Motor Neurone Disease Research Australia

ABSTRACTOn July 1, 2025, Australia commenced screening eligible participants in a ground‐breaking health initiative with the launch of a national lung cancer screening program (NLCSP). Designed for individuals at high risk, this program aims to promote early detection and improve both survival rates and treatment outcomes. Radiology will serve as a cornerstone of the program's success. This article provides a comprehensive overview from the radiologist's perspective.

Mycobacterium tuberculosis (M.tb) infection infects human alveolar macrophages (HAMs). In freshly isolated HAMs from 28 healthy adults, we observe large inter-individual differences in bacterial uptake and growth, with tenfold variation in M.tb load by 72 h. While M.tb infection triggers expression changes of numerous host mRNAs, we examined which genes are most variably expressed (VE genes) between donors, as potential biomarkers of individual tuberculosis (TB) risk. The HAM RNA transcriptome following infection revealed thousands of differentially expressed (DE) genes and differential secretion of 25/27 proteins. Yet only 324 DE genes represent VE genes detected exclusively among DE genes in infected cells. Of 36 DE genes detected at all time points (2, 24, and 72 h), 14 are VE genes, indicating early emergence of the VE gene profile. 9/27 DE proteins following infection were encoded by VE genes. Systems analysis of VE RNAs identified a top-scoring network anchored by IL1B, involved in TB immune response. Independent M.tb-HAM transcriptome results from a TB-endemic region show significant overlap in DE genes, including VE genes identified in the main study. Thus, we identify a VE gene network activated upon M.tb-HAM infection with high inter-person variability, guiding studies on determining individual risk of M.tb infection and/or disease.

ObjectivesThis study aimed to assess preferences of patients and doctors regarding treatment attributes for early-stage triple-negative breast cancer (eTNBC) in the Asia–Pacific region.DesignA discrete choice experiment (DCE) by cross-sectional survey was conducted with patients and doctors. Key attributes relevant to eTNBC treatment decision-making were verified through a consultative process with clinical experts. The levels and description of seven attributes were refined through cognitive interviews. A D-efficient fractional-factorial design was employed to create 15 choice sets with seven key attributes.SettingAn online web-based DCE with the 15 choice sets was developed and made available to participants in Australia, Japan, Korea, the Philippines and Taiwan.ParticipantsThe final dataset comprised 115 patients who self-reported a diagnosis of eTNBC and 86 medical oncologists, breast and general surgeons with at least five years of experience managing eTNBC patients.Primary outcomesPatients’ and doctors’ preferences on seven attributes: pathological complete response (pCR), disease-free/event-free survival (DFS/EFS), chance of undergoing breast-conserving surgery after receiving anticancer treatment, febrile neutropenia, peripheral sensory neuropathy (PSN), diarrhoea and irreversible endocrine-related side effects requiring lifelong medication. Data were analysed using a mixed logit model to determine preference weights for attribute levels, which were then used to compute the relative importance score (RIS) for each attribute.ResultsThe median age of patients was 44.0 (IQR 38.0–56.5) years. Most patients (68%) were married, and 77% had children. Additionally, 40% were employed full-time, and 70% held a college degree. Nearly half (46%) were diagnosed before the age of 40. Among the doctors, 58% were medical oncologists and the remaining breast or general surgeons. pCR, DFS/EFS and PSN were the three most important attributes in both doctor and patient groups. pCR had the highest weighted preference among patients and doctors (RIS, 28.5 and 32.9, respectively). In general, patients assigned more weight to safety attributes compared with doctors, while doctors assigned more weight to efficacy attributes than patients did. Surgeons assigned more weight to irreversible endocrine-related side effects than medical oncologists (RIS, 14.4 vs 5.4). Differences in preferences within the regions were noted.ConclusionsWhile our study revealed a concordance between patients’ and doctors’ ranking of the seven assessed treatment attributes, patients generally assigned greater emphasis on safety-related attributes in comparison to doctors.

BackgroundA substantial number of people experiencing self-harm or suicidal ideation present to hospital emergency departments (EDs). In 2014, a National Clinical Programme was introduced in EDs in Ireland to standardise care provision. Internationally, there has been limited research on the factors affecting the implementation of care for people who present with mental health crises in EDs.MethodsThis qualitative study examined factors influencing the implementation of the National Clinical Programme for Self-harm and Suicide-related Ideation in 15 hospitals in Ireland from early (2015–2017) through to later implementation (2019–2022). Semi-structured interviews were conducted with staff involved in programme delivery, with the topic guide and thematic analysis informed by the Consolidated Framework for Implementation Research.ResultsA total of 30 participants completed interviews: nurse specialists (n=16), consultant psychiatrists (n=6), nursing managers (n=2), emergency medicine staff (n=2) and members of the national programme team (n=4). Enablers of implementation included the introduction of national, standardised guidance for EDs; implementation strategies led by the national programme team; and training and support for nurse specialists. The following inner-setting factors were perceived as barriers to implementation in some hospitals: limited access to a designated assessment room, delayed access to clinical input and poor collaboration with ED staff. Overall, these barriers dissipated over time, owing to implementation strategies at national and local levels. The varied availability of aftercare impacted providers’ ability to deliver the programme and the adaptability of programme delivery had a mixed impact across hospitals.ConclusionsThe perceived value of the programme and national leadership helped to advance implementation. Strategies related to ongoing training and education, developing stakeholder interrelationships and evaluation and monitoring have helped address implementation barriers and promote continued sustainment of the programme. Continued efforts are needed to support nurse specialists delivering the programme and foster partnerships with community providers to improve the transition to aftercare.

To compare prostate artery embolisation (PAE) to the combination of tamsulosin and dutasteride therapy as a potential first-line therapy for obstructive benign prostatic hyperplasia (BPH) in treatment-naïve patients in the 'Prostate Embolisation AS first-line therapY compAred to meDication in treatment naïVe men with prostAte eNlargement, a randomised ControllEd trial' (P-EASY ADVANCE). A total of 39 men with enlarged prostates, moderate-severe lower urinary tract symptoms (LUTS) and obstructed/equivocal urodynamic studies (UDS), and who had no prior treatment for BPH, were randomised to receive either combined medical therapy with tamsulosin and dutasteride (medication) or PAE. Follow-up UDS, International Prostate Symptom Score (IPSS), uroflowmetry and ultrasound were performed at short- to medium-term intervals following interventions and compared to baseline. The medication and PAE treatment groups had similar baseline characteristics, including prostate volumes (87.8 and 85.4 mL respectively), maximum urinary flow rate (Qmax; 6.5 and 6.6 mL/s, respectively), IPSS (19.5 and 21, respectively) and obstructed UDS (79% and 74%, respectively). Both interventions improved voiding and bladder outflow obstruction from baseline, with more patients unobstructed after PAE (63%) compared to medication (28%) (P = 0.03). PAE patients had significantly greater reductions in prostate size (P < 0.001), incomplete emptying (P = 0.002), total IPSS (P = 0.032), Qmax (P = 0.006) and quality of life (P = 0.001). Altered ejaculation, erectile dysfunction and nausea were more common in the medication group. Prostate artery embolisation was more effective than combined medical therapy at reducing urinary obstruction, decreasing prostate volume and improving LUTS in patients with BPH who had not previously been treated. This is the first randomised control study to compare PAE and combined medical therapy in exclusively treatment-naïve patients and raises the potential of PAE as an alternative early treatment option for BPH. Further randomised comparative trials are planned to further validate the role of PAE in mitigating obstructive BPH.

Abstract As part of the Kunming‐Montreal Global Biodiversity Framework (K‐M GBF), signatory nations of the Convention on Biological Diversity (CBD) aim to protect at least 30% of the planet by 2030 (Target 3). This bold ambition has been widely celebrated and its implementation seen as pivotal for the overall success of K‐M GBF. However, given that many CBD signatory nations prioritised quantity (e.g., area) over quality (e.g., important areas for biodiversity) when attempting to meet their 2010 CBD Aichi protected area commitments, it is critical that nations focus on protecting those terrestrial, inland waters and marine areas that have the best chance of halting and reversing biodiversity loss and thus contribute to Goal A of the K‐M GBF. Here we provide a review on the type of areas that nations need to prioritise when implementing Target 3 that relates to area ‘quality’: areas of particular importance for biodiversity and ecosystem functions and services, are effectively conserved and managed through ecologically representative, well‐connected and equitably governed systems. We show that data is available for 12 distinct biodiversity conservation and ecosystem service elements that can be mapped and, if conserved, will (with appropriate management) help meet the broad intention of Target 3. We highlight examples of the planning methods available that can be utilized so these areas can be targeted for protection. We discuss issues related to trade‐offs regarding how to prioritise amongst them as well as to operationalise some of the vaguer concepts like ‘representation’ and ‘ecosystem functions and services’ so that they achieve the best outcomes for biodiversity.

Abstract Simplified perovskite solar cells (PSCs) were fabricated with the perovskite layer sandwiched and encapsulated between carbon‐based electron transport layer (ETL) and counter electrode (CE) by a fully blade‐coated process. A self‐assembled monolayer of amphiphilic silane (AS) molecules on transparent conducting oxide (TCO) substrate appeals to the fullerene ETL deposition and preserves its integrity against the solvent damage. The AS serves as a “molecular glue” to strengthen the adhesion toughness at the TCO/ETL interface via robust chemical interaction and bonding, facilitating the interfacial charge extraction, increasing PCEs by 77 % and reducing hysteresis. A PCE of 18.64 % was achieved for the fully printed devices, one of the highest reported for carbon‐based PSCs. AS‐assisted interfacial linkage and carbon‐material‐assisted self‐encapsulation enhance the stability of the PSCs, which did not experience performance degradation when stored at ambient conditions for over 3000 h.