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Surgery for rheumatic heart disease in the Northern Territory, Australia, 1997-2016: what have we gained?Between 1964 and 1996, the 10-year survival of patients having valve replacement surgery for rheumatic heart disease (RHD) in the Northern Territory, Australia, was 68%. As medical care has evolved since then, this study aimed to determine whether there has been a corresponding improvement in survival.
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Harnessing neuroplasticity to improve motor performance in infants with cerebral palsy: A study protocol for the GAME randomised controlled trialCerebral palsy (CP) is the most common physical disability of childhood worldwide. Historically the diagnosis was made between 12 and 24 months, meaning data about effective early interventions to improve motor outcomes are scant. In high-income countries, two in three children will walk. This evaluator-blinded randomised controlled trial will investigate the efficacy of an early and sustained Goals-Activity-Motor Enrichment approach to improve motor and cognitive skills in infants with suspected or confirmed CP.
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Maternal diet modulates the infant microbiome and intestinal Flt3L necessary for dendritic cell development and immunity to respiratory infectionPoor maternal diet during pregnancy is a risk factor for severe lower respiratory infections in the offspring, but the underlying mechanisms remain elusive. Here, we demonstrate that in mice a maternal low-fiber diet led to enhanced LRI severity in infants because of delayed plasmacytoid dendritic cell recruitment and perturbation of regulatory T cell expansion in the lungs.
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Multi-ancestry genome-wide association analyses improve resolution of genes and pathways influencing lung function and chronic obstructive pulmonary disease riskLung-function impairment underlies chronic obstructive pulmonary disease (COPD) and predicts mortality. In the largest multi-ancestry genome-wide association meta-analysis of lung function to date, comprising 580,869 participants, we identified 1,020 independent association signals implicating 559 genes supported by ≥2 criteria from a systematic variant-to-gene mapping framework. These genes were enriched in 29 pathways. Individual variants showed heterogeneity across ancestries, age and smoking groups, and collectively as a genetic risk score showed strong association with COPD across ancestry groups.
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The application of environmental health assessment strategies to detect Streptococcus pyogenes in Kimberley school classroomsChildren spend almost one-third of their waking hours at school. Streptococcus pyogenes (Strep A) is a common childhood bacterial infection that can progress to causing serious disease. We aimed to detect Strep A in classrooms by using environmental settle plates and swabbing of high-touch surfaces in two remote schools in the Kimberley, Western Australia.
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Automated Insulin Delivery Is Associated with Reduced Hospital Admissions and Costs for Acute Diabetes Complications in Children with Type 1 DiabetesThis study evaluated the association between insulin regimen, hospitalization for acute diabetes complications, and related health care costs in children with type 1 diabetes (T1D). Hospital admissions for diabetic ketoacidosis or hypoglycemia between January 5, 2022, and April 30, 2024, were analyzed in Western Australian children with T1D. Admissions due to newly diagnosed T1D were excluded. Incidence rate ratios were calculated using generalized estimating equations, adjusted for age, diabetes duration, and socioeconomic status.
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Intranasal phage therapy overcomes antibody neutralization challenges in pulmonary Pseudomonas aeruginosa infectionsPhage therapy is a promising approach against multidrug-resistant infections, yet systemic administration can lead to incomplete cures. We investigated the distribution, immune responses, and efficacy of the therapeutic phage KPP10 delivered via intranasal or intraperitoneal routes in murine Pseudomonas aeruginosa lung infection models.
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Finding the optimal regimen for Mycobacteroides abscessus treatment (FORMaT) in people with Mycobacteroides abscessus pulmonary diseaseMycobacteroides abscessus (MABS) is within the non-tuberculous mycobacteria family. It inhabits soil and water, exhibits multi-antibiotic resistance and causes opportunistic lung infections, which may progress to symptomatic MABS-pulmonary disease (MABS-PD) associated with substantial morbidity, increased healthcare utilisation, impaired quality of life and increased mortality.
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The impact of obesity on influenza Vaccine immunogenicity - A systematic reviewInfluenza vaccines are important for reducing the burden of influenza, particularly for populations at risk of more severe infections. Obesity is associated with increased influenza severity and therefore individuals with obesity are often specifically recommended for annual influenza vaccination. Obesity is also associated with an altered inflammatory profile, which may influence vaccine responses. This systematic review aimed to evaluate the evidence for any association between obesity and influenza vaccine immunogenicity.
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Evaluating the Introduction of Humidified High-Flow Nasal Cannula Therapy Into an Australian Aeromedical Service Within a Paediatric Population: A Retrospective Cohort StudyHumidified high flow (HHF) oxygen is increasingly used to treat acute respiratory illnesses in children; however, use during aeromedical transfer is not well described. This was a retrospective cohort study. Children who were transferred from rural locations and were initiated on HHF prior to transfer between 1 January 2015 and 31 December 2018 were identified from the Royal Flying Doctors Service database. Clinical variables prior to transfer, during flight and after transfer were collected from medical records and flight records.