University of Tasmania

Spawning aggregations are critical reproductive events for many reef fishes around the world, yet they are highly vulnerable to exploitation, making effective management essential for sustaining fisheries and conserving aggregation-forming species. In Palau, a proposed management plan seeks to protect a longnose emperor ( Lethrinus olivaceus ) spawning aggregation during the full moon at an outer reef corner (Mutiaur). We identified migration pathways, examined environmental and biological drivers of aggregation timing, quantified depth use, and evaluated the adequacy of proposed protection measures. An array of 32 acoustic receivers was used to track 16 longnose emperors from 2022 to 2025 across Mutiaur and surrounding habitats. Presence at the aggregation site was significantly influenced by lunar phase, day of year, time of day, tidal height, and seawater temperature. Lunar phase was the strongest predictor, with peak detections from three days before to eight days after the new moon, contradicting the full-moon timing assumed in the management plan. Aggregation presence was highest from January to April and primarily during nighttime hours. Migratory pathways followed the outer reef, with individuals traveling up to 13 km to reach Mutiaur. High detections outside the proposed protected area indicate that current closure boundaries are insufficient. Effective protection will require shifting temporal measures to the new-moon period and expanding the protected area from 0.14 km² to include at least the entire reef corner (0.22 km²). These results highlight the value of species-specific movement data for designing spawning aggregation protections and contribute to broader efforts to improve aggregation-based fisheries management globally. Longnose emperor spawning aggregations peaked around the new moon. Presence at the aggregation site was highest from January to April and at night. Fish migrated up to 13 km along outer reef corridors to the aggregation site. Proposed protection measures do not match observed patterns. Effective protection requires new-moon timing and full reef corner coverage.

Jack Jumper ant (JJA) venom immunotherapy (VIT) is highly efficacious but the lowest effective dose is unknown. Delta-inulin adjuvant (Advax) is known to enhance honeybee VIT immunogenicity. This phase 1/2 single-blind, randomised controlled trial aimed to compare the efficacy and safety of JJA VIT with different doses of venom ± Advax. Adults aged 18-65 with a history of immediate systemic reaction (SR) to JJA stings were randomised to receive JJA VIT at a maintenance dose of 25 mcg or 50 mcg ± Advax; participants were blinded to treatment allocation. Primary outcomes were the response to sting challenges after 12 months and venom-specific IgE and IgG4 responses to treatment. Forty-nine of 50 screened subjects met inclusion criteria and were randomised; 44 started treatment (25 mcg n = 12; 25 mcg + Advax n = 13; 50mcg n = 12, 50 mcg + Advax n = 12). Subsequently, two withdrew due to SRs to treatment, and two withdrew due to unrelated factors. The higher JJA venom maintenance dose was associated with reduced likelihood of SRs (OR 0.53 (95% CI, 0.28-0.98)), while Advax did not have an effect (OR 1.17 (95% CI, 0.59-2.32)). Forty proceeded to sting challenge, with six developing SRs. There was no difference between groups for sting challenge outcome (p = 0.98), and the ORs for 25 mcg vs. 50 mcg venom dose (0.89, 95% CI, 0.38-2.09) and Advax vs. no Advax (0.99, 95% CI 0.42-2.33) indicated no effect. There were no differences between groups for venom sIgE (p = 0.78), sIgG4 (p = 0.25), sIgE/IgG4 ratio (p = 0.42), intradermal (p = 0.77), and basophil activation test (BAT) (p = 0.69) responses to treatment. Subjects with high baseline BAT sensitivity, which reduced markedly in response to treatment, were less likely to have a positive sting challenge (p = 0.006). Challenge outcomes were similar for all groups, with no significant difference found between 25 and 50 mcg maintenance dose or between treatment with and without Advax. Further research of low dose JJA VIT is warranted to confirm its efficacy and tolerability. NCT03066986.

BackgroundPreservation of normal-quality infrapatellar fat pads (IPFP) during total knee arthroplasty (TKA) has been proposed, and IPFP of abnormal quality are recommended for resection.MethodsIn this trial, patients with knee osteoarthritis (OA) undergoing TKA were stratified by IPFP status on magnetic resonance imaging (Group 1 with normal IPFP [signal intensity score ≤1; ranging from 0 to 3]; Group 2 with abnormal IPFP [signal intensity score ≥2]) and randomly assigned in a 1:1 ratio to IPFP preservation or IPFP resection. The primary outcome was 12-month change in the mean of five Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales (KOOS5), which range from 0 (worst) to 100 (best).ResultsIn Group 1, 179 participants were randomly allocated to IPFP preservation (n=90) and IPFP resection (n=89), and 198 participants were randomly assigned to IPFP preservation (n=101) and IPFP resection (n=97) in Group 2. The increases in KOOS5 score were 38.1 and 36.1 in Group 1 and were 39.2 and 37.5 in Group 2 in IPFP preservation and IPFP resection groups, respectively, resulting in between-group differences of 1.9 (95% confidence interval [CI], −1.7 to 5.6) in Group 1 and 1.6 (95% CI, −1.3 to 4.6) in Group 2. Adverse events were predominantly nonserious musculoskeletal or skin-related events (three vs. two in Group 1 and eight vs. two in Group 2).ConclusionsResection of abnormal IPFP and preservation of normal IPFP did not improve postoperative outcomes 12 months after TKA. (Funded by National Key Research & Development Program of China, Clinical Research Startup Program of Southern Medical University, and National Natural Science Foundation of China; ClinicalTrials.gov number, NCT03763448.)

Robust medicines governance is an essential component of good clinical governance for health service organisations. Standardisation of hospital medicines governance supports consistency in clinical care and equity in medicines access for patients both within those hospitals and at transitions of care. Medicines and Therapeutics Committees (MTCs) provide the strategic lead for medicines governance in Australian hospitals and have done so for many decades. Changes to the healthcare environment in which MTCs operate, however, have necessitated adaptation and evolution of these committees. Contemporary guidance is therefore required to support MTCs to provide consistent, high-quality medicines governance in Australia's modern healthcare environment. Achieving effective medicines governance: Guiding principles for the roles and responsibilities of Medicines and Therapeutics Committees in Australian hospitals was released in July 2025 with recommendations for the purpose, functions, structure, processes, documentation, communication and resourcing for Australian MTCs. The guidance is accompanied by a checklist to measure the performance of MTCs and other supporting resources. Australian hospital MTCs are encouraged to measure their practice against these guiding principles, using the associated tools, to achieve the best possible medicines governance within their available resourcing. Practice across jurisdictions is variable, and working to align individual MTC practices with the guiding principles will promote standardisation in approach to hospital medicines governance.

ABSTRACT Introduction Overweight and obesity are increasing rapidly in most countries. Underweight body mass index (BMI), though much less common, is also associated with adverse health outcomes. There is poor understanding of the implications of BMI in lymphoma patients. Recent international guidelines indicate that curative‐intent cancer treatment should not be modified for obesity alone, with no specific recommendations for low BMI patients. Our aim was to examine the impact of BMI on outcomes in a contemporary cohort of lymphoma patients. Methods We examined BMI in relation to baseline clinical features and outcomes in an Australasian cohort of 4686 lymphoma cases from the national registry. Results Patients with an overweight or obese BMI had no significant decrement in overall survival (OS) or progression free survival (PFS) compared to those with a normal BMI for any of the histological subtypes examined in this study. However, the minority of patients with underweight BMI demonstrated inferior OS for Hodgkin lymphoma (adjHR = 2.55, 95% CI = 1.05–6.19, p = 0.04) and OS (adjHR = 1.54, 95% CI = 1.02–2.32, p = 0.04) in diffuse large B‐cell lymphoma compared to patients with a normal BMI. Conclusion These findings support continued standard dosing in overweight and obese patients and identify poor outcomes requiring careful management in underweight populations. Trial Registration The authors have confirmed clinical trial registration is not needed for this submission.

Effective management of invasive species requires robust projections of how alternative management strategies influence long-term invasion outcomes, required effort, and associated trade-offs. We used a spatially explicit population model, linked with empirical data on aerial culling efficiency, to project (from 2023 to 2060) alternative management scenarios for limiting the spread and establishment of an invasive fallow deer ( Dama dama ) population in a high-value conservation area, the Walls of Jerusalem National Park (WJNP), Tasmania, Australia. We compared six feasible aerial culling scenarios that varied in the frequency (annual, biennial, or five-yearly) and spatial extent (broad versus concentrated management zones) of control, relative to a baseline scenario with no future management. Scenarios were evaluated in terms of their ability to limit deer occupancy and abundance within the WJNP, the cumulative presence of deer over time, the amount of management effort required, and population-level animal welfare outcomes. All management scenarios reduced deer invasion into the WJNP relative to no management, but strategies that applied culling across a broad spatial extent were consistently more effective than those targeting only high-density source areas. More frequent culling further improved outcomes, although gains were modest relative to changes in spatial extent. Strategies that combined broad-scale culling with annual or biennial frequency achieved the best balance between reducing invasion pressure and limiting management effort, while also resulting in fewer deer being culled overall. Complete exclusion of deer from the WJNP was achievable only under a more intensive strategy involving annual culling across a substantially expanded area, but this required a nearly four-fold increase in effort compared to the scenarios aimed at minimising, rather than eliminating, invasion. Our results highlight trade-offs between management effectiveness, effort, and welfare outcomes, and demonstrate how spatial population models coupled with operational data can support practical, evidence-based decisions for managing invasive species.