Autism spectrum disorder (ASD) is a complex neurodevelopmental condition that affects individuals across the globe, including Australia. With an increasing awareness and understanding of autism, Australia has made significant strides in providing support and services for individuals on the spectrum and their families. However, there remain challenges in diagnosis, access to appropriate interventions, inclusive education, employment opportunities, and societal acceptance [1,2]. This editorial article explores the current state of autism in Australia, delving into the prevalence, diagnostic criteria, early intervention programs, education, employment, and support services available. By examining these aspects, this article aims to provide a holistic view of the challenges and advancements in addressing autism in Australia, shedding light on the ongoing efforts to create an inclusive and supportive environment for individuals with ASD. ASD is a lifelong developmental condition characterized by difficulties in social communication, repetitive behaviors, and restricted interests. It is estimated that approximately 1 in 70 Australians are on the autism spectrum, with prevalence rates continuing to rise [3,4]. Over the past few decades, the prevalence of autism in Australia has seen a significant increase, leading to heightened awareness and understanding of the condition [5]. The recognition and understanding of autism in Australia have evolved over time. In the past, autism are often misdiagnosed or misunderstood, leading to limited data on its prevalence. However, as diagnostic criteria and awareness improved, the accurate identification of individuals on the autism spectrum became more common [6,7]. The data are based on surveys, screenings, and diagnostic assessments conducted in various settings, including schools, health-care facilities, and research studies [8]. The increasing prevalence of autism in Australia can be attributed to several factors such as broadening diagnostic criteria, heightened awareness and screening efforts, diagnostic substitution, genetic and environmental factors and increased support and services [9,10]. The prevalence of autism in Australia has shown that males are more likely to be diagnosed with autism than females, with a male-to-female ratio of approximately 3:1. In addition, autism prevalence rates may vary among different ethnic and cultural groups, potentially influenced by factors such as access to healthcare, diagnostic practices, and cultural perceptions of autism [4-10]. The rising prevalence of autism in Australia has significant implications for individuals, families, and society as a whole. With an increasing number of individuals on the autism spectrum, there is a growing need for appropriate and accessible support services, including early intervention programs, educational accommodations, and employment opportunities [4-10]. It is essential for policymakers, healthcare professionals, educators, and community members to work collaboratively to address the needs of individuals with autism and their families. This includes promoting awareness and understanding of autism, providing training and support for professionals working with individuals on the spectrum, and ensuring that policies and programs are inclusive and person-centered. Research on autism prevalence should continue to be a priority, as it can provide valuable insights into the condition’s causes and inform the development of more effective interventions and support services. By addressing the unique needs of those on the autism spectrum and promoting understanding and acceptance, Australia can build a more inclusive future for all its citizens and residents by taking care of the following factors:  Diagnosis and Early Intervention: The early identification of autism is crucial for providing timely and appropriate support to children and their families [11]. The diagnosis of ASD in Australia typically involves a comprehensive assessment by a team of qualified professionals, which include pediatricians, psychologists, speech therapists, and occupational therapists. The process involves gathering information from parents, caregivers, and teachers, as well as observing the child’s behavior and development [12]. In  Australia, there are no specific age restrictions for autism diagnosis, and children can be evaluated at any age if there are concerns about their development. However, early detection and intervention are essential for better outcomes, so diagnosis often occurs in early childhood [12]. The National Disability Insurance Scheme (NDIS) is an important aspect of autism support in Australia. It is a nationwide system that provides funding for disability related services and supports, including early intervention for children with autism. The NDIS aims to provide personalized support plans based on individual needs and goals [13]. Early intervention programs often focus on areas such as communication and language development, social skills, behavior management, sensory processing, and adaptive skills to enhance the child’s overall development and functioning. In addition, many non-governmental organizations and community-based services offer early intervention programs for children with autism and their families. These services may include therapy sessions, parent training, and support groups to assist families in understanding and supporting their child’s needs in Australia [13]. Education and Inclusion: Education is a fundamental right for all individuals, including those with autism in Australia.[14] Education and inclusion of autism are integral components in nurturing the potential of every child affected by ASD. In Australia, there is a growing emphasis on inclusive education, aiming to provide all students, including those with disabilities such as autism, with equitable access to quality education [15-17]. The Disability Discrimination Act (DDA) 1992 and Disability Standards for Education (DSE) 2005 are legal supports in Australia. These legal frameworks protect the rights of individuals with disabilities, including autism, against discrimination in education settings and outline the obligations of educational institutions to provide reasonable adjustments [18,19]. In addition, schools in Australia offer various forms of special education support, such as learning support officers, teacher aides, individualized learning plans and Autism-specific programs and services to meet the needs of students with autism [20,21]. Furthermore, the Australian government initiatives and funding schemes also support the inclusion of students with disabilities, including those with autism, in mainstream education [22]. Employment and Autism: As individuals with autism transition into adulthood, employment becomes a significant aspect of their lives. As of the last update in September 2021, Australia has been making efforts to support individuals with autism in gaining meaningful employment and achieving workplace inclusion [23]. The Australian government, along with various organizations, offers initiatives and programs aimed at improving employment opportunities and support for individuals with autism. The Disability Employment Services (DES) is a government program that provides support and assistance to people with disabilities, including autism, in finding and maintaining employment. DES providers offer personalized support tailored to the individual’s needs, which may include job training, workplace modifications, and ongoing support in the workplace.[24,25] In addition, some organizations in Australia also offer supported employment programs specifically designed for individuals with autism and other disabilities. These programs provide structured work environments and individualized support to help individuals develop job skills and gain work experience.[23-25] Moreover, Autism-specific Employment Programs organizations in Australia focus specifically on helping individuals with autism find suitable employment. These programs often provide job coaching, skills training, and ongoing support to ensure successful integration into the workforce. Furthermore, community and nonprofit organizations in Australia also offer employment support and advocacy for individuals with autism [26]. These organizations may assist with job placement, offer mentoring programs, and provide resources for employees and employers [23-26]. Support Services for Individuals and Families: Families and individuals living with autism often require comprehensive support services to navigate various aspects of their lives. Support services for individuals and families affected by autism are crucial in providing the necessary resources and assistance to navigate the challenges associated with ASD [27-29]. These services encompass a wide range of interventions, therapies, and support networks tailored to meet the unique needs of each individual. For individuals with autism, support services may include behavioral therapies, speech and language therapy, occupational therapy, social skills training and assistive technologies and adaptive tools are employed to enhance communication and daily living skills [30-32]. For families, support services offer vital guidance, education, and emotional support, helping them better understand autism and its impact on their loved ones. Support groups and counseling sessions provide a safe space for families to share experiences, exchange coping strategies, and build strong support networks. The collaborative effort of support services empowers individuals with autism and their families, fostering a sense of community and equipping them with the tools to lead fulfilling lives [27-32].  Autism Research and Advancements:  The field of autism research in Australia is continuously evolving, leading to a better understanding of the condition and improved interventions [33]. Autism research and advancements in Australia have been instrumental in expanding our understanding of ASD and improving the lives of individuals with autism. The Australian research community has made significant contributions to identifying genetic and environmental factors contributing to autism, as well as the development of early detection and intervention methods [33]. Research institutions, universities, and organizations in Australia have collaborated on numerous studies exploring various aspects of autism, from brain development and neural connectivity to sensory processing and social communication [33]. These research efforts have paved the way for evidence-based interventions and therapies, ensuring that individuals with autism receive tailored support and accommodations. Moreover, Australia has been at the forefront of promoting inclusivity and neurodiversity, with educational institutions and workplaces implementing progressive policies to create supportive and accepting environments [33]. Through continued dedication to research and the implementation of innovative approaches, Australia remains committed to empowering individuals with autism and promoting a more inclusive and compassionate society. Government Policies and Initiatives: The Australian government plays a crucial role in shaping the support and services available to individuals with autism. The Australian Government has demonstrated a commitment to addressing the needs of individuals with autism through various policies and initiatives [22]. One of the key initiatives is the National Disability Insurance Scheme (NDIS), which provides funding and support to people with disabilities, including autism, to access essential services and therapies [13].  The NDIS aims to empower individuals with autism to lead more independent lives and participate fully in their communities. In addition, the Australian Government has invested in research and early intervention programs, recognizing the significance of early diagnosis and support for better outcomes [11,29]. Inclusive education policies have been promoted, encouraging schools to create supportive and accommodating environments for students with autism [14-19]. Moreover, the government has worked to increase autism awareness and understanding in society, reducing stigma and promoting acceptance of neurodiversity [34]. Through these comprehensive policies and initiatives, the Australian Government continues to strive for a more inclusive and accessible society, ensuring that individuals with autism receive the support and opportunities they need to thrive. Autism Awareness and Acceptance: Promoting awareness and acceptance of autism are essential to create a more inclusive society. Autism awareness and acceptance in Australia have significantly improved in recent years, thanks to the collective efforts of individuals, advocacy groups, and government initiatives [34]. The Australian community has become more knowledgeable about ASD through public awareness campaigns, educational programs, and media representation [34,35]. This increased awareness has fostered greater understanding of the challenges and strengths of individuals with autism, promoting empathy and inclusivity. Furthermore, efforts to promote autism acceptance have focused on embracing neurodiversity, recognizing the unique perspectives and talents that individuals with autism bring to society. Schools, workplaces, and public spaces have increasingly implemented inclusive practices to accommodate the needs of individuals with autism, breaking down barriers and creating more accepting environments. Through ongoing advocacy and open dialogue, Australia continues to make significant strides in building a society that values and celebrates the diversity of all its members, including those living with autism. Future Directions and Recommendations: As the understanding of autism evolves, there are opportunities for further improvements in addressing the challenges faced by individuals with autism and their families. Looking toward the future directions of autism in Australia, it is essential to build upon the progress made thus far and continue to prioritize the needs of individuals with autism and their families. First and foremost, increased investment in autism research is crucial to deepen our understanding of the condition and identify more effective interventions and therapies. In addition, there should be a continued focus on early detection and intervention, as early support can significantly improve outcomes for children with autism. The Australian Government should continue to expand and refine the National Disability Insurance Scheme to ensure equitable access to essential services and support for all individuals with autism. Moreover, promoting inclusive education and employment opportunities will be vital in fostering an inclusive society that values neurodiversity. Enhancing awareness and acceptance through public campaigns and education will help reduce stigma and create a more empathetic and accommodating environment for individuals with autism. By fostering collaboration among researchers, educators, health-care providers, and advocacy groups, Australia can continue to lead in advancing autism support and resources, ensuring that every individual with autism can live a fulfilling and meaningful life. References 1. Available from: https://www.aph.gov.au/parliamentary_business/committees/senate/autism/autism/report [Last accessed on 2023 Jul 24]. 2. Available from: https://www.dss.gov.au/disability-and-carers/nationalautism-strategy [Last accessed on 2023 Jul 24]. 3. Available from: https://www.aihw.gov.au/reports/disability/autism-inaustralia/contents/autism [Last accessed on 2023 Jul 24]. 4. 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Estimating the prevalence of autism spectrum disorder in New South Wales, Australia: A data linkage study of three routinely collected datasets. J Autism Dev Disord 2023. Doi: 10.1007/s10803-022-05887-3. 11. Available from: https://www.nichd.nih.gov/health/topics/autism/conditioninfo/treatments/early-intervention [Last accessed on 2023 Jul 25]. 12. Available from: https://www.nhmrc.gov.au/about-us/resources/impactcase-studies/autism-assessment-diagnosis-guideline [Last accessed on 2023 Jul 25]. 13. Available from: https://www.autism.org.au/ndis [Last accessed on 2023 Jul 25]. 14. Boyle C, Anderson J. The justification for inclusive education in Australia. Prospects 2020;49:203-17. 15. Available from: https://www.amaze.org.au/creating-change/research/community-attitudes-education [Last accessed on 2023 Jul 30]. 16. Available from: https://humanrights.gov.au/sites/default/files/ahrc_20191219_submission_disabilityrc_education.pdf [Last accessed on 2023 Jul 30]. 17. 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Objectives: Nutritional protocols and guidelines are essential to guide health-care practitioners toward effective enteral feeding management for critically ill patients. Despite the wide availability of international guidelines to direct enteral feeding practices, there are no nutritional guidelines regarding enteral feeding practices tailored for the Saudi Arabian population. In addition, different enteral feeding practices may result in negative outcomes like malnutrition. Methods: A qualitative study was conducted through multiple focus group sessions. Pre-formulated structured open-ended questions were asked from the participants during the focus group sessions to gain an in-depth understanding of the current enteral feeding practices. All sessions were audio-recorded, and the transcript was coded and cross-validated. Results: A total of five focus group sessions were conducted until data saturation was reached. Data saturation was reached when no additional information was mentioned in the fifth focus group session when compared to all previous sessions. All 24 participants were specialized in the clinical nutrition field with enteral feeding experience in critically ill patients and working in Riyadh city. Twelve themes of the current practices, four themes of obstacles, and four themes of needs were identified with subthemes. Conclusion: This qualitative study shows different enteral feeding practices, obstacles, and needs among registered dietitians. Thus, the need for developing national nutritional guidelines tailored to local population characteristics is highlighted. National guidelines are recommended to be compatible with a defined registered dietitian role with clear standards of practices and responsibility for each discipline to achieve a competent health care service.

Objectives: Due to the continues emergence of antimicrobial resistance, discovery of novel compounds are urgently required. Thus, this study is focused to identify a novel antimicrobial peptide (bacteriocin) targeting multidrug-resistant pathogenic bacteria. Methods: About 80 environmental isolates were recovered and screened for anti-bacterial activity using simultaneous antagonism assays. Produced peptide (AB3) was purified using Strata-XL-C and Sep-Pack columns. Matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) analysis and MIC were conducted on the AB3 peptide to determine its molecular weight and spectrum of activity. Extraction and amplification for the 16S rRNA gene of the producing strain was accomplished using QIAamp DNA Mini Kit and GeneAmp PCR system thermocycler, respectively. Novelty of the compound was assessed based on all obtained genomic and proteomic data using Basic Local Alignment Search Tool search and Unni-Prot and Bactibase, respectively. Results: About 5% of screened isolates showed antagonistic activity toward tested indicators. Obtained compound showed narrow spectrum of activity toward certain Gram-positive species including, methicillin-sensitive Staphylococcus aureus (MSSA), methicillin-resistant Staphylococcus aureus (MRSA) and Bacillus species. MALDI-TOF analysis revealed the flowing molecular masses: 1288.207 Da, 1304.536 Da, 1326.529 Da, 1403.591 Da, and 1472.792 Da. The extensive genomic and proteomic analysis have indicated the discovery of novel bacteriocin produced by Bacillus malacitensis. Conclusion: A novel bacteriocin (AB3) was identified from B. malacitensis, which has showed promising in vitro bactericidal activity toward MSSA, MRSA, and Bacillus subtilis. This compound holds great potential to replace or used in combination with currently used antibiotics to treat serious untreatable bacterial infections. However, further investigations to determine its suitability for therapeutic use in human health are needed.

Objectives: Inflammatory bowel diseases (IBDs) are a multiple inflammatory status in small intestines and colon. Bromelain and Papain were cysteine proteases enzymes extracted from pineapple and papaya, and possess antioxidant and antiinflammatory characteristics. Therefore, this comparative work aimed to examine the anti-inflammatory and antioxidant effect of bromelain and papain in intestinal inflammation of rats and to evaluate the most potent effect of both types of enzymes. Methods: Forty rats were used in this study (8 rats/group), G1: control group, G2: (Indo group) intestinal inflammation was induced by two doses of Indomethacin (7.5 mg/kg body weight) apart 24 h. G3: (Indomethacin + Bromelain) intestinal inflamed rats treated by oral dose of bromelain (1000 mg/kg/day). G4: (Indomethacin + Papain) intestinal inflamed rats treated by oral dose of papain (800 mg/kg/day). G5: (Indomethacin + Sulfasalazine) intestinal inflamed rats treated by oral dose of sulfasalazine (500 mg/kg/day). Oxidative stress and inflammatory markers were measured along with histological assessment. Results: Indomethacin-induced intestinal inflammation (in both Jejunum and Ileum) characterized by increased oxidative stress biomarkers: Xanthine oxidase, Catalase, Glutathione reductase, and Protein carbonyl and Inflammatory biomarkers: Tumor necrosis factor-α, Interleukin-10, Monocyte chemoattractant protein-1, Nuclear factor-kappa β, C-reactive protein, and Prostaglandin E2, as compared to control rats. On the other hand, administering either bromelain or Papain would effectively decrease symptoms of intestinal inflammation and modulate biomarkers of oxidative stress and pro-inflammatory cytokines. Conclusion: Comparing results revealed that bromelain showed the most potent protective effect and possesses an apparent role in protection against the development of intestinal inflammation.

Objective: The study aimed to determine the correlation between sacrum displacement and ground reaction force (GRF) during walking on a level surface. The kinematic parameters of angular displacement of sacrum bone in the three directions are measured, and a correlation was derived to integrate the effect of GRF to sacrum displacement. Methods: Forty healthy university students participated in this study. Each student was asked to walk with a normal gait without targeting a slope during walking. Double-sided adhesive tape was used to place all markers on the specific landmark points. Qualisys system was adjusted before picking up the required parameters to enable each camera to determine the locations of the reflective markers in combination with a force plate component to extract the correlation data. Results: A positive correlation in the vertical direction was observed in the early and late phases of the stance phase in females. In males, a positive correlation was demonstrated in the middle and late phase of the stance phase. However, a positive correlation was found only among the male group in the anteroposterior direction during the middle part of the stance phase. Conclusion: The findings of our study point to the incorporation of strength-training exercises to increase the rotator muscle strength of the trunk and lower extremities in both males and females. The results indicate that in the male group, the flexors and extensors of the trunk and lower extremities in the middle part need to be focused during strength training, especially for athletics. This would be useful in decreasing the incidence of sports injuries.

Objectives: The prevalence and reactivating pattern of cytomegalovirus (CMV) among renal transplant recipients in Sri Lanka is scarce. The study was aimed to describe the replication patterns of CMV in post-renal transplant recipients who were on preemptive therapy and identify the risk factors and time period for CMV reactivating during the 1st year of transplantation and provide an insight into the selection of preemptive therapy in the local setting. Methods: A retrospective and cohort study was conducted, enrolling renal transplant recipients who have completed routine 1-year follow-up for preemptive management at the National Hospital, Kandy, from January 2016 to January 2021. CMV quantitative polymerase chain reaction results and demographic data of enrolled recipients were analyzed to investigate the CMV replication pattern and risk factors. Categorical data were analyzed using Pearson’s Chi-square test, considering P < 0.05 statistically significant. Continuous variables were presented as percentages. Results: Two hundred and fifty-one renal transplant recipients’ data were included in the study. Of them, 75.70% were male patients, and the mean age of the study population was 43.25 years. CMV DNAemia incidence was 56.57% during the 1st year of post-renal transplantation. Only 9.16% had developed more than 104 IU/mL or significant DNAemia. Sex and donor type were not risk factors for CMV reactivation. However, the recipient’s age was significantly associated with CMV viraemia among renal transplant recipients. Conclusion: Considering the low incidence of significant viraemia among the study population, pre-emptive treatment would be the cost-effective strategy for management of the post-renal transplant recipients in local settings.

Objective: According to findings from the previous studies, quitting smoking can significantly reduce mortality from all causes and is linked to better treatment results. Even though quitting smoking has many benefits, little is known about the evidence supporting the particular quit services offered to smokers after a cancer diagnosis. Methods: To find the articles related to area in question, different electronic databases including PubMed/Medline, Google Scholar, and EBSCO were searched on April 1st, 2023. All full text randomized controlled trials with one or more intervention and control groups that assessed the outcomes of smoking cessation interventions were included. Participants of included studies were adults diagnosed with head and neck cancer (HNC) and current smokers or those who had recently quit. There were interventions (pharmacological and/or pharmacological) that aimed to help patients with HNC succeed in quitting smoking. Results: We identified 15352 papers from the initial search from different electronic databases, 2560 remained after excluding duplicates. After screening titles and abstracts for relevance, 2345 articles were removed. Full text articles of remaining 215 papers were assessed in depth by two reviewers for their eligibility, amongst which, 210 articles were excluded. Finally, we included five papers that met the inclusion criteria in the present systematic review. Conclusion: According to the findings of this review, a multi - component strategy might very well benefit patients with HNC who smoke cigarettes after diagnosis. More studies with high methodological quality and standardized outcome measures must be conducted in this population to inform the development of smoking cessation program.