE-AIM framework (Glasgow et al.

Lipid-Lowering Efficiency and Safety of Alirocumab 300 mg Using a 2-mL Autoinjector Device in Real-World Practice: The MARS Study.

Background: Alirocumab is a fully human monoclonal antibody to proprotein convertase subtilisin kexin type 9 used for the reduction of low-density lipoprotein cholesterol (LDL-C) in high-risk patients not reaching their LDL-C target. Recently, a 2-mL prefilled autoinjector has been developed to support the monthly 300-mg dosing regimen with a single-injection administration.

Methods And Objectives: Monthly application of 300 mg AlirRocumab (Praluent) using the 2-mL SYDNEY Device (MARS) is a non-interventional, open, prospective, multi-center cohort study conducted in Germany between 2021 and 2023 with an observational period of 12 weeks.

An online multidomain lifestyle intervention to prevent cognitive decline in at-risk older adults: a randomized controlled trial.

Effective, scalable dementia prevention interventions are needed to address modifiable risk factors given global burden of dementia and challenges in developing disease-modifying treatments. A single-blind randomized controlled trial assessed an online multidomain lifestyle intervention to prevent cognitive decline over 3 years. Participants were dementia-free community-dwelling Australians aged 55-77 years with modifiable dementia risk factors.

Ginsenoside Rd protects against acute liver injury by regulating the autophagy NLRP3 inflammasome pathway.

Ginsenoside Rd (Rd) is a bioactive compound predominantly found in Panax ginseng C.A. Meyer and Panax notoginseng (Burkill) F.

OCT-based diagnosis of glaucoma and glaucoma stages using explainable machine learning.

Glaucoma poses a growing health challenge projected to escalate in the coming decades. However, current automated diagnostic approaches on Glaucoma diagnosis solely rely on black-box deep learning models, lacking explainability and trustworthiness. To address the issue, this study uses optical coherence tomography (OCT) images to develop an explainable artificial intelligence (XAI) tool for diagnosing and staging glaucoma, with a focus on its clinical applicability.

How unprofessional behaviors between healthcare staff threaten patient care and safety.

Introduction: Unprofessional behaviors (UB) such as bullying and incivility among healthcare staff are a significant and pervasive issue, impacting staff wellbeing, and patient safety and experiences of care. Despite its prevalence, misconceptions persist regarding the impact of UB and the mechanisms through which it affects patients.

Areas Covered: We draw upon evidence including outcomes from an extensive realist review and empirical research, to demonstrate impacts of UB on patient safety and experience, particularly focusing on how even mild forms of incivility can compromise care quality.

Unravelling phylogenetic relationships within the genus Lispe (Diptera: Muscidae) through genome-assisted and de novo analyses of RAD-seq data.

Lispe represents a species-rich genus within the family Muscidae. The current subdivision of Lispe species into species groups is based mainly on adult morphology and ecology, with the only available phylogenetic study based on three molecular markers. Nonetheless, certain species groups remain unclear and the relationships and composition of these groups are still unresolved.

Experimental measurements of particle deposition in the human nasal airway.

Intranasal drug delivery is a promising non-invasive method for administering both local and systemic medications. While previous studies have extensively investigated the effects of particle size, airflow dynamics, and deposition locations on deposition efficiency, they have not focused on the thickness of deposited particles, which can significantly affect drug dissolution, absorption and therapeutic efficacy. This study investigates the deposition patterns of dry powder particles within the nasal airway, specifically examining how factors such as flow rates, particle size, and particle cohesiveness influence deposition patterns and their thickness.

Sodium bisulfite boosted exopolysaccharide production by Auxenochlorella protothecoides: Potential mechanisms harnessing HO signaling and carbon reallocation.

Microalgal exopolysaccharides (EPS) possess significant functional benefits across various industrial sectors, but their commercial feasibility is constrained by inefficient synthesis and poorly understood synthesis mechanisms. This study found that 1.25 mmol/L sodium bisulfite promoted EPS accumulation to 224.

Clinical outcomes and management following progressive disease with anti-PD-(L)1 therapy in patients with advanced Merkel Cell Carcinoma.

Aim: Merkel Cell Carcinoma (MCC) is a rare skin cancer with a rising incidence worldwide. Anti-programmed death-1/ligand-1 (anti-PD-(L)1) therapies are effective for the treatment of advanced MCC. This study examines patterns of response / progression of advanced MCC to anti-PD-(L)1 therapies and describes subsequent management.

Cancer-specific utility instrument for health economic evaluations: A synopsis of the EORTC QLU-C10D user manual and current validity evidence.

The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Utility - Core 10 Dimensions (QLU-C10D) adds a preference-based scoring algorithm to the EORTC measurement portfolio. It is built on the most widely used health-related quality of life (HRQoL) measure in oncology, the EORTC Quality of Life Questionnaire - Core 30 (QLQ-C30), allowing for the calculation of both HRQoL profiles and health utilities. This is an important advancement for integrating cancer-specific values into health economic evaluations and decision making, offering greater content validity and statistical power than some generic measures.

Ethical issues in conducting health research with people in prison: Results of a deliberative research project conducted with people in Australian prisons.

Planning research involving people in prison raises concerns based on past abuses of incarcerated people amongst other factors. Despite the development of guidelines for the ethical conduct of research in prisons, researchers and advocates have questioned whether current approaches aimed at protecting incarcerated persons from unethical research unfairly exclude this group from participating in and benefitting from research. Discussion of these issues comes mostly from expert opinion.