The Royal Adelaide Hospital (RAH), colloquially known by its initials or pronounced as "the Rah", is South Australia's largest hospital, owned by the state government as part of Australia's public health care system. The RAH provides tertiary health care services for South Australia and provides secondary care clinical services to residents of Adelaide's central metropolitan area, which includes the inner suburbs.The original Adelaide Hospital was built in 1840 at the eastern end of North Terrace, Adelaide, with its first building superseded in 1856 and many alterations and additions over the following 175 years. It was prefixed by the "Royal" in 1939. In 2017 it was replaced by the new hospital, built at the western end of North Terrace. The new hospital is the most expensive building ever built in Australia, and the most expensive hospital ever built anywhere in the world, at US$2.44 billion in construction and equipment costs. The redevelopment on the site of the old RAH is known as Lot Fourteen.
Aim To map artificial intelligence (AI) systems developed for triage in primary care and describe their characteristics, performance and clinical applicability. Methods A scoping review was conducted in accordance with PRISMA-ScR. PubMed, MEDLINE (via Ovid), Embase, Web of Science, CINAHL (via EBSCOhost), IEEE Xplore and the ACM Digital Library were searched until March 14th 2026. Two reviewers independently screened studies and extracted data on system characteristics, triage function, performance, validation, safety, equity and implementation. Each system was charted by triage function and by whether it was patient-facing, clinician-facing or fully automated. Results Seventeen studies were included, published between 2013 and 2026 across 12 countries (14/17 high-income). Most were clinician-facing decision support (14/17), three had a patient-facing component and none were autonomous. Diagnostic or screening triage was the most common function (n = 7), followed by prioritisation (n = 4) and referral routing (n = 4). Only two performed urgency classification or self-triage. As a clinician aid, AI improved performance (fundus accuracy 82.8 % to 91.1 %; dermoscopy management sensitivity 72.9 % to 94.2 %), but standalone models sometimes fell below clinicians. Reported accuracy ranged from 41.2 % to 98.28 % and AUROC from 0.65 to 0.90, on heterogeneous outcomes. Validation was mostly internal (11/17), external in four. None reported a prospective randomised comparison or measured patient outcomes. Conclusion AI triage in primary care is concentrated on clinician-facing diagnostic and referral tasks and is most valuable for augmenting clinician workflows, particularly non-specialists. The evidence base remains immature, constrained by internal validation, unreliable reference standards, sparse equity assessment and absent prospective outcome data. Future work should prioritise prospective, outcome-anchored evaluation, with attention to safety and equity.
Implant-associated bone infection involves a complex interplay between pathogenic stimuli and host cell responses, yet analysis in preclinical models has typically relied on qualitative or semi-quantitative measures. We aimed to establish a quantified evaluation framework to define host-pathogen relationships in a preclinical implant infection model. Staphylococcus aureus-coated stainless-steel implants were inserted trans-cortically in mouse tibiae and bone changes recorded longitudinally by in vivo micro-CT. An automated segmentation task list was developed to independently isolate and quantify cortical, periosteal-reactive, and trabecular bone compartments. RGB trichrome histomorphometry was used to quantify bone matrix integrity, osteocyte lacunar geometry, and osteoclastic activity. Droplet digital PCR was used to determine absolute bacterial and host genome copy number. Infected implants produced marked reductions in trabecular bone volume fraction, number, and bone mineral density (BMD), together with decreased cortical bone volume fraction and increased cortical porosity, accompanied by significant elevations in periosteal bone volume fraction. Histologically, infected bone exhibited increased eroded surface indicative of osteoclastic resorption, extensive degraded bone matrix and pathological remodelling of osteocyte lacunae toward circularity, consistent with an osteocytic osteolysis response. Infection-induced changes to cortical bone structure correlated mostly with host cell rather than bacterial load; however, cortical BMD negatively correlated with the bacterial:host genome ratio. This multifaceted, quantified framework reveals distinct pathobiological effects of implant-associated infection on trabecular, cortical, and periosteal bone compartments, bone matrix and osteocyte and osteoclast populations, consistent with reports in human patients, suggesting that major pathological changes are driven by the host bone cell response to infection.
The osteoblast lineage has traditionally been viewed through a structural and metabolic lens, yet growing evidence indicates that these cells possess diverse functions, including roles in innate and adaptive immune responses. To establish a coherent mechanistic framework, we performed a systematic review of the literature concerning immune signalling, antigen presentation, and pathogen responses across the osteoblast lineage. We identified 463 unique studies, with 43 meeting the inclusion criteria. Our synthesis reveals a stage-specialised immune continuum. Osteoprogenitors appear to initiate early inflammatory signalling while mature osteoblasts operate as microbial sensors and conditional antigen-presenting cells via inducible expression of cell membrane and cytosolic pattern recognition receptors, and a functional major histocompatibility complex class II apparatus. Osteocytes, the most abundant and long-lived bone cell type, are also capable of detecting microbial danger and activate extensive interferon, chemokine and cytokine programmes within the lacunocanalicular network. Together, these properties define a stromal immune system that coordinates both innate and adaptive immunity across bone surfaces and the mineralised matrix. This osteoblast lineage-integrated immune architecture provides a conceptual basis for understanding osteomyelitis incidence and persistence, biomaterial–immune interactions, as well as inflammatory bone remodelling, reframing this lineage as a previously underappreciated regulator of skeletal and systemic immunity.
Synchronous measures of head kinematics and in vivo brain deformation during rapid head rotation are needed to advance understanding of traumatic brain injury (TBI) mechanics and enhance computational modeling as a tool for injury risk assessment and prevention. The aims of this study were to produce repeatable rapid rotation of the in vivo sheep head, to assess the viability of the sonomicrometry method for measuring multipoint brain displacement, and to quantify the in vivo brain deformation response to rapid rotation. In three anaesthetized adult sheep, arrays of sonomicrometry transceivers were implanted into the brain and rigidly attached to the inner skull surface. Repeatable, rapid, sagittal plane head rotation (nominally about the second cervical vertebra) was induced with a non-impact head rotation apparatus. Computed tomography imaging was performed to assess relative motion between transceivers and brain tissue. Three-dimensional brain displacement, strain, and head kinematics were assessed for repeatability. The location of up to 13 (mean = 11) brain transceivers were tracked in each of 11 rapid head rotation tests. Peak head angular acceleration and velocity were up to 38.56 krad/s2 and 30.43 rad/s, respectively, and average duration of head motion was 241.9 ± 23.1 ms. Pre-to-post-test transceiver displacement in brain tissue was less than the spatial resolution of the measurement system, and brain displacements measured during rapid head rotation had excellent repeatability (CORA score 0.99). Brain displacements and strains up to 2.47 mm and 18
To compare perioperative, oncological, and survival outcomes of total gastrectomy (TG) versus subtotal gastrectomy (SG) in patients with locally advanced distal diffuse gastric adenocarcinoma treated with perioperative 5-fluorouracil, leucovorin, oxaliplatin and docetaxel (FLOT) chemotherapy. Diffuse distal gastric cancer is characterized by infiltrative growth patterns and early nodal metastasis. Whilst radical resection remains the cornerstone of curative treatment, the optimal extent of surgery with TG or SG, remains debated. This international multicenter cohort study analyzed data from patients with histologically confirmed diffuse gastric adenocarcinoma, located > 5 cm from the gastroesophageal junction. Endpoints included surgical margin status, nodal yield, perioperative morbidity, recurrence patterns, time-to-recurrence (TTR), and overall survival (OS). Outcomes were compared using multivariate analyses. In total, 188 (39.0
