Can sponge morphologies act as environmental proxies to biophysical factors in the Great Barrier Reef, Australia?

Sponges play a vital role in the world’s most complex and vulnerable marine ecosystems. Various in situ studies have suggested that sponge morphologies (developed from exposure to a range of biophysical factors) can be considered as ecological indicators to current detrimental environmental changes such as climate change, overfishing, pollution and dredging for coastal development. Regional and long-term taxonomic data on sponges within each geographic range is not always available, especially from the Great Barrier Reef (GBR), due to dearth of sponge research. In this study, to understand large-scale variation and advance sponge research and knowledge, morphological characteristics were adopted as a rapid practical way to identify sponges from photo-transect images of a long-term dataset from the GBR. Biennial surveys were carried out in 2008–2014 from 28 pairs of take and no-take zones of the GBR. To evaluate the temporal changes in sponge morphology and correlation between abiotic factors, remote-sensed data such as chlorophyll a, current, wave height and sea surface temperature (SST) during the survey period were analyzed. Results showed sponges were ubiquitous in all six surveyed locations and their distribution was spatially heterogeneous. Encrusting forms were dominant followed by upright, massive, cups and tabular growth forms. Sponges were more prevalent in Innisfail, Pompey and Townsville compared to Cairns, Swain and Capricorn Bunker. Biennial observations showed greater sponge coverage in 2010 and 2014, especially in the central GBR, which may be related to the geomorphology and habitat of reefs along with its influence by wind and wave action. Also, the aftermath of Cyclone Hamish (2009) and Yasi (2011) would have triggered suspended particulate matter that are beneficial to sponge growth. Geostrophic current showed a weak relationship on encrusting, upright and massive forms, whereas, chl-a, wave height and SST appeared to have no effect on sponge morphology, suggesting sponges may be resilient to adverse conditions in the GBR. Whilst selected sponge morphologies can act as environmental proxies to monitor adverse conditions, further in situ research on other environmental parameters such as turbidity, sedimentation, cyclone, tides are required to bring substantial conclusions on sponge morphologies as ecological indicators

Personalizing dental screening and prevention protocols in dentulous patients with oropharyngeal cancer undergoing radiotherapy:A retrospective cohort study

Objectives:Patients with head and neck cancer are routinely screened for dental foci prior to radiotherapy (RT) to prevent post- RT tooth extractions associated with an increased risk of osteoradionecrosis. We evaluated the risk factors for post-RT tooth extraction to personalise dental screening and prevention protocols prior to RT. Materials and methods: This retrospective cohort study included dentulous patients diagnosed with oropharyngeal cancer who had undergone radiation therapy at doses 60–70 Gy and achieved a disease-free survival of ≥ 1 year (N = 174). Risk factors were assessed using Cox regression models. Results: The cumulative incidence of post-RT tooth extraction was 30.7 % at 5 years. Main indications for extraction (n = 62) were radiation caries (n = 20) and periodontal disease (n = 27). Risk factors associated (p &lt; 0.05) with radiation caries-related extractions included active smoking, alcohol abuse, poor oral hygiene, parotid gland irradiation, and mandibular irradiation. A high-dose volume in the mandible was associated with periodontal disease events. Conclusion: Post-RT extractions due to radiation caries were influenced by lifestyle factors and RT dose in the mandible and parotid glands. Periodontal disease-related extractions were primarily associated with the mandibular dose. During dental screening these post-RT risk factors should be taken into account to prevent osteoradionecrosis.</p

Origins and Implications of a Primary Crown-of-Thorns Starfish Outbreak in the Southern Great Barrier Reef

The crown-of-thorns starfish (COTS) is a major predator of hard corals. Repeated COTS outbreaks in the Cairns and Central sections of the Great Barrier Reef (GBR) have been responsible for greater declines in coral cover than any other type of disturbance, including cyclones, disease, and coral bleaching. Knowledge of the precise timing and location of primary outbreaks could reveal the initial drivers of outbreaks and so could indicate possible management measures. In the central GBR, COTS outbreaks appear to follow major flooding events, but despite many years of observations, no primary outbreak has ever been unequivocally identified in the central and northern GBR. Here we locate a primary outbreak of COTS on the southern GBR which is not correlated with flooding. Instead it appears to have been the result of a combination of life history traits of COTS and prevailing oceanographic conditions. The hydrodynamic setting implies that the outbreak could disperse larvae to other reefs in the region

Surgery alone for papillary thyroid microcarcinoma is less costly and more effective than long term active surveillance

Background: Papillary thyroid microcarcinoma is a subtype of thyroid cancer that may be managed with active surveillance rather than immediate surgery. Active surveillance decreases complication rates and may decrease health care costs. This study aims to analyze complication rates of thyroid surgery, papillary thyroid microcarcinoma recurrence, and survival rates. Additionally, the costs of surgery versus hypothetic active surveillance for papillary thyroid microcarcinoma are compared in an Australian cohort. Methods: Papillary thyroid microcarcinoma patients were included from a prospectively collected surgical cohort of patients treated for papillary thyroid cancer between 1985 and 2017. The primary outcomes were the complications of thyroid surgery, recurrence-free survival, overall survival, and cost of surgical treatment and active surveillance. Results: In a total of 349 patients with papillary microcarcinoma with a median age of 48 years (range, 18–90 years), the permanent operative complications rate was 3.7%. Postoperative radioactive iodine did not decrease recurrence-free survival (P = .3). The total cost of surgical treatment was $10,226 Australian dollars, whereas hypothetic active surveillance was at a yearly cost of$756 Australian dollars. Estimated cost of surgical papillary thyroid microcarcinoma treatment was equivalent to the cost of 16.2 years of active surveillance. Conclusion: Surgery may have a long-term economic advantage for younger Australian patients with papillary thyroid microcarcinoma who are likely to require more than 16.2 years of follow-up in an active surveillance scheme

XAIR: A Framework of Explainable AI in Augmented Reality

Explainable AI (XAI) has established itself as an important component of AI-driven interactive systems. With Augmented Reality (AR) becoming more integrated in daily lives, the role of XAI also becomes essential in AR because end-users will frequently interact with intelligent services. However, it is unclear how to design effective XAI experiences for AR. We propose XAIR, a design framework that addresses "when", "what", and "how" to provide explanations of AI output in AR. The framework was based on a multi-disciplinary literature review of XAI and HCI research, a large-scale survey probing 500+ end-users' preferences for AR-based explanations, and three workshops with 12 experts collecting their insights about XAI design in AR. XAIR's utility and effectiveness was verified via a study with 10 designers and another study with 12 end-users. XAIR can provide guidelines for designers, inspiring them to identify new design opportunities and achieve effective XAI designs in AR.Comment: Proceedings of the 2023 CHI Conference on Human Factors in Computing System

Evaluation of the current knowledge limitations in breast cancer research: a gap analysis

BACKGROUND A gap analysis was conducted to determine which areas of breast cancer research, if targeted by researchers and funding bodies, could produce the greatest impact on patients. METHODS Fifty-six Breast Cancer Campaign grant holders and prominent UK breast cancer researchers participated in a gap analysis of current breast cancer research. Before, during and following the meeting, groups in seven key research areas participated in cycles of presentation, literature review and discussion. Summary papers were prepared by each group and collated into this position paper highlighting the research gaps, with recommendations for action. RESULTS Gaps were identified in all seven themes. General barriers to progress were lack of financial and practical resources, and poor collaboration between disciplines. Critical gaps in each theme included: (1) genetics (knowledge of genetic changes, their effects and interactions); (2) initiation of breast cancer (how developmental signalling pathways cause ductal elongation and branching at the cellular level and influence stem cell dynamics, and how their disruption initiates tumour formation); (3) progression of breast cancer (deciphering the intracellular and extracellular regulators of early progression, tumour growth, angiogenesis and metastasis); (4) therapies and targets (understanding who develops advanced disease); (5) disease markers (incorporating intelligent trial design into all studies to ensure new treatments are tested in patient groups stratified using biomarkers); (6) prevention (strategies to prevent oestrogen-receptor negative tumours and the long-term effects of chemoprevention for oestrogen-receptor positive tumours); (7) psychosocial aspects of cancer (the use of appropriate psychosocial interventions, and the personal impact of all stages of the disease among patients from a range of ethnic and demographic backgrounds). CONCLUSION Through recommendations to address these gaps with future research, the long-term benefits to patients will include: better estimation of risk in families with breast cancer and strategies to reduce risk; better prediction of drug response and patient prognosis; improved tailoring of treatments to patient subgroups and development of new therapeutic approaches; earlier initiation of treatment; more effective use of resources for screening populations; and an enhanced experience for people with or at risk of breast cancer and their families. The challenge to funding bodies and researchers in all disciplines is to focus on these gaps and to drive advances in knowledge into improvements in patient care

Intermediaries, vulnerable people and the quality of evidence: An international comparison of three versions of the English intermediary model

Since 2004, witness intermediaries have been utilised across the justice system in England and Wales. Two witness intermediary schemes based on the English model have also been introduced in Northern Ireland (2013), and more recently, in New South Wales, Australia (2016). The purpose of the intermediary in these jurisdictions is to facilitate the questioning of vulnerable witnesses, but there are clear differences in the application of the role. This paper presents the first comparative review of the three related intermediary models, and highlights the pressing need for further research into the efficacy and development of the role in practice

Immunological Change in a Parasite-Impoverished Environment: Divergent Signals from Four Island Taxa

Dramatic declines of native Hawaiian avifauna due to the human-mediated emergence of avian malaria and pox prompted an examination of whether island taxa share a common altered immunological signature, potentially driven by reduced genetic diversity and reduced exposure to parasites. We tested this hypothesis by characterizing parasite prevalence, genetic diversity and three measures of immune response in two recently-introduced species (Neochmia temporalis and Zosterops lateralis) and two island endemics (Acrocephalus aequinoctialis and A. rimitarae) and then comparing the results to those observed in closely-related mainland counterparts. The prevalence of blood parasites was significantly lower in 3 of 4 island taxa, due in part to the absence of certain parasite lineages represented in mainland populations. Indices of genetic diversity were unchanged in the island population of N. temporalis; however, allelic richness was significantly lower in the island population of Z. lateralis while both allelic richness and heterozygosity were significantly reduced in the two island-endemic species examined. Although parasite prevalence and genetic diversity generally conformed to expectations for an island system, we did not find evidence for a pattern of uniformly altered immune responses in island taxa, even amongst endemic taxa with the longest residence times. The island population of Z. lateralis exhibited a significantly reduced inflammatory cell-mediated response while levels of natural antibodies remained unchanged for this and the other recently introduced island taxon. In contrast, the island endemic A. rimitarae exhibited a significantly increased inflammatory response as well as higher levels of natural antibodies and complement. These measures were unchanged or lower in A. aequinoctialis. We suggest that small differences in the pathogenic landscape and the stochastic history of mutation and genetic drift are likely to be important in shaping the unique immunological profiles of small isolated populations. Consequently, predicting the impact of introduced disease on the many other endemic faunas of the remote Pacific will remain a challenge

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Macroalgal feedbacks and substrate properties maintain a coral reef regime shift

Coral reefs are among the world's most diverse and productive ecosystems, yet they are also one of the most threatened. The combined effects of local human activities and climate change have led to corals being replaced by macroalgae in various tropical settings, lessening the ecological, social, and economic value of these reefs. Once established, macroalgal regimes are maintained by a range of physical, chemical, and biological feedback mechanisms that suppress the settlement, survival, growth, and hence recovery of coral populations. Our understanding of these feedbacks has come largely from small‐scale experimental studies, but their relative importance in sustaining a regime shift has rarely been examined in situ. We investigated the role of macroalgae in limiting coral recovery on an inshore reef on Australia's Great Barrier Reef that shifted to macroalgal dominance in 2001. Coral recruitment on terracotta tiles in habitats with low cover of macroalgae at the regime‐shifted reef and at comparable habitats at an adjacent coral‐dominated reef was similar, suggesting that neither larval supply nor reef‐wide “avoidance” by coral larvae was contributing to the lack of coral recovery at the regime‐shifted reef. However, within the regime‐shifted reef, recruitment of corals on tiles, and their survival in the first two months post‐settlement, was substantially lower in habitats characterized by dense beds of the brown macroalga Lobophora than in habitats just meters away that were relatively free of macroalgae. Despite the negative effects of Lobophora on recruitment and early recruit survival, there was no effect of Lobophora on the persistence of juvenile corals (1–50 mm diameter). Juvenile coral persistence in beds of Lobophora (50%) was comparable to that in neighboring habitats free of Lobophora (60%) over nine months. Rather, the persistence of juvenile corals was lowest (10%) in unconsolidated rubble habitat, where photographs of fixed quadrats showed that, over nine months, rubble substrate had been redistributed. Our results highlight two bottlenecks to coral recovery; inhibition of coral recruitment and recruit survival by macroalgae, and reduced juvenile coral persistence in patches of loose rubble substrate. Importantly, these processes appear to be habitat‐specific and are unlikely to constrain coral recovery at a reef‐wide scale