Colin Robertson, Smile A While: Dentistry, History, Theater and Golf.

Many commentators argue that, until the 1980s, Brisbane and Queensland were cultural backwaters within the Australian context. However, with the hosting of the highly successful XII Commonwealth Games (1982) and World Expo 88 (1988) and with the development of the Queensland Cultural (1976-) and South Bank (1974-) Precincts, Brisbane and Queensland cast aside perennial apologism to acquire prominence, maturity, and self-respect. Within these national, state, and municipal settings, the theme, timing, and venue for the 24th Australian Dental Congress (1985) involved risk. Enter a Brisbane dental practitioner, Colin Robertson: a theater critic and a scriptwriter, who possessed competitive and entrepreneurial streaks, a vivid imagination, a steely resolve, and a love of golf. Robertson became an erudite, incisive, and prolific commentator, who penned much of the historical musical Smile A While (aka Smile Awhile) for the abovementioned congress. He contributed to an outstanding Dental Health Week (1980), served on the Australian Dental Association Queensland Branch Council (1981), its Fluoridation Committee (1973) and chaired both its Oral Health Education Committee (1981) and the Congressional Entertainment Division within the Congress Organizing Committee (1982-1985). Accordingly, the authors use historical methods to expose and explore a scarcely acknowledged narrative within dental history in Queensland.

Seahorse brood pouch morphology and control of male parturition in Hippocampus abdominalis.

INTRODUCTION: Syngnathids (seahorses, pipefishes and seadragons) are among the few vertebrates that display male pregnancy. During seahorse pregnancy, males incubate developing embryos embedded in a placenta within a fleshy brood pouch, before expelling fully developed neonates at parturition. The mechanisms underpinning seahorse parturition are poorly understood. METHODS: We examined the morphology of the brood pouch using microcomputed tomography and histological techniques, in combination with physiological assays, to examine how male pot-bellied seahorses (Hippocampus abdominalis) control labour. In female-pregnant vertebrates, nonapeptide hormones (such as vasopressin- and oxytocin-like hormones) produce contractions of gestational smooth muscle to produce labour. RESULTS: Histological analysis of the seahorse brood pouch reveals only scattered small smooth muscle bundles in the brood pouch, and in-vitro application of isotocin (a teleost nonapeptide hormone) to the brood pouch do not produce measurable muscle contractions. Micro-computed tomography shows differences in size and orientation of the anal fin assembly between male and female pot-bellied seahorses, and histological analysis reveals large skeletal muscle bundles attached to the anal fin bones at the male brood pouch opening. DISCUSSION: We conclude that seahorse parturition may be facilitated by contraction of these muscles, which, in combination with body movements, serves to gape open the pouch and expel the neonates. Future biomechanical studies are needed to test this hypothesis.

Christensen House: A Case Study for Inclusive Decision-making within Professional Associations.

Accounts of dental history in Queensland are few and almost invariably authored by those who either held or hold power. The focus is 'who, what, when' rather than 'why and how'. House-related developments as a case study provide an opportunity to assess aspects of the Australian Dental Association Queensland Branch's (ADAQ) model of administration in the early 1970s. The authors use literature review and historical methods. The ADAQ's articles of association, codes of conduct and memoranda centralized Brisbane-based authority and elite leadership into its management. The ADAQ council's decision to build Christensen House in Brisbane, prompted by the posthumous benevolence of George Christensen, was informed, logical, measured and appeared timely. The advocates for the house were innovative, optimistic, resolute, and well-intentioned, with their design and selected location of the building being appropriate. However, the decision occurred at a time of latent discontent within the membership, many of whom did not support the project financially. Distance in Queensland dictates that provincial members either accept or tolerate Brisbane-based centralized authority within ADAQ administration. Nonetheless, when it comes to policy warranting membership subscription, the Christensen House experience demonstrates that the modus operandi of the ADAQ council should be, as far as possible, inclusive, and representative.

Anadromous fish as biomarkers for the combined impact of marine and freshwater heavy metal pollution.

Rivers along the eastern seaboard of the United States and Canada are becoming increasingly contaminated with heavy metals. This includes the Tusket River (Nova Scotia, Canada) which empties into the Gulf of Maine, near the Bay of Fundy. Whether anadromous fish such as alewife (Alosa pseudoharengus), exposed both to marine and freshwater contaminants, are accumulating these heavy metals and experiencing any changes in their morphology was explored in this study. Adult (4-6 years of age) Tusket River alewife (n = 38) were harvested and had external examinations including morphometrics (fork length, weight). Biopsies were taken and structural abnormalities noted. Morphometric data was compared to historical alewife reference data from 1985. Biopsies of muscle, liver and kidney had heavy metal profiles assessed. Major findings of this study include detectable levels (µg/g wet weight) of a number of heavy metals and concerning maximum concentrations achieved of arsenic (liver: 14 µg/g), cadmium (kidney: 2.6 µg/g), mercury (liver: 0.26 µg/g), magnesium (muscle: 460 µg/g), selenium (kidney: 4.0 µg/g) and zinc (liver: 38.0 µg/g). As well, reduced body weight for length and in 87% of fish, presence of spine curvatures (3-24°) not visible externally were noted. This study is the first detailed report in alewife of key tissue heavy metals, some at levels of concern, reductions in weight for length and spine abnormalities. These findings validate concerns regarding potential impacts of deteriorating conditions of rivers and their surrounding waters such as the Gulf of Maine on anadromous fish species.

Essential and non-essential heavy metal levels in key organs of winter flounder (Pseudopleuronectes americanus) and their potential impact on body condition.

This study explored whether winter flounder, a benthic species, are potentially exposed to contaminants such as heavy metals released from the sediment of the Bay of Fundy/Gulf of Maine, both critical habitats identified to have increases in heavy metal levels. Experimentally in fish, exposure to certain heavy metals resulted in reduced weight for length and structural abnormalities, but it is unknown if this occurs in wild fish. Winter flounder (n = 72), harvested between 2015 and 2018 from the aforementioned western Atlantic region of Canada/USA, had detectable levels of most heavy metals, with some exhibiting levels of concern (arsenic, cadmium, lead, selenium, zinc) in muscle, liver, and kidney. A 1.4% incidence of structural abnormalities was noted. When compared to 1980 regionally matched flounder data, the 2018 flounder had significantly reduced weight for length, exacerbated with age. Clearly winter flounder are affected by worsening heavy metal contaminant levels in this geographic area.

Evolving epidemiology of carbapenemase-producing Enterobacterales: one hospital's infection prevention and control response over nine years.

BACKGROUND: Preventing carbapenemase-producing Enterobacterales (CPE) transmission is a significant challenge for hospital infection prevention and control teams (IPCTs). Control measures include screening at-risk patients, contact tracing, and the isolation of carriers with contact precautions. AIM: The evolution of infection prevention and control measures was assessed in a tertiary acute care hospital with predominately multi-bedded patient accommodation, from 2011 to 2019 as cases of CPE increased. The implications for, and the response and actions of, the IPCT were also reviewed. METHODS: CPE data collected prospectively from our laboratory, IPCT, and outbreak meeting records were reviewed to assess how the IPCT adapted to the changing epidemiology, from sporadic cases, to outbreaks and to localized endemic CPE. FINDINGS: Of 178 cases, 152 (85%) were healthcare-associated and there was a marked increase in cases from 2017. The number of screening samples tested annually increased from 1190 in 2011 to 16,837 in 2019, and six outbreaks were documented, with larger outbreaks identified in later years. OXA-48 carbapenemase was detected in 88% of isolates and attendance at outbreak meetings alone accounted for 463.5 h of IPCT members, and related staff time. CONCLUSION: Despite considerable efforts and time invested by the IPCT, the number of CPE cases is increasing year-on-year, with more outbreaks being reported in later years, albeit partly in response to increased screening requirements. Infrastructural deficits, the changing epidemiology of CPE, and national policy are major factors in the increasing number of cases.

[Multidisciplinary management of diabetic foot ulcer infection]. / Prise en charge multidisciplinaire de l'infection de l'ulcération plantaire diabétique.

Infection is one of the most common complications of diabetic foot ulceration resulting in lower extremity amputations and early mortality in this population. Several factors influence the course of diabetic foot ulceration infection and in that context, integrated multidisciplinary management is required as soon as possible. In fact, a holistic interdisciplinary approach should be the standard of care. Whether the infection is categorized as mild, moderate or severe, with or without bone infection, the overall individual's characteristics must be addressed, in addition to local wound care, offloading and antibiotic therapy. Some severe infections have potential indications for hospitalization and are considered as surgical emergencies. In some DFU cases, surgical revascularization of the limb is mandatory to treat the infection. However, surgical interventions and amputations, are sometimes inevitable, they are predictors of bad prognosis. Although some adjuvant therapies are effective to promote wound healing, their use is not recommended to treat diabetic foot ulcer infection. Infection management can be divided into three general interventions: proper clinical diagnosis, microbiological and imaging investigations, and treatment. This review is an update on the up-to-date evidences in scientific literature and includes the latest recommendations from the International Working Group on the Diabetic Foot (IWGDF).

A Causative Approach to Demographic and Socioeconomic Factors Affecting Parental Ratings of Child Oral Health.

INTRODUCTION: Many studies have investigated associations between demographic, socioeconomic status (SES), behavioral, and clinical factors and parental ratings of child oral health. Caries experience, pain, missing teeth, malocclusions, and conditions and treatments likely to negatively affect the child or family in the future have been consistently associated with poorer parental ratings. In contrast, effect sizes for associations between demographic and SES indicators (race/ethnicity, country of birth, family structure, household income, employment status, and parental education levels) and parental ratings vary greatly. OBJECTIVES: The primary objectives of this study were to estimate effect sizes for associations between demographic and SES variables and parental ratings of child oral health and then to consider possible causal implications. METHODS: This article uses a nationally representative data set from 24,664 Australian children aged 5 to 14 y, regression analyses guided by a directed acyclic graph causal model, and sensitivity analyses to investigate effects of demographic and SES factors on parental ratings of oral health. RESULTS: One in 8 children had oral health rated as fair or poor by a parent. Indigenous children, older boys, young children with a migrant parent, children from single-parent families, low-income households and families where no parent worked full-time, and children whose parents had lower education levels were much more likely to receive a fair or poor parental oral health rating in crude and adjusted models. CONCLUSION: This cross-sectional study helps to clarify inconsistent findings from previous research and shows many demographic and SES variables to be strong determinants of parental ratings of child oral health, consistent with the effects of these variables on other health outcomes. Sensitivity analyses and consideration of the potential for chance and bias to have affected these findings suggest that many of these associations may be causal. KNOWLEDGE TRANSFER STATEMENT: Based on regression analyses driven by a directed acyclic graph causal model, this research shows a strong impact of demographic and socioeconomic determinants on parental ratings of child oral health, consistent with associations between these variables and other oral and general health outcomes. Many of these associations may be causal. We demonstrate the value of causal models and causal thinking when analyzing complex multilevel observational data.

James Meyrick Croker: A Model for Professional Behavior.

The rationale that underpins volunteering has long fascinated behavioral scientists. James Meyrick Croker's personal life, professional career and community engagement conform to the classic twentieth century model for professional behavior. Accordingly, the authors use historical methods of investigation to evaluate the influences on and the legacies from a remarkable contribution to the professions and the community. The narrative demonstrates elements of altruism, collaboration, conviction, compassion, drive, entrepreneurialism, familial and grammar school influence, leadership, pragmatism and vision. Croker's professional and community service was multi-organizational. Concurrent demands on his time warranted discipline, energy and expertise. For the behavioral scientist, achievement, affiliation, nature and nurture appear relevant to the outcome. Available archives provide no evidence of ego-driven motivation. Leadership style was transformational not transactional. Major legacies to the national and state Australian Dental Associations are ADAQ Christensen House (1972-1980), the eventual financial stability for the Australian Dental Association Queensland Branch, formal dental assistant training, policies of the Australian and Queensland Councils of Professions, a notable Goddard Oration and the successful 24th Australian Dental Congress.

Air-transfer production method for large-area picosecond photodetectors.

We have designed and prototyped the process steps for the batch production of large-area micro-channel-plate photomultipliers (MCP-PMT) using the "air-transfer" assembly process developed with single LAPPDTM modules. Results are presented addressing the challenges of designing a robust package that can transmit large numbers of electrical signals for pad or strip readout from inside the vacuum tube and of hermetically sealing the large-perimeter window-body interface. We have also synthesized a photocathode in a large-area low-aspect-ratio volume and have shown that the micro-channel plates recover their functionality after cathode synthesis. These steps inform a design for a multi-module batch facility employing dual nested low-vacuum and ultra-high-vacuum systems in a small-footprint. The facility design provides full access to multiple MCP-PMT modules prior to hermetic pinch-off for leak-checking and real-time photocathode optimization.

Management of anal intraepithelial neoplasia and anal squamous cell carcinoma at a tertiary referral centre with a dedicated infectious diseases unit: an 18-year review.

INTRODUCTION: Anal squamous cell carcinoma (ASCC) is a rare malignancy with rising incidence rates. Risk factors include human immunodeficiency virus (HIV) infection, high-risk sexual activity and HPV-related genitourinary dysplasia/neoplasia. There is an overlap between high-risk patients and those attending HIV Medicine/Sexual Health (HMSH) services. We hypothesised that HMSH involvement may facilitate earlier referral to colorectal surgeons, with better outcomes. METHODS: Retrospective review of all ASCC and anal intraepithelial neoplasia (AIN) treated at a tertiary-referral hospital with a dedicated HMSH clinic between 2000 and 2018. Comparative analysis was performed of demographics, management and outcomes between HMSH and non-HMSH patients. RESULTS: One hundred and nine patients had anal pathology, eighty-five with ASCC (78%) and twenty-four with AIN (22%). Seventy (64%) were male. Median (range) age at ASCC diagnosis was 51 years (26-88). Thirty-six percent of all patients attended HMSH services, 28% were HIV positive, and 41% of males were men-who-have-sex-with-men (MSM). Eighty-one ASCC patients (97.5%) were treated with curative intent. Sixty-seven (80%) had primary chemoradiation therapy. Fifteen (17.5%) had primary surgical excision. Twelve (14%) developed recurrent disease. Ultimately, seven required salvage APR. Overall 3-year survival (3YS) was 76%. HMSH patients were significantly younger at ASCC diagnosis (p < 0.001), with a higher prevalence of HIV, HPV and MSM. HMSH attenders also tended to be diagnosed at earlier stages, were less likely to develop recurrence and achieved better overall outcomes, with a superior overall 3YS than non-HMSH patients (92% vs 72%, p = 0.037). CONCLUSION: ASCC incidence is increasing worldwide. The HMSH cohort has emerged as a distinct subpopulation of younger, high-risk, male patients. Collaboration between HMSH and colorectal surgeons offers an opportunity for risk reduction strategies and earlier intervention.