The Sydney system for lymph node FNA biopsy cytopathology: A detailed analysis of recent publications and meta-analysis and a proposal for the components of an ideal prospective study of a cytopathology reporting system.

BACKGROUND: The Sydney system for fine-needle aspiration biopsy of lymph nodes has five categories, stressing the role of correlation of cytopathology with clinical, ultrasound, and ancillary findings to achieve diagnosis. The five categories constitute a hierarchical system with increasing risk of malignancy from benign to atypical, suspicious, and malignant categories, which informs recommendations for further workup to achieve a final diagnosis as possible. This article analyzes 10 publications using the Sydney system and a meta-analysis of nine of these studies. The primary goal of the analysis is to ascertain the causes of the large ranges in risk of malignancy for the "atypical" and "inadequate" compared to "benign," "suspicious," and "malignant" categories, which were comparable to well-established reporting systems. Research protocols are proposed to improve future studies. METHODS: PubMed literature search from January 2021 to December 2023 identified studies evaluating performance of the Sydney system. RESULTS: Ten studies showed heterogeneity with clinical setting, study design, ultrasound use and rapid on-site evaluation, operator, cutoff points for "positive" cases, with inherent partial verification biases, resulting in a wide range of risk of malignancy, specificity, and sensitivity values. CONCLUSION: Analysis shows the large range is due to heterogeneity of the studies, which suffer from biases and variable statistical analysis that are ultimately included in any meta-analysis, detracting from the usefulness of the risk of malignancy derived by the meta-analysis. Components for ideal analyses of reporting systems are presented.

Integrating point-of-care diabetes detection with lifestyle counselling in community settings: outcomes from Western Sydney, Australia.

INTRODUCTION: Early detection and prevention of type 2 diabetes and its complications are global health priorities. Optimal outcomes depend on individual awareness and proactive self-management of health risks. This study evaluates the effectiveness of a community-based diabetes detection and intervention program in a high-risk area in western Sydney, Australia. RESEARCH DESIGN AND METHODS: We collaborated with the Workers Lifestyle Group, Tamil Association Arts and Culture Association, and the National Aboriginal and Islanders Day Observance Committee to implement our program. Participants underwent HbA1C testing via point-of-care blood spot testing. They received personalized feedback, education on diabetes management, and were offered opportunities to enrol in lifestyle modification programs. Participants identified with pre-diabetes (HbA1C 5.7-6.4%) or diabetes (HbA1C > 6.4%) were advised to consult their General Practitioners (GPs). A follow-up questionnaire was distributed 3-8 months post-intervention to evaluate the programs usefulness and relevance and lifestyle changes implemented by the participants. RESULTS: Over eight months, 510 individuals participated. Of these, 19% had an HbA1C > 6.4%, and 38% had levels between 5.7 and 6.4%. Among those with diabetes, HbA1C levels ranged as follows: 56% <7%; 20% 7-7.9%; 18% 8-8.9%; and 5% >9%. Post intervention survey indicated that the program was well-received, with 62.5% of responses reporting lifestyle changes and 36.3% seeking further advice from their local healthcare providers. CONCLUSION: The study demonstrates a significant prevalence of pre-diabetes and diabetes in the community, similar to findings from larger-scale hospital and general practice studies. Point-of-care testing combined with personalized education effectively motivated participants toward healthier lifestyle choices and medical consultations. The paper discusses the scalability of this approach for broader population.

Development of a Dutch Version of the Sydney Swallow Questionnaire: Assessing Oropharyngeal Dysphagia Severity in Dutch-Speaking Populations.

Aims: The oropharyngeal dysphagia (OD) poses substantial health risks and affects quality of life. Patient-reported outcome measures (PROMs) are gaining prominence for their crucial role in early detection and adapting rehabilitation and management decisions. This highlights the need for culturally pertinent versions in different languages, especially when addressing conditions like OD. This study aimed to translate, culturally adapt, and assess the test-retest reliability of the Sydney Swallow Questionnaire (SSQ), a PROM designed to detect the risk of OD, for Dutch-speaking populations. Materials and Methods: The SSQ was translated and adapted based on Beaton's guidelines. Validity and test-retest reliability were assessed in 100 healthy participants, with a subset of 30 participants assessed over a 15-day interval. Intra-class correlation coefficient (ICC) values were calculated to determine test-retest reliability. Results: The SSQ-Dutch was well received and well understood, with a median total score of 65.5/1700. Notably, 95% of participants scored below the established dysphagia risk cut-off, consistent with previous validations. The 15-day interval ICC for the SSQ-Dutch total scores was 0.82 (CI 95%: 0.66-0.91), indicating good reliability. While most questions had moderate-to-good reliability, five showed slightly lower ICC. Conclusion: The SSQ-Dutch emerges as a validated and reliable tool for assessing OD risk in Dutch-speaking individuals. Future studies should evaluate its efficacy in symptomatic populations and consider cultural variations in Dutch-speaking regions. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-024-04484-3.

Older urban rats are infected with the zoonotic nematode Angiostrongylus cantonensis.

Rats, being synanthropic, are hosts to agents of zoonotic diseases that pose a threat to human and domestic animal health. The nematode parasite Angiostrongylus cantonensis, commonly known as the rat lungworm, is no exception; it can cause potentially fatal neural disease in humans, dogs and other species. The distribution of A. cantonensis (haplotypes SYD.1 and Ac13) and its close relative, Angiostrongylus mackerrasae is not well understood in Australia. We investigated the prevalence of Angiostrongylus in rats in Sydney, Australia, primarily via faecal qPCR, and identified the species and haplotypes using partial cox1 sequencing. We found a moderate prevalence of infection (29%; 95% CI: 16.1-46.6%) in black (Rattus rattus) and brown (Rattus norvegicus) rats around public parks and residential areas. This study demonstrates that Sydney's urban rat population is a reservoir for A. cantonensis. Modelling infection status as a function of rat species, sex, tibia length (as a proxy for age), and health index (a measure of weight by size) revealed that older rats are statistically more likely to be infected (χ 2 1 = 5.331, P = 0.021). We observed a dominant presence of the A. cantonensis SYD.1 haplotype, for which the implications are not yet known. No A. mackerassae was detected, leading us to suspect it may have a more restricted host- and geographical range. Overall, this study illustrates the presence and potential risk of A. cantonensis infection in Sydney. Public education regarding transmission routes and preventative measures is crucial to safeguard human and animal health.

Operational relevance of the Sydney Declaration: The example of the Australian Federal Police (AFP) Forensics Command.

In 2022, a group of eminent forensic scientists published The Sydney Declaration - Revisiting the essence of forensic science through its fundamental principles in Forensic Science International. The Sydney Declaration was delivered to revisit "the essence of forensic science, its purpose, and fundamental principles". At its heart, revisiting these foundational principles is hoped to "benefit forensic science as a whole to be more relevant, effective and reliable". But can these principles be translated operationally by a forensic services provider to achieve the benefits prescribed? How do we make the leap from a theoretical concept and begin to put it into practice to bring about the real and meaningful change that the declaration hopes to achieve? In this paper we will attempt to discuss how the Australian Federal Police (AFP) Forensics Command has reflected on the Sydney Declaration by relating reforms developed and implemented to our operating model with some selected principles. We hope to show that while the Sydney Declaration could be perceived as academic and disconnected from operations, it has the potential to impact and positively influence reforms and changes for forensic science providers. The AFP Forensics Command experience shows the operational relevance of The Sydney Declaration.

Molecular Evolution of GII.P31/GII.4_Sydney_2012 Norovirus over a Decade in a Clinic in Japan.

Norovirus (NoV) genogroup II, polymerase type P31, capsid genotype 4, Sydney_2012 variant (GII.P31/GII.4_Sydney_2012) has been circulating at high levels for over a decade, raising the question of whether this strain is undergoing molecular alterations without demonstrating a substantial phylogenetic difference. Here, we applied next-generation sequencing to learn more about the genetic diversity of 14 GII.P31/GII.4_Sydney_2012 strains that caused epidemics in a specific region of Japan, with 12 from Kyoto and 2 from Shizuoka, between 2012 and 2022, with an emphasis on amino acid (aa) differences in all three ORFs. We found numerous notable aa alterations in antigenic locations in the capsid region (ORF2) as well as in other ORFs. In all three ORFs, earlier strains (2013-2016) remained phylogenetically distinct from later strains (2019-2022). This research is expected to shed light on the evolutionary properties of dominating GII.P31/GII.4_Sydney_2012 strains, which could provide useful information for viral diarrhea prevention and treatment.

Kirk's 'Ontogeny of Criminalistics' revisited under the lens of the Sydney Declaration.

The present commentary reviews the considerations of the famous American criminalist Paul Kirk in his seminal publication of 'The Ontogeny of Criminalistics,' written sixty years ago, regarding the status of forensic science and its fundamental principles. Professor Kirk aimed to examine forensic science as an independent scientific discipline, resulting in the identification of six key topics: 1) The need for fundamental principles; 2) the distinction between 'identification' and 'individualization;' 3) the qualifying elements of a profession; 4) the qualifying aspects of a science; 5) the need for a research-oriented basis; 6) the need for application of statistics and probability. In particular, Kirk deemed the nature of the progress made during his time as technical, practical, and transient at the cost of being fundamental, theoretical, and permanent. Predominantly, it is still the case today, with a post-effect fragmentation of forensic science into a myriad of ultra-specialized subdisciplines and applications. The lack of proper articulation of the most fundamental principles of forensic science was one of Kirk's most pressing concerns. The Sydney Declaration aimed to recapture the current fundamental (ontological and epistemological) status of forensic science, resulting in the redefinition of forensic science and its prime object of study, the trace, and in the consolidation of seven principles. The present commentary attempts to address Kirk's arguments in the Ontogeny in the context of the principles of the Declaration, with particular emphasis on the fundamental principles as well as Kirk's distinction between 'identification' and 'individualization,' which is considered critical to understanding the overall scope of forensic science.

The Sydney Declaration - An unique opportunity for Africa.

The Sydney Declaration (SD) has the inherent virtue of shifting the focus from the tools used in forensic science to the fundamental characteristics of appropriate forensic practice analysis of a situation and all related trace data for the purpose of resolving a case. Though several differences might be observed between countries regarding the technologies used, the fundamental principle of forensic logical reasoning are universally applicable to all contexts and environments and not only restricted to sophisticated, well-resourced, established forensic science laboratories based in countries that offer adequate resources, strong networks and legal frameworks. In Africa, several countries lack resources to train practitioners and to develop forensic science institutes, laboratories and other relevant institutions. The SD can serve as departure point to attain appropriate forensic science outcomes. Upholding its sound guidance can help forensic science practitioners remain faithful to their science, acknowledge their limits, give expert opinions based solely on facts and scientific analysis and interpretation, whilst also enhancing communication with their stakeholders. As forensic science develops in Africa, the SD presents a timely opportunity for us to proceed with a common understanding and a solid foundation through which our field can grow.

Strongyloides stercoralis in two dogs from a household in temperate Australia.

Strongyloides stercoralis is parasite affecting both humans and dogs and is most prevalent in tropical and subtropical areas of Australia. This case report describes two dogs from a household in Sydney, New South Wales, one with chronic gastrointestinal signs and the other who was asymptomatic who were subsequently diagnosed with S. stercoralis. Diagnosis can be challenging in humans and dogs due to intermittent shedding and low worm burdens and in this case the symptomatic dog had Strongyloides spp. rhabitiform larvae detected on a direct faecal smear and PCR, the asymptomatic dog on PCR only. Obtained sequences from the symptomatic dog confirmed the presence of the S. stercoralis clade affecting both dogs and humans. Infection does not respond to commonly used deworming drugs for dogs. Treatment in both cases was undertaken using off-label doses of ivermectin and follow-up PCR testing was negative. This case report should increase practitioner awareness of this parasite as present and transmissible in temperate areas of Australia.

Upcoming World Health Organization system for reporting lymph node cytopathology-A preliminary outline.

Purple book for WHO reporting for lymph node cytopathology - 2023. Lymph node cytopathology reporting system may use standardized nomenclature and usage of the terminologies harmonizing with the WHO Blue Book on hematolymphoid tumors.

Systematic Review and Meta-Analysis of the Diagnostic Accuracy of the Sydney System for Reporting Lymph Node Fine-Needle Aspiration Biopsy in Diagnosing Malignancy.

INTRODUCTION: The aim of the study was to perform the first meta-analysis for assessment of the pooled risk of malignancy of each category of the Sydney system for reporting of lymph nodal aspirates along with the evaluation of diagnostic accuracy. METHODS: PubMed/MEDLINE and Embase were searched with the following keywords: "(Lymph node) AND (fine needle aspiration biopsy) OR (International system OR Sydney system)" in the timeframe 2020 to August 4, 2023. The selected articles were assessed for the risk of bias by the QUADAS-2 tool. The meta-analysis for sensitivity (SN) and specificity for each cut-off, that is, "atypical considered positive," "suspicious of malignancy considered positive," and "malignant considered positive" for the lesions, was carried out after excluding the inadequate samples in each study. To assess the diagnostic accuracy, summary receiver operating characteristic curves were constructed, and the diagnostic odds ratio was pooled in both scenarios. RESULTS: Nine studies, all of which were retrospective cross-sectional studies, were evaluated with a total of 13,205 cases. The SN and specificity for the "atypical and higher risk categories" considered positive for malignancy were 97% (95% CI, 95-99%) and 96% (95% CI, 91-98%), respectively. The SN and specificity for the "suspicious of malignancy and higher risk categories" considered positive for malignancy were 91% (95% CI, 85-95%) and 99% (95% CI, 97-100%), respectively. The SN and specificity for the "malignant" considered positive for malignancy were 75% (95% CI, 65-84%) and 100% (95% CI, 99-100%), respectively. The pooled area under the curve was 99-100% for each of the cut-offs. CONCLUSION: This meta-analysis highlights the accuracy of the Sydney system in reporting lymph node aspirates. It exhibits the significance of the "suspicious" and "malignant" categories in diagnosing malignancy and of the "benign" category in excluding malignancy.

Impact of multidisciplinary care of diabetic foot infections for inpatients at Campbelltown Hospital.

BACKGROUND: Diabetic foot infection (DFI), including diabetic foot ulcer, is a serious complication of diabetes, particularly in the South Western Sydney (SWS) region where it is a leading cause of diabetes-related hospitalisations. Multidisciplinary team (MDT) involvement is effective at improving the health outcomes of DFI patients. This study investigated the impact of MDT (High Risk Foot Service, HRFS) on the length of stay and surgical outcomes of inpatients with DFI in a Sydney tertiary hospital. METHOD: A retrospective audit of electronic medical records of inpatient admissions for DFI at Campbelltown Hospital between January 2019 - December 2021, was performed. The main outcome of the study was MDT involvement, defined as having two or more specialities involved in the patient's treatment. The other measured variables included length of stay (defined as the total duration from admission to discharge), and surgical outcomes including debridement, minor amputation, and major amputation. RESULTS: Over the three years, 78 participants presented to the hospital for 89 unique DFI admissions. There were 24 admissions in 2019, 28 admissions in 2020, and 37 admissions in 2021, with MDT attendance showing a steady increase at 62.5%, 75.0% and 83.8% respectively. Patients with serious comorbidities such as chronic kidney disease were more likely to have MDT involvement (84.8% vs. 15.2%, P = 0.048). Imaging was more likely to be performed with MDT involvement (78.8% vs. 21.3%, p < 0.05). Comparing patients who received and did not receive MDT care, the mean HbA1c (%) (8.4 ± 2.0 vs. 8.2 ± 2.7, P = 0.701), median length of stay (LOS: 7.8, IQR 15.0 days vs. 4.8 IQR 7.9 days, P = 0.243) and rate of surgical outcomes (74.6% vs. 72.7%, P = 0.262) were similar. Patients who required major amputation had significantly longer LOS (24 days, IQR 21.5 vs. 5.2 days, IQR 13.0, P = 0.004) but similar HbA1c (P = 0.552) compared to those who had conservative intervention. CONCLUSION: Adopting an MDT approach was associated with more thorough investigation of DFI, with similar rates of surgical outcomes. Further research on the impacts of MDT on length of stay and surgical outcomes of DFI patients in other SWS hospitals is needed.

Organic enrichment reduces sediment bacterial and archaeal diversity, composition, and functional profile independent of bioturbator activity.

Eutrophication is a worldwide issue that can disrupt ecosystem processes in sediments. Studies have shown that macrofauna influences sediment processes by engineering environments that constrain microbial communities. Here, we explored the effect of different sizes of the Sydney cockle (Anadara trapezia), on bacterial and archaeal communities in natural and experimentally enriched sediments. A mesocosm experiment was conducted with two enrichment conditions (natural or enriched) and 5 cockle treatments (small, medium, large, mixed sizes and a control). This study was unable to detect A. trapezia effects on microbial communities irrespective of body size. However, a substantial decrease of bacterial richness, diversity, and structural and functional shifts, were seen with organic enrichment of sediments. Archaea were similarly changed although the magnitude of effect was less than for bacteria. Overall, we found evidence to suggest that A. trapezia had limited capacity to affect sediment microbial communities and mitigate the effects of organic enrichment.

Morphological Spectrum of Gastritis in Endoscopic Biopsies and Its Association With Helicobacter pylori Infection.

Introduction Helicobacter pylori (H. pylori) infection is the most common cause of gastritis. The consequences of the persistent infection range from acute ulceration to the development of gastric neoplasia. The purpose of the study is to determine the histopathological pattern of gastritis in gastric biopsies and its association with H. pylori. Materials and methods This is a retrospective study of all the gastric biopsies received in the Department of Histopathology, Chughtai Institute of Pathology, Lahore, Pakistan from January 12, 2021 to April 10, 2021. Sections were cut from formalin-fixed, paraffin-embedded (FFPE) tissue blocks. Slides were stained with routine, special and immunohistochemical stains. The cases were then blindly reviewed by two pathologists with a special interest in Gastrointestinal Pathology. Microscopic features based on updated Sydney classification were recorded. The collected data were then analyzed by using SPSS version 20 (IBM Corp., Armonk, NY). Results A total of 429 gastric biopsies were examined. Out of which, 202 (47.1%) were male and 227 (52.9%) were female with a female-to-male ratio of 1.2:1. Their ages ranged from 12 to 100 years and a peak in the fourth decade of life with a mean age of 43 years (median age 49 years). Among gastritis, activity was seen in 194 (45%) and chronicity in 237 (55%) cases. H. pylori was seen in 174 (40.5%) cases and there was a strong statistically significant association between H. pylori infection and severity of gastritis (p<0.001). Other parameters of Sydney classification, such as atrophic changes, were seen in 144 (33%) cases, and intestinal metaplasia in 10 (2.3%) cases. Conclusion H. pylori organism was the most common cause of gastritis in our environment. The severity of gastritis is directly related to the H. pylori infection. If neutrophils are identified on surface epithelium, then H. pylori should be searched with increased attention on morphology and/or on immunohistochemical stain of H. pylori. Chronic inflammation and H. pylori density can also guide treatment which is necessary to avoid complications.

Prevalence of Human Norovirus GII.4 Sydney 2012 [P31] between 2019 and 2021 among Young Children from Rural Communities in South Africa.

Acute gastroenteritis (AGE) accounts for considerable morbidity and mortality in the paediatric population worldwide, especially in low-income countries. Human norovirus (HNoV), particularly GII.4 strains, are important agents of AGE. This study aimed to detect and characterise HNoV in children with and without AGE. Between 2019 and 2021, 300 stool samples (200 AGE and 100 without AGE) were collected from children below 5 years of age referred to the healthcare facilities of the rural communities of Vhembe District, South Africa. After detection using real-time RT-PCR, HNoV positive samples were subjected to RT-PCR and Sanger sequencing. Partial nucleotide sequences (capsid/RdRp) were aligned using the Muscle tool, and phylogenetic analysis was performed using MEGA 11. The nucleotides' percent identity among HNoV strains was compared using ClustalW software. A significant difference in HNoV prevalence between AGE children (37%; 74/200) and non-AGE (14%; 14/100) was confirmed (p < 0.0001). Genogroup II (GII) HNoV was predominant in AGE children (80%; 59/74), whereas most non-AGE children were infected by the GI norovirus genogroup (64%; 9/14). GII.4 Sydney 2012 [P31] strains were dominant (59%; 19/32) during the study period. A phylogenetic analysis revealed a close relationship between the HNoV strains identified in this study and those circulating worldwide; however, ClustalW showed less than 50% nucleotide similarity between strains from this study and those from previously reported norovirus studies in the same region. Our findings indicate significant changes over time in the circulation of HNoV strains, as well as the association between high HNoV prevalence and AGE symptoms within the study area. The monitoring of HuNoV epidemiology, along with stringent preventive measures to mitigate the viral spread and the burden of AGE, are warranted.

Emergence of GII.4 Sydney[P16]-like Norovirus-Associated Gastroenteritis, China, 2020-2022.

Newly evolved GII.4 Sydney[P16] norovirus with multiple residue mutations, already circulating in parts of China, became predominant and caused an abrupt increase in diagnosed norovirus cases among children with gastroenteritis in Shanghai during 2021-2022. Findings highlight the need for continuous long-term monitoring for GII.4 Sydney[P16] and emergent GII.4 norovirus variants.

Long-term swallow outcomes and factors affecting swallowing dysfunction and quality of life among oral cancer patients: a prospective observational study.

BACKGROUND: Oral cancer is one of the most common cancers among the Indian population. India bears the most burden of oral cancer globally. Impairment of swallowing function is often seen after treatment for oral cancer. The oral phase of swallowing is disrupted in patients undergoing resection for oral cancer. The primary purpose of this study was to evaluate the long-term swallowing outcomes of oral cancer patients using a patient-reported outcome questionnaire. METHODOLOGY: All consecutive oral cancer patients in the cT2-T4 category undergoing curative-intent surgery and reconstruction at our institute from March 2020 to March 2022 were included in the study. The Sydney Swallow questionnaire (SSQ) and functional oral intake scale (FOIS) assessed swallowing outcomes six months after definitive treatment. WHO BREF quality-of-life questionnaire was used to assess health-related quality of life. RESULTS: A total of seventy patients with oral cancer were included. The median age was 49 years. The majority of them were males (90%). Tumors with cT4 constituted 62%; the rest, 48%, were cT2 and cT3 categories. The bulk of them were buccoalveolar tumors (64.3%. Almost two-thirds of the patients received multimodal treatment. Trismus and xerostomia were at 46% and 88%, respectively. The mean SSQ score was 257.4 ± 99.1. Swallowing outcomes are affected by T stage (p = 0.01), extent of resection (p = 0.01), multimodality treatment (p < 0.01), trismus (p = 0.05), and xerostomia (p = 0.01). Almost 69% of them required special food preparation for swallowing (FOIS 4&5). Patients with buccoalveolar disease (p = 0.05) had significantly poor quality of life. CONCLUSION: An advanced stage with extensive resection and receiving multimodal treatment has adverse swallowing outcomes. Post-treatment trismus and xerostomia also significantly affected swallowing results.

Urban shading and artificial light at night alter natural light regimes and affect marine intertidal assemblages.

Urban development in many coastal cities has resulted in altered natural light regimes, with many coastal habitats being artificially shaded during the daytime by built structures such as seawalls and piers, while artificial light emitted from buildings and associated infrastructure creates pollution at night. As a result, these habitats may experience changes to community structure and impacts on key ecological processes such as grazing. This study investigated how changes to light regimes affect the abundance of grazers on natural and artificial intertidal habitats in Sydney Harbour, Australia. We also examined whether differences in patterns of responses to shading or artificial light at night (ALAN) varied across different areas within the Harbour, characterised by different overall levels of urbanisation. As predicted, light intensity was greater during the daytime on rocky shores than seawalls at the more urbanised sites of the harbour. We found a negative relationship between the abundance of grazers and increasing light during the daytime on rocky shores (inner harbour) and seawalls (outer harbour). We found similar patterns at night on rocky shores, with a negative relationship between the abundance of grazers and light. However, on seawalls, grazer abundances increased with increasing night-time lux levels, but this was mainly driven by one site. Overall, we found the opposite patterns for algal cover. Our findings corroborate those of previous studies that found that urbanisation can significantly affect natural light cycles, with consequences to ecological communities.

Similarity in human health risk assessment using models of soil-blood lead levels (IEUBK) and non-carcinogenic condition (US EPA 2002).

Soil lead (Pb) concentrations in Sydney estuary (Australia) catchment are substantially elevated and strongly associated with traffic networks. This study compared the health risk predictions of blood Pb levels (BLL) in children using the soil IEUBK model and an independent, non-carcinogenic human health risk (NCR) assessment using the soil US EPA 2002 model. The predictions by the two models were significantly correlated (p < 0.001) and showed similar spatial distributions, but the NCR model may be more stringent in protection of human health when exposed to soil Pb in relation to adverse health effect, as the warning soil Pb concentration from the BLL was 4.6-fold higher than that from the NCR. The empirical IEUBK model considers gastric phase adsorption only and of the three exposure pathways (ingestion, inhalation and dermal) assessed by the theoretical NCR model, ingestion was the major exposure route. The reason for the similarity in outcomes of the two models is unknown, however the close correlation may be due to broadly similar formulations and, or that neurological and non-carcinogenic risks may be related to the adverse effects of Pb on bodily function. Parallel studies of human health risk based on BLL and NCR models have not been attempted previously and this opportunity to compare results from the two health risk assessments employing the same soil metal data is therefore unique.

An exercise in scientific problem-solving: Illustrating the utility of the principles of the Sydney Declaration.

In forensic science, scientific problem-solving is characterized by the recognition of traces as part of iterative reasoning processes to assign meaning to those traces in order to interpret and reconstruct events. Through a set of fundamental principles, the Sydney Declaration presents a foundation of forensic science through the lens of a scientist. The distinction between a scientist and a technician may require clarification-where a prototypical technician follows a prescribed set of 'standard operating procedures' and may be limited in the interpretation of the resultant data, the scientist utilizes knowledge, skills, experience and imagination to identify the issue at hand and develop lines of inquiry for testing and interpretation. This case report draws on the Sydney Declaration in order to highlight the importance of learning about events from careful consideration of both obvious and less obvious traces. A case involving the assault of a police officer is examined to illustrate the use of the Principles: the problem originally defined by investigators at the scene and later by prosecutors resulted in incorrect analysis and interpretation of traces, hampering efforts at an accurate reconstruction of events. This exercise serves to demonstrate that in order to engage in scientific problem-solving, it is necessary to apply observation and reasoning in forensic investigations in order to yield an outcome that can be clearly articulated. The overarching goal is to support the drive to improve forensic science practice, education, and research through a case illustrating the value of the principles of the Sydney Declaration.