The Queen Elizabeth II Medical Centre (QEIIMC), commonly known as just QEII, is a medical campus in Perth, Western Australia, situated in the suburb of Nedlands directly adjacent to Kings Park. It contains Sir Charles Gairdner Hospital, the Perth Children's Hospital, the Harry Perkins Institute of Medical Research, and various smaller facilities.The current QEII site was bought by the state government in 1910, and in 1922 a 999-year lease was granted to the University of Western Australia (UWA). The land remained largely undeveloped, so in 1953 the land was designated for the construction of a new medical centre with a teaching hospital at its core. The site was originally known as the Perth Medical Centre, but changed its name in 1977 to commemorate the Silver Jubilee of Elizabeth II. A 1966 act of parliament created a separate trust to manage the land, with UWA receiving representation on the board.
Background Bordetella pertussis continues to circulate globally despite widespread vaccination, with a notable epidemic in 2024. Its resurgence is confounded by the emergence of pertactin-deficient, macrolide-resistant B pertussis strains in Asia and Europe, which are under-recognised by conventional diagnostics. We aimed to apply targeted culture-independent next-generation sequencing (tNGS) of respiratory specimens to improve global B pertussis diagnostic capability and genomic surveillance. Methods We did a nationwide genomic epidemiology study of B pertussis RT-PCR-positive respiratory specimens that were retrospectively and prospectively collected by diagnostic and public health laboratories in six of seven states and territories of Australia. Specimens underwent tNGS and macrolide-resistant B pertussis-specific PCR, and an opportunistic subset from New South Wales and Queensland were cultured for confirmatory susceptibility testing and whole-genome sequencing. Sequencing data were analysed for genome recovery, virulence profiles, and macrolide resistance mutations, and were compared with international macrolide-resistant B pertussis genomes and ancestral Australian genomes. The performance of the tNGS approach was assessed with logistic regression relative to RT-PCR cycle threshold values, and sensitivity and specificity values were calculated. Findings 255 respiratory specimens positive for B pertussis were included in the study. 64 (25%) were retrospectively collected between Jan 12, 2012, and Dec 31, 2023, and 191 (75%) were prospectively collected between Jan 1 and Oct 28, 2024. Of these 255 specimens, 148 (58%) yielded near-complete B pertussis genomes through tNGS. Seven co-circulating lineages of B pertussis were documented, including two associated with macrolide-resistance. Eight epidemiologically unrelated and geographically dispersed cases of macrolide-resistant B pertussis with a 23S rRNA 2037A→G mutation were identified by tNGS and confirmed by whole-genome sequencing. Three of these were further validated by phenotypic testing. The estimated prevalence of macrolide resistance among Australian cases positive for B pertussis was 4% (eight of 188). Interpretation tNGS can recover near-complete B pertussis genomes directly from clinical specimens, enabling identification of macrolide resistance mutations and high-resolution phylogenetic analysis. These findings show that tNGS complements PCR-based surveillance by providing genome-wide assessment of resistance, virulence, and genomic diversity in a single workflow. Funding NSW Health Prevention Research Support Program.
From 2000 to 2019, the global malaria death toll fell from 864,000 to 576,000 deaths; however, progress on reducing this toll has since slowed, with the COVID-19 pandemic contributing to an increase in the mortality rate since 2020. The emergence of widespread resistance in the major malaria parasite (Plasmodium falciparum) to first-line treatment drugs has highlighted the need for new antimalarials and smarter drug delivery strategies. Nevertheless, recent successes of the first malaria vaccines (RTS,S/AS01 and R21/MM) have renewed the promise of widely applicable vaccines in the future. Since 2015, the Eastern Mediterranean Region has experienced an overall increase in malaria cases and deaths. In the Arabian Peninsula, while most of the Gulf Cooperation Council (GCC) countries have been declared free of indigenous malaria (Bahrain, Kuwait, Qatar, and the United Arab Emirates), malaria is still endemic in two GCC countries (Saudi Arabia and Oman) and their neighbors (Yemen). Furthermore, a number of factors threaten malaria control in this region, especially antimalarial drug resistance, the emergence of highly invasive mosquito species, increasing average temperatures, and imported malaria. In this review, we assess the current worldwide status of malaria before providing a critical evaluation of the malaria situation in the GCC countries.
AIM:To describe the frequency, burden, and pathogen profile of acute respiratory illnesses (ARIs) in very preterm infants during the first year after neonatal intensive care unit (NICU) discharge. METHODS:Very preterm infants were followed prospectively (August 2015-January 2017) with monthly assessments of symptoms, medication use, and healthcare utilisation. Parent-reported ARIs triggered additional clinical follow-up. Nasal swabs were collected monthly and during ARIs and tested for respiratory pathogens using real-time PCR. RESULTS:Of 125 eligible infants, 99 (79.2%) were enrolled, and 89 completed the 12-month follow-up. All infants experienced at least one ARI during the first year. Male sex was associated with increased risk of wheezy lower respiratory tract illness (LRTI) (RR 1.61), hospitalisation (RR 3.89), and asthma medication use (RR 5.89). NICU discharge during summer was associated with higher ARI rates (RR 1.33) and hospitalisation (RR 2.54). Rhinovirus was most frequently detected (13.5% of monthly swabs; 43.8% of ARI swabs), whereas respiratory syncytial predominated in emergency department presentations and hospital admissions (18.8% and 20.0%, respectively). CONCLUSIONS:Very preterm infants experienced substantial respiratory morbidity during the first year after NICU discharge. These findings highlight the need for improved preventive and post-discharge strategies in this high-risk population.
Total knee arthroplasty (TKA) with various guidance methods for bone cuts and soft-tissue balancing yields excellent outcomes for end-stage knee osteoarthritis, offering durable pain relief and functional restoration. However, there is a growing interest in further enhancing intraoperative accuracy and consistency, with the aim of reducing complications and reducing recovery times through the introduction of robotic-assisted surgery (RAS). As with any new technology, concerns remain regarding the surgeon learning curve, operative efficiency, and safety profile of RAS compared to conventional techniques. This study evaluates the clinical utility of a RAS system (ROSA, Zimmer Biomet) in a public hospital setting, assessing its impact on procedure duration and adverse event incidence at 90 days postoperatively. A retrospective comparative cohort study was conducted at a secondary public hospital (Queen Elizabeth II Jubilee Hospital) in, Brisbane, Australia. Data was extracted from a departmental registry, electronic medical records, and intraoperative reports from September 2017 to February 2023. The study included 568 TKA cases: 173 instrumented or navigated TKAs performed before RAS introduction (Pre-RAS), 258 robotic-assisted TKAs after RAS adoption (RAS group), and 137 TKAs performed by other department surgeons who did not use RAS (non-RAS), serving as a benchmark for department-wide outcomes. The primary outcomes were procedure duration and adverse event incidence including surgical site infection (SSI), venous thromboembolism (VTE), knee stiffness, and all-cause readmission within 90 days postoperatively. Among 67 recorded adverse events, no significant differences in total adverse event incidence were observed between the pre-RAS and RAS groups (12.1
Congenital myopathies are a group of genetic muscle disorders present from birth or early infancy and characterised by a lack of muscle tone causing difficulties breathing, feeding, and moving. Pathogenic variants in the ryanodine receptor 1 gene (RYR1) are associated with a large spectrum of congenital myopathies; the most common being central core disease (CCD). The majority (∼90%) of CCD cases are autosomal dominant (or de novo), in which one of the two gene copies produce a toxic RyR1 protein monomer. There are currently no disease-modifying treatments available for congenital myopathies. The primary aim of this project is to design and test exon skipping antisense oligonucleotides (ASOs) as a novel treatment strategy for RYR1-related CCD. Our approach is to target single nucleotide polymorphisms that are common in the general population to enable allele-selective exon skipping, subsequently activating the nonsense-mediated mRNA decay pathway and knockdown of the toxic mRNA copy. We designed eight candidate 2’-O-methyl-modified phosphorothioate (2’OmePS) ASOs which were predicted in silico to result in RYR1 exon skipping. To test these ASOs, we developed a set of protocols for delivery of ASOs to patient-derived myotubes and subsequent assessment of exon skipping, allele-selectivity and cellular toxicity. Several ASO delivery methods (gymnotic delivery ± chloroquine, and transfection), reagents (Lipofectamine 2000, 3000, and polyethylenemine ± NaCl), and controls were tested to optimise effective delivery and screening methods. Exon-skipping and transcript knockdown was achieved for every ASO, however, skipping was not allele-selective. Refinement of ASO design is now being conducted to improve allele-discrimination. Lead candidates shown to induce allele-selective skipping in patient myotubes in 2D, will subsequently be tested in 3D engineered muscle tissues derived from the same patient cell lines. Future work also aims to expand safety and toxicity screening.
