To determine age-specific and age-standardised incidence trends of acute rheumatic fever (ARF) or rheumatic heart disease (RHD) among Indigenous Western Australians aged less than 35 years of age.
A population-based retrospective cohort study with linked data analysis.
Western Australian hospital admissions (1996–2022) and RHD notifications to the state-based register (2011–2015).
Patients, both Indigenous and non-Indigenous aged
Of 1746 incident ARF/RHD cases, 1526 (87%) were Indigenous peoples, with the highest rates observed in patients aged 5–14 years, with an annual estimated increase of 4.3% (95% CI 3.2% to 5.2%). The 0–4 years age group experienced an annual increase in incidence rates of 4.8% (95% CI 1.4% to 8.2%). Overall, Indigenous patients experienced an annual increase of 1.9% (95% CI 1.3% to 2.6%) from 1996 to 2022. However, most cases (n=894) were identified after multiple significant policy developments (2011–2022) with an annual increase of 5.7% (95% CI 3.7% to 7.5%) for this period.
Increasing trends of incident ARF/RHD were observed in Indigenous patients aged under 15 years, with the greatest annual increments observed after policy implementation for disease reporting and awareness in the period from 2011 to 2022. Improvement in case ascertainment of ARF/RHD may be contributing towards increasing trends with improved reporting and monitoring of incident cases in very young Indigenous Australians more recently.
Radioembolisation (RE) is gaining traction as a robust treatment option for patients with hepatocellular cancer (HCC) across all cancer stages. RE allows the delivery of targeted high-dose radiation directly to tumours, with relative sparing of the surrounding liver tissue. Traditionally, radiation has been delivered using 90Yttrium ([90Y]Y)-labelled microspheres, either glass or resin. The success of RE is dependent on the dose delivered to the tumour. When using [90Y]Y microspheres, dose prediction is calculated through a 99mTechnitium ([99mTc]Tc)-macroaggregated albumin (MAA) scan, which allows the calculation of the dose to be administered to the tumour. However, [99mTc]Tc-MAA is not a true surrogate of [90Y]Y microspheres, and this will impact on the final dose delivered. [166Ho]Ho, like [90Y]Y, is a beta emitter but unlike [90Y]Y also emits gamma-radiation, allowing for quantitative nuclear imaging. The primary aim of this pilot study was to investigate the safety and efficacy of dosimetry-based individualised 166Holmium ([166Ho]Ho-RE) in patients with HCC.
15 eligible participants will be recruited to receive [166Ho]Ho-RE. The primary objective is to establish the toxicity profile of dosimetry-based individualised [166Ho]Ho-RE. The secondary objective is to assess efficacy as measured by modified Response Evaluation Criteria in Solid Tumours (mRECIST) and Response Evaluation Criteria in Solid Tumours (RECIST) 1.1 criteria. Additional exploratory objectives include quality of life assessment and identification of a radiomic signature of response. The results from this study will be combined with the prospective iHEPAR study to form a larger analysis.
The study has received approval from the East Midlands—Nottingham 1 Research Ethics Committee—approval number 23/EM/0239. The study will be performed in compliance with the Declaration of Helsinki and the principles of Good Clinical Practice. Signed informed consent will be obtained from each patient before study entry. The results will be disseminated through publication in a peer-reviewed scientific journal.
Clinicaltrials.gov NCT06302400.
by Ziyue Wang, Bowen Lu, Hao Yang, Weijie Zhao, Xinru Kong, Chuanhao Mi, Jianlin Wu
ObjectiveEdaravone is a neuroprotective agent, but the characteristics of its adverse events (AEs) remain insufficiently explored. This study aims to examine AEs associated with edaravone use by analyzing real-world data from the FDA Adverse Event Reporting System (FAERS).
MethodsThis retrospective study extracted adverse event reports related to edaravone from the FAERS database, spanning from the second quarter of 2017 to the second quarter of 2024. Disproportionality analysis methods, including the Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), and Bayesian Confidence Propagation Neural Network (BCPNN), were employed to detect AE signals associated with edaravone use.
ResultsAmong 2,931 adverse event reports (AERs) in which edaravone was identified as the primary suspected drug, 86 preferred terms (PTs) and 20 system organ classes (SOCs) were included. At the PTs level, the significant drug-related adverse events were death (n = 589, ROR = 8.64), disease progression (n = 266, ROR = 28.26) and drug ineffectiveness (n = 252, ROR = 2.16). Additionally, rare but notably strong adverse event signals were observed, including thrombosis at the catheter site thrombosi, gastric fistula, and vein collapse.
ConclusionOur research found that edaravone has some overlooked adverse reactions. Further epidemiological studies are needed to more comprehensively explore and assess the risk-benefit profile of edaravone.
With the COVID-19 pandemic driving people into social isolation, causing a financial crisis and creating uncertainty, individuals were at an even greater risk of experiencing negative mental health outcomes. Individuals who identify as women living with diabetes mellitus (DM) of low socioeconomic status (SES) are potentially at increased risk of negative mental health outcomes secondary to health-related risks of COVID-19, as well as financial barriers to access to medications and diabetes-care supplies.
The objective of this scoping review is to investigate how the COVID-19 pandemic affected the mental health of those who identify as women living with DM of low SES including the consequences of public health measures put in place to stop the spread of the virus. The review aims to identify what is known about the impact of COVID-19 on this and identify potential areas for further investigation.
The scoping review protocol was developed with guidance from the framework created by Arksey and O’Malley and refinements from the Joanna Briggs Institute and Levac et al published studies employing experimental and correlational designs to collect quantitative and/or qualitative data will be considered. Search strategies were developed for the MEDLINE, Embase and PsycINFO databases to identify relevant sources. Article titles and abstracts will be screened for eligibility by two independent reviewers. Full-text review will be conducted by two reviewers with a third reviewer being included if disagreement must be resolved. Data extraction will be conducted by two reviewers, one extraction and one quality check, and a third will resolve conflict if necessary. Data will be synthesised and reported in a narrative structure that provides a thematic analysis of the currently available literature.
As this is a scoping review, there are no ethical approval requirements. There is to be a full publication of findings and analysis in a peer-reviewed journal.
Marginalised populations—such as racialised groups, low-income individuals, newcomers and those in rural areas—disproportionately experience severe diabetes-related complications, including diabetic foot ulcers, retinopathy and amputations, due to systemic inequities and limited access to care. Although community-based programmes address cultural and accessibility barriers, their isolation from mainstream healthcare systems leads to fragmented care and missed opportunities for early intervention.
Artificial intelligence (AI)-powered technologies can enhance accessibility and personalisation, particularly for underserved populations. However, integrating AI into community settings remains underexplored, with socioethical concerns around inclusion, diversity, equity and accessibility requiring urgent attention.
This realist review aims to examine how, why and under what circumstances AI applications can be effectively integrated into community-based diabetic care for marginalised populations. The review will develop a programme theory to guide ethical, inclusive and effective AI implementation to ensure AI-driven innovations address health disparities and promote culturally sensitive, accessible care for all.
Using the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) extension for Reviews guidelines, this realist review will systematically search MEDLINE, Embase, CINAHL, Cochrane library, Google Scholar and Scopus, alongside grey literature. A two-stage screening process will identify eligible studies, and data extraction will use a developed tool. Synthesis will employ realist logic, analysing relationships between contexts (eg, organisational capacity), mechanisms (eg, AI functionalities) and outcomes (eg, reduced disparities).
Ethics approval is not required for conducting this realist review. Ethics approval will be obtained from the University of Toronto; however, following the completion of the realist review for patients and community members’ engagement to support knowledge mobilisation and dissemination to ensure practical application and reciprocity.
This protocol was registered at PROSPERO (CRD42025636284).